Dental care: Cautiously returning to a new “normal” for the foreseeable future

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By Lee Egerstrom

Putting health care on hold as precaution against the coronavirus pandemic was a balancing act for patients and medical specialists who had to weigh pain, obvious emergencies and routine medical checkups against what could be considered urgent or “elective” procedures or services.

Dentistry was among them. Full dental services are coming back.

Most dental clinics and practices either shut down completely or went into emergency standby mode as COVID-19 precautions earlier this year under state or local shelter in place rules and guidelines. That is changing with many clinics reopening with new cautionary safeguards in place.

“There is a backlog,” said Dr. Kimberly Rostvold, dentistry director for the Indian Health Board of Minneapolis. “People did put off dental care, probably longer than they should have. We think they are still doing it.”

The Minnesota Health Department (MDH), the Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have all issued guidance for dental practices on how to return to “normal” and resume routine dental care. The federal Occupational Safety and Health Administration (OSHA) also has infection control recommendations for dental and other medical practices.

New precautions and preliminary discussions and consultations aren’t a return to “normal,” although a new “normal” may be evolving day by day.

Rostvold said that is to be expected. Many procedures and examinations can be carefully conducted, but filling cavities, for instance, are a challenge because water droplets and moisture can be sprayed around the dental chair. At the same time, she added, neglected dental problems won’t get better by themselves.

Minnesota’s MDH guidance for dental patients states:

“If you are in pain that would normally lead you to call the dentist, call your dentist. A dental emergency may include swelling, pain, infection, a crown that has fallen off, or an injury to the mouth, like a broken tooth.

“Your dentist will help you make care decisions, which may mean coming into the dental office for an emergency procedure, self-care strategies at home, or a referral to another dentist.”

A particularly thorough explanation of how dental clinics are now functioning, or procedures being implemented for getting restarted, is provided by the Lower Sioux Community Dental staff. In an online update for dental patients that was posted for reopening on May 29, it explained why calls and telephone consultations were sought before scheduling in-person visits.

“You may see some changes when it is time for your next appointment,” it clearly states.

“As we open up to comply with protocols and keeping the most sanitary conditions for our patients and staff, aerosol producing procedures must be kept to a minimum as dental produces produce an environment within the air that can harbor the virus for a period of time.”

It stressed the Lower Sioux staff wanted to communicate with patients two days before an appointment to monitor health conditions and assess possible exposure to COVID-19. It provides information on social distancing and sanitary producers for patients and families.

Lower Sioux HHS also warned that in June, at least, some non-emergency appointments would be rescheduled for a later date as the dental staff worked through a backlog of patient visits.

Information links:

Helpful information for patients and for dental health professionals is available from the Minnesota Department of Health at https://www.health.state.mn.us/people/oralhealth/resources/covid19.html; and from the Centers for Disease Control and Prevention (CDC) at https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html.

The American Dental Association has a similar “toolkit” for dental practices reopening their services. It is found at https://success.ada.org/~/media/CPS/Files/Open%20Files/ADA_Return_to_Work_Toolkit.pdf.

The Lower Sioux Community’s Health and Human Services department offers an especially thoughtful synopsis of these reports for patients online at https://lowersiouxhhs.org/update-for-dental-patients/.