Is it safe to go to the dentist right now? Here’s what the experts are saying
For months after the COVID-19 pandemic hit the US, dental offices around the country closed their doors. Now that many practices have reopened, the World Health Organization (WHO) is advising people to avoid routine, non-essential dental work until transmission rates drop more.
“WHO advises that routine non-essential oral health care – which usually includes oral health check-ups, dental cleanings, and preventive care – be delayed until there has been sufficient reduction in COVID-19 transmission rates from community transmission to cluster cases,” the warning stated. “The same applies to aesthetic dental treatments. However, urgent or emergency oral health care interventions that are vital for preserving a person’s oral functioning, managing severe pain or securing quality of life should be provided.”
The guidance comes from growing concerns around coronavirus spread through tiny respiratory droplets or aerosols.
“The coronavirus that causes COVID-19 spreads through respiratory droplets. That’s what flies through the air when someone coughs or sneezes,” WebMD reported. “If another person breathes this in, they can get sick. It’s also in the mucus and saliva in your mouth and throat. Those are fluids your dentist and their tools easily come in contact with. Some dental devices can spray these droplets around.”
Michele Neuburger, a dental officer for the CDC’s Division of Oral Health and a member of the CDC’s COVID-19 Response Infection Prevention Control Team, echoed this, saying dental office settings need to take specific considerations into account when controlling infection spread.
“Dental health care personnel use instruments such as dental [drills], ultrasonic scalers, and air-water syringes that create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris,” Neuburger said.
According to Harvard Health Publishing’s coronavirus resource center, aerosolized droplets can remain suspended in the air for up to three hours after a dental exam. This means it’s extremely important to fully sanitize and disinfect equipment, as well as take every necessary precaution to prevent infection spread.
General dentist and speaker on workplace culture Kyle Bogan said he feels people should be getting back to the dentist office, as oral care is an important essential need.
“It’s important for people to get back to the dentist for routine treatment,” he said. “The virus can give some people a reason to stay away, so it’s critical for dental practices to do all the right things to mitigate risk.”
Can the risk be managed appropriately in a setting where up close, face to face interaction is unavoidable? Bogan said he thinks it’s possible with the right practices in place.
“Dentists have always prioritized safety, but now we’ve significantly ramped up our precautions and standard practices because we want both patients and workers to feel comfortable during a time of great uncertainty,” Bogan said. “After three months of being able to handle only emergency cases because of the pandemic, we understand the challenges as we reopen for elective and preventative care. The experience, knowledge and concern for patients that oral care workers bring to their positions is especially important at this time.”
The WHO’s dental chief Benoit Varenne agrees that dental care is important, noting that oral disease is a problem in many countries.
“At the global level, last estimates that are available show that 3.5 billion are affected by oral disease,” Varenne said. “Untreated dental caries in permanent teeth is the most common health condition in human beings.”
However, there are still too many unknowns to confidently say that it’s safe to return to the dentist office.
“The likelihood of COVID-19 being transmitted through aerosol, micro-particles or airborne particles … today I think is unknown, it’s open to question at least. This means that more research is needed,” Varenne said.
Both the WHO and the Centers for Disease Control and Prevention (CDC) advise that, if you are accepting patients, it’s important to pre-screen for appointments when possible, to make sure risk is limited.
“Provide dental treatment only after you have assessed the patient and considered both the risk to the patient of deferring care and the risk to dental healthcare personnel and patients of healthcare-associated SARS-CoV-2 transmission. Ensure that you have the appropriate amount of personal protective equipment (PPE) and supplies to support your patients. If PPE and supplies are limited, prioritize dental care for the highest need, most vulnerable patients first – those at most risk if care is delayed,” the CDC warned.
Dr. Bogan listed some additional protocols being implemented as offices reopen, including:
- Waiting outside until appointment time, to avoid wait room crowding
- Temperature checks upon arrival
- Proper personal protective equipment for attending staff, including face shields, N95 and KN95 masks, goggles, and disposable gowns
- Proper air ventilation and ultraviolet lights to reduce aerosol exposure
- Diligent hygiene and cleaning before and after contact with patients, contaminated surfaces or equipment, and after removing PPE
The good news is that both the World Health Organization and the CDC have reported no confirmed cases of COVID-19 transmitted in a dental office so far. So, talk to your doctor about what safety procedures are in place, and assess what needs medical attention right now versus what could wait a little while longer.