Covid 19 Pandemic and Oral Health care Providers

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On March 11, 2020 World Health Organization declared Covid 19 (a respiratory virus) as a Pandemic that means whole world has been affected by it. In one’s life time rarely people encounter with such Pandemic. This is the most challenging aspect of the pandemics as no expert in the world would be ready to predict about its actual course and outcome until it infects significant amount of population. No text books and Journals would have any page written about it until is shows the clinical impact. No students would have been taught about it nowhere in the world however advanced the teaching learning methodology might be.

As a respiratory virus the mode of entry of the Covid 19 to the human body is via the oral cavity, nasal cavity and secretions from the eye. Oral health care workers are one of the most vulnerable professionals to be infected with Covid 19. Thanks to the tremendous research and dissemination of information, safety measures and working guidelines have significantly decreased the risk to the oral health care Professionals but the risk always remains till the Pandemic persists.

The HIV/AIDS pandemic in the 1980s caused great anxiety among Oral health care Providers, fear of the spread of infectious disease in dental offices accelerated the adoption of universal precaution that focus on sterilization, hand hygiene and use of personal protective equipment (PPE) during the provision of dental care .Basic PPE that includes facemasks, gloves, isolation gowns or coats, and eye protection goggles has been widely adopted in dental offices and contributed to a much safer environment for Oral health care providers.

World Health Organization says only the essential and Emergency dental procedures be performed during the Pandemics, it has discouraged the Aerosols generating procedures in the oral cavity and advice that routine dental check up and procedures be differed. Nepal Medical Council with the help of Nepal Dental Association and Ministry Of Health, Oral division published the guidelines for Dental treatment and management of Oral health conditions. In the guidelines it clearly states how the dental surgeons and Oral health professionals should handle the patients and how specific conditions be managed, it has outlined the Emergency Dental Procedures that requires immediate intervention.

Though Personal Protective Equipments (PPE) are supposed to protect the Dentist during the work there has been heightened anxiety among the Oral health care workers regarding the effectiveness of the PPE. Recent studies have concluded that risk of COVID-19 transmission in dental office is very low based on available evidence on effectiveness of PPE and prevalence of asymptomatic patients. Face shields and pre-procedure oral rinses may further reduce the risks.

Though Pandemic exists and the Intensive care unit beds for Covid symptomatic patients are still hard to find, daily life seems to be going in normal direction in Nepal. The way marriage celebrations are being celebrated and people moving for Vacation Covid hazardous impact seems to be less cared by the general public, which has cause fear among the epidemiologists and health care providers.

An article in the New York Times graphically illustrated the risk levels of different occupational group and Oral Health care providers top the list. Dentists have provided around 19million fewer treatments in England since March this year compared to the same period last year, an article in BBC reads. British Dental Association (BDA) warns hundreds of practices could be forced to close within the next year without extra financial support.

Dental Health Practitioners in Nepal are also in dire need of support from the government. New corona virus regulations mean dentists have had to significantly reduce the numbers they treat – in order to minimize the risk of transmitting the virus.

Dental Health care Providers have been economically hit harsh by this pandemic, the jobs have been cut, fewer patients are turning up in the clinics and many Dental colleges citing the Pandemic have failed to give the Dental Specialists and staff the salary in time and even if they are paying they are cutting the amount citing the lock down and less number of Patients. Nepal Dental Association which is supposed to bring this issue to concerned stake holders and policy makers is clue less about how and where to start up with. The government of Nepal and Ministry of Health should come forward for the upliftment and support of Oral Health care providers, the sooner the Better.

Associate Professor – Department of OMFS
Treasurer , National Doctors Association Nepal (NDAN)

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