DENTISTRY IN POST COVID-19 ERA

The COVID-19 pandemic was firstly reported in December 2019 in Wuhan,

China where there were a cluster of patients presented with atypical pneumonia.
Since 2019, there has been no major relief in the cases of COVID 19 across the
globe, especially India. The folly became evident in the last week of March, 2021
when a tidal wave of infection hit India leaving its citizens gasping for life. From
around 11,000 cases of new infections daily, it skyrocketed to over a lakh, rapidly
doubling every week till April end and early May in 2020, the numbers infected
crossed 400,000 daily. The big question on everyone’s mind: when will the
nightmare end?
The answer to this threatening question especially in a large and
heterogenous country like India is very difficult to answer. Studies have even
acclaimed that a third wave of pandemic will hit the country but no one can predict
when. The key for protection is to build surge capacity in health care infrastructure
that acts as an insurance policy against future waves. As its said that true
prevention is not waiting for bad things to happen, its preventing things from
happening in the first place. Prevention is daughter of intelligence and that’s why
an ounce of prevention is worth a pound of care. So, our healthcare systems have
to embrace the new normal and fight back with vigorous impact. COVID 19 has
substantially affected the growth projects and economies all over the world. The
global spread of COVID 19 has put into notoriety the vulnerability of dental
professionals as well. The susceptibility and accessibility of dental professionals to
COVID 19 dictates proportionate consideration to be constructed in the profession
of dentistry. Dentists are very much liable to infections in this pandemic because of
their unceasing and extended exposure to aerosols and droplets coming out of
patient’s oral cavity. Common risk factors like stress, alcohol and tobacco use,
substance misuse, behavioral health issues have been heightened during the
pandemic. These health issues have exacerbated chronic diseases and poor oral
health outcomes. So, the role of health care providers in providing efficacious
dental care becomes rudimentary. Its very important that we understand that
infection control and patient safety protocols become a routine process. For
patients with confirmed or suspected COVID 19 who need to receive emergency or
urgent dental care, various treatment guidelines have been developed by the
Centres for Disease Control and Prevention (CDC), the American Dental
Association (ADA), the Occupational Safety and Health Administration (OSHA),
and others to prevent spread of infection. Studies have shown that coronavirus was
detected in the self-collected saliva of 91.7% patients. Hence precautions like
facemask and face shield are the minimum requirements for every dentist in the
post COVID-19 era. Screening, triaging, teledentistry, preprocedural mouth wash
rinses with 0.2% povidine-iodine, hand hygiene, judicious use of PPE and
efficiently disposing off the Biomedical waste are some of the many things that we
as dentists have to follow in post-covid era for our safety as well as for the safety
of patients.
Regular fumigation of dental clinics, practicing 4 handed technique for
controlling infection, performing dental procedures with rubber dams, high volume
suctions or saliva ejectors, using extraoral dental radiographs such as panoramic
radiographs as alternatives to intra oral radiographs have to be practiced. The post
COVID era might last for how long, we never know and we the dentists will be
most affected by this end because we end up treating both the symptomatic and
asymptomatic covid patients. Hence every patient should be considered as
potentially infected by the virus. Dental health care providers must keep
themselves up to date about this evolving disease allowing dental care to be
provided to the patients in a safe environment.
Since the dental care paradigm is now shifting its focus to a more preventive
aspect, the role of a public health dentist comes into the point of convergence.
Adequate preventive strategies with sufficient policy changes can only reform the
current scenario of our country. It is very important for the government to rework
on the existing dental acts and regulations and revise them to increase the access to
prevention. It becomes the responsibility of dentists to reinforce all the resources
available in terms of manpower, human capital and technology for a better and
radiant tomorrow.
Coronavirus, while being the reason behind almost all bad things in recent
times, can also be the harbinger of a positive change in the field of dentistry – Dr.
Biju Abraham.
All these revised recommendations being proposed by various health agencies for
the prevention of COVID 19 among dental health care professionals fundamentally
are producing two major economic effects. First, an increase in the time period
between subsequent treatments and an increase in fixed costs (e.g. adapting to air
conditioning plants & HEPA filters) and variable costs (e.g., Personal Protective
Equipments). For tackling these issues, rigid financial support should be rendered
to the dentists so that they can adjust to these revised, protective recommendations.
Such an injection of liquidity, also by means of guaranteed loans or non-repayable
grants, would definitely permit the moderation of a natural increase in dental
charges which, in turn, would boost the choice of seeking dental health care.
This pandemic has impacted how dental care can be safely delivered in the short
term, and likely will stimulate permanent changes in how ideal dental care can be
delivered. The COVID-19 pandemic may also hasten the adoption of innovative
dental workforce models, including dental therapists who complete at least 3 years
of academic training and provide a limited scope of treatment, such as prevention,
fillings, and treatment for periodontal disease, in collaboration with a dentist.
Dental therapists have been found to reduce overall dental costs and expand access
in rural and tribal areas. Its time for dental researchers to focus on key issues and
reevaluate the existing unanswered questions for delivering effective dental care to
masses.
As rightly said by Albert Einstein – “The measure of intelligence is the ability to
change”.

Dr. Sagrika Grover

PG (3RD YEAR)
Pacific Dental College & Hospital, Udaipur.