Implications of COVID for Oral Care: How will Dentistry Change?

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Covid-19 has brought many changes to our daily lives. As life begins to “open up,” Karen Ridley shares what changes to expect as you visit the dentist.

Karen Ridley, RDH, MSDH
University of Michigan
Center for Bleeding and Clotting Disorders

Covid-19 has brought many changes to our daily lives. As life begins to “open up,” we all have questions about how our normal routines will change. One routine which will change dramatically is professional dental care. This article will attempt to provide some information for you. The questions and answers below are based on current best practice information available, but like everything else, are subject to change.

When will I be able to visit the dentist? In March, the American Dental Association and Michigan Dental Association followed recommendations from the CDC and advised all dentists to close their offices. Some continued to provide emergency care for their patients. Michigan dentists were advised to postpone elective dentistry, oral surgery, and all non- urgent dental care. Michigan dentists have been waiting for the CDC and Governor to give them the “go ahead” to expand to additional procedures and have been preparing their offices and staff to be ready to provide the best and safest care for their patients. Recently, they got that green light and while dentists can reopen their offices, most have said that moving forward to full practice will occur in steps.

What changes will I experience?
1. You will be asked to “register” for your appointment online ahead of time. Update your medical history, insurance information and any changes in your address and phone number. If you do not have access to a computer, tell the appointment person so that they can assist you. Add your treatment center contact information to your medical history.
2. You will be asked to call into the office when you arrive for your appointment but wait in your car until directed to come in. Unless you need assistance or are with children, you should plan to come into the office by yourself. When the dentist or hygienist is ready for you, you will be escorted from the door directly into the treatment room.
3. You will be required to wear a face mask until it’s time to start your treatment.
4. Most likely there will not be a waiting room. Toys, magazines, videos, and other “entertainment” will be gone. If you are bringing children, or assisting another adult, bring a book or magazine of your own. Please don’t bring food or beverages.

Will I notice changes with the appearance of the dental staff and treatment area?
1. You may notice that equipment is covered or wrapped. The dental chair may be encased in a plastic bag. (This can be hot or sticky on your legs. When possible, wear leg covering)
2. Dental staff will be wearing more PPE (personal protective equipment). You may notice head and shoe covers, face shields and scrub gowns in addition to gloves, face masks, and protective glasses.
3. You may be asked to wear protective eyewear or a head cover. Some dental offices may change from the patient bib to a larger sheet like patient cover.

How will the appointment be different?
1. You will have your temperature taken and if it is above 100.4 you will probably be rescheduled.
2. You will be asked to wash your hands.
3. You will rinse your mouth with an oral disinfectant such as hydrogen peroxide, Listerine, or similar for one minute at the beginning of the appointment.
4. Hygienists may not be using power scalers because of the aerosol they create. Dentists may not be using high speed handpieces for the same reason. Polishing teeth can create a saliva saturated aerosol so at least initially this procedure may be changed to a final toothbrushing.
5. The dentist will no longer be able to move from one patient to another without a complete change of PPE. After your teeth cleaning appointment including a thorough examination by the hygienist, you may have a virtual video exam with the dentist.
6. Your appointment may be a little longer than usual to accommodate these changes.
7. After the appointment you will schedule your recall appointment or any treatment appointments before leaving the room.
8. You will be asked to pay for your treatment (including your insurance copay) electronically. You may notice a small change in dental fees to reflect increased costs of PPE and supplies.
9. At the completion of the appointment, you will be escorted out of the office by a staff member. The exit door may be different from the front office door.

Another important note about dental care.
1. If you have switched to Hemlibra or one of the new extended factors, be sure to consult your treatment team about dental recommendations. There may be changes!
2. If this is your first visit with the dentist, ask your treatment team to send a letter of introduction and their contact information to the dental office in advance of your appointment.

Finally… have you heard about COVID-19 weight gain? If you are eating more, you are probably increasing your risk for dental decay, especially if you are eating more snack foods. Be sure you are taking good care of your teeth. Brush thoroughly for at least two minutes. Use an antibacterial and/or fluoride mouth rinse once a day. Avoid sweetened beverages. Water is best!

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The Hemophilia Foundation of Michigan strives to improve the quality of life for all people affected by hemophilia, von Willebrand disease, other coagulation disorders, and related complications.

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