Dental Health and the Covid-19 Pandemic

April 2020

Mid-march of 2020, everything changed for every person in the United States of America. We were warned that there was a new deadly virus that we had little information about. We had to close everything down, with the exception of essential businesses, and stay indoors to prevent its spread.

Several weeks have passed and I am being asked “Why can’t I get my cleaning?”, “Aren’t dentist essential?”,” I don’t understand why I can’t have my fillings done?”, “What can I do if I have a dental emergency?”.

Let’s start by explaining that dental treatment is essential. However, unlike many other out -patient procedures, dental treatment generates lots of aerosols i.e respiratory droplets. This is the number one way that Covid- 19 is transferred from person to person.  Just think of the last dental procedure you had, more than likely there was water spraying in your mouth and all around it. In this water, there are droplets of your saliva and other body fluids. For this reason dentists, dental assistants and dental hygienists are at very high risk for contracting this disease. 

An article published in the New York Times, ranked health care professionals by risk of exposure and dentist scored the highest. Below is that ranking taken from Becker’s Hospital review March 18th 2020.

Five at-risk healthcare professions with their respective scores:

Dentists
Exposure to diseases: 95
Physical proximity: 99

Paramedics 
Exposure to diseases: 89
Physical proximity: 97

Nursing assistants
Exposure to diseases: 83
Physical proximity: 91

Nurses
Exposure to diseases: 80
Physical proximity: 77

Personal care aids
Exposure to diseases: 62
Physical proximity: 86

As a result of this high risk, your dental professional has been mandated by state dental boards all across the country to limit dental procedures to emergencies only and if possible to not to use a dental hand piece to reduce risk of exposure and spread.  This is likely the reason  many of you may find that you are trying to get a dental appointment with your provider and cannot. Most dental offices, my own included, can be reached for a true dental emergency and will take measures to relieve your symptoms. What is a true dental emergency?  On March 18th the American Dental association issued guidance on what is considered dental emergency during Covid -19. 

“Examples of urgent dental care treatments, which should be treated as minimally invasively as possible, include:
•    Severe dental pain from pulpal inflammation.
•    Pericoronitis or third-molar pain.
•    Surgical postoperative osteitis or dry socket dressing changes.
•    Abscess or localized bacterial infection resulting in localized pain and swelling.
•    Tooth fracture resulting in pain or causing soft tissue trauma.
•    Dental trauma with avulsion/luxation.
•    Dental treatment cementation if the temporary restoration is lost, broken or causing gingival irritation.

Other emergency dental care includes extensive caries or defective restorations causing pain; suture removal; denture adjustments on radiation/oncology patients; denture adjustments or repairs when function impeded; replacing temporary filling on endo access openings in patients experiencing pain; and snipping or adjustments of an orthodontic wire or appliances piercing or ulcerating the oral mucosa.” For more information visit www.ADA.org

Simply put and emergency is any dental issue that is causing pain, swelling , and or infection . if you are not sure if your dental need can wait contact you provider for advice and directions. 

Not to worry, dental professionals are accustomed to being in the direct line of communicable diseases. Because of the nature of our procedures and proximity to patients during treatment we have been at risk for HIV, Hepatitis and all strains of the flu, just name a few. We have always taken all the necessary steps to protect patients, ourselves and our staff. This disease is no different. During this time of quarantine, I assure you your dental provider, the state dental boards and the CDC are working on measures to keep everyone safe upon reopening of the dental offices. Be patient, be safe and be well!