Dentists here and nationwide argue that they are among the most “at-risk”  of contracting the virus due to proximity between staff and patients, and the aerosol that is produced during routine procedures.

Dentist offices, which largely remained closed during the COVID-19 pandemic, are now reopening only to find that the personal protective equipment (PPE) they need to protect themselves and their staff has increased in price, is limited or unavailable.

Now the fight is on for dentists in the Washington area to not only recover from being closed, but adapt to new procedures and protocols, and secure PPE. 

Closure

Dental offices responded to the pandemic by taking precautions and then ultimately decided to close their doors to patients with the exception of emergency cases.

Among the practices in Washington The Missourian spoke with, the amount of time offices were closed varied. Some were closed for four weeks while others were closed for as long as nine weeks.

For practices such as Apple Dental, the closure raised financial concerns.

Dr. Elizabeth Clary of Apple Dental reported that her practice was closed for six weeks. Three of those weeks Clary was able to provide her employees with a paycheck by dipping into the company’s reserve fund. Her employees were then able to collect unemployment the remaining time the practice was closed.

“Since reopening it has been okay (in terms of finances),” she said. “I am not paying myself right now so I can pay my employees.”

Clary also reported that she did receive a loan which has helped alleviate the financial burden that has been caused by the pandemic.  

PPE Crisis

Dentists in the area and across the board have voiced their concerns over obtaining quality PPE that is affordable.

Dr. Jacqueline Demko of Demko Orthodontics said the cost has been unreal.

“Price gouging or whatever you want to call it has been an issue,” she said. “Before the pandemic I could buy a box of 100 masks for $12 and now it is $50.”

She said it’s been hard for everyone in the dental community to find FDA-approved masks.

Clary explained that in addition to the price inflation there also are limitations on how much can be purchased.

“They are limiting everything — gloves, Level 3 masks and antiviral/bacterial wipes,” Clary said.

Dr. Melissa Zyk of Lighthouse Dental reported that in the nine weeks her practice was closed she spent that time trying to locate supplies.

“I was obsessed with making sure the PPE we needed was going to come in,” she said. “Because now everything is limited to about three boxes a week, which we can go through in a day.”

Zyk added that her staff has been “on top of” monitoring the PPE the office has and when it can be reordered.

“A box of 40 masks was $17 before this all started, now it is $80,” Zyk said. “This has the ability to hurt practices.”

Dr. Kevin Walde of Walde-Miller Orthodontics said the PPE his practice requires looks different from general dentistry, but it has not been any easier to find.

“Disposable gowns are the biggest thing that we have used,” Walde said. “Everything else we use, like gloves, face masks, things like that, (the vendors) are limiting us.”

Walde also noted there has been a price increase on PPE products.

Dr. Martin Brunworth of Washington Smiles Complete Health Dentistry reported that in an effort to be mindful of PPE, the practice is utilizing state sterilization.

“We are sanitizing our N95 masks and sending them off,” Brunworth said. “It takes about a week for them to come back and we rotate out other PPE during that time.”

Dr. Jessica Skully of Four Rivers Periodontics and Implants reported that her practice, which does surgical dental procedures, also has been limited on what it can purchase and she cannot always get what she needs.

“Before I could buy multiple boxes of whatever PPE I needed,” she reported. “Now it is limited to about three.”

Skully said she has been getting creative during this time on how to handle the situation by making reusable surgical caps the staff can wear during a procedure.

Protocol

Each dentist The Missourian spoke to reported the same base line procedures for patient interaction.

Patients are called the day before their appointment and asked generic screening COVID-19 questions.

The day of their appointment they contact the office upon their arrival and are asked another set of screening questions. After they have completed the screening process, patients have their temperature taken before being taken back to the chair.

Some practices, such as Lighthouse Dental, also have opted to check oxygen levels with a reader. Others, like Washington Smiles, take blood pressure readings in addition to taking a patient’s temperature.

Extra cleaning measures also are in place at all of the offices.

Demko is using hypochlorus acid to clean her facility in addition to air purifiers. Zyk and Skully reported that at their practices also are using air purifiers with a hepa filter.

Zyk added her staff is utilizing the office’s in-house washing machines to clean scrubs and showering before leaving the office to help decrease the spread of COVID-19. Clary reported that employees are washing their scrubs at the office as well.