Dental Practice during COVID-19 Pandemic: An Observational Study

Abstract

Introduction: Occupational Safety and Health Administration (OSHA) classified health care professionals and exposure risk to Coronavirus, identifying Dental Professionals in very high risk group due to specificity of dental procedures and instrumentations used. As per guidelines from relevant bodies to provide only emergency and urgent dental treatment has led majority of dental practice to stop, instilling apprehension in profession and fear in public. Aim: To narrate the experience from Department of Dentistry, on how to safely and effectively practice dentistry that would provide guidance to practicing dental professionals without major environment alteration and capital items requirement. Materials and Methods: This was an observational study from Department of Dentistry from May to August 2020, attached to a rural tertiary care medical teaching institute, following customised protocol after reviewing available guidelines in relation to Coronavirus Disease-2019 (COVID-19) and dentistry. Data collection was done from Institutional Electronic Medical Record System for patients receiving dental treatment during the study period. It used descriptive narrative analysis to provide chronology of experiences for practicing dentistry as per various unlock phases declared by Government of India. Results: The Department of Dentistry was able to manage four Non-Aerosol Generating Procedures (Non-AGP), three Aerosol Generating Procedures (AGP) and eighteen Outdoor Patient Department (OPD) consultations on an average for a working day, from May to August 2020. During the tenure while providing dental care, none of the member of dental team was detected COVID positive. The result was achieved by simple alteration done by patient, man-power, practice and environment management. Conclusion: A simple alteration in practice and practice area ensuring safety of all members of dental team was made by department. It included the effective use of Personal Protective Equipment (PPE) during all dental procedures including oral examination. Special emphasis on history of patients, facility and environment management along with regular training for hand hygiene, donning-doffing, aerosol appointment and practice was given. An attempt to provide prophylactic and elective dental need of patients were done and department was successfully able to treat seven patients per day on an average during May to August, 2020.