Coronavirus: How dentists, at high risk of exposure, operate in UAE

Dubai: As precautionary measures are adapted across different professions in the wake of the COVID-19 outbreak, dentists, who are attending only to emergency cases, are being extra cautious to protect themselves and their patients given the nature of their work.

Dentists are said to be among the top list of people at high risk of exposure to coronavirus in cities, along with doctors, nurses, paramedics, clinical care workers, food delivery boys, janitors, pilots, flight attendants, barbers and maids.

According to medical research reports, dentists are eight times more at risk of contracting COVID-19 infections. The American Dental Association has cautioned all dentists of their risk of exposure as they deal with the oral cavity, which is one of the easiest routes to infection due to the presence of saliva and other secretions.

Recognising the high risk, UAE health care authorities have cancelled all elective surgeries, including cosmetic dentistry.

In the current climate, dentists are hardly seeing any patients, with some of them reporting a 90 per cent drop in patient visits in recent days.

Biggest threat

The biggest threat of infection at a dental clinic is airbone because of the use of aerosol sprays.

Dr Manejah Majid, Medical Director and dentist with the Jumeirah Prime Clinic, told Gulf News: “Dentists work with high pressured compressed air. Even to dry out the cavity in an infected tooth we use air spray. The aerosol effect of this can cause virus particles to fly out in the room and keep suspended for a longer time, unlike in other situations where virus falls to the ground or any other surface which can then be sanitised.”

Because of this reason, patients are being discouraged from coming in unless it’s an emergency. “We now work four hours a day and are on rotation duty. Earlier if one appointment lasted 30 minutes, now we give a gap of one hour to provide ample time to sanitise and clean the place after a patient leaves.”

Emergency interventions

Dr Marwan Al Obeidi, clinical head and general dentist at Dr Michael’s Dental Clinic, Dubai, said: “We have asked a majority of our staff to take leave and be quarantined at home for the next two weeks, as we do not want them to be exposed to any infection. Right now, the only cases we are attending to are those that deal with swelling, infection, pain or bleeding. Patient with these complaints are treated as dental emergencies and if required, we do root canals or surgeries to relieve them from infection and swelling. We have stopped all kinds of dental implants, braces, etc but have an emergency orthodontist on stand-by just in case a client has trouble with braces or a wire is biting into his cheek.”

Dr Majid said in case of patients requiring emergency intervention, they are first given palliative care during an emergency consultation with antibiotics and pain killers being prescribed. “In some cases, we are using our telehealth facilities to consult as well avoid any kind of hazardous exposure to patients. Next, even I have to do a root canal, I try and space out the visits. Right now, I space it out to 10 days, putting medicines in the cavity, treating the troubled spot and prescribing pain killers and antibiotics.”

Dr Sanoop George, head of the dental department at RAK Hospital and an endodontist said: “Earlier, if I was seeing about 15 patients a day, I see only four now. We do consultations with patients to advise them on their problems and opt out of any kind of procedure unless absolutely unavoidable.”

High level sanitisation

According to the dentists, maintaining hygiene is critical.

Dr Al Obeidi said : “Even on a normal day, we follow very strict rules for infection control in our patient consultation rooms. Now we are also sanitising the community areas of the clinic , providing 70 per cent alcohol sanitsers and masks for our clients and making sure every area is safe. All dentists use Personal Protection Equipment including eye glasses, N95 masks, gloves and disposable aprons.”

Dr George explained how all doctors, including dentists, change their casual clothes and get into surgical scrubs once they enter the hospital. These are sanitised top and trouser sets that we use for surgery. We also wear an apron and surgical mask and eye wear for regular consultation. When a patient comes in, he or she is asked to fill out a questionnaire to ascertain any travel history and chances of exposure to COVID-19. If at all I have to do a procedure, then I wear double protection. This includes a disposable garment over the scrubs and hospital apron. On the face, I wear a surgical mask and an N-95 mask with eye wear and a special shield. Hands of course are in gloves.”

He said, “It is extremely challenging to work like this, but we take no chances at all. Once the procedure is completed, the whole consultation room is sanistised by the central sterilising unit at the hospital. We discard all the PPE in the hazardous waste bin.”

Dr Majed added: “As dentists, we are taking the extreme precaution to protect ourselves and our patients from any kind of exposure.”