Dentistry is facing its darkest hour yet, with the growth and spread of the coronavirus pandemic....
covid-19
Within two decades, the world has experienced three outbreaks of the very fatal coronavirus, Covid-19, caused by SARS-CoV-2. Coronavirus has posed an unprecedented situation for the world and has affected all facets of life. According to the World Health Organization (WHO), to date 30,675,675 new cases and 954,417 deaths have been documented (till 20th September) and 216 countries or areas have been affected. This dire situation has provoked many to reassess the cracks in our pre-existing governmental and societal systems and also think about what the post-Covid world may look like.
In many countries, the unanticipated cascade of events has overwhelmed the already strained healthcare systems, Pakistan being one of those unfortunate nations to experience this. As evidenced by research, healthcare providers are the most prodigious sector in contracting this virus. Amongst them, those that work in the dental sector are especially vulnerable due to their distinctive nature of work. According to Occupational Safety and Health Administration (OSHA), dental health care personnel (DHCP) are placed in very high exposure risk category as dentists work in close proximity to the patient's oral cavity. Also, dental procedures involve the use of rotary instruments such as handpieces and scalers, which generate aerosols. Thus, the nature of this virus in conjunction with routine dental procedures, poses a bilateral risk for both the dentist and the patient.
Dentistry is facing its darkest hour yet, with the growth and spread of the coronavirus pandemic. -Dental surgeons are at the highest risk of contracting and transmitting the coronavirus, alongside paramedics, nurses, and other healthcare workers. Considering these risks, it is imperative that when performing elective procedures, DHCP (dentists, dental hygienists, dental assistants, and receptionists) should update their knowledge and skills regarding infection control and strictly follow protocols recommended by the relevant authorities to protect themselves and their patients against infections. In addition, it is advisable for the patient to only visit the dental clinic in cases of emergency that include trauma, swelling and excruciating pain. This has also been endorsed by the Centers for Disease Control and Prevention (CDC) recommends that patients with active Covid-19 infection should not be seen in dental settings and should be referred for emergency care where appropriate transmission-based precautions are available.Where possible, patients in need of dental care should be entertained through Telephone Triage and this should encompass all queries regarding any symptoms, travel history or any contact with Covid-19 positive patient in the prior 14 days. Based on the patients' signs and symptoms, a decision should be made to determine whether the patient needs to be seen in the dental clinic. Scheduling appointments with at least one hour of gap in between is necessary to avoid crowding of patients around the work place.
Covid-19 has been one of the primary reasons to drive the descent of Pakistan's economy leading to a temporary halt in the imports business. This roadblock has also manifested in the dental sector where DHCP are unable to stock up on basic dental materials that were previously imported from foreign countries. The president of Dental Trade and Manufacturers Association, Liaqat Humayun referred to the current scenario as a ‘complete economic meltdown’. “The impact we are seeing is huge, with institutions closed and prices of consumables soaring it is time that the dental industry prepares itself for the unusual challenges once this is over,” he says.
On the other hand, the professional future of dental practitioners and the sustenance of their practices is a serious concern. Wages and clinic rentals have to be accounted for every month even though there have been no revenues, causing a huge socio-economic impact.
Adding to this, as the patient turnout rate has significantly dropped, existing resources and equipment nearing expiration, compound the current scenario, potentially imposing a situation where dental professionals may likely face a shortage of essential dental supplies due to supply chain disruptions. Equally worrisome is the lack of adequate PPEs for frontline health care workers including masks, respirators, gloves, face shields, gowns and hand sanitizers. This pandemic has caused an upsurge in demand of preventive gear as it has been an essential requirement for all health care providers not only to ensure their own but also patient safety.
Following the uninterrupted spread of the coronavirus in Pakistan, hospitals all across the country saw a massive influx of patients. A primary response to this by the government has been the conversion of any and all available places to isolation centres and wards, dental clinics/hospitals and colleges being one of them now. This extraordinary situation has immensely altered the academic activity throughout the country for the medical students. However, most schools and colleges had to reshape the academic system by shifting to virtual education, which many may agree, may not be as intellectually and practically nourishing. However to make the most out of the current situation, schools should encourage students to engage in self-learning, make full use of online resources and learn about the latest academic developments in dentistry.
A prompt exorbitant impact of Covid-19 was also observed within the dental research department. All research projects requiring clinical trials and dental research seminars were consequently suspended. Research work that involves clinical trials requires a broad range of samples that would jeopardise the motive of social distancing. Funding that was previously granted for this project has now been redirected. However, we must not forget that oral health researchers can still continue to play a key role in the early identification and diagnosis of the disease through deciphering the mechanisms of dry mouth and loss of taste in Covid-19 patients. Preliminary data indicate that oral symptoms are prominent in many patients with Covid-19, especially in the early stages before other symptoms occur.
In order to overcome this ubiquitous Covid-19 impediment, government should devise policies with health ministers, economic advisers and dental fraternity to prevent the plummet of dental profession and compromises in the safety of healthcare workers. Accordingly, they should allocate funds for such contingencies to sustain the dental economy.
The current pandemic and any future public health emergencies that may emerge, mandate concerted efforts to overcome a sui generis situation. Also, it requires a great level of courage and endurance in order to take imperative steps to invigorate the healthcare system and successfully defeat the diseases. We should work together today to ensure a safer, healthier and happier tomorrow.
