FBI Goes Dental

FBI Goes Dental

Rutgers School of Dental Medicine offers training to FBI agents so they can treat unexpected dental emergencies

The dental school faculty had to get special permission from the New Jersey State Board of Dentistry to provide hands-on instruction in the school’s clinics.

The FBI goes on worldwide missions to remote areas, where dental care is either hundreds of miles away or not available at all, and when an emergency strikes, the impact is huge.

Clarice Starling (aka Jodi Foster) unraveled the mystery of Dr. Hannibal Lecter in “The Silence of the Lambs.” Eliot Ness (aka Kevin Costner) brought crime boss Al Capone to justice in The Untouchables and Joe Pistone (aka Johnny Depp) successfully infiltrated the New York mafia in “Donnie Brasco.”

FBI agents are almost always portrayed as being nearly indestructible. They never get the flu, migraine headaches or debilitating toothaches, and they are never pulled from a mission because of ill health. In reality, of course, that is simply not the case.

Special Agent H. Gulick, an advanced capability paramedic in the Newark FBI office, says agents are, indeed, taken off operations for medical emergencies, and the two most common reasons are complications from existing medical conditions and dental emergencies.The FBI goes on worldwide missions to remote areas, where dental care is either hundreds of miles away or not available at all, and when an emergency occurs, Gulick explains, it has a huge impact.

“Usually there is only a minimal number of agents deployed on an operation, so when even one agent is sidelined, it means losing a vital skill set,” Gulick says. “It’s almost like a sports team; we try our best to keep everyone on the field.”

Special Agent Gulick

Special Agent H. Gulick is an advanced capability paramedic in the Newark FBI office.

Photo Credit: John Emerson
In cases of dental emergencies that was sometimes difficult. FBI paramedics had only a few solutions they could offer. If Tylenol or Advil was not effective, there was morphine; but some of the side effects – confusion and memory lapses – made it difficult, if not impossible, for an ailing agent to work. It became clear that paramedics needed other options, so the special agent in charge at the Newark FBI contacted Rutgers School of Dental Medicine. He wondered if the faculty could provide some type of training for his agents.

August Pellegrini, assistant dean for clinical affairs, designed a course that specifically fit the bureau’s needs. The daylong course consists of modules on infection, relieving pain and administering local anesthesia. Pellegrini; Mahnaz Fatahzadeh, an associate professor in diagnostic sciences; Victor Petriella, assistant professor in oral and maxillofacial surgery; and Marc Rosenblum, associate professor in restorative dentistry, each taught part of the course.

Because the agents are not dentists or dental students, Pellegrini had to get special permission from the New Jersey State Board of Dentistry to give them hands-on instruction in the school’s clinics. The agents first had classroom training on infections, which focused on the types of lesions they might come across and ways to treat them. Then they went into the clinic, and after learning how to give injections of a Novocain-like anesthesia into the jaw, they practiced the procedure on each other. “They also learned to mix and place a temporary filling that contains a sedative,” Pellegrini says. “By keeping food, air and water out of a damaged tooth, these paramedics are equipped to provide a certain level of comfort, until the agent can get to a dentist.”

There is no other training like that offered by the dental school, according to Gulick. “We receive some emergency training, but a whole day of instruction that includes hands-on experience is unheard of,” he says. “It is especially valuable when we are on missions that involve what’s known as delayed or deferred evacuations. An example of that is the 51-day standoff we had with David Koresh and the Branch Davidians in Waco, Texas. "

"Another time this training would have come in handy was when we were collecting evidence at the embassy bombing in Africa. Everyone is hesitant to go to the dentist in a third world country. And it’s extremely useful when you’re on a plane for 10 to 12 hours heading to Asia.”

Gulick says he had the opportunity to use his new skills during a recent trip to Saudi Arabia, when an Air Force bomb technician broke a tooth and was in excruciating pain. The paramedic gave him a mandibular block (anesthesia in the lower jaw) and cemented the pieces of the tooth together with an emergency dental filling product known as Dent-Temp. “He was able to complete the mission,” says Gulick. “If I hadn’t been able to help him as I did, that might have been the longest 12 hours of his life.”

While it may not be the stuff blockbusters are made of, helping FBI agents do their jobs when unexpected dental emergencies occur is worth far more than the price of a movie ticket. It’s invaluable.

Reprinted from UMDNJ Magazine Spring/Summer 2013