THE PANDEMIC has changed our world in so many ways, in profound ways that we can only start to fathom.
And so it is with oral health.
‘’One year after the first lockdowns dentists around the world confront the consequences of the COVID-19 pandemic on people’s oral health: higher incidence of tooth decay and more advanced gum disease,’’ says the Fédération Dentaire Internationale (World Dental Federation or FDI).
The FDI represents over one million dentists in 200 national dental associations and specialist groups in over 130 countries.
One year into the pandemic, FDI councilors and members say they are ‘’seeing first-hand the catastrophic aftermath of the virus on the health of people’s teeth and gums in dental practices around the globe.’’
While skipping twice-daily toothbrushing may have been common pre-pandemic, the long lockdowns has prompted snacking between meals at home (and not brushing after) and not visiting the dentist due to transport constraints and protocols; in the Philippines, minors and elders are not allowed outside unless very necessary.
“Let’s call it for what it is – a dental disaster,” said Dr. Gerhard Konrad Seeberger, President of FDI, the Geneva-based international group of dental professionals.
Restrictions have played a part in oral health hesitancy but, he pointed out, ‘’they don’t tell the whole story.”
During the first wave of the COVID-19 outbreak, dental practices around the world were forced to close. For two to three months, all dental appointments had to be postponed or cancelled, except for urgent emergency treatments.
The World Health Organization reported that oral health services were among the most affected essential health services because of the COVID-19 pandemic, with 77 percent of countries reporting partial or complete disruption.
Between the first and second waves, dental practices in many countries were able to reopen.
Dentists, who have always abided by the most stringent infection prevention and control protocols before, have now revised hygiene measures mandated by governments during the COVID-19 pandemic.
So much so that, according to the FDI, a recent survey indicates oral health professionals have significantly lower SARS-CoV-2 infection rates than other healthcare workers in most parts of the world.
Despite this, many people have still avoided routine check-ups and only visit the dentist once they are in extreme pain. Many have developed advanced tooth decay and related complications, including infections, which makes treatment more complex.
Professor Paulo Melo, an FDI Councilor who teaches and practices dentistry in Porto, Portugal, has seen a dozen of high-risk patients who were afraid of being infected with COVID-19 and postponed their appointments.
High-risk patients are encouraged to have a dental check-up every three to six months. Instead, many patients have waited nine months to a year, or more, between appointments. Many have reported severe toothaches and complications, leading to extractions for some and root canal treatments for others.
“During the pandemic, high-risk patients have tended to develop more than one problem, often exhibiting three or four at the same time because too much time has gone by without a check-up,” said Dr. Melo, pointing out that problems typically include gum disease and dental caries, or tooth decay.
“Dental caries that could have been treated with a simple restoration have now gone to the stage of more sophisticated treatment,” said Dr. Vanishree MK, a Professor in Public Health Dentistry in Bangalore, India. “Patients should set aside their fear and not postpone essential, routine dental treatment.”
“One of the dramatic consequences of the pandemic is that oral health issues that were not considered urgent during the outbreak of the pandemic did in fact became urgent after having to wait two months to seek treatment,” said Dr. Maria Fernanda Atuesta Mondragon, President of the Colombian Dental Federation and FDI councilor.
“Teenagers usually suffer from dental caries, and I’ve observed an increasing level of tooth decay in this age group,” said Dr. Nahawand Abdulrahman Thabet who practices in Cairo, Egypt, and is an FDI councilor. “A 15-year-old patient of mine admitted he had been snacking more while stuck at home since the closure of his school. I imagine thousands of kids his age are in a similar situation.”
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Dr. Joseph D. Lim is the former Associate Dean of the UE College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN
