“So I need to tell you something,” I said as I made my appointment. “I have not been to the dentist since 2020, since the start of COVID. So I’m really nervous about this.”
I felt slightly embarrassed baring my dental soul to the reception staff of a local practice I’d never been to, but after years of avoiding having my mouth checked out, vanity in the form of coffee-stained teeth ensured I could no longer put this off. The receptionist said exactly the right thing.
“That’s OK,” she assured me. “We’ll take care of you.”
That assurance, and the relief that washed over me, ended four years of playing pandemic-related keepaway with the dental industry. It’s been a long time coming.
It’s not shocking that a lot of people have been historically afraid of sitting in that big dentist chair, even before a contagious virus made it even more precarious. It’s scary! “People are afraid of being hurt,” said my friend Holly Perella, the chief operating officer of North Palm Beach Dentistry in Florida, a practice she runs with her dentist husband, Dr. Paul Perella. “I think there’s a vulnerability sitting there with your mouth wide open and people in your face. A lot of people had bad experiences when they were kids.”
A study published in the Journal of Dental Hygiene in 2017 found that between 50-80% percent of American adults have some sort of dental anxiety. An article from a January 2021 science journal found that nearly half of American adults put off dental care during late May and early June of 2020. And weekly dental visits between March and August 2020 dropped 33% from that period in 2019, according to a study in the Journal of the American Dental Association.
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It took not months, but years, for me return to the dentist, in which time I’d moved to a new city and needed to replace my trusted practice.
Except I didn’t.
For long periods of my adulthood, the cost of care made me keep my visits mostly to emergencies, but things got better as my income and dental insurance increased. I’d found a great practice near my house in Florida and gotten into a groove of regular care. (I acknowledge that dental insurance is unfortunately a privilege, one everyone should have.)
Then COVID hit, and my next cleaning was canceled. I never rescheduled it. I was afraid of having my mask off long enough to contract what could be a fatal virus. The longer I stayed away from the dentist, the more my fear of judgement of the damage I’d done increased.
Sara Anderson, who lives in the Ednor Gardens area of Baltimore, gets it. She didn’t go to the dentist in her 20s because, she said, “nothing was broken and I didn’t need to fix it.” But it didn’t stay that way.
“There was a lot of shame involved. I had broken teeth in my mouth, and I have to tell somebody and they’re going to yell at me,” she said.
Annie Richard of Pikesville didn’t mind going to the dentist until she was diagnosed with a prolapse of her mitral valve, a flap in the heart that controls blood flow, that meant she had to premedicate with antibiotics before visits. But then she had an experience where “the Novocain had really raced my heart, and that really scared me,” she said. “It’s not even the teeth stuff that scares me. And I’m so scared that’s gonna happen again.”
Richard stopped going to the dentist prior to 2020 because the industry changed protocol about premedication. Dentists told her she no longer had to, but she didn’t believe them. She said COVID further “freaked me out and added another layer. I was like, ‘You’re not breathing in my face. I’m not taking off my mask. Nope.’ I love my dentist. My husband and daughter go to him, and I say, ‘Tell him I say hi.’ He says, ‘Yeah, we need to get her in here.’ And then I don’t go.”
Like my practice in West Palm Beach, the Perellas’ office shut down for a time at the beginning of the pandemic (Note: The pandemic has not ended, even though the societal acknowledgment of it has, so I will never use the term “post-COVID.”) When North Palm Beach Dentistry did reopen, they were fully prepared, taking temperatures, putting up plastic partitions at the counter and even making patients sit in the car prior to their appointments until they were called to come inside. “We had a couple of patients so nervous, one came in with a swimmer’s mask on their face and yellow dishwasher gloves,” Holly Perella said.
Eventually, their patients became more comfortable and the practice, like others, gradually rolled back precautions. Although some still haven’t been in since COVID, those who have returned have done so because they feel comfortable doing so. “A good dentist doesn’t judge you or yell at you. A good dentist is nice and says, ‘Let’s get back on track,’” she said.
Having understanding professionals work with her finally let Anderson get past her hesitations. “They were like, ‘This is what we need to do,’ and set me up on a plan. They treated me like I was going to run screaming out of the chair every time,’” she said. “They didn’t lecture me. It wasn’t fun, but my worst fears weren’t realized.”
By the time COVID started, she had a good relationship with her dental hygienist and had gotten into the routine of regular dental visits every few months. Her practice canceled at least one appointment, “and I may have canceled another in the first year. When I first went back I didn’t want to get sick, but they were doing full PPE and there were filters everywhere. Then I relaxed. I still wear a mask when I go. Now, when I need another crown, it’s not a moral failing. It’s just, ‘Your teeth are crappy, we have to fix what’s wrong and then move on.’”
Richard is still trying to get there. She takes good care of her teeth at home, going so far as to buy a device that “can go behind your teeth and scrape your teeth. You have to be very careful. I’m sure dentists are like, ‘What are you doing?’” she said, laughing. “I really do have to go. I know what I’m doing is just so bad. But forever I’ve been terrified. I need someone to go easy on me, like the Adele song.”
As for me, my appointment went well, though years of avoidance understandably have given way to things I need to correct. But I have a plan now, and a group of people I trust. And that means, for once, I can breathe easy.
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