Hello and welcome to Living In The Lehigh Valley, a health and wellness show for everyone.

I'm your host, Brittany Sweeney.

Coming up on this episode, keeping fit in a pandemic.

Getting a workout in isn't what it used to be.

I'll have the story of how some people are hitting the gym without ever leaving their home.

Plus, do you grind your teeth?

Some do and don't even know it.

Our own Grover Silcox tells us the fractured story of what happened to him.

And getting back into the swing of things - Covid lockdown's robbed seniors of their gathering places and chances to mingle.

Now many senior centers have reopened.

We are going to stop on by.

But first up, finding a way to fit in your fitness during a pandemic.

It's definitely required some adjustment, but gyms are finding a way to make it work for those who want to work out.

I paid a visit to an Allentown woman who says she may never fully return to in-person classes.

For Mallory Henry, working out is a priority, but in 2021, those workouts are looking a little different.

She went from having classes in a family-like atmosphere to having her family.... - Will you do it with me?

- ..as her classmates - And then we do this.

- Oh, yeah.

- When the pandemic hit, my gym shut down, obviously.

So I was trying to figure out a way that I could still work out.

- The past year and a half has changed the way people like this Allentown mom of two get their exercise.

- I never in a million years was someone that would have said they would have worked out at home, I was always someone that really needed the accountability of going somewhere, having someone instruct me and then coming home.

But really, over this time, I realized that I can do it with the accountability of people, you know, not right in front of me.

You know, I can sign up for classes, the accountability's there because I already signed up for it.

So it's like, OK, I have to attend, they think I'm coming.

But also just the convenience for me has just outweighed everything else.

- Early on in the pandemic, Henry's gym, Inner Strength Fitness Studio, found a way to keep clients safe and still in shape by posting the classes online as part of the gym membership.

- The link to the class comes to my e-mail, so I just pull up my e-mail address.

I can either do it on my phone or on my computer.

And we started with just a couple of classes but eventually went to now where we live-stream all our classes.

- The owner of the Bethlehem Township business, Shannon Hoke, began by posting on YouTube but quickly adapted, offering both live-streamed and taped classes.

- We kind of had to quickly move to how are we going to still keep our community together and get everybody to still get their workout in?

Because I think that was still just as important as ever during the pandemic, not only for people's physical health but their mental health.

- Hoke says it hasn't been easy, but worth it.

- We definitely lost people.

I mean, we're still not back.

We're not even close to back to where we were.

I mean, we were down to less than 50% of the normal business.

And I would say we're slowly coming back.

- And with safety protocols in place, people are coming back.

- I put markings on the floor so that people would keep six feet apar, at least.

I can open my front and back doors, so we had air flowing through.

I asked people to wear masks into the studio, but since everyone's pretty separated, we took them off for a class, put them back on when you were going to move around and then wear them out the door.

- Though the convenience of online versus in-person classes has changed where some people exercise for good.

- I do think that more people are going to take advantage of the virtual classes and I think especially to try different things.

- One of those people sticking to at-home workouts is Henry.

- I've live-streamed classes from North Carolina, I've live-streamed classes from Aruba, where we traveled this summer.

So things like that I never would have been able to do in the past.

- You seem fully equipped.

So where did you get all this equipment?

Nobody just has this in their basement, or some people do.

But where did you get all this?

- So when I first started, I had absolutely nothing.

So I was using water bottles as weights and things like that.

So over time I've just accumulated things.

Facebook Marketplace is usually typically where I got most of my stuff.

So this is a paper plate slider.

- Yes!

This is the trick.

- You can use them for, like, sliding on the ground, a lot of times using for, like, Ab workouts.

- Henry's makeshift way of fitting in some fitness during a pandemic turned into a professional in-home workout routine for the long haul.

- Having the ability to do it in my home has really been a game changer because I don't have to factor in a commute, I don't have to factor in my kids.

If one of them is sick or something like that, I can still get my workout in.

- While many fitness locations were able to adapt, the Global Health and Fitness Organization estimated that as many as 25% of US gyms, health clubs and studios closed by the end of 2020.

For our next story, let's bring in our Grover Silcox.

Grover, great to have you.

- Great to be here, Brittany.

- Always a pleasure.

So, what do you have for us?

- Well, you know, it's easy to forget that there are health care issues other than Covid and the Delta variant, right?

- Sure.

With all of this going on, easy to forget that.

- But, of course, there are.

And my story focuses on a particular dental health issue called bruxism.

Bruxism?

I've never heard of it.

So what is it?

- Well, I'd never heard of it either until I discovered that I actually suffer from it.

Bruxism is when someone grinds their teeth in their sleep, or they might be awake but they're grinding unconsciously.

And physicians believe that it's primarily caused by tension and anxiety, stress.

- We've had plenty of that in the past year and a half.

- Right.

And it can lead to fractures of the teeth, erosion of the teeth, headaches, soreness, particularly around the jaw and neck.

One day prior to the pandemic, I awoke and discovered one of my teeth had fractured.

Half a front tooth was broken off.

Well, turns out I grind my teeth in my sleep.

It's a condition, as we said, called bruxism, and it affects 10% of people, 50% in children.

Dentists attribute it primarily to anxiety, which might be worse with the pandemic.

Here's a primer on bruxism, we shot this pre-pandemic at the Montgomery County office of cosmetic dentist Dr Steven Bunting.

- This is a case of bruxism or the grinding of teeth against each other, which can cause muscle-spasm issues and discomfort in the joint area.

Or they can grind at night.

The teeth are grinding around side to side, and that's where you see the actual wear of the teeth or in situations where the tooth actually fractures because it just gives.

We look at how your bite position is when you bite together.

Bite down for me.

The lower tooth here occludes and hits right up against the upper tooth here, where the fracture line was started and you were clenching right up against the edge of that to creating a stress fracture, which caused that to break.

Patients will deny.

They say, that I'm not a grinder, I know I'm not.

And we convince them that we see patterns that there are and we recommend a night guard.

And when they get the night guard, they bring it back to us for their regular checkup visits, and we can see the patterns that they've created on the night guard.

And you look in their mouth and that's the tooth that's been affected.

It's now being protected by the night guard.

I determined by looking, clinically as well as radiographically, in seeing a healthy tooth that Grover's situation was caused by bruxism.

Here are the options for a broken tooth.

If you have the piece, keeping it moist is the key, because once a tooth is exposed to air for a prolonged period of time, it dries out.

And so color wise, it wouldn't even match the rest of the teeth now.

Keep it water and let's see it and we might be able to re-use it.

You can do bonding, and depending on the size of the broken tooth, that may be the most appropriate thing to do.

If it's a bigger chunk or in a vulnerable area that the bonding's not going to hold, then we look at possibly doing a crown, and a crown should last longer than the bonding.

Bonding is a less expensive procedure than going with a crown.

The fractured tooth here is the lateral incisor, the upper lateral incisor.

Here's his front tooth, the canine tooth.

This pattern here is where the fracture line is.

I think that there's enough tooth structure that structurally we'll be fine with just adding the bonding to the tooth to create the restored tooth.

When we first saw Grover with his broken tooth, we took an impression so we could create a model of how his teeth are, and this is the wax that we've added to replicate what he's missing.

And I'll use this in his mouth to guide us so the end product looks like a natural tooth.

The first thing we need to do is figure out the colors of the tooth that we want to use to match.

This is the etchant that actually opens the pores of the tooth, creates the foundation for the bond.

Prior to putting on the bonding liquid and when we use the putty, we change our light to an amber light so it doesn't cause the premature setting of the material and increases the working time that we have to manipulate the bonding material.

When you polish bonding, you're basically removing scratches, getting finer and finer and less scratches to create the luster of a tooth.

Sometimes the artistic time it takes to do the bonding is more labor intensive than cupping the tooth for a crown.

So now, when you bite together, you feel like you're hitting anything strange?

- Yeah.

Which tooth was it?

I can't even... Is it this one?

- It was that one.

- Yeah.

Wow!

That looks like my other teeth.

That's the real artistry of doing this.

Thank you.

- My pleasure.

- Wow!

I have my smile back.

- So, Grover, I think in order for that bonding to have a lifespan, we need to get that night guard for you, to protect yourself at night.

We take an upper impression, which will protect your teeth up top.

We use a tray, put a little alginate material, which is like a putty-type material in there, fit it into place, and we'll just hold it in place like that about a minute and a half or so.

- Now with my tooth restored and my smile back, I can rest easy.

And with my new night guard, I'll be able to keep my smile for a long, long time.

Here's my night guard.

I wear it religiously and, thankfully, haven't had a problem since.

As I had mentioned, we produced that piece prior to the pandemic, but we thought it an important issue to cover now because bruxism is primarily triggered by stress.

And we're living in particularly stressful times.

Today, Dr Bunting and his staff work in masks and apply all the CDC-recommended precautions to keep their patients safe.

Brit, back to you.

- Thanks, Grover.

Now, as we heard, Grover's dental troubles happened just before the pandemic, but Covid-19 has had a tremendous impact on dental practices and how patients receive care.

I'm joined now by Dr Joseph Krutsick, a dentist in Palmer Township just outside of Easton.

Dr Krutsick, thank you so much for joining us.

It's nice to have you here.

- Thank you for inviting me.

It's a pleasure to be here.

- Before we get into all of this and talking about bruxism and that kind of thing, let's talk about overall oral health and how this pandemic has impacted that.

What are you hearing from some of your patients and what are you seeing?

- Well, when we initially came back after our shutdown in mid-June, about a week or so into coming back full time, I looked at my assistant, Valerie, and I said, is it my imagination or have we done nothing but fix fractured teeth?

And that assumption was borne out a couple of months later.

The American Dental Association sent out a survey to dentists nationwide, and it came back that over 50% of dentists reported increases in clenching and grinding, bruxism, chipped teeth, fractured teeth and TMJ jaw problems.

And if you think about it, all those dental maladies are either related to or exacerbated by stress.

I think one thing everybody can agree on is we've all been under a lot more stress in the last 18 months.

- Absolutely.

We sure have.

So what Grover was talking about fits right in here to what you're seeing the past 18 months.

And so does that go hand in hand with cavities, gum disease?

Is it mostly fractured teeth or is it overall oral health?

- Well, that survey actually showed those four categories, over 50% of the dentists said, yes, we see a significant increase.

Cavities and gum disease, I think a third of the dentists surveyed said they saw an increase in that.

And I think that was a little bit of a mixed bag.

It was kind of kind of funny, because some folks would come in and say, you know, and he said, well, everything looks great.

And they said, well, you know, at work I couldn't stop at lunchtime to brush and floss, but now I'm working from home I can do that.

So I think that could swing both ways in those categories.

- So when was it apparent to you that 2020, the pandemic, everything that was happening with the pandemic, when was it apparent to you that that was going to have a big impact on your work and your practice?

- Pretty early on, So, my background before going to dental school was in microbiology, and I looked at the level of contagiousness that was becoming apparent and the mode of transmission.

And pretty much, I would say early January, I thought this is something dentists are going to really have to worry about.

- So what are some of those upgrades and changes that you've had to have made throughout the past year and a half to keep your patients and your staff as well as yourself safe?

- That's right.

It's a good point, because I literally say to people all the time, look, we're literally all in this together.

So I think it boils down to, well, there's changes in protocol.

And then there were some pieces of equipment that made scientific sense to us that we put in.

Some things, yes, were mandated.

Other things just made, again, good scientific sense to me.

So one of the obvious things that we put into place were air purifiers in every single room.

And we made sure that they were high-efficiency ones that could filter out the particles about the size of the particles we were worried about.

The second thing that we put into place we affectionately named Snuffy after your beloved character Snuffleupagus, because it looks like an elephant's trunk strapped to a shop vac.

And that's essentially what it is.

It's a shop vac for mouths.

But what it's designed to do is to pick up the aerosols right where they're being generated.

When it picks them up, it sends them through a series of filters and then bombards them with a UV light before it exits the back door.

So that was the second piece of equipment that we invested in.

The third thing came out of looking at studies from Wuhan, China, and I think the Netherlands that showed in a restaurant.

So you had a person who was infected here and people around them got infected.

You know, the table over here next to them, those folks got infected.

But then there was a bunch of tables that were fine.

But then these folks over here got infected, and they looked at that, said, what's going on?

OK, but the airflow went in this duct and out the AC duct on the other side.

- Ah!

- So I thought, OK, we got to think about that.

- Sure.

- I was fortunate to be put in touch with a company that actually produces the same technology that filters the air in the International Space Station.

- Wow!

- So, International Space Station and my basement!

So we put that in the HVAC system.

And then last but not least, if anything gets through that set of defenses, we come in and fog rooms with like an industrial disinfectant fogger between every single patient.

- Sure.

So that level of safety has really been stepped up by all of this equipment that you've had to then purchase.

So what's the cost associated with this?

And were there any grants or any ways that dental offices could recoup some of this money to keep people safe?

- Oh, absolutely.

Well, you know, I looked at that, and I think the easy thing to put a number on was the pieces of equipment I just talked about.

And that was around... And our office was around, say, $10,000 to $12,000.

That's actually a small piece of the puzzle as far as the economic downside of the pandemic.

I think the other things you look at - people understand that N95 masks cost more than surgical masks.

I had my assistant look at the cost of gloves, which was kind of like the stock market for a while.

So, pre-pandemic, we were paying maybe $15 for a box of gloves.

And my assistant came in and said, Doctor, you know, I see this box of gloves for $70.

And I said, oh, how many are in that case?

And she said, no, that's a box.

I said, keep looking.

- Wow.

- So at the high point, I think we paid, like, $60 for a box of gloves.

Now, we go through 8,000 to 9,000 gloves a month.

- Wow.

Wow.

That cost has to be astronomical.

- Yes.

We did get help.

- Oh, you did?

OK. To just follow up on your second part of your question.

Yes, the payroll protection program has a factor in it that so much of it has to go through for payroll but a certain percentage can be used for things like mitigation equipment and stuff.

- Good, good, good that you can accrue and can get back some of that money, because it was it was not cheap to survive this pandemic for many businesses.

How do you think dentistry as a whole has changed throughout this pandemic and will continue to change moving forward into the future?

- Well, I think some of the protocols put in place, things like I think N95 masks are here to stay.

I don't think we're going back to surgical masks.

I think face shields, full gowns being changed in-between every patient, I think that's here to stay.

The one thing I hope can start to hopefully at some point, as vaccine percentages go up, maybe we can start to have, you know, families come in and stay in the waiting room and basically have a little bit more hallway interaction, I guess you could say.

But that remains to be seen.

- Sure, especially with the Delta variant the way it is right now.

And my final question for you, what has the impact of vaccines, if any, had on dentistry?

Has it helped at all that people are getting vaccinated?

- I think the most profound effect is we go to work and we're not fearing for our lives, because when we first came back and nobody was vaccinated, I was personally fearing for my life and for the lives of my staff.

So I think the comfort level that it gives us, that we can come in and safely treat our patients has that effect.

And as far as patients coming in, we do ask them if they're vaccinated.

We hope that they're being straightforward with us, because it helps us help them, helps us keep them safe.

So we try to minimize interaction, you know, again, hallway interaction, reception room interaction.

Certainly, it's been shown that, hey, if you have two people that are not vaccinated, the risk of transmission is far greater than if you have two people who are vaccinated.

I mean, everybody's wearing masks anyway, at least until time of treatment, because there's only one way in.

- Sure!

- So I think that's kind of the gist of how it's affected us.

- Dr Krutsick, thank you so much for being here.

- Thank you very much for inviting me.

Appreciate it.

- You got it!

And the pandemic definitely kept people away from the dentist's office, but folks came back as vaccines became more available.

According to the American Dental Association, 89% of people had returned to their dentist for care and checkups by August of this year.

The last year and a half has been tough on everyone, but especially older adults.

I want to bring in Genesis Ortega.

Thank you so much.

You recently spent some time at a senior center, a recently reopened senior center.

This is the hub for many older adults of their activity, where they get to socialize and meet other people.

That didn't happen over the past year and a half.

Now it's reopened.

So what are things like?

Where did you go?

- Well, Britney, I visited the Basilio Huertas Senior Center in South Side Bethlehem.

They've been operating for over 50 years.

And like you said, if the past year and a half has taught us anything, it's that social isolation can be hard on anyone, especially our older adults.

So, the center that I visited was closed for much of the pandemic but reopened its doors this summer.

I visited to see how the seniors and staff were handling getting back into the swing of things.

- It has been wonderful to see our facility, to have them back every day.

They always come in with a smile.

There were a lot of very happy seniors the day the Basilio Huertas Senior Center opened its doors again.

Victoria Montero is the executive director of the Hispanic Center Lehigh Valley, which runs the center, whose clients are mostly Spanish speaking.

- Our services are a little bit different.

Prior to Covid-19 pandemic, we were serving between 60 to 80 to 100 seniors in the facility throughout the year.

Unfortunately, due to the pandemic, we're only able to serve 50 seniors.

And we have extended our hours operations.

We are open now from 8:00 in the morning to 4:30 in the afternoon.

We have a morning shift of 25 and then we have a second shift of 25 for the afternoon.

- Because of a surge in Delta variant cases and the higher risk posed to older adults, the center has strict rules.

- All of the seniors who are enrolled have to be fully vaccinated.

They have to wear their mask all the time they're in the facility.

We follow a lot of the health and safety regulations from the state and work very closely with Northampton County to ensure that we're following the state regulations for seniors, - The seniors are happy to be together again.

Bethlehem resident Ramonita Garcia has been coming here for 20 years now.

- This is like our second house because we be with our friends.

We play dominoes, we play bingo or so many activities.

They treat us very nice.

- Garcia says she never lost touch with her friends, even in the months when they couldn't be together in the same place.

- We call by telephone, we communicate, and sometimes we go to the stores, you know, like that.

- But it's not the same.

- Oh, no, no, no, it's not the same when we be face to face talking.

Yeah, it's very nice that they open the center.

The center is very, very important for us.

- Socialization plays a key role for older adults.

Heather Nicolella is the senior center director for Lehigh County's Office on Aging and Adult Services.

- Social isolation is huge for the senior group, and this gives an opportunity for people to not stay in their apartment, especially after Covid, or their home and really get out and just socialize with others about the same age range.

- And she says it's also good for the mind and body.

- There's an increased risk of premature death due to loneliness and social isolation.

So it really does impact their physical health in addition to mental health.

- She says while senior centers are a great place for socialization, there's also a vested interest in keeping everyone safe.

- I mean, Covid has turned around the senior center life completely, and we were delivering meals through a lot of the pandemic until we really reopened.

So I think right now the challenge is just getting back into the groove.

- Getting seniors back in person may be slow going, with limitations on how many people can be in a room together.

But Nicolella says one way they've been taking advantage of senior center spaces is with vaccine clinics.

- When the vaccines were being distributed, we did a lot of vaccine clinics at Lehigh Valley Active Life, which is the bigger senior center, and it just had the ability to bring more people in there because it is larger.

And then our Cedar View Senior Center, we had one or two clinics there.

- The Hispanic Center in Bethlehem hosted a number of vaccine clinics during the time the doors were closed to the public.

- The Hispanic Center Lehigh Valley has been working for the past few months in vaccine in our community, and a lot of our seniors actually were able to get vaccinated in those clinics.

We were able to schedule them appointments here at the Hispanic Center, at the Community Wellness Center.

- Now there's a waiting list to use the center's services, so they're not taking anyone else at this time.

But those that were able to secure their spot couldn't be happier.

- They are excited that we are back.

They are excited to be home.

They're excited to be sharing the time here with their friends, with the staff at the Hispanic Center.

We could not be more excited to have them back.

It feels like our facility's life and the energy, the music, the food.

Just knowing that kitchen in the morning, when we're cooking breakfast, their lunch, the smell, the sofrito, you know, it's exciting to have them back in.

Our seniors are happy every day walking through the door, so we're hoping that we're able to remain open and we'll continue to follow the Covid-19 regulations from this day in the county.

- Culture most certainly unites this group of seniors, but Victoria Montero says the connections established at places like this go far beyond that.

- The Hispanics in our senior center is a family, a Hispanic family that is celebrating every holiday, is gathering here to celebrate our food, our culture.

And this is the place where they want to be Monday through Friday.

Every Friday when we walk in, I say good morning and they'll reply back, I'm sorry, Victoria, I won't be here over the weekend.

So this is definitely a place they want to be in this, you know, the second home for them.

The Basilio Huertas Senior Center is just one of many senior centers in the Lehigh Valley, so make sure to reach out to your county office on aging if you'd like more information.

- So, Genesis, this senior center has a vaccine policy.

So does that mean all of the senior centers have a vaccine policy in place right now?

- Well, not necessarily.

So, this center does mandate that people have to be vaccinated, but it's not the case across the Lehigh Valley.

So, again, people will have to check with their county office on aging to see what the different requirements are.

But from what I understand, masking is in force.

- Sure.

So case-by-case basis, check with your local senior center first.

- Correct.

- OK, so what was the big takeaway once you visited here?

- They're like family, Brittany.

I mean, these people have known each other for years.

When the pandemic first hit and the center had to be closed down, they called each other every day just to stay in touch.

And one of the women even told me that she went grocery shopping with some of the other seniors because they didn't really have anybody else.

And so, you know, now that they've been open, it's just been a big family reunion.

You can imagine.

They're so happy to be together.

- I'm so happy they're back together!

The family, the gang's all back together.

I love it.

Genesis Ortega, thank you so much for sharing that.

- Thank you, Brittany.

On the next episode of Living In The Lehigh Valley, it's a fun way to get out and get some exercise - we'll hit the tracks on a new trail with a rail bike in the area.

Thank you for joining us for Living In The Lehigh Valley.

I'm Brittany Sweeney.

We hope you stay happy and healthy.