Orthodontic care during the COVID-19 pandemic

During the pandemic, many of you will be due to a trip to the orthodontist or dentist for a routine appointment. The current circumstances mean you might be wondering whether now is an appropriate time to proceed with dental procedures.

We spoke to the leading orthodontist, Dr Moira Wong, to find out about the current situation with dental care during the COVID-19 pandemic. She also let us know about the availability of e-Consultation and how she integrates the use of video calls in her private practice.

How is orthodontic and dental care being affected by COVID-19?

The government has recommended orthodontic, and dental care should be stopped during the pandemic. Emergency care, including the management of facial swellings, life-threatening issues such as blockage to the airway, persistent bleeding and trauma, are being looked after in the urgent treatment centres provided by the NHS. For patients who do not fit into these categories, e-Consultation allows patients to seek advice virtually.

During e-Consultations, what I’ve been able to, is to assist those with self-activating removable braces and also supervise the wearing of elastics remotely. I have been able to examine their mouths and their smiles via a video link to ensure that the right tooth movements are taking place.

Many of my patients are children, so it’s really lovely to see how they’re getting on to ensure that their teeth stay healthy during this time. It’s quite endearing to see how parents and their little ones point at their teeth as I speak to them in real-time, via video call to see what’s going on in their mouths.

What counts as emergency/urgent care?

The NHS defines this as bleeding, swelling, infection and where the general infection would threaten the general health of the patient. Analgesics can provide pain relief prior to the provision of definitive treatment. In the worst-case scenario, teeth causing infections may be extracted.

If someone needs an emergency appointment, what should they do?

What would happen is they’d have to go to the 111 NHS triage system. The service would determine if they’re COVID-19 patients or not. Currently, there are some centres specifically for COVID-19 cases. These centres are beginning to open up and have not reached their full capacity yet, so some patients may struggle to access care.

What about orthodontic/braces problems?

There are currently no orthodontic appointments taking place. I’m seeing many of my own patients remotely to progress their treatment, and all my patients have access to me simply by contacting my surgery on the main number or e-mailing the surgery for an E-consult. These appointments are scheduled during working hours.

Should my child continue wearing their braces during the pandemic?

For my patients, the reason I’m seeing them via e-Consultations is that it is so important not to suddenly stop wearing their removable appliances as this can result in loss of all the beneficial tooth movements that we have worked so hard to achieve over the last 6-12 months.

Fixed braces will continue to move the teeth over the initial 5-6 weeks and then will tend to hold the teeth in this corrected new position. However, if they break a fixed brace, teeth will tend to move in an unfavourable direction. It is important that this isn’t allowed to happen during the lockdown.

How can patients manage dental problems at home, such as toothache or mouth pain?

I think with a toothache, normally, you would ring your dentist for them to diagnose if it was caused by the supporting structures such as the gum or if the cause is from an infection inside the tooth. It’s good to seek advice because your dentist should be able to answer these questions based on your previous dental history, radiographs and your symptoms.

As mentioned, analgesics can help. Often antibiotics can be prescribed remotely if required. If swelling appears and persists after antibiotics, then you’d probably need to go to the urgent treatment centre.

If you’d like to seek advice during this time, don’t hesitate to book an e-Consultation with a leading dental specialist such as Dr Moira Wong. You can visit her Top Doctor’s profile for more information.