Update from Dr. Rachel Squier

Helping our dental patients through the coronavirus crisis

By Dr. Rachel Squier

As this coronavirus situation has unfolded, all of us – your dentist, the dental staff, and our patients –
have been faced with questions about how to lead our daily lives while being told we must stay at
home. And we’ve all felt how uncomfortable and frustrating the uncertainty and restrictions can be. My
staff and I have seen that those feelings are magnified when your health, or that of a family member, is
the cause of that uncertainty.
We’re now getting numerous questions every day from our dental patients about handling their dental
appointments and needs since the stay-at-home measures went into place. We hope that by sharing the
answers to the most common questions that you’ll feel more confident in dealing with your dental
health during this time.

Is our practice open?

March 21, Governor DeSantis issued an executive order to close all dental practices to elective dental procedures until May 8th. Not only will this help limit exposure to and transmission of the virus for patients and staff, but it also helps preserve and extend the supply of personal protective equipment that is badly needed in both hospitals and dental offices.

Dental offices are allowed to see patients who are having an emergency. At Treasure Coast Dental, we’re staffing the phones as we should be while we are all sheltering in place. So, don’t worry if you should run into a problem – we can and will provide emergency care.

What is considered a dental emergency?

Dental emergencies, according to the American Dental Association, “are potentially life threatening and
require immediate treatment to stop ongoing tissue bleeding [or to] alleviate severe pain or infection.”
What constitutes an emergency is actually pretty simple – it’s about pain or trauma. Some common
dental emergencies include:
• Severe dental pain (most people think of this as a “toothache”)
• Pain from a wisdom tooth
• Post-operative pain from a dental surgery or procedure
• An abscess or localized pain and swelling
• A broken tooth resulting in pain or cutting your tongue or cheek
• A tooth being knocked out
• Dental treatment if a temporary crown or bridge is lost, broken, or causing gum irritation

Other emergency dental care includes extensive decay or defective fillings that cause pain, removal of
stitches, denture adjustments for radiation/oncology patients, denture adjustments or repairs to
address difficulty chewing, replacing a temporary filling on a tooth with a root canal if you are
experiencing pain, and snipping or adjusting an orthodontic wire or appliance that is cutting your lips or

The ADA has a terrific website for patients called mouthhealthy.org where you can download their guide
to help decide if you’re having a dental emergency.

What about my dental checkup that’s scheduled?

This will be one of the few times that you’ll hear a dentist advise that you avoid your six-month checkup.
But routine hygiene and cleaning appointments are considered elective procedures. A more complete
list of elective or non-emergency dental procedures includes:
• Initial examinations (including x-rays)
• Periodic (six-month) checkups (also including x-rays)
• Routine dental cleanings and other preventive therapies
• Orthodontic procedures other than those to address a problem (e.g., pain, infection, trauma)
• Extraction of teeth that do not hurt (like having your wisdom teeth pulled)
• Fillings on cavities that aren’t causing pain
• Aesthetic dental procedures (such as whitening)
Make no mistake — six-month exams are still very important. As soon as the crisis passes let’s get that
hygiene appointment rescheduled for you.

What happens when I get to the dental office with an emergency?

This may vary based on the protocols put in place by any individual dental office to maintain social
distancing. In our office, we are working hard to maintain exceptional standards of disinfection throughout the day and between patients. We schedule patients so their visits do not overlap, we are using hospital grade disinfectants, and we are cleaning all common surfaces that everyone touches continuously. Our office is requesting that you stay in the car and we will text or call you when it is appropriate to enter the office. Your safety and reducing the possible spread of the virus between patients is of the utmost importance.

In addition, our staff will ask you questions, and for everyone’s safety you’ll want to answer honestly. These questions may include:
• Have you had symptoms commonly associated with COVID-19? (common symptoms include
fever, shortness of breath, dry cough, runny nose, or sore throat)
• Within the past 14 days have you traveled by airplane?
• Within the past 14 days have you been in close proximity (less than six feet) at a gathering of 10
or more persons?
• Within the past 14 days have you had close contact with a person who has been confirmed
positive or suspected to be positive for COVID-19?

In some cases, you may be required to sign a Patient Request for Treatment, Representations and
Consent document. In others, just speaking with the dentist maybe enough. We will also monitor
the health of the staff in order to limit possible exposure to the virus.

If the dentist is comfortable with the answers to the screening questions and your condition does need
emergency attention, then she will render the appropriate treatment. Even if you have what might qualify as an emergency, the dentist will evaluate if a procedure can be delayed for 30 days. This judgment would be based on assuring that waiting won’t cause you undue harm or pain. An example is a lost or broken filling where a temporary filling can be quickly and easily placed, allowing you to return in the future for the more involved final filling.

What safety measures will the office take if I have to come in for an emergency treatment?

As health-care providers, dentists and their teams are trained on the CDC guidelines for infection control
and using the appropriate personal protective equipment (PPE) such as mask and gloves. If for some
reason our office doesn’t have appropriate PPE available, we’ll refer you to another dental professional
for your emergency treatment. (In our office we don’t anticipate that happening and as of now we have
a good supply of PPE.) If we do need to provide emergency treatment, we’ll attempt to minimize the use
of equipment that creates airborne spray. This is a precautionary measure to limit the potential spread
of the virus since any patient could be positive but undiagnosed and not yet exhibiting symptoms.
Our team has been trained in the latest ways to minimize the possibility of transmitting the virus. Again, we have implemented even stricter control of disinfection protocols. We are also requiring every atient that enters our office to wash their hands for 20 seconds and rinse their mouths with an antibacterial rinse for 30 seconds. We’re disinfecting every doorknob and countertop. From the front entrance to the treatment rooms, everything is wiped down between patient visits and at the end of each day. We are going the extra mile to make sure every inch of the treatment areas and equipment are disinfected.

If I’m missing my checkup should I do anything differently?

Make sure you are brushing and flossing. Do everything as you would normally. It’s never been more
important to do the best job possible to maintain your oral health.
Since many of us will have extra time on our hands, make sure you brush at least twice a day for two
If you feel like you want to take extra steps to protect your hygiene during this time, here are a few
1) Use a powered toothbrush. Our favorite brand is Oral B, but any powered toothbrush will do.
2) Use an irrigation device, such as a Waterpik or WaterFlosser.
3) Use your favorite mouthwash. We recommend ACT mouthwash for added fluoride protection.
4) Floss or use disposable picks for in-between your teeth – if you don’t currently floss or use these picks, it’s a great opportunity to start. You have the extra time and once you’re in the habit you’ll like the extra clean feeling while also strengthening your gums!

Stay home, stay safe, and know that we’re here for you

During this time that we’re all asked to stay home, with good dental home care, you can be comfortable that your dental health will be fine. If you’re still confused or unclear as to whether you need to be seen in the office, email us or call us.

Contact details are on our website at www.tcdentalpros.com or call our office at (772) 337-2338.

My staff and I are here for you, as are our dental colleagues on the Treasure Coast.
During this time there will be a lot of things that may seem different in the dental office, but as soon as
the virus is under control and it is safe to return for normal dental treatment, we’ll be happy to welcome
you back!

Stay safe and healthy!