195 CMAAO CORONA FACTS and MYTH COVID : Dentistry
Dr K Aggarwal
President CMAAO
With input from Dr Monica Vasudev
1067: Update on Covid-19
IMA-CMAAO Webinar on
“COVID-19 and Dentistry”
22nd
August, 2020
4-5pm
Participants
Dr
KK Aggarwal, President CMAAO
Dr
Ramesh K Datta, Hony Finance Secretary IMA
Dr
Jayakrishnan Alapet
Dr
S Sharma
Faculty
Prof Dr Mahesh Verma
Prosthodontist
Vice
Chancellor, Guru Gobind Singh Indraprastha University
Former,
Director and Principal of Maulana Azad Institute of Dental Sciences
Key points from the
discussion
- Dentistry has progressed in the
past few decades and it is now a huge group of Dental Sciences.
- Nine specialties where MDS is
offered: Oral medicine & Radiology, Prosthodontics, Conservative
Dentistry & Endodontics, Orthodontics, Pediatric Dentistry and
Preventive Dentistry, Periodontology, Oral & Maxillofacial surgery,
Oral Pathology and Public Health Dentistry.
- The dental profession has been
very aware and proactive in strategising how to tackle the infection.
- Initially only emergent and
urgent cases such as pain, infection, bleeding, trauma, were attended to
and elective procedures were delayed or postponed.
- Guidelines for dental
professionals were the first guidelines issued by the health ministry.
- Every patient is a potential
source of infection, whether Covid-19 or not.
- All specialties other than oral
medicine, oral pathology and a little bit of orthodontics generate
aerosols as dentists work with a hand high speed instrument. Air and water
produces a splatter of droplets with microbes.
- The risk of infection in the
dental profession is because of close proximity to the patient,
micro-organisms in the mouth (remain viable and suspended in the air for
long time as droplets) and droplets adhere to the surfaces (fomites).
- Safety not only of the
patient/doctor, but also the staff in the immediate vicinity and other
staff is important.
- For aerosol procedures, gown
(impervious), mask (N95and triple layer), face shield, goggles, shoe
cover, gloves are required.
- Clinic is cleaned and sterilized
before and after every patient. This is time-consuming so fewer patients
are attended to now. One chamber works at a time, more ventilation,
exhaust, windows open, extra-oral suction system, HEPA filters, UV lights,
more air changes in AC (8-12/hour)
- Infection and biomedical waste
protocols are strictly followed now as increased risk of cross infection.
- Earlier dentistry as a speciality
was studied after completing MBBS (UK Royal Colleges), including in India
(Annamalai University). As there are lot of biomechanical procedures
involved, dentistry soon grew as a separate speciality.
- Dentists work together with many
medical specialities like ENT, plastic surgery, oncosurgery.
- Often oral manifestations of a
disease appear first and so are first incidentally diagnosed by dentists.
- Oral cavity has lot of ACE2 receptors.
So, the coronavirus can cause gingivitis, periodontitis. It does not
involve tooth. But, if periodontium is affected, it can loosen the tooth.
- Oral hygiene is very important as
the oral cavity has millions of different pathogens. It is important to
reduce the viral load before any procedure so fewer aerosols are formed.
Ask the patient to do pre-treatment or pre-procedural rinse with hydrogen
peroxide, povidone iodine.
- Three basics for dental health:
Brushing, flossing and swish (with water).
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