The response to the COVID-19 pandemic has many of us readjusting to a new way of life in hopes of slowing the spread of the virus. On March 18, as part of the new guidelines put in place to encourage social distancing as well as free up equipment to care for patients in need, the U.S. Centers for Medicare & Medicaid Services announced the suspension of all elective surgeries, non-essential medical, surgical, and dental procedures during the outbreak.
The restriction has left many confused about what, exactly, is still considered essential on the dental spectrum. A cavity? A chipped tooth?Right off the bat, Matt Nejad, DDS, a celebrity dentist in Beverly Hills, says that the safest thing for everyone is to avoid seeing a doctor altogether. "Your goal should be to avoid needing to see a doctor and this includes your dentist," he says. "Right now the medical community is trying to pool resources to care for those afflicted by COVID-19, as well as simply trying to keep people at home.”
That doesn't mean all dental services are completely off the table, particularly if the situation is dire. Jon Marashi, DDS, and byte Chief Dental Officer says that there are a handful of dental services that are considered essential by the American Dental Association: uncontrollable bleeding, painful swelling around the mouth, and pain in your tooth or jawbone. Post-surgery treatment, including dressing change and stitch removal, also fits the bill. Dr. Marashi adds that a broken or knocked-out tooth is considered an emergency, as is a biopsy of abnormal tissue.
Exams, cleanings, X-rays, braces removal: They'll all have to wait until the restrictions have been lifted. But while there's a long list of things to avoid going to see your dentist for, Dr. Nejad says there's a lot you can do at home to protect yourself during the COVID-19 pandemic. “I’d suggest replacing your toothbrush right now, then doing it again in one to two weeks," he says, in order to help reduce the risk of contracting any virus from the bristles. "Continue this until we're on the backside of this crisis." If you don't have any backup brushes, Dr. Marashi says that you can soak your current toothbrush in antibacterial mouthwash for 30 seconds. "You could also use two tablespoons of baking soda or a teaspoon of 3% hydrogen peroxide in a cup of water," he adds.
If you're self-isolating with a partner or family, Dr. Nejad says to avoid sharing at all costs. "Have your own roll of floss and even your own tube of toothpaste," he says. "Store them separately from the products of anyone who shares your bathroom." Dr. Nejad also recommends cleaning your retainer or mouthguard with soap and water after each use.
Ultimately, both doctors assure patients that those in need of emergency care will receive it, but it's best to pause all other work that doesn't pose an imminent threat at the moment. "Postponing dental work right now is absolutely critical for flattening the curve of COVID-19 and reduction transmission of the virus," Dr. Marashi says. "Because dentistry involves such close proximity of the respiratory systems for both dentist and patient, the likelihood of spread is exponentially increased."
If you're currently worried about or experiencing any dental concerns, Dr. Marashi recommends calling your dentist for advice before physically going into a facility. He also recommends keeping over-the-counter pain relievers nearby in case a minor toothache arises. "Maintaining good oral hygiene through proper brushing and flossing is the best protocol for good oral hygiene during this time," Dr. Marashi says. "Avoid excessive consumption of sweets, acidic beverages, and other known things that can cause tooth decay."
To be more specific, Dr. Nejad advises against eating anything that can get stuck between your teeth or under your gums. "Popcorn is the most common culprit," he says, "but hard or sticky candy and gum should also be skipped because they may cause a tooth to crack or break." Again, he reiterates, the goal is to not need your dentist right now.
Dr. Marashi, like many other professionals, has pivoted to digital means of connecting with patients during the COVID-19 outbreak. "Teledentistry can provide remote support for patients to address their concerns at this time," he says. byteCares, the philanthropic dental-care organization Dr. Marashi co-founded, is currently providing free teledentistry services to anyone in need.
In the meantime, Dr. Nejad urges everyone to follow guidelines from health officials as we navigate the coronavirus, to keep you — and your smile — as healthy as possible. "Do your part," he says. "Stay home and take care of your teeth."
COVID-19 has been declared a global pandemic. Go to the Public Health Agency of Canada website for the latest information on symptoms, prevention, and other resources.