The Coronavirus pandemic is having devastating effects on the global economy, the healthcare sector—including the dental care sector—and society at large. The new normal has brought numerous changes in how the dental care sector operates.
In the wake of the pandemic, there are several concerns regarding the various risks faced by dental practitioners and patients. This apprehension prompted local health authorities worldwide to close dental offices shortly after the World Health Organization declared the pandemic. To this effect, dentists were only allowed to render emergency care when needed.
However, national health authorities such as the National Health Service of England and the United States Center for Disease Control and Prevention developed and enacted provisional infection control guidelines for dental healthcare providers to follow to protect everyone during necessary appointments.
A 2020 research paper by researchers at the International Academy of Oral Medicine and Toxicology in Florida took a deep dive into the effects of infection control changes implemented to curb the pandemic's spread while providing dental care. The study states that these guidelines were issued in the best interest of public health.
It also analyzed many critical issues, including proper respiratory protection, the use of face masks, the role of saliva in disease transmission and diagnosis, and the need for dentists to contribute to understanding the virus's pathology. These provisional guidelines are changing the trajectory of dental care delivery.
Infection Control Measures
Dental practice requires the use of surgical and rotary instruments, including ultrasonic scalers, air-water syringes, and handpieces. These tools usually cause visible sprays that contain tiny droplets of blood, saliva, water, microorganisms, and other particles.
Dental health professionals use surgical masks to keep these droplets away from the mucous membranes in the nose and mouth; however, they do not entirely protect against inhaling contagious agents.
To this effect, dental practitioners need to create a balance between providing dental care and reducing the risks of transmission for patients and healthcare providers. They must adhere to the CDC framework for delivering non-emergency care during the pandemic.
Dental healthcare providers should constantly reach out to the state or local health departments and dental boards to get information about the specific requirements of delivering dental care in their locale. It will also help them discover the level of community transmission, its impact, and any local health authorities' specific recommendations.
Practitioners must ensure that their offices are adequately cleaned and disinfected after every patient, and they must clean equipment and rooms following the 2003 Guidelines for Infection Control in Dental Healthcare Settings.
The guidelines require them to execute routine cleaning and disinfection procedures using water and specific cleaners for surface cleaning before applying hospital-grade or Environment Protection Agency-registered disinfectants to frequently touched surfaces.
The CDC does not recommend the use of sanitizing tunnels because their effectiveness in reducing the virus's spread is unknown. Additionally, sanitizing tunnels may have counterproductive results because patients could get eye, respiratory or skin damage and irritation from the chemicals in them. It is also essential for dental care providers to adhere to the policies created for waste and laundry management.
Hand hygiene is critical in the provision of routine dental care. Therefore dental practitioners must ensure that they strictly adhere to the hand hygiene rules of the CDC. They must wash and sanitize their hands before and after treating patients, before wearing and after removing personal protective equipment, and after coming in contact with possible infectious materials. Dental clinics should also provide hand hygiene supplies at every patient care location.
Another essential aspect of COVID-19 infection control is physical distancing. To deliver in-person dental care, dentists need to be in close contact with their patients. However, it is vital to adopt physical distance when necessary. Teledentistry has been a savior during this time. It allows providers to limit face-to-face contact while still providing patient care with virtual appointments, triage, consults, follow-up and education.
Only visitors who cater to patients' emotional and physical well-being should be allowed into dental care facilities. Also, modern technology such as video conferencing and teledentistry can help reduce physical interaction between patients and non-essential visitors. Offices should schedule all appointments to reduce the number of people in a health facility at a given time.
Will COVID-19 Pandemic Change The Trajectory Of Dental Care Delivery In Future?
It is difficult to foretell the future of dental practice, particularly after it took such a brutal hit from one of the deadliest pandemics to exist. But judging from recent occurrences, the changes witnessed in dental care delivery will be around for an extended period.
Since the pandemic started, patient management systems have been altered, and teledentistry has quickly become a feature for many offices. Dentists use various platforms, including social media, websites, emails, and voice messages, to schedule dental visits and keep patients informed. Clinics should recapitulate the strict infection control guidelines that must be adhered to and implement them thoroughly.
Going forward, there will be increased use of personal protective equipment such as goggles, gloves, face masks, and gowns by dental professionals. Also, all patients will require testing for viral antigens before each appointment at a dental clinic. Currently, dental procedures take twice as long because dental practitioners are trying to be more careful to reduce transmission risk.
Over the past few months, the cost of running dental clinics has skyrocketed because everyone needs to wear PPEs to interact with patients. In addition to this, they have to be tested regularly to ensure that they are not infected. Unfortunately, the government cannot cover the entire cost for both state-owned and private clinics.
The physiological and pathological characteristics of the COVID-19 virus put dental healthcare practitioners at a higher risk of infection. The virus is invisible and contaminating in numerous ways. All team members must follow the infection control guidelines strictly to curb rapid transmission.
Many of these guidelines are new to the entire healthcare community, but it is the only way to stop the virus from spreading. It may take a while to adjust to the new normal, but we will surely see the benefits in the long run.