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'We risk spreading the virus': Dentists call for cancellation of routine procedures and establishment of emergency dental hubs

Dentists are concerned that procedures which generate aerosol spray could be a risk.
Mar 25th 2020, 6:36 PM 29,629 34

IRISH DENTISTS HAVE called for health officials to order the cancellation of all routine procedures as they fear the coronavirus could be further spread in the community if they continue as normal.

An open letter signed by 500 dentists, refers to correspondence from Chief Dental Officer Dr Dympna Kavanagh on 18 March telling dentist there was no scientific evidence to justify denial of dental care to patients who do not have symptoms of the virus.

“The procedures that would particularly concern us are those that generate aerosol spray, which effectively include most procedures carried out in dentistry,” the open letter states. 

“These have the potential to expose all patients and dental workers to significant risk of contracting Covid-19. Aerosol generating procedures are accepted as being the highest risk procedure to carry out in a patient affected by Covid-19, and the personal protection equipment (PPE) requirements are far in excess of those available in the typical dental setting.

Nevertheless the Chief Dental Officer advises us that “If a patient is asymptomatic the evidence is that aerosol equipment can be safely used in dental practice, as long as they are adhering to the Dental Council codes of practice.” There is in fact no such evidence whatsoever, as this is a novel virus. The very mechanism of transmission is still being debated.

In her correspondence to dentists, Dr Dympna Kavanagh advised that the National Public Health Emergency Team (NPHET) had assessed the particular risks for the dental profession and their patients.

“Their advice is that there is no current scientific evidence to justify denial of dental care to members of the public who have neither fever nor respiratory symptoms. Neither is there scientific evidence to support the use of respirator masks for routine dental practice,” she wrote.

She added:

“To be clear, at this time, the advice is that dental practices can remain open and that there is currently no need for a change in dental interventions.”

Speaking to RTÉ’s Drivetime this evening, Cork dentist John Seaward said dentists “risk spreading the virus through the community by carrying on as normal”. 

His practice has been closed since 16 March. 

Although he said he and colleagues want to see routine procedures stopped across the country, they recognise the need for emergency interventions. 

“We don’t want to take up frontline staff time in Accident and Emergencies,” he said.

Seaward said they are proposing 20 hubs across the country to provide emergency dental procedures. 

However he said staff at those hubs would need personal protection equipment made available to them. He said the equipment would only be used for “dire emergencies” as he recognised frontline healthcare workers need it most. 

“We can’t tell whether someone has the virus so we have to treat everybody as if they have the virus,” he said.

In their open letter, dentists said most practices had already voluntarily suspended all elective procedures and were “scrambling” to upgrade their protective equipment to allow basic emergency services to operate. 

“Many of us will endeavour to try and treat urgent emergencies such as swelling and bleeding to keep those patients out of our hospitals for as long as we can, even if by doing so we place ourselves in harm’s way. ”

They called on the Chief Dental Officer to act decisively and advise a halt to all elective dental procedures. 

“Otherwise even more lives in our vulnerable and elderly populations in particular will be lost.”

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Michelle Hennessy

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