Dr. Andriy Biliak and his assistants perform dental treatment during a blackout.

Challenges of war don’t slow down Ukrainian dental pros

Jan. 4, 2023
The threats facing Ukrainian dentists do not seem to be easing. Their creativity and dedication make dental care possible for people in the war-torn country.

Electricity blackouts, extremely cold weather, and water shortages: Ukrainian dental professionals face daunting challenges during the ongoing war. Working in the dark has become a daily occurrence, yet Ukrainian dentists have learned to get things done with dental units, practice schedules, and patients' manners.

As the Russian aggression rages on and troops deliberately target power grids, winter chills and long nights deliver ongoing problems for Ukrainian dentists. Electricity has become irregular and unreliable because the power can be shut off at any given moment.

Drs. Valery Horbenko and Sergii Gashynsky, members of the volunteer organization Tryzub Dental, which serves the military near the frontlines, describe what’s happening. “We’ve had to purchase gasoline generators. As an example, a nearby pharmacy uses a 2.0 kV generator, which is enough for their refrigerator and lights. The typical dental unit requires a 5.5 kV inverter generator. The military mobile dental clinics use 6.5 kV generators, and these satisfy all equipment needs: compressor, evacuation, distillation, light, and even a heater for a teapot.”

Although generators can save the day, they’re not a panacea. These huge power banks are in demand, so they're currently extremely expensive in Ukraine. Second, not every dental practice can use generators due to safety rules. A building where a generator is in use cannot be of historical or cultural value, and an office must have access to the outside and people can be no more than 19 feet from an entrance or window.

This doesn’t even consider the sad reality of a war-torn country with an impoverished population. People might consider stealing an unguarded generator. So, another necessity is a very strong person on staff who's able to bring the generator in and out every day.

Health risks also must be taken into consideration. Not all generators are equipped with carbon monoxide sensors. Dr. Roman Samborsky warned, “It's easy to get poisoned. Five minutes is enough to become sick.” Dr. Samborsky himself became ill from the gasoline generator in his dental office.

Beyond the generator

If a generator is too expensive, heavy, or dangerous for a practice, another option to provide light is to modify the practice schedule. Dr. Valentina Kovtok explained, “We work for four hours, take a break for two hours, then work again for four hours because this is our city’s power scheme. We’re glad we can do dentistry this way at least. The problem we also must tackle is voltage fluctuation: sometimes we have 160 kW instead of the 220 kW required, so voltage transformers have become dentistry’s essential office tech gadgets.”

Modification of the dental unit can also be helpful in the dark. Additional emergency devices are savvy products created from collaboration between dentists and dental unit technicians. Dr. Horbenko from Cherkasy said, “My dental system tech is very knowledgeable, a genuine engineer. He has helped me build an additional receiver. This can be made from an old receiver or a residential/automobile gas tank, then refilled by compressed air. My dental unit is pneumotic, so with two receivers, turbine, air micromotor, and waste evacuation hooked up to the centralized water and sewerage, I’m all set. I just need a headlight with a polartec fleece sweater on it because it's not only dark, but also terribly cold.”

Also by Anna Filonenko

From the front lines: Ukrainian dentists’ stories of heartbreak and survival

Warm clothes have become a necessary part of clinical attire as the cold rages on. Dental offices operate in temperatures as low as 13° C (55° F). ”Layering clothing, a heater, and enthusiasm—these are our weapons against General Winter,'' laughed Dr. Natalia Borkovska.

Dr. Serhii Bas from Odesa said, “Due to constant air attacks and power shut offs, our furnace is doomed. We preserve our generator to charge the dental unit. I bought warm sweaters for my staff and blankets for the patients. Our decorative fireplace that we built for its esthetics now warms us and cheers us up.”

Water not as affected

Unlike the darkness and cold, the water supply disruption is not quite as serious in Ukraine. But vigilant Ukrainian dental professionals tend to store up to 1,500 liters of water just in case, which they keep on hand for treatment and technical use.

“Our patients look at those medieval hygiene tools with understanding,” sighs Dr. Maryna Zapolska, emphasizing the common ground of Ukrainians to survive, rely on ingenuity, and look at the bright side. “People appreciate that we work with perseverance. There are no more capricious ‘Let’s do it next time’ or ‘I can’t come that early.’ Patients now make a point to finish their dental treatment because next time may not come.”

This article originally appeared DE Weekend, the newsletter that willelevate your Sunday mornings with practical and innovative practice management and clinical content from experts across the field.  Subscribe here.

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