During the COVID-19 pandemic, prevention of oral problems and self-care remain a high priority. Patients should be given advice through remote consultation or social media channels on maintaining good oral hygiene.
Transmission of SARS-CoV-2, the virus that causes COVID19, can occur through direct, indirect, or close contact with infected people through infected secretions such as saliva and respiratory secretions or through their respiratory droplets.
COVID transmission occurs mainly in three ways in a dental setting:
- Direct transmission through inhaling the droplets (cough or sneeze)
- Direct transmission through exposure of eye, throat or nose to the infectious droplets
- Indirect transmission through contaminated surfaces
Aerosol-generating procedures (AGPs) are widely performed in oral health care settings. They can remain suspended in the air, travel over a distance and can cause infection if they are inhaled. Clinical procedures that use spray-generating apparatus cause aerosolization in the treatment area, leading to immediate contamination of surfaces and potential for the infection to spread.
Dentists work in close proximity to patients’ faces for extended periods. Their procedures involve frequent exposure to saliva, blood, and other body fluids and handling sharp instruments. So, they are at high risk of being infected with SARS-CoV-2 or passing the infection to patients.
Guidelines used for dental professionals in COVID Pandemic:
- According to WHO it has been advised that routine non-essential oral health care (oral health check-ups, dental cleanings and preventive care) be delayed until there has been enough reduction in COVID-19 transmission. However, emergency cases that are vital to preserve a persons’ oral functions, managing severe pain, etc should be provided.
- Oral health care workers should maintain 1 meter from the patient while conversing and wear medical masks throughout the shift. It is mandatory for the oral health care team to wear medical masks throughout their shift and remove it only while eating or drinking.
- Prior to treatment, all oral health care personnel undertaking or assisting in the procedure should perform hand hygiene according to the WHO’s “5 Moments” recommendations, preferably using an alcohol-based (60-80% alcohol) hand rub (ABHR) product or soap and water. Hand should be dried with disposable paper towels. Patients should be asked to do the same before entering the clinic.
- Until the dental procedure begins, patients are advised to keep their mouth masks on.
- Patients should be unaccompanied until require assistance.
- Only admit the patient and the staff required to provide care to the treatment area.
Ventilation in oral health care settings:
- Adequate ventilation in oral health care facilities reduces the risk of transmission in closed settings.
- Avoid the use of split air conditioning or other types of recirculation devices and consider installation of filtration systems (exhaust fan, whirlybirds, etc).
Protection of oral health care personnel and patients during treatment:
- All the surfaces in the treatment area should be declutters, only the instruments and materials needed for the procedure should be kept outside.
- Ensure that the oral health care worker undertaking the procedure has washed/sanitized their hands before starting the treatment.
- Ensure that oral health care personnel are trained to use appropriate Personal Protective Equipment (PPE), following a risk assessment and standard precautions: gloves; fluid resistant disposable gown, eye protection (face shield that covers the front and sides of the face or goggles) and a medical mask. A fit tested N95 or FFP2 respirator (or higher) is recommended when AGPs are performed.
- Patients should be advised to rinse their mouth with 1% hydrogen peroxide or 0.2% povidone iodine for 20 seconds prior to examination or starting any procedure for the purpose of reducing the salivary load of oral microbes, including SARS-CoV-2.
- Oral health care involving AGPs should be avoided or minimized, and minimally invasive procedures using hand instruments should be prioritized. Is incase AGP cannot be avoided, four handed dentistry should be used where the dental assistant should use high speed suctions and rubber dams. Dentist and their team should wear PPE kits along with N95 or FFP2 respirators.
- Patient should be instructed to use a cup to spit or high-speed suction should be used for the same.
- Dentist should try to finish all the procedures in a single visit.
Cleaning and disinfection procedures in between patients:
- Standard cleaning should be done of the entire treatment area after every patient.
- High touch surfaces like door handles, chairs, phones and reception desks are regularly cleaned.
- All patient-care items (dental instruments, devices, and equipment) must be sterilized or otherwise subjected to high-level disinfection.
- Staff performing cleaning and disinfection should wear appropriate PPE.
- Respirators, surgical masks, gowns and gloves must be discarded after every patient. Re-usable eye protection and face shields must be cleaned and disinfected prior to re-use.
- Dental hospitals should dispose health care waste according to the recommended procedure.
The Dental Roots, being the best dental clinic in Delhi and Gurgaon makes sure that all the procedures are done under extremely sterilized and ventilated zone. Dentists in India along with their team have undergone intensive training and process management in following the guidelines provided by the government. Dr Dheeraj Setia along with his team of highly qualified dentists work together to provide the highest level of dental treatment in a trusted and compassionate environment. We welcome you to receive the individual attention you rightfully deserve.