By Michael Forde, DDS, MS
Late this summer, the World Health Organization (WHO) advised that so-called “non-essential” oral health care—which usually includes dental checkups and cleanings—be delayed until there is a significant reduction in COVID-19 transmission rates.
While it is correct that patients need to manage COVID-19 risk and should prioritize emergency care, the WHO’s guidance ignores that dental professionals have always taken significant measures to provide a clean, safe environment–and have since doubled-down with strict safety procedures that go beyond the Centers for Disease Control and Prevention (CDC) infection control guidelines for COVID safety.
More importantly, the greater risk of the WHO’s guidance is that it reinforces people’s bad habits when it comes to regular dental checkups. Incorrectly classifying dental care as “non-essential” makes people think it is not needed. Yet, dentists play a critical role in the early detection and treatment of serious systemic conditions. Indefinite postponement of preventative treatment can lead to the need for more drastic emergency procedures later.
I have seen it. For more than 6 years as the lead Prosthodontist at ClearChoice Dental Implant Center in Roseville, CA, I have provided dental implant treatment for people with chronic dental issues. There are many serious problems that start in the mouth that can become worse when oral health is ignored. During this pandemic, the last thing people want is one more potential health issue.
Once people come to me it is often because their lives have been seriously affected by oral health problems that could have been avoided. While I am delighted to be able to restore their smiles and help them reclaim their lives–and always hope people will come to one of the 64 ClearChoice centers across 27 states if they need help– prevention is key.
People don’t always think of dentistry when they think about their overall health, but the scope of dental care goes far beyond teeth cleanings, braces and cavities. For decades, the medical community has recognized the “oral-systemic link,” the strong connection between oral health and overall health.
Periodontal disease has been associated with a number of health conditions, including heart disease and diabetes, pregnancy-related complications, osteoporosis, Leukemia, oral cancer, pancreatic cancer, and kidney disease. For example, a sign of diabetes is bad breath and bleeding gums, initial stages of osteoporosis bone loss are often identified in dental x-rays, and an oncoming heart attack can be foreshadowed by a sore and painful jaw.
In fact, according to the Academy of General Dentistry, “more than 90 percent of all systemic diseases produce oral signs and symptoms,” including swollen gums, mouth ulcers, dry mouth and excessive gum problems. For many patients, dental checkups are the most frequent health care they receive and where indications of potentially larger problems are more likely to be identified, making dentists key in diagnosing systemic diseases.
In a research brief issued by the Health Policy Institute and the American Dental Association entitled, “Majority of Dental-Related Emergency Department Visits Lack Urgency and Can Be Diverted to Dental Offices,” more than two million dental visits to the emergency rooms every year are due to dental issues. During the pandemic, the ER is not the place people with dental issues should be, both to manage their own risk, and because it is critical for medical community to stay focused on the fight against COVID-19. Dentists must be the first line of defense.
So, what should you do?
First, talk to your dentist. A simple conversation can help the dentist advise you on what care is needed.
Second, take advantage of new technology. Telehealth—where doctors use live streaming video— is growing by leaps and bounds, and many dentists have made virtual visits a regular part of their service. However, while telehealth can help doctors identify some obvious conditions, it is no substitute for an in-person exam.
Third, see for yourself. Patients should absolutely take precautions when it comes to their personal safety, but they should not assume that a dentist’s office is automatically high risk. In June, an MIT study of COVID-19 transmission risks and social benefits determined that dentists, were among the “most essential and safest businesses to visit during the pandemic.”
Dentistry has always operated as a safety-conscious profession, employing stringent infection control procedures and the use of personal protective equipment (PPE). In July, both the World Health Organization and the CDC said there have been no confirmed cases of COVID-19 transmitted in a dental office.
Office safety protocols you should be on the lookout for include social distancing in the office, temperature testing and symptom screening for all visitors, self-monitoring guidelines for staff, availability of PPE for patients and staff and enhanced room and equipment disinfection, to name just a few. Your dental professional should be able to provide you with full details on what they are doing to help keep you safe.
In the era of COVID-19, many elements of people’s regular routines that they take for granted have been canceled or put off indefinitely. Some of these, such as annual family vacations, summer sports leagues and going to the movies, are annoying but fall short of creating real hardship. When it comes to postponing healthcare—including dental care—however, the decision should not be made lightly because regular treatment really impact your overall health and how you fare in the pandemic.
Dr. Michael Forde is an accomplished lecturer and prosthodontist at ClearChoice Dental Implant Center in Roseville, CA. Dr. Forde earned his DDS from the University of Southern California School of Dentistry in 2003. His passion for advancing his education and honing his skills in the dental field led him to the Mayo Graduate School of Medical Education, where he received his certificate in prosthodontics and maxillofacial prosthetics. While at Mayo, he continued on to earn his MS in Biomedical Science. With more than 15 years of experience, when asked what continues to drive his passion for dentistry he replied, “The impact that you can have on a person’s life and wellbeing, to transform them through restored function is just incredible.”