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Office Visit: Treating "Terminal" Patients by Benjamin Lund, Editor, Dentaltown Magazine

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Treating “Terminal” Patients
by Benjamin Lund, Editor, Dentaltown Magazine

Layovers are efficient at Vancouver International Airport. Not only can travelers grab a bite to eat, but they can get their six-month cleaning! Airport employees enjoy similar lunch-break benefits. Dr. Amy Nunrha, who owns the airport practice, tells Dentaltown Magazine about the idea behind the unique practice model and what it’s like treating a different kind of “terminal” patient.

To begin, why did you choose dentistry as your career?
Nunrha: Growing up, I always had good experiences with my dentist. I was interested in science and I enjoyed working with my hands. I always felt that the impact of dentistry went beyond treating teeth and I enjoyed that aspect. In high school, I had a friend who wore braces and as her teeth straightened, her self-confidence grew. I also have my law degree, which I earned after my dental degree, but I don’t practice law. At one time, I considered practicing law for medical and dental professionals, but that got postponed once I bought the dental practice at the airport. However, having a legal background has made me more knowledgeable about issues relating to employment, contracts, negligence, malpractice, informed consent, duty of care and standard of care.

How did you end up practicing at a dental facility in an airport? How did the practice start and how did you get involved?
Nunrha: The Vancouver International Airport (YVR), the second busiest airport in Canada, is located on Sea Island in Richmond. Richmond is a suburb just outside of Vancouver, a major metropolis. Sea Island is comprised of a working community of at least 25,000 people. YVR is the main building and attraction on Sea Island. Most of the other businesses on Sea Island are related to aviation or travel, such as car rentals and aircraft maintenance.

The Vancouver Airport Dental Centre is located inside YVR in the domestic terminal on level one. There is a pharmacy on one side and a medical office on the other. As the beginning of the millennium approached, YVR recognized a need to offer health-care services to the employees, contractors and public on Sea Island. The dental office opened in 2001 with Dr. Arthur Ross as the owner and has been busy since day one.

In 2009, I heard that the practice was for sale and I was intrigued by its location. I began working there as an associate dentist first because I wanted to ensure that the office was a good fit for me. I immediately loved the atmosphere and sense of community. A few months later, the paperwork was complete, I became the new owner, and Dr. Ross stayed on as my associate.

What is your practice philosophy? And how do you cultivate it?
Nunrha: My practice philosophy is to keep clients informed about the state of their oral health in order to engage and motivate them. I believe in educating patients about their dental health and treatment at every stage. I want patients to be aware of everything from their periodontal status, to their restorative and functional needs, to their aesthetic options. I spend a lot of time talking to clients and making sure that they understand the condition of their mouths, necessary treatment and elective treatment. I try to divide a treatment plan into stages of what must be done, what should be done, what could be done and then maintenance. I always present treatment options and I always encourage patients to ask questions.

What type of patients do you see – locals or travelers?
Nunrha: Of the patients I see, 95 percent of them work on Sea Island, mostly at the airport. Patients include office employees, passenger screeners, baggage handlers, mechanics, pilots and flight attendants, etc. Patients who see me who do not work on Sea Island are usually spouses, friends or children of employees. I also see travelers, mostly on an emergency basis. However I do occasionally treat someone who wants to get some Botox or teeth whitening while they are between flights.

What is the dental competition like in your area? And, aside from being located at the airport, what sets your practice apart from other practices in the area?
Nunrha: YVR is located just minutes outside of Vancouver. Just like every urban center, patients have many dentists to choose from.

My office is very modern and progressive. It is computerized, chartless and 95 percent paperless. Being located at the airport is advantageous because this is the only dental office on Sea Island and it is very convenient and accessible for the working community. People make dental appointments before, during or after their shifts. They don’t have to take time off work to see a dentist or waste personal travel time. However, I recognize that convenience is not the only factor people consider when choosing a dentist. That’s why I strive to perform dentistry using the best technology available in order to ensure my patients receive the best dental care that I can provide.

Another advantage of the location is that my staff and I get to know our clients because we have a lot of face-to-face contact. I run into my patients all the time when I’m going for lunch or walking to my car. In addition, most times, patients do not call to make their appointments, they just stop by. It’s nice to see them outside the operatory and to talk to them informally. These elements really foster the community feel.

What piece of technology has the biggest “wow” factor for your patients?
Nunrha: Digital X-rays. People are so amazed when they see the immediate images of their teeth on a large screen. Digital Xrays are such an effective visual tool for discussing bone levels, areas of decay, defective restorative margins, root problems, etc. In addition, patients love the fact that they use 90 percent less radiation than conventional ones.

How do you market your practice to new patients?
Nunrha: I do very little advertising outside the airport. The most important referral base is through word-of-mouth and internal referrals. New employees are informed about their dental insurance benefits upon hiring and they know that there is a dental office at the airport. There are signs for the office located throughout the terminals. I advertise in publications distributed to all employees. I also do oral health-care sessions to promote employee wellness for different employers at the airport. This past summer, through a YVR campaign to make people aware of the range of services offered at the airport, I offered free checkups and cleanings to new patients 12 years of age and younger and this initiative was advertised by YVR through their Web site, Twitter and Facebook, as well as local newspapers. Lastly, if a traveler gets off a plane with a toothache or broken tooth, YVR employees or signage will direct them to my office.

 

What is a typical day’s schedule?
Nunrha: The office is open six days a week. On a typical day, both the dentist and hygienist are working. We offer a full range of dental services and this variety is reflected in a typical day’s schedule. Many employees also bring their kids so we get the opportunity to work on patients from a wide range of ages. We do restorative dentistry, endodontics, removable and fixed prosthodontics including implants, removable orthodontics and oral surgery. We also offer cosmetic dentistry including veneers and teeth whitening. Special services include laser soft-tissue procedures and gum treatments, screening for oral cancer using tissue fluorescence (Velscope) and Botox.

How do you accommodate emergency patients?
Nunrha: Emergency patients are always accommodated. The office has an overflow operatory where an emergency patient can be assessed and seen as soon as possible amongst the booked appointments. In the rare event that an emergency patient needs more time, I will reschedule the booked client. Although this seems unfair, YVR employees know that the dental office must accommodate emergency patients as part of its customer service to the public, especially travelers, and employees are very understanding.

In your opinion, what is the biggest problem a dentist faces today and what do you think should be done about it?
Nunrha: The biggest problem dentistry faces today is declining public trust. A recent survey by the Canadian Dental Association found that the Canadian public’s perception of dentists is at an all-time low. This is very alarming to me. There are many reasons for this declining trust, and I think that one of them is the effect of excessive advertising. Today, dentists advertise more than ever before and aggressive advertising may lead people to see dentists as salespeople rather than health-care professionals. The harm is that the public may start separating dentistry from the overall health-care system. The erosion of the public’s trust in dentists as health-care professionals needs to be taken seriously and reversed or else dentistry will be seen more as a business and less about oral health care, and that will damage the integrity of the profession.

Dentists need to focus on building relationships with patients in order to rebuild this trust and value.

What advice would you give someone who is thinking about entering dentistry?
Nunrha: I would highly recommend it! Dentistry is a great career if you enjoy working with your hands and communicating with people. There is so much variety in your day that it never gets mundane. It is flexible in the sense that you can work as much or as little as you want and you can restrict or expand the scope of your practice. In this way, it is easy to balance work with whatever stage you are at in your personal life, especially for women. It is an exciting time for the profession as well because there is so much research going on and there are always new products and techniques to try and evaluate.
Dentaltown Magazine
September 2025
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