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Photo from the Republican American.

Coronavirus anxieties bring problems to dental practices

Article from the Republican American, December 21, 2020. (Mike Patrick)

As a dentist, Dr. Cheryl Sobieraj is used to wearing a mask, even when there isn’t a worldwide viral pandemic. She knows of their protective properties, but she said she’s also aware of their drawbacks.

“People are wearing masks and holding their teeth together more than they ought to,” Sobieraj said from her Waterbury practice. “They don’t even realize they’re doing it. You’re not used to having something in front of your face.”

Clenching teeth under the mask can inflict hundreds of pounds of pressure the teeth were not meant to bear, and could crack or break them, she said.

These trying days, dentists said, there is a lot of teeth-clenching and -grinding, masks on or off, as the pandemic, and social and political unrest cause tension and anxiety.

The result, they said, is more broken and cracked teeth than they’ve ever seen.

“The American Dental Association Health Policy Institute did a survey, which is sort of a study, that finds that there’s more than half of dentists that saw an increase of patients with dental conditions related to stress, such as grinding teeth, broken teeth and jaw pain,” Dr. Tam Le said. “Personally, I, too, have seen that in my own practice.”

Le, a dentist in Hamden, is president of the Southington-based Connecticut State Dental Association.

The association, he said, conducted its own survey that determined fewer people have been going to the dentist since the start of the COVID-19 pandemic. The survey found that while 87% of residents indicated they visit a dentist in a typical year, only 63% indicated they had done so in 2020.

Of those who had not been to the dentist yet this year, according to the survey, two-thirds (65%) indicated they put off a visit for routine preventative work because of the COVID-19 pandemic, and one-quarter said they had issues with their teeth or gums but decided not to go to the dentist because of the pandemic.

“The good news is that nine out of 10 feel very safe when they come in to see their dentists,” he said, adding the survey found expanded safety protocols and the use of personal protective equipment put patients at ease.

“Dentists have always been known to be the place to be in terms of cleanliness,” he said. It was another global health crisis decades ago that prompted greater safety in the dental office, he said.

“The AIDS epidemic has raised a bar for our profession,” he said. “We have raised a standard very early on, and as a result we have maintained the safest care.”

And just as dental visits did not prompt a rise in AIDS cases then, he said, there has been no documented spike in coronavirus cases connected to the dental profession.

“That’s actually a positive piece of news,” he said. “Back in November, the American Dental Association and others have done a study to show that there has not been any kind of cluster or outbreak within the dental communities at all.”

Regardless, however, people are shying away from seeing their dentist.

“Since the pandemic started in March, we’ve seen people hesitate to come in,” Sobieraj said. “It’s people delaying treatment, which is concerning. What we have seen across the board is people are fracturing teeth they have haven’t had previous problems with. They’re wearing down fillings.”

People are also not following up on recommended treatment for problem teeth, making them “significantly worse,” she said.

“We’ve seen so many fractured teeth. People are losing teeth when they shouldn’t be,” she said. “That’s concerning and expensive.”

In addition to nervous grinding and mask-related jaw-clenching, Sobieraj said, other elements of the pandemic are affecting dental health.

“Across the board, nobody’s drinking enough water these days because they have the mask on,” she said. “Dehydration cracks teeth. Dry teeth break.”

Treatment can range, Le said, from a simple night or day guard to prevent clenching, to more serious measures, such as bonding, the use of crowns, or even root canal or extraction of the tooth.

“We don’t want to wait until the breaking point, no pun intended,” he said. “If we see signs or symptoms of stress-related grinding, we therefore can make appropriate recommendations.”

But that requires patients to actually show up.

“I think there’s a whole class of people who have not come in. That is concerning because they think it is unsafe and that’s hard. There’s been so many documented studies that say most people do think it is safe,” Sobieraj said. “If you’re scared, I can’t control somebody’s fear. What we can control is the environment to see somebody_”

She does so, she said, through extensive use of PPE such as gowns, masks, face shields, goggles, caps and more.

Some dentists go further than the CDC guidelines. Le said his office uses HEPA air filtration and ultraviolet light as a disinfectant.

In late May, Le said, he worked on a state Department of Public Health task force to put together a best practices guide for all dental offices in Connecticut to implement.

“What we do is we follow the best practices and the use of PPE at all times in a dental setting. That’s how we maintain safety,” he said. “It is not just my opinion. The study that came out in November confirmed that dentistry is safe, and what we have done has shown that.”

For information about Connecticut dentists’ response to the pandemic, visit Contact Mike Patrick at