I’m a pediatric dentist. Here’s what I want parents to know about dental care during COVID-19.

By Dr. Richard Mungo, chair of pediatric dentistry at CHOC Children’s

At CHOC Children’s, we know you want to give your child the very best care every day, especially during these uncertain times.

Kids are kids, even during a pandemic. They may trip playing hopscotch and crack a tooth or cause harm to the soft tissues of the mouth, have a toothache that prevents them from eating, or develop a dental abscess.

Oral health is a vital component of overall health. Proper oral health ensures one’s ability to eat and maintain proper nutrition – essential to a growing child’s overall health and development.

Many families feel anxious about seeking dental care during a pandemic. But not taking care of emergency dental issues can cause a moderate problem to develop into something much more serious, if it’s not corrected in a safe and timely manner. Here’s a guide on what qualifies as a dental emergency, and how your dental office may look different during this time.

Is it safe to go to the dentist during COVID-19?

The majority of dental practices are open for emergency care during this time. Practices will make every effort to ensure the dental visit is safe and comfortable for the patient, parent and staff present.

Dental offices in California follow safety and infection prevention guidelines from the Centers for Disease Control, California Dental Board, the California Division of Occupational Safety and Health (Cal/OSHA) and the U.S. Food & Drug Administration. During the COVID-19 pandemic, practices have been given additional recommendations from the California Department of Public Health.

If you need to make an emergency trip to the dentist during COVID-19, you will likely notice some differences from your last standard cleaning, including:

  • Scheduling changes — Necessary appointments are booked in a more limited manner, to ensure office staff have sufficient time to thoroughly clean and disinfect treatment areas between each patient. Therefore, the number of available appointments will be lower per day than in the past.
  • No crowds in the reception room — Patients should call the office when they arrive to the parking lot and stay in their car until a staff member comes to escort them into the office. The toys and books that usually populate the reception area of a child-friendly office will also have been removed for the time being. Once you are in the office, you will be taken to the treatment area immediately, which has been thoroughly cleaned and disinfected.
  • Fewer people in the office — Only one parent or guardian may accompany a child to the appointment, unless more are needed to assist a child with special needs.
  • Health screening — A staff member should take your temperature and ask several screening questions related to recent illness before you enter the office. If you have a recent history of COVID-19 exposure you may not be allowed in the office.
  • More masks — Masks should be worn by dental office staff at all times. Dentists, dental assistants and receptionists will be wearing personal protective equipment, also known as PPE, which may also include gowns or jackets, plus face shields, hair coverings and eye protection. Parents or guardians accompanying a child to an emergency appointment must also wear a mask.
  • Strong suction — Strong suction will be used to keep aerosolization particles as minimized as possible.

What qualifies as a dental emergency?

There are a number of potential dental problems that qualify as an emergency. Parents should be mindful of pain; infection; trauma; broken teeth, braces, retainers or fillings causing pain; or anything else in the mouth so difficult that it prevents eating or sleeping.

Children may have trouble verbalizing their dental pain or even pointing to a specific area that hurts or feels uncomfortable. It can be difficult for parents to see in a little mouth without good lighting, which can be a challenge in identifying the source of the pain. In these cases, contact your child’s dentist and ask for the possibility of a telehealth visit. This can help determine if your child should come into the office for care, or if the problem can be solved with a pain reliever, antibiotic or change in diet.

Other forms of dental emergencies affect children with medical complications or treatment, such as undergoing chemotherapy, radiation therapy or bone marrow transplantation. In these cases, they cannot have any form of infection present in their body in order to continue those treatments. Cavities are bacterial infections, and other oral soft tissue infections can also challenge the safety and success of cancer therapy. Children with co-occurring conditions may experience worsened medical conditions due to oral infections or difficulties.

There are other time-sensitive cases, including infants born with craniofacial abnormalities such as cleft lip and palate that require pre-operative dental care before their first plastic surgery.

Catching up on cleanings

Biannual dental visits are extremely important with children, who are growing and developing rapidly. With teeth coming in and falling out, it’s important to monitor their dental health regularly and keep an eye on cavities.

Pediatric dental offices perform a caries risk assessment, which consists of a questionnaire, examination and plan assigned to each patient. It identifies those who are at high risk and those who are at low risk for dental disease such as cavities and soft tissue problems.

If your child has had healthy check-ups and is a low risk for any dental problems, one missed dental checkup is probably OK. Once dental offices open up more broadly, schedule your child’s missed cleaning as soon as possible.

If your child is at high risk for dental problems, then some form of communication with their dentist should take place around the six-month interval. That could come in the form of a discussion between a parent or guardian with the dentist or clinical dental assistant over the phone. You can share photos with your child’s provider of any changes or areas of concern, or they could ask that you come into the office to address any concerns.

Practicing good oral hygiene at home

With stay-at-home orders in effect, many of us are spending more time at home than ever before. Sometimes, subtle changes in our diet take place that we are not necessarily aware of, and they can impact our dental health. If we’re snacking more and preparing more comfort foods, we should be mindful of sugar intake, and how that and sticky foods can harm our teeth and gums. Remind your children to practice proper teeth brushing. Here’s some tips and tricks for getting kids to brush their teeth.

When in doubt, call your dentist

Parents or guardians should feel comfortable seeking advice from their pediatric dentist’s office to determine whether or not their child needs immediate attention, or if can things safely be delayed until after the COVID-19 pandemic.

If your child’s dental condition is an emergency, call your dentist as soon as possible. Pediatric dental experts are also on call 24/7 at the Julia and George Argyros Emergency Department at CHOC Children’s Hospital.

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