A novel coronavirus came up in 2019 called SARS-CoV-2, it is a new strain not previously identified in humans. COVID-19 is the infectious disease caused by this SARS-CoV-2. Declared a pandemic, COVID-19 represents a global public health crisis of unprecedented dimensions. COVID-19 attacks the airways and transmission can occur by respiratory droplets expelled through nose and mouth as an infected individual coughs or sneezes.
The dental profession is particularly at risk, due to the possibility of aerosols and saliva droplets being sprayed into the air by oral procedures. The droplets can be inhaled, come in contact with mucous membranes or skin or lodge on the materials used or the surfaces of the dental clinic during the dental appointment where hands can then get contaminated.1
Dental professionals are advised to refrain from routine dental appointments and dental treatment during the period of the COVID-19 pandemic and limit treatment to dental emergencies only.2 Dental emergencies can occur and exacerbate within a few hours and require immediate treatment. Patients are advised to phone in before arriving at the dental clinic. Relevant history is taken on the phone to determine that a dental emergency exists and screen for respiratory and other symptoms.
Dental emergencies would include potentially life threatening conditions that require immediate treatment to stop ongoing tissue bleeding, alleviate severe pain or infection.2 Dental treatment provided should be as minimally invasive as possible and avoid or minimize operations that produce aerosols and droplets. Aerosols can be produced by air/water triple syringes, high and low speed handpieces, ultrasonic scalers, taking intra-oral radiographs and patient coughing.
Strict and effective infection control protocols should be observed in the dental clinics. Staff schedule should be reviewed to minimize patients contact. Patients while waiting should be given a medical mask. The use of four-handed dentistry is recommended for infection control.1 Dentist and other staff should observe strict personal protection measures, wear appropriate personal protective equipment (PPE) such as N95 mask, face shield, head covering, gloves, and apron. Rubber dam and low or high volume saliva ejectors should be used to reduce production of aerosols and droplets.3 Strict adherence to the World Health Organization (WHO) guidelines is important.1 Routine dental work should be suspended and only dental emergencies attended to in the face of a pandemic such as Covid-19.
Fervently pray for God’s guidance and protection.
References:
- FDI World Dental Federation. Covid-19 outbreak: Guidance for oral health professionals. 31st March 2020
- American Dental Association. What constitutes a dental emergency? 31st March 2020
- Coronavirus disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. Meng L, Hua F, Bian Z. Journal of Dental Research 2020; 1: 1-7 17th March 2020
Contributed by:
Dr. Donna Chioma Umesi
Associate Professor and Consultant Dental Surgeon
Department of Restorative Dentistry CMUL and LUTH
