Coronavirus bans cause pain for dentists, patients

Dentists say COVID-19 restrictions limiting them to emergency work will set many patients up for far worse dental conditions in the months ahead.

Dentist Yvonne King at her surgery in Caulfield, Melbourne. Picture: David Geraghty

Dentists warn COVID-19 restrictions limiting them to emergency work will see some patients develop severe conditions, while making practices financially unviable.

The profession was restricted to a limited range of procedures and emergencies this week, amid medical equipment shortages and virus fears linked to airborne particles released by the use of high-speed dental drills.

Dental procedures have since been cancelled for many thousands of Australians, as practices close or scale back, forcing staff to rely on wage subsidies or government benefits.

While the Australian Dental Association appears to support the restrictions, some dentists argue they should be able to continue to work on non-urgent cases involving decay and active disease.

Melbourne dentist Yvonne King told The Australian there was “no question” the bans would set many patients up for far worse dental conditions in the months ahead.

“We can still treat those with high risk of rapid progression of dental disease; if it’s smaller we don’t treat it,” Dr King said.

“But what’s going to happen in six months’ time? By then, it may well need a root canal treatment. So it’s not an ideal situation in any shape or way. I wish we would treat anyone with active disease.

“We have patients in our data base booked for restorations for (small) fillings and we’ve had to cancel them. But from a preventative point of view, and in terms of maintaining the structural integrity of the tooth, now is the time to intervene, because it’s only going to get bigger.”

While stressing she was not a virologist, and fully understood the concern about airborne particles, Dr King said dentists should be allowed to treat all cases of active disease, just as doctors still treated other active medical problems.

Under the restrictions, practices are limited to urgent work, such as fixing front teeth damaged due to trauma, managing soft-tissue problems and treating patients who would otherwise suffer complications to other medical problems.

Dr King said there was “no way” practices could survive financially on emergency work only, and that her practice had shrunk from four dentists and two hygienists to just enough work for one dentist. Staff had been forced on to government support.

She said the practice had adopted extra hygiene measures, including giving patients a viral-killing mouthwash before treatment, and wearing two masks, and had sourced protective equipment from non-medical suppliers.

ADA president Dr Carmelo Bonanno told The Australian the restrictions were based on expert advice and were unlikely to be eased until there was significant reduction in coronavirus infection rates.

“The restrictions are designed to allow dentists to continue to treat patients with problems so that they don’t present to emergency departments,” he said. “So they allow treatment of infection and severe pain.

“It’s really just the way it is and it’s a measure designed to reduce exposure and risk to the whole community.”

He said it was inevitable some dental practices would not survive the crisis. “I’m sure that’s the case,” Dr Bonanno said.