The recent COVID-19 pandemic has changed how countries, states, medical facilities, and individuals operate. Not only have the ways in which people engage in shopping, schooling, and recreational activities shifted, but the nature of medical care as a whole has too.
The desire of some people to sprint to the doctor with any and every ailment has been advised against (unless it’s really an emergency), as has close proximity to others. It’s been suggested, however, that society’s overall mental and physical health has declined due to many people’s inability or hesitancy to visit clinics as needed.
Due to the addition of several government-mandated rules and regulations—aimed at keeping individuals safe—many people have experienced heightened feelings of anxiety, irritation, and isolation. Families aren’t, however, the only ones to feel this pandemic-caused strain. Due to the fast-spreading nature of the virus, there has been a severe increase in the demand for medical care and preparedness.
Health care professionals have been kept on their toes managing the influx of potentially-infectious patients. While a lot of pressure has been placed on nurses, doctors, and physicians in direct contact with positive cases, the role of dentists shouldn’t be overlooked. They can also offer invaluable information and expertise that could aid in the fight against COVID-19.
Qualifications and training
You may associate your family dentist with oral health expertise only, thinking that they’d prove less helpful in medically-demanding situations that don’t revolve around your pearly whites. This, however, isn’t so. Similar to physicians, dentists undergo training and education in several health sciences. These generally include:
• Pharmacology. (1)
Dental practitioners need to understand how to react if an emergency situation were to occur in their clinic, another reason their capabilities are wider than oral hygiene. Dentists often undergo basic cardiac life support training, for example, to prepare for and respond to any emergencies of this type.
When it comes to COVID-19-specific medical processes, dentists are no strangers to the necessary licensing and training. Their general skillset surrounding sterile surgical techniques has enabled them to also carry out COVID-19 diagnostic swab tests, and other methods of prevention which will be explored further below.
Risks and concerns facing dentists
Despite the knowledge of dental professionals, they’re not immune to the threats posed by the virus. Some may say that they’re more in the “splash zone” than other professions and must take further precautions to minimize their chances of infection.
Most dental practices are considered aerosol-producing. The respiratory droplets produced also tend to carry saliva and blood particles that, if a person is infected with the virus, could pose a risk to the dentist. Although many clinics now only accept emergency cases, the willingness to still practice despite the possible risks shows great integrity and selflessness on the dental practitioner’s part. (2)
Falling victim to those tiny infected droplets isn’t, however, the only concern that dentists must acknowledge. According to a COVID-19 study published by Springer Nature, the following areas of the dental industry should also be recognized as threatened during and after the pandemic.
• Financial loss due to the reduced number of patients.
• Increased costs of acquiring personal protective equipment (PPE) and other forms of environmental management.
• Closing down of clinics and services.
• Restricting services to those in need.
• Postponed routine appointments.
• The level of tele-dentistry effectiveness.
• Lack of patient privacy.
• Possible decrease in oral health due to restrictions.
• The mental health of dentists (anxiety and fear of falling ill).
• Higher levels of stress among workers.
• Social responsibility to assist the public (especially in deprived areas).
• Impacts on the future of the profession.
• Managing patients with special needs.
• Difficulties in rebuilding the practice with new restrictions set in place. (3)
Health and safety control strategies
When entering a medical facility in the past year or so, you may have noticed the additional signage on the walls reminding you to sanitize your hands, the barriers built around reception desks and even security guards manning the door to ensure no social distancing breaches or inappropriate behavior take place.
You, however, aren’t the only ones expected to uphold your end when it comes to COVID safety and prevention. The doctors and dentists you visit must also abide by several new pandemic-related laws in order to maintain your safety and theirs.
In order to counteract, or at least minimize, the concerns outlined above, many clinics have been advised to adopt new precautions and biosafety measures.
As mentioned previously, in accordance with government-mandated requirements set by authorities such as Centers for Disease Control and Prevention (CDC) in the United States and the National Health Service (NHS) in the United Kingdom, many clinics have reduced their services to that of emergency-only. (1)
Other patient and infection control strategies include:
• Ask patients about their recent exposure to possible cases.
• Take patient’s temperature upon their entry.
• Frequently wash hands with soap and water (or alcohol-based/sanitizer gel).
• Shield others from your coughing and/or sneezing.
• Provide masks and sanitizer to patients.
• Practice social distancing.
• Store dental equipment carefully to avoid the spread of bacteria.
• Disinfect surfaces before and after consultations and treatments.
• Remove unnecessary objects from clinic that may contribute to the spread.
• Wear PPE (masks, gloves, goggles, face coverings, gowns).
• Undergo practices in a negative pressure room (isolation technique to prevent cross-contamination from room to room).
• Limit number of dental nurses/professionals during the treatment period.
• Limit number of visitors. (1) (2) (4)
As mentioned above, dentists are more than capable of fighting against the pandemic based on their own skillsets. This has been evident through the voluntary role they’ve taken up during the spread.
Dentists have been called upon to assist in inpatient settings, carrying out duties such as the monitoring of vital signs, early symptom detection, patient triage, writing prescriptions and even administering oxygen, injectables, local anesthesia, and suturing if and when required. Dental clinics with the aforementioned negative pressure rooms have also been advised to offer their facilities for COVID-19 screening services. (1)
There are several examples that could be given to highlight the voluntary efforts of dental professionals during these trying times—some of which include the following:
Despite efforts to slow and halt the spread of the virus, Singapore experienced large volumes of cases contained within dormitories. In attempts to mitigate the issue, authorities implemented mass-scale testing among those affected or possibly at risk. Singapore Health Services (SingHealth), the Singapore Police Force, and the Singapore Armed Forces were all involved in this operation. (1)
The National Dental Centre Singapore (NDCS), however, did not shy away from the challenge. They instead decided to deploy dental clinicians and volunteers to assist in swab testing, and to work alongside a wide array of professionals (nurses, medical social workers, radiographers, etc.). The contribution the dental industry offered was a well-received and appreciated part of virus prevention efforts. (1)
Dentists practicing within the UK were called upon to offer their assistance. Not only were they asked to deliver vaccinations (after correct certification, of course), but they were also deployed to work with emergency and critical care cases as well as within the maternity wing. (1) (5)
According to BBC News, the aged care sector has been hit the hardest when it comes to the virus. Due to the increased demand for safety measures within these facilities, 76 dentists in Northern Ireland volunteered to provide support and training to aged care staff members regarding the prevention of infection.
Several U.S. states, including California, not only offered their dental expertise to those in emergency situations, but also wrote into law a more flexible scope for those providing uncompensated care to others. The law prevents professionals from being held liable if their assistance was given as a response to crisis without the expectation of payment or reward. (1)
In order to confirm that any further outbreaks will be met with appropriate preventative measures, dental clinics are required to adjust their practices accordingly. Maintaining recent/current alterations may also be necessary in order to fight against COVID-19 in the present and the future. The medical sphere may not spring back to “normal” until the pandemic is mostly or completely eradicated.
Methods of future preparedness may include:
• Dental education facilities should strengthen their teachings on infection prevention, control strategies, and voluntary medical work.
• Dental clinics should adopt and reinforce their health and safety procedures:
- Hygiene protocols (washing/sanitizing hands)
- Cough etiquette
- Equipment sterilization
- Workplace disinfection.
• Dental students should be trained in swabbing and other COVID-19-related practices.
• Dentists should act as a form of surveillance and inform authorities if individuals display any unusual symptoms.
• Continue with/improve telecommunications.
• Maintain a limit on patients and visitors.
• Continue to screen patients/implement new pre-appointment screening processes. (1) (4)
The role of dentists in the fight against COVID-19 should not be overlooked or underappreciated. Not only are dentists qualified and trained to tackle infection prevention and emergency procedures, the equipment and facilities they control are also useful during this time.
Their voluntary efforts, and their future preparedness, highlight dental professionals’ willingness to put themselves at risk while serving others. Their contribution has been recognized as an important part of the COVID-19 response.
1. “The Role of Dentists in COVID-19 Is Beyond Dentistry: Voluntary Medical Engagements and Future Preparedness”, Source: https://www.frontiersin.org/articles/10.3389/fmed.2020.00566/full#B21
2. “The Role of the Dental Surgeon in Controlling the Dissemination of COVID-19: A Literature Review”, Source: https://www.hindawi.com/journals/tswj/2020/7945309/
3. “Global concerns of dental and oral health workers during COVID-19 outbreak: a scope study on the concerns and the coping strategies”, Source: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-020-01574-5
4. “COVID-19 and Dentistry: Challenges and Opportunities for Providing Safe Care”, Source: https://psnet.ahrq.gov/primer/covid-19-and-dentistry-challenges-and-opportunities-providing-safe-care
5. “COVID-19 vaccination – dental professionals’ moral duty to help”, Source: https://dentistry.co.uk/2021/01/15/covid-19-vaccination/