IT COULD send the wrong message.
That’s what may happen with the World Health Organization (WHO) recommendation that non-emergency dental visits should be postponed in areas with high COVID-19 transmission rates.
That is, for patients to avoid routine dental procedures to slow the spread of COVID-19.
On Aug. 3 the WHO said going to the dentist be postponed until such time that COVID-19 transmission rates are reduced from community spread to cluster cases or when public health authorities so advice.
Emergency dental care is exempted to avoid more serious oral health issues.
WHO says checkups and cleanings should be postponed because dentists are exposed to saliva, blood and aerosols which may harbor the coronavirus.
The recommendation is valid. Dentists “work in close proximity to patients’ faces, for a prolonged period of time,” the United Nations highest health care body cautions.
Dentists are closely exposed to saliva and blood perhaps more than other health front liners except those in ICU and surgery rooms.
Still, the American Dental Association (ADA) disagrees. “Dentistry is essential health care because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can affect systemic health,” it says.
Dentists are also worried, and with good reason too. Routine visits may uncover symptoms of other diseases that first appear in the mouth – such as diabetes, liver diseases and cancers.
Delaying treatment may cause dental issues to get worse. Without a filling, a small cavity, for example, may become a dental abscess or infection. Then it becomes an emergency case.
Treating patients in dental clinics is always preferable to treating them in Emergency Rooms.
A virtual clinic is also possible for patients who are not comfortable in going to a dental clinic. That is, consultations can be made through the Internet, by email and by mobile phones and other social media devices.
Missing dental appointments could lead to even worsen oral health issues for both patients and the healthcare system in the long term.
“Our concern is if we continue delaying or postponing treatments the outcome will be very bad and it will be very difficult to catch up,” says Dr. Eli Eliav, director of the Eastman Institute for Oral Health in Rochester.
He believes there is no reason to return to the precautions taken in March when little was known about the virus and cases were going up. That was a time when lockdowns led to the suspension of dental procedures except for emergency cases.
Dr. Eliav says emergency treatments have more than doubled. “And one of the reasons is the delay people had with their treatments.”
The reason is that patients were missing out on important routine care, says Dr. Yan-Fang Ren, also of the Eastman Institute for Oral Health.
“Oral care is very important, so if you delay you will run into trouble,” said Dr. Ren.
“If you don’t do that routine check-up, bacteria will build up on teeth and gums, so gum infection or cavities will progress to a degree of pain and infection … you have to come to urgent care and a treatment much more complicated will be needed. You want to come in early, and prevent this from happening.”
“Oral health is integral to overall health,” says Dr. Jay Freedman, ADA President. “Dentistry is essential health care.”
He says dentists are familiar with many infectious diseases and are following safety protocols recommended by the ADA and the U.S. Centers for Disease Control and Prevention or CDC.
“There are about 40,000 publications about this disease, so we know a lot more, and we are pretty sure protective measures are very effective,” says Dr. Ren.
In the United States many dentists designate parking lots as waiting areas before patients, pre-screened for COVID-19 symptoms, are allowed inside clinics.
Dentists, the clinic staff and patients are all screened with health checklists such as a temperature check.
There is air filtration and even high-speed suctions that capture 97 percent of aerosols generated during dental procedures.
Dentists and dental staff wear extra Personal Protective Equipment, all use N95 respirators with facial masks on top, hair covers, face shields and gowns. Rooms where procedures are conducted are routinely disinfected.
The bottom line, dentists advice, is for patients to take good care of their teeth and gums by following good oral health habits such as regularly brushing and flossing the teeth.
***
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 or text 0917-8591515./PN
