Gnashing and Grinding of Teeth in the Time of the Coronavirus

Dr. Halligan
Dr. Halligan

“Within any important issue, there are always aspects no one wishes to discuss.”  ~George Orwell

Every year a handful of my patients break or otherwise damage their night appliances or dental orthopedic appliances. Since the word Handful implies five, that might even be an exaggeration, although I’d say it’s pretty close. That is, breakage does occur but fortunately not frequently.

But in just the last week or so, I have seen as many broken appliances as I might usually see in a year. Do you think we could be witnessing an unusual level of stress? Perhaps magnified by a factor of ten or more?

And a few days ago I visited a general dentist with whom I share a mutual patient. When I called his office, his front office person, Doris (not her real name), let me know that with the coronavirus lock-down they are only in the office a few hours a week and just for emergencies. In fact, I was lucky to catch them.

“He’s seeing two emergency patients today. Both have broken or chipped teeth that they want him to take care of. He should be free around one o’clock though.”

So, I went to his office at 1:00. He was still in the back office with a patient.

During the next 15 minutes or so, three more people came through his front door. I overheard their conversations with Doris. One of the three, bothered by a rough tooth but not in pain, was given an appointment for the last week in May. “Hope we’re actually open by then,” Doris said cheerfully.

The other two folks were told to wait. The doctor would see them that day.

I did get a chance to talk with the dentist a bit later—he did keep his mask on and stayed six feet away. “I don’t want to be doing crown preparations and impressions during this lock-down, but I’ve sure been placing temporary crowns and bonded composite repairs just to hold things for a while. We’re seeing several people every week with broken or chipped teeth. I know we’re supposed to be closed, but I’m here a couple of hours at least twice a week.”

There’s no question that this time of the coronavirus is highly stressful. The Biblical references to wailing and gnashing of teeth are many. Fear, disappointment, and anger are the causes, and in our society today we are witness to all three. It is difficult to know which is most prevalent, the fear of catching the illness, or impatient anger at being told what to do by government.

In any case, it is as apparent as ever that dentistry is certainly an essential business.

Whether exaggerated fear from watching too much catastrophic news (and I believe ANY TV news may be too much), or anger at perceived government overreach, our patients are indeed gnashing their teeth and doing damage that you will be asked to remedy when we’re allowed to reopen.

OSHA has suggested additional practices to safely welcome your patients back. The OSHA Airborne Contagion Control Plan is available online. Look for it. Your local dental society is also an excellent source of information. Your dental supply company may also be a resource to help you welcome back your patients and to do so safely.

As I write this, it is early May. We do not yet know when Californians will be given the go-ahead to get back to work. If it is in phases, I certainly hope that dentistry is given the priority it deserves.

The Bible mentions much wailing and gnashing of teeth, often in anger. I am not sure about the wailing, but the gnashing of teeth is a certainty. The longer this forced time-out continues the greater will be the need. Time to consider a manual for your office; time to make sure the team is ready with proper precautions that are strictly followed. This is a new game. We’ve never participated in this kind of government mandated experiment involving the quarantine of the healthy. We will all need to stay on top of the data as the restrictions are relaxed.

In some states, the gates have already been opened. California, according to Governor Newsom, is “weeks, not months away” from reopening.

Be ready. Be safe. Be smart. Your services are essential. Time to prepare.



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