The dental office as an essential place

Dr. Cynthia K. Brattesani, D.D.S.

“You can take your mask off now, Sam.”

What sweet words that we can tell patients who come to our office wearing their masks during the COVID-19 pandemic.

For many, this is their first public outing that feels “normal,” albeit a “new normal.”

While historically, people usually didn’t relish a dental visit, no matter how friendly we all try to be, now, patients are responding differently around the country.

Since reopening from the stay-at-home order, patients recognize that we are risking our own safety for their dental health. They are thanking us for being open.

Patients are now asking, “How are you coming along? How did this change affect you?”

What a nice welcome back.

Some of my colleagues have said that they are envious of people who can work remotely. Over 90% of my patients are able to work from home. Even with teledentistry, dentists and team members really cannot perform our entire job remotely. Our profession is dependent upon physical contact, and therefore, we are at high risk. But despite this negative, I also feel very fortunate.

Early in the shelter-in-place order, dentistry was not considered “essential,” and for 10 weeks, I saw only emergency patients.

Even with teledentistry as a diagnostic tool, if they called for a problem like a broken tooth or swollen gum, I still needed to see them in person.
Some with small problems were afraid that if their issue got worse over time, they would not be able to get in-person treatment if COVID-19 restrictions became more stringent.

Besides their dental issues, I noticed they were craving human interaction. It often took me 20 minutes to fix the patient’s clinical issue and then another 30 minutes just to get him/her to leave the office. They wanted to talk and compare experiences — and it became a joyous few moments of normalcy.

As dental offices reopen, these one-to-one relationships will return. After months lacking human contact, we will provide the human connection that is the essence of dentistry.

Besides the patients, I also have been providing support for my team — to let them know that I understand their pain, that we are going to be OK, and that we are striving to create the safest environment possible. At team meetings, we go around the room and try to substitute dwelling on the negatives with accentuating the positives.

Patients are discovering that dentistry figures into their overall health. A higher functioning immune system can prevent disease — people need to sleep well and eat well — and dentistry is a part of their total health picture too. This is the first time I have heard from so many patients telling me how vital dental care is; I always told them how their overall health included their dental health.

Even though dentists weren’t categorized as “essential” during the shelter-in-place order, we still played a vital role. For some patients, it was essential to access their dentists. And dentists also played a pivotal part in lowering dental-related emergency room visits and helping to alleviate the personal protective equipment shortage at overburdened hospitals.

And now, as patients are returning for more “routine” procedures, misunderstandings still stoke fear.

Recently, media reported the World Health Organization’s recommendation to delay “routine” dental care. Interestingly, WHO Chief Dental Officer Benoit Varenne, Ph.D., sent an email to global dental leaders on August 13, that explained, “Unfortunately, a number of media headlines intentionally or not — when they are referring to the WHO guidance, did not mention that the recommendation to delay routine oral health care is only suggested in an intense uncontrolled community transmission scenario. A scenario that [does] not fit with the current situation of [most countries] around the world.”

Again, dental professionals need to ramp up communication with patients to allay fears and concerns.

As the reopening of dental offices rolls across our country, dentists are searching for ways to mitigate the dangers from aerosols and to maintain appropriate levels of PPE. As dentist, I am proud to say that our courage outweighs our fear.

As we keep ourselves and our teams safe, we should see our dental offices as essential places where we are not fearful of treating our patients. I know it has been hard wondering what the future will look like — wondering how will it all play out. Despite the challenges of the COVID-19 crisis, we will persevere — remember always, we have a real gift.

Dr. Cynthia K. Brattesani, D.D.S. practices in San Francisco.

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