Have you received an email from your dentist saying that they will only be available during emergencies? You are not alone, noted Robert Glatter, MD of business news Forbes. Oral health is important to our wellbeing, but limiting visits has made it more difficult for patients with complex dental health needs. This is the new normal for US dental care considering that dentists and dental staff are susceptible to contracting the virus.
Jordanian Dentists’ Awareness, Perception, and Attitude About COVID-19 and Infection Control
Yousef Saleh Khader and colleagues of journal portal Research Gate said that the study included a total of 386 dentists who work in Jordan, regardless of if they work in private clinics or health centers. Regarding the incubation period of COVID-19, 44% said seven to 14 days, 36.1% said one to 14 days, 16.6% answered seven to 21 days and 3.3% said two to seven days.
When asked about the symptoms of the virus, 98.6% said fever, 91% answered cough, 85.9% said shortness of breath, and 39.9% stated diarrhea. Other symptoms cited by the dentists were vomiting (32.3%), runny nose (36.1%), sore throat (28.5%), red eyes (7.6%), skin rash (5.7%), and joint or muscle pain (1.9%). Only 34.5% answered “may present with no symptoms.”
When asked about the mode of transmission, 90.5% said coughing and sneezing, 85.6% answered hand shaking, and 93.2% stated touching surfaces like doorknobs and tables. 96.2% of dentists said frequently cleaning hands with alcohol-based hand rub or soap and water can prevent coronavirus transmission. 94.3% said routinely cleaning and disinfecting surfaces in contact with known or suspected patients can prevent transmission and 92.9% said the virus can be prevented with PPE such as dental goggles, masks, and gloves.
Other preventive measures mentioned by the dentists were putting facemasks on known or suspected patients (88.3%) and avoiding moving and transporting patients unless it is necessary (84.2%). 82.6% said that all health staff members should wear protective clothing to prevent infection while 77.2% said that placing known or suspected patients in adequately ventilated single rooms can prevent infection.
Regarding the dentists’ perception of COVID-19, 17.7% deemed the virus as very dangerous, 71.7% saw it as moderately dangerous, and 9.5% saw it as not dangerous. However, only 36.7% said that the virus is not a serious public health issue. On the other hand, 97.8% said that it is important to educate people about the virus to curb the spread of the disease.
When asked about their attitude toward the treatment of patients with the virus, 55.2% said that the symptoms often resolve with time and don’t require any treatment. 74.7% said it was necessary to ask patients to sit far from each other, wear masks in the waiting room, and wash hands before sitting on the dental chair to minimize disease transmission. Moreover, 21.7% stated that it was not necessary and could cause panic. Meanwhile, only 82.6% of dentists mentioned that they prefer avoiding working with a patient with a suspected case of COVID-19.
43.8% said they would refer the patient to the hospital without treating them, 4.6% stated they would refuse treating the patient and ask them to leave the clinic, and 49.5% said they would treat the patient and ask them to go to the hospital. Further, 32.3% answered that they would allow any of their dental staff to work with patients if they exhibit flu-like symptoms.
Only 58.2% mentioned that they know whom to contact if there has been an unprotected exposure to a patient with known or suspected COVID-19. Alternatively, only 75.8% said that they know what to do when they exhibit signs of COVID-19. Regarding the dentists’ role in disseminating information and increasing awareness, 67.7% reported that their role in teaching others about the virus is very significant while 25.5% said it is moderately significant.
The New Norm of Dentistry
Jenna Smith, RDH of LLM Dental Associates in midtown Manhattan explained that the most important rule she learned in school was using Universal Precautions when treating patients. Dentists and hygienists are at risk of infection, and they should be placed on equal footing as other frontline line workers such as doctors, respiratory therapists, and nurses.
She emphasized that it is important for dentists to treat patients as if they are infected when attending to their needs. However, dental staff can minimize their risk of infection by wearing the proper PPE and adhering to OSHA rules and regulations for sterilization and disinfection. With regard to COVID-19 testing, Gabriela N. Lee, DDS, of LLM Dental Associates in midtown Manhattan said that she would love to test herself, her team, and her patients for active COVID-19, including antibodies to see their status before treatment.
As of this writing, dentists are not legally able to give such tests. Still, most patients are hesitant to visit a dental clinic unless it’s for emergencies such as swelling, intractable bleeding, or unrelenting pain.
Advice for Patients Who Need Immediate Dental Care
You should see a dentist if you are experiencing swelling or pain in your mouth, stated Mary-Jane Hanlon, associate dean for clinical affairs at Tufts School of Dental Medicine and president-elect of the Massachusetts Dental Society, as quoted by Laurel Wamsley and Pien Huang of National Public Radio, an American media organization.
But some dentists are not seeing emergency patients because they themselves have underlying conditions that make them vulnerable to COVID-19, Hanlon added. You should call your dentist if you are in pain, however, you may be referred to another dentist that caters to emergency care. Don’t go to the dentist if it is not an emergency. You can check the American Dental Association for a list of dental issues that can wait and those that can’t. “Believe it or not, there are patients getting upset with us because we can't they can't have their teeth cleaned, but we just can't take the chance,” Hanlon explained.
Upon visiting your dentist, expect them to ask if you have COVID-19 symptoms. You will also be asked to wear a mask and gloves and use a hand sanitizer. Don’t go into the office until your dentist tells you to do so. Hanlon reminded, “What we're trying to do is make sure we stagger appointments and have adequate time to clean up between patients."
Dentists and hygienists should be put on equal footing as other medical professionals. Since they are at risk of contracting the virus, dental appointments should only be reserved for emergency treatment.