When dental workers perform any procedure, just about every powered tool they use – anything that spins, buzzes or shoots air or water – can spray droplets of the patient's saliva into the air. If the patient happens to have COVID-19, then the coronavirus will get sprayed into the air, too.
So, now dental workers are taking extra care to reduce the danger.
“I get very close with my suction," says Lorraine Santos, a dental assistant in New Bedford. "The patient, even if they talk, things can get in the air.”
Because dentistry is, by nature, in people's mouths, the threat of the coronavirus haunts each working day during the pandemic. Using the suction more liberally is just one way dental offices are adapting to that unique risk as they ramp up their practices again.
Many dentists have remained open through the pandemic, but only for emergency procedures. Now, Massachusetts is allowing them to expand their work to address issues that need attention sooner rather than later. Patients can now schedule appointments for fillings, crowns or to get a toothache checked out.
It’s not always easy adapting to the changes though. Santos says they have to be increasingly careful as they see more patients and do more procedures – taking extra time to prep rooms between appointments.
“We disinfect the room always, but now we spray the air with hydrogen peroxide and water,” she says. “And I wipe down the counters, the pens, the clipboards, everything. I’m double, double cautious.”
Santos also has to wear full protective gear for every procedure, including two masks, gloves and a surgical gown. Since there isn’t enough equipment to change between appointments, Santos wears one set for the whole day and does her best to clean it after each patient.
“I spray the room, and then I leave the room and spray myself with the peroxide and water,” she says. “The mask is so tight. It squeezes my face. And you know, it’s very hot [in the gear]. I put the AC on, but at the end of the day, I’m drenched in sweat.”
While dental workers have always faced a high risk for infections like the common cold or the flu, they don’t normally have to worry about a virus like the coronavirus, which is highly contagious and can be deadly.
“It’s terrifying. You know, statistics show that one of us is probably going to get this,” says Dr. Mike Mayr, a dentist in Boston, discussing his staff. “But we can’t think that way. It’s my livelihood and my obligation to the patients that need care from us. So, we’re just rolling with the punches.”
Part of that is changing the way he runs his practice, Mayr says. For one thing, patients need to be screened for symptoms before coming through the door. Staff need to be trained on the proper use of protective gear and new disinfection protocols, too.
“It’s just a whole new process and workflow that we’re bringing. It’s going to take time for staff to learn all the nuances,” he says.
All of those changes mean appointments are taking a lot longer than they used to. Before, dentists would schedule 30 minutes for a typical visit, but now it takes an hour or more. Dr. Paul Gamache, a dentist in Pittsfield, says that’s going to make things a lot more difficult, financially.
“I would not be surprised to see my personal income decrease by 50%,” he says, because of the limited number of patients he can see each day.
That’s on top of two months of emergency appointments only, where some dental offices saw patients as infrequently as once a week. Gamache says some practices may have to lay off workers or shut down completely.
“I’m fortunate to own my own practice and the building that the practice is in,” he says. “But if you asked me 20 years ago, a 50% decrease in my income would have been devastating.”
And if dentists can only see half as many patients, Gamache says that also means people aren’t getting as much dental care as usual. He worries that will lead to worse health outcomes for patients.
“The amount of people I can serve, that’s shrinking. So, the cavities that I can detect and do something about, that’s shrinking,” he says.
Dental assistant Lorraine Santos says she's glad that offices are opening back up for more procedures – even if they can’t get to everyone that they used to serve. This way, at least people can get some dental work done.
“You know, I feel that I’m doing my part,” she says. “If I had a family member in the chair, and they needed dental work in the middle of this epidemic, I’d want them to feel safe and confident.”
Massachusetts officials have made routine dental care such as cleanings part of the second phase of the state's reopening plan. That could begin as early as June 8.
This segment aired on May 28, 2020.