Skipping appointments could cause harm, doctors and dentists warn

RALEIGH, N.C. (WTVD) -- While many people are taking safety precautions to protect themselves from contracting COVID-19, doctors and dentists are worried over some who are delaying or skipping medical appointments due to concerns.

"The main group of people we see here in our practice are adults with chronic medical problems. Making sure the blood pressure is staying under control, making sure their diabetes is staying under control, having their cholesterol checked. Unfortunately having people skip those visits may run the risk that they may not be controlled if they're not monitoring themselves well," said Dr. Howard Newell, UNC Health Care.

In fact, some chronic health conditions, such as unchecked diabetes and hypertension, can increase one's risk of severe complications from COVID-19.

"If you have chronic medical conditions, you want to keep them on check. You want to treat your hypertension, you want to treat your diabetes. You want to make sure if you have asthma or other things that you have exaggerations for in the winter, check with your primary care doctor," added Dr. Viviana Martinez-Bianchi, a family medicine and primary care doctor with Duke Health.

According to The Commonwealth Fund, a private research foundation, young children are missing out on their regular check ups the most. As of early October, visits for children two years old and younger were down 18% compared to pre-pandemic levels, while visits for children 3-to-5 years old were down 10%.

In its report, the Commonwealth Fund said younger children need to stay on a well-visit schedule to get necessary vaccine and booster shots and so doctors can track their developmental progress.

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Fortunately, overall visits have returned to normal levels, though there is variation based on specialty. For example, both pulmonology and cardiology visits are down (20% and 10%, respectively) while dermatology and adult primary care are actually up compared to pre-pandemic levels, (17% and 13% respectively).

UNC Health Care reports flu shot frequency is on track compared to last year's numbers, with some doctors noting that precautions people are already taking to stop the spread of COVID-19 could help keep flu numbers down.

"That is the hope right now. In fact, some of the epidemiologists have looked at what happened in the southern hemisphere this past winter. They were dealing with COVID and flu as well. I was at a virtual meeting two weeks ago about this same thing, and they plotted out the number of COVID infections and the number of flu infections in South America, Australia, and South Africa. And there was a significant drop in the number of flu infections in those populations there. They attributed a lot of that to people keeping social distance, wearing a mask, and good hand hygiene," said Newell.

Dentists are also reporting similar dips. A September report from the American Dental Association said despite more than 99% of practices reopening, patient visits were just over 80% compared to pre-pandemic levels.

"There are a few days in either September, October, or November that span the eight weeks we were closed where there's literally not a hygiene patient on the schedule," said Dr. Christine Laster, a Raleigh dentist, referring to check-ups that had to be pushed back due to her office being closed for eight weeks in March - May.

RELATED: Dentists see increase in broken teeth, dental emergencies during pandemic

Upon reopening, Laster said about half her patients were uncomfortable returning, a number that has significantly dwindled to an estimated 5-10%.

"We're just really trying to communicate about the safety precautions that we do take, that we've been very fortunate to not have any (COVID-19) incidents in our office," said Laster.

Laster said delaying treatment can lead to longer-term issues.

"All patients have bacteria in their gums, in the pockets in their gums. And if those are left to go a long period of time and you've got that tartar on your teeth that only a hygienist can scale off for you, then you're risking developing further increased periodontal disease," explained Laster, adding cavities can also progress in severity leading to potentially more intense remedies.

Laster further noted that the unpredictability of the virus should give people pause to continually delaying appointments.

"If you can imagine, if your appointment was last fall, and you're now looking at a year and if you wait until this goes away-- and we don't really know when COVID will go away, and I don't think it's really going anywhere (soon)," Laster said.

She expressed concern over a spike in COVID-19 numbers, and encouraged people to take care of their appointments now.

"It's not going to get better over this winter, and so then now all of a sudden waiting a month or two months, it's going to turn into that much longer. It will be next spring, next summer perhaps until they feel comfortable," Laster said.
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