Singing the praises of the unsung heroes

When the Covid-19 pandemic came to our shores, dentists and dental team members went the extra mile to help with the national effort in the fight against the virus.

The JIDA spoke to just some of the dental team members on how their jobs changed overnight and how they adapted.

Dr Amalia Pahomi

HSE Public Dental Surgeon, Hartstown Health Centre, Dublin 15

Amalia was among the first volunteers from the HSE for redeployment to Covid-19 testing: “I started my redeployment in Swords testing centre on Saturday, March 21. That was the very first day the Swords drive-through testing centre opened. Then on Sunday April 19, we joined the National Ambulance Service, medics from the Defence Forces and other HSE staff to swab residents and staff in nursing homes and other care facilities. From June on, I also started swabbing in the walk-in testing centre in the Croke Park handball alley”.
Although the work was a challenge, Amalia says she felt privileged to be able to help: “Obviously, the swabbing work was very different to my regular dental job. It was quite a challenging task at that time from many perspectives. Each testing centre had its own particularities and requirements. In the drive-through and walk-in centres, we worked 12-hour shifts, including weekends. It was very demanding, both physically and mentally, and we constantly had to be extremely careful with our cross-infection measures and the proper use of PPE, as we were in contact with potentially Covid-positive people”.
Swabbing in nursing homes was again very different to dentistry: “It was also the most rewarding knowing that we were part of a national effort in fighting Covid-19 spreading in nursing homes and ultimately saving lives. All these challenges aside, I felt extremely lucky and privileged that I was in a position to help during the pandemic in such a meaningful way, alongside my dental colleagues and other HSE staff. I have never experienced such a high level of camaraderie, goodwill and support as I did during the redeployment. I felt inspired and humbled by my colleagues’ effort and dedication, and the way they overcame their personal circumstances, either childcare or family difficulties, to be present and give 100% to their work”.

Dr Sinéad O’Hanrahan

Private and HSE Orthodontist, Navan and Louth 

Sinéad was seconded from her HSE role to perform swab testing in the testing centre in Co. Louth, before moving on to do testing in nursing homes. She is now back in her orthodontic clinic and, looking back, she says she really enjoyed the testing work: “You felt you were doing something, but at the time it was extremely tiring. It’s also a bit stressful because you’re wondering are you bringing it home? My parents are old. I couldn’t see my partner… Otherwise, I was glad. The ambulance guys were also great craic”.
There were many people in the HSE redeployed into testing from different specialties, and Sinéad thinks the dental team members had particular transferable skills that made them suited to it: “I think we’re good at it because we’re all trained in cross-infection, especially the nurses, and we’ve a good sense of doing our own disinfecting. We understand viruses, within reason. I think we’re well placed also because we’re good at organising clinics. We organise patients, we organise volume of patients. We work fast in orthodontic services. We don’t have long appointments and I think that’s a skillset that these two [hygienist Tara Mundow and dental nurse Joanne O’Kane] definitely brought to the testing unit”.
The HSE can sometimes get a lot of flak, but Sinéad says: “Everyone loves to put down the HSE, but I was really proud of the HSE for its response to Covid-19 – and the people who came on board. It was amazing to put together such a team effort; normally, we can’t agree on anything, and suddenly this massive effort arrived from the HSE. I have to say, overall, I was really proud of the HSE and its clinical staff. It was well organised, it was fast, they pulled all the stops out and to be fair, I think they did a really good job”.

Dr Sarah Roux

Senior Dental Surgeon – Special Needs, Dublin North City

Sarah started her redeployment in the Swords testing centre the weekend after St Patrick’s Day: “They were doing a drive-through testing centre at that point over there. I was there for about three weeks and then I was with a team that was going out with the National Ambulance Service out of Cherry Orchard Hospital and we were going from there to test in nursing homes, direct provision centres, homeless shelters and places like that. After that I was in the handball alley at Croke Park for a while and then I was in Swords again. Then I came back to work in August, properly back in clinic”.
Although she was understandably a bit apprehensive at first, once she settled into the role of testing and had gotten used to wearing more PPE than she would in the dental surgery, she found the work quite enjoyable.
The scale of the redeployment was something that has probably never been seen before in the HSE: “I’d say around 70 or 80% of the staff were redeployed. Most were redeployed into testing and then there were a handful of people who were contact tracing. Then everyone else was doing the admin of the clinics and the emergencies”.
Although the effort to fight Covid-19 should be commended, the fact that so many staff members were redeployed has meant that there are now delays to the already stretched HSE dental services: “It takes longer for one treatment appointment than it would have before. The other thing that’s quite worrying about the dental services at the minute is that we don’t seem to have our GA service back for children to have extractions done. That would have been done through the private sector and there doesn’t seem to be any provision for that at the moment still, so that’s really worrying”.

Monique Le Feuvre

Treatment Co-ordinator, Kinsale Dental

Private practice was of course also affected by the pandemic, and Monique explains how the team in Kinsale Dental did all they could to continue to care for their community.
The practice owners are Drs Janet and PJ Power. Janet joined an Ireland-wide WhatsApp group of 700 dentists and Monique says: “The support for each other to preserve the industry fairly for every practice/dentist was astounding. There was no competition and all information was openly discussed and all opinions considered”.
When the practice had to close its doors, they set about doing what they could, says Monique: “We volunteered our time and operated as not for profit (ran at a loss like most practices) to man the phones and get to work on a solution. We could not put a value on our patients’ care. All phone calls were triaged for the level of emergency assistance required and Dr PJ and Dr Janet Power were fully committed to phone consultations. We received video calls and photos to assist the dentists”.
Monique explains that the practice already operated stringent decontamination standards before lockdown: “We aimed to increase them again and did extensive research into ionised air cleaning, dry fogging and more. We followed closely what different countries were putting into place for donning and doffing PPE, PPE required, social distancing, preventing cross-contamination in communal areas, and more. We then used this to develop our own standard operating procedures and training for staff when they returned to work”.
All in all, the pandemic has invoked positive change at the practice, says Monique: “We have become very forward thinking about dental emergency management so our patients can have immediate care and practice footfall is managed in line with Covid-19 procedures. Patient care is our priority”.

Dr Gráinne Gillespie and Dr Eabha Cronin

former dental students, Dublin Dental University Hospital

It wasn’t just dental work that was affected by Covid-19, it also proved quite a challenge for those undergoing dental education. Grainne and Eabha were final-year dental students when the pandemic struck. On March 12, clinics were cancelled and the Dublin Dental University Hospital (DDUH) closed for students. Luckily, their class was close to finishing the academic year. For the following month, they were unsure what was happening or what to expect. Some lectures were moved online. They studied from home, unsure about where, when or what format final exams would be or if they would even happen. This was a manic and stressful time for both students and examiners.
The final examinations were changed to online, open-book written exams, with the Vivas and OSCE proctored over Zoom. The day they finished their examinations, there was a Zoom call with the rest of their classmates to celebrate. On June 19, they officially graduated online. The DDUH staff held the annual end of year awards over Zoom to finish a memorable day.
On June 29, they both began their dental careers as junior house officers in the DDUH after online interviews. Due to the pandemic, their degrees couldn’t be posted to the Dental Council, so their registration couldn’t be approved for another two weeks. Therefore, they couldn’t treat patients until this requirement was fulfilled.
Once they obtained their registration, it was off to work with a service limited to accident and emergency, avoiding aerosol-generating procedures where at all possible. In August, the college reopened, dental school students returned and most elective clinics resumed.
Now six months into their new careers, they are learning to adapt to the ‘new normal’ every day and finding enjoyment in caring for their dental patients.

Tara Mundow

Dental Hygienist, HSE Orthodontic Unit, Louth Hospital, Dundalk 

When Tara and her colleague Joanne O’Kane were first seconded to the Covid-19 testing centre, their skills in clinic management and infection prevention and control were quickly recognised and now they are running the centre in Co. Louth.
Tara explains what this involves: “It’s making sure that it’s running efficiently, making sure that the samples are sent to the labs and that the correct number of samples to the number of patients we’ve seen have been sent”.
Tara enjoys working with people in the HSE that she normally wouldn’t: “I’ve liked meeting people from other specialties within the HSE. The swabbing itself is the easiest part of all of this. The admin side is the tough part. I don’t mind swabbing. In March, we were all terrified that we would catch Covid-19. To date none of us have, which is a huge testament to our dedication to infection control and following a very stringent swabbing process. This whole process was led by Hilda McConnon, Assistant Director of Public Health Nursing”.
Tara says now she’s enjoying the work: “It’s something new that I’ve been kind of thrown into. I’ve been working as a hygienist since 1999 and I never thought I wouldn’t be working as a hygienist, so it’s been a crazy few months”.
It has changed her outlook on work: “I would have gone to work, done my day’s work and come home and switched off. But this Covid-19 testing and the running of the centre: you come home and you’re constantly thinking about it. For weeks, myself and Joanne were trying to figure out how we could work it more efficiently because there seemed to be a lot of paperwork being repeated. All in all, it’s been a good experience. I’ve liked that I’ve been able to be a frontline worker and really help when it was needed”.

Dr Annie Hughes

Restorative Senior House Officer, Dublin Dental University Hospital 

When the pandemic spread across the country, things in the Dublin Dental University Hospital (DDUH) changed rapidly, becoming emergency treatment only. Annie explains how the Hospital adapted quickly to all of this: “The Hospital closed many services in line with national guidance, but was able to maintain the A&E service to provide acute dental care to those in need. The hospital quickly adapted in line with current recommendations to ensure the service was as safe as possible for both patients and staff. To reduce the risk of transmission of Covid-19 in the Hospital, we had to change our triaging system to a phone-based one”.
Dentists are used to PPE, but Covid=19 required another level of it: “We all had to rapidly acclimatise to a whole new range of masks and PPE, which we had never seen or worked with before”.
Annie enjoyed working throughout the pandemic, even though it was a challenging time and the DDUH was inundated with extra calls because many dental practices were closed: “Despite this, staff morale remained high and we all felt fortunate to be able to provide our skills and services to the public when most needed. Naturally, it was unnerving at times, given that the nature of our work is extremely high risk and there was very little understanding of this entirely novel virus. During this time, I was contact traced by the HSE informing me that a patient I treated had tested positive for Covid-19; fortunately, my subsequent test was negative, reassuring me that our PPE and precautions were effective”.
Annie pays tribute to how dentistry dealt with the pandemic: “I think it’s very impressive how resilient the profession has been through these times. As a team, we quickly learned to adapt and come together in the best interest of the public, which has been a very rewarding process. I would like to commend the Hospital on their prompt adaptations and implementations, which provided an exceptional workplace throughout these difficult times and has more recently allowed for the safe return of teaching in the hospital”.

Joanne O’Kane

Dental Nurse, HSE Orthodontic Unit, Louth Hospital, Dundalk 

Joanne started out swabbing in Louth test centre but was soon made lead of the centre with one of her colleagues: “I was asked to lead with one of my other colleagues who works in the orthodontic unit, Tara Mundow. We were there from the very start. I was redeployed full-time, as was she. A lot of the other people were there part-time”.
She explains how she’s grown more used to the role over time: “I was a little nervous naturally, but I was at an advantage in being very used to the mouth. And I also had good training from the National Ambulance Service (NAS) and in infection prevention and control. We have an amazing clinical lead to guide and support all staff. I really enjoyed it and I still do enjoy it. We’re dealing with different situations every day and you have the stress of trying to do tests and work with the labs, but I really do like it. It’s completely different”.
Joanne praises the atmosphere of the centre, where everyone is working together for a common cause: “No matter what grade or discipline, we have learned to work together and support each other, and learn from each other. This has created lifelong friendships, which is a lovely positive to come out of this pandemic. I’d like to take the opportunity to thank these colleagues, and they know who they are, and recognition should be given to the NAS, the Defence Forces, and the food providers and all the caretakers, the clerical staff, security, cleaning staff, who were all thrown into this and who were all very nervous at the beginning, but who all put themselves forward and have provided an excellent service for the public. I think that should be recognised. And all the different disciplines – fabulous people – everyone’s just been wonderful to work alongside”.

Dr Catherine Gallagher and Siobhán Lynch

Cork University Dental School and Hospital 

Catherine is Chair of Clinical Governance in the Hospital and her other role is teaching. When the pandemic came along, the Hospital had to figure how it would move forward: “The two main things that I was involved in were getting the emergency service up and running and trying to do that safely, and then since all the students had been sent home, it was moving to teaching online and getting examinations organised online”.
With the available staff in the Hospital, an emergency service was set up, says Catherine: “We kept an emergency clinic open all the way through from the beginning of the lockdown. How to organise that was the biggest challenge. What was actually safe to do? There was very little information. What PPE should we use? Where would we get PPE? What procedures were dangerous? We always operated a walk-in emergency service in Cork and we couldn’t do that any longer, and it was setting up a whole system of how we triage patients, how we remote manage patients where we can, and then how we appoint them and how they come into the hospital and what we can do for them”.
All the routine appointments were cancelled and had to be reorganised for when the Hospital could get back up and running. Most of the treatments that were done were ones that didn’t involve creating an aerosol.
Siobhán is Dental Hospital Manager and says that when it was clear that the lockdown was going to go on longer than expected, they moved all they could to remote working. Staff were still coming in on a rostered basis and she says they all felt very safe because of the measures that had been put in place.
Catherine explains that in the University, all teaching that can be online is online. The first- to third-year dental students are all online, while the fourth and fifth years are in, because largely what they do is clinical.