You may have been waiting to see the dentist ever since you first heard the term "COVID-19" — perhaps even despite significant dental pain or obvious problems with your teeth. Since nobody knows how much longer we will have to live under the spell of the coronavirus pandemic, you may now be considering getting dental work done.
How risky is it, really, to see a dentist now? What precautions should be taken by patients and dentists alike?
What is a coronavirus?
"Coronavirus" is a generic term that should not be confused with specific virus causing the current pandemic. Coronaviruses represent a group of viruses which possess 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, and not all even infect humans.
Most coronaviruses that can infect humans are believed to have initially emerged in animals before mutating. Since it is impossible to predict future mutations, they have a tendency to arise unexpectedly.
COVID-19 has, these days, taken over a large portion of our daily lives. The entire world has been in the grip of this serious 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 the COVID-19 pandemic might affect dental care — and how it won't.
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. There is now increasing evidence that COVID-19 is also airborne, meaning you may catch it by breathing in particles suspended in the air found in enclosed spaces — very much like dental clinics.
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 of catching COVID-19 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. In addition, some COVID-19 positive people remain symptom-free for the entire duration of their infection, seemingly unaffected themselves but able to spread the virus. 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.
- Dental patients should wash or disinfect their hands properly and under supervision when they come into the clinic, and pass over a disinfection barrier with their shoes. They should be instructed not to touch any surfaces they do not need to.
- Even the slightest of doubt 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.
- Dentists and dental assistants should wear standard protective barriers like face masks, eye shields (visors), head caps, latex or nitrile gloves, and any other protective gear deemed necessary. Administrative staff working in the dental office, too, should be provided with basic personal protective 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 for all staff. Dental chairs and surfaces, including in the waiting room, should be disinfected after each patient.
- The number of patients present in the clinic or dental office at any one time should be limited, in accordance with the space.
- 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?
It is 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.
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. However, with this pandemic lasting longer than many had anticipated at the start, many people will simply need to go to the dentist — and taking all the protective measures we have grown used to is the best we can do to limit our risk.
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