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June 5, 2020

As many businesses and daily activities reopen, many South Carolinians may be rescheduling missed dental appointments or planning for upcoming trips to the dentist.
 
Dr. Julia Mikell, president of the South Carolina Dental Association, wants South Carolinians to know dentists are ready to take care of patients safely.

Are there risks going to the dentist right now?

I don't so much see the question to be "what are the risks?" but "how are you protected when you're at the dentist’s office?" Dentists have always been focused on infection control. The professionals you're going to be close to will have on a mask, gloves, a gown and probably a face shield. They're going to have a clean room and you're not going to be standing around with anyone who isn't protected.

How has COVID-19 changed dental care?

Dentists’ offices have always had a high level of infection control. Standard practice before COVID-19 required the use of a mask and gloves and disinfecting surfaces and instruments. What has changed is that for certain procedures we wear face shields as well as masks.

Other things that may be different:

  • You may be asked to stay in your car rather than in a waiting room.
  • You may be screened before scheduling or coming in for an appointment to verify that you do not have symptoms of COVID-19 such as fever or cough.

 
We have probably spent the most time over the last four or five weeks thinking through re-opening our practices on the question of "how do we do dentistry safely during coronavirus?" Because coronavirus is not going away anytime soon. And we have an ethical responsibility to take care of our patients.

Should people go to their dentist right now?

Absolutely. At first, we were asked to only see emergency and urgent care patients. And to a dentist, what that means is to only see people who are in pain that can't be controlled with some kind of over-the-counter pain medicine. Or, you see people who have an infection that can't be controlled with antibiotics. That kind of criteria holds up for a week or two.

After that, you get to a different definition of the type of care that patients need, which is also referred to as medically necessary care. That's when you start to talk about cavities that aren't hurting yet but are continuing to grow. We don't want to wait for it to start to hurt. We want patients to get taken care of before they have symptoms. Because when you wait for symptoms, you have waited for the problem to grow. That often means you have to choose between a root canal or loosing a tooth.

So, should people be going to the dentist? Absolutely. Should they trust their dentist to determine if it's the right time for them to come in? That's the best thing to do at this time. Dentists will be asking patients to communicate their concerns – whether concerns about the risk of coming in or concerns about risks of postponing dental care. Communicate, and trust your doctor’s decisions in this situation. They're looking out for all of their patients health and safety.

Who shouldn’t go to the dentist right now?

The people who should not go to the dentist’s office are those who can't pass the screening questionnaire. So, people who have a cough or cold or flu symptoms or people who have been traveling in areas that have high risk. People with high risks — such as heart disease, respiratory disease, autoimmune disorders and even diabetes — should seriously consider postponing a dental visit.
 
Diabetes is a complicated category and there is no one right answer. Some people manage their disease well and others have a harder time keeping their diabetes controlled. It’s very important for people with diabetes to make sure they don't get a dental infection because they have a harder time fighting off infections. On the other hand, those individuals may also be more at risk to contract coronavirus and have a complication.
 
The screening process is about trying to reduce the risk for people to contract it and for people to spread it. Currently we don't want to encourage somebody with respiratory disease or heart disease to come out at all, much less to come to a dental appointment, unless they have an an urgent dental need. 
 
If someone with heart disease, for example, has an emergency or urgent need, then we're going to find a way to see them that will be safest for them — first thing in the morning as the only patient in the office. If somebody has coronavirus symptoms and they have a dental emergency, then they have to go to the hospital emergency room.

What advice do you have for anyone who is high risk or is maybe unsure about going to the dentist right now for taking care of their teeth at home?

My advice to them is really just good, old-fashioned preventive dentistry, which means brushing at least twice a day with fluoride toothpaste, flossing at least once a day, avoiding sugary foods and eating healthy foods.

For individuals going to the dentist now, any advice for the visit?

People probably need to be patient and understanding that their visit is likely to take a little bit longer than it used to. They should know that their dentists are probably working a limited schedule. Understand they may be asked to stay in their cars and not the waiting area. They will probably be asked to have their temperature taken and asked to wear a mask in the office when they are not having dental work done.

For anyone who may be feeling unsure about going to their dentist for routine care, what would you say to them?

People who are concerned need to communicate with their dentist and talk about what they're afraid of. It's really a matter of communication. Trusting that you express to your doctor what you're afraid of, but knowing that if you put things off, it could backfire on you. We're talking about your health. Getting regular cleanings is not something you choose to do just because you want to. You do it because you want to be healthy. I don't want people to put off their dental treatment strictly out of fear. I would like for them to talk to the dentist and decide if it's wise to postpone it or wise to try to get it done.

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