Is More Important Than You Think!
Taking Care Of Your Teeth
Written by Dr Jeffrey Kestenberg, Coburg Dental Group
Coming out of Lockdown number 6 in Melbourne and with the easing of the harshest and longest restrictions in the world, our dental patients have started to return for their regular dental care.
During the lockdown, the government restrictions meant that we could only see patients who had urgent, or emergency needs with symptoms such as unrelenting pain, or broken teeth, or swelling or a condition which if left would cause a significant issue in the future. Our dental hygienists couldn’t work as the most common treatment which they usually do, is scaling and cleaning. Tooth whitening and all other aspects of cosmetic dentistry were set aside and delayed. If you had bad breath or bleeding gums, we couldn’t treat you.
Our patients are returning, and the phones have been running hot with patients desperate to make appointments. Our hygienists are booked out for weeks. Patients have been so happy to come to the dentist. Many of them have not had a regular check-up and cleaning since the beginning of the pandemic. It is a weird phenomenon. They are so appreciative to have clean teeth after their one-hour hygiene appointment. It’s like having a spa for your teeth.
However, this absence from the dentist and the delays in receiving dental treatment has created a dental pandemic. Many patients have presented with chronic gingivitis or gum inflammation which was worse than ever before. For these patients, they have persevered with sensitive teeth, receding and bleeding gums, and food packing areas between the teeth. Whilst these conditions are not life-threatening or serious health issues requiring hospitalization, they do affect the quality of life and the conditions are most uncomfortable. A simple tablet or mouthwash alone, won’t resolve these issues. Unfortunately, when your gums have receded, they won’t grow back to where they were, and we can only limit future recession. This means that you may have discomfort from food packing and ongoing discomfort from time to time for the rest of your life.
Hence, we have the real need for regular maintenance visits with your dental hygienist or dentist to maintain the health of your gums and teeth.
This week alone, we have seen a number of patients who have had significant swellings of their gums but have been reluctant or scared to leave their homes and come to the dentist. Detailed examinations with x-rays have confirmed long-standing infected teeth requiring root canal treatment or extraction of the infected tooth to stop the spread of the infection. A dental infection should never be ignored. It can spread to the jawbones, or to the sinus of the upper jaw, to the airway, throat or neck. These infections can be very serious and sometimes the patient will require hospitalization with intravenous antibiotics. This has been an unfortunate, unintended consequence of the lockdown rules.
Poor old grandma and grandpa are still suffering.
Another unintended consequence of the lockdown has been the effect on the dental health of residents in nursing homes and aged care facilities. For most of the lockdown period, visitors have not been able to attend these facilities. Regular dental care by visiting dentists was not undertaken as it was considered to be elective treatment. It’s hard to believe but it was considered the same as going to the hairdresser. This has also meant that private carers, family members and other loved ones have not had the opportunity to assist in the care of the residents. It is these visitors who are often required to attend to the residents’ oral hygiene requirements. They are often the ones who initiate dental appointments with private or public dentists. The employees of the aged care facilities are often overworked and under-resourced.
As a result, brushing and flossing of teeth is ignored or completely neglected. Many residents cannot fend for themselves due to physical impairment or mental health issues such as dementia. Eighteen months of lockdown neglect is now showing up as irreversible dental damage with rampant tooth decay and gum disease. No one has been aware that there was an issue because the patient didn’t complain of pain or discomfort. So many of these patients then lose their teeth and cannot tolerate false teeth. As a result, the diet may be modified to eat soft or pureed foods. No one wants to live like that. It has been so upsetting for the residents, their families and my staff to see this supervised neglect.
We still need to be careful and mindful that we are still in the middle of a pandemic.
Many people are still concerned about coming to the dentist during this latter stage of the pandemic. They are concerned about the aerosols which the dental drill can create, spreading the virus from an infected patient to the next. Likewise, our staff have also been concerned. We want to create the safest possible work environment for our staff, patients, visitors and their families. In particular, we want to minimize the risks to those people who cannot be vaccinated, being young children and those few people with genuine medical exemptions for receiving the COVID vaccinations.
Our staff now wear full personal protective equipment including level 3 masks, headwear, disposable gowns over their scrubs, gloves and protective eyewear. Hand sanitiser, and regular deep cleaning of the treatment rooms and common areas, have been added to our previous stringiest infection control procedures. The sterilization and disinfection of our dental and surgical instruments and equipment now involve thermal disinfection in a machine that looks like a dishwasher, and ultrasonic cleaning prior to the instruments being placed in state-of-the-art autoclaves. Our staff have needed to undergo extensive training and recently undertook further training to update their skills to comply with the new guidelines.
To further protect everyone, we have recently introduced a policy of only treating patients who are double vaccinated or who had a negative COVID PCR test not longer than 3 days prior to their appointment. In cases where a patient needs to be treated urgently, such as a patient with a severe toothache, we will perform a rapid antigen test which will give us a very good indication that a patient is COVID-free (95% certainty). Our patients have been wonderful and have co-operated to make this policy very workable. It has certainly given them confidence, knowing that we are doing everything possible to make their visit a safe one.
My message to you today is to make sure that you see your dentist regularly. You may very well have a problem and you’re not even aware that there’s an issue. Do it, before it’s too late.