Professor, Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Sciences, King George’s Medical University, Lucknow, India
Corresponding author details:
Amit Nagar, Professor
Department of Orthodontics and Dentofacial Orthopaedics
Faculty of Dental Sciences King George’s Medical University
Lucknow,India
Copyright:
© 2020 Nagar A. This is an
open-access article distributed under the
terms of the Creative Commons Attribution
4.0 international License, which permits
unrestricted use, distribution, and
reproduction in any medium, provided the
original author and source are credited.
The outbreak of corona virus disease 2019 (COVID-19) in Wuhan-China has evolved
rapidly into a public health crisis and has spread exponentially to the other parts of
world. On 11th Feb 2020 WHO named the novel viral pneumonia as “Corona virus Disease
(COVID-2019)”While the international committee on taxonomy of virus (ICTV) suggested
this novel corona virus name as “SARS-CoV-2” due to phylogenetic and taxonomic analysis
of this novel corona virus. Due to compact dental setting dental professionals are at high
risk for nosocomial infections and can become potential carriers of the disease. These
risks can be attributed to unique dental intervention procedures like aerosol generation,
handling of sharps and proximity of dentists to patients oropharyngeal region. If adequate
precautions are not taken the dental office can expose patient to cross contamination.
Dental practitioners should be better prepared to identify a possible COVID-19 infection
and refer the patient to appropriate treatment center.
Droplet and aerosol transmission of 2019-n CoV is of the most important concern in
Dental Clinics and hospitals because it is hard to avoid the generation of large amount of
aerosol and droplet mixed with Patient’s saliva and blood during dental treatment. We must
be fully aware how 2019-n CoV spreads and how to identify patients having 2019-n CoV
infection [1,2]. A proper dental and medical history should be taken which should include
history of any febrile respiratory illness (fever and cough), travel to an area having high
incidence of COVID-19 and exposure of the person to any known case of CIVID-19. Fever
should be recorded with non-contact forehead thermometer. Hand hygiene is considered
to be the most important measure in reducing risk of transmission as the virus can stay
on the surface from hours to days depending on the type of surface. PPE (gloves, gowns,
goggles, face shield and N-95 or FFP-2 masks) should be used. 1% hydrogen peroxide or
2% povidine iodine is recommended as a mouth rinse before any procedure to reduce the
salivary load of oral microbes. Use of rubber dam also minimizes production of saliva and
spatter of aerosol and blood. Extra high volume suction should be used Manual devices like
Carisolv® (mix of NaOcl and amino acids) and hand scalars are recommended for caries
removal and scaling to minimize generation of aerosols [3,4]. Anti-retraction high speed
dental hand piece can reduce the backflow of oral bacteria into the tubes and dental unit. If
a suspected or confirmed case of COVID-19 is treated the medical waste generated it should
be collected in double layered yellow medical waste package bags and gooseneck ligation
should be used. The bags should be marked and disposal done as per waste management
protocols. Other recommendations include use of disposable mirror, probes, syringes and
tweezers , extra oral imaging instead of intraoral to avoid cough reflex, minimal use of
ultrasonic instruments, high speed hand pieces, 3 way syringes etc. and use of negative
pressure treatment rooms.
Copyright © 2020 Boffin Access Limited.