Hector Peralta knows the importance of paying attention to his teeth.
The 70-year-old Lynbrook man makes sure to brush, floss and see the dentist to take care of his sensitive gums and bridge. But Peralta admits he was a bit nervous about seeking dental care through the worst of the COVID-19 pandemic.
"There was still a little bit of fear because it was a pandemic and no one knew much about it," he said during an appointment at Long Island FQHC’s Dental Office in Roosevelt on Tuesday, which focuses on providing care to low-income, underinsured and uninsured residents. "But I was also looking forward to coming back."
For more than a year, people have been hiding their pearly whites behind masks as a key defense against COVID-19. But too many also have been hesitating to give their teeth the attention they deserve, as dentists said they are seeing more cavities, inflamed gums and other conditions. Peralta was seeing the dentist for the second time since the pandemic.
"People are out of rhythm," said Dr. Matthew Messina, consumer adviser for the American Dental Association. "We used to get up in the morning, get a cup of coffee, brush our teeth and go to work. Now we get up in the morning, have a cup of coffee, take our computer to the couch or wherever we are working in the house and have another cup of coffee."
Messina said failing to brush allows for plaque — bacteria and loose food particles — to build up, leading to cavities and periodontal disease.
No reason to fear, dentists say
Dental offices in New York were closed to patients during the early days of the pandemic, except for emergency procedures. When they got the green light from the state to reopen in June, dentists faced two challenges: trying to accommodate those who wanted appointments with new social distancing requirements, and luring back reluctant patients.
Dr. David Lam, chair of oral and maxillofacial surgery and interim associate dean for clinical affairs at Stony Brook University’s School of Dental Medicine, said dentists are following strict safety protocols and noted there has been no recorded case of COVID-19 transmission in a dental practice.
On its website, the Centers for Disease Control and Prevention states there is "currently no data available to assess the risk of SARS-CoV-2 transmission during dental practice."
What to know
Dentists say their officers are taking extra precautions during the COVID-19 pandemic.
Most people should see a dentist every six months for a check-up, but some patients may need more frequent visits.
Experts say delaying regular oral care maintenance could lead to bigger dental and overall health problems.
Dr. Winardo Lomboy, a dentist and clinical director of the LIFQHC’s Roosevelt Dental Office, which also serves patients with Medicare, Medicaid and private insurance, said patients should find comfort in the fact that dentists routinely use personal protective equipment and take precautions — and had been doing so even before the pandemic.
They have added even more equipment, such as extra oral suction and machines with HEPA filters, to reduce risk.
"We are practicing safe dentistry, so they don't have to worry about coming here," Lomboy said. "I tell patients, ‘If you can’t trust your dentist, who can you trust?' "
Experts recommend six-month dental checkups for most people. But patients with chronic dental issues may need to be seen more frequently.
Restrictions on dental offices during the pandemic made it difficult for many people to schedule regular checkups. "It was kind of a perfect storm for people not coming in as often as they routinely did and not taking as good a care of their teeth and gums as they did," Messina said.
'Everything is worse'
When offices reopened, appointments were backed up for weeks, sometimes months, because there were limits on how many patients doctors could allow into an office. And some people just put off making appointments, which often had consequences once they finally sat in the dentist’s chair.
"Pretty much everything is worse because of a hesitation to see someone sooner," said Lam, who oversees the school’s Dental Care Center, which served about 80,000 patient visits a year before the pandemic.
"If something was a little cavity that needs a little filling, now it’s been delayed and needs a big filling or you might have to put a crown on the tooth," he explained. "If it’s a big cavity and you delay it, it might become a root canal, to save the tooth. If it can’t be saved, the tooth would be removed."
Lam said, in some cases, patients who were advised to see a surgeon because of possible oral cancers put it off until the fall or later.
Dr. Scott Asnis of Dental365, which has 40 locations on Long Island, said periodontal conditions have worsened because of such disruptions.
"We are treating recurrent disease as well as new disease at a very high rate," Asnis said. "Periodontal disease can be symptomatic, such as swollen or bleeding gums. More often than not, patients do not know they have periodontal disease until diagnosed by the dentist and hygienist."
Wearing masks for prolonged periods of time without taking breaks to sip water could lead to dehydration and other oral health problems as well. Experts were hesitant to draw a direct correlation between mask-wearing and dental issues.
"When you change the environment and make it drier, it throws the balance off, and that can definitely have effects on the soft tissues such as the gum tissue and the tongue," said Dr. Bruce Valauri, chief dental officer at ProHealth Dental who has a practice in Lake Success.
Being diligent about oral hygiene is key to overall health, Valauri said. He pointed to studies that show a link between poor oral health and resulting periodontal and cardiovascular disease.
Peralta's checkup included X-rays and a teeth cleaning. Lomboy again reiterated the importance of caring for his sensitive gums. He said he would encourage family and friends who have been putting off dental exams to make an appointment.
"You have to overcome that fear and go to the dentist," Peralta said, "because something minor could turn into something bad."