A five‐step risk management process for geriatric dental practice during SARS‐CoV‐2 pandemic

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is an RNA virus that causes coronavirus infection (COVID‐19). COVID‐19 is a highly contagious disease transmitted through respiratory droplets, saliva and other contact routes. Within 10 months of its outbreak, SARS‐CoV‐2 has infected more than 23 million people around the world. Evidence suggests that older adults are the most vulnerable to infection and have an increased risk of mortality. Reduced immunity and underlying medical conditions make them risk‐prone and vulnerable to critical care. Older adults affected with the SARS‐CoV‐2 virus present with distinct clinical manifestations necessitating specific treatment needs and management protocols. While it is crucial to prevent the spread of novel coronavirus (2019‐nCoV), the role of oral healthcare workers in addressing the specific needs of ageing adult patients by adopting specific guidelines and appropriate infection control protocols is timely. This paper aims to develop specific guidelines and protocols for the dental management of geriatric patients during the COVID‐19 pandemic.

How Dentists Face the COVID-19 in Mexico: A Nationwide Cross-Sectional Study

“…The oral conditions that have been reported as rare and that have occurred in confirmed COVID-19 patients, are enlarged lymph nodes in the submandibular region, inflammation in the mouth, dry mouth, ageusia, herpetic lesions, desquamative gingivitis, tongue pain and blisters on the lip mucosa [ 8 ]. The prevention measures recommended for dental emergency care in Mexico are the following: give the patient pre-operative antimicrobial mouth-rinse (0.2% povidone iodine and 1% hydrogen peroxide) [ 9 , 10 ], avoid as possible the use of rotary equipment and triple syringe, use of rubber dam, disposable shoe covers, use of disposable gown, surgical goggles or face shield, use of N95 surgical mask and frequently cleaning and disinfecting public contact areas including door handles, chairs and washrooms [ 4 , 11 ]. Additionally, the American Dental Association (ADA) has published recommended preventive measures for dental care; however, dentists may not be aware of recent recommendations [ 12 ].…”

Dental Health Service During Pandemic Covid-19 : A Literature Review

“…Penggunaan instrument yang menghasilkan aerosol sebaiknya dihindari digantikan dengan instrument tangan seperti alat scaling manual atau ekskavator yang dikombinasikan dengan bahan penghilang karies chemomechanical seperti natrium hypoklorit (NaOCl) 8,14,19 . Posisi operator saat tindakan sebaiknya dilakukan dalam posisi jam 10 atau 11, posisi jam 8 harus dihindari, untuk menghindari percikan yang terjadi saat prosedur perawtan gigi dan bekerja dengan teknik four handed 21,27,30,31 . Penggunaan handpiece tanpa fungsi anti-retraksi harus di hindari 20,23,24 .…”

Remote Management of Prosthodontic Emergencies in the Geriatric Population During the Pandemic Outbreak of COVID-19

“…Healthcare providers are at a higher risk of transmission susceptibility of COVID-19 ( 2 , 3 ); among them, oral healthcare professionals are at the front line. Oral health problems are more likely to be seen in the geriatric age groups than in the other age groups ( 4 , 5 ). The geriatric population is prone to increased risk from COVID-19 because of psychological and pathological changes, decreased immune function, and existing comorbidity making them more susceptible to COVID-19 ( 6 , 7 ).…”

“…According to the Malaysian national oral health survey of adults, it has been reported that 50.8% of the elderly aged 60 years and older geriatric patients had some form of oral prosthesis ( 11 ). The majority of prosthodontic procedures require direct contact with the patients and indirect contact with dental technicians and dental laboratories for the procedures which include dental casts, dental impressions, fabrication of removable prosthesis, and mock trials ( 4 , 5 ). The provision of prosthodontic care in geriatric patients could be urgent and/or emergency, depending on the procedure.…”

“…Some of the emergencies in prosthodontics include provisional restoration debonding, denture adjustments or repairs, prosthetic fractures, and screw loosening in implant prostheses (12)(13)(14). There is an impending need to formulate specific guidelines/protocols for managing the geriatric population in the backdrop of COVID-19, considering the physiological, psychological, and treatment needs of geriatric patients, which are unique (4,5). Nonetheless, the aims of this minireview were to gain an overview of prosthodontic emergencies in the geriatric population and provide recommendations for their management during this pandemic outbreak of COVID-19.…”