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From Rotten Teeth to Advanced Cancer, Patients Feel the Effects of Treatment Delays

From Rotten Teeth to Advanced Cancer, Patients Feel the Effects of Treatment Delays

Dr. Despina Markogiannakis examines a patient at her dental practice in Chevy Chase, Maryland. Markogiannakis says she has noticed an increase in patients grinding or clenching their teeth, conditions likely caused by pandemic-related stress. (Ronald Flores Photography)

With medical visits picking up again among patients vaccinated against covid-19, health providers are starting to see the consequences of a year of pandemic-delayed preventive and emergency care as they find more advanced cancer and rotting and damaged teeth, among other ailments.

Dr. , chair of the cardiology department at Montana鈥檚 Billings Clinic, was confused in the early days of the covid pandemic. Why the sudden drop in heart attack patients at the Billings Clinic? And why did some who did come arrive hours after first feeling chest pains?

Two patients, both of whom suffered greater heart damage by delaying care, provided what came to be typical answers. One said he was afraid of contracting covid by going to the hospital. The other patient went to the emergency room in the morning, left after finding it too crowded, and then returned that night when he figured there would be fewer patients 鈥 and a lower risk of catching covid.

鈥淔or a heart attack patient, the first hour is known as the golden hour,鈥 Rah said. After that, the likelihood of death or a lifelong reduction in activities and health increases, he said.

, executive vice president and chief clinical officer at SCL Health of Colorado and Montana, said he is 鈥渒ept awake at night鈥 by delays in important medical tests. 鈥淧eople put off routine breast examinations, and there are going to be some cancers hiding that are not going to be identified, potentially delaying intervention,鈥 he said.

Valin is also concerned that patients aren鈥檛 seeking timely treatment when suffering appendicitis symptoms like abdominal pain, fever and nausea. A burst appendix generally involves more risk and a week鈥檚 hospitalization, instead of one day of treatment for those who get care quickly, he said.

Dr. Fola May, a gastroenterologist who is also quality director and a health equity researcher at UCLA Health, worries about the consequences of an 80% to 90% drop in colonoscopies performed by the health system鈥檚 doctors during the first months of covid.

鈥淎ll of a sudden we were downplaying health measures that are usually high-priority, such as trying to prevent diseases like cancer, to manage the pandemic,鈥 May said.

Along with exacerbating existing health problems, the covid pandemic has also caused a host of new medical issues in patients. The American population will be coming out of the pandemic with teeth worn down from grinding, back problems from slouching at makeshift home-work stations and mental health problems from a combination of isolation and being too close to family.

, a dentist in Chevy Chase, Maryland, said patients don鈥檛 argue when she tells them they have been grinding or clenching their teeth and might require a root canal procedure, dental implant or night guard.

鈥淭hese are people stuck at home all day and feeling lonely and feeling a little depression. It is induced by the world we live in and all the changes in our lives,鈥 said Markogiannakis.

A recent American Dental Association survey that more than 70% of member dentists reported an increase in patients grinding or clenching their teeth since covid. More than 60% reported an increase in other stress-related conditions, such as chipped and cracked teeth.

, a Detroit pediatrician, finds his young patients are suffering more stress, depression and weight gain than before the pandemic. They are confined in their homes, and many are living in multigenerational homes or foster homes or have experienced covid illnesses or death among family members.

鈥淪ince their ability to get out is limited, they can鈥檛 vent to friends or other family members. Also, most will not have access to mental health for grief counseling,鈥 Mosby said.

, a Bridgeport, Connecticut, licensed professional counselor and art therapist, said that, in addition to struggling with isolation, her patients are conversely stressed by living too closely with people without the benefit of breaks on work and school days.

Meanwhile, optometrist Matthew Jones, who practices in Blytheville and Osceola, Arkansas, reports worsening eye conditions for patients, some of whom stopped taking drops during covid for conditions like glaucoma. He鈥檚 also seeing much more eyestrain 鈥渂ecause people are spending so much time in front of a computer screen鈥 and recommends eyeglasses that filter out blue light to his patients.

Physical therapist Kaylee Smith, who runs a treatment studio in La Jolla, California, says she is seeing more injuries related to poor posture due to makeshift home workstations used during the pandemic. (Zachary Smith)

Physical therapy needs are also on the rise.

鈥淧atients that have transitioned to remote work are typically working with poor ergonomic set-ups and spending a lot more time sitting,鈥 said Kaylee Smith, founder and president of Smith Physical Therapy and Performance Studio in San Diego.

鈥淚 am seeing more pain and injuries related to poor posture (i.e., neck pain, low back pain, etc.) and a significant increase in patients coming in with tight hips related to increased sitting time,鈥 Smith said in an email.

Some providers report they are finally nearing pre-covid patient levels, but others still face covid resistance.

鈥淎lthough we have seen an improvement over the past six weeks, it鈥檚 still not much,鈥 said Neville Gupta of Gupta Gastro in Brooklyn and Far Rockaway, New York. 鈥淥ur patients are still avoiding getting the care they need, no matter the safety precautions in place.鈥