The year 2020 has not been very kind to us. The pandemic has affected us all, from the richest to the poorest. It is a public health emergency.
As a dentist, I believe one of the most affected professions post COVID-19 will be dentistry.
Surgeons and other health care workers are at risk undeniably. But because of the setting in a dental clinic, dentists as well as the patients will be put at higher risk.
On March 15, an article was published by the New York Times, which claimed that the dentists are the most exposed to the risk of being infected by the virus—even more than nurses and GPs.
The chances of cross-infection are magnified in a dental setting. We might see higher rates of nosocomial infections in a dental clinic, as compared to other hospital settings.
The use of dental instruments like aerotors, ultrasonic scalers and various other such instruments causes the secretions and blood of the patients to dissipate in the surrounding and aerosolise the air in the clinic.
Studies indicate that saliva has a significant role in human-to-human transmission. One of the studies by Xie X, Li Y, Sun H, Liu L, in 2009, states that larger droplets could contribute to viral transmission to subjects nearby, and on the other side, long-distance transmission is possible with smaller droplets infected with air-suspended viral particles.
Without rigorous sterilisation of the instruments, they could be contaminated with the virus as well.
A study indicates that the life of the virus varies with different surfaces. It explained that the virus can sustain for a longer period of time on metals, and the longest on plastics. By that reasoning, handpieces would be the biggest source of infection. Use of saliva ejectors, proper chair positions, anti-reflux devices on hand pieces to avoid contamination and following procedures that will reduce the volume of aerosol production are some of the basic guidelines.
Guidelines have been issued by the American Dental Association and various other organisations, which must be followed to its core.
Proper sterilisation protocol and personal protective measures must be implemented. Thorough sterilisation of the clinic after every appointment and following strict infection control will not only reduce the risk of cross-infection to the patients but will also reduce the risk for dentists.
In dental school, we would test all the patients for haemoglobin, HIV, vitamin, calcium etc. before any surgical procedure.
In a post COVID world, I think that testing will become feasible eventually, hence I would recommend testing all patients before any dental procedure.
I hope we all come out of this pandemic really soon and get used to the New Normal.