Dentistry in COVID-19 Pandemic
July 03, 2020 | Farah Jassawalla

Dentistry in COVID-19 Pandemic

The highly infectious and novel coronavirus, or SARS-CoV-2, was first reported in China and has led to a global pandemic that has affected people worldwide. The World Health Organization (WHO) declared it a public health emergency of global concern.

All healthcare professionals, including dental professionals, are at high risk of coming into close contact with COVID-19 patients. The role of dental healthcare providers in preventing the spread of COVID-19 is critical. Interaction with COVID-19 patients, particularly those who are asymptomatic, in the dental care setting could result in significant exposure of the dental staff if proper infection control procedures are not put in place. Therefore, it is imperative to identify any risks associated with incoming patients before carrying out the dental treatment.


What Is the Risk?

Dentistry heavily relies on the use of rotary dental and surgical tools, such as handpieces for drilling the cavities, ultrasonic scalers for scaling or air-water syringes. These dental instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. Masks, face shields, and protective goggles do protect mucous membranes of the mouth, eyes, and nose from droplet spatter. However, they do not guarantee complete security from the inhalation of airborne infectious agents.


Is the Dentist’s Office Safe?

You can come into contact with germs any time you leave your house. However, all healthcare workers should follow standard operating procedures to create a safe and uncontaminated environment for their patients. Your dentist and their staff should wash their hands and sterilize tools as often as possible. Every instrument should be sterilized after being used on any patient. Some gear and needles are never meant to be reused and should be discarded by the dentist after one use. Your dentist's office may go even further to ensure the safety of their patients during the pandemic, by:


     Disinfecting all surfaces and tools more often

     Cleaning, replacing, and covering tools after every use

     Wearing more protective gear than usual, including gowns and respirator

     Covering the patient's mouth with a rubber dental dam to minimize aerosol production


Other Steps to Be Taken

     Space out appointments.

     Call the patient before the appointment to ask about their health and if they're facing any symptoms related to COVID-19

     Check temperature and other symptoms before allowing entry

     Ask about recent travel history

     Ask whether the patient has been in contact with people who have COVID-19

     Tell the patient not to arrive early, so their duration in the clinic is limited

     Request that the patient restricts the number of people they bring along, such as dependants

     Have the patient wait outside the clinic until the dentist is ready for them

     Ensure that waiting room chairs are six feet apart to follow social distancing protocols

     Get rid of all common surfaces that patients could touch in the waiting room, such as cushions, magazines and TV remotes


While all standard dental care has been suspended in all countries experiencing COVID-19 for the duration of the pandemic, the need for organized emergency care delivered by teams provided with appropriate protective equipment takes priority. While all dental procedures are not provided, some urgent and emergency dental care needs to be done by following strict personal protection measures. It has been recommended that dental professionals do their utmost to reduce and avoid the production of tiny droplets and aerosols, use of high-volume suction, and minimize all other hazards.


Emergency Treatment for Which You Should Visit Your Dentist

According to the ADA, something should be treated right away if it's life-threatening, causes severe pain, or carries a high risk of infection. Generally, your dentist decides what's urgent. This may include:


     Serious pain

     Bleeding that won't stop and continues for an extended period

     Tissue that needs a biopsy as soon as possible

     Swollen areas in or around your mouth which may show signs of malignancy

     Broken teeth, especially if they cause severe pain or tissue trauma

     Signs of infection (pain, swelling, and bleeding)

     Post-surgery care you can’t do yourself

     A temporary crown that’s lost or broken

     Dental work related to cancer treatment

     Dentures that don’t work the right way

     Wires in your braces that hurt your mucosa

     Accidents or trauma that may affect your ability to breathe


Non-Urgent Treatments in Which You Can Reschedule Your Appointment for Later

Non-urgent dental treatments, or elective procedures, refer to dental work that doesn't pose an immediate problem to your health. In other words, you can reschedule your appointment to a later date if you're worried about contracting COVID-19. Some examples include:


     Teeth cleaning or exams


     Treatment for things that don’t hurt (cavities, tooth removal)

     Teeth whitening

     Fixing cosmetic problems

     Checkup for braces

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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.