Is It Safe to Go to the Dentist Again?
At Dr. Todd Bertman’s office, the receptionist wears a plastic face shield. So do the hygienist and the nine doctors in the practice in Manhattan’s East Village.
Dr. Bertman reopened the office two weeks ago after closing it in March in response to the coronavirus pandemic. In another change from the past, he has switched from ultrasonic cleaners that spray water and saliva into the air to laser instruments.
The dentists and hygienists wear head-to-toe personal protective equipment that they change between appointments, a time-consuming, awkward ritual that requires them to take off booties, gowns, goggles, masks, gloves and the shields and replace them with clean ones.
“It’s like changing out of a spacesuit,” Dr. Bertman said. “It’s annoying as hell but this is what it kind of comes down to until we find a vaccine.”
As of June 19, every state had allowed dentists’ offices to reopen for all procedures, according to the American Dental Association, which surveyed thousands of dentists earlier this month and found that patient volume is at nearly 60 percent of what it was before March 15, when dentists were told to shut down except for emergencies.
James Famularo, a real estate broker in Manhattan, said he was desperate for a cleaning after three months of eating too many sweets and indulging in alcohol. He recently returned to Dr. Bertman’s office, where the dentist told him there was “a lot more shmutz” on his teeth than usual.
“I asked Dr. Bertman, ‘What’s all this extra digging that I’m not used to?’” said Mr. Famularo, 51.
His teeth, he said, now feel “squeaky clean.”
But should patients take the risk? When surveyed by The Times, many epidemiologists have said they were comfortable returning to their doctors. Health specialists said neglecting routine dental care was unwise. Some also noted that it is the dentists and hygienists who are more at risk of getting sick since they are the ones on the receiving end of any aerosol droplets that could contain the virus.
“All that drilling and suctioning, it’s the provider, it’s not the patient, getting aerosolized secretions,” said Laurie Anne Ferguson, dean of the College of Nursing and Health at Loyola University New Orleans and a nurse practitioner.
The American Dental Association has made a series of recommendations including advising patients to wear a face covering when they come in, having them wait outside or in their car until the dentist is ready to see them, removing magazines and toys from the waiting area, and placing hand sanitizer throughout the office.
Getting the first appointment of the day may also limit risk, though many dentists said they are seeing fewer patients so they have more time to disinfect rooms between visits.
Still, other health experts, including dentists, said they were skeptical about going to the dentist for anything that is not urgent, like an abscess, especially in the many parts of the country where coronavirus cases are rising.
“For everything that we’re doing, we need to ask if it’s really necessary,” said Peter Jüni, an epidemiologist at the University of Toronto and St. Michael’s Hospital. “We want to make sure we don’t contribute to transmission.”
Dr. Neetu Singh, the oral health program director at Health Care For All in Boston, said for now people should use telehealth or call the dentist first for a consultation, then assess whether to come in.
“A remote conversation is probably the wiser step to take at this juncture,” she said.
But Professor Ferguson said her experience treating patients during the pandemic had made her feel reasonably secure visiting the dentist.
If a dentist is taking proper steps, like wearing protective gear and seeing fewer patients, people should feel confident, she said.
“None of us like to go to the dentist and we’ll use any excuse not to go,” Professor Ferguson said. “But there is growing preponderance of evidence that our oral health is very much connected to our overall health.”
Dr. Bertman said his staff had been tested for the virus and the results had all been negative. He said to reduce the risk of transmission he had scaled back the number of the treatments the office normally offers, including cleanings.
Dr. Eli Eliav, director of the University of Rochester’s Eastman Institute for Oral Health in New York, which provides dental care for low-income patients and people with complicated medical needs, said patients coming in for invasive procedures must be tested for infection at least three days before their appointment
The office has set up tents for waiting outside the facility and extended its hours so doctors can see more patients and adhere to social-distancing guidelines at the same time.
“And we’re adding more time between patients to be able to disinfect the room,” said Dr. Eliav, whose institute remained open. “I understand why people are anxious and concerned. That’s part of our job — to make sure that people are comfortable coming back.”
Dr. Tim Lahey, an infectious disease specialist at the University of Vermont, said he believed now was not the time for people to “come face to face with someone you don’t know.”
But those who feel they must return should ask a lot of questions, he said.
“Are they being clear about people not coming in if they have symptoms? Are they being strict about wearing masks? Are they making sure that the person who works on you is wearing a face shield and a mask?” Dr. Lahey said. “These are probably a few highlights that people should be looking up.”
Mr. Famularo, the Manhattan broker, said he served as the “guinea pig” for his family and was comfortable with his two sons and wife going to the dentist after seeing the precautions Dr. Bertman took.
“I felt like even if somebody had something, I wouldn’t be infected,” he said.