Dentists Operating Under Heavy Restrictions

Richard Kirby, at Dr. Lennon’s office. Photo credit: Richard Kirby

By Katie Mulkerin

Going to the dentist twice a year is both common and essential, but not essential enough during the COVID-19 era.

Finally in Phase 3, dentists are now allowed to see patients in person. But having a cavity filled during the pandemic is a whole new experience.

Preventative healthcare visits to primary care physicians and dentists have been put on the back-burner for the year of 2020 and Telehealth visits have been taking the place of in-person appointments. Dentist visits have been off limits during the pandemic, but when cavities go untreated it can lead to root canals and more expensive procedures.

Massachusetts Gov. Charlie Baker issued a four-phase plan to reopen the state. Phase 1 is “Start,” limited industries resume operations with severe restrictions. Phase 2 is “Cautious,” additional industries resume operations with restrictions and capacity limits. Phase 3 is “Vigilant,” additional industries resume operations with guidance. And Phase 4 will be the “New Normal,” development of vaccine and/or therapy enables resumption of new normal.

According to Massachusetts Dental Society, “[In Phase 1,] dental practices will be able to treat patients with emergent or likely to become emergent if care is deferred symptoms. Dental practices should continue only treating emergency and urgent care patients until Phase 1 begins.

Dentists are advised to keep records of these emergent or “likely to become emergent procedures” per CDC guidelines.

Baker announced Phase 2 reopening details on June 6, 2020. Phase 2. The “Cautious Phase,” “allows dental providers to cautiously and incrementally resume all elective, non-urgent procedures and services, including routine hygiene appointments. Phase 2 initially excluded elective cosmetic services, but effective June 24, those procedures are now allowed.”

Phase 3 offers no change for dental practices, which can continue to see patients for all procedures,” according to the Massachusetts Dental Society [MDS.]

The MDS said it approved of the plan.

All reopening phases were contingent on being under 30% in the ICU and in hospital beds.

According to the MDS, “Dentists should prioritize care for patients as follows_

Richard Kirby, a resident of Tewksbury, Mass., went to Lennon Dental in Woburn for his bi-annual dental appointment. “My experience at the dentist was a little different this year,” said the 27-year-old life insurance agent. “When I arrived, I was instructed not to come to the door. I was waiting for the office to call me to come and meet my hygienist at the door,” he said.

From there, Kirby went to a specific area to have his temperature taken, and he answered about eight questions regarding COVID-19. Then he went to the chair. “I was given specific mouthwash right when I sat down,” he said. “I’m assuming it cleans your mouth of germs.”

Kirby said the hygienist was wearing much more personal protective equipment than before, including a full-face shield and a different coat that can be thrown away after. “Usually I have my mouth cleaned with water, but they told me that was no longer allowed—something about how it can spread germs more easily,” he said.

Even the dental billing department followed COVID-19 protocol. “After I was done, they instructed me to leave right away and not go to the front desk to retrieve my bill,” he said. “I was told to call the office to get a copy.”

Dentists are not the only businesses having clients wait outside for their appointments. Hair salons, med spas, doctors and so on are following a similar protocol. Hair salons were able to open before dentist offices.

Dentist offices in Billerica are following the same protocol. A registered dental hygienist, who wishes to remain anonymous, is happy to be back to work following a three month hiatus.

“When COVID first happened, we were working but we knew it was only a matter of time before we would get shut down because of the close proximity we are to our patients,” she said. “Eventually, routine dental procedures were not allowed, so I did not work for three months to the day almost. It was difficult during this time because we were not sure when we would be able to work again and what our normal day to day was going to look like.”

Dental hygienists have an extensive list of duties that they perform each day. There is no way around getting up close and personal with their patients.

“On a regular day I see a mix of children and adult patients of all different ages. I take routine radiographs and do a mix of regular prophylaxis treatments which [are] regular dental cleanings, deep cleanings which is what some patients need if they have a lot of buildup and they’re gum health is in jeopardy and periodontal maintenance which is done after deep cleanings and it is a shorter recall, which means they come in more frequently than every 6 months,” she said. Additionally, she performs oral cancer screenings, diet and nutritional counseling, smoking cessation, place sealants, and educates her patients.

Personal protective equipment is in high demand, especially within the medical field. The dental staff in Billerica feel safe and glad to be back to work.

“We have felt ok about everything! The amount of PPE we have to wear is definitely a lot and it gets pretty hot wearing it all day, but we do it for not on the patient’s safety but our own,” she said. Adding that there are pros and cons with everything. “The amount of PPE is necessary for everyone’s safety, but it can be a challenge to wear it all for 8 plus hours a day, very hot and exhausting! We are happy to be working again because routine dental care is so important to one’s overall health care,” she said.

About Kaitlin Mulkerin 4 Articles
Katie Mulkerin is a graduate student at Emerson College who aspires to be an on-air reporter. She loves communicating and connecting with other individuals and helping to create social change. In her spare time you'll find her spending time with family and friends, reading, or running.