Abstract
The practice of dentistry has been dramatically altered by the coronavirus disease 2019 (COVID-19) pandemic. Given the close person-to-person contact involved in delivering dental care and treatment procedures that produce aerosols, dental healthcare professionals including dentists, dental assistants and dental hygienists are at high risk of exposure. As a dental clinic in a comprehensive cancer center, we have continued to safely provide medically necessary and urgent/emergent dental care to ensure that patients can adhere to their planned cancer treatment. This was accomplished through timely adaptation of clinical workflows and implementation of practice modification measures in compliance with state, national and federal guidelines to ensure that risk of transmission remained low and the health of both immunocompromised cancer patients and clinical staff remained protected. In this narrative review, we share our experience and measures that were implemented in our clinic to ensure that the oral health needs of cancer patients were met in a timely manner and in a safe environment. Given that the pandemic is still on-going, the impact of our modified oral healthcare delivery model in cancer patients warrants continued monitoring and assessment.
Highlights
The outbreak of coronavirus disease 2019 (COVID-19) [1] has dramatically changed the practice of dentistry worldwide, given the close “person-to-person” contact involved in delivering dental care and treatment procedures that produce aerosols, often resulting in dental providers being exposed to blood, saliva and respiratory droplets [2,3]
The division of Dentistry and Maxillofacial Prosthetics (DMFP) is a clinical service within the Department of Oral Oncology at Roswell Park, a National Cancer Institute (NCI)-designated Comprehensive Cancer Center located in Buffalo, New York
In response to the pandemic, a DMFP clinic task force was created in early March 2020 to implement clinic-centric measures that were in compliance with Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), New York State (NYS) and institutional guidelines and develop protocols for safely providing dental care for cancer patients
Summary
The outbreak of coronavirus disease 2019 (COVID-19) [1] has dramatically changed the practice of dentistry worldwide, given the close “person-to-person” contact involved in delivering dental care and treatment procedures that produce aerosols, often resulting in dental providers being exposed to blood, saliva and respiratory droplets [2,3]. Given the mode of transmission of COVID-19, dental healthcare professionals including dentists, dental assistants and dental hygienists are at high risk of exposure among all healthcare personnel [4,5] In this regard, studies from multiple groups around the globe have reported on critical infection control measures [5,6,7] and guidelines for modifications to dental clinic workflows that were implemented during the pandemic [8,9]. Cancer patients are immunocompromised and, as a result, susceptible to oral and respiratory infections, including COVID-19 [21] Given this “double whammy” (increased risk for cancer patients and dental providers), the pandemic has necessitated rapid implementation of changes to our oral healthcare delivery model, including adaptation of clinical workflows and diagnostic and treatment paradigms. Implementation of practice modification measures was critical to ensure that patients and dental clinic staff remained protected and the risk of transmission remained minimal
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