Introduction:
The pandemic crisis of β-coronavirus (2019-nCoV) originated in China and has become a major public health disaster not only for China but for all countries on the globe. 2019-nCoV causes severe pulmonary condition and even fatal pneumonia. The cross-infection risk is high between dental practitioners and patients due to the unique situation of dental procedures causing the the route of infection transmission through air-droplet of cough or sneeze, droplet inhalation transmission, and contact of oral, nasal, and orbital mucous membranes.
Symptoms of COVID 19:
Primarily, people exhibit
- Fever
- Cough
- Shortness of breath
Some also exhibit:
- Loss of taste
- Loss of smell
- Chest pain
About 15% to 25% of 2019-nCoV patients have severe conditions and their chest CT showed bilateral pneumonia, with ground-glass opacity and bilateral patchy shadows which are the most common patterns.
Incubation period
The incubation period of asymptomatic 2019-nCoV had been estimated as an average of 5 to 6 days, but there is current evidence that it could be up to 14-days or more, which is considered now as the adopted duration for medical quarantine.
Route of transmission of 2019-nCOV in dental clinics
- Use of high-speed hand pieces or ultrasonic instruments in dental patients with a cough or a sneeze can drive their saliva, secretions, or blood to aerosolize to the surroundings.
- Infections can also occur through the puncture of sharp instruments or direct contact between mucous membranes, contaminated hands or indirect contact with contaminated instruments and surfaces which can persist on surfaces up to two days.
Steps to be taken for treatment of patient in the dental clinic:
1. Identify a suspected case of COVID- 19
The dentist should be able to able to identify a suspected case of 2019-nCoV through precheck triage clinic to evaluate and measure the temperature of every patient as a routine procedure. The practitioner should take medical history including history of cough, shortness of breath and/or sore throat and travel history to infected area.
Once patients and their accompanying persons enter the clinic, their temperature should be measured. Any patients suffering from fever should be referred to designated hospitals.
2. Infection control in dental clinic
Hand hygiene: Proper hand washing technique should be followed.
Barrier protection for the contact areas: Complete coverage of clinical contact areas of dental chair are needed.
Disinfection and sterilization prototocol in dental clinic:
Spray machines are needed for sanitization of dental clinic.
High volume suction and HEPA filters are required for proper cleaning and creating vacuum that traps about 99.97% of dust.
Procedures that are undertaken in dental set up can be categorised under green, orange and red circles -
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