DIY dentistry during the SARS-CoV-2 pandemic
LONDON, UK: As a result of the SARS-CoV-2 pandemic, dental practices across the world have been partially or completely shut down and routine dental check-ups largely postponed. For a few unlucky people, however, widespread lockdowns have left them unable to access dental services during oral emergencies, leaving them with a single viable option: do-it-yourself (DIY) dentistry.*
When the severity of the coronavirus outbreak’s destabilising impact became apparent earlier this year, many national dental associations were relatively quick to react. By late March, dental practices in a number of countries, including Canada, Australia, the UK and the US, had been ordered to effectively close their doors to the general public owing to the potential for the spread of SARS-CoV-2 in such environments.
Though many of these countries have since eased health restrictions and begun to reopen dental practices for non-essential services, there are nevertheless a wide range of precautions now in place to limit the transmission of SARS-CoV-2 in healthcare settings. These precautions have resulted in vulnerable patient groups having to opt for such alternatives as teledentistry, and in recent weeks, numerous dentists and patients have come forward to share their experiences with at-home dentistry.
Patients taking matters into their own hands
“We have heard tales of people attempting to take their own teeth out,” Dr Catherine Tannahill, regional head of clinical dentistry at Portman Dental Care, recently told the BBC. “We’ve had people sticking crowns back on with superglue, then finding that they’ve stuck their lip to their tooth. We’ve had people bursting abscesses—none of this we would advise.”
Though Tannahill’s examples might seem extreme, there have been multiple reports of patients performing dental procedures on themselves owing to their inability to secure an appointment. Billy Taylor, a 33-year-old aircraft fitter, achieved a certain kind of notoriety in April when the story of him extracting his own infected tooth was widely published, and Debroy Parrington told the BBC that he experienced “immediate relief” after pulling a tooth out that had been giving him toothache.
Dr Yasmin George, a Surrey-based dentist, told Dental Tribune International (DTI) that the abruptness with which dental services in the UK were shut down resulted in several of her practice’s patients missing out on pre-scheduled appointments for critical treatments such as denture fittings. As a result, she immediately turned to providing teledentistry services that, at times, included instructing patients and their family members on how to perform somewhat complex dental procedures.
“On the last day we were open, I just loaded up the car with gloves, masks and hand sanitisers and began distributing them to some of our patients who wouldn’t have access to these sorts of things,” George said to DTI.
She continued: “A couple of weeks into lockdown, one of my patients broke her tooth at the gingival level. If she’d been able to come in, I would have sealed it off with a bit of temporary filling material to prevent it from getting infected, but since she couldn’t see me, I had to instruct her husband on how to do it over the phone, with their daughter holding a camera so that I could follow along.”
“He ended up doing a fantastic job, but it was still a very stressful experience,” George concluded.
The way forward
Despite her misgivings about the technology, George stated that she would certainly continue to offer teledentistry services in the future, particularly during the early pre-diagnostic stages of dental treatment. It is a sentiment that she shares with Dr Jalal Khan, the operator of a mobile dental surgery truck. In an interview with DTI last month, the Australia-based dentist said that he believed that the major use of teledentistry services was for triage purposes prior to an initial consultation rather than for diagnostic purposes.
Both George and Khan were, however, broadly opposed to the idea of dentist-guided DIY dentistry becoming a more common treatment option in the future. The American Dental Association (ADA) echoed its concerns in a response on the topic to DTI, stating: “Before any DIY dental treatment, it’s important that patients speak with their dentist about the potential risks and benefits. The ADA believes that, without the involvement of a licensed dentist, patients lose a very important quality control checkpoint—their dentist—to ensure all aspects of their treatment are performed and are progressing in the best interests of the patient.”
Whereas there might seem to be benefits to conducting DIY dentistry, particularly during these trying times, the truth of the matter remains: the best way for patients to take care of their oral health is under the guidance of a dental professional.