Can dentistry survive another public health emergency? 8 dentists weigh in

As the number of monkeypox cases continues to rise globally and in the U.S., several dentists feel confident that they can survive another public health emergency. 

The Biden administration declared the monkeypox outbreak a public health emergency Aug. 4, clearing the way for officials to access additional resources to control the outbreak. The U.S. currently has more than 8,900 cases, according to an Aug. 8 CDC case count.

Editor's note: Responses were lightly edited for clarity and length.

Robin Henderson, DDS. Private Practice in Clarkston, Wash.: While the business of my practice has still not fully recovered from the effects of the COVID-19 pandemic, I believe that the improved procedures in infection control with a new awareness of additional disease prevention by addressing aerosols has made my team stronger than ever before. Therefore, yes, I do believe that the resilient individuals attracted to a career in the dental industry would allow for the survival of dentistry in another public health emergency. 

I don't think monkeypox is a threat to dental practices. Standard precautions should be very effective against the virus as it requires direct contact and, unlike SARS-CoV-2, it appears to only be transmissible while the patient is symptomatic, so an infectious patient would be less likely to present for dental treatment.

Michael Davis, DDS. Smiles of Santa Fe (N.M.): The dental industry already has protocols and patient protective equipment, which are more than adequate to deal with monkeypox among our patient populations. We learned a great deal after the pandemics of HIV and COVID-19.

I anticipate the media will hype up fear among citizens to sell advertising. …  We might again witness an attempt at mandated school and business closings. … However, a powerful Johns Hopkins study demonstrated there were no mortality benefits to states enacting lockdowns. On the contrary, the GDP suffered, unemployment increased, businesses closed, students lost education, drug abuse elevated, mental health problems including suicides increased and domestic violence amplified.

I seriously doubt citizens will tolerate future lockdowns and closures, especially based on a lack of supportive medical science, as was the unfortunate outcome of the COVID outbreaks. Naturally, clinical settings inclusive of dentistry must adhere to CDC guidelines for infection control and PPE.

Robert Trager, DDS. Dentist at JFK and LaGuardia Airports (New York City): The dental profession as well as medical is well positioned to navigate through another health crisis. We are well positioned to utilize the armamentarium that we used during the COVID-19 pandemic: PPE, temperature gauge, negative air pressure, oximeters and protective barriers. With monkeypox, this virus is spread by personal contact (skin to skin, sex) as well as contact with infected surfaces, bed sheets, towels, fabrics (clothing). As dental practitioners, we must be aware of the location of your practice, the lifestyle of the patients that you treat and the travel habits of your patients. 

Having my office being physically in JFK Airport I am always aware of the travel locations of where many of my patients have been in order to ascertain an updated health history and to protect all. We must screen our patients to see if they have any flu-like symptoms and rashes on their skin and refer them to the appropriate health facility.  As dentists we should be aware of the fact that the monkeypox virus can occur in the mouth as well as on skin surfaces. As we have been doing in the past, we should continue to disinfect the operators and all surfaces and all areas where the potential virus may be harboring.

Frank Clayton, DDS. Clayton Dental (Suwanee, Ga.): COVID was once in a generation. Monkeypox fear is being driven by the media, period. Yes it's real, but look at the statistics. 

We take universal precautions; there's no discrimination between diseases. Being in close contact with patients is part of what we do. 

If we're even thinking about closing down offices due to the disease of the month, we're not being honest with each other. 

We've held on to COVID too long. It's a bad virus, yes, but realistically, it's time to move on. Universal precautions in play, and let's get on with living without added fear and anxiety.

Laurence Stone, DDS. Doylestown (Pa.) Dental Solutions: Having survived the AIDS epidemic of the 1980s, I can unequivocally say that the dental industry will absolutely survive another public health emergency. Bear in mind, when AIDS first appeared the dental profession did not have the benefit of "universal precautions," not to mention that no one actually knew

what caused AIDS or how it was spread. For a time, the public was even led to believe that AIDS was spread through dental visits!

Dental practices may continue to suffer the effects of the public's fear of monkeypox via economic and staffing challenges, but I am willing to wager that monkeypox will not prove to be as severe a problem as COVID-19. Dentistry is resilient and an integral part of our overall health. Dentistry has made remarkable strides in the last 50 years and will continue to advance the health of the world population.

Matt Carlston, DMD. Comfort Dental (Lakewood, Colo.): I believe that we can (and will) survive another public health emergency. I believe much was learned by the dental profession during the pandemic. Many of those lessons were hard for many but have helped their practice to survive. It showed us the importance of universal precautions. This keeps us safe, our staff safe and our patients safe. We learned the importance of maintaining a dental clinic where we are able to treat emergencies. Financially, I believed we learned the importance of having a dental practice that can survive through rough financial times. It's always important to have a rainy day fund.

I believe that as we continue to practice universal precautions in the office, we will help with the outbreak of monkeypox. From the data collected so far, it appears to be an urban issue at this time. Dentists in all areas should be aware of the spread of monkeypox, just as we should be aware of the trends of COVID-19.

Manny Chopra, DMD. Center for Dental Health (Cincinnati and Wilmington, Ohio): Yes, we can survive a possible future public health emergency. We were caught off guard with COVID-19, but there are many new systems in place through the various state [health departments] that would allow us to manage a future outbreak. Further, most dental practitioners have a better understanding of the proper safety guidelines as updated by the CDC and the [American Dental Association]. The concern becomes the availability of necessary PPE if the supply chain system slows down.

Kaori Ema, DDS. Printers Row Dental Studio (Chicago): After COVID-19, the dental industry is particularly well-equipped to handle another public health emergency, especially one related to another infectious disease. Transmission of COVID-19 was low in dental settings thanks to enhanced infection control measures, and monkeypox is thought to be less transmissible than SARS-CoV-2. However, dentists must become aware of the oral manifestations of monkeypox, especially since the first signs can often show up as oral lesions. More education is needed for dentists to know what to look for and what to do if they suspect a patient may have contracted monkeypox.

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