Dental emergencies don’t go away in a COVID-19 world… in fact, some consider emergencies involving teeth to be their most fearful events! In a recent interview with reporter Maureen Dowd of the New York Times, Larry David, the creator of TV shows “Seinfeld” and “Curb Your Enthusiasm” fame, was quoted:
I asked what [Larry David] fears most [during COVID-19 quarantine] and he replied: “Anarchy and a potential dental emergency — and not necessarily in that order.” – Maureen Dowd NY Times
Dental emergencies happen when it’s least convenient and during the COVID-19 recommended lock-down, we should stay home as much as possible.
I recently received a phone call on my emergency line from a patient who said, “Doctor, my implant is loose!!” As someone who treats a lot of implant patients, I often get emergencies indicating patients with “loose implants” but really have loose healing abutments or minor issues… but it can be something more serious if left unchecked. So I asked her, “what does it look like?” She mentioned, “it looks like a little gold cufflink!” Ah… I wonder?
I immediately used my remote viewer to log into my office computer and checked her most recent radiographs, “phew” I said… turns out she was one of my many overdenture patients I have successfully treated with Zest Dental Solutions LOCATOR abutments over 5 years ago. Turns out it’s just a loose LOCATOR abutment, no big deal and an easy fix in a normal world… but a bit trickier with the pandemic virus affecting all of our practices. I ask her, “Ms [Name Removed], that’s an easy fix, the part just came loose, we just need to put it back on, when can you get to our office?” But she was scared and told me, “Doctor, I’m 86 years old and worried about going anywhere right now, is there something I can do from home?”
I immediately thought…. Teledentistry! I asked her to take a photo with her phone of the implant part and send it to me. She send me a bunch of pictures (the one on the right turned out really good!!) and I could tell immediately that the implant was fine, just the abutment was missing from the implant. I reassured her that everything was going to be OK, we can fix it in a week or two when she’s ready to come in. But she was concerned about being able to eat and maintain good nutrition during the pandemic with a loose implant denture… so I asked her, “Do you ever use FaceTime with your grand kids?” The patient said, “Why yes, I do!”
I said, “Let’s video conference and I’ll take a look! So I opened up a video conference line with her and coached her through the process of trying the LOCATOR abutment back onto her implant.
“Remember… Righty-tighty, lefty-loosey” I said to her through the whole process. I coached her through rinsing out the inside of the dental implant with some mouthrinse and replacing the LOCATOR abutment back onto the implant surface, tight enough. I asked her, “Can you snap your teeth back on?” and she replied, “Oh my goodness, it worked!!! Thank you Doctor!!”
Is it a permanent fix? Certainly not! I recommended to the patient that as soon as the COVID-19 pandemic cools off a bit and we can see her in our office. I want to see the patient back ASAP to properly clean out the implant, retorque the abutment, and to ensure nothing has been damaged. I instructed the patient that she needs to be careful and to check the implant after each time she has a meal to ensure it hasn’t gotten looser throughout the day.
I was proud of her!!! She’s 86 years old and was able to #1- remotely video-conference connect with me, and #2- she able to fix a minor dental implant problem that avoided the risk of a potential emergency room visit. The inspiring part of this entire experience is frankly that we, as dentists, can really make an impact in our patients lives.
Looks like teledentistry, when involving a dentist that can directly communicate with patients, can really make a difference in people’s lives. Dentists, together with open minded patients, are capable of doing amazing things.
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Want to learn more about full arch implant dentistry and implant overdentures? Make sure you check out our online course “Fast Track Full Arch Dentistry – Implant Overdentures” with 11hr of CEU by UNLV School of Dental Medicine. Visit www.LearnOverdentures.com