You can still treat Dental Emergencies during COVID-19
On March 15, 2020, Ontario dentists’ governing body, the Royal College of Dental Surgeons of Ontario, issued the following statement: The RCDSO strongly recommends that all non-essential and elective dental services should be suspended immediately. Emergency treatments should continue.
It is approaching a month since the statement was first circulated to all dentists in this province. There is no sign that this recommendation will be revoked anytime soon. Instead, our College further reiterated the definition on a “true emergency situation” and guidelines on how emergency cases should be managed.
Due to the unprecedented time span of the lockdown, the College sent out an email on March 26, providing direction for Ontario dentists on the acceptable use of teledentistry during the current State of Emergency. It becomes a billable procedure with its specific codes.
However, a lot of dentists aren’t providing the necessary teledentistry to screen and provide help for emergencies. Instead some dental clinics are simply closed and provide only a simple voicemail message redirecting patients with dental emergencies to their local hospital or a local dental emergency service. In the eyes of the College, that simple voicemail message is not adequate or appropriate. That prompted the College to give us a direction a few days ago that instructs all dentists with professional, legal and ethical responsibilities to provide or arrange for dental emergency treatments for their patients during this exceptional time.
I have been providing dental emergencies for my patients who are truly in need of treatment since the start of this crisis. I triaged emergencies on the phone, then either provided reassurance or taught some simple do-it-yourself remedies over the phone to alleviate the situation, until it was safe for them to come see me in person for proper treatment. Some also needed prescriptions over the phone to the pharmacy.
Today, for example, one of my patients called and asked me about a loose baby tooth in her son’s lower front jaw. By using a popular real-time chatting platform, I was able to have visualizations of the teeth in his mouth and saw the loose baby tooth dangling in front of the erupting adult tooth. Since they are my patients and I have the son’s dental records including the panorex X-ray image of his mouth, I have a good knowledge of his dental and medical conditions. With some questions and answers back-and-forth, I had decided to ask his mom to remove the loose tooth with my real-time instructions with a clean cloth. After some reassurance and encouragement, she finally was able to remove the tooth without much effort or difficulty.
Another case today was a patient of mine who had swollen gums. His mom called and described the situation on the phone. I requested the mom to take a photo of the swelling and text it to me. Immediately I was able to come up with the diagnosis after referencing his dental records and X-rays. In this case, since the patient had no pain, fever, or difficulty in chewing, there was no urgency to come in to have the treatment performed. I then prescribed antibiotics over the phone through his pharmacy.