For those who have been using the pandemic as an excuse to avoid going to the dentist, Dr. David Mambrino, an owner of the East Hampton Dental Group, has a message: "I want people to know that it's safe."
Since the beginning of the pandemic, Dr. Mambrino and his business partner, Dr. Ven Sampathkumar, have been hard at work, first tending to patients in need of emergency care -- for fractured teeth, root canals, abscesses, and other severe ailments -- and now, since the state allowed dental offices to fully reopen on June 1, to the rest of their clientele.
During the emergencies-only phase, when Covid infections were at their peak here, the two would alternate days in the office to limit their risk of exposure and ensure the practice could keep functioning. "We were the only dental office in the area open to new patients at the time," said Dr. Sampathkumar.
Although dentists, like medical doctors, are expected to abide by an ethical code to "do no harm" and "put the welfare of the patient first," the American Dental Association had issued Covid-era guidelines that provided members with an option not to treat patients infected with the virus.
The organization advised dentists to consult with a doctor before deciding whether to provide services to the "potentially infectious," because "dental settings are not typically designed to carry out all of the transmission-based precautions recommended for hospital and other ambulatory care settings."
"That was unheard of," Dr. Sampathkumar said of the guidance. He and Dr. Mambrino took the risk of seeing patients, he said, because otherwise "a lot of people would have had to go to the E.R. instead."
Dr. Mambrino had begun stocking up on personal protective equipment like gowns, face shields, and masks "when I started seeing what was happening in Italy," he said. When supplies became scarce, the practice donated some of the gear to Stony Brook Southampton Hospital and other local medical offices.
To operate safely during the pandemic, the dentists instituted protocols recommended by the A.D.A. and the Centers for Disease Control. "Most of what Dr. Ven and I put in place we had been doing way before, but we just upped our game," Dr. Mambrino said. "I feel strongly that P.P.E. works."
The office's ventilation system has been outfitted with an ultraviolet germicidal irradiation device, and medical-grade HEPA air filters.
Patients are required to wear masks, remain in their cars prior to an appointment, and have their temperatures taken with a forehead thermometer upon entry.
Instead of mouthwash, a 1-percent solution of hydrogen peroxide is provided for a pre-procedural rinse. Studies have shown that the solution has been especially effective in preventing the spread of the virus, said Dr. Sampathkumar.
Since certain dental tools -- such as an ultrasound scaler, which is used to remove tartar and plaque, and an air-water syringe, used to irrigate and dry the mouth -- cause patients to emit aerosols, the respiratory droplets known to carry the virus, they are not being employed.
As a further precaution, the room is left empty for 15 minutes after a procedure to allow any aerosols to fall from the air. The space is then fully sanitized.
Clients have been "pleasantly surprised" at how routine a visit to the dentist can be in the midst of a pandemic, said Dr. Sampathkumar.
Because patients are the only ones who have unmasked mouths opened wide during an appointment, it's actually the dentists and hygienists who are potentially putting themselves in harm's way, noted Dr. Mambrino. Being a dentist "is the number-one most dangerous job right now," he said.