Precautions to be taken for Novel CoronaVirus or COVID-19 patients in Dental Clinics

With the news about the spread of novel Coronavirus or 2019-nCoV or COVID-19 it is important for Dental Staff who are prone to be exposed to aerosols from patients having symptoms of novel Coronavirus. Center for Disease control and prevention is reminding clinicians to use standard precautions without fail and isolate patients who show signs and symptoms of the virus. The incubation period of novel Coronavirus is anywhere between 2-14 days according to the CDC, it has not been mentioned for how long the infected patients carry the virus which is said to be several weeks. It is important that Dentists and Dental Staff follow strict protocols and some simple steps to be safe from COVID-19 as according to this Article in The Newyork Times, Dentists are said to have the highest Exposure to Coronavirus patients – Nytimes article

Basic Precautions to be taken in Dental Clinic – COVID-19:

1. Ask for any travel History of the patient or his or her relatives who they have met recently to any infected countries.
2. Ask for Symptoms such as Fever, Cold, Cough etc and do not hesitate to postpone the treatment if not urgent
3. Wear Facemask – 3 ply or N95 if available for the Dentist and Dental Assistant during and after the treatment
4. Avoid Scaling and Oral prophylaxis cases if not urgent, as these are the procedures which lead to most Aerosols
5. Clean all exposed surfaces from patients aerosols with disinfectant like Chair, any surface in the waiting rooms touched by the patients etc.
6. Provide Hand Sanitizers to all patients entering the practice at the entrance it self
7. Clothes worn in Clinic in the operating area should not be taken home as it is said that the virus can survive on cloth surface for more than 48 hours.

Note: All the basic Sterilization protocols which we follow in our day to day practice is more than enough to control the spread of Coronavirus or COVID-19.

Image credit: Centers for Disease Control and Prevention (CDC) Alissa Eckert, MS, and Dan Higgins, MAM.

It is advised to postpone any Dental non emergency or elective Dental procedures in patients with symptoms similar to novel coronavirus. Any person who has a history of traveling to China in the recent months should have their appoints postponed during the incubation period of the Virus.

What Protective Gear should the Dentist wear to treat Coronavirus patient?

At the moment it is not adivsed to give dental treatment to a COVID-19 positive patient in the normal Dental clinic set up as steralization and isolation becomes a major concern to the Dental Staff and other patients who might visit the Dental Clinic. But in cases where the patient is a suspected positive patient the Dentist needs to very a complete PPE kit – Personal Protective Equipment.

Protective gear to treat non-COVID-19 patients:

N-95 Mask or Surgical mask, head cap, disposable Coverall gown, face shield, gloves (Nitrile gloves are preferred over Latex Gloves), shoe cover.

Every Dental Council around the world has issued statements requesting Dentists to perform only Emergency or Essential Dental procedures and avoid any Non-Essential Dental procedures in the coming days. So it is important that we take proper precautions and follow strict protocol while performing these Emergency procedures. Here is a list of Emergency vs Non-Emergency Dental Procedures.

How is novel Coronavirus Spread or Transimtted?

Coronaviruses are a large family of viruses and are commonly seen in many species of animals – cattle, cats, bats and camels. Animal coronavirus is not known to be spread to people but in case of novel coronavirus or 2019-nCoV has been transmitted to people and spread between people similar to SARS and MERS.

Person to Person spread happens in close contacts (6 feet) through – respiratory droplets by Coughing, sneezing. The droplets travel through air and land in the nose of mouth of dental staff or any surface nearby and can be inhaled into the lungs leading to spread of the disease. It is not clear if touching any surface having infected droplets and later touching your mouth or nose can lead to the spread of the disease.

Which mouth mask or face mask can prevent spread of Coronavirus?

A regular Surgical or medical mask will not prevent the spread of Coronavirus but a specialized mask known as “N95 Respirator” will help in preventing the disease from spreading to the person wearing it.

Image credit: Shutterstock

The N95 Respirator is thicker and seals the mouth and nose properly from any infectious aerosols from spreading to the person. It is not advised for common people to wear this mask at the moment but medical professionals who can come in direct contact are recommended to wear one. One cannot work for prolonged duration while wearing a N95 Respirator.

Coronaviruses is fairly common in many animals in humans which is a large family of Viruses, but the particular strain 2019-nCoV is deadly as it is seen to progress rapidly and spreads fast. Health care professionals should be on the lookout for patients who have recently traveled to China and show symptoms such as Fever, cough, shortness of breath, decreased respiratory rate etc. If any patient is found with related symptoms the Dental staff should be instructed to place a face mask on the patient and isolate him/her and report such cases to local and state public health authorities.