COVID-19 and Dentistry: Challenges and Opportunities

The coronavirus disease 2019 (COVID-19) outbreak significantly affected employment in the Philippines. The majority of employees reported their job was suspended, and a total of 6 out of 10 families lost income. On a global scale, most dentists reported practice closure because of COVID-19, and greater impacts were reported in the private sector than in the non-private sector. The closure was associated with professional, practice, and country-level factors. Luckily, with the rollout of vaccines and fewer restrictions, most dental clinics are opened with compliance to safety health protocols.

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The widespread transmission of SARS-CoV-2 in many communities, the potential for infected individuals who are pre-symptomatic or asymptomatic to transmit the virus to others, and the unique nature of dental interventions with the proximity of the provider to the patient’s mouth and throat, all contribute to the high risk for dental personnel teams becoming exposed and transmitting the virus to other patients or staff. Some dental procedures may lead to aerosol generation, further increasing transmission risk to dental providers or future patients through direct inhalation or contact with contaminated surfaces.

Infection control and prevention in the dental office setting

Dental professionals are very familiar with occupational health issues and corresponding risk assessments to reduce risk and apply Standard Precautions for minimizing the spread of the infection directly or through cross-contamination.

Using a negative pressure room may create challenges as most private practice dental offices lack AIIRs, and larger dental organizations may have dental operatories clustered in open spaces without physical barriers.

Access for patients needing oral healthcare

Delayed dental care has a variety of consequences, whether it is due to dental office closures, reluctance to seek care during a pandemic, loss of employer-sponsored dental insurance coverage, or other factors. Routine dental visits are opportunities to provide preventive oral health care (e.g., fluoride treatment and sealants) and to identify oral manifestations of systemic disease that might otherwise be missed.

Future Considerations

The COVID-19 pandemic has impacted how dental care can be safely delivered in the short term and likely will stimulate permanent changes in how dental care is delivered. The profession will need to consider several unanswered questions, for example, whether the workflow and layout of dental clinics should be permanently reorganized and whether expanded PPE is warranted for the care of all dental patients as part of Standard Precautions. Dental care providers should be prepared to assist patients in understanding their dental insurance benefits, which may have changed due to the pandemic.

The COVID-19 pandemic presents several opportunities for dental researchers to focus on crucial issues. Important research priorities may include estimating the costs and benefits of expanded PPE use, developing and testing innovative approaches to minimize aerosol generation during dental procedures, testing and validating tele-dentistry models, and evaluating alternative dental workforce models, such as dental therapists.