Oral and Dental Medicine Under COVID-19: International Forum
19 May 2020
Oral Health experts from across the world, including UCL Eastman Director Professor Stephen Porter and Professor Stefano Fedele, hosted a unique online forum this week that considered the implications of COVID-19 upon oral and dental medicine delivery.
Organised by the Eastman Dental Institute (Rochester, NY), speakers described their experiences to-date in China, the US, UK, Sweden and Israel. They also discussed the research that is urgently required.
The seminal meeting, the first of its kind, attracted almost 3000 registrants from all parts of the globe, including South Africa, Australia, Saudia Arabia, Brazil, Argentina Greece, Egypt and Germany - an indication of the importance of collaborative working in these exceptional times.
Professor Porter said: “The delivery of oral and dental medicine care comes with a number of notable challenges during the present COVID-19 outbreak and the expected future of - hopefully smaller - pandemic waves.
“The answers to the many present and future issues thrown up by COVID-19 are complex, potentially costly and in some instances unknown, nevertheless this forum demonstrated, very clearly, that international collaborations are possibly the only way by which solutions will be realised.”
The speakers each discussed mitigating measures to ensure the safe and effective delivery of oral and dental medicine care to populations affected by COVID-19. There was considerable discussion of the likely risk of clinic-based transmission.
Professor Fedele said: “The close proximity of oral healthcare providers to patients and in particular the upper respiratory tract presents unique challenges.
“A high prevalence of oral disease leads to a high volume and turnover of patients who cannot wear masks. This is compounded by the risk of room contamination and disease transmission via saliva and aerosol-generating procedures*.
“There is an urgent need to develop research programmes that, amongst many topics, identify ways of minimising transmission in the healthcare setting and establish non-invasive point of care testing utilising saliva.”
The forum also noted the remarkable changes that have been instigated to allow continuance of undergraduate and postgraduate education in academic and clinical Institutions.
*Why are Aerosol Generating Procedures a concern?
Aerosol generating procedures (AGPs) are defined as any medical or patient care procedure that results in the production of airborne particles (aerosols). Aerosols are produced when an air current moves across the surface of a film of liquid; the greater the force of the air the smaller the particles that are produced.
High speed drilling during dental procedures, for example, uses a water spray to keep the tooth cool and remove debris – this creates an aerosol.
Aerosols are a big problem when trying to prevent transmission of respiratory viruses like the COVID-19 virus as they greatly increase the distance the virus can spread and the time it remains infectious. As a result one of the big problems facing dentistry now is continuing to provide effective high quality care whilst avoiding or minimising the use of aerosol generating procedures