The following message was sent to governors and state health officials on behalf of AAE’s 8,000+ members:
To Governors and State Health Departments,
The American Association of Endodontists (AAE) urges your Department of Health to recognize endodontists as essential emergency health care providers for distribution of necessary N95 masks and other personal protective equipment (PPE), for the following reasons:
- Endodontists treat dental emergencies that become life-threatening if untreated;
- Endodontists engage in emergency care in high aerosol environments; and
- Endodontists mitigate the burden on medical and hospital emergency departments.
Endodontists treat dental emergencies that become life-threatening if untreated.
In 2007, a 12-year-old boy from Baltimore named Diamonte Driver made national news when he died because an untreated infected molar resulted in an abscess that spread to his brain. In 2011, a 24-year-old Cincinnati resident died of an untreated tooth infection. In 2017, a 26-year-old truck driver died of a tooth infection that had only been treated with pain medication. Unfortunately, these are not the only such cases.
The conditions that led to Diamonte’s and the others’ deaths are the very same emergency conditions that are treated effectively by endodontists in the dental practice. It is critical to understand that dental emergencies become life-threatening emergencies if they are not treated properly.
Endodontists provide emergency care in high-aerosol environments.
Endodontics is the branch of dentistry concerned with “the morphology, physiology and pathology of the human dental pulp and periradicular tissues,” specifically, the “treatment of diseases and injuries of the pulp and associated periradicular regions.”1
Put simply, endodontists treat pulpal conditions often produced as a result of untreated decay, often exhibiting with abscessed pulp, and often experienced as severe pain. Endodontic treatment includes surgical and non-surgical therapies, both of which require the use of a high-speed drill. The drill creates aerosols that have been affirmed by the CDC as capable of transmitting the Coronavirus. These aerosols are necessary in emergency dental care, but require N95 masks for protection of the dentist and staff.
Endodontic care reduces the burden on emergency departments.
In 2016, there were 2.2 million emergency department visits for dental issues in the United States; that’s one every 14 seconds2. In 2009, the top two dental conditions that resulted in emergency department visits were dental decay (41.8%) and abscesses (37.4%); these are the conditions most effectively treated by endodontists.
Today, with the need for emergency departments to focus their limited resources on the COVID-19 pandemic, avoidable dentally-related emergency department visits are especially problematic. Dentists, especially endodontists, must serve as the first point of contact for dental emergencies if we are collectively going to minimize the burden on the limited capacity of emergency departments. Moreover, by helping patients with dental emergencies through telehealth or emergency office visits that respect social distance, these patients avoid becoming agents and recipients of transmission of the Coronavirus in emergency departments where social distance is a challenge.
For the reasons explained here, it is critical for ensuring the safety of patients and for protecting valuable emergency department resources and staff, that endodontists be included as essential emergency health care providers for distribution of necessary N95 masks and other PPE.
Keith V. Krell, D.D.S., M.A., M.S.