January-February 2022 | Health

How the pandemic impacted our smiles

A Chevy Chase prosthodontist talks about how stress and anxiety can worsen dental health

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Photo by Lisa Helfert

Dr. Kambiz “Kaz” Fotoohi understands the tooth ailments that bring patients to him for treatment. The 61-year-old prosthodontist—a dentist who is highly specialized in restorative procedures—clenches his teeth just like many of the people who come to him with worn-down enamel and jaw pain. He wears a night guard like the ones he often prescribes.

“It’s not the easiest thing to wear,” he says. “After a couple of hours of wearing it, you might find it at the bottom of the bed. Or if you have a dog or a cat, it might disappear.”

Fotoohi has seen more stress-induced dental problems at his Chevy Chase office since the start of the pandemic. Everybody’s anxieties are in overdrive, he says, and their teeth are suffering the consequences. Scared to leave the house and contract the virus, some have let the problems fester.

“Nobody knew what was going to happen—when the shutdowns would end, if they were going to lose their house because they weren’t working,” says Fotoohi, who lives in Chevy Chase within walking distance of his office. “The unknown factors were what was causing all this stress. And after the reopening, what we ended up seeing was cracked teeth that needed to be managed with extraction, bridges, whatever could treat it.” Some patients were asking for cosmetic changes after seeing themselves every day on Zoom, he says—they’ve come in for veneers and teeth whitening because they want to look better on camera.

Dentistry wasn’t in Fotoohi’s life plans; he dreamed of becoming an oceanographer. But after graduating from Syracuse University, he found himself stumbling between jobs, including one at a dental office. The dentist didn’t think Fotoohi was good chairside and sent him to the lab, where moldings were made. There, Fotoohi shined. In hindsight, he had always been good with his hands, he says, and he counted woodworking and ceramics as hobbies in high school. He enrolled in dental school at Boston University, where he spent the next four years, then studied there for an additional two years to specialize in prosthodontics.

Prosthodontists are considered experts in mouth restoration, often using implants, crowns, bridges, dentures and veneers to treat an injury or improve a smile. The toughest jobs can involve several operations. Fotoohi has one patient who was knocked to the ground by the mirror of a construction truck that hit her while she was exiting her car. She lost four teeth and bruised her chin and jaw, injuries that took nine months of reconstructive surgeries to repair.

Fotoohi has carved out a special niche in what he calls “salvage operations,” or taking failed dental procedures and trying to fix them. Patients often come to him in distress and ready to give up on dental work—the aim is to save teeth rather than extract them. “At this point they want to rip everything out and forget it,” he says. “We try to help them with expectations. Make what they have work for them. Not short term, but long term.”

In his own words…

A tough year

“This has been the most challenging time in my career. Not just for me, but for everybody. When we were closed, different groups of my general dentist colleagues were all in different text groups, all texting information to each other. Especially to the younger general practitioners, trying to keep them hopeful, telling them, ‘This will be OK.’ We tried to tell dentists to be prepared when things opened back [up]. But many still weren’t.”

Digital dentistry

“Dentistry has changed quite a bit. The materials change every year, but the biggest change is the digital transformation. I still follow my alma mater, and their programs have changed to focus on digital laboratories and how to work with the digital age and being able to manipulate digital images. For those of us who didn’t study that, we try to get all caught up and try to learn the new demands. I had two teenagers when digital came out, and I asked for their help. It’s like trying to get from your old phone to an iPhone.”

Getting to know you

“What I really enjoy is talking to patients and hearing their backgrounds. They tell me about their kids and spouses, and have all these stories. You can kind of put a picture together about what the patient is like; how they are at home is different. It helps with the planning of their treatment. It is also just fascinating to get to know the patient. Really, they become a family; they become [a] dental family. And they want to know about you, too.”

Hearing patients out

“Listening to the patient is super, super important. They need to be comfortable with you. They are entrusting their whole face to you. Patients are usually nervous or anxious from past experiences. A couple of dentists refer their emergencies to me. These patients come in raving about their dentists—and I love it. That is how patients should feel about their dentists.”