Helping Our Dental Patients Through the Coronavirus Crisis

As this coronavirus situation has unfolded, all of us – myself, Ken and Alla –have been faced with questions from patients every day about handling their dental appointments and needs since the stay-at-home measures went into place. We hope that by sharing the answers to the most common questions that you’ll feel more confident in dealing with your dental health during this time.

Is the dental office open?

Currently, our office is closed until at least June 15th, which is based on Governor Cuomo's estimate, so this date is just an educated guess.

Dental offices are, however, allowed to see patients who are having an emergency only. At our office we are checking our voice mail daily; so, don’t worry if you should run into a problem – we can and will provide emergency care.  If for any reason we cannot see you within a reasonable amount of time, we will be happy to refer you to someone who can.

What is considered a dental emergency?

Dental emergencies, according to the American Dental Association, “are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding [or to] alleviate severe pain or infection.”  Simply put -- it’s about pain or trauma.

Some common dental emergencies include:

• Severe dental pain (most people think of this as a “toothache”)

• Pain from a wisdom tooth

• Post-operative pain from a dental surgery or procedure

• An abscess or localized pain and swelling

• A broken tooth resulting in pain or cutting your tongue or cheek

• A tooth being knocked out

• Dental treatment if a temporary crown or bridge is lost, broken, or causing gum irritation

Other emergency dental care includes extensive decay or defective fillings that cause pain, removal of stitches, denture adjustments for radiation/oncology patients, denture adjustments or repairs to address difficulty chewing, replacing a temporary filling on a tooth with a root canal if you are experiencing pain, and snipping or adjusting an orthodontic wire or appliance that is cutting your lips or cheeks.

The ADA has a terrific website for patients called mouthhealthy.org where you can download their guide to help you decide if you’re having a dental emergency.

What would be considered a non-emergency procedure?

Routine hygiene and cleaning appointments are considered elective procedures. A more complete list of elective or non-emergency dental procedures includes:

• Initial examinations (including x-rays)

• Periodic (six-month) checkups (also including x-rays)

• Routine dental cleanings and other preventive therapies

• Orthodontic procedures other than those to address a problem (e.g., pain, infection, trauma)

• Extraction of teeth that do not hurt (like having your wisdom teeth pulled)

• Fillings on cavities that aren’t causing pain

• Aesthetic dental procedures (such as whitening)

What about my dental checkup that was scheduled?

Once we are back in the office and allowed to go to work, we will call you to reschedule your appointment if yours was cancelled due to Governor Cuomo's Stay at Home Order issued.

What will happen when I get to the dental office with an emergency?

Your safety and reducing the possible spread of the virus between patients is of the utmost importance. We will ask questions, and for everyone’s safety you’ll want to answer honestly. These questions may include:

• Have you had symptoms commonly associated with COVID-19? (common symptoms include

fever, shortness of breath, dry cough, runny nose, or sore throat)

• Within the past 14 days have you travelled by airplane?

• Within the past 14 days have you been in close proximity (less than six feet) at a gathering of 10 or more persons?

• Within the past 14 days have you had close contact with a person who has been confirmed

positive or suspected to be positive for COVID-19?

In some cases, you may be required to sign a Patient Request for Treatment, Representations and Consent document. In others, just speaking with the dentist maybe enough. If we are comfortable with the answers to the screening questions and your condition does need emergency attention, then you will receive the appropriate treatment.

Even if you have what might qualify as an emergency, we will evaluate if a procedure can be

delayed until we officially open again. This judgment would be based on assuring that waiting won’t cause you undue harm or pain. An example is a lost or broken filling where a temporary filling can be quickly and easily placed, allowing you to return in the future for the more involved final filling.

What safety measures will the office take if I have to come in for an emergency treatment?

As health-care providers, we are trained on the CDC guidelines for infection control and using the appropriate personal protective equipment (PPE) such as mask and gloves. If for some reason we don't have appropriate PPE available, we'll refer you to another dental professional for your emergency treatment. In our office we don’t anticipate that happening and as of now we have a good supply of PPE. If we do need to provide emergency treatment, we’ll attempt to minimize the use of equipment that creates airborne spray. This is a precautionary measure to limit the potential spread of the virus since any patient could be positive but undiagnosed and not yet exhibiting symptoms.

We are aware of the latest ways to minimize the possibility of transmitting the virus, so we have added extra cleaning and disinfection protocols in our practice in response to the coronavirus. — e.g., in our office we are requiring every patient to use hand sanitizer upon entering. We’re disinfecting every doorknob and countertop. From the front desk to the treatment rooms everything is wiped down between patient visits and at the end of each day. We are going the extra mile to make sure every inch of the treatment areas and equipment are disinfected.

If I’m missing my checkup should I do anything differently?

Make sure you are brushing and flossing. Do everything as you would normally. It’s never been more important to do the best job possible to maintain your oral health. Since many of us will have extra time on our hands, make sure you brush at least twice a day for two minutes.

If you feel like you want to take extra steps to protect your hygiene during this time, here are a few ideas:

1) Use a powered toothbrush. such as a Philips SoniCare or Oral B Spin Brush

2) Use an irrigation device, such as a WaterPik

3) Use your favorite mouth wash. We always recommend any of the Listerine brands of mouthwash.

4) Floss – if you don’t currently floss it’s a great opportunity to start. You have the extra time and once you’re in the habit you’ll like the extra clean feeling while also strengthening your gums!

If I am in orthodontic treatment, will missing appointments cause harm?

The simple answer is “No.” Your teeth will just stop moving at some point. Once elective procedures are allowed again, treatment can easily be restarted, and your teeth will start moving from right where they left off. If you have aligners you may be able to have a teledentistry consultation and we may possibly send you your next set of aligners. Otherwise, continue to use your current aligner. Even though your teeth will generally stop moving after a week or two in the same aligner, it will act as a retainer holding the teeth in place until you can be seen for your next aligner.

As soon as the virus is under control and it is safe to return for normal dental treatment, we’ll be happy to welcome you back! If you still have questions or if you are unclear as to whether you need to be seen in the office, email us or call us.

Stay home, stay safe, and know that we’re here for you.

Yelena Shapiro, DDS