Had a crown done today. Nothing different other than the dentist said he was trying to hurry before being shut down.....

Zero Corpus cases

My dentist in Austin was still full biz as usual yesterday.

Yep. I spoke with former Head of Perio Dept early this morning who was speaking with dean of the dental school in Nebraska. They have been told by epidemiologists that the peak in Nebraska will be mid-May.

So, hospitals want dentists taking out all infected teeth or treating abscesses. Because if all dentist shut down these people will overload the emergency rooms and be another infection route not only in hospital but then when sent back to dentist. So they definitely want us serving in some capacity.

I've been nothing but urgent care since yesterday.

ADA just sent email defining urgent care:

Emergency or Non Emergency? ADA Offers Guidance for Determining Dental Procedures
In a statement issued on March 16, the American Dental Association (ADA) called upon dentists nationwide to postpone elective dental procedures for three weeks in order for dentistry to do its part to mitigate the spread of COVID-19. Concentrating on emergency dental care only during this time period will allow dentists and their teams to care for emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.

The ADA recognizes that state governments and state dental associations may be best positioned to recommend to the dentists in their regions the amount of time to keep their offices closed to all but emergency care. This is a fluid situation, and those closest to the issue may best understand the local challenges being faced.

The following should be helpful in determining what is considered "emergency" versus "non emergency." This guidance may change as the COVID-19 pandemic progresses, and dentists should use their professional judgment in determining a patient's need for urgent or emergency care.

1. Dental emergency

Dental emergencies are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding, alleviate severe pain or infection, and include:
Uncontrolled bleeding
Cellulitis or a diffuse soft tissue bacterial infection with intra-oral or extra-oral swelling that potentially compromise the patient's airway
Trauma involving facial bones, potentially compromising the patient's airway
Urgent dental care focuses on the management of conditions that require immediate attention to relieve severe pain and/or risk of infection and to alleviate the burden on hospital emergency departments. These should be treated as minimally invasively as possible.
Severe dental pain from pulpal inflammation
Pericoronitis or third-molar pain
Surgical post-operative osteitis, dry socket dressing changes
Abscess, or localized bacterial infection resulting in localized pain and swelling.
Tooth fracture resulting in pain or causing soft tissue trauma
Dental trauma with avulsion/luxation
Dental treatment required prior to critical medical procedures
Final crown/bridge cementation if the temporary restoration is lost, broken or causing gingival irritation
Other urgent dental care:
Extensive dental caries or defective restorations causing pain
Manage with interim restorative techniques when possible (silver diamine fluoride, glass ionomers)
Suture removal
Denture adjustment on radiation/oncology patients
Denture adjustments or repairs when function impeded
Replacing temporary filling on endo access openings in patients experiencing pain
Snipping or adjustment of an orthodontic wire or appliances piercing or ulcerating the oral mucosa
2. Dental non emergency procedures

Routine or non-urgent dental procedures include but are not limited to:
Initial or periodic oral examinations and recall visits, including routine radiographs
Routine dental cleaning and preventive therapies
Orthodontic procedures other than those to address acute issues (e.g. pain, infection, trauma)
Extraction of asymptomatic teeth
Restorative dentistry including treatment of asymptomatic carious lesions
Aesthetic dental procedures
The ADA is committed to providing the latest information to the profession in a useful and timely manner. Please visit ADA.org/virus for the latest information.

Had a temporary crown done today in round rock. Hoping the permanent comes in and can get it done before they get shut down.

Interestingly there has been no such directives from the CDC, DHHS, TX State Board of Dental Examiners, or Governor Abbot. The Texas Dental Association provided a webinar on protocols including pre-screening, extended infection control and offering to postpone elective procedures. Dr.Birx suggested dentists postpone elective surgeries. The ADA recommended postponing all elective procedures to do our part.

Also of note is that all my elderly patients have vehemently insisted on keeping their appointments. After following all screening protocols we have so far allowed that. However I believe that tomorrow may be the last day until we see where things are in a couple of weeks. I want to take care of my employees too but an extended reduction of clinical procedures will not allow me to carry them forever. Tough decisions.

TamuKid said:

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Had a temporary crown done today in round rock. Hoping the permanent comes in and can get it done before they get shut down.

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I've got a temp in right now and debating if I should go in tomorrow or next week to get the permanent one in.

Any downside to leaving the temp one in?

My wife will have a compromised immune system starting today (whole other long story) so trying even harder to not risk anything.

This isn't medical advice but personally I wouldn't mind a temporary crown in my mouth for a month or so. stay off of it at least with hard foods so it doesn't break or come off. I've had patients in temp for 4-6 weeks before whether they left town or we were watching for symptoms on a tooth.

Thanks, I just wonder if things are going to be as bad/worse in 4-6 weeks.

Quote:

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Just to be safe, stop eating olives.

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Haha. You're a genius.

Trying to add a little bit of humor to this time when we are up against this great challenge...

I remember the exact day I cracked a tooth - November 22, 2018.

Was having a nice Thanksgiving dinner when the event occurred. Pain Pain Pain. However, the next day was travel day to Aggieland (LSU game on Nov 24th). I girded my loins for battle and made the trip. Lots of pain. Made it to the game. 7 overtimes. Ags win. No pain for awhile

And I haven't had an olive since...

I went to skin Dr today to get my checkup, they said business is really slow all the sudden/cancellations. Why would you cancel a skin Dr appt? But OK to stand in line at HEB? People are weird.