Dental surgeries are adapting the way they work in and around a patient’s mouth to account for this complicated reality. Dentists monitor patients’ symptoms by limiting the number of appointments in a day, implementing rigorous remediation protocols and wearing multiple protective devices to prevent respiratory diseases.
The Centers for Disease Control and Prevention and the World Health Organization suggest that respiratory droplets are expelled when an infected person coughs, sneezes, speaks or breathes is the main way the virus spreads. But the CDC reports that “no data are available to assess the risk of SARS-CoV-2 transmission during the dental office.”
The Washington Post has sent thousands of questions to readers about life during the coronavirus pandemic and many have asked whether to go to the next dentist appointments. Dentists and public health experts fear that Americans will postpone routine cleaning, which could aggravate health problems in the months or years to come.
“Dentistry is not an elective procedure,” said Purnima Kumar, professor of periodontology at Ohio State University. “They are important for the health of your mouth and for the health of the rest of your body.”
In March, the CDC recommended that dentists only conduct emergency procedures for patients who would otherwise have ended up in overloaded emergency rooms. Since then, states across the country have largely lifted residence restrictions, companies are starting to reopen and dentists are carrying out regular checkups. The American Dental Association and the CDC are providing practical guidance on how practices should proceed with dental procedures by limiting face-to-face interactions.
Bill Miller, an OSU epidemiologist and doctor, said it is important to remember that going to the dentist is not the same as going to the barber or hairdresser.
“Dentists are used to thinking about the risk of infectious diseases,” said Miller. “They are already taking precautions.”
Talk to your doctor, find out how appointments have changed.
Even before going through the door to see the dentist, you will notice some changes.
Dental surgeries call patients two or three days before their appointment to ask if they are experiencing common covid-19 symptoms, such as fever, cough or muscle pain.
Of course, fever can also be a common symptom for an oral health problem such as an abscess, an infection of the tooth caused by an untreated cavity. In those cases, Kumar said, patients will also notice swelling and sharp pain in the mouth. Kumar said he would then prescribe an antibiotic to help the fever fall before he enters the patient for an appointment.
Everything that can be done by phone or email, from payments to health questionnaires, should be done. Kumar said she was also on FaceTime with patients to physically see what the problem might be.
“My phone is constantly exploding with patient text messages,” said Kumar.
The ADA recommends that patients sit outside in their cars rather than in waiting rooms before any appointment. Dentists ask patients to come to their appointments on their own, if possible, to limit the number of people in the office.
Once inside, patients will need to wear a mask and have their temperature measured in a second series of health screening steps. You can also bring your pen, in case you need to sign any document.
Bridgett Anderson, executive director of the Minnesota Board of Dentistry, said the appointments “will take a little longer than normal” to keep patients and staff safe.
At the end of the exam, staff will disinfect the room and equipment. Some practices are purchasing air purifiers to be placed in the office. Charlie Doring, a dentist from a private practice in Rockville, Md., Said he went from eight to ten patients a day to just five or six to provide enough time between appointments.
The more dental practices can stagger programs and reconfigure their spaces to ensure “there are fewer people unmasked in one possible space,” the better, said Emily Sickbert-Bennett, director of infection prevention in UNC hospitals.
And if you’re not feeling well, Sickbert-Bennett said, you should cancel the appointment.
“You don’t want to put yourself in a situation where you’re close to other people when you’re not feeling well,” said Sickbert-Bennett. “This, I think, cannot be said enough.”
Teeth cleaning will take longer.
Devices used in dental procedures often vibrate, rotate and spray the spit from the patient’s mouth into tiny drops of water or aerosol, which can remain in the air for a while.
An increasing number of studies show that coronavirus can remain suspended in these aerosols. Whenever possible, dental hygienists are switching to manual tools that have less chance of creating these small droplet clouds, said JoAnn Gurenlian, a professor in the dental hygiene department at Idaho State University.
Dentists say they also depend more on suction devices that clip around the mouth to suck up potential aerosols at the source.
But the inherent risk of working alongside the respiratory system cannot be avoided and the CDC recommends that dental workers wear an N95 mask or other respirator when conducting “aerosol-generating procedures” on a patient.
“All of us are aware that when we got back to practice, we weren’t going back to a world free of covids,” said Kumar. “So we’re trying to compensate and – maybe – even some overcompensation.”
There are results published on covid-19 every week, said Gurenlian. It is a new virus and dental practices are working with caution to protect themselves from any potential spread.
Dentists wear new or disinfected personal protective equipment or PPE, such as face protectors, gloves, clothes and masks at each scheduled appointment. To date, there have been no reports of covid-19 cases grouped in dental offices, according to the CDC.
“Whatever dentistry is doing today is based on an abundance of caution,” said Kumar.
In the meantime, brush and floss your teeth
Today more than ever, dental health experts say that people should be diligent about their personal health at home, whether it’s diet, exercise or oral health.
“The health of your mouth is also affecting your heart, lungs, kidneys, brain, everything,” said Gurenlian. “These are positive and positive steps to fight any infection in our body.”
Take the time to brush your teeth and use dental floss twice a day in case you have to refuse an appointment for some reason. And, if there is a day when your teeth feel funny or you can’t eat a scoop of ice cream because it’s too cold, contact your dentist, Kumar said. Be alert and ask questions.
“If in doubt, if in doubt, answer the phone and call the dentist,” said Kumar. “Let the professional be the judge of: Do you have to enter now or can you wait longer?”
As the number of covid-19 cases reported increases and decreases in different parts of the country, some communities will run a greater risk than others. Dental health experts and epidemiologists say that people should monitor the number of cases from their public health department before making an appointment with their dentist. What is safe and when it might depend on where you live.
“If you live in a county that has experienced rapidly increasing cases in the past three weeks, you should behave differently than when you are in a county where you haven’t seen cases in a couple of months,” said Miller. .