Frequent Lockdowns And Delayed Treatment Making Kashmiris ‘Toothless’


Sheikh Shahid attending to his patient at his clinic

Text/Photos by Hirra Azmat

AN archetypal anguish, toothache remains a seething yet silent pain troubling Kashmiris during the Covid pandemic. For the fear of the viral infection, many prefer staying home, and bear the excruciating pain, than visiting their dentist. This searing agony in the valley where “the majority of people suffer from tooth decay” is now taking an additional toll on the lockdown-weary people.

Studies have also shown that good oral hygiene has been recognized as a means to prevent airway infections in patients, especially in those over the age of 70. Researches further show that those with periodontal disease are at a 25 percent raised risk of heart disease, thrice the risk of getting diabetes, and 20 percent raised risk of getting high blood pressure. These’re all risk factors of severe COVID-19, the studies reveal.

These health challenges have thrown up unlikely heroes who not only have to step outside their homes, but abandon all social distancing to provide essential services.

But while the role of frontline health workers has been much lauded, dentists in Kashmir have rarely received any appreciation despite falling directly in line of aerosol.

In a candid chat with Kashmir Observer, dental surgeon Dr. Sheikh Shahid details how his tribe is replacing pain with relief, frown with a smile, and discomfort with ease in the current testing times when escalating anxiety is only disturbing one’s oral health.

To begin with, how has coronavirus affected dentistry?

Dentists work around the area that can potentially transmit the most — the mouth, teeth and around the nose. These areas are unavoidable during the treatment. So it is a risk both for the dentist and the patient.

Further, dentists use certain instruments which create aerosol or droplets mixed with saliva or blood in the air. Since COVID-19 is spread from an infected person, these aerosols leave the patient and the dentist more vulnerable to the infection.

But then fear of infection is such that not many come forward for the supposed “supplementary” oral treatment in Kashmir. How can delaying treatment affect the teeth?

While it’s okay for patients wanting a crown, regular cleaning to put their plans on hold, there’re certain procedures that should not be delayed.

As we all know, COVID-19 isn’t going anywhere and this is the new normal. So we’ve to learn to live with it. But there’re serious challenges ahead.

Dental care is sometimes urgent, and putting it off can at times flare up the issue. While some issues can be handled through tele-consultation, but many times it requires personal visits.

Years of dental practice has taught me that nothing is worse than a dental pain irrespective of nature and reason.

Also, it purely depends on the pain threshold of the patient. What might be just sensitivity for us can be sleepless nights for someone.

But according to the Indian Dental Association, pain related to swelling, inflammation, fracture tooth, and bleeding come under severe dental emergencies.

Since dentistry itself remains a risk area, how do you ensure the safety of your patients?

First, the hospital carries out temperature screening at the entrance. After that, patients are checked upon their contact with any infected person recently / travel history/ any symptoms they had recently.

If all clear, their hands are sanitized and patient protective gowns are given to wear during their visit.

And also, brief breaks in-between patients are given to sanitize and disinfect surfaces and things around in dental settings.

What’re the most common dental problems among Kashmiris? And has Covid-19 escalated them?

The most common dental problem encountered by Kashmiris is dental caries or cavities, more commonly known as tooth decay, caused by a breakdown of the tooth enamel.

This breakdown is the result of bacteria on teeth that breaks food and produce acid that destroys tooth enamel and results in tooth decay.

Due to frequent lockdowns and delayed treatment, an unattended cavity might have reached the stage of root canal or even tooth removal.

Some degree of risk is also involved in case of unaddressed gum issues. It can lead to inflammation, which can lower down one’s immunity.

So what options patients have then? How should they seek a dental appointment during the pandemic?

Well, they should call up their doctor and explain their problems. If the issue is small and can be rectified over the phone, then appointment can be avoided for the sake of social distancing.

Also, patients should inform the doctor about medication they are taking. They should take along their health reports so that a second visit can be avoided.

It brings us to the common question: how should people maintain oral health during the current crisis situation?

See, the real challenge is to keep the mouth clean and free from at least bacterial infections. A cleaner and healthy mouth is less prone to viral infections.

The bacteria lives in everyone’s oral cavity, predominantly sticking on the teeth, the top surface of the tongue and below the visible margin of the gum that touches the tooth.

Good oral hygiene has been recognized as a means to prevent airway infections in patients, especially in those over the age of 70. Those with periodontal disease [Periodontal disease is an infection of the tissues that hold your teeth in place. It’s typically caused by poor brushing and flossing habits that allow plaque—a sticky film of bacteria—to build up on the teeth and harden] are at a 25 percent raised risk of heart disease, thrice the risk of getting diabetes, and 20 percent raised risk of getting high blood pressure, the researchers wrote. These are all risk factors of severe COVID-19, the studies reveal.

One can follow standard dental care procedure at home. Avoid consuming food that is too hot or too cold if you are sensitive so that the pain does not aggravate. Diet control is crucial.

Brush your teeth twice daily or use medicated mouthwashes. Use medicated toothpastes for sensitivity if it’s mild. Else personal visit is mandatory. Wash your hands frequently with soap and water or an alcohol-based hand sanitiser. Clean the toothbrush properly after use to ensure it is not contaminated.

Most importantly, flossing teeth is an important habit for proper health and hygiene for protecting teeth from decay.

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