How safe are Dental Procedures during COVID-19? Dr K P Senthamarai Kannan, Secretary, IDA- TN, explains..!

Coimbatore: Almost 8 months after Covid outbreak and subsequent lockdowns, doctors at private clinics and hospital OPDs are witnessing back to normal inflow of patients. Especially at places with a downward trend of new Covid cases like in Tamil Nadu, people have begun to visit hospitals and private clinics for treatments that they had postponed during the lockdown. 

Among such postponed treatments are dental procedures which majorly took a hit during Covid lockdown. Skeptical on how safe it would be to carry dental procedures which involves insertion of tubes during procedures, most of the people with dental problems managed with home remedies like clove oils, salt water gargles and over the counter medications. 

However, dental issues concerning decayed tooth pain or a severe gum infection cannot be managed conservatively for long and would  require medical intervention. 

It was on August 3, 2020, the World Health Organisation (WHO) issued guidelines for the administration of oral healthcare during COVID19. Since then almost all the dental procedures around the world have neither been suspended nor had few cases. As dental procedures include procedures largely involving  insertion of suction tubes to pull fluids from the mouth, there is a huge possibility of contracting coronavirus, if the equipments are not sterilised.

In a bid to understand the reality behind safety of patients undergoing dental treatments during Covid time, we spoke to Dr K P Senthamarai Kannan, Secretary, Indian Dental Association (IDA), Tamil Nadu. 

Despite dentists following guidelines issued by IDA and WHO, Why are people reluctant to undergo dental procedures? 

First and foremost, the reason for people to not seek appointments is due to the fear of the novel coronavirus. As the virus  predominantly spreads through respiratory droplets, people are unwilling to carry out dental procedures that are manageable for few more months.

While a majority of dentists follow all guidelines of wearing PPE kits, sanitising tools, screening patients before appointment etc. Yet, there are a notable number of small dental clinics across the state who dont afford to buy PPE(s). 

Such clinics, refrain from attending patients. PPEs are not given to them by the government because they aren’t registered under clinical act.

However, to specifically mention as to why people are not seeking appointments is because only 10% population of people in India require dental procedures and after the emergence of Covid, many patients are managing conservatively. With or without Covid, its just 10% of the population who seek dental services.  

Hence, it cannot just be attributed to just fear of people over the spread of viruses, alone. A recent survey by the IDA says that only below 10% of India’s population seek dental procedures.

During these unprecedented times, routine check ups in dental care may not have been possible, for all. But we did attend pediatric cases and others who had serious dental problems. If serious dental issues are postponed, they can lead to complications. 

Since March, after the WHO declared the pandemic, nearly 1000 dentists across the state were tested positive for the Coronavirus. As many as 30 dentists in and around Salem region were tested positive for the virus. 

With dentists reporting less positivity rate of COVID-19, should people with non-urgent ailments also seek an appointment?

Dentists are strictly advised to follow all the guidelines issued by IDA and WHO to safely treat patients and ensure a safe environment both for the dental care providers and the patients. Yes, people even with dental ailments (urgent or non urgent) can consult dentists by following all health protocols. 

It is not effective at all. As the percentage of people consulting dentists is below 10% in the country, teledentistry is not popular. However, taking into consideration the situation, teledentistry can be sought as an option.  

Of course it does. Almost all the clinics are now equipped with clinic-centered standards and focussed on prevention and control of infection. Be it essential equipments like air filtration, sanitising tools, disposal of bio wastes, screening of patients and following social distancing norms, overall, the infrastructure of the system has considerably improved, thanks to the pandemic. 

We are using the opportunity to expand our services and innovate new ideas to ensure safety of both patients and health care providers. More improvements are possible, if the government helps us get our representation in the clinical establishment act. Despite multiple representations, we have not been acknowledged by the Government of India, under the clinical establishment act.

Dr K P Senthamarai Kannan alleged that Indian Dental Association (IDA) has not been registered in the Clinical Establishment Act and hence not beneficiaries of any government support. He added that in these tough times, the government did not issue any guidelines for them nor helped them financially. 

Indian Dental Association (IDA) is an authoritative, independent and recognised voice of dental professionals across India.

Dentists from Government hospitals in Tamil Nadu opine there are chances for the patients and doctors to test positive for the virus, if dental equipments are not properly sterilised after every procedure and the clinic premises, chairs are not sanitised. Any callousness, might lead to nosocomial infection. 

Dentists also fear that prolonged delay in certain dental problems like 

cavity problems, could lead to tooth removal. Dentists also suggest that patients requiring immediate treatment but unable to visit a dentist due to Covid or during quarantine can try home remedies like use of ice packs on cheeks and chewing garlic, clove which can aid in pain reduction. 

Good dental habits like brushing the teeth before sleep, gargling will help to stay away from several tooth and gum problems. However, we advise patients to avoid self medication of antibiotics and pain killers, especially at these pandemic times. 

"Earlier, during dental procedures, a majority of patients were administered ibuprofen for pain. However, using the drug is now not recommended during Covid time, as the drug can potentially increase the risk of kidney failures among patients who either have coronavirus or suspected to be. Fearing high level risks, dentists are not suggesting ibuprofen", said a dental practitioner.

The drug can be prescribed only after checking the patient's hemoglobin and renal levels. Avoiding self medication of any nature can save your life during pandemic, he advised.