Health

The Dentist Will Screen You Now

I never feared going to have my teeth cleaned. Then the pandemic hit.


dentist chair

Photo via Getty Images

Way back when, during the simpler days of December, I made a routine appointment for a teeth cleaning. It was the sort of thing I didn’t think twice about at the time, but as the months raced by it began to take on the outsize importance of an existential question: Was I willing to risk getting COVID-19, or giving it to those around me, in the name of improving my gum health? I was caught between two poles: the knowledge that Massachusetts had one of the lowest transmission rates in the country, and my sheer horror—after months holed up at home without going anywhere unless my mouth remained duly covered—of sitting in an enclosed space with a stranger while my jaws hung open for 20 minutes straight.

As the date rapidly approached in mid-August, I leaned toward canceling. It just didn’t seem worth it, but then my dentist’s office called and walked me through the prescreening protocol. It was the same list of hygiene-theater questions we’ve all heard—Had I been running a fever? Had I been around anyone who’d tested positive?—and so forth, as though there is anyone in America this net would catch. Either you’re asymptomatic and have no idea you’re infected, or you’re a buffoon or someone who doesn’t care about other people’s safety, in which case the screening probably won’t be enough to stop you. At the end of the call, though, the scheduler caught me off-guard with six little words: “So, are you going to come?” I was still unsure: Six months into this pandemic, I remained utterly incapable of assessing risk meaningfully. Was a dentist’s office safe? As much as I fear the consequences of not getting my teeth cleaned, maybe it really wasn’t that important. Or maybe it was just important enough.

It’s the sort of constant decision-making paralysis so many of us have suffered during quarantine, and could be the reason why a a recent survey done by the American Dental Association found that less than 36 percent of Massachusetts dentists reported experiencing business as usual in August. But for me, it was combined with my lifelong struggle to make choices with the best possible outcome for the highest number of people. If you read that sentence and thought, “That sounds like it would lead to you never making a decision,” you are correct. It is a horrible way to live, and I don’t recommend it. During the pandemic alone, I have argued with myself over everything from whether shopping online or in person is more ethical to whether I could justify visiting the library. Having lived inside this particular mind for a good long time, though, I have developed an important strategy: I let myself go down whatever feverish neural pathways my brain decides are “necessary” with a given subject area, mentally close the door on them once I’ve run out of time, and impulsively make a final decision. In this case, I put blind faith in the document the dentist’s office emailed me when I got off the phone.

As soon as the letter arrived, I scoured that thing, reading every bullet point like I was going to have to argue it in court. The precautions felt reassuring. The dentist had eliminated her waiting room, installed a lot of air purifiers, and developed a method of getting clients in and out that seemed tantamount to an airlock system in space. If I went, I’d be interacting only minimally with the unwashed masses while I sat there with my mouth open. Still, it meant embracing far more risk than I previously had been. On the other hand, I was very aware that the number of new cases had started ticking up again, and the great College Student Return Experiment was about to begin. If widespread office closures returned, this might be my last chance at smooth, sparkly whites for a while. In the end, I decided it was time to get my dang teeth cleaned.

On the big day, I left my home earlier than I had since March. As a lifelong goody two-shoes, I had booked my appointment for long before the start of the workday so I wouldn’t be late to the office. Now that my commute is the time it takes to get from my bed to my dining room table, arranging a cleaning at the ungodly hour of 7:30 a.m. no longer seemed necessary. On the bright side, I thought, at least I was one of the first patients of the day—there’d be fewer germs lingering in the office from those who had come before me.

As an inveterate rule follower and keen appreciator of the dentist’s written guidelines, I tried to park in her parking lot rather than on the street, as is my right as a parking-pass-owning Cantabrigian. My thought was that it might help the office time my arrival if they knew I was walking over from the designated lot, since another part of the protocol was for me to call the front desk from my car to say that I’d arrived. This theory turned out to suffer from a couple of flaws, one being that it took me multiple calls before someone finally picked up and told me to walk over and call again at the back door, and the other being that when I arrived at the back door, I learned that I had mistakenly parked illegally near some condos. I am an even more keen appreciator of the city of Cambridge’s fondness for towing, so I turned heel, reparked, then sprinted back, anxious about ruining what was clearly a schedule crafted with military precision to avoid patients running into one another. This also ensured that I showed up short of breath and overheated, i.e., looking like I was ill. Go ahead and put me in that buffoon category I mentioned previously; I have earned it.

Despite this setback, I soldiered on, cycling through the airlock system and hand-sanitizing procedures before marching directly into an exam room, where my usual hygienist awaited, wearing a traditional mask, plus one of those large plastic face shields we’ve all come to recognize. Up to that point, I’d kept my mask on, but then the hygienist politely instructed me to hang it on a coat hook—sending me down the first of many paranoid mental pathways. When the written protocols stated that the office was cleaned thoroughly between patients, did that include the hook and the wall space behind it? Is it even possible for someone else’s mask to leave germs on the wall, and for my mask to then pick up those germs, and/or leave its own germs behind? Should I ask? Was I letting my natural instinct not to cause a stir overwhelm a wise and important question? Was this particular bout of paranoia simply a reaction to feeling like I was driving a motorcycle without a helmet because I was maskless and within 6 feet of someone who wasn’t my roommate for the first time in six months? It was all a blur.

Nonetheless, I dutifully hung up my mask and then sat in the chair like I hadn’t just lost my entire mind over a simple instruction. In the corner, a white cylinder that looked like a trashcan from an Apple Store was visible, and I realized it must have been some kind of very fancy air purifier. Or perhaps it was just a trashcan. I didn’t ask because I’d already lost track of what a normal question might be, and also entered into a realm where speaking to the hygienist any more than absolutely necessary was disrespecting the degree of risk she was taking simply by interacting with me.

Clearly, I had already worked myself into a lather, and I hadn’t even gotten to the supposedly risky part of the whole operation. Up until now—thanks to my decision to keep my pressing questions private—my maskless mouth was still shut. But not for long.

The hygienist kicked things off by directing me to rinse my mouth out with what I would characterize as rubbing alcohol mixed with water for a full 60 seconds. I responded by immediately sloshing the mix straight into my gag reflex, accidentally filled my mouth with an exhalation, and then reflected on how 60 seconds might actually be the longest unit of time known to man.

Then it was time to get down to picking. She told me she would not be using the “ultrasonic” tool due to how it sprayed aerosols, and while I do not know exactly what an “ultrasonic” tool is, I used my sharp analytical skills to deduce that it’s the thingy that makes a loud grinding noise while they buff your teeth with it. Instead, she poked and scraped with a collection of metal tools, which all seemed pretty normal—the sound of your teeth being scraped by metal remains profoundly unpleasant, and the process in fact does still make you feel embarrassed by how much gunk they’re able to find in there.

As ever, the removal of plaque was a prolonged affair that left me with plenty of time to think, which is always dangerous. I shuffled through every worry I could generate, which as you can probably guess by now was a rather long list. At some point, I realized it was the closest I’d been to another human outside the various people in my quarantine pod in six months, and I wondered if it was normal to want to hug one’s dental hygienist.

Our relationship, however, stayed the course of traditional hygienist/patient interactions. She complimented the low plaque levels on my front teeth and I bragged about the electric toothbrush I use. She asked if I flossed regularly and I said yes, and I think we both knew I meant in the two weeks leading up to my appointment. She then took a few glamour shots of the inside of my skull (looking great, tooth roots). All normal dentist stuff, apart from how she told me repeatedly that I have thin gums, which I chose to take as a compliment.

Still, even through the normal, humdrum procedures of my appointment, I couldn’t stop thinking about the risk my hygienist was taking simply by doing her job. The interaction needed for my work can be accomplished either on my cell phone or while I’m unsubtly trying to see if I have a double chin on Zoom. I am not required to get breathed on at any point. I try to minimize my outside interactions. I get takeout, but I don’t dine at restaurants. I go to the grocery store, but I limit my visits to once a week and suck it up when I forget something. Yet every day, this woman spends hours next to the gaping maws of strangers she has to trust are being careful, while invisible germs that could either kill her—or pass unnoticed and asymptomatically from her to other people—come right at her. At one point, I sighed, then felt guilty about breathing harder.

I wanted to ask how she was feeling at that moment, but I knew my query was even less important than the one I had about the trashcan/air purifier. So I stayed quiet, but my mind, well, it never does. How does she feel about spending every day in close proximity to the open mouths of strangers? Does she think about the dangers she is facing while she’s poking my gums? Is she able to place all of these useless panicky thoughts into a tiny box and shut them away in her mind until she can consider them in the future? And, most important, can she give me lessons on how to do this? Please?

In the days following my appointment, I didn’t manifest any COVID-19 symptoms. The virus continued its spread outside my home, leaving me as trapped as ever, but with far cleaner teeth, which was at least a slight improvement. Life resumed its new-normal rhythm: a schedule of the exact same series of actions every single day of the week except on weekends, when I switch it up and stare at the TV instead of my computer screen. But now I face a new dilemma: Turns out the thin-gums comment wasn’t a compliment after all. On my way out the door, the hygienist handed me a referral for a periodontist.

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