Syracuse, N.Y. — Since they were essentially shut down two months ago, Central New York dentists have spent up to $30,000 apiece to get ready to resume their normal practices again.
They have no idea when that will be.
“The governor’s office has been very mum on that,” said Steven Stacey, a Syracuse dentist and president of the state’s Fifth District Dental Society. “The No. 1 frustration from the dental community is the lack of information from the state.”
Dentists were declared essential when the novel coronavirus lockdown began in March, but could perform only emergency procedures. For two months, dentists have had to rely on money from the occasional procedure while spending thousands to upgrade. Even when they start filling the chairs again with cleanings and cavity-fillings, it will take a long time to recoup those costs. Dentists will see fewer patients than before because they’ll spend more time cleaning exam rooms and equipment.
Patients are suffering from the lack of routine and preventative care, said Dr. Tansy Schoonmaker, a pediatric dentist and co-owner of the “Little Jaws, Big Smiles” practice in DeWitt.
“If it was a cavity eight weeks ago, it was a quick filling, but you wait eight weeks and it will be a crown at double the cost,” she said. “You wait two more weeks and it will be a root canal at triple the cost. You wait two more weeks and you have to pull the tooth.”
Dentistry was considered a high-risk occupation for spreading the virus because drills and water-sprayers “create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris,” the federal Centers for Disease Control said. Surgical masks aren’t enough to protect the doctor, and the patient obviously can’t wear a mask during a procedure.
All other medical professionals have been allowed to open for non-emergencies except for dentists, orthodontists, and chiropractors.
In an emailed statement to Syracuse.com on Tuesday, the state Department of Health said there is no timeline yet for dentists to widen their scope.
“Given the potential vector of transmission due to aerosolized saliva, the state wants to ensure that appropriate safeguards are established and adhered to,” read the statement. “The state continues to engage public health officials to develop appropriate and applicable guidance for re-opening of dental offices for preventive and non-emergent care that will ensure public health and safety.”
Onondaga County has heard nothing from the state about when local dentists might open, but they will be required to file business plans when they do, said county spokesman Justin Sayles.
Schoonmaker estimates the upgrades to their office and the additional personal protection equipment will cost her and her partner, Dr. Cosmina Nolan, $30,000.
“The cost is insane,” Schoonmaker said. They’ve have installed room-by-room filtration systems in the ductwork. They’ll replace plastic tubing after each patient who needs nitrous oxide, or laughing gas. They’ve stocked up on gloves and masks, and held staff training sessions on Zoom.
In his practice in Syracuse, Stacey has installed virus-killing ultraviolet lights in the air filtration system. He’ll cover each chair will plastic that will be disposed after each patient. Counters will be bare so they can be swabbed with alcohol.
“The people we treat are our neighbors and family and friends,” Stacey said. “We want to be safe and responsible.”
Some dentists are also installing air-suction devices that will whoosh away air inches from your mouth, and clear shields that will be placed between the dentist and the patient’s mouth.
At Schoonmaker’s practice, dentists and staff will wear covers over their hair, an N-95 mask covered with a surgical mask, and a face shield. They’ll also don gloves and neck-to-toe gowns.
Even that basic equipment has become scarce and expensive.
“The cost of PPE has gone through the roof,” Stacey said. “The price of a mask has gone up three- to four-fold.”
You’ll see big changes at your dentist’s office even before the exam room. Before appointments, you might be quizzed by phone about potential coronavirus exposure and symptoms. You’ll wait in your car until called — waiting rooms are a thing of the past — and you’ll have your temperature checked and be given a mask you’ll wear until the dentist asks you to open up.
Practices will see fewer patients, both to keep them from bumping into each other in hallways and because it will take longer to clean rooms in between appointments. That means dentists who’ve already had virtually no income for two months will have reduced incomes for the foreseeable future.
The 12,000-member New York State Dental Association last week called on Gov. Andrew Cuomo to let dentists resume full practice.
“Dental offices have been open for emergent/urgent care throughout this health crisis and have been handling these most challenging cases with extreme care,” wrote Mark J. Feldman, executive director. “If we can manage these most dire cases, we are certainly prepared to provide standard dental care.”
Dentists say they know how to do infection control: It’s central to their work every day. Patients can transmit viruses and bacteria in their blood and breath, and doctors are keenly aware of how to protect themselves, Schoonmaker said.
Schoonmaker said she and her patients are anxious to reopen, and she doesn’t understand why it’s taking so long. Phase one reopening started early this month with expanded manufacturing and construction, phase two could come as early as Friday, with expanded personal services and retail.
“Hairdressers are in phase two, but we still don’t know about dentists,” Schoonmaker said. “The ice cream stores are open and the beaches are opening in New York, but dentists aren’t allowed to.”
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