Dentists and dental clinics in Southern California are absorbing a devastating blow from the coronavirus pandemic, with most following California Dental Association recommendations to shut their doors to routine exams, cleaning and cosmetic work.

After Gov. Gavin Newsom issued a shelter in place order on Thursday, March 19, directing all Californians to stay at home with the exception of stepping out for food, medicine and other necessities, the association issued a recommendation to all dentists “to suspend all in-person dental care with the exception of emergency treatment, until further notice.”

While this is a recommendation and not a mandate, a majority of dentists practicing in Southern California should take it seriously to make this combined effort to “flatten the coronavirus curve,” said Dr. Richard Nagy, a Santa Barbara-based periodontist and president of the California Dental Association.

But, he said, the impact of this shutdown on dentistry has been devastating and it will be a while before its long-term impact can even be gauged.

‘Staff getting laid off’

“Dentists work in a small setting,” Nagy said. “We’re seeing staff getting laid off because we’re not open for business.”

A dental emergency is a situation that involves uncontrolled bleeding, trauma that requires tooth extraction or root canal therapy or infection that could be life-threatening, he said. What is not considered an emergency, Nagy said, is routine cleaning, exams and aesthetic dentistry. But, he said, those who have pain, swelling or a fever should contact their dentist right away.

“Since distancing is the only way to flatten the curve and save personal protective equipment for front-line health workers, we believe this is the best way to go,” Nagy said.

The association also is asking dental practices to donate personal protective equipment such as masks, gowns and gloves to medical clinics and hospitals that are on the front lines battling the coronavirus pandemic, he said.

Dentists in Southern California have interpreted the association’s guidelines based on their individual practice and capabilities.

All patients canceled for 3 weeks

Dr. Jaewoo Cho, who owns Diamond Bar Dental Studio, said he has suspended routine procedures such as cleanings, preventive services and even fillings that can wait. He has decided to cancel all patients for the next few weeks with the exception of emergency procedures.

But, for Cho, who got out of dental school in 2016 and has only had his own practice for a little over a year, it’s a serious financial struggle.

“The uncertainty of it all is what’s really frightening,” he said. “Like many young dentists, I have a student loan that I carry as well as a business loan. I still have to pay monthly rent for my office. And that’s a lot right now. But, what’s important at this time is we set a good example as health-care providers to do the right thing.”

Keep dental patients out of ERs

It is still important for dentists to take on emergency dental cases to prevent those patients from clogging up emergency rooms and urgent care centers, which are already overwhelmed by COVID-19 cases, Cho said. For his part, Cho has been talking to patients over the phone as much as possible to solve their issues. He also views teledentistry as a way to address patient needs, at least for the time being.

“I still recommend patients call their dentists so we can make the determination if they can wait or if it is an emergency,” he said. “The last thing we want right now is people with dental pain crowding emergency rooms.”

Coastal Dental in Dana Point and Los Alisos Dentistry in Mission Viejo are both open for emergency procedures, said Irina Bond, who manages the offices.

“If you can postpone, it’s better to postpone,” she said. “But, we’re continuing to keep the office open because there are so many people in need. You just cannot abandon people in pain and ask them to go to the emergency room, which is not equipped for dental emergencies anyway.”

As providers who see low-income families, Bond said, it’s a crucial time to stay open because not many dental care providers in the area accept Medi-Cal.

Corona clinic open, buzzing

Centro Medico Community Clinic in Corona is probably one of the very few in the region to see individuals for all dental care needs. They have a medical and dental wing and both are buzzing with patients right now, said executive assistant Christine Khatchoyan.

“We’re seeing patients as long as as they don’t have symptoms of coronavirus,” Khatchoyan said, adding that every patient who comes for dental care is first taken to the medical clinic and screened. The clinic is accepting all patients, including those who need cleaning, checkups or other dental work done.

“This is really the time for many people to come in to take care of their teeth as school is out and everyone is home,” she said. “We’re seeing a lot of response in our dental clinic. We are confident doing that because we take every possible precautionary step to screen patients.”

Their medical clinic even has COVID-19 tests available to test patients, if necessary, she said.

The clinic now offers telehealth or video visits for both the medical and dental side, which makes it easier to safely screen patients before they come over, Khatchoyan said. In addition, Centro Medico has been doing house visits for medical patients, particularly for those who are elderly or too sick to venture out.

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