Covid 19 and Dentistry

I apologize in advance that this is a very long blog but there is a lot of critical information that I’d like to share with you! These challenging times change our priorities and make it difficult to take care of ourselves. Isolation and fear of traveling have made many people put off both needed dental care and preventive dental care. Untreated silent dental issues go unnoticed without proper clinical exams and x-rays. These issues get more complex and expensive over time without treatment.

Dental offices are one of the safest indoor environments that you can be in! Dentistry has been at the forefront of infection control for decades since the HIV/ Aids crisis of the ‘80’s. Back then, dentistry adopted an approach called Universal Precautions. This means that all instruments, environmental surfaces and the entire office assumes that every patient is infected and uses the same protocols for sterilization and disinfection as if this was true. Every ethical dental office in the United States has been trained this way and should have been practicing this for decades. The ADA has recently published a study showing that dentists and dental personnel have less than a 1% positivity rate for Covid-19 showing that these precautions are effective and in use. That doesn’t account for behaviors outside of the office so the statistics bear out that dental offices are safe.

Safety at the NYC Smile Spa

Dr. Michael Krochak and his entire team of doctors and staff at the NYC Smile Spa take our responsibility to our patients, staff and ourselves very seriously. Our doors are kept locked and no one can enter our space without a medical screening verbal questionnaire, a temperature check and then instructions to wash their hands immediately. This includes any vendors entering our space. We have limited our appointments to maintain social distancing so that most of the time, you are brought directly into a treatment room with a minimal number or no people in the reception area. The staff is provided with a full complement of PPE equipment and Universal Precautions as explained above are always used. All doctors and staff are also regularly tested for Covid-19 as well.

Our treatment rooms have no doors and we continually run the HVAC fan to maximize air circulation throughout the office. We have gone above and beyond and also made the investment of placing hospital grade UV lighting throughout our Air duct system that kills 99.9% of viruses and bacteria. Even after Covid-19, we thought this would be a great investment for killing typical cold viruses and germs to increase the level of safety in our office.

Stressful Times

Drs. Michael Krochak and his team have witnessed a significant uptick in stress related dental issues. The ADA also researched this and had reported the same phenomenon nationally. Many patients have stress induced clenching or grinding habits, especially during sleep when these unconscious stress release habits do their most damage. These habits can lead to TemporoMandibular Disorders (TMD). This is the overworking of your jaw muscles, which lead to muscular overuse, overstretching of your ligaments and inflammation of the entire jaw joint and neuromuscular complex. It also causes compensatory muscular activity in adjacent muscles leading to headaches, earaches, neckaches and chronic pain conditions.

A distinction between grinding and clenching must be made which very few dentists do. This is critical because the therapeutic devices that can be made to wear at night to decrease the effects of clenching or grinding are designed very differently. Dr. Krochak is an expert at this and has helped countless numbers of patients with these issues. He has seen a major increase in the frequency of TMD driven by the stresses of the pandemic.

Another reported increase in dental issues that we have also verified is an increase number of fractured and broken teeth. This also tends to happen more frequently with patients who clench or grind, but stress eating can contribute as well. Teeth that have had large cavities in the past and have very large fillings in them are prone to these fractures. The remaining walls of these teeth are mechanically weakened and often fracture. When we examine your teeth routinely, we look for hairline fractures and signs of premature wear and often recommend putting a porcelain crown on these teeth before they fracture to strengthen those teeth at risk. Waiting until the tooth fractures often causes the need for additional work such as root canals if the fracture is near the nerve of the tooth or even the need for extractions and implants. Again, only preventive checkups can catch these issues before they happen.

Direct Covid-19 Effects On Your Oral Health

A multitude of anecdotal reports are surfacing that Covid-19 may have a direct impact on your oral health. People have been sharing stories on Survivor Corps, a group of Covid-19 survivors who have been reporting medical symptoms that haven’t been widely reported or researched yet. There have been reports of teeth turning gray or becoming loose, increased dental decay and painful and sensitive gums. These patients had no know oral issues and were seemingly healthy. The founder of Survivor Corps reported that her 12 year old son who became sick with Covid-19 had his lower front adult teeth loosen and one fell out without any bleeding.

Researchers now suspect that the dental deterioration in Covid-19 patients could ultimately be a problem with blood flow. The virus is already known to infect and attack blood vessels. If blood can’t reach our organs, damage occurs. That’s why doctors are starting to see complications within the heart, lungs, intestines, brain and kidneys. The same could be true with the oral cavity. Your jaw is richly fed with blood vessels. Your tongue is highly vascular and the lack of blood flow could be the reason for the alteration in taste.

Your gums are highly vascularized and the inside of your tooth is the dental pulp. This part is packed with blood vessels and nerves. What’s also interesting is that when the coronavirus infects the body, it latches onto a part of our cells called the ACE2 receptors. These receptors are rich in certain areas of the body including the lungs (hence the respiratory damage). The mouth, it turns out, is also flush with ACE2 receptors.

There is an intimate connection between your mouth and the rest of your body so the take home message here is do not put off preventive dental checkups and take care of any known issues before they exacerbate.

In Office Covid-19 Testing Available Soon!!

We will be offering a covid-19 test as a convenience and benefit for our patients soon! We will have an FDA approved test. Because we are not registered with medical insurance carriers, we cannot submit this test to your insurance. But the laboratory will bill your insurance for their portion of the cost. The test is being provided as a medical service for the benefit and convenience of our patients. We know how difficult it is to take the time needed to go and get tested with long wait times, etc. We thought since patients visit the dentist routinely and often only go their physicians when sick, that we should offer this service not only for your benefit to keep yourself and those around you safe but as a public health service as well. Please tell us upon your arrival to the office if you would like this service.

For more information, you can contact Dr. Michael Krochak at

drk@nycsmilespa.com

NYC Smile Spa

30 E. 60th St., Rm 1201