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Dentists seeing emergency patients only during Covid-19 pandemic

Buffalo dentist David Weinman only sees emergency patients these days, including the six he has treated in the past week.

Weinman has always been concerned about infection control, but now – for the first time in his nearly 40 years as a dentist –  he truly worries about his personal health and safety when he probes his fingers into the mouth of a patient.

“But I’ve told my patients, if they are in enough pain or discomfort that they are willing to risk coming in to see me, I’ll take that risk, too," said Weinman, who runs Allentown Dental on North Street. "I’m a health care professional. When you sign on to do this work, you take an oath. You accept a certain amount of risk.”

Weinman is one of 190,000 licensed American dentists – including about 940 in Western New York – who are dealing with the dangers and uncertainties caused by Covid-19. Another 185,000 dental hygienists face the same challenges.

Imagine working a job that requires you to stand face-to-face with your patient, sometimes just inches away, while spraying jets of water and repeatedly putting your fingers into his or her mouth.

For decades, back to the 1980s, Weinman has worn a face mask and gloves when he treats patients, but he said he’s never had this much concern about the possibility that a patient could make him seriously ill.

Following the guidance of the Centers for Disease Control and other government health agencies, dentists for the past several weeks have only been treating patients with emergency problems.

So what should a person do if they get a painful toothache that won't wait until the pandemic is over?

"If you have a dental emergency, call the office of your regular dentist," said Joseph E. Gambacorta, an assistant dean at the University at Buffalo Dental School. "Most dentists will either arrange to treat you, or they will have relationships with another dentist they can refer you to."

Two of the region's biggest dental clinics – Westermeier Martin Dental, which has six local offices; and Western New York Dental Group, which has 21 local offices – said they will take emergency patients who are usually treated by other dentists.

The CDC told the nation’s dentists they should postpone all “elective procedures, surgeries and non-urgent dental visits” during the pandemic.

The federal agency said dental work can be dangerous, not only to dentists but to dental assistants and hygienists.

“Dentists and dental hygienists are some of the most vulnerable workers in America right now,” Gambacorta said. “The work they do produces aerosols, which go into the air where we practice. These people are also working with the upper respiratory tract, which is exactly where the virus likes to live.”

Gambacorta heads a team of UB instructors who run the region’s largest dental clinic, the UB School of Dental Medicine Patient Care Clinic at the university’s South campus. About 100 professional staffers and instructors work with more than 500 dental students at the clinic.

“Right now, we’re screening people three different times before we treat them in the clinic, to determine if they have any symptoms of the virus or have been in contact with someone who is infected,” Gambacorta said. “We also have our personnel wearing gloves, masks and protective face shields.”

He said a lot of dentists who work in smaller offices do not have access to the protective face shields

Weinman said he is well aware of the dangers, especially now. He knows that a patient who looks completely healthy could be infected with the dangerous virus.

“I take every safety precaution I can possibly take,” Weinman said. “But you know that to a certain point, you’re taking a roll of the dice and hoping you will not become infected.”

He said he has treated 15 patients in the past three weeks, far less than 10 percent of his normal workload. He treated six of those patients on Wednesday.

The pandemic has put most dental workers, at least temporarily, out of work.

Aside from Weinman, every other employee of his clinic – including his fellow dentist, Elana Korn, and about nine other employees – is furloughed and has applied for unemployment benefits.

“When I go in to see patients, I go in alone,” Weinman said. “We are putting off billing until later.”

Some dentists, including Scott Westermeier of Westermeier Martin Dental Care, are using computers and iPhones to perform “virtual consultations” with patients.

Patients can still go to Westermeier Martin’s six local clinics for emergency services, but Westermeier also invites non-emergency patients to send the office “one full-face picture showing your smile” and another picture showing the “area of concern.”

Staffers from the clinic then communicate with the patient to discuss what care is needed.

“For a lot of dentists, our main goal right now is to limit the burden on hospitals by having us help people rather than them showing up at an emergency room for treatment of a toothache,” Westermeier said. “Our clinics have seen about 100 emergency patients in the past three weeks.”

Do people with toothaches actually go to hospital emergency rooms?

“Believe me, some do,” said Westermeier, a dentist for 34 years. “When you have a severe toothache and feel like you need immediate care, it’s no joke.”

Westermeier’s company runs three local clinics under the Westermeier Martin name and three Winning Smiles clinics that see mostly children. He said 140 of his 150 employees are currently on furlough.

Even before the pandemic, the risk of infection worried many dental workers.

Gambacorta said he is very thankful about one thing. So far, he has not heard of any dentist in Western New York being infected with the virus.

“All of us are being very careful, not only to screen patients, but to treat them in isolated areas,” he said. “Except for the time when they are actually being treated, our patients wear masks the whole time they are in our building.”

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