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Yokohama dentist uses camera and monitor setup to examine patients without getting close

Hidehiro Fujie, left, is seen at Fujie Dental Clinic using a camera as he observes a feed on a monitor of the inside of a patient's mouth, in Yokohama. (Mainichi/Tsumuki Nakamura)

YOKOHAMA -- Dental treatments for cavities or tartar removal involve unavoidable close contact, with dental practitioners required to use a number of methods such as touching the inside of or peering into patients' mouths.

    But with the spread of the new coronavirus, patient numbers have fallen, leading some clinics in Japan to devise new methods to reduce infection chances, such as by using small cameras to examine people's mouths.

    At the Fujie Dental Clinic in the eastern Japan city of Yokohama's Kanagawa Ward, the windows are open in the examination room even though it's the height of summer. The clinic's head, Hidehiro Fujie, is sat upright in front of a patient, who lies facing up. Affixed to the dentist's chair is a monitor which shows the inside of the patient's mouth as captured by a camera Fujie is manipulating with his left hand. Through this method, he is able to always maintain a distance of around 50 centimeters between his face and the patient's mouth -- which he also doesn't need to try to peer into.

    Dental treatment generally requires medical professionals to get close to people's mouths, so the proximity of dentist to patient is short. If a patient coughs during treatment, the dentist is in the direct path of any airborne droplets. When filing down teeth with a drill, aerosols, which measure about 5 micrometers in diameter and are even smaller than droplets, are produced and drift through the air.

    Since the new coronavirus began spreading, many patients have hesitated going to receive dental treatment due to fear of infection. A survey by the Kanagawa Prefecture Medical Practitioners Association aimed at dental clinics found that, during the state of emergency declaration period over April and May, 95% of 114 responding dental care providers reported a fall in patient numbers. Additionally, 59% said that they had seen cases of patients' conditions becoming much worse as a result of delayed consultations, and there were even some cases where dentists were forced to remove teeth.

    Fujie has been using his idiosyncratic camera set up to examine people's oral health for around 20 years. Originally, the camera was used just to take still images of teeth, but now it's used to watch a live feed on a monitor for treatment purposes.

    The camera can zoom in up to 20 times, enabling a visual confirmation of areas under treatment clearer than that of the naked eye. As patients can also look at the monitor, dentists can also explain the treatment as they give it, and one of its merits is that it makes it easier for people to understand the circumstances around their condition.

    Amid the coronavirus outbreak, it ensures a fixed distance between dentist and patient, and reportedly is also effective at reducing chances of infection. But because the system used by dentists like Fujie requires practitioners to break old habits of looking into patients' mouths, and investment in equipment is also necessary, it is rare for dentists to offer similar services.

    His clinic is also doing as much as possible to reduce the amount of work it does with aerosol-producing drills, instead of opting for treatment by hand. As part of infection prevention measures, staff are also wearing disposable gowns and faceguards. Fujie said, "Through an accumulation of small things, we've been able to reduce the chances of infections to a great degree. Although the coronavirus situation is serious, taking care of one's dental health is also important. We want people to come and have the treatment they need without feeling excessively fearful."

    (Japanese original by Tsumuki Nakamura, Yokohama Bureau)

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