DR. JACQUELINE PARAMO
As this coronavirus situation has unfolded, all of us – your dentist, the dental staff, and our patients – have been faced with questions about how to lead our daily lives while being told we must stay at home. And we’ve all felt how uncomfortable and frustrating the uncertainty and restrictions can be. My staff and I have seen that those feelings are magnified when your health, or that of a family member, is the cause of that uncertainty.
We’re now getting numerous questions every day from our dental patients about handling their dental appointments and needs since the stay-at-home measures went into place. We hope that by sharing the answers to the most common questions that you’ll feel more confident in dealing with your dental health during this time.
Is Hudson Family Dental open?
Our office is currently open only for dental emergencies. On March 16, the American Dental Association issued guidelines advising dentists nationwide to postpone elective procedures for three weeks until April 6. This was recently extended until April 30, and there is a chance that date may be extended again. At Hudson Family Dental, we have chosen to follow the ADA. Not only will this help limit exposure to and transmission of the virus for patients and staff, but it also helps preserve and extend the supply of personal protective equipment that is sorely needed in both hospitals and dental offices.
Dental offices are allowed to see patients who are having an emergency. At Hudson Family Dental, we’re staffing the phone and text message lines for non-emergency questions and concerns. Our office voicemail recording also provides our emergency number, so don’t worry if you should run into a problem – we can and will provide emergency care. You may be asked to video conference with me. This is called teledentistry and allows me to assess your problem without you needing to come into the office. After the consultation, I can determine what the appropriate next steps may be.
Please refer to our website, voicemail recording, and latest emails, and then call if you’re still unclear about whether the office is open for emergencies only or if it can handle elective procedures as well.
What is considered a dental emergency?
Dental emergencies, according to the American Dental Association, “are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding [or to] alleviate severe pain or infection.”
What constitutes an emergency is actually pretty simple – it’s about pain or trauma. Some common dental emergencies include:
• Severe dental pain (most people think of this as a “toothache”)
• Pain from a wisdom tooth
• Post-operative pain from a dental surgery or procedure
• An abscess or localized pain and swelling
• A broken tooth resulting in pain or cutting your tongue or cheek
• A tooth being knocked out
• Dental treatment if a temporary crown or bridge is lost, broken, or causing gum irritation
Other emergency dental care includes extensive decay or defective fillings that cause pain, removal of stitches, denture adjustments for radiation/oncology patients, denture adjustments or repairs to address difficulty chewing, replacing a temporary filling on a tooth with a root canal if you are experiencing pain, and snipping or adjusting an orthodontic wire or appliance that is cutting your lips or cheeks.
The ADA has a terrific website for patients called mouthhealthy.org where you can download their guide to help decide if you’re having a dental emergency.
What about my dental checkup that’s scheduled?
This will be one of the few times that you’ll hear a dentist advise that you avoid your six-month checkup. But routine hygiene and cleaning appointments are considered elective procedures. A more complete list of elective or non-emergency dental procedures includes:
• Initial examinations (including x-rays)
• Periodic (six-month) checkups (also including x-rays)
• Routine dental cleanings and other preventive therapies
• Orthodontic procedures other than those to address a problem (e.g., pain, infection, trauma)
• Extraction of teeth that do not hurt (like having your wisdom teeth pulled)
• Fillings on cavities that aren’t causing pain
• Aesthetic dental procedures (such as whitening)
Make no mistake — six-month exams are still very important. Our staff has been working diligently to try to reschedule as many patients as possible to dates that we are expected to be reopened. We are reevaluating these dates weekly as we receive further updates on office closure and we will continue to follow up with patients once we reopen our doors. Please do not hesitate to call us and reschedule once this crisis passes!
What happens when I get to the dental office with an emergency?
In our office, we are scheduling emergencies appointments so that they do not overlap to avoid any patient contact in the office. We are also allowing patients to stay in the car and call or text us once they have arrived. When the room is clean and the previous patient has left, we will then call or text you to enter the office for your appointment. Your safety and reducing the possible spread of the virus between patients is of the utmost importance.
I or my staff will ask questions, and for everyone’s safety you’ll want to answer honestly. These questions may include:
• Have you had symptoms commonly associated with COVID-19? (common symptoms include fever, shortness of breath, dry cough, runny nose, or sore throat)
• Within the past 14 days have you travelled by airplane?
• Within the past 14 days have you been in close proximity (less than six feet) at a gathering of 10 or more persons?
• Within the past 14 days have you had close contact with a person who has been confirmed positive or suspected to be positive for COVID-19?
You may be required to sign a Patient Request for Treatment, Representations and Consent document, but just speaking with me may be enough. I am also monitoring the health of the staff in order to limit possible exposure to the virus.
If we feel comfortable with the answers to the screening questions and your condition does need emergency attention, then I will render the appropriate treatment.
Even if you have what might qualify as an emergency, I may still evaluate if a procedure can be delayed for 30 days. This judgment would be based on assuring that waiting won’t cause you undue harm or pain. An example is a lost or broken filling where a temporary filling can be quickly and easily placed, allowing you to return in the future for the more involved final filling.
What safety measures will the office take if I have to come in for an emergency treatment?
As health-care providers, I and my team are trained on the CDC guidelines for infection control and using the appropriate personal protective equipment (PPE) such as masks and gloves. (As of now we have a good supply of PPE.) If we do need to provide emergency treatment, we’ll attempt to minimize the use of equipment that creates airborne spray. This is a precautionary measure to limit the potential spread of the virus since any patient could be positive but undiagnosed and not yet exhibiting symptoms.
The Hudson Family Dental team has been trained in the latest ways to minimize the possibility of transmitting the virus. Our office is adamant about taking all possible precautionary measures on top of regular protocol to ensure that the space is safe for patients and staff. All of our staff is professionally trained in following clinical protocol in patient rooms and at the front desk to disinfect all operatories, equipment, and frequently touched objects (such as furniture, door handles, pens, keyboards, faucets, and phones) throughout the day and after each patient using medical-grade disinfectants. We are also requiring all staff members to change into their scrubs upon arrival and out of their scrubs when leaving the office.
In the coming weeks, our office is expecting shipments of all necessary personal protective equipment including face shields, masks, gloves, disposable gowns, and more. We are also investing in air purifiers and equipment that will minimize airborne spray during each appointment.
For patient use, we have provided a bottle of hand sanitizer at the front desk along with a box of gloves and a container of our medical grade disinfectant wipes for patients to use on waiting room surfaces if they feel inclined. We are going the extra mile to make sure every inch of the treatment areas and equipment are disinfected.
If I’m missing my checkup should I do anything differently?
Make sure you are brushing and flossing. Do everything as you would normally. It’s never been more important to do the best job possible to maintain your oral health. Since many of us will have extra time on our hands, make sure you brush at least twice a day for two minutes.
If you feel like you want to take extra steps to protect your hygiene during this time, here are a few ideas:
1) Use a powered toothbrush such as a Sonicare or an OralB (my personal favorite)
2) Use an irrigation device. Such as those made by Waterpik.
3) Use your favorite mouthwash such as Listerine with fluoride
4) Floss – if you don’t currently floss it’s a great opportunity to start. You have the extra time and once you’re in the habit you’ll like the extra clean feeling while also strengthening your gums!
If my child or I am in orthodontic treatment, will missing appointments cause harm?
The simple answer is “No.” Your teeth will just stop moving at some point. Once elective procedures are allowed again, treatment can easily be restarted, and your teeth will start moving from right where they left off. If you have aligners you can give our office a call and, based on your case, we may possibly send you your next set of aligners. Otherwise, continue to use your current aligner. Even though your teeth will generally stop moving after a week or two in the same aligner, it will act as a retainer holding the teeth in place until you can be seen for your next aligner.
Stay home, stay safe, and know that we’re here for you
During the stay-at-home order, unless there is a dental emergency, which means pain or trauma, you can rest assured that with basic home hygiene your dental health will be fine. If you’re still confused or unclear as to whether you need to be seen in the office, email us or call us. (Contact details are on our website at https://www.paramodds.com/appointment-request.) My staff and I are here for you, as are our dental colleagues for patients all over the country and the world for that matter.
During this time there will be a lot of things that may seem different in the dental office, but as soon as the virus is under control and it is safe to return for normal dental treatment, we’ll be happy to welcome you back!
Stay safe and healthy!