COVID-19 has shut down dental practices and changed the way we have traditionally seen patients over the past many months. Offices were scrambling to find a way to continue patient care in addition to abiding by the guidelines set forth to reduce the spread of the pandemic. Fast-forward a few months to the summer of 2020 and dental offices began to open cautiously with information coming from all angles — and it was often conflicting. In some areas of the country, dentistry is back to (a new) normal with extra PPE and working standards in place under the watchful eye of the ADA, ADHA, CDC, OSHA and World Health Organization. WHO released new guidelines regarding elective care, advising that “routine oral health care – which usually includes oral health check-ups, dental cleanings and preventative care – be delayed until there has been sufficient reduction of COVID-19 tranmission rates…” However, the organization recommends giving advice on oral care through “remote consultation” to ensure self-care remains a priority to maintain good oral hygiene.
Transmission Dangers
The World Health Organization released new recommendations on August 3, 2020 in regards for the provision of oral health services during COVID-19. WHO recognizes the virus is transferred three main ways within a dental practice, posing risks to workers and patients alike. The most common manners of transmission include…
1) direct transmission through inhalation
2) direct transmission via mucous membranes (eye, nasal or oral), and
3) indirect transmission via a contaminated surface.
Dental professionals top the list of highest risk of exposure, especially though aerosol generating procedures. Working in close proximity to the face for prolonged periods of time and nearly everything in dentistry generates aerosol.
WHO Encourages Virtual Visits
Finding avenues to provide dental care, especially when emergency evaluations are needed, poses a challenge. Teledentistry is proving to be a viable alternative. The World Health Organization encourages screening patients through virtual/remote technology whenever possible, to provide triage and screening services. The virtual evaluation not only saves on crucial PPE, it also allows the provider to screen for COVID symptoms. Providing emergency care by virtual evaluations may help individuals avoid a trip to the ER to seek relief and help curb the spread of COVID.
In Response to the Recommendation
In response to the WHO recommendations the ADA has issued a statement regarding the health of the public and the importance of dental care in overall health. In addition, the following statement from Dr. Myechia Minter-Jordan, President and CEO of the DentaQuest Partnership for Oral Health Advancement and Catalyst Institute, Inc. works to clarify the recommendation of the World Health Organization:
“Recent WHO guidance has caused quite a bit of confusion at a time we can least afford it. Let us be clear – oral health directly impacts overall health, and this guidance does nothing to prevent people in the U.S. from continuing preventive dental care during this pandemic. In fact, the WHO guidance specifically defers to recommendations at the national and local levels. In the United States, leading public-health organizations have issued clear infection control measures that should be implemented by dental practices to ensure that in-person preventive dental care can be administered as safely as possible. We have worked to compile those best practices into easily accessible resources for dental providers and patients to follow. As long as national and local recommendations support it — and dental providers follow these procedures — patients do have the option to visit their dentists for routine dental care.We urge people to continue addressing their oral health needs in whatever way they are most comfortable — whether at home, via teledentistry appointments, or by visiting their dental provider. Delaying oral health treatment now can lead to more significant health problems down the line.”