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 Table of Contents  
EDITORIAL
Year : 2020  |  Volume : 14  |  Issue : 2  |  Page : 49-50

COVID-19 and dental preparedness


Dte Gen Dental Services, New Delhi, India

Date of Submission30-May-2020
Date of Acceptance02-Jun-2020
Date of Web Publication15-Jul-2020

Correspondence Address:
Sanjay Manohar Londhe
Dte General Dental Services, 'L' Block Army HQ, New Delhi - 110 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JODD.JODD_40_20

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How to cite this article:
Londhe SM. COVID-19 and dental preparedness. J Dent Def Sect. 2020;14:49-50

How to cite this URL:
Londhe SM. COVID-19 and dental preparedness. J Dent Def Sect. [serial online] 2020 [cited 2020 Sep 30];14:49-50. Available from: http://www.journaldds.org/text.asp?2020/14/2/49/289755



Nature has a tendency to remind us time and again that all living and nonliving matters in the universe are transient. The Journey called “Life” is in a constantly dynamic state. Situations such as health emergencies and pandemics such as COVID-19 are unforeseen, of a vast global magnitude and have the potential to severely hamper day-to-day activities encompassing every sphere of human life, be it social, professional, or economical. This new disease has already affected approximately 12.3 million individuals of our planet while claiming 5,55,769 lives worldwide. Furthermore, it has resulted in countrywide lockdowns across the world spanning more than 8 weeks. Consequently, historic events such as the 2020 Olympic Games have been postponed for the first time, and a global economic slowdown has affected all sectors besides significantly altering life as we knew it.

As the dictum in the Armed Forces goes-“the more you sweat in peace the less you bleed in war,” the oral health-care providers at every level render cutting edge professional care and infection control and barrier methods comprise an integral part of this delivery system with time-tested protocols and proven practices in place at all times.

However, a contagion of such amplitude like the Covid-19 has taken the global health care community completely by surprise, and they all are struggling to find means and ways to tackle it and expeditiously get things under control. This health emergency has brought to the fore few lacunas in health-care services but has a lot to offer in terms of lessons learnt in the process.


  Lessons to Learn Top


Perhaps, the first and foremost among the lessons from Covid-19 pandemic is the “Will to be proactive while rising to the challenge both courageously and fearlessly.”

Dental Practice, Training and Education are the cornerstones of dentistry. Dynamic improvisation and adaptation to the present situation are the keys to survival. A fearless approach with proper checks and balances in place at every echelon of the oral health care delivery shall help us not only to circumvent the present critical situation but will also prepare us for similar unforeseen calamities in future as well.

The approach toward teaching and training needs to be modified extensively and on a war footing. The concerned authorities responsible for formulation, amendment and promulgation of policies with regard to Covid-19, must take the initiative with an impetus on expeditiously providing practical solutions which are both provider and patient friendly.


  Improvise and Integrate Top


The suffering of patients, dental practitioners, support staff, and students must be addressed. Although dental personnel associated with organized services such as the Armed Forces and other Government Organizations may feel some sense of job security, they represent only a small fraction of the entire dental fraternity. The present situation demands a safe and secure working environment for both patients and doctors. Personal-protective equipment (PPE) comprising items such as face masks, face shields, surgical gowns, scrubs, shoes covers, hand hygiene solutions, and social-distancing norms have become the part of essential day-to-day activities for dental personnel.

The outlook toward dental treatment needs to be revamped from a definite corrective approach to a preventive and interceptive one. Aerosol-producing procedures involving air rotors, three-way syringes, ultra-sonic scaling, etc., need to be grossly curtailed, if not ceased. That means traditional dental treatment procedures and mechanics are back in business. The slow-speed electric hand pieces, hand scaling procedures, and early preventive interventions to avoid further tooth reductions need to be promoted with a new found vigor. Dissemination of knowledge and information coupled with intensive training is imperative with regard to judicious and optimum utilization of PPE, hand hygiene, cough/sneeze etiquettes, social distancing and most importantly, laws of the land.

As well-known virologist, Nathan Wolfe had said “With epidemics, people have been standing on the shore, waiting for the gusher to hit the ocean. However, to prevent epidemics, you have to look at the various little sources that feed into the river.” To take it ahead, I would say, these rivers need to be blocked by different measures. The five levels of protection in relation to dental treatment procedure should be a mandatory protocol for prevention from now on. The protocol encompasses all aspects of the oral health-care delivery and includes:

  1. Direct physical proximity to patient orofacial region
  2. In relation to dental chair equipment and treatment procedure
  3. In relation to dental workforce protection
  4. In relation to dental clinic/chamber/operatory
  5. In relation to entire dental unit premise including nontreatment and administrative area.


Suffice to say the uncertainty associated with the present situation demands customized improvisations which should be integrated within the existing protocols as deemed fit by authorities. A notable example of custom improvisation can be in the form of the PPE such as use of modified outer disposable covering over standard PPE and scrubs to maintain cost-effectiveness, modification of existing dental treatment complex with dedicated patient triage area, donning and doffing rooms and independent operatory with designated trained assistants, modifications in treatment procedures mentioned above to reduce aerosol generation, continuous education of dental workforce, other support staff and patients in the form of educational posters and information leaflets, regular mock drills and quality assurance checks to ensure effectiveness and efficiency is of paramount importance.


  Conclusion Top


It should be remembered that we are fighting a “Health emergency” and its implications are not limited merely to physical health but also to social and psychological wellbeing of individuals. Therefore, it is suggested that continuous monitoring of the social and psychological well-being of the dental personnel and support staff forms an essential element in tackling the Covid-19 menace.

Simultaneously, constructive measures to maintain the morale and psychological health of the personnel during the period of the lockdown shall go a long way in keeping them afloat and committed to the primary role as oral health-care providers.

In despairing situations like this, each step, however small, can lead to a positive incremental change and these cumulative changes shall become more effective through proper knowledge, attitude, and practice.

The present Covid-19 crisis needs us to recapitulate and reinforce the words of wisdom from a learned man-“there is nothing to fear, because you cannot fail but only learn, grow, and become better than you have been before.”






 

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