Information for Our Colleagues: COVID-19 Concerns
What is a true dental emergency?
Maybe it’s just the fact that we are the most experienced group in Southern NJ as far as dealing with “real” emergencies at a University Level I Trauma Center, as founders of the OMS division at Cooper Hospital, but we were glad to see the ADA put something out to define emergency vs urgent.
There Are Only Three True Dental Emergencies–
- Infection compromising the airway
- Facial fractures compromising the airway.
Every other dental problem is urgent at best!
What should I do if my patient has a true dental emergency?
- This is an easy one; call our office just like you normally would. We are here to help 24/7 as always!
What should I do if my patient has an urgent need?
- This is the more difficult one for you and us as your OMS support team. These are the situations that can put us both at risk.
Thinking this through there are 2 major considerations for both your team and ours. First remember that a completely asymptomatic patient can be a carrier and able to infect others. Second, recommendations and common sense tell you that using a dental drill puts the dental team at the highest risk. We both know that the simple extraction you start may end up a surgical extraction with need for use of a drill. Surgical medical associations and the American Association of Oral & Maxillofacial Surgeons all recommend the use of PPE to include an N95 mask to protect the surgical team when the patient has or could have the virus. Taking all those factors into consideration this is how we will manage urgent needs.
Management of Urgent Needs:
- Medicate patient to treat pain and/or infection and monitor by phone.
- See patients with urgent needs only if they can’t be managed with medications.
- Allow only one patient in your office at a time and only after screening with a history, cursory exam, and a normal temperature taken at the door.
- Do any procedure using a regular mask and routine protection that doesn’t require a drill that will aerosolize irrigation and saliva. Disinfect all areas of the office after discharging the patient including everywhere the patient came in contact with.
- If a procedure needing a dental/surgical drill is indicated, you must don recommended PPE including N95 masks to protect yourself and your staff.
What are our concerns for your team and what has been happening?
Some of you continue to see patients on an emergency basis and feel comfortable doing that. We care about you and your team so we would just caution you to be very selective. We all realize these same urgent needs have usually been bothering the patients for weeks or months before they seek care. The routine urgent issues can wait if these people are medicated!
We have no N95 masks left so we can’t protect ourselves and our staff to the level required for protection against aerosol. We are constantly seeking PPE that we need to do a surgical procedure and we will update our referring doctors should that equipment become available. Until then if we deem it a worthy case to operate on, we have to do in a setting that has the proper equipment, like a hospital, and this burdens the entire system. It’s exactly what we are trying to prevent but we may have no other choice for urgent cases that can’t be managed any other way.
That’s why we are sending this to you, our referring doctors, with whom we have a relationship, in an effort to achieve two goals:
- Know that we are here for you as always so don’t hesitate to call
- You should be careful and don’t take risks!
I observe that all the dentists I work with are compassionate people who would put themselves at risk out of a sense of duty and dedication. In the current circumstance you are risking not only your health but your families. So, remember what the patient thinks is a true emergency usually is NOT.
Hopefully if we as a society come together and do what needs to be done, we can minimize the impact of this virus. My gut feeling being around Cooper, just yesterday, is that this will take at least a month before we have some picture of when things might normalize. We are in this together and we care about you so don’t hesitate to call.
You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.