COVID 19 & Dental Health - Dentist Trips & Protections to Take

COVID 19 & Dental Health - Dentist Trips & Protections to Take
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COVID 19 & Dental Health - Dentist Trips & Protections to TakeClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. Current State of COVID-19 in the U.S.
  2. Is COVID a Threat to Your Oral Health?
  3. What to Expect at the Dentist’s Office
  4. Are Extra Precautions Needed During Orthodontic Treatment?
  5. Should You Put Off Dental Procedures Due to COVID-19?
  6. Resources to Learn More
  7. References

The COVID-19 coronavirus pandemic has changed, at least temporarily, the way Americans access dental care. Now that routine checkups pose some risk, many patients are choosing to delay treatment temporarily until conditions improve. However, this extra caution may not be necessary.

Dental care can currently be delivered safely with the proper precautions. In fact, it may be riskier to wait to see a dentist than to attend your appointments as usual. Your dentist knows what to do to minimize the risk of spreading COVID-19, including using proper personal protective equipment and avoiding procedures that generate aerosols.

Current State of COVID-19 in the U.S.

As of October 1, 2021, a little more than 100,000 new COVID-19 cases are being reported each day on average. Case counts are falling in comparison to previous weeks. 

More than 77 percent of Americans over the age of 18 have received at least one dose of an approved vaccine, and nearly 67 percent are fully vaccinated.

There is some concern that the protection offered by vaccination may be wearing off over time. This may be happening in part because the new Delta variant is significantly more contagious than the previous versions of the virus.

Health officials are still monitoring COVID-19 transmission levels closely. They recommend wearing a mask while indoors with others in high-transmission areas. They are not currently discouraging non-essential activities.

Is COVID a Threat to Your Oral Health? 

According to the American Dental Association, there is currently no reason to believe that COVID-19 has any significant oral health effects. While some uncommon oral health conditions have been noted in individuals who have tested positive for COVID-19, experts say that there is no verifiable link between the two conditions.

However, there is some evidence that good oral health may protect you from contracting a more severe form of COVID-19. In a study by McGill University, COVID-19 patients with gum disease (even mild forms) were found to be:  

  • 3.5 times more likely to require intensive care
  • 4.5 times more likely to be placed on a ventilator  
  • 8.8 times more likely to die as a result of the virus
The link between good oral health and COVID resistance has not been fully investigated. However, these findings reinforce the importance of maintaining good oral health even when dental care is less accessible than usual.

What to Expect at the Dentist’s Office 

Dentists are taking every possible precaution to ensure that they can continue to serve their patients as safely as possible.  

When you visit your dentist, you will be asked to wear a mask when not in the dentist’s chair. You will also be asked to stay home if you have any symptoms of COVID-19 prior to your visit, such as a cough or a fever. 

The staff in your dentist’s office will also be wearing masks during your visit. They may also wear additional personal protective equipment (PPE), such as: 

  • Gowns
  • Gloves 
  • Eye goggles  
  • Face shields 
  • N95 filtering masks

Certain dental tools generate aerosols, or clouds of spray that can pick up viruses and spread them across longer distances through the air. This includes high-speed handpiece drills that cool themselves using water sprays, as well as ultrasonic scaling devices that are used to clean tartar from teeth. 

Because using these tools poses additional risks, many dentists are avoiding them as much as possible. Your dentist may recommend waiting longer to fill any developing cavities than they would usually advise. Your dental cleaning will probably also be done using sharp metal scalers instead of ultrasonic tools.

Are Extra Precautions Needed During Orthodontic Treatment? 

Since aerosols are generated during the debonding process (removing the wire brackets from teeth), orthodontist appointments are somewhat risky during this pandemic.

In addition to wearing a mask and practicing good hand hygiene before and after your appointment, there are a few things that can help keep you and your dentist or orthodontist safe.

Using suction devices during the debonding process may help to contain some of the spray and limit the spread of the virus. Some studies also suggest that using a povidone-iodine mouth rinse before your orthodontist begins working on your mouth can lower the risk of disease transmission.  

Since it is difficult to purchase povidone-iodine outside of the healthcare industry, both of these precautions can only be initiated by your dentist or orthodontist. If you are worried about the risk of transmitting COVID-19, ask them if they are open to offering these things during your appointment. 

If you are interested in beginning orthodontic treatment and want to be as safe as possible during this pandemic, it may be a good idea to choose clear aligners over metal braces.  

Clear aligners do not need to be manually adjusted, so they require very few in-person appointments and no debonding procedures. This makes them arguably the safest way to receive orthodontic treatment in pandemic conditions.

Should You Put Off Dental Procedures Due to COVID-19? 

Because visiting the dentist does pose a risk at this time, many patients are waiting for the situation to improve to seek dental care. 

A September 2020 study published in the Journal of Dental Research found that:

  • 46.7 percent of respondents delayed going to the dentist during the early days of the pandemic
  • 74.7 percent were only due for a routine checkup, but 12.4 percent delayed seeking care for something that was bothering them
  • 10.5 percent delayed scheduled treatments for problems that had already been diagnosed

It is easy to understand why so many people are reluctant to visit their dentist at this time. However, this decision may be short-sighted. 

The longer you wait to undergo necessary dental treatment, the worse the problem will get. A cavity that currently only needs a filling may progress much more quickly than you expect it to. 

COVID-19 is dangerous, but dental infections are much worse. If you delay a dental procedure that you really need, you could put yourself at risk of a dental abscess or sepsis. Sepsis is a serious infection that can lead to death.

You may choose to put off elective dental procedures if you feel that the risk is too great right now. However, it is important to remember that no one knows how long the COVID-19 pandemic will last. With the proper precautions in place, elective procedures can be very safe and may still be worth your while even with a small risk involved. 

Only you can decide what level of risk you are comfortable with. Ask your dentist about what they would recommend in your situation, weigh the options, and make sure you are fully confident in whatever decision you make.

Resources

If you are interested in learning more about how COVID-19 is affecting dentistry in the United States, check out some of these resources for more information. 

  • The CDC publishes a weekly COVID-19 update with current case counts, vaccination numbers, and relevant public health recommendations.
  • This blog post by MouthHealthy (part of the American Dental Association) explains some of the COVID-19 precautions dentists are taking in further detail.

The American College of Dentists maintains a list of resources (including webinars, fact sheets, and other documents) to help dentists operate their practices safely during the pandemic. Even though this information is aimed at dental professionals, it can also help you learn what to expect at your dentist's office.

References

COVID-19 and Oral Health Conditions. (February 2021). American Dental Association.

Precautions and recommendations for orthodontic settings during the COVID-19 outbreak: A review. (May 2020). American Journal of Orthodontics and Dentofacial Orthopedics.

Dental Health. (February 2021). Sepsis Alliance.

Good oral health reduces risk of fatal outcomes from COVID-19. (April 2021). McGill University.

Aerosol generating procedural risks and concomitant mitigation strategies in orthodontics amid COVID-19 pandemic - An updated evidence-based review. (September 2021). International Orthodontics.

Dentistry Workers and Employers. (2021). Occupational Safety and Hazard Administration.

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic. (September 2020).  Journal of Dental Research.

COVID-19 Data Tracker Weekly Review. (October 2021). Center for Disease Control (CDC).

Activities, Gatherings, and Holidays. (August 2021). Center for Disease Control (CDC).

COVID-19: What to Expect at Your Dental Appointment. (2021). MouthHealthy.

COVID-19 Resources. (2021). American College of Dentists.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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