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The current coronavirus infection has taken the world by storm. Six out of the seven continents have now been infected and just a handful of countries remain uninfected. Here is some vital information for dentists or those planning to visit dentists.

COVID-19 is all the rage these days. The entire world seems to be talking about the newest possible pandemic and a lot of half-correct information is being passed around — along with, of course, the odd bit of outright misinformation.

As the famous English poet Alexander Pope has rightly said in his Essay on Criticism, "a little learning is a dangerous thing". It is therefore important for the public at large and for healthcare professionals, in particular, to bust through the myths surrounding COVID-19, the novel coronavirus, and educate themselves and others to prevent hysteria and unwarranted fears.

Let's take a look at how this outbreak might affect dental care — and how it won't. 

What is a coronavirus?

"Coronavirus" is a generic term that should not be confused with the current outbreak. Coronaviruses represent a group of viruses with spikes that resemble a crown, and that can cause a wide range of diseases — from common colds to more life-threatening diseases like SARS, MERS and now COVID-19. So not all coronavirus infections are life-threatening.

Most coronaviruses that can infect humans are believed to have initially emerged in animals before mutating. Since it is impossible to predict possible mutations, they have a tendency to arise unexpectedly.

The current strain of coronavirus has not been identified before and is believed to have affected human beings for the first time. The term nCov, which stands for "novel coronavirus" is still being used, alongside terms like "Wuhan coronavirus" and just plain "coronavirus" (which would be an incorrect way to describe it) — but the virus has now officially been named COVID-19. 

A number of theories regarding the emergence of COVID-19 have been doing the rounds, some of which have a racial element. The currently most accepted theory seems to be that bats may be the original source of this virus.

How does COVID-19 spread?

It is important to know how COVID-19 spreads in order to limit cross-infection among laypeople and healthcare professionals.

COVID-19 is, like all viruses, believed to be transmitted most efficiently via person-to person-contact. The contact can either be direct (like touching) or indirect (like coughing or sneezing). The virus can, however, remain alive on various surfaces for a couple of days, infecting unsuspecting individuals who come in contact with them.

Are dentists at an increased risk of catching COVID-19?

An infected person can transmit COVID-19 to another person through direct or indirect contact via droplet infection. Since dentists do have closer physical contact with people than those in many other professions, dentists are definitely likely to have a higher risk than, say, an IT specialist working from home.

COVID-19 has an incubation period of around one to 14 days. During this period, the infected person can be totally asymptomatic but can still act as a carrier and infect other healthy individuals. This means dentists can be vulnerable to contracting the virus from an asymptomatic patient who isn't yet aware they have been infected with the novel coronavirus.

The most common dental procedures — like scaling, fillings, and root canals — invariably lead to the formation of aerosols, very fine droplets of water that disperse in the air and remain suspended for a long period of time. These aerosols, when mixed with the saliva or blood of a person infected with the new coronavirus, can act as a potent mix to infect not only the dentist, but assistants, receptionists, and other patients in the clinic.

Dental treatment also includes a lot of face-to-face communication. Any coughing or sneezing can expose the dentist or dental nurses at an increased risk of infection.

What can dentists and dental patients do to  minimize the risk of COVID-19?

Simple precautions can go a long way in minimizing the risk of spreading COVID-19 in a dental office.

Screening patients who report to the dental office for a fever, coughing, and sneezing helps identify potential carriers. Being familiar with these patients' recent travel history and social contacts can help detect a potential case of COVID-19 as well.

Patients deemed to be at risk should be provided with disposable masks to limit the spread of infection. If possible they should be made to wait in a single sitting area to prevent exposure to other patients as well as assistants.

Even the slightest of doubts means the patient should be advised to undergo a test for COVID-19 and any elective procedure or conditions manageable by medication can be deferred to a later date. Only acute conditions should be treated to relieve the patient of pain.

In all other cases, preventative measures can still help protect everyone involved:

  • The dental operator should wear standard protective barriers like face masks, eye shields, head caps, latex or nitrile gloves, and any other protective gear deemed necessary. Assistants working in the dental office, too, should be provided with basic safety gear.
  • The use of disposable or single-use materials go a long way in the prevention of cross-contamination between patients.
  • Basic rules of sanitation and disinfection should be followed at all times. Frequent washing of hands, or use of alcohol-based sanitizers, should be mandatory.
  • Patients should be asked to gargle with mouthwash at the beginning of a procedure to limit the spread of infection.
  • Using a rubber dam can help reduce the amount of saliva dentists or their assistants are exposed to.

Should I postpone my dental appointment because of the coronavirus?

If your dentist maintains proper sterilization and other basic hygiene steps, the risk of cross-infection is low — but the very nature of the disease is infective.

If you are living in an area with a high rate of viral transmission, you can ask your dentist to postpone your appointment by a couple of weeks if the treatment required is not an emergency. This can help limit the risk of infection.

It is also important for patients to make their dentists fully aware if they have the slightest symptoms of any viral infection like fever, coughing, sneezing, or if they have recently traveled to a country with a high rate of COVID-19, or any history of contact with a person suffering from COVID-19. This will help the dentist take proper precautions during the treatment or they may delay your appointment to a later date.

Conclusion

Unnecessary panic sometimes is more harmful than the disease itself. While there is no doubt that COVID-19 is a potential pandemic, its spread can be limited by using simple precautions. Dentists are at a higher risk because of potential close contact with patients. But simple precautions can greatly reduce the amount of cross-contamination between patients as well as prevent infecting the staff working at the clinic.

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