However, in the government’s determination of the businesses and services that are essential beyond these vital providers, dentistry was left on the sidelines. Inexplicably, the dental profession was grouped with malls, gyms, movie theaters and other entertainment and leisure businesses as something optional, or non-essential. In some states, florists were still able to deliver bouquets, and medical marijuana dispensaries and golf courses made the cut— but dental practices were shuttered.
Education is critical, as dentistry is a meaningful component of our healthcare system. The U.S. Surgeon General’s 2000 Report on Oral Health in America was instrumental in raising awareness to the connection between oral health and general health. Since that time, a myriad of research has supported the ‘oral-systemic’ connection through the association of poor oral health to a variety of systemic diseases, including diabetes, obesity, cardiovascular diseases, and dementia.
The American Dental Association reports that over 2 million visits to the emergency room (ER) each year are dental related. Whether to improve overall health, or to ensure that our front-line emergency workers can focus on non-dental medical emergencies, it is essential that dental practices remain open in order to fulfill the critical role they bring to the overall healthcare system.
Dentistry is Both Safe and Essential
As Fast Company reported in June, an MIT study of COVID-19 transmission risks and social benefits determined that dentists, were among the “most essential and safest businesses to visit during the pandemic.” No surprise that dentistry is both essential and safe for those who are paying attention. Dentistry has always operated as a safety-conscious profession, employing stringent infection control procedures and the use of personal protective equipment (PPE). In July, both the World Health Organization and the CDC said there have been no confirmed cases of COVID-19 transmitted in a dental office.
Indeed, the industry has responded quickly in the midst of the COVID-19 crisis, with heightened safety standards, including the use of PPE by administrative staff, daily health screenings for staff and patients, social distancing in common areas and enhanced processes for cleaning and disinfecting. In recent months, the ClearChoice network established a multidisciplinary team comprising network prosthodontists, oral surgeons, clinical assistants and operations managers, environmental safety and infection control experts on staff, as well as an independent compliance consulting expert, to further refine our “best in class” protocols.
It is not a question of whether dentistry is just now focusing on safety — it has always been safe. The relevant question is whether dentistry has adapted its safety measures to the new COVID environment, and, based on my interactions with dental practices all across the country, the answer is a resounding yes!
It is understandable that certain procedures, such as tooth-whitening, weren’t considered a critical service while COVID-19 was surging, but it is absolutely essential to treat active dental pain and infection, progressing disease, such as periodontal disease, or issues of function that prevent the patient from consuming a normal, healthy diet. To determine that these services are elective, or nonessential, ignores the impact that these conditions will likely progress to have on the patient’s overall health, while driving many to overcrowded emergency rooms in the interim.
The oral-systemic link has been well known for years, but there remains a chasm between the treatment of one’s oral health – through dentistry – and the treatment of one’s general health within the medical profession. Until that chasm is crossed, a patient’s oral cavity will continue to be disengaged from their overall anatomy and reduced to a non-essential component thereof… even when the evidence shows it plays a critical role in the health of the integrated whole!
As professionals, we have discussed this among ourselves for years, but we have yet to bridge the gap with stakeholders outside of the dental profession—including patients, regulators, and the broader medical community. Until we do, we will continue to deal with the consequences of a perception that dentistry lives outside the healthcare profession.
There are initiatives underway to cross this chasm. One such example is the Harvard School of Dental Medicine. As a means of inciting change, the school has spearheaded an initiative to integrate oral health and medicine, bringing together academics and leaders in the health care community to find ways to connect oral health and primary care. There are other examples, but progress has been slow.
As dental professionals it is imperative that we collaborate with medical professionals in order to achieve optimal health for our mutual patients—and to change the perception of dentistry from non-essential to essential. We have got data and knowledge on our side and the imperative now before us is to take more control of our collective destiny by taking action.
To read part II of this article please click here.