Visits to the Dentist

[RWebb]

I'm wondering how many people are going to the dentist for the std. checkup and cleaning, given the pandemic...

[stevej37]

Every 3 months for cleaning.
She wears a mask and a plexi-glass shield.

[stevej37]

I should also add that I am met at the outside door by a gal with a contact thermometer.
If I don't pass that...I'm out.

[RNajarian]

I’ve been a dentist since 1991, currently I am full time faculty at a Dental School.

If your dentist is following the posted CDC and ADA guidelines you will likely have a safe experience.

The key is NOT to aerosolize. One Example: You know that “water squirty thing” (Three way syringe, it can squirt water, air or both at the same time)

Dentists are NOT to use both the compressed air and water at the same time. That creates an aerosol.

Also, offices are encouraged to use a device which resembles a hair dryer that vacuums the air near the patients mouth to eliminate aerosols.

Believe me there are many other guidelines in place. Dentistry is one of the highest risk professions out there, but with proper precautions it can be done safely

[onewhippedpuppy]

Cleanings as usual, no worries. Oldest son gets his wisdom teeth removed on Monday, poor SOB.

[RNajarian]

Here is a photo of the device. It is positioned near the patient’s mouth while procedures are being done to eliminate aerosols.

[red-beard]

With the mess with HIV, Dentists have had very good PPE and engineered controls in place for a long time. Very safe to go to the dentist.

[GH85Carrera]

I go every 6 months for a cleaning. The dentist himself does it. I have gone to him for 42 years.

[DonDavis]

To each their own, but does he have a Hygienist?

Quite frankly, a DDS is not trained on teeth cleaning. But many DDS do not hire a Hygienist to save money.
I used to think the DDS was "checking" the Hygienist's work, till I was educated otherwise.
Different roles for each.

My ex is a Hygienist and a very close friend maintained several DDS office equipment, ( chairs, xray, autoclaves, etc ).

I'm guessing your teeth are fine, but I bet your gums could be better.

[stomachmonkey]

I go for cleanings every 3 months.

Missed the first couple beginning of the year mostly because the Docs were still trying to sort out what were "necessary" procedures.

In the last 6 months have had my cleanings, a cracked crown replace, a molar extracted and last month the post for the implant placed.

[LEAKYSEALS951]

My wife's car just broke, so I am in a very bad mood.

With that in mind.
I am a dentist. Is it safe?
1.The ADA is applauding itself for having a less than 1% covid + rate for dentists. That is below the national average .

2.The biggest risks for dental offices are the dental staffs contracting covid themselves from patients. Many dentists never closed down during covid, including numerous other countries. I figure I have seen thousands of patients. With a 2% generalized asymptomatic positive rate in our community, I estimate I have seen 40- 80 patients who have been positive. To date, none in our office have had problems. At our office, we have had a recent high number of patients who HAVE contracted (not by us, by their coworkers/etc. ) covid in the 'spreadable' timeframe 48 hr window as specified by CDC. We have not gotten sick. Ancedotal, so refer to comment #1 for nationwide results after 6 months of 'back to work.'

3. The aerosols mentioned before were a major concern, and caused the ADA (starting in my state- Virginia Dental Association) to voluntarily close down to elective care. We were further shut down when PPE concerns in Mid March/April caused a mandate to close all elective care, shifting to emergency care only. Since then, tremendous amount of research has gone into examining what is going on aerosol-wise. One thing to consider, is that with dental aerosols, the vast majority of that is the dentist's own water supply contributing to the aerosol, which will be clean.

4.If this aerosol were wafting about and endangering people, the first wave of dental office outbreaks should be seen in dental professionals. That has not occurred. See #1. The dental profession, seeing multiple patients per day, would be at most immediate risk. There have been millions of patient visits since starting back up.

5. If aerosols were lingering about and cross infecting different patients treated in the same room later in the day, after 6 months (more like 9 months for me- I was open for emergency procedures), we should be tracking more outbreaks tracked back to the dental office. We are not.

6. Contrary to popular belief, and PPOT memes, a lot of medical professionals, have NOT been walking around in N95 gear. In fact, a recent study stated only 75% (of the dental professionals) were wearing all gear as recommended by CDC- meaning a lot of professionals have only been wearing surgical masks. But... wait a minute, with so many star trek bong hitting memes on the internet of their inefficiency, those medical and dental professionals should all be sick by now. But guess what- No. A track record speaks louder than memes.

6.5 Even if the office were following guidelines, there are many others in the office NOT required to wear faceshields and N95 mask by CDC guidelines- Read FRONT DESK/admin. Earlier in the year, the CDC guidelines did mention considering specialized HVAC environmental control considerations- namely, pulling out the central HVAC system and hooking it up in reverse from the norm, having the usual outputs by the room perimeters become the intakes, to suck up any contaminated air into the HVAC system directly, whereby it could be filtered by the HVAC system, in reverse of the current system, where fresh air is introduced into the rooms, (contaminated) by patient care, and then sucked through the hallways only to be taken up my the main HVAC intake- after- you guessed it- contaminating all the support staff not wearing precious N95s.
I personally know of no office that has done this. I know of no support personnel sickened by only wearing surgical masks. I am seeing no evidence of outbreaks in professional/national news.

7. In addressing cross contamination between patient to patient, the CDC interim guidelines recommended 15 minutes between patient treatment and cleaning a room to let things "settle." Much to the chagrin of the hygiene community, the CDC relaxed that guideline. After 6 months- still no notable cross contamination between patients that I am aware of.

8. There are a lot of new products on the line with unknown efficacy or need. We have ozone generators at our office. All sorts of new gadgets, such as the suction mentioned above. I am not seeing any definitive conclusions/results regarding these devices.

Am I saying it is safe? No. I am reporting the track record. You go be you. Do what you need to do.

Again, my wife's car just broke, and I'm super pissed off.
Hope this helps.

[LEAKYSEALS951]

Originally Posted by DonDavis

To each their own, but does he have a Hygienist?

Quite frankly, a DDS is not trained on teeth cleaning. But many DDS do not hire a Hygienist to save money.

Incorrect, on both counts.

[wdfifteen]

Every six months for a tune-up or whatever they call it. I delayed my latest as long as I could, but I needed a crown and some fillings and he had house payments, so we made it work.

[DonDavis]

Originally Posted by LEAKYSEALS951

Incorrect, on both counts.

How so? Don't leave me hangin'.

[wdfifteen]

Originally Posted by LEAKYSEALS951

Again, my wife's car just broke, and I'm super pissed off.
Hope this helps.

I hope it's a minor issue and she's back on the road soon without too many $$ spent.
Thanks for the info. Very informative.

[LEAKYSEALS951]

Originally Posted by DonDavis

How so? Don't leave me hangin'.

Tell your ex to get a dental degree and get back to me.

Dentists learn that inside out and backwards, especially when learning periodontal surgery where we flap the gum tissue and peel it backwards, clean the teeth and reshape the bone/add in bone to reduce osseous defects, and stitch it back together.

Same goes for tissue grafting.

[stevej37]

Originally Posted by LEAKYSEALS951

Dentists learn that inside out and backwards, especially when learning periodontal surgery where we flap the gum tissue and peel it backwards, clean the teeth and reshape the bone/add in bone to reduce osseous defects, and stitch it back together.

Same goes for tissue grafting.

I had that done 8 years ago. Once on each side of my lower gum area.
Grafted bone tissue in to fill pockets. Fun, fun, fun. (maybe not bone tissue...but human tissue)
The dentist did a great job...not much pain at all.

[DonDavis]

Originally Posted by LEAKYSEALS951

Dentists learn that inside out and backwards, snip.

I should not have said "many DDS",...poor wording on my part.

Serious question, how often do you perform routine cleanings?
I've always heard DDS don't do that. Could be practice driven, but isn't your time and effort better spent elsewhere throughout the day?

And while we're on it, do you ever debrief your Hygienists on their skills/results?

[Tobra]

Raffi, what does a vacuum like that cost? The ones I have are ridiculously pricey. A grand for a little vacuum cleaner, ouch.

[RNajarian]

Originally Posted by Tobra

Raffi, what does a vacuum like that cost? The ones I have are ridiculously pricey. A grand for a little vacuum cleaner, ouch.

$1,500 each unit. They are recommended for use anytime a rotary instrument is in use or when an ultrasonic unit is in use.

Looks like you got a better deal. . .