Las Vegas Sun

June 23, 2021

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Las Vegas dentists urge patients to get back in the chair

Dental Atelier on Rampart

Steve Marcus

Dentist Pouyan Shahrokh poses with Genie Cinquegrani, office manager, and dental assistants Ame Clark, left, and Krista Nuno at Dental Atelier on Rampart Tuesday, May 25, 2021.

More than a year after COVID-19 temporarily shut down dental offices, then led to heightened sanitary demands upon reopening, dentists are urging people who got out of the habit of receiving regular dental care to come back to the hydraulic chair.

Patients have started returning, but volume still hasn’t gotten back to normal for Dr. Pouyan Shahrokh.

Shahrokh, who runs a small private practice in Summerlin, said his whole staff is vaccinated against COVID-19 and he is offering deeply discounted specials for people still in financial need, but patient flow isn’t what it was, something he said colleagues are also seeing.

“I’ve done everything I can to make patients more comfortable,” he said.

“This is the least likely place to be exposed to COVID.”

The holdouts are the people who need care the most, Shahrokh said. And telehealth consultations tend not to work as well for most dental issues, he added.

Dental practices were considered essential services in the hard shutdown phase, but during the pandemic’s early days, the state health department recommended postponing elective procedures and only treating emergencies. Shahrokh said the local practice where he was an associate at the time closed then and still hasn’t reopened.

He said the disconnect between medicine and dentistry comes from medicine potentially treating matters of life and death, while dentistry is seen as addressing lower-stakes quality-of-life issues.

But, he urges, poor oral health can bring down overall immunity.

Dr. Ron Lemon, a professor and associate dean at the UNLV School of Dental Medicine and practicing endodontist, said dentists’ methods are like they were at the height of the outbreak.

Because dentists “have practiced infection control to a very high degree even before this pandemic,” that’s a normal thing for dentists, and also a good thing.

The Nevada State Board of Dental Examiners, of which Lemon is a member, sought to assure the public early on of its concern. Use of masks, gowns, gloves, goggles and face shields were already common, because even minor procedures, like fillings, are invasive and practitioners work inside mouths, the source of varied bacterial and viral infections.

“The board would like to remind the public that all Nevada dental offices are required by law to follow the latest CDC recommendations for cross contamination and infection control, which are the most stringent of recommendations,” the board said in a March 2020 announcement. “These rules, regulations and guidelines specifically define the ‘Universal or Standard Precautions’ which make the dental offices in Nevada among the safest medical facilities anywhere.”

Lemon said the pandemic gave people another way to rationalize not going to the dentist, though — he acknowledges that people typically aren’t excited to go in for any medical procedure. Getting back into good proactive health habits will take time.

Practically speaking, the pandemic has been hard on dentists’ ledgers, too. Shahrokh said once-scarce protective equipment is plentiful again, but is still more expensive than it was pre-pandemic — though he no longer has to use medical tape on wonky, hastily sourced N95 masks to get a good seal. His practice, because it is new and small, didn’t qualify for a federal Paycheck Protection Program loan.

Overhead, from protective equipment to intentionally scheduling fewer patients to space them out so as to put fewer people together in waiting rooms, has increased, but payments from Medicaid haven’t, Lemon said. UNLV’s community dental clinic, where Lemon screened 30 patients on a recent Wednesday, is geared toward people of modest means.

And the need for more complicated — which translates to more time-consuming, more painful and more expensive — work inched up during the pandemic, while routine care dropped. That’s because time is the enemy of dental disease. People who put off cleanings and fillings ended up needing treatments like root canals, Lemon’s specialty as an endodontist, and surgery as their conditions progressed.

It’s also, of course, more difficult for the doctor.

“The best dental care is preventive care,” Lemon said.