Dr. Charles Carriere Expands Access to Patient Care as Hospital-Setting Dentist at OHSU

 Dr. Charles “Chip” Carriere’s first memory of being in a dental chair left a lasting impression, but one that would have a significant impact on his career trajectory that eventually led him to work as one of four hospital-based dentists at Oregon Health & Science University (OHSU).

 “I had really bad teeth as a child,” said Dr. Carriere. “My first memory of the dentist was when I was three years old. My dad was in the army, and I remember getting swooped up from my mom’s arms and being taken to an operatory room in the army hospital and had four stainless steel crowns put on my front teeth.”

 Once his dad’s time in the army ended, Dr. Carriere says he had an “awesome” pediatric dentist who significantly influenced his interest in the profession.

 “I had to get fillings all the time and teeth pulled, and I just remember her being wonderful,” said Dr. Carriere. “I initially had an interest in being a dentist after meeting her.”

 He considered following that path to dentistry but realized in undergrad that his upper-level science courses weren’t his favorite, so he switched his major to engineering, before acknowledging that a career in engineering would keep him in an office every day and not necessarily interacting with people as he desired. Dr. Carriere eventually decided on a career in nursing, given he had already taken many of the necessary undergraduate courses, and nursing would allow him to continue on a patient care path. He worked as an emergency room (ER) nurse for almost ten years.

 “During that time, I realized that I think dentistry is what I want to do,” said Dr. Carriere, who was accepted to OHSU School of Dentistry and began looking at where his second profession might take him. “In my third year of dental school I learned of hospital dentistry. I didn’t know that existed before dental school.”

 After graduating, Dr. Carriere did a General Practice Residency (GPR) at OHSU and realized that the parts he enjoyed about working as an ER nurse could translate to his work as a dentist.

 “I really enjoy having a lot of variation in the day,” said Dr. Carriere, who today serves as the Clinical Site Director of General Practice Residency/Hospital Dental Services at OHSU. “Being from the ER where you never knew what you were going to see hour to hour—it’s a different way of thinking than working in a private dental practice.”

 As a hospital setting dentist—one of just a few permanent hospital dentists in Oregon—Dr. Carriere spends his days treating special needs adults who need to receive dental procedures in a hospital setting, medically complex patients who need dental evaluation before starting chemotherapy, organ transplants, or starting medications, and consults for OHSU’s emergency department, treating patients or severe infections.

 “For example, on Monday, I had exams for surgical clearance as well as typical dental treatments like fillings on people with special needs, a consult for a patient who was having a heart transplant, and a trauma in the ER,” said Dr. Carriere, who says OHSU recently brought on a hygienist who does cleanings for their special needs adult patients who can tolerate some dental treatment in the clinic.

 Dr. Carriere says he doesn’t know of any other hospitals that have dentists in the hospital every day who doctors can consult when they have a patient who has oral health needs. He says some hospitals have oral surgeons on call who can do some of that work, but most don’t have services for standard cleanings and fillings for special needs patients available.

 While hospital dentistry is rare, Dr. Carriere was certain it was the right fit for him, particularly since he’d already worked in a hospital setting for ten years as a nurse and liked the environment.

 “Part of why I left nursing was that I graduated nursing school in 2007 and was in the ED in 2008 when everything fell apart,” said Dr. Carriere. “I didn’t see a lot of good continuity of care, especially in the ED with people losing insurance and basically putting band aid fixes on patients.”

 “I wanted to do something where I could see people long-term and hopefully see them become and stay healthy. Then I learned about hospital dentistry and seeing how many people couldn’t receive care anywhere else, it seemed like being comfortable in the hospital and having that interest was the perfect place I could work to provide that kind of care in an environment where I already felt comfortable.”

 Dr. Carriere admits that it takes a certain type of personality to work as a hospital setting dentist, not only because of the hours—he is on call for 24 hour shifts once or twice during the week and rotates with his colleagues on the weekend and stays until the work is done for the day—but because of the pace and variation in the day.

 “It takes a lot of effort to be a dentist in a hospital,” said Dr. Carriere. “I think everyone who does it is there because they have a passion for it and know there’s a need.”

 Dr. Carriere, who also serves as an Assistant Professor of General Practice Residency at OHSU’s School of Dentistry, says he’s working with OHSU to get dental students to participate in a rotation through the hospital as part of their training.

 “I’d like them to get exposure and see what we do because a lot of the time, some of our special needs patients need a little extra TLC and you realize that you can help someone if you can just allow the time for it,” said Dr. Carriere. “You’re not really doing dentistry very differently; it’s just more people management. I’d like to help them get that exposure and maybe spend some time in an operating room and see that it’s kind of fun and maybe they can take part of their practice in the future to a similar setting to increase access for these types of patients.”

 Dr. Carriere brought his passion for expanding access to care for patients in need to his work with the ODA, where he has served on the Leadership Development Committee for four years.

 “I’ve seen how involved the ODA is and how much they want to promote the profession,” said Dr. Carriere. “It’s been a great experience.”

 Dr. Carriere also joined the ODA and Oregon dentists and dental students in Washington, D.C. this year for the ADA’s annual lobby day.

 “I never knew I could become involved with that,” said Dr. Carriere. “I was amazed that they gave us time with our representatives and their staff to promote important causes for everyone, including student loans, insurance reform, public health—not just dentists!”

 Dr. Carriere wants to continue to work with the ODA to elevate voices of dentists in a diversity of practice settings in order to improve the perception of the profession, as well as to expand access to care.

 “It’s important that people can realize there are different types of dentists out there including public health dentists who work with vulnerable populations—dentists like my colleague Dr. Zeller who has her master’s in public health and is helping people get teeth extracted without having to sedate them fully and providing a service they might not otherwise be able to get without having to go to an oral surgeon.”

 It’s important to Dr. Carriere that Oregonians know that dentists have one collective goal, whether they’re operating in a private practice, in public health, in a hospital setting or another environment: “We’re just trying to make a difference and help everyone become the healthiest version of themselves.”