The Challenges of Pandemic Dental Care

“We always did a lot with respect to personal protective equipment and keeping the office clean, and now we’re tweaking what we already did to be even safer,” Dr. Lee said. After every patient, all surfaces in the treatment room are wiped down with a chemical that kills viruses within one minute. To clean instruments, a top-of-the line autoclave is used that first sucks all the air and liquid out of instruments, then sterilizes them with high heat and pressure before drying them completely to minimize the risk of recontamination.

On May 20, the Centers for Disease Control and Prevention issued updated guidelines for dentists preparing to resume nonemergency dental care that include recommendations for treating those with Covid-19 as well as those without the virus. Such strategies are important because no test is 100 percent accurate. There have been many false-negatives for Covid-19 virus, so even if I tested negative the day before coming to the office, it would not guarantee that I don’t have the virus.

Dental procedures are especially challenging because many involve the use of high-pressure sprays of water and air that could disperse virus-containing aerosols from a patient into the treatment room. Dr. Lee knows people worry about aerosols, which is why the office has installed HEPA filtration to keep the air cleansed and moving. The dentists are now also using a special device to control aerosols that are unavoidable during dental procedures. For practitioner protection against aerosols, the dental hygienists now wear face shields when cleaning teeth, as will the dentists under certain circumstances.

The Drs. Lee are also taking further steps to protect both their workers and the workers’ families from Covid-19. All employees wear masks, gloves and gowns, and at the end of the workday, these are left at the office and cleaned.

Still, these dentists are among many others worried about the risks to patients who postponed dental care during imposed Covid lockdowns. A patient who in January may have had a cavity that could have been addressed with a simple filling may now have a much larger area of decay that requires a more costly and involved root canal or even removal of the tooth and an implant.

Patients who had had a tooth pulled and were ready to get an implant when the pandemic struck and dental offices closed could have lost enough bone during the delay to impair the success of implant surgery. Or if, as in my case, the implant was already in place but the usual months of healing had passed and the patient was awaiting placement of a crown, the surrounding teeth could have shifted toward the empty space, leaving insufficient room for the false tooth.

I now understand why a friend’s dental surgeon advised him to have an implant done while Covid-19 infections peaked in New York City. The procedure, my friend said, was done with extraordinary attention to safety and all went well.

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