There is a concern among all health care providers, including dentists, in managing patients who are suspected of being infected with the coronavirus. However, dentists have been managing these concerns for a myriad of highly infectious diseases for decades, and are well poised to maintain safe clinical environments for both their patients and the dental team.
I attended dental school in a section of Manhattan back in the early 1990s during the height of the HIV epidemic. The area was particularly hard hit by the disease, well before antiretrovirals were available to manage infection. Tuberculosis and hepatitis were all equally in the front of our minds as very young practitioners.
For the next 30 years, risk of infectious disease, and management of that risk has always been one of the most critical parts of my daily life and practice as a dentist. As is ensuring the safety and well being of my dental team and the patients who entrust their care to us. As a profession, we have always confronted the new realities of infectious diseases head on, and developed guidelines that have made the public and profession safe.
Since the mid-1980s, dental health care workers have had guidelines from the U.S. Centers for Disease Control and Prevention and have been updated regularly as new scientific information has become available about the many pathogens in our daily tasks that held a risk of disease transmission. All of our patients are treated with “standard precautions,” the assumption that everyone is infected with one of the many possible infectious diseases we fear contracting or spreading. These guidelines were developed by the CDC, and subsequently adopted by both the American Dental Association, as well as state licensing boards for dentists in the United States.
The practice of standard precautions has become a reflex to us all, and the idea of treating patients without gloves or masks as was done prior to standard precautions is unimaginable to every dentist today. Aside from wearing single-use gloves and masks while treating patients, we must wear shirts that have full length sleeves and must launder those clothes on site. We must place instruments after each use into an autoclave, which is a high-pressure steam oven, to ensure every known infectious organism, including coronavirus are killed on our instruments. Each dental operatory is wiped down after each patient visit with a surface disinfectant that kills all known infectious diseases, including coronavirus.
We must either wash our hands or apply an alcohol-based compound between each patient. We have worked daily for decades to protect our patients and our staff from potential harm.
We ask that if you have symptoms of influenza, you stay home, to protect our staff and other patients.
The good news is nothing has to change for us to ensure the public’s safety from being contaminated with coronavirus in a dental setting. The same protocols that protect you from contracting HIV, hepatitis, herpes, tuberculosis and a slew of other infectious diseases at a dental office, will also protect you from contracting coronavirus at a dental office.
Dentistry is well poised to manage new infectious diseases and protecting everyone in a dental setting. We have quickly adapted to new and emerging diseases, and will do so again with coronavirus. There may be changes to our protocols in the coming months if there is science to support it, and rest assured, we will do what’s in the best interest of the public and the profession.
Dentists and the dental team will do our part to protect the public, we just ask that you wash your hands for 20 seconds, stop buying masks, cough and sneeze into your arm or into a tissue, and stay home if you have upper respiratory symptoms.
Jonathan Shenkin is a pediatric dentist in Augusta and a faculty member in health policy, health services research and pediatric dentistry at Boston University School of Dental Medicine.