COVID-19 and what dentists are doing for infection control

At this point, the COVID-19 coronavirus has hit more than 80,000 infected worldwide with a rapidly climbing death toll of around 2,619 people. With 34 countries and regions affected, containment efforts by medical professionals and their practices is absolutely imperative. People worldwide are largely eschewing public areas; preferring to hide away at home whilst the tide of infections subside. But is that really necessary?

The news of the South Korean “superspreader”, a lady who infected more than 300 of her fellow churchgoers, is shedding light on just how contagious this virus can be when it takes into account bodily contact within a close proximity. With that said, when visiting a dentist, close bodily contact is an inevitability. So what exactly are dentists doing for precautionary measures?

Of course, in 2020, using modern sterilization methods is a given for all certified dental establishments. But did you know that as recently as 1986, less than 30% of all dentists wore protective apparel like gloves, masks and dental gowns? Putting the coronavirus aside, there are many dangerous viral diseases like hepatitis B, herpes, syphilis amongst others that might get transmitted through contact with unsterile equipment. All dentists are vaccinated against hepatitis B to prevent potential transmission.

Sterilization of all dental equipment

Sterilization of dental instruments is also important. Before you enter a dental hall, all surfaces where bacteria might survive like the dental chair, trays and countertops are sterilized beforehand. Between each patient, dentists use heat sterilization methods in order to keep their tools clean. To sterilize larger pieces of equipment, like X-rays units, a liquid disinfectant is used to keep the environment germ-free.

Recommended sterilization methods include the use of an autoclave, which cleans the metal tools with steam under pressure. Other methods include the use of a chemiclave, which uses chemical vapor in order to kill all germs on the tools. If you don’t see an autoclave or dry-heat oven in your dentist’s room, don’t worry! Most of the time, the equipment is sterilized away from the dental studio in order to save space.

Wearing of protective apparel

All dentists, by recommendation of the CDC, have to wear protective apparel at all times during surgery. This includes a proper surgical mask, latex or vinyl gloves and sometimes eyewear. Oftentimes, you will also see dentists and their assistants using a variety of disposable protective items, such as gloves, paper drapes, disposable masks, as well as suction tube tips and needles. For various hygiene reasons, these items are not cleaned but disposed of between every patient.

 Washing hands and maintaining hygiene

It sounds simple enough, but a simple thing like washing your hands is actually a great deterrent to keeping the coronavirus from spreading. Dentists have a set hygiene routine which usually starts with washing their hands in between patients. You’ll commonly see that this is the first thing that dentists do once you enter their clinic.

Many dental procedures involve direct contact with bodily fluids such as blood and saliva. Even through protective clothing, it is possible that a miniscule bit of fluid managed to make it through and contaminate the dentist’s skin during surgery. Washing their hands and forearms with a proper disinfecting agent and water is a very effective way in removing any forms of pathogens that might’ve got through the initial layer of protection.

Should I avoid the dentist until the coronavirus scare is over?

While it is indeed scary to go for a dental procedure during this trying time, the Singapore government has stated that the chances of picking up COVID-19 from the dentist or even more crowded places like the A&E at a hospital is low. Their advice is to stick to your schedule, go for the appointment and return home quickly. They also state that with proper infection control measures, it is unlikely to catch COVID-19 from the clothes or protective equipment of a medical worker.

Remember, that as medical professionals, we are committed to ensuring your health and safety at all times. Be vigilant in this time while the virus is still going strong and adapt the necessary measures to control infection in both public and private places to keep you and your family safe and sound.

References

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   Estela Sanchez-Gayle Macdonald - (https://www.sciencedirect.com/science/article/abs/pii/S0002817715610376)

3. Patient Preferences For Dental Clinical Attire: a Cross-sectional Survey in a Dental Hospital
   McKenna-G. Lillywhite-N. Maini - (https://www.nature.com/articles/bdj.2007.1109)

4. A 10‐year Survey Of Compliance with Recommended Procedures For Infection Control By Dentists in Beijing
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5. Surgical Gloves: Current Problems
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6. An Assessment Of Hand Hygiene Practices Of Healthcare Workers Of a Semi-urban Teaching Hospital Using the Five Moments Of Hand Hygiene
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