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Maine Dentists Report Spike In Emergencies As Pandemic Forces Offices To Pause Routine Care

Patty Wight
Maine Public
Dr. Killian MacCarthy (left) and Dr. Whitney Wignall.

It’s been eight weeks since dental offices in Maine have been closed for routine care. During that time, minor dental issues in some patients have progressed into emergencies.

Dentists are included in the state’s first stage of reopening, but conflicting guidance has stymied their efforts to resume their practices, and in the meantime, they say their patients are suffering.

Three days before dental offices closed for elective procedures due to the coronavirus pandemic, Torrie Lajoie of Vassalboro had a broken tooth pulled. Afterwards, she says, it was sore, and didn’t feel like it was healing right.

“I called up and asked them to look at it, and that’s when they told me that the virus was going around and they were closed, they were only doing emergencies,” she says.

This marked the beginning of what would become a weekslong effort for Lajoie to get care. She says she was prescribed antibiotics multiple times as her pain persisted and her jaw became swollen.

“Again, I was calling around, nobody’s taking patients,” she says.

Lajoie says she doesn’t know why her issue wasn’t considered an emergency, but it became one. She ultimately had to go to an oral surgeon, who told LaJoie the infection was in her jawbone.

“And that’s why I was in so much pain. And he ended up having to pull a bunch of teeth to relieve the pressure. That I truly didn’t want pulled, but had to,” she says.

LaJoie says she spent a few days in the hospital recovering. The oral surgeon who treated her, Portland-based Dr. Killian MacCarthy, says he’s witnessing an increasing number of emergencies.

“The amount of infections I’ve seen over the eight weeks so far are more than I’ve seen in a year normally,” he says.

MacCarthy says patients have come from as far as Bangor seeking care — some by ambulance. Dr. Whitney Wignall, a pediatric dentist in Portland, says her office is also seeing a surge of emergencies.

“On a given day for emergencies we might see five patients now. In the beginning we were maybe seeing one,” she says.

Both Wignall and MacCarthy say emergencies are erupting because dental offices are still closed for routine care. Dentists are included under Stage One of Maine’s plan to reopen the economy. But the plan directs them to follow the guidance of the U.S. CDC, which says that dental care should be limited to emergencies only.

Maine Department of Health and Human Services Commissioner Jeanne Lambrew acknowledged that conflict last Friday during a daily state briefing on the coronavirus.

“We are trying to approach this process in a collaborative way with our health care partners, but this is the rare example of the U.S. CDC being at odds with the American Dental Association,” she says.

Lambrew says dentists have to wait until the federal CDC changes its guidance. If that doesn’t happen in the coming days, she says Maine will consider issuing its own. But she has emphasized that the state prefers to use federal recommendations.

Dr. MacCarthy is unsatisfied with that response.

“Having Commissioner Lambrew saying we can’t open indefinitely until the federal CDC says yes is, I think is shortsighted, because Mainers are going to continue to suffer,” he says.

Other states are allowing dentists to reopen. According to a map on the American Dental Association’s website, at least 31 states have reopened dental offices for elective procedures. Some states, such as New Hampshire, aren’t reflected in that number, but officials issued guidelines for resuming routine care last week.

Dr. Wignall says Maine dentists should be allowed to open, with limitations.

“Nobody is asking to go back and do elective or cosmetic procedures. But we really need to be allowed to do necessary treatment. It is a disease. It is a disease process. If left unchecked, it has really negative ramifications,” she says.

One of Wignall’s patients, a 10-year-old boy, had an appointment to have a cavity filled in mid-April that had to be postponed due to the state shutdown. His mom, Kristen DuShane, says she worked with Wignall to try to first manage it with ibuprofen and Tylenol.

“And it was just Band-Aiding it. And it got to the point where he was just, screaming in pain,” she says.

By then, it was deemed an emergency, and DuShane was able to bring her son in. She says the pain is gone now, but she doesn’t think he should have had to wait for it to become an emergency.

DuShane hopes the state will allow dental offices to reopen soon.

“I mean, hospitals still have to function. They still have to see patients for different reasons. They make it work, so why can’t they make it work for dentists? Why is that any less important?” she says.

The American Dental Association is also pressing the federal CDC to update its guidance to reflect the fact that dental practices in some states are opening for nonemergency care.