GLIMPSE OF NEW NORMAL. Dentist Anna Jeanine Ferrer, wearing full personal protective equipment, works on a patient in her clinic. She said the Philippine Dental Association guidelines prompted dentists not to accept walk-in patients for now and instead used telemedicine services to screen patients and set a schedule. (Photo courtesy of Dr. Ferrer)

MANILA – When dentists in the Philippines were allowed to reopen their clinics in June, patients were hesitant about showing up over fears of contracting coronavirus disease 2019 (Covid-19). To help patients feel safe about returning, oral healthcare professionals are taking all the maximum precautions.

Rizal-based dentist, Dr. Anna Jeanine Ferrer, 31, said they have also been dealing with the possibility of coming into contact with infectious diseases even before the pandemic -- the only difference now is that infection control precautions are more stringent.

Based on the guidelines of the Philippine Dental Association, Ferrer said they have stopped accepting walk-in patients to prevent crowding in the clinic. Instead, telemedicine services will be used to screen patients.

“By appointment na kami ngayon. Before pumunta ang patient, we have online consultation muna. Assess muna namin if the case is urgent or emergency (We’re now by appointment. Before a patient visits our clinic, we have online consultations first. We assess if the case is urgent or emergency),” she told Philippine News Agency in an interview.
Urgent or emergency cases such as patients experiencing tooth pain or swelling are immediately given treatment, she said. But aerosol-generating procedures such as teeth cleaning or prophylaxis must be avoided.
Fully clad in personal protective equipment, dentist Anna Jeanine Ferrer (right) and her assistant Sweetheart Hotohot (left) are ready to attend to patients in the new normal. (Photo courtesy of Dr. Ferrer)
Currently, Ferrer said they could only set an appointment with four to five patients a day -- only one patient at a time inside the clinic but children and the elderly can go with a companion. Before the pandemic, they could accommodate 10 to 20 patients.

She said all patients have to fill out Google forms indicating their personal information for contact tracing purposes before showing up at the clinic.

They have also covered both the reception area and treatment area with medical-grade plastic sheets, removed their waiting rooms, provided alcohol and sanitizers, installed air purifiers, and utilized PPE -- which is changed after treating every patient, she added.

To reduce the creation of aerosols, Ferrer said she also purchased intra and extra oral aerosol suction machines.

Aerosols, as defined by the Center for Disease Control and Prevention, are a suspension of tiny particles or droplets in the air, such as dusts, mists, or fumes.
She said ultraviolet light is also used to sanitize the air, surfaces, and equipment in dental offices. These machines and equipment are the reasons why dentists also charge extra fees or infection control fees.

Ferrer's clinic has two branches -- 81 A. Bonifacio Ave., Cainta, Rizal, and 15 De Castro Ave., Pasig City. Both are open from Monday to Saturday, 10 a.m. to 5 p.m., but one day would be allotted for disinfection.
The reception area and treatment area of Dr. Anna Jeanine Ferrer's clinic is separated by medical-grade plastic to ensure everyone's safety. (Photo courtesy of Dr. Ferrer)
Good oral health

According to Ferrer, it’s important to maintain the trust and confidence of patients by taking steps to demonstrate that they place their health and safety above all.

She also believes that patients will keep seeing dentists because more Filipinos now understand the value of good oral hygiene.

Dati ang mga tao hindi naman nila naiisip na importante ang ngipin. Ngayon mas educated na ang patients (In the past, people didn’t give much importance to their teeth. Now, patients are more educated),” she said.

Oral health, she said, also gives clues about a person's overall health by detecting the early signs and symptoms of systemic disease.

“Ang dentist nakakakita din ng signs ng any medical condition. For example, diabetic 'yung patient, ‘di puwede bunutan, soft ang gums (A dentist can see signs of medical conditions. For example, a patient is diabetic, they can’t extract your teeth, their gums are too soft),” she said.

Sometimes, she said poor oral health can also increase a person's risks of serious health problems such as cardiovascular or heart disease.

“Kung nag-iipon ng calcular deposit puwede magkaroon ng problem sa heart. Pagka yung ngipin mo madumi, iikot ‘yan dadaloy sa dugo mo. Anything na madumi sa mouth nasa system mo ‘yun (When you start to have calcular deposit, you’re at risk of having heart problems. If your teeth are dirty, it will join your bloodstream. Anything dirty in your mouth will be part of your system),” she added.

According to Ferrer, seeing the dentist regularly would save patients a lot of money on treatment for complications.
“Mas mahirap kapag masakit ang ngipin. Mas masakit sa bulsa kasi magiging mas magastos ‘yun (It would be more difficult once your teeth start to ache. You’ll have to spend more because it’s more expensive),” she added.

Ferrer also reminded everyone to brush and floss every day to avoid tooth loss, painful gums, and other problems. (PNA)