Even dentist visits go remote during the COVID-19 pandemic

The COVID-19 pandemic has transformed many in-person activities into remote services delivered over the internet. The latest example is the dreaded visit to the dentist.

Dvora Brandstatter used to drive her son Elchanan half an hour to the orthodontist and back every month to make sure his braces were working properly. Now, from the comfort of her home in Bergenfield, New Jersey, she attaches a special scope to her smartphone camera, opens an app and inserts the contraption into the 11-year-old’s mouth. A video of the boy’s choppers is sent to his dentist, who checks progress, diagnoses any issues and sometimes ends the appointment right there.

“As a parent, having fewer appointments is a good thing,” Brandstatter said. “I haven’t seen a downside so far. It’s probably the way everything is moving anyway.”

The app and the scope were created last year by New Jersey-based startup Grin. After the pandemic hit, Chief Executive Officer and dentist Adam Schulhof said the company sped up development of the technology and partnered with manufacturer 3M to quickly distribute it to as many orthodontists as possible. About 5,000 units have shipped out and roughly 1,000 patients have used the system so far, according to Grin.

Schulhof, who uses the system for his own practice, said the coronavirus has spurred huge demand for new procedures that help people reduce the close contact that typically happens when they visit the dentist. The CDC has warned that dental instruments create spray that can contain droplets of water, saliva, blood and other debris, and has advised the use of “teledentistry” as an alternative to in-office care.

When the Grin videos arrive at the dentist’s office, other software from the startup helps practitioners analyze the condition of the teeth and integrates the footage with existing patient management systems. The app also lets patients see what the dentist sees inside their mouth. Not for the faint of heart.

There are already new, internet-focused dental services that Grin is going up against. Companies such as SmileDirectClub mail invisible aligners and braces to consumers. SmileDirectClub shares have more than doubled since the middle of March. Schulfhof said Grin’s offering is aimed at fighting the challenge to conventional dentistry from such direct-to-consumer offerings. “We’re trying to disrupt the disrupters,” he added.

In the short term, the technology will help orthodontists keep their businesses running while many patients avoid the dentist’s office completely, the CEO said. As smartphone capabilities improve and the software develops, Schulhof expects Grin’s scope to use artificial intelligence image analysis to become a more powerful diagnostic tool for dentists.

The CEO also sees the technology gaining traction in general dentistry where insurance companies may back its use. People’s teeth decay at different rates and more regular, remote checks, could be used to identify problems before they require more complicated and expensive treatment at in-person visits every six months, he said.

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Local dentist researches technology to help make office visits safer in time of COVID-19

CHICAGO — Oral health can be a concern for people who are sheltering at home.

Dentistry is defined by close contact with patients, and distancing in the era of COVID-19 poses new challenges.

From the air down to the water, a local doctor is bringing high tech infection control to his neighborhood office.

When news of the virus shutting down China made its way to the U.S, Dr. Michael Czarkowski sunk his teeth deep into research.

“We’ve got to come up with a plan and I’m a pro-active person so I tried to figure out what do I have to do in my practice to protect my patients, my team and my family,” he said.

The dentist who typically sees 80 to 100 patients a week now sees about five for emergency procedures only.

And with worries about COVID-19, the phone isn’t exactly ringing off the hook.

“I can just tell some people are nervous,” he said. “But once they see what we’ve done, I can see their anxiety level diminish.”

Air filtration system bathed in UV light cleans particles from the air. The office has its own heating and cooling system.

“We can control the air coming in so we have kind of a positive pressure system you’d see in a hospital operating room,” Czarkowski said.

In the dental chair, droplets are an occupational hazard.

“We have to deal with patients as far as aerosols,” he said. “When we prepare teeth we drill, we create an aerosol. How are we going to control that? What’s the best thing we can do?”

Czarkowski said they use a unit that “takes the aerosol we create when we prepare a tooth for a filling, a crown or a bridge, and sucks it through the machine and runs it through a series of filters.”

Any aerosolized droplets are filtered through a medical grade system that eliminates virus bacteria and mold particles and vented out of the building.

“These units we can rotate the air and clean the air 16 times per hour,” Czarkowski said.

With all the new tools in place, Czarkowski hopes the high tech will ease some of the pain when it comes to a visit to the dentist.

“They know me. They trust me. They expect me to provide and take care of them,” he said. “I take that responsibility seriously.”

All the new technology and the necessary PPE adds up. Czarkowski said he will have to consider an infection control fee to cover the added costs.

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Va. Gov. Ralph Northam to allow non-emergency doctor, dentist visits

Northam (D) said he was lifting the ban on elective surgeries he imposed five weeks ago, allowing doctors, dentists and veterinarians to resume seeing patients on a non-emergency basis beginning Friday.

That ban, which applied to hospitals, outpatient surgery centers, dental offices and veterinarians amid concerns that the state’s hospitals would be overwhelmed by a surge in coronavirus cases, was originally scheduled to expire last week, but Northam extended it to May 1.

On Wednesday he confirmed that he would not extend it further, touting the decision as proof that the commercial and social restrictions he has imposed have successfully slowed the spread of the virus.

Northam said the change also was possible because of the work that state and medical officials have done to secure more capacity for treating and testing coronavirus patients. But he warned that if cases surge again, it might be necessary to reinstate restrictions.

Meanwhile, Sen. Chris Van Hollen (D-Md.) pleaded with Senate Majority Leader Mitch McConnell (R-Ky.) to impose safeguards when the chamber resumes its work in Washington next week to avoid risking the spread of the virus.

In his letter, Van Hollen said that recalling Senate lawmakers and staff members to Capitol Hill without precautions that maximize telework, minimize support staff, and institute temperature checks and rapid testing would undermine stay-at-home orders imposed across the District, Maryland and Virginia.

“While the Senate has critical work to do on behalf of the American people, we must be attentive to our role in controlling the spread of COVID-19 and have clear plans in place to ensure the safety of the staff and Capitol Police who support our work and care for the Capitol,” the letter states. “. . . I am ready to get back to the Capitol but you have an obligation to ensure the safety of all the staff that work there.”

McConnell’s office declined to comment beyond referring to a radio interview in which the senator said that “it’s essential for senators to carefully man our [stations] and support those folks who are out there on the front lines.”

Van Hollen called the D.C. region a “covid-19 hotspot.” The District, Maryland and Virginia on Wednesday reported 106 new deaths and 1,471 new infections — bringing their total number of coronavirus cases past 39,000 and total deaths to 1,818.

The District, which Van Hollen noted was shortchanged in a federal relief act, is scrambling to manage the pandemic — including limiting service for the Metro rail and bus lines that many Senate staffers use to commute to work.

D.C. officials said Wednesday that covid-19 restrictions and closures might need to be extended another three months under the “most stringent” scenario.

In a town hall Wednesday on reopening the city, District officials said a less stringent approach to reopening would phase in reopening in two to three months. The most stringent option would extend current closures for three months.

Mayor Muriel E. Bowser (D) has declared a public health emergency through May 15. Health

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