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A patient undergoes a dental check-up in Ras Al Khaimah Image Credit: Atiq ur Rehman, Gulf News

Abu Dhabi: With an easing of restrictions, dental care is now available to patients in the UAE. For many putting off treatment since the start of the coronavirus outbreak, this is welcome news.

To reassure patients and keep them safe, dental clinics are adopting a series of recommended guidelines, including sanitation measures, limits on waiting time and crowds, and screenings for both patients and staff.

Dr Shrey Pandya

“All kinds of major dental treatments could be administered effectively, as long as certain guidelines are followed. Most clinics have laid them down, including calling all patients on the day of the appointment and checking if they are suffering from any symptoms,” said Dr Shrey Pandya, clinical director and specialist oral and maxillofacial surgeon at VPS Tajmeel Dental Centre in Karama, Abu Dhabi.

Theorised risks of dentistry

The UAE temporarily suspended dental services in March as a means to limit the COVID-19 outbreak. Experts had theorised that the coronavirus, which resides in the saliva, throat and nasal passages of infected patients can be propelled into the air if the patient coughs or gags, thus posing a threat to medical personnel and patients.

In addition, the US Centres for Disease Control had said that the use of rotary dental and surgical instruments in dentistry, such as handpieces, ultrasonic scalers and air-water syringes, create a visible spray that can contain particle droplets of water, saliva and microorganisms. While surgical masks protect mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne and aerosolised infectious agents.

However, as restrictions have eased, a number of dental services have begun to be offered across the UAE.

Dr Marija Pavlovic

“The range of treatments may be limited, however, to dental extractions only rather than fillings or other restorative care. [So as a first step], most people with dental problems are being offered video or phone consultations, which allow dentists to safely triage problems and offer interim advice of self-management of dental pain and infection,” said Dr Marija Pavlovic, periodontist and oral implantologist at Medcare Hospital, Al Safa.

Steps taken by clinics

Clinics and hospitals have also followed suit, putting in place precautionary measures to limit coronavirus transmission during treatment.

“In our opinion, it is safe for the patients to visit such facilities for their dental treatments as required. They should also follow guidelines laid down by the government, such as wearing a face mask and pair of gloves at all times while also maintaining social distancing,” Dr Pandya advised.

Dr Pavlovic said medical staff wear surgical masks, eye protection like goggles or eyewear with full-face shields, and a gown during procedures likely to generate slashing or splattering of bodily fluids.

Equipment is also thoroughly sterilised before and after treatments, and all medical staff and patients are screened to ensure they are not infected.

Dr Pavlovic said patients are also advised to rinse their mouth with chlorohexidine – a disinfectant – a few times before treatment procedures are begun.

In addition, patients are also encouraged to visit the hospital or clinic alone whenever possible to reduce crowding.

Should you delay treatment?

Given the risk of coronavirus, some kinds of treatment, as well as some groups of people, should still put off seeking dental care.

Quite obviously, patients who test positive for COVID-19 must delay dental treatment.

“[This applies ] unless they have emergency concerns like dental trauma, prolonged or severe bleeding, severe swelling, or pain that is not relieved by maximum strength analgesia, said Dr Marija Pavlovic,

In addition, residents aged 60 years or older, and children 12 years and younger, should avoid dental care at the moment if possible.

“COVID-19 has often been fatal among those who are older than 60 years, and particularly among those with underlying diseases,” Dr Pandya explained.

“And whenever a patient [in these age groups is] treated, [we make] sure that there is zero wait time and that the clinic is sterilised more effectively just prior to the patient’s arrival. [We also ensure that] he or she doesn’t interact much with any staff, except the doctor and the nurse,” he added.

According to Dr Pavlovic, telemedicine consultations can also help these patients explore avenues for the self-management of dental concerns.

“For instance, if you have a broken filling or tooth that is causing sensitivity or problems eating, the dentist may ask you to visit a local pharmacy and buy an off-the-shelf temporary filling kit for ‘self-dentistry.’ This is usually in the form of a soft, sticky paste, which you can press into the cavity or hole with a clean finger and let it set hard after a few minutes with instructions not to eat or drink for a couple of hours. This is an effective self-management strategy and temporary fillings such as these will usually will stay in place for a few weeks,” she said.

Finally, residents can continue to put off appointments for simple teeth cleaning or restorative care like fillings.

When visiting the dentist

  • Delay seeking dental care if you have the coronavirus.
  • For patients aged 60 years or older, and less than 12 years, put off dental treatment if possible.
  • Opt for a telemedicine consult with your dentist to first explore avenues for self-management. For instance, self-dentistry kits can allow patients to apply temporary fillings.
  • Wear a mask and glove when visiting the clinic, and only remove the mask during the procedure.
  • Try to visit the clinic alone to avoid crowding, and maintain social distancing.
  • Do not venture into public places without absolute necessity around the time of needing a dental procedure.