Impact of COVID-19 on Dentistry and Dentistry’s Impact on COVID-1

I want to weigh in on this topic of COVID-19 for our industry and offer a few thoughts of preparedness you might want to consider. First I want to offer some facts on the topic and to be clear these aren’t my facts but rather from either the CDC or WHO and I will reference all my sources at the end if you want to read them yourself. I share all of this because between the media and social media, it is very difficult to get to what is real, so I will provide what I believe to be credible sources of information. The reason why this is important will be obvious to some, but not all.

Misinformation about COVID-19 is causing widespread panic and resulting in people stockpiling a years worth of toilet paper as an illustration of the level of the insanity in the world right now.

COVID-19 Facts

According to the CDC the seasonal flu in the US in 2017–2018 resulted in 61,000 deaths and 810,000 hospitalizations with 45,000,000 illnesses. This works out to a case-fatality rate (CFR) of 0.13%. In the years 2016–2017 it was 38,0000 deaths and 497,000 hospitalizations for 29,000,000 illnesses. This is a CFR of 0.13% as well.

As of 3–13–2020 in the United States, there have been 41 deaths for total reported cases of 1,629. This works out to a CFR rate of 2.5%. This CFR rate is expected to change quite a bit because of the test methods being limited to those who had foreign travel. This change in testing protocol just changed this week. So likely there are far more who have the illness but have not been tested. I am not under the impression that ultimately they think the CFR rate will go up or down. I think there is too much unknown at this point.

COVID-19 Transmission- One of the challenges creating some the hysteria is that there isn’t enough known about how this virus is spread. It is thought to be spread via liquid sprayed from a person to another via cough or sneeze. There is thought that the virus can live for some time on a hard surface such as a door knob. No evidence of its transmission via water but has been found in feces. Some early evidence shows that a person exhibiting no symptoms could be contagious. This is disturbing for sure. Lastly it appears as though the incubation period for this virus is about 5 days and the symptoms appear to develop in about 11 days.

What does it all mean?

If you are a “normal healthy” person, the likelihood of death from COVID-19 is quite low. Now that being said, you might be miserable for 2 weeks while you recover from it. So clearly, not getting sick is the best method and hence the world closing most all large gatherings lately. So the odds of your dental office being impacted with no shows and cancellations is quite high. The fact that many schools across the country have closed is going to impact every parent in this country and create employment challenges for them all.

What could happen next?

My prediction if things continue to get out of control is this. Assuming hospitals start to overflow and can’t handle the volume of people needing or wanting to be tested for COVID-19, public health officials are likely to seek other facilities and teams to do this testing. I see them next turning to medical and dental schools to be transformed into triage facilities for testing and potentially treatment. In areas that lack these facilities, I could see a potential of public health officials tapping into surgical facilities and dental offices. Think about it, where else are their facilities and employees with asepsis training and capabilities? If things get out of control, I think this would be a real possibility.

Now that I have shared my doom and gloom prediction about COVID-19, I think the more likely is something less dramatic. I for sure see economic loss for business owners as a result of this crisis. If we as trained professionals can calm the public and teach them logical things to do, such as good hygiene, the severity can be decreased. Sadly, there is plenty of the opposite of being level headed.

The worst story I have heard thus far was from a physicians assistant who took a call from someone asking if they were at risk because they ate Chinese food last week. Now I am not trying to pick on this person’s ignorance. This level of ignorance and then inciting panic as a results with similarly minded people will stir the public into a frenzy. My greatest concern for this country and world isn’t the sickness but the damaged caused from the panic.

Mindset matters

I have studied neuroscience for the past 10 years and here is a super short lesson on it. The frontal lobe of the brain is responsible for many things but relative to this, judgement, planning and problem solving. The amygdala by contrast is responsible for the processing of emotions and specifically for this purpose, fear. When one becomes fearful, the body shifts blood flow from the frontal lobe to the amygdala so it can decide whether you should fight or flight. Clearly when you see people fighting over toilet paper in Costco, I can tell you where the blood flow in their brain is and it sure isn’t to the problem solving portion of the brain. One’s ability to solve problems during this “triggered” time is quite low. The problem is that right now we all need better problems solving skills!!

What can you do?

What can you do to be more rational during tough times? Some simple things can help. Just stop and take at least 10 really deep breathes. This will not only help you make better decisions but also help to boost your immune system during a time when we all need this. You will find a calm at the end of taking deeper breaths. Another technique we teach all the time is to change your focus. Being entirely focused on the terrible news or social media feeds that are “scaring” you, you will create a perfect storm in your brain.

If by contrast you can find something positive or bright in your day, celebrate something, enjoy a moment or anything to pull your attention away all off the doom and gloom, again you will shift the blood flow in your brain and dramatically increase your problems solving skills. Now some of you might be asking yourself the question, but I don’t have something bright today or something to celebrate? Look harder, of course you do. Maybe you don’t have COVID-19, or your family doesn’t or you still have a job, or your son or daughter is desperately seeking your attention during this scary time. You should be thankful you have this son or daughter. If you even try a little bit you should be able to create a list of reason to be thankful for!!!

I have great concerns for anyone who has health issues and I am equally concerned for the impact of the panic on our children. This virus has the ability to dramatically negatively impact our children for years to come. The economy will recover, our health for most of us will recover. The emotional scars of any of us acting like fearful idiots could leave life long scars on our children. My advice, calm down so you can calm your family. Turn off the news and turn on a family comedy. Laughter can very positively impact your immune system and your body as reported by the Mayo Clinic.

The Dental Office and COVID-19

People in the medical community are seen, on some level, as experts in health and medicine. Act like an expert and talk sense into your patients, friends and families. Do what you can to attempt to maintain normalcy in your life and practice. But use every chance you have to inspire hope and calm into the public. You have to live it to be able to lead people to it. If you need someone to talk you off the ledge of panic, hit our website (https://acceleratemypractice.com) where we have people standing by on our chat that can offer you some peace in the storm. It would be our pleasure to serve you and help you and your team during this crisis. We can offer you ideas with your practice, patience and family. We are here to support and serve you!

In the meantime I would suggest writing/publishing a Facebook, YouTube, email message to your patience explaining the following. Infection control measures that have always existed in dentistry and were designed such that dental offices assume all patients are infected with something. Meaning, there is no safer place in this country than a dental office. For sure safer than your local grocery or big box store. I would scream this message from the roof top!

From a social distancing perspective, consider having your patients wait in their cars for you to call them in. Patients and staff members are able to stay in a safe spot but yet still get done the things that need to be done.

A Healthy Mouth

Also, one of the best ways to prevent you contracting any illness is to ensure your mouth is healthy. One of the biggest pathways for disease into your body is your mouth. An unhealthy mouth would be far more prone to infection than a healthy one. In addition to this, if you body is busy fighting oral infection, it is taking away resources to fight other and potentially more important infections. There is no better time to have great oral health than now!! I would also passionately share this message with your patients. Feel free to cite the resources I have as evidence to support this message.

Bottom line, the dental office is a very safe place to be right now. Patients can get sound professional advice on public health topics from dental professionals. There is no better time to have great oral health than right now.

Be the calm in the storm for your patients and wash your hands!

Sources & References