COVID-19 and new dental restrictions

By MiNDFOOD

COVID-19 and new dental restrictions
While dentistry is considered an essential service, new restrictions are limiting the dental work that can be done.

As transmission of COVID-19 is thought to occur mainly through respiratory droplets and through contact with contaminated surfaces, the aerosol generating procedures commonly used by dentists – such as syringes, scalers, abrasion and sandblasters – increase the risk of spread. According to the New Zealand Dental Association, evidence from experimental studies suggests that human coronaviruses is detectable in aerosols for 3 hours, can survive on inanimate objects and can remain viable for up to 2-3 days at temperatures of 21-23°C and relative humidity of 65% which is particularly relevant with aerosol generating procedures. As a result tough restrictions have been introduced as to what can and can’t be done in the dental chair.

The Australian Government has ordered that all dentists adhere to Level 3 restrictions and only treat cases that meet “emergency” criteria. Level 3 restrictions mean dentists can no longer treat patients for things like extractions of asymptomatic teeth without swelling, broken or chipped teeth, bleeding or sore gums, denture concerns, crown and bridge issues, or jaws that click and grate. It also rules out the routine scale and clean. Treatments that are allowed to continue must not generate aerosols unless for patients with acute pain, the management of significantly damaged front teeth or soft tissue pathology, for example ulcers.

New Zealand has been at COVID-19 Alert Level 4 restrictions since March 25. This means non-emergency and elective dental procedures for all patients must be postponed and only emergency care provided and special precautions apply if procedures generate an aerosol. Emergency dental care is where the patient has pain that requires operative management to control, if infection is present which is not manageable by antibiotics alone or if non-treatment will severely impact on the health of the patient. All other care is to be considered non-essential.

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