Need a dentist? Pennsylvania dentists may be able to help, thanks to updated guidance from the commonwealth’s Department of Health — though there are some stipulations.
Before the update, dentists were only allowed to help with emergency dental issues. But now, as long as procedures can be done safely, that limitation has been removed.
“We do not want to create additional public health needs after the pandemic related to dental issues,” Health Secretary Rachel Levine said. “By taking appropriate precautions, dentists across Pennsylvania can provide necessary public health treatments in a safe and effective way.”
So, can you go see a dentist right now? Yes, but an in-office visit depends on several factors, and the decision is up to your provider. Here is what you need to know.
While the new guidelines allow for more dental work, the Health Department did not give the go-ahead for the return to routine dentistry — but there is also no list of approved procedures. Instead, providers “should apply their clinical judgement” when deciding whether to perform a procedure.
“If we evaluate a patient and determine that the lack of treatment would result in irreversible damage, then that clinician should pursue that treatment with the appropriate level of [personal protective equipment],” said Dr. James Tauberg, president of the Pennsylvania Dental Association. “It gives us a certain flexibility to use our ability as doctors to make that judgment.”
So, some procedures may be put off until the pandemic slows down. If you don’t have a dentist, you may be stuck: some offices are only seeing current patients, so you may have to check around.
Dentists are supposed to consider the prevalence of COVID-19 cases in their area, the needs of patients and staff, and whether they have enough PPE. Dental practices are not currently prioritized for PPE distribution in Pennsylvania, and have to get the equipment on their own, according to the Health Department.
“If you don’t have the appropriate PPE, they’re basically telling you that you defer the care completely — meaning, don’t do anything — or try to refer it to someplace that maybe has it,” Tauberg said.
And dentists are only supposed to perform “non-aerosolizing” procedures — or treatments that do not “create a visible spray that contains large particle droplets of water” unless an “aerosol generating” procedure is necessary “as a last resort,” the DOH says. The coronavirus is thought to be able to spread through aerosols, according to the CDC, and many dental procedures, especially those that require dental drills, produce an aerosol, Tauberg said.
Dental offices will start by interviewing you over the phone or by video chat, based on the DOH’s guidance. That, Tauberg said, is the “new reality of dentistry,” and will likely stick around “well past the COVID-19 crisis.”
During the call, they will ask you about your symptoms and your possible exposure to the coronavirus, said Penn Dental Medicine Dean Mark S. Wolff. You will likely be asked health-related questions about having had a recent loss of smell or taste, any fever within the last 14 days, and whether you have had recent contact with anyone known to have had the coronavirus.
“All of those things are reasons why you shouldn’t see the dentist unless you have a significant and potentially life-threatening dental item,” Wolff said. “Our goal is never to bring somebody in who is highly likely to have had the disease unless it is an absolute emergency — and those patients need to be treated in hospitals.”
While many procedures can be done safely, Wolff said, the better question is, “Should they be done, and should they be done now?” So, if you’re thinking about going to the dentist, you should consider whether you need treatment right now or if you can wait.
“If you have great teeth, you’re not the cleaning I need to do. I need to fit in the cleaning on the patient that does have gum disease and is going to break down,” Wolff said. “We have to get patients out of pain. We have to take care of deep decay that will become a root canal if we don’t take care of it.”
Tauberg agreed, and said that you need to think about whether you can put off treatment for the time being. If a procedure can be put off without causing “irreversible damage,” the Health Department indicates, dentists can provide care through teledentistry, as “patients might be able to be treated virtually with antibiotics and pain medication.”
“They’re telling us, ‘Look, if you can, try not to treat the patient. If you can treat them with teledentistry and antibiotics, you should still do that,’” Tauberg said. “It’s all about asking us as doctors to be doctors.”
Should you get an in-person appointment, don’t expect the visit to be the same as past trips to the dentist. As per the DOH, you should wear a mask when you’re not being treated, frequently wash your hands, and maintain social distancing in the office. Practices, Wolff said, must also up their safety and cleanliness regimens.
“Your dentist should always be wearing a mask. Your dentist should never be shaking your hand,” he said. “If my school smelled like you were walking into a swimming pool because of all the Clorox and cleaning, I wouldn’t feel bad about that.”
And the days of packed waiting rooms are over. You may be asked to wait in your cars, not bring anyone with you, and not come early to an appointment. You’ll also likely to have your temperature taken. Some offices, like those at Penn, Wolff added, will check in with you again 48 hours after your appointment to monitor for any potential symptoms.
“We’re into a little bit of a new unknown for fear of this virus,” Tauberg said. “We’re being a very, very cautious group. We have to make sure we use our knowledge and keep everybody safe."