My long-time dentist’s office, Waialae Dental Care, called me yesterday to say I hadn’t been in for a long time and was way overdue for my regular teeth cleaning.
I said thanks-but-no-thanks, I’m not quite ready to have somebody working inside my mouth in this Time Of The Covid.
Am I being too cautious? Are clean teeth worth the relatively small risk of viral infection at the dental procedure room? What’s the downside of some tooth plaque and a little debris along the gum edge?
Inquiring patients want to know, so I haunted the best sources I could find nationally on the topic.
Back in March, the CDC told states they should close all dental offices except for emergency care. Dentists weren’t ready yet for all the precautions that needed to be in place. Most did not have the recommended personal protection gear or know much about viral transmission.
We eventually reopened here with guidelines in place. So, is it safe to go to the dentist now?
The CDC says despite precautions, dentists and their assistants cannot completely eliminate the coronavirus transmission risk. Dr. Gregory Poland, an infectious disease specialist at the Mayo Clinic and a spokesman for the Infectious Diseases Society of America, says he thinks some infections in dental settings are likely to be inevitable.
“But the hope is that recommendations for their practices that all dentists should be following will mitigate that risk,” Poland says.
Michele Neuburger, a dental officer for the CDC’s Division of Oral Health and a member of the CDC’s COVID-19 Response Infection Prevention Control Team, says;
“Dental health care personnel use instruments such as dental [drills], ultrasonic scalers and air-water syringes that create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms and other debris.”
Large droplets can land directly on others in the exam room and can contaminate frequently touched surfaces. The spray could also include small “aerosolized” droplets of COVID-19 if a patient has the virus. And those droplets can remain in the air for up to three hours, according to some estimates, and potentially spread the virus to dental staff or the next patient unless stringent precautions are taken — such as providing personal protective equipment for staff and disinfecting the treatment room, instruments and surfaces between patients.
BUT —- No cases of COVID-19 have been traced to dental offices so far.
Here are the CDC guidelines for dentists. Is yours following them?
* Screen patients before each appointment, and when they arrive, for symptoms of COVID-19 — such as cough and fever — and postpone if they have symptoms that could indicate they have the virus.
* Use each patient’s car or a spot outside the office as the waiting room.
* Remove items such as toys, magazines and coffee stations [which can be infection sources] from waiting rooms.
* Require masks for patients and anyone with them while in the office area and immediately after procedures and checkups.
* Place a plastic or glass barrier between patient and reception staff.
* Avoid using powered tools when possible — some practices no longer use a polisher for teeth cleanings, for example.
* Use rubber dams over a patient’s mouth for procedures when possible to limit spray of secretions.
* Install high-efficiency particulate air filters to improve room filtration, which might, research suggests, reduce transmission of airborne particles of the virus.
Now here’s what patients have to consider. Delaying checkups can turn a small cavity into a root canal or tooth extraction. In rare cases missing out on dental care can result in serious infections.
“I think everyone is looking for the best science as we go forward,” says Connie White, president of the Academy of General Dentistry. The National Institute of Dental and Craniofacial Research is soliciting coronavirus-related research proposals onways to improve disinfection and prevent disease transmission.
Remember, infectious disease specialists note, that we all have important responsibilities as patients, too, to let the dentist know before or on the day of the appointment if we’re feeling sick in any way. We’re all in this together — if you’re sick, stay home.
Me? I guess I’m about ready to accept the very small risk and get my teeth cleaned next month.