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SHORT COMMUNICATION
Year : 2022  |  Volume : 13  |  Issue : 1  |  Page : 38-40

The changing perception of pediatric dental practice post-COVID: The new normal


Department of Pediatric and Preventive Dentistry, I.T.S Dental College, Ghaziabad, Uttar Pradesh, India

Date of Submission02-Feb-2022
Date of Decision17-Feb-2022
Date of Acceptance18-Feb-2022
Date of Web Publication14-Mar-2022

Correspondence Address:
Dr. Shraddha Saikia
Department of Pediatric and Preventive Dentistry, I.T.S Dental College, Muradnagar, Ghaziabad - 201 206, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/srmjrds.srmjrds_15_22

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  Abstract 


The outbreak of coronavirus has wreaked havoc as it has become a global emergency. It has affected the entire world population as well as the economy due to its uncontrolled spread. Amidst all sectors which are heavily affected, the health-care unit is exposed to the highest risk as they are on the frontline of combating the novel virus. This risk is far more elevated for dentists due to their work being confined to the oral cavity through which maximum transmission has occurred. Pediatric dentists faced a formidable challenge as the children are mostly asymptomatic carriers of the novel virus. Recently, various protective guidelines have been recommended by various health-care associations such as World Health Organization, American Dental Association, and Center for Disease Control and Prevention around the globe. However, due to the boisterous expansion of this virus, the various spheres such as markets, government and private offices, transport, and dental practice have now started to function with proper guidelines and safety measures. Thus, the most afflicted dental practice is also back to serve the masses for comprehensive oral health care. Along with emergency procedures undertaken ensuring strict regulations of protection, dentistry is now emerging to service with the new normal post-COVID era to take up all essential procedures. Thereupon, this article will shed some light on the post-COVID new normal era of pediatric dentistry.

Keywords: Changing perception, COVID-19, pediatric patients


How to cite this article:
Saikia S, Mathur S. The changing perception of pediatric dental practice post-COVID: The new normal. SRM J Res Dent Sci 2022;13:38-40

How to cite this URL:
Saikia S, Mathur S. The changing perception of pediatric dental practice post-COVID: The new normal. SRM J Res Dent Sci [serial online] 2022 [cited 2022 May 16];13:38-40. Available from: https://www.srmjrds.in/text.asp?2022/13/1/38/339634




  Introduction Top


Dentistry suffered a major setback during this period of the COVID pandemic as it mainly dealt with the initiation of aerosol-generating procedures, which is the prime source of cross infection. Hence, during this period, the entire dental fraternity shifted to telephonic dentistry or teledentistry and emergency procedures only. Pediatric dentistry which has always been more concentrated toward preventive procedures, now all the more came to a standstill with children reported to be asymptomatic carriers of the deadly virus. Although children showed milder symptoms as compared to adults, it, however, led to higher and increased risk of unknown exposure. Now, at this stage of the pandemic, it has to be assumed that all children and their parents/caregivers are probable carriers with the potential of disease transmission to the health-care workers and public.[1] This leaves an impact on medical and dental procedures that are aerosol-generating ones necessitating health-care workers in all disciplines to wear fully enhanced personal protective equipment during treatment.[2] Therefore, during the onset of the pandemic, health authorities around the globe recommended suspension of dental procedures as most of them were elective in nature. However, currently, accepting the new normal post-COVID era, the American Academy of Pediatric Dentistry (AAPD) issued re-emergence practice checklist to help prepare pediatric dental practices to start rendering their services to the patients.[3]

Pediatric dentists especially have always faced a lot of hurdles while trying to explain the importance of dental treatment to the parents of young children. Most people have the view that the milk teeth need not be preserved as they are temporary in the oral cavity and therefore often neglected its treatment. Many others have the opinion that any treatment within the oral cavity will have detrimental effects on the child and their psychology. Thus, it was extremely difficult for dentists to explain oral hygiene care to the parents of these children. With the advent of the new post-COVID era, these health-care workers will have to go an extra mile to be able to convince parents about the need of treatment for their children. The current article will shed some light on the post-COVID new normal era of pediatric dentistry.


  Post-COVID-19 New Normal Strategies to be Incorporated into Pediatric Dentistry Top


Triaging dental patients with COVID-19 by telehealth conferences is suggested to be implemented to reduce undue exposure risk for the patient and the clinician. The online medium can be used for consultation. Here, all relevant questionnaire formality can be completed and depending upon the nature of treatment decided the appointment can be fixed.[4]

Like the above recommendations, every country has their health association that has suggested different preventive protocols and treatment can be safely carried out abiding by the same. The following principles can be implemented by the pediatric dentists in clinical practice with determination for the welfare of the patients as a whole.

  1. The pediatric dental clinic should firstly be well ventilated and strictly sanitized before and after treatment of every patient. The play area should be modified and must be provided with toys and games that can be sanitized or sterilized and also appointments should be scheduled with gaps with one patient at a time so that the waiting area is not crowded unnecessarily. As soon as the patient and their guardian arrive, the temperature scanning is to be carried out. The staff should be well protected before meeting the patient. The doors should be installed with sensors so that touching it can be avoided. The patient and the attendant should then asked to put on shoe covers, head caps, face shields, etc. They are then directed to wash their hands with soap and water. The patient is given a peroxide mouth rinse and is directed to the treatment room. Contact should be kept as less as possible. An isolated room has to be dedicated to carry out aerosol procedures, and it should be completed within 15–20 min. The operatory is disinfected before and after the procedure. Between every patient, at least a half hour time interval should be kept. After the exit of the patient, all necessary cleanup is to be done[5]
  2. Children with special health care needs can be treated as well. A mandatory consultation with the child's physician has to be undertaken before the treatment for the child's safety. Special considerations should be given regarding the timing of the appointment (first appointment and early appointments should be given to them) and if possible consider building a room that meets the hospital standards for infection control and air turnover[6]
  3. Access to general anesthesia (GA) procedures – AAPD has encouraged to develop a risk-based scale for scheduling patients under GA. The following children may be considered under GA.[1]


    • Trauma to teeth that cannot be controlled by pharmaceuticals and treatment is so extensive that it cannot be carried out under local anesthesia
    • Trauma to permanent teeth that needs to be treated under GA
    • Acute dental infection that does not respond to antibiotics
    • Poor dental health that is compromising the medical health status as well
    • Learning disabilities such as autistic patients, where dental pain can lead to self-harm and other disruptive behaviors.


  4. Pediatric patients can pose a high risk to clinicians due to being asymptomatic carriers of the virus thus it has been suggested that a wide range of preventive treatments can be carried out with proper protection. Some of the procedures that can be undertaken with special care are listed in [Table 1].
Table 1: Special measures undertaken while treating pediatric patients

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Hence, the stated measures taken up effectively can help us overcome our fears as, COVID-19 is a pandemic that does not seem to want to leave anytime soon. We, as pediatric dentists thus, have to take extra measures to instill confidence in our patients and their caregivers since the future of our next generation lies in our hands. It will set a precedent in their impressionable young minds about the value of good health. A healthy individual will have a healthy mind filled with new and more innovative ideas, and this health is not just physical, mental, or spiritual health but most importantly one's oral health. Therefore, every individual has to come forward to take up their responsibilities for the welfare of the nation and its citizens to make this world a better one to live in the post-COVID era [16].

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Royal College of Surgeons England 2020. Recommendations for Paediatric Dentistry during COVID-19 Pandemic. Weblink: https://www.rcseng.ac.uk/-/media/files/rcs/fds/guidelines/paediatric-dentistry-covid19.pdf . [Last accessed on 2022 Jan 20].  Back to cited text no. 1
    
2.
Heij R, Steel AG, Young PJ. Testing for coverage from personal protective equipment. Anaesthesia 2020;75:966-7.  Back to cited text no. 2
    
3.
American academy of Pediatric Dentistry 2020. A Guide for re-Entry Into Practice for Pediatric Dentists during the COVID-19 Pandemic. Weblink: https://www.aapd.org/globalassets/media/covid-19/re-entry-2020.new.pdf [Last accessed on 2022 Jan 20].  Back to cited text no. 3
    
4.
Al Halabi M, Salami A, Alnuaimi E, Kowash M, Hussein I. Assessment of paediatric dental guidelines and caries management alternatives in thepostCOVID-19 period. A critical review and clinical recommendations. Eur Arch Paediatr Dent 2020;21:543-56.  Back to cited text no. 4
    
5.
American Dental Association 2020. ADA Interim Guidance for Minimizing Risk of COVID-19 Transmission. [Last accessed on 2022 Jan 22].  Back to cited text no. 5
    
6.
RCSENG. Number of Children Aged 5 to 9 Admitted to Hospital due to Tooth Decay Rises Again. The Royal College of Surgeons of England; 2018. [Last accessed on 2022 Jan 22].  Back to cited text no. 6
    
7.
American Academy of Pediatric Dentistry. Use of vital pulp therapies in primary teeth with deep caries lesions. Pediatr Dent 2017;2017:146-59.  Back to cited text no. 7
    
8.
BaniHani A, Duggal M, Toumba J, Deery C. Outcomes of the conventional and biological treatment approaches for the management of caries in the primary dentition. Int J Paediatr Dent 2018;28:12-22.  Back to cited text no. 8
    
9.
Kühnisch J, Ekstrand KR, Pretty I, Twetman S, van Loveren C, Gizani S, et al. Best clinical practice guidance for management of early caries lesions in children and young adults: An EAPD policy document. Eur Arch Paediatr Dent 2016;17:3-12.  Back to cited text no. 9
    
10.
Slayton R, Urquhart O, Araujo M, Fontana M, Guzmán-Armstrong S, Nascimento MM, et al. Evidence based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American dental association. J Am Dent Assoc 2018;149:837-49.e19.  Back to cited text no. 10
    
11.
Urquhart O, Mp T, Pilcher L, Slayton RL, Araujo MWB, Fontana M, et al. Nonrestorative treatments for caries: Systematic review and network meta-analysis. J Dent Res 2019;98:14-26.  Back to cited text no. 11
    
12.
De Amorim RG, Frencken JE, Raggio DP, Chen X, Hu X, Leal SC. Survival percentages of atraumatic restorative treatment (ART) restorations and sealants in posterior teeth: An updated systematic review and meta-analysis. Clin Oral Investig 2018;22:2703-25.  Back to cited text no. 12
    
13.
Berg JH. Glass ionomer cements. Pediatr Dent 2002;24:430-8.  Back to cited text no. 13
    
14.
Welbury RR. The hall technique 10 years on: Its effect and influence. Br Dent J 2017;222:421-2.  Back to cited text no. 14
    
15.
Seifo N, Robertson M, Maclean J, Blain K, Grosse S, Milne R, et al. The use of silver diamine fluoride (SDF) in dental practice. Br Dent J 2020;228:75-81.  Back to cited text no. 15
    
16.
Kidd E. Should deciduous teeth be restored? Reflections of a cariologist. Dent Update 2012;39:159-62,165-6.  Back to cited text no. 16
    



 
 
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