A pandemic has worsened the oral health of the Portuguese – and there are serious cases that can go undetected Health

The pandemic and childbirth made oral health problems worse. Dentists have been handling more urgencies – and extracting more teeth – since the public health crisis began, with cavities, infections, devitalized teeth, and fractures becoming more common in professional offices. Fears of Covid-19, financial difficulties and the reduction in the number of consultations are delaying the search for professional help.

More serious, however, is the fact that the first symptoms of oral cancer go undetected. Or that ignored cases of periodontitis (inflammation of the gums) can lead to complications in the infection with Covid-19.

The alerts are created by Miguel Pavão, President of the Portuguese Dental Association (OMD). “I have no doubt that oral cancer cases are disappearing under the radar because people are going to the dentist less,” said the president, speaking to the PUBLIC about World Oral Health Day, which will be held on Saturday March , is celebrated 20th.

“A large proportion of cancers in the oral cavity are discovered in routine consultations. People who are usually asymptomatic don’t notice it right away. It is the dentist who recognizes the first sign of an injury, ”continues Miguel Pavão.

According to preliminary data from OMD for the first few months of 2021, most dentists saw a decrease in the number of visits: almost 53% have up to five visits per day and almost 28% have six to ten fewer patients than usual. The information is based on surveys of around 4,800 dentists between January 19 and March 10, 2021.

Miguel Pavão classifies the data as “worrying”. “Oral health cannot be ignored. A patient with periodontal disease is 3.5 times more likely to have complications with Covid-19 and has to be hospitalized, ”emphasized the President.

The number comes from the conclusions of a January study published in the Journal of Clinical Periodontology, which suggests that Covid-19 complications are caused by a severe inflammatory reaction that has some common signs of periodontal disease.

“It has to do with the fact that these problems lead to the release of pro-inflammatory mediators. This is one of the reasons why obesity is also an important risk factor for Covid-19, ”explains Pavão. If left untreated, inflammation caused by periodontal disease can spread throughout the body.

More fear, fewer consultations and financial problems

What Makes People Avoid the Dentist? According to OMD surveys among professionals, 56.4% find that there is greater financial availability for patients.

Access to dental exams (NHS guides on how to cover dental expenses) has decreased significantly over the past year. According to the SNS transparency portal, 99,160 fewer checks were issued in 2020 (a 24% decrease from the previous year) and only 44% were used. The Oral Cancer Early Intervention Project (PIPCO) saw the usage rate decrease by 40%.

“Oral health in Portugal has always been outside the NHS,” laments Miguel Pavão, who estimates that at least 250 dentists are needed to ensure the presence of these specialists in all health centers in the country. Achieving this number was one of the goals foreseen in the 2020 Oral Health Plan. “The number is currently 160. And the pandemic did not help,” says the president.

In addition, about 80% of consultations due to disinfection protocols take at least another 15 to 30 minutes to prevent infection with Covid-19, which may limit the number of consultations available per day.

After all, there is fear. “Although the risk of transmission to the dentist is low, there are people who are afraid to visit us because they are exposed there and have to remove their mask,” explains Joana Matos Alves, general dentist in the Seixal area, Aroeira and Moorland .

At the beginning of the second delivery, the specialist saw several patients in the middle of treatment to cancel appointments. “In January, when the numbers in Portugal were the worst in Europe, many patients were talking about fear of infection,” he said.

The dentist is among those who have discovered a “scary scenario” with more cases of advanced cavities, fractures and missing teeth since the beginning of the pandemic. “I believe that there are still routine appointments to be completed as these are no longer seen as a priority. And without these consultations, silent caries, which do not hurt, continue to develop and people only notice when the tooth breaks, ”warns the specialist.

Stress, sweets and a lack of routine don’t help

One of the big problems was changing habits. “Oral health suffered just as much as physical activity and a healthy diet,” says Miguel Pavão. “When people are in custody and in a stressful situation, their habits change, which in many cases requires less careful eating with more sweets.”

Over the months, the trend has reversed. A study by food market analyst FMCG Gurus finds that 73% of Europeans have difficulty eating more carefully due to Covid-19. However, this does not completely prevent dental problems caused by covid-19. The pandemic stress and fatigue environment has led to an increase in bruxism (clenching or grinding of teeth) around the world which, in addition to impairing sleep quality, can cause headaches and break teeth.

“Little is said about the effects of anxiety on oral health, and even less about the physical effects of these problems,” said the president of OMD. “The pandemic in particular has shown us that public health is priceless. There is no point in having large stadiums or airports without ensuring public health. And that goes through oral health. “

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