Bellingham dentist offering coronavirus test before treatment

Bellingham dentist offering coronavirus test before treatment

Until he could test his patients for COVID-19, a Bellingham periodontist said he had to use a hammer and chisel to remove teeth if they broke during an extraction.

That’s what David Baker said he did for three weeks during emergency dental procedures at the Implant and Periodontal Clinic.

“It’s quite unpleasant,” said Baker, whose surgical practice focuses on dental implants, extractions and gum disease.

That’s because using a drill, which sends small droplets into the air from patients, was putting Baker and the clinic’s dental staff at risk because of the COVID-19 pandemic, he said.

But he’s been able to resume using a drill since being able to offer COVID-19 testing to his patients, starting last Wednesday, April 8. Testing is allowing him to provide safety for his staff as well as patients — and he’s expecting testing to remain part of the future if dentists are going to be able to reopen their practices.

As of Monday, April 13, swabs have been taken from seven patients at the clinic and picked up and tested by Northwest Laboratory two doors down, Baker said.

The turnaround for results is about 24 hours, although it can be as fast as six hours if needed, the dental surgeon said.

Emergency dentistry

Washington state Gov. Jay Inslee has prohibited medical and dental procedures that aren’t urgent through May 18, which means that Baker is treating dental patients who are in pain and on an emergency basis.

The issue, he said, is that there’s no way to safely treat patients.

Dentists are among the workers most at risk for contracting — and therefore transmitting — the virus that causes COVID-19 disease, a contagious respiratory illness, because they are working in people’s mouths, according to Baker.

Baker- profile pic.jpg
Dr. David Baker Courtesy to The Bellingham Herald

He wears personal protective equipment but patients can’t wear masks during treatment, for obvious reasons. And while patients are screened for symptoms, that’s no guarantee they are healthy because people who have the illness don’t always have symptoms.

So testing is needed to prevent transmission in dental offices. Baker highly recommends it for all of the clinic’s patients, adding that he won’t use a drill without that test.

“The amount of virus in saliva is significant, along with just routine exhaled air,” Baker said to The Bellingham Herald, adding that testing — and subsequently knowing that a patient doesn’t have COVID-19 at the time of treatment — creates “a much safer environment.”

Additionally, the procedures and tools that dentists and hygienists use, whether for a crown or a filling or for cleaning, create aerosols, or small droplets.

“Almost all dental procedures use a dental drill, which causes significant aerosol into the air and particulates, which may linger in the air for some time,” Baker explained, adding that lingering might last as long as three hours.

Testing for COVID-19 has expanded, but availability remains limited, with the Whatcom County Health Department still recommending that people not be tested unless they have symptoms. But Baker said testing for emergency dental care is legitimate because “it’s a screening test due to high risk of exposure and then transmission if we were to get infected.”

Testing won’t be needed for just the short term, given that there is no vaccine or medication yet for COVID-19, he said.

“Both are too far in the future to wait,” he said of dental care. “This is a potentially huge problem that doesn’t have any obvious solutions.”

Problem resuming

To him, some form of screening via testing will be needed in order for routine dental care to resume once social-distancing rules relax.

“We are doing everything we can, but it’s still not enough, even with KN95 masks, considering the potential exposure risk that a dental team encounters,” he said. “Most dentists are simply closed due to the virus. In the future, I envision a combination of patient testing along with modified PPE. Dentistry will be a different experience moving forward.”

For now, his clinic is swabbing patients and sending them to Northwest Laboratory.

“You can’t solve a puzzle unless you do it one piece at a time. This isn’t the end-all but this is one piece of it,” Baker said.

Jenny Bull, chief operating officer for Northwest Laboratory, said the lab has the capacity to run 4,500 tests a day and is adding more equipment to bump up the number of tests it can analyze as part of its effort to add much-needed testing during the pandemic.

The lab has the ability to run tests for Baker’s clinic.

“It really doesn’t hit our capacity at all. We’re happy to see that it’s happening,” Bull said to The Herald.

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Kie Relyea has been a reporter at The Bellingham Herald since 1997 and currently writes about social services and recreation in Whatcom County. She started her career in 1991 as a reporter and editor in Northern California.

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