February 14, 2019

Medical + dental = lifesaving care

Kaiser Permanente Northwest’s practice of integrated medical and dental care helped identify a life-threatening condition for one of our youngest members.

For Eloise Hirata, a routine visit to the dentist led to the detection of the 7-year-old girl's unusually high blood pressure — ultimately saving her life.

As part of Kaiser Permanente Northwest’s total health approach, dental assistants routinely check patients' blood pressure. That's what happened when Eloise Hirata, a seemingly healthy child, came to have a cavity filled at the Cedar Hills Dental and Medical Office in Beaverton, Oregon, in 2017.

Her blood pressure was extremely high. A registered nurse and a physician assistant double-checked and confirmed Eloise's elevated blood pressure. They encouraged her mom, Melisa Hirata, to follow up with the girl's pediatrician.

Doctors determined the problem: Eloise was born with her ureters positioned so that urine backed up from her bladder into her kidneys, diminishing their function and causing hypertension.

“If she hadn’t had her blood pressure checked at the dental office, we wouldn’t have known this was going on until her next well-child check,” Hirata said. That wouldn't have been for another 10 months.

Eloise had laparoscopic surgery in February 2018 to attach her ureters to her bladder wall in a way that helps prevent further kidney deterioration. Eloise’s right kidney is severely damaged, but the situation could have been far worse if it had gone undetected.

A holistic, lifesaving approach

“Since many people visit their dentist more often than their physician, it’s helpful when the dental team takes a holistic approach to care,” said Eloise’s pediatrician, Donna Linvog, MD, who practices at Sunset Medical Office in Hillsboro, Oregon.

“The dental clinics have truly become our partners in providing health care for our patients,” Linvog said.

“Being integrated with a patient’s medical care allows us to collaborate with the rest of the health care team to readily address concerns,” added Eloise's pediatric dentist, Piper Huber, DDS. “For Eloise, we identified an abnormal finding and guided her to the care she needed. This coordinated care is what we strive for to improve not only convenience, but also health outcomes.”

The hope is that, with medication, Eloise will be able to live a healthy life and keep both kidneys. Her care team is still working to stabilize her blood pressure.

Seamless communication

When she visits the dentist, the team checks Eloise's blood pressure and communicates with her doctor, who adjusts medication as needed.

“The communication back and forth has been seamless,” Hirata said. “That’s made it less chaotic for me, not having to run to different appointments. The dentist is in communication with the pediatrician and knows exactly what happened before and what needs to happen next. I’ve never experienced that."

Hirata is a single mom who works full time, so being able to address dental needs, blood pressure screenings, and urinalysis with one stop is convenient and helpful.

“Someone was looking out for my daughter every step of the way,” Hirata said. “As scary as the whole process has been, I feel very supported and connected with the care providers my children have had.”

Learn more about integrated medical and dental care at Kaiser Permanente Northwest.