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Elective Medical Procedure Postponements Challenge Dentists, Patients

STEVE INSKEEP, HOST:

It's easy to understand why dentists have canceled a lot of appointments. If the coronavirus is spread by breathing, would you want to be poking around in people's mouths all day? But this move for safety is causing real problems for both dentists and their patients. Here's Craig LeMoult of our member station WGBH.

CRAIG LEMOULT, BYLINE: Jeffrey Lowenstein runs a small orthodontic practice outside of Boston and says when he first started hearing about the virus, he thought the steps dentists routinely take to prevent the spread of infection should be enough.

JEFFREY LOWENSTEIN: And then, as we did more and more of the research, we found that this coronavirus was unlike any other virus we have ever come into contact with.

LEMOULT: In particular, dentists' drills - or handpieces, as they prefer to call them - can actually aerosolize the virus, making it easy to inhale.

LOWENSTEIN: So the combination of the handpiece and the high-speed evacuation system - we're able to remove most of the aerosol. We're just not able to remove all of the aerosol.

LEMOULT: And that puts everyone in the dentist's office at risk. So in mid-March, the American Dental Association made a recommendation to its members. Kathleen O'Loughlin is the group's executive director.

KATHLEEN O'LOUGHLIN: We were one of the first health care associations to publicly request that all of our dentists only practice emergency dentistry or urgent care dentistry and to postpone all elective procedures.

LEMOULT: O'Loughlin says nationally about 80% of dental care is performed in small private practices. Most of those offices have now shut down and laid off staff. That's been a real burden for pediatric dentist Lindi Ezekowitz.

LINDI EZEKOWITZ: You know, we have fixed costs in our office that don't go away, rent and loan payments and utilities, and, you know, those happen every month.

LEMOULT: Ezekowitz's husband is also a dentist, adding to the financial stress.

EZEKOWITZ: Besides my office expenses, we have personal expenses too, just like everybody else. And so all of a sudden, we found ourselves in a very odd situation where we're both unemployed.

LEMOULT: Ezekowitz has business interruption insurance, but that doesn't cover pandemics. The dental societies in Massachusetts and other states are pressing for state legislation that would compel insurance companies to cover this, and dentists across the country are busy applying for small business loans to get them through. Ezekowitz's office isn't totally closed. She still needs to take care of emergency patients.

EZEKOWITZ: I'm definitely nervous when I see a patient, and I'm also nervous about the parent, you know, giving me something as well. I try to keep the parents at a distance.

LEMOULT: Of course, dental offices shutting down isn't just a problem for the dentists. Some patients can't get care because their problems don't rise to the level of emergency. Then there are patients like Suzanne Sege. She's in a lot of pain.

SUZANNE SEGE: Tylenol, extra-strength Tylenol, has not touched it, and it's been 24 hours a day.

LEMOULT: Her dentist says Sege probably has an abscessed tooth that would qualify as an emergency. But a couple of weeks ago, Sege had a fever, and she's worried that may have been a symptom of COVID-19.

SEGE: I did not want to expose anyone to what potentially could be someone who might have had the virus or necessarily that I wanted to be exposed.

LEMOULT: So for now, she's not going to her dentist. And with many people staying away, dentists worry when they reopen, they'll face a huge backlog of patients, many of whom will be in pretty bad shape. That's if they can keep their dental practices alive until then. For NPR News, I'm Craig LeMoult in Boston.

(SOUNDBITE OF KOLOTO'S "PRIMER") Transcript provided by NPR, Copyright NPR.


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