Are you avoiding the dentist?
Putting off medical visits due to virus isn’t so wise.
It’s been at least a year since Carla Mundwiler has been to the dentist.
Some people avoid the dentist because of money. Others are afraid of pain. For Mundwiler, it’s concerns about COVID-19 that are keeping her away.
“Normally, I’d go for my regular cleaning every six months and I just haven’t gone in a horrifyingly long time,” says Mundwiler, a Toronto resident who works in communications. “I’m lucky that I got the family in for our physicals right before lockdown. I knew things were getting bad and I had this feeling that we should make sure we got these appointments in.
“I remember asking the family doctor if we should be worried about this thing right now and he said, ‘Not right now,’ ” she continues. “And then things went sideways really quickly after that, so we’re lucky.”
Mundwiler, of course, isn’t alone. Full disclosure: ever since the medical world opened back up for non-emergency procedures, I’ve been meaning to go, but waiting for numbers to go down.
That seems pretty common. Although about half the people in my social networks say they’ve been back to the dentist and comment on how safe it felt, the rest told me they were overdue. Some can’t afford it, having recently lost their jobs. Others, like Mundwiler and myself, have just really taken the “stay home” message seriously. One friend reported that she finally made it to the dentist last week and had two new cavities, which was attributed to “COVID mouth”: gum and/or tooth problems caused by missed cleanings.
“I haven’t heard that specific term before,” says Andrea Gelinas, owner of Gelinas Dental Studio in Toronto’s west end. “But the reality is that, in the beginning, there was a lot of uncertainty and so it was understandable that people were postponing things three or maybe even four months, but now we’re going into a year, so there are going to be significant changes.”
People with periodontal disease can expect more recession, and cavities that haven’t been treated will probably be deeper. Worse, issues that arise from missed cleanings are compounded by the fact that a lot of people have let good habits lapse during lockdowns, Gelinas says.
“I’m noticing on X-rays where patients came in last year compared to now that things are changing, like their cavities are getting bigger,” she says. “And some of this is just because of behavioural changes from staying at home, like we’re probably staying up later, and our eating and snacking patterns aren’t what they used to be.”
It’s not just oral health that people are neglecting, either. Emergency rooms are quieter than usual and clinicians with services that require in-person visits are seeing a little less demand — depending, especially, on the demographic they cater to.
“I’m seeing more people that are in the 25 to 35 range,” says Dale Blacker, a registered massage therapist at Leaside’s Insight Naturopathic Clinic. “They’re coming in more because they’re working from home, feeling a lot more isolated and have seen their work expectations go way up. And, since they’ve got no boundaries between work and home, they’re feeling the effects of stress a lot more than usual, so I think it’s outweighing their sense of personal safety.” He adds: “My older clientele, though, are just staying home for the most part, unless they’re actually hurt.”
From the outset of the pandemic, it’s been clear that different people have different ideas about relative risks, some of which are exaggerated because of fear. For example, I’m perhaps overly cautious since, as a person who can’t afford any more brain fog than I already have, who writes for a living, I’m afraid of long-haul COVID-19. But I still go to the grocery store, so maybe I should reevaluate some choices.
“I think one of the safest places you probably could be is a dental office,” Gelinas explains, “because we already have very strict guidelines and protocols as far as sterilization and all of our infection control, and now that’s kind of been upped even further. We’ve always been wearing masks, we’ve always worn gloves, we always sterilize things. That’s just part of our norm and we’ve always lived in that world so, you know, having a few extra things that we’re doing felt like a very natural shift.”
Of course, that’s true of essentially all licensed professional medical services, all of which we visit regularly for a good reason. Taking a year off massage therapy, for example, might not lead to problems as visceral as bleeding gums and root canals, but that doesn’t mean they might not also be serious.
“People mostly come to me for idiopathic pain, so that’s the knots in the shoulder and the lower back, and even though that stuff feels like it’s connected to posture, it’s usually more about stress management,” says Blacker.
“And that has something to say about long-term mental health and, potentially, longterm immune function.”
Blacker says he worries that, after this phase of COVID-19 is quelled with vaccines (we hope), we’ll start to see a lot of aftershocks: health problems stemming from people not looking after themselves as well as they would have liked to.
And, as both Blacker and Gelinas point out, it’s not as simple as learning to live with a knot in your shoulder or a toothache. Stress and poor oral health are both linked to overall health outcomes.
“The reality is that the best way to mitigate this is to make sure your immune system is functioning properly, so having gingivitis or an underlying infection is only going to tie up your immune system,” she says.
“Now is the perfect opportunity to talk about health and wellness in general, and what we are eating and putting into our bodies, and are we actually taking care of ourselves.
“And we’re actually not doing that, which is quite surprising.”
“Since they’ve got no boundaries between work and home, they’re feeling the effects of stress a lot more than usual.”
DALE BLACKER
REGISTERED MASSAGE THERAPIST ON HIS RECENT CLIENTELE