Faced with the growing threat of COVID-19, dental offices were among the first businesses to halt operations, many limiting service to emergency care weeks before the state’s stay at home order went into effect on March 30.
While necessary to protect staff and patients, dentists say they’ve had to make difficult decisions as a result: furloughing hygienists, putting student loans on hold, and postponing cleanings and other elective procedures indefinitely.
“Most dental offices are small businesses … and as a small business, it’s tough,” says Dr. Jenny Gandhi of Pearl. Dentistry Reimagined.
Gandhi’s two Uptown offices have been closed for a month, and she says it’s admirable to see local dentists sticking together to protect their staffs and patients, despite the tough place it puts their practices.
She estimates every month Pearl. is closed, she loses “hundreds of thousands” in revenue.
Dr. Adrian Lineberger of Lineberger Dentistry closed his office on March 16 in response to the American Dental Association and N.C. Board of Dental Examiners’ recommendations. Lineberger says he’s not taking emergency visits except in the rarest of cases in order to minimize risk to his family and staff.
Plus, he says, many dental emergencies fall on endodontists, for procedures like root canals, or oral surgeons — not general dentistry offices.
Like all health care professionals, there’s always risk in being a dentist or hygienist.
“(The) major things that we could be exposed to would be Hepatitis C, HIV, influenza, but nothing on this scale,” says Plaza Midwood Dentistry’s Dr. Mike Farmer, who’s still available to see patients on an emergency basis. “For me, I’m here to help people and I’m willing to take the risks.
“Obviously minimize those as much as we can, but … I’m not gonna just sit on the sidelines while my fellow healthcare workers are taking that risk as well.”
Taking emergency appointments, Farmer says, keeps more people out of hospitals and reduces the risk that they may be infected there.
Gandhi says at least half of emergency calls from patients experiencing jaw pain or broke a tooth, both symptoms of stress-induced clenching and grinding. “Because these are such uncertain times, people have a lot more anxiety than they did two months ago,” she says. “And when you’re anxious or stressed, you clench your teeth a little bit more at night.”
If dentists aren’t available to treat patients in an emergency — even remotely using tele-dentistry technology — those patients could clog already strained hospitals.
In addition, local dentists are supporting fellow healthcare workers with a personal protective equipment (PPE) drive, donating the supplies they’re not currently using.
The Charlotte Dentists Society organized the effort in March, which benefited Novant Health, Atrium Health, and Tryon Medical Partners.
In total, dentists donated more than 12,000 N95 masks, nearly 10,000 gloves, 150 gowns, 640 medical-grade disinfectant wipes, and more, according to Dr. Michael Williams, a member of the society’s board of directors.
With little to no work coming in to dental offices, layoffs and furloughs are common.
Farmer has tried to delay layoffs and furloughs by giving his staff two weeks of additional sick leave to use in addition to already accrued paid time off. He hopes that, paired with the Paycheck Protection Program, will help the business get by without losing staff.
Gandhi furloughed most of her 22 employees, and Lineberger furloughed his staff of four.
Dentists aren’t sure how that will financially affect their practices longterm, but with every week the offices are closed, the greater the burden.
Aside from the lack of revenue, many dentists have large student debts. Gandhi says she’s fortunate to paid hers off by now, but when she graduated 10 years ago she estimates she had nearly $500,000 in debt.
Lineberger says he put his student loans on hold with zero percent interest as part of the federal government’s student loan interest waiver.
Even when their offices can reopen, there’s the fear that the rising unemployment rate could translate to a drop in dental insurance coverage and, thus, less of a demand for check ups.
“Those patients that are out of work, are they gonna run back to the dentist?” Gandhi says. “Probably not.”