Taking care of one’s teeth is important to anyone, but it is especially vital for people who live with an inflammatory bowel disease (IBD). We often say that Crohn’s disease, ulcerative colitis, and indeterminate colitis affect the whole person. The mouth is included in this, but we often short change ourselves where oral care is concerned. Mouth ulcers can be common in people with IBD. Cavities and infections of the gum and teeth may be more common in people with IBD. True Crohn’s disease of the mouth is less common, though it does occur. This all means that while most of us have lots of doctor’s appointments already, seeing a dentist is one that we need to keep on our list as well.

All of this is why, when my dentist office opened up, even while cases of COVID-19 were high in my area, I kept my appointment to get my teeth cleaned. A few weeks later, when the pediatric dentist opened up, I took my kids for their appointments. Here’s why I went and what to expect when visiting the dentist in the era of corona.

Tips for Your Next Dental Appointment

Some things may be different about your next dental appointment. Here are a few things you might expect.

1. Plan for a solo appointment. You may be asked to come by yourself, and anyone with you might need to wait outside. This may also be true for pediatric appointments: older kids might be asked to come into the office by themselves (call your dentist if you have concerns about this).
2. Wear a mask. This can be a cloth face covering or a surgical mask or a disposable mask. If you don’t have a mask, ask your dentist if they can supply you with one when you get to the appointment. Don’t remove your mask until you are told to do so.
3. Remember your cell phone and put your dentist’s phone number in your contacts. You may need to contact the office from the parking lot. You’ll then be given instructions on when you can enter the office. If you don’t have a cell phone, let the office staff know so that they can work out a procedure with you.
4. Hand sanitizing should be used. You will hopefully be asked to use hand sanitizer, which your dentist will provide, before entering their office.
5. Prepare to answer questions. You will be asked several questions about recent travel, contacts, and signs and symptoms. These questions are for everyone’s safety: answer them truthfully.
6. Temperature checks are necessary. Everyone entering the office will need their temperature taken, even if you are escorting a child or another person to their appointment.
7. Be prepared to follow directions. There likely won’t be any magazines, toys, games, TVs or anything else in the waiting room. You will be directed where to stand and where to sit in the office. If you don’t know where to go: ask.
8. Staff will be wearing personal protective equipment (PPE). Don’t be surprised that everyone, even the reception staff, will be wearing face coverings. Dentists, orthodontists, and hygienists may be wearing two masks and a face shield and other PPE. Talk to children beforehand about this and show them photos so they are not frightened by what it looks like (it can even be a little off-putting for adults).
9. Dental procedures might change. Depending on what your appointment requires, procedures may change in order to protect everyone from possible virus transmission. Check with your dentist before your appointment or ask that the procedure be explained and that any differences are pointed out.
10. Bring patience. Remember that your dentist is far more at risk from you than you are from them. They will be following guidance from the American Dental Association and the Centers for Disease Control and Prevention. They’re doing their best to keep everyone safe, and your patience with new procedures will be appreciated.

I’ve Been Nowhere

Since March 14, which was a day after schools closed and the last day I was out (selling Girl Scout Cookies), I have only been away from my neighborhood a handful of times and I have not gone inside any stores or pharmacies, or anywhere else. I have driven to a few places to make a drop off or a pick-up, or to say “happy birthday” to friends from 6 feet away, while wearing face coverings. But that has been the extent of my outings.

In the beginning we didn’t know much about how COVID-19 would affect people with IBD. We know more now, and having IBD doesn’t put us at risk for a more severe course of the disease. However, receiving an immune-suppressing medication might put us at risk, and I fall into that category, so I have been following guidelines put out by my town, county, and state.

I was anxious about going to the dentist.

Not because I have any real worry about procedures to keep myself (and the dental staff) safe, but because I felt as though I didn’t know how to move about the world anymore. This is especially true as we all have to assume that we are asymptomatic carriers of SARS-CoV-2 and that everyone around us is as well.

I bought cloth masks in April, when it became clear that they might be needed for some time. I also got a few filters for them. Even though the mask is washable and reusable, the filters aren’t, so one thing I think about when I send my husband on errands is if the trip is “filter worthy.” Even for him, going out has not been common and has been only for essentials, like getting the car repaired. 

Brush Your Teeth and Grab Your Mask

The day of my appointment, I grabbed my mask, with the filter in it, which we keep by the door, and headed out. The procedure was that I would call the dentist when I was in the parking lot. They would then let me know when I could come in. There’s no “waiting room” anymore. You come in when the hygienist or the dentist is ready for you and the chair is available. Not before. When it was time, I got out of my car in the parking lot and walked to the front door of the office.

The first thing that happened was that I had to ask a man, who was not wearing a face covering, to get out of my way. Here I was, anxious about my own behavior and not wanting to do anything that made anyone else feel uncomfortable or unsafe, and I had to defend myself. He was on his cell phone, standing in front of the office doors, blocking the way. With no mask on. I had to ask him several times to move away from the door so that I could go in. I can only imagine what my tone was, the third time I asked him, because I know that my heart rate went up and I was angry by the time I got upstairs.

It’s Like I Tell My Kids: “Don’t Touch Anything”

The thing I was most concerned about was doors. Which is maybe a little silly. But I didn’t want to touch doors and I didn’t want to wear gloves, because disposing of gloves is troublesome (as you may have seen from the many photos of shopping center parking lots littered with disposable gloves on social media). I had to open the front door and then the doors to the stairs (I always take the stairs, and especially now) but the door to the office was open.

As I walked in, there was a hand sanitizer station near the door, which the receptionist had told me over the phone. I used the sanitizer and stood on the “X” on the floor next to the desk. There were several more changes besides the open door, the “X,” and the hand sanitizer station. There was a huge plexiglass barrier between the waiting room and the reception area. The kids play area (such a great help to me when I needed to bring my kids with me for my many, many dental appointments) was blocked off. There were no magazines on the table. There were signs with the same directions that I had been given over the phone. Everyone in the office was wearing a mask.

At that point I was asked a series of questions: had I been exposed to anyone who had tested positive or who was waiting for test results for COVID-19, had I been out of the country, did I have any signs or symptoms such as fever; loss of taste or smell; diarrhea; or cough. The answer to all of these was “no” and so the receptionist reached over the plexiglass and took my temperature with an infrared thermometer.

My temperature was “normal” and so I was then directed to a specific seat in the waiting room. (Turns out the hygienist chair wasn’t quite ready yet.) Another patient came in and underwent the same procedure (though she walked past the hand sanitizer station and was sent back to use it). She was directed to sit in a specific chair several feet away from me. I was grateful that there was a “gatekeeper” managing all of this. I know that’s not his usual job.

There is construction going on in the building. At this point I begin to see the construction workers pass to and fro outside the open door to the office. None of them are wearing face coverings. It makes me feel unsafe. And angry. 

Some Things are Different — But Not Everything

I’m called back to my appointment and there are more changes. My hygienist is wearing a face shield and a hair covering and a mask and gloves even to come to the waiting room to fetch me. She changes gloves several times during my appointment. She tells me when to take off my own mask. I talk with her for a few minutes about how it’s my understanding that she is more at risk from me (and from her other patients) than I am from her. She tells me a little more about how they’ve stepped up their cleaning and sterilizing, but they were always concerned with these things, so it’s not terribly different, but they are taking more precautions.

At this point, my visit is the same as it always is: she cleans my teeth and we talk about what’s been going on with my dental health. There was just one small change: I was asked to rinse with hydrogen peroxide for one minute. From everyone I’ve talked with who has been to a dental appointment since the pandemic began, I am the only one to be asked to do this. I know that it’s not a big deal, although there is scant evidence that it helps in reducing the risk of transmitting SARS-CoV-2, so I comply.

I don’t like dental procedures. But I adore my dentist. This has been helpful over the years as I’ve endured many procedures in her office. Like other people with IBD, I suppose, my dental health wasn’t always my first concern. Finding a dentist after moving always seemed to take more time than it should. And I am well aware how closely our dental health mirrors our overall health. That’s why, even with COVID-19 in the mix, I wasn’t about to skip what was a routine cleaning appointment. I’m up to 3 cleanings a year now so it won’t be long before I’m back. It might seem like it’s not so important in the grand scheme of things, but it is so key for catching dental problems early and preventing others from occurring.