Elaine Thompson/Associated Press
As cities, counties, and states continue to modify their multi-month home orders to reduce COVID-19 infection and hospitalization, add dental visits to the list of services you can book now, or you can book in the short term.
After the American Dental Association and the Centers for Disease Control and Prevention recommended the closure of dental clinics in March, dental clinics in other regions were basically closed except for emergency services in the United States. Many people are completely closed.
The hope is that by allowing dentists to continue to treat serious cases (such as severe tooth pain and infections), these patients will not be in the emergency room of the hospital, where medical staff are busy with severe coronavirus patients. And because of the particular shortage of dentists and other health care providers in personal protective equipment, at least initially, routine dental inspections and cleaning are considered unnecessary.
However, recently restrictions on routine care have been relaxed in many places. So, is it really safe to go to the dentist now?
The risk of coronavirus transmission cannot be completely eliminated
Dr. Gregory Poland, an infectious disease specialist at the Merlot Clinic and spokesperson for the American Society of Infectious Diseases, said he believes that certain infections in the dental environment are inevitable.
Poland said: “But it is hoped that all dentists should follow their operating recommendations to mitigate this risk.”
Understandably, during the visit to the dentist, I was concerned about the risk of spreading COVID-19. Michele Neuburger, a dental officer in the Department of Oral Health at the Centers for Disease Control and Prevention and member of the COVID-19 response to the Centers for Disease Control and Prevention, said that the dental environment has “unique characteristics that warrant the need for specific infection control.”
“Dental health personnel use tools such as dentistry [drills]Ultrasonic scalers and air-water syringes produce visible sprays that may contain droplets of water, saliva, blood, microorganisms and other debris. “Newberg said.
Large water droplets can fall directly on other objects in the examination room and contaminate surfaces that are frequently touched. If the patient has a virus, the spray may also contain small “atomized” droplets of COVID-19. Moreover, according to some estimates, these droplets may stay in the air for up to three hours, unless there are strict precautions (such as staff equipped with PPE and disinfection of the surface between the treatment room, equipment and surface), Otherwise these viruses may spread the virus to the dentist or the next patient. Patient-not taking.
So far, no COVID-19 cases can be traced back to the dental clinic
Despite these potential risks, it is gratifying that both the World Health Organization and the Centers for Disease Control and Prevention have stated that so far, confirmed cases of COVID-19 have not been transmitted in dental clinics. Neuburger said that this included the CDC’s tracking of news reports suggesting such infections.
In mid-May, the Centers for Disease Control and Prevention (CDC) and the American Dental Association simultaneously released more guidelines on dental practice, which will be updated regularly.
Ron Greenberg, 62, a professor of computer science at Loyola University in Chicago, returned to the dentist in early June. He said: “Since mid-March, I have been afraid to go anywhere.” However, when he finally found the courage to delay the examination, the dental clinic adopted “a lot of procedures”, which made him feel better. A staff member called him a few days before the appointment, asked for a list of questions about his health, and then raised it again on the day he conducted the examination.
Greenberg was told to call the receptionist from his car when he arrived and waited for the staff to open the front door of the office-so he didn’t even need to touch the door handle.
He said: “They took me directly to the hand sanitizer.” “The temperature check is next. Everyone puts on masks until I have to take them off to work on me. And the hygienists and dentists work nearby. Wearing a full face mask.”
Greenberg said that after going through all these extra precautions, he was confident enough to arrange a follow-up appointment a few days later to repair the missing teeth.
CDC Guidelines: Avoid using power tools whenever possible
Greenberg’s visit included many precautions recommended by the CDC. For clarity, these contents have been edited to include:
- Screen patients before and after each appointment to find symptoms of COVID-19 (such as cough and fever), and if the symptoms may indicate that they are infected with the virus, they should be postponed.
- Use each patient’s car or place outside the office as a waiting room.
- Remove toys, magazines and coffee stations [which can be infection sources] From the waiting room.
- Wear a mask for the patient and any patients with the patient immediately in the office area and after procedures and examinations.
- Place a plastic or glass barrier between the patient and the receptionist.
- Avoid using power tools whenever possible-for example, certain practices no longer use polishers to clean teeth.
- Keep only the tools needed by each patient to avoid contamination of other tools.
- When possible, use a rubber dam on the patient’s mouth to limit secretions.
- When possible, when performing an aerosol-generating procedure, hire multiple dentists to speed up the examination and minimize exposure.
- Studies have shown that installing HEPA filters to improve the filtering effect of the room may reduce the spread of virus-borne airborne particles.
Although ADA’s weekly survey of national dental practice found that as of June 22, their number of patients had reached 65% of pre-COVID-19 levels, dentists knew that at least some patients were still worried enough to stay away from reality, even if they were Surgery (such as gum surgery) and painful or overdue.
Howard Golan, a dentist in Williston Park, New York, has recently resumed practice and has only seen patients undergoing emergency treatment since mid-March. He said that in rare cases, missing dental care can cause serious infections or even death.
Dentists have a vested interest in taking all possible preventive measures.
Louis G. DePaola, associate dean of clinical affairs at the University of Maryland School of Dentistry in Baltimore, noted: “Dentists are usually 12 to 18 inches away from patients.” “When doing their work, if the dentist has COVID -19, their mouth must be in close contact with the most infectious part of a person’s current.”
It is also important to protect the health of other employees in the office.
What about an orthodontist?
Daniella Smith of Silver Spring, Maryland, went to the dentist in late May, when she also restored the orthodontics of two children, aged 12 and 15.
Smith said: “All these new measures have left a deep impression on me,” Smith said, including employees opening all doors and not using a high-power polisher during the cleaning process. It is recommended that children brush their teeth before going to work to reduce the saliva sprayed during appointments.
Smith said: “Since spending a lot of time and money on children’s braces, we really don’t want their teeth to move backwards, which is why we have to make an appointment when the office reopens.”
Ideally, the dentist will perform a COVID-19 test on the patient before making an appointment and then reschedule the patient who tested positive. Marko Vujicic, chief economist and vice president of the ADA Institute for Health Policy, said that “immediate care” tests that can produce results in about 15 minutes may produce erroneous results.
Vujicic said: “We have been paying attention to testing to see if there is an effective way to really determine the patient’s COVID status before treatment.” “Before that, we recommend that dentists pay more attention to the guidelines when treating patients.”
Connie White, dean of the clinical program at the School of Dentistry at the University of Kansas City, Missouri, and dean of the College of General Dentistry, said: “I think everyone is looking for the best science because we are a step forward.” The Craniofacial Science Institute is soliciting research suggestions related to coronavirus, including methods to improve disinfection and prevent disease transmission.
At the same time, White and other dental leaders also stated that they are aware that the continued rise of coronavirus cases across the United States may lead to the closure of dental clinics in certain areas.
White said: “Of course I hope not.” However, as the opening and closing keeps changing, it’s best to make sure that any dental surgery that starts in one appointment can be completed shortly thereafter. White suggested: “Patients should discuss with the dentist what they need to do now and what they can wait for.”
Remember, infectious disease experts point out that as patients, we all have important responsibilities. If we feel any discomfort, we must also inform the dentist before or on the day of the appointment. We are together-if you are sick, please stay at home.