The new coronavirus 2019-nCOV and the care of dental patients

Dentists, as health personnel, have the duty to always think about the well-being of their patients, also safeguarding their own physical integrity, due to the high risk of contracting any disease when working on the oral cavity (one of the main sources of contagion of the human being).

This special work in prevention is of high importance and priority due to the pandemic situation that currently afflicts the world. The Digital Communication Group EL SUMARIO thanks its timely preparation by doctors Carlos Rauseo, María Elisa Pérez Mukel and Adriana Rodríguez, members of the team of professionals from LaplanaBologna. Here is the document they prepared:

“We have to face a situation that not only exposes our health, but also that of our environment, due to a new virus that has caused controversy after becoming a pandemia, and which started in China at the end of last year (2019).”

This virus was detected for the first time in the province of Wuham – China, generating a high impact on medical personnel and the general population, surrounded by lack of knowledge regarding its origin and treatment, and witnessing the rapidity of its spread, since it has become a pandemia in less than two months that affects a large number of countries.

It is known that the virus has mutated from an animal species to the human being, but it is still unknown which animal it comes from. In the last few weeks two 2019n-VOC strains have been identified: L (more aggressive) and S (less aggressive).

There are no bases that define the exact time that the virus can remain in the environment, but the few available studies speak of up to 6 to 8 hours, it could even remain active for several days on certain surfaces. The mortality rate generated by the virus is around 2%, this being higher or lower depending on the age and immune capacity of the patient.

It is important to know the symptoms presented by the infected patient,. The most common being: cough, fever, muscle pain, fatigue and respiratory distress. And less frequent symptoms such as: sore throat, nasal congestion, sputum production.

“As mentioned previously, we are part of the health personnel who are most exposed to contracting diseases of this type, the main route of spread being the oral cavity and any contact with other mucous surfaces (nasal and ocular). Understanding this, the dentist must implement multiple measures to promote adequate prevention and control of viral spread.“

As a recommendation, prior to the care of any patient who comes to the consultation, a specific anamnesis (set of data that is collected in the clinical history of a patient with a diagnostic objective) should be performed in relation to certain aspects associated with the virus, ruling out its probability of carrying and spreading it.

1. Do you have  fever or have you had it in the last 14 days?
2. Have you had respiratory problems, including cough, in the last 14 days?
3. Have you traveled or visited risky countries in the last 14 days?
4. Have you been in contact with anyone with symptoms or confirmation of coronavirus?

Subsequently, protection barriers and disinfection measures must be established, in addition to those that are carried out routinely, as well as the implementation of a protocol to enter the clinical area for both the patient and health personnel, which include:

a) It is important to prevent crowding of patients inside the waiting room, and to eliminate as many contact areas as possible, such as magazines and water filters. In the case of the handles, they should be disinfected after the admission of each patient.

b) Before entering the clinical room, the patient must undergo the described questionnaire and check body temperature as well as disinfect their hands. If the temperature exceeds 37.5 degrees Celsius or there is a positive response in the questionnaire, the patient should be warned of the possible contagion and the need to notify the competent authorities. Just being positive to the questionnaire, dental treatment should be postponed for a minimum of 14 days.

c) Reinforce hand washing before and after each patient with soap and water, then adding hydroalcoholic-based products with at least 60 – 70%, until it evaporates.

d) Use of all relevant protective barriers: Gloves, mouth cap, protective masks, hat and work clothes. It is important to remember that the half-life of a mask is approximately 2 hours, and it should be changed before the pre-established time if there is any risk of fluid contamination.

e) Before treatment, it is recommended that the patient rinse with a 1% solution of hydrogen peroxide. It has activity on the virus and decreases the oral viral load.

f) Avoid procedures with aerosols.

g) Once the treatment is finished, the correct cleaning and disinfection of all work surfaces must be carried out, including drawers and handles that may have been affected by the turbine spray, using products that contain alcohol (minimum 60%) or products based on Hydrogen Peroxide.

Taken and with information from El Sumario