Since many dentists closed their doors to routine cleanings and exams in response to the COVID-19 pandemic, many patients were left wondering what the office would look like upon their return. “The dental industry has been particularly impacted by the COVID-19 pandemic, and those effects will continue to be seen and felt for months to come,” says Dr. Kyle D. Bogan, DDS.
Now that many dental offices are open across the country, prepare yourself for a lot of new preventative protocols to ensure safety for patients and staff. These steps are driven by recommendations from the American Dental Association, the Occupational Safety and Health Administration and the CDC.
If you’re due (or overdue!) for your bi-annual checkup, you may be worried about what you’ll be exposed to. “It’s important not to sacrifice your oral health for fear of COVID-19,” says Dr. Charles Sutera, FAGD. “Remember, your mouth is a critical part of your overall health and ability to ward off disease. The bacteria that build up in tartar, which can only be removed with special scaling tools, can create a number of oral health issues that, left untreated, can move on to infect other parts of the body. If you put off routine dental cleaning and checkups during the lockdown, schedule an appointment so you can get back on track to protecting your overall good health.”
It’s up to you to decide what risk you’re comfortable with. Here’s what you can expect before, during and after your appointment.
BEFORE YOUR APPOINTMENT
Many dental offices will space out appointments to minimize interactions between patients. “With the backlog of patients, many patients are finding that it is more difficult to get in to see their providers,” says Bogan.
Once you're scheduled, you’ll probably receive a phone call before your appointment to discuss any concerns and answer pre-screening questions (be prepared to answer them again when you arrive). You’ll be told to wear a mask, or will be told if the office will provide you with one. Since it takes much longer to disinfect the office between patients, expect delays.
WHEN YOU ARRIVE
If you were planning to have someone join you for your appointment, they will likely have to wait in the car, as reception areas are being limited to patients. Many dentists are requesting that patients call when they arrive, to limit exposures to others in the waiting room. Once you are in the waiting room, you’ll likely find that it has been modified for social distancing guidelines. All magazines, reading materials, game stations, water coolers and other objects that may be touched by others may be removed. “Changes to a dental appointment will go beyond the waiting room, as dentists are among the health care providers at the highest risk of transmitting COVID-19,” says Dr. Sean Boynes, DMD. “Because they’re working in people’s mouths, they need to take every precaution necessary to keep themselves, their staff and their patients safe.”
Upon entrance, you will have to use hand sanitizer and/or wash your hands. There may also be a paperless check-in using their smartphones or an office iPad. Dental professionals are conducting temperature checks with a touchless thermometer and completing patient screening questionnaires. Many dentists, hygienists and office staff across the country are also having their temperatures taken daily. You may be asked to leave your personal items in a car or place them in a locker, if they exist.
IN THE PATIENT CHAIR
Although you’ve been in your mask until this point, you’ll have to remove it during the exam. Before your dentist or hygienist starts treatment, you’ll be given a hydrogen peroxide rinse to reduce bacteria in your mouth and possibly decrease the spread of the virus. Your dentist, hygienists and staff will be wearing extensive layers of personal protective equipment, like face shields, N95 masks, antimicrobial scrubs, gloves and disposable coats.
One of the key words you’ll probably hear from your dentist is “aerosol.” Many dental instruments can produce aerosols, which are a mix of air and water from the patient. Since aerosols can be suspended in the air, many dental professionals are only using hand instruments to limit aerosol production.
A dentist may also use new extra-oral suction devices to capture airborne particles and control exposure. “I believe you will start to see this technology implemented at more offices in the near future, as dentists make greater investments in patient and staff safety, says Dr. Mitchell Josephs, DDS. “The extra-oral suction, which resembles the end of a vacuum cleaner with a clear funnel shaped attachment positioned just outside the mouth, removes these aerosols to prevent them passing between doctors and patients.”
You might find that your dentist is doing cleanings and procedures differently. “We're also utilizing our laser dentistry tools, instead of drills, for all applicable procedures, such as fillings,” says Dr. Izzy Naem, DDS. “The good thing about lasers is that they produce fewer aerosols, and thus create less opportunity for germs releasing into the air. Lasers are also quieter and virtually painless, which is awesome, but patients who are used to the drill might be confused. Your dentist should explain beforehand, but don't be afraid to ask.”
AFTER THE APPOINTMENT
Although you’re on your way out the door, there is a lot that happens to keep the office sanitized. “What you're not seeing is that after your appointment, we wipe down the entire treatment room (as we did pre-COVID-19), and then we are cold fogging the room with hypochlorous acid, a very safe and effective cleaning agent, to ensure that any potential virus particles are killed,” says Dr. Stacey Cohen, DMD.
Once you return home, you may receive a post-visit call from the dental office to check on your health, and also inform you if any cases were traced back to the office. Also, be prepared for long delays if you have dental insurance. Many of those companies have laid off or furloughed the employees who would be processing your claim.
WHAT’S HAPPENING BEHIND THE SCENES?
The technology being used to keep a dentist’s office safe is fairly advanced. Many dentists are implementing UV-C in their air conditioning systems and using air purifiers that clean the air with state-of-the-art technology. Some dental offices are also using germicidal UV sanitation lights, which can be moved throughout the office to sterilize rooms and clothing. “The first thing I did was buy medical-grade air filters for each of our rooms,” says Dr. Bobbi Stanley. “The filters turn over the air in the room every 20 minutes. This ensures that the aerosols from a previous patient cannot infect the next patient.”
YOU MAY BE SURPRISED
Some patients across the country are reporting that their dentist required them to sign a form releasing the dentist of any liability. This is not a national mandate, but you may need to seek care from another provider if you are uncomfortable with this request.
Some dentists are asking their patients to help cover the costs of protective gear, new machines and costly sanitation technology. This PPE fee can range from $10 to $40, and is generally not covered by insurance. “As in any other service industries, such as fast food, the rising costs and difficulty of obtaining PPEs has driven dental offices to raise prices to stay afloat,” says Dr. Mary Pham, D.D.S, M.S. Aside from the PPE fee, rates for treatment may have also increased. It’s a good idea to ask your doctor before your appointment.
If you’re still wondering if you should put off your appointment, have a conversation with your dentist. The more you ask, the more you'll learn about what they're doing to protect you, and the more you'll feel comfortable. On the other side, you could discover some red flags that make you hold off awhile longer.
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