By Haydee M. Rodriguez
After months of routine dental appointments taking a backseat to the pandemic, patients are returning to the dentist’s chair.
But they may find that dentist offices look a little different, with emptier waiting rooms, higher-quality personal protective equipment and constant cleaning.
Two local Jewish dentists, one in a family practice and one endodontist, shared their experience of treating abscesses, infections and dental pain during COVID-19.
Dr. Herbert Mendelson
Dr. Herbert Mendelson joined his father in the family practice, Mendelson Family Dentistry in Owings Mills, 27 years ago.
While COVID-19 has disrupted business as usual for everyone, it hit the family practice hard. “The pandemic hit us just as we were planning to celebrate the practice’s 50th year anniversary, and it just ended up as a Facebook post,” said Mendelson, who is also the director of the Dental Implant Continuum at the University of Maryland.
When it comes to the actual work, Mendelson said, “we changed the filtration of the masks to N95s, and added elastomeric masks, which are custom fit and tested, as well as using eye protection and face shields when appropriate. Because we have always been up close and personal, obviously ventilation is critical. We constantly spray things down, and we amped it up a bit.”
But for dentists, working under difficult conditions is not really that new.
“Back in the 80s, when diseases came into the field, there was a lot of concern for practitioners about patient and staff safety,” said Mendelson. “That’s when PPEs entered dentistry in a heavy way. Fast forward to COVID-19, and we were aware that patient and staff safety was paramount.
“What became more of a challenge,” Mendelson continued, “was getting our hands on PPEs since now we were heavily competing with other practitioners in different fields.”
Handling the shortage of PPE at the beginning of the pandemic proved a challenge, and Mendelson said he could not have navigated the difficulty without the assistance of Wendy Mendelson, his wife and office manager.
“Wendy made all the calls. She stayed on top of things as everything changed drastically between mandates and recommendations,” Mendelson said. “You don’t want to operate against a recommendation, and she was really constantly scouring the internet and speaking to organizations and helping to consolidate the information for me.”
The practice stayed open even at the height of the pandemic as Mendelson treated emergencies from his patients and patients from other practices. “We were getting slammed as we were taking emergencies from all over. But our goal was to handle all emergency type procedures and keep people out of the emergency room.”
Mendelson’s family practice continues to play it safe: Everything gets wiped down and sanitized after each patient, the waiting room has been closed and patients with an appointment now wait in their cars so that there is only one person in the hallway at any one time.
“I don’t foresee opening the waiting room back up now that people are used to waiting in their car,” Mendelson said. “Because of the pandemic, there certainly has been a significant change in numbers, but our policy has been, if someone in pain, we will see them the same day. We try to get on schedule. We have nine operatories in the office, but we have lightened our patient load because I can’t have multiple people in the hallways. We are extremely cautious,” Mendelson added.
Routine hygiene visits took a back seat to emergencies a few months ago, Mendelson said. Now, as people feel more comfortable, calls for dental hygiene are starting to increase. Even with all the adjustments and the need to follow safety protocols, Mendelson said that patients have been extremely understanding.
“Patients understand the need for safety and caution,” he said.
Dr. Jeffrey Gardyn
Dr. Jeffrey Gardyn specializes in root canals and has been in practice for a little more than five years at Endodontics, P.A. in Lutherville, a practice with eight specialists and offices in different locations throughout the Baltimore metropolitan area and Annapolis.
“We did not shut down at the height of the pandemic,” Gardyn said. Instead, the practice decided to focus solely on emergencies and canceled all non-emergency appointments. “We wanted to be there for people who were in pain, with an abscess, or an infection.
“Seventy-five percent of root canals can be done by general dentists,” Gardyn continued, “but we get the tough cases.”
When many practices did close at the beginning of COVID-19, Gardyn and his colleagues saw many referrals from other practices.
“We have always practiced Standard Precautions, as recommended by the CDC and OSHA. Additionally, we have eliminated unnecessary equipment, and made sure that everything that is handled by anyone is sanitized each time,” Gardyn said.
Something as simple as completing a form on a clipboard has changed. Consent forms are now provided one at a time, in individualized clipboards, which get cleaned after each use. Equipment is no longer laid out, as in pre-COVID times. Instead, each tool remains in its sterilized unit until ready to use.
“The amount of work has increased because of the enhanced protocols necessary to keep staff and patients safe,” Gardyn concluded.
There is light on the horizon. Gardyn, his colleagues and staff received the first dose of the COVID-19 vaccine on Jan. 5, and they are looking forward to getting the second dose on Feb. 2.