Most dental healthcare facilities have opened for elective procedures.  The re-opening of dental practices has come after many weeks of preparations and with guidance from local and state officials yet there is still controversy over whether it is safe to return to routine dental care.  The American Dental Association’s (ADA’s) Advisory Task Force on Dental Practice Recovery has released interim care recommendations for dental practices during the COVID-19 pandemic. The American Dental Association President Chad P. Gehani, D.D.S. recently made a statement, “Oral health is integral to overall health,” as a response to the World Health Organization’s suggestion to delay routine dental care.  He stated, “Dentistry is essential health care because of its role in evaluating, diagnosing, preventing, or treating oral diseases, which can affect systemic health.”

Patients receiving cancer treatment therapy are often at risk for oral complications, I am hoping the information that I provide you with will help you understand what the dental profession is doing to protect their patients and staff during the COVID-19 Pandemic.  If you are an active cancer therapy patient, always refer to your treatment team before starting a dental procedure, especially during this time. Some cancer treatments such as chemotherapy can weaken your immune system and may increase your risk for severe illness from COVID-19. 

Due to the evolving understanding of the world’s knowledge of SARS-CoV-2, it is expected that more recommendations may come forward that might change how dentists deliver care.  Please keep yourself well informed and in good communication with your physicians. 

What should you consider before returning to routine dental care?

  • Are you cleared for dental procedures by your oncology or hematology team?  This is the most important consideration.
  • What is the transmission rate in my area?  A transmission rate of 1.0 means that each person who has the virus passes it to one other person, while a rate below 1.0 means that the virus is spreading to fewer and fewer people.  
  • Does the benefit of you receiving treatment outweigh the risk? A simple cavity could turn into a more serious infection.

What changes might you see in the dental practice?

  • Screening for symptoms of COVID-19 before each appointment and when you arrive.  Treatment will be postponed if you have symptoms that could indicate the virus.
  • You may be asked to sign an informed consent prior to being seen.  Informed consent is used to ensure that you are armed with the facts needed to make decisions before accepting treatment. 
  • Some offices will use your car or a spot outside the office as the waiting room.  Some city offices will have you sit in the waiting area, if this is the case, you will be placed at a safe distance and asked to keep your mask on.  Most offices have staggered the start time of their appointments to limit the number of patients in the waiting area at one time.  
  • Waiting rooms may have been cleared of magazines and decluttered to help keep the area clean.
  • You may find the temperature in your dental practice cooler than normal. Consider bringing a sweater if your body runs cold.
  • You will be required to wear a mask while in the office area and immediately after procedures and checkups, always keep your mask close by.
  • You will see a plastic or glass barrier between patient and reception staff.
  • The use of powered tools may be limited, and when in use there will be high powered suction in place.   
  • A rubber dam may be used for certain procedures when possible to limit aerosol production. This is a small latex sheet placed in/around the mouth so that only the area being worked on is exposed.
  • Air purifiers have been added to treatment rooms to help reduce airborne particles.

What extra precautions can you take?

  • Immediately after your appointment, wash your hands and use a hand sanitizer when washing is not available.
  • Keep your mask on your lap or close by so that you can put it on once your treatment and exam has ended.  You can wear your mask while talking with the staff before treatment.
  • Your dental team may ask you to do a preprocedural rinse (rinse your mouth before they begin) to help cut down on the aerosol particles.    
  • Regularly check the CDC’s Interim Infection Prevention and Control Guidance for Dental Settings.  The “What’s new” page will provide you with regular updates when they are available.

About the author: Kimberly Meehan, RDH, is a practicing dental hygienist in Philadelphia, Pennsylvania.  She is a 1994 graduate of Community College of Philadelphia’s Dental Hygiene Program. Kimberly is also CEO and dental hygiene consultant for KMC Hygiene.  She is married to her husband James, who works for the Naval Surface Warfare Center Philadelphia Division, and serves in the United States Air Force Reserve.  They reside in Brooklawn, New Jersey, where Kimberly is chairmen of the Planning and Zoning Commission.  In her spare time, she enjoys running, cycling, CrossFit training, skiing, relaxing on the beach, and pageantry.  Kimberly is the former Mrs. New Jersey International 2008, and she currently is a co-director of the New Jersey International Pageants.