My pre-quarantine to-do list was filled with minor but nagging tasks, like scheduling dental appointments. Now, I’m considered to be “doing my part” by not completing these tasks at all. Never mind the fact that it’s been a year since my last cleaning –– the world has far bigger things to worry about than my chompers.
The thing is, it’s been drilled into my head since I was still on my first set of teeth that I was supposed to go to the dentist twice a year, or else suffer the consequences of bloody toothbrushes and root canals.
But now, any scheduled routine dental appointments (like bi-annual cleanings) for the next month or so have probably already been postponed. In fact, the American Dental Association has recommended that all non-urgent appointments through April 30th be canceled or rescheduled for a later date. This deadline is likely to be extended further, as the Centers for Disease Control and Prevention continues to state that all non-essential medical treatments should be put off “until further notice.” Enforcement, however, varies from state to state. For example, the Oklahoma Board of Dentistry recently agreed to re-open dental offices on April 30th, while the governor of Kentucky announced over the weekend that dental offices wouldn’t be included in the state’s plan to re-open medical offices on April 27th.
Dental workers are at the highest risk for contracting illnesses on the job compared to nearly any other profession based on their physical proximity to others and exposure to disease. According to a New York Times study on labor and coronavirus risk, dental hygienists ranked most likely to contract an illness, scoring 100 out of 100 for both proximity and exposure. Oral surgeons ranked one point less in each category, while dental assistants and dentists ranked at 99 for proximity and in the mid-90s for exposure. Registered nurses, by comparison, rank 76 and 84.
“There is no question that dentists, our teams and our patients will be exposed to a level of risk as we return to work in the coming weeks,” says Rick Mars, general dentist and author of The Big Smile: The Principles of Modern Dentistry — For Dentists and Patients. “This risk can and will be mitigated in several ways. First, patients probably do not need to be reminded that their dentist’s office is one of the cleanest environments that they come in contact with on a regular basis. That said, you’d be hard-pressed to find a dental office that isn’t upping their game. Protective face shields, no seating in reception areas, disposable gowns, and of course COVID-19 screenings of every patient and team member will be just a few of the visible changes patients will see when they enter our facility.”
On top of that, there are measures that patients might not notice, like dental techniques that create less aerosol of saliva and stronger disinfectants. “This is the new norm, but we will do everything within our power to protect our patients and our team,” he says.
Emergency treatments, however, are still the priority, even if a patient has the virus. Currently, the ADA says dental emergencies can be “potentially life-threatening and require immediate treatment to stop ongoing tissue bleeding or to alleviate severe pain or infection.” Such qualifying conditions include uncontrolled bleeding in the mouth; swelling or trauma to facial bones that might compromise breathing; broken or knocked-out teeth; infections to the gums; and severe pain. Dental equipment such as dentures or orthodontic devices causing pain and needing adjustments can count here, too.
Going to the dentist is obviously a risk for both parties, but leaving certain dental conditions untreated can have serious repercussions. Not only can you lose teeth, but certain infections are capable of traveling to other parts of your head and neck. A tooth abscess, for example, could even develop sepsis and kill you. Usually, though, abscesses and other conditions considered urgent are very painful. If you’re unsure whether your situation is urgent enough, give your dentist a call.
“There is absolutely a potential long-term risk if one delays their dental treatment,” says Mars. “Cavities can turn to root canals, minor gum disease can advance to tooth loss and infection can result in hospitalization or even death. This might sound dramatic, but it’s important for patients to know that they cannot delay their dental treatment indefinitely, as it can — and probably will — advance to more serious issues.”
For those who live in a state where dentists are going back to their scheduled work, it’s ultimately your decision if you want to keep that appointment or not. On one hand, they’re most certainly doing everything they can to mitigate the spread of COVID-19. On the other, considering the risk dental workers have for getting sick, you might want to avoid contact with them for your own sake. Even with temperature checks and potential antibody tests, we still don’t know for sure who’s carrying the virus and who isn’t.
We can only hope that these questions will be answered before any tiny cavity becomes a not-so-tiny extraction.