COMMENTARY

Time to Let Dentists Give Flu Shots

Arthur L. Caplan, PhD

Disclosures

February 02, 2017

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Editor’s Note: In this video, bioethicist Art Caplan discusses the controversial subject of dentists and vaccinations. How do you feel about the issue? (The transcript follows immediately after the poll questions.)

Hi. I am Art Caplan from the New York University School of Medicine, Division of Medical Ethics. What healthcare provider do most of us see more frequently than any other? Well, it turns out that it's the dentist.

The dentist is someone you go to for teeth cleaning. If you are unlucky, you must get gum disease treated, or maybe a broken tooth fixed, or a cavity filled. We come in contact with dentists very, very frequently, and so do your patients. However, dentists, as a study we recently did at the Division of Medical Ethics shows, are not getting their flu shots.[1] With flu season running from October all the way out to March, at least in the northern part of the United States, we thought we would ask dentists in New York State: Do you get a flu shot?

Only 40% of them said they did. Many of them do wear masks. But it turns out that unless you are a pretty efficient mask user, a mask is not the best way to control transmission of the flu. It is important to have dentists get flu shots. They encounter lots of folks in and out of their offices. They can bring the flu to your patient. The patient can bring it to your office or to other patients you see. Dentists come into close contact with their patients.

That said, one way to get dentists to think more about flu shots is to give them some authority to give vaccines. That sometimes raises hackles. It gets doctors thinking, " I don't know whether I want them impinging upon my turf." Nurses, as we have seen at stores like Walgreens and CVS, are already giving flu shots regularly. A good number of people are getting flu shots and, indeed, other vaccinations at their drug store.

Why not bring dentists into this picture as well? Get dentists to think about vaccinating their patients. After all, they see patients frequently. Patients come in when there is a problem. Why not to get a flu shot? If we gave dentists some training, it would be pretty easy to have a new wave of healthcare professionals providing primary care who are often difficult for patients to otherwise find if they live in a place where there is not a general practitioner or family physician, or if they just cannot make the time to set up an appointment. They seem to make it to the dentist when their tooth hurts. I am not sure that they get themselves and their kids to the doctor just as easily for those checkups.

I would argue that it is time to bring the dentist into the vaccination business. I think we will get more people vaccinated, help them get their recommended vaccines, and it will remind the dentists themselves and their hygienists: "It is time for you to get your vaccinations as well."

I am Art Caplan from the New York University Medical Center. Thank you for watching.

Talking Points: Should Dentists Be Required to Get Flu Shots? Should They Be Able to Give Them?

Issues to consider:

  • The Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, and the Healthcare Infection Control Practices Advisory Committee recommend that all US healthcare workers get vaccinated annually against influenza.

  • In some locations, healthcare workers are mandated to get a flu vaccine. Those who don't are required to wear a mask.

  • Dentists give anesthetic injections and many perform sedations

  • In some states, dentists can already give flu shots. For example, in Minnesota, dentists can give flu shots if they have completed a training course and agree to follow federal vaccination recommendations.

  • There is currently no groundswell movement from dentists to be able to give flu shots.

  • For patients, dental insurance plans typically don't cover flu shots, and medical insurance plans typically don't cover vaccines given by dentists.

  • Many dispute the assumption that people see their dentists more often than they see their physician.

  • Some have expressed concern over how the flu shots or vaccinations will be noted and accounted for on the patient's medical record with the physician.

  • A number of physicians have questioned whether dental offices are experienced in dealing with anaphylactic shock and can immediately address an emergency situation.

See what your colleagues think by taking our poll on the previous page.

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