The current coronavirus health crisis is a historic public health issue that is bringing light to the power of preventing disease through social distancing and surface sanitation.  These are important health safety measures.  However, it is important to understand how to balance oral health needs, maintenance, and implications during this time.

how does covid-19 affect dentistry

Can I Go to The Dentist During the COVID-19 Pandemic?

The short answer is yes, however, it is recommended patients see their dentist only for emergency or urgent care during the outbreak as recommended by the American Dental Association (ADA). During this time, patients should not attend routine dental examinations, and should plan to contact their office to reschedule.

You’re probably thinking, “How is emergency care defined?” If you have swelling, uncontrolled bleeding, dental pain, or complications from dental surgery you should call your dentist to discuss. If needed, it is acceptable to go to your dentist for an appointment for urgent care.

Going forward as we return to normal, the ADA recognizes that the state dental associations may be best positioned to recommend to the dentists in each region the amount of time to keep their offices closed to all but emergency care. This is a fluid situation and will be evaluated locally depending on risk of each area as the conditions evolve and procedures return to normal.

What precautions have dentists/dental clinics put in place during the COVID-19 pandemic to prevent the potential spread of the virus?

Dentists practice CDC universal precautions to safely protect all patients which include disposal and sterilization of all instruments per patient, wearing personal protective equipment, placing barrier protection on touched surfaces, and disinfection of all operatory surfaces with hospital grade disinfectants.

In addition, when open during COVID-19 pandemic, dental offices are recommended to enforce social distancing between all individuals in the office when not wearing personal protective equipment, and are recommended to routinely disinfect common surfaces in lobbies or waiting rooms, for example doorknobs, countertops, and pens.

 

Remember not to neglect oral health

It is important for people to not sacrafice oral health maintenance in exchange for preventing COVID-19. Patients should understand that dental emergencies do arise, and it is necessary to treat dental emergencies in a timely manner to prevent damage to your overall health or weakening your immune system. Therefore, patients should not be embarrassed to report, nor should they feel obligated to suffer with a dental emergency during this time.

If you have a dental concern contact your dentist directly to discuss his or her recommendation for your situation. Often a prescription can be phoned in to your pharmacy as an initial treatment. If your dentist does request you to go to their office, you do not need to be overly anxious about the risk of contracting the virus. You should plan to practice the typical recommendations for COVID-19 prevention in public places such as social distancing when not wearing personal protective equipment.

During this time, many normal routines are disrupted, and anxiety may increase. Patients should be mindful to maintain their normal oral health maintenance at home. These routines should include brushing your teeth twice per day and flossing once per day. While at home for an extended period of time, it increases the likelihood of people snacking on sweets or drinking alcohol to cope with stress. Be mindful to maintain proper nutrition and avoid substances such as alcohol or smoking that weaken the immune system.

Why are Dentists limited during this time only for urgent and emergency care?

social-distancing to prevent covid-19 at the dentistThe goal of the ADA recommendation is to lower incidences of potential exposure with non-symptomatic individuals for the community benefit. By limiting exposure to COVID-19, the rate of transmission in the community is lower which has been referred to as “lowering the curve”.

There are two primary benefits to this action: 1) Lowering the rate of spread reduces the chance that the community exceeds the threshold of hospital capacity to treat COVID-19, and 2) Limiting non-emergency medical and dental procedures preserves medical supplies such as masks and gloves so they may be used by hospitals to treat COVID-19 if needed.

COVID-19 prevention is more than washing your hands

Individuals can touch their face an average of 15 times per hour[1], usually without realizing they are doing so. The problem with this subconscious habit is it literally provides a direct on-ramp for germs to connect with your face, nose and mouth, which is central to transmission of the coronavirus.

Stress creates a desire to self-sooth through repetitive habits.  A good example is nail-biting.  A study[2] found that 76% of people who bit their nails had E. coli in their saliva, compared to 26% of non-nail-biters. That’s a significantly higher chance of picking up germs.

The catch-22 is that nail-biting often increases with anxiety and it happens before we catch ourselves. People also subconsciously bury their face in their hands and touch their face significantly more often in times of stress.  Creating calm is a great antidote for these unconscious actions (plus you’ll just feel better overall).

Here’s some recommendations to help reduce the spread of Coronavirus or any transmittable disease.

CORONAVIRUS ORAL HEALTH TIPS:

  1. Be Mindful, Not panicked

Keep calm and be conscious of your hand-to-mouth movement; so easy to do unconsciously when you are stressed!

  1. Soap up

Can’t stress this enough; make sure to keep your hands thoroughly washed, at least 30 seconds of scrubbing.

  1. Keep your hands away from your mouth

Limit hand and mouth contact, your number two way to stop disease spread (hand washing is number one!)

  1. Trim your nails

Yes, it’s that easy!  The shorter the nails, the less pathogens can hide underneath them.

  1. Reduce stress

Parafunctional activities (otherwise known as unconscious actions or “habits”) often increase with stress as a natural way to cope with anxiety. Try meditation, controlled breathing, or self-sooth and occupy your hands with a stress ball.

  1. Chew gum                                

Gum chewing is a great substitute stress-reliever when you’re trying not to bite your nails. Just don’t stick that chewed gum under a desk or on a sidewalk!

If you have more questions about dentistry feel free to contact us. Dr. Charles Sutera is owner of Aesthetic Smile Reconstruction, a high profile reconstructive cosmetic dental practice located in the Boston Metro area. Dr. Sutera has elite expertise in a combination of areas including cosmetic dentistry, TMJ treatment, and sedation dentistry.

[1] https://pubmed.ncbi.nlm.nih.gov/18357546-a-study-quantifying-the-hand-to-face-contact-rate-and-its-potential-application-to-predicting-respiratory-tract-infection/

[2] https://www.ncbi.nlm.nih.gov/pubmed/27387832