In the light of WHOdeclaringCOVID-19virusto bea pandemic Indian Dental Association (IDA) recommends preventative measures for dental professionals to minimize transmission --- as scientific information leads to improvements in infection control, risk assessment, and disease management.
Possible transmission routes of 2019-nCoV indental clinics
Virus can be passed directly from person to person by respiratory droplets; emerging evidence suggested that it may also be transmitted through contact and fomites. Dental patients and professionals can be exposed to pathogenic microorganisms, including viruses and bacteria that infect the oral cavity and respiratory tract. Dental care settings invariably carry the risk of infection due to the specificity of its procedures, which involves face-to-face communication or directtransmission (cough, sneeze, and droplet inhalation transmission) and contact transmission (contact with oral, nasal, and eye mucous membranes). In addition, studies have shown that respiratory viruses can be transmitted from person to person through direct or indirect contact, or through coarse or small droplets, and 2019-nCoV can also be transmitted directly or indirectly through saliva.
Dental patients and professionals can be exposed to pathogenic microorganisms, including viruses and bacteria that infect the oral cavity and respiratory tract. Dental care settings invariably carry the risk of
2019-nCoV infection due to the specificity of its procedures, which involves face-to-face communication
with patients, and frequent exposure to saliva, blood, and other body fluids, and the handling of sharp instruments. The pathogenic microorganisms can be transmitted in dental settings through inhalation of airborne microorganisms that can remain suspended in the air for long periods, direct contact with blood, oral fluids, or other patient materials, contact of conjunctival, nasal, or oral mucosa with droplets and aerosols containing microorganisms generated from an infected individual and propelled a short distance by coughing and talking without a mask, and indirect contact with contaminated instruments and/or environmental surfaces.
Minimize Chance for Exposures
- Posta sign at theentranceto thedentalpractice which instructs patients having symptoms of a respiratory infection (e.g., cough, sore throat, fever, sneezing, or shortness of breath) to please reschedule their dental appointment and call their physician. The same thing applies if they have had any of these symptoms in the last 48 hours.
- Rescheduleappointment if your patients have traveled outside India in the last two weeks to an area affected by the coronavirus disease. This includes China, Hong Kong, Iran, Italy, France, Spain, Germany, Japan, Singapore, South Korea, Taiwan, Thailand, Vietnam or any other COVID19 affected country.
- Takea detailed traveland health history when confirming and scheduling patients. Do not provide non-emergent or cosmetic treatment to above patients and report them to health department immediately. Screen patients for travel and signs and symptoms of infection when they update their medical histories.
- Incorporate questions about newonsetof respiratorysymptoms into daily assessments of all patients.
- Taketemperature readings as part of the routine assessment of patients before performing dental procedures.
- Takethe contact details and addressof allpatientstreated.
- Installphysicalbarriers(e.g.,glassorplasticwindows) at reception areas to limit close contact with potentially infectious patients.
- Make sure the personalprotective equipment being used is appropriate for the procedures being performed.
- Use a rubberdam when appropriate to decrease possible exposure to infectious agents.
- Use high-speed evacuation for dental procedures producing an aerosol.
- Autoclavehand-pieces after each patient.
- Have patientsrinsewith a 1% hydrogen peroxide solution before each appointment.
- Clean and disinfect public areas frequently, including door handles, chairs and bathrooms.
Postvisualalertsicon(e.g.,signs,posters)attheentranceandinstrategicplaces(e.g., waitingareas,elevators,cafeterias)toprovidepatientswithinstructions(inappropriate languages)abouthandhygiene,respiratoryhygiene,andcoughetiquette.Instructionsshould includehowtousetissuestocovernoseandmouthwhencoughingorsneezing,todisposeof tissuesandcontaminateditemsinwastereceptacles,andhowandwhentoperformhand hygiene.
Providesuppliesforrespiratoryhygieneand cough etiquette,includingalcohol-basedhand rub (ABHR)with 60-95%alcohol,tissues,and no-touch receptaclesfordisposal,atentrances, waitingrooms,and patientcheck-ins.
RiskAssessmentis Critical
Dentalpersonnelshould be alert and identify patients with an acute respiratory illness when they arrive, give them a disposable surgical face mask to wear and isolate them in a single-patient room.
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