The pandemic caused by Covid-19 has been extremely arduous both health wise and economically on a global scale. Dentistry and dental emergencies in particular have not escaped this devastating global concern.
Factors such as loss of employment, reduced income, delayed graduation, increased job workloads and sentiments of futility over when will this pandemic ever end have contributed to significant anxiety in the general population. The dental profession is seeing symptoms of augmented anxiety manifesting itself through increased clenching, bruxism and other parafunction. Dentist are reporting an increased frequency of severe unrelenting toothaches, broken denture, broken filing, broken fixed prosthesis and broken or fractured teeth resulting in dental emergencies. Temporomandibular disorder exacerbation is also being seen at increased levels in the general population.
You Can Still Go to the Dentist
Broken or fractured teeth may result in severe pain, toothache, particularly if the infraction exposes or involves the nerve or pulpal tissue of the tooth and severe , resulting in the need for root canal therapy or tooth extraction. Molar and premolar teeth that have been treated with root canal therapy can significantly have the risk of tooth or root fracture reduced by the placement of full covered crowns, but unfortunately many teeth are left without crowns resulting in fractures which require emergency tooth extraction. A very common dental emergency is a patient presenting with a previously root canaled tooth with no protective crown having been placed , subsequently fracturing in a way that the only treatment is an emergency tooth extraction for pain and infection control.
Oral piercings, particularly of the tongue often cause infractions in teeth, particularly molars and premolars on the lingual aspect of the tooth. The infractions often increase the risk of tooth fracture resulting in tooth extraction or endodontic or root canal therapy.
Intra-oral dental infections may move rapidly through fascial planes inferiorly in the neck causing massive inflammation which has the potential to cause life threatening compromising of the airway or difficulty breathing. Dental abscesses associated with maxillary canine toothaches and infections have the potential to spread superiorly into the cavernous sinus leading to permanent blindness. Symptomatic teeth with irreversible pulpitis often with severe, debilitating tooth ache causing pain that cannot be mitigated with over the counter or even prescription medications will require root canal therapy or extraction. Tooth extraction may be the only choice due to financial constraints which make the price of restorative dentistry prohibitive.
Canada’s National Dental Plan
The political agreement in 2022 between the governing Federal Liberal Party and the NDP to avoid an election for the next three years involves the creation of a national dental plan. The details of this plan are still under development and it has yet to be announced specifically which dental services will be covered, who will provide the dentistry, where it will be performed, the effect on private dental plans and specifically what financial coverage will be provided per dental procedure code. How the proposed national dental plan will affect dental emergencies such as broken teeth, broken dentures, tooth extractions, broken restorations and fillings, dental abscess treatment remains to be seen. Some patients without dental coverage are even forgoing dental visits presently as they wait for the national dental program.