With strict guidelines being passed around the world by Dental councils that all dentist and dental clinics and hospitals avoid Non-Essential Dental procedures and only perform Essential Dental Procedures, it is important for everyone to know what are the Essential and Non-Essential procedures. This helps in preventing Dentists and Dental Staff from being endangered as we are exposed to contaminants directly. There was a recent article published in nytimes.com stating that Dentists are the most exposed profession in the world.

It is important to postpone Elective or Non-Essential Dental procedures in your practice and only attend to Essential procedures to protect yourself and your staff from any local contamination or spread of the disease due to aerosols. Let us look at the List of Elective or Non-Essential and Essential Dental Procedures from each branch of Dentistry.

Can Dentists Work during Covid 19 or Coronavirus Outbreak:

I would say, it is better that Dentists do not work during this pandemic. With the symptoms of Coronavirus not appearing the infected patient for up to 14 days, it makes them a carrier, without showing any symptoms. It becomes very difficult for the Aerosols to be controlled and as we dentists cannot follow the full protocol by wearing a full PPE kit for each and every case. Dental clinics can turn into a breeding ground for the Virus and aid in the spread of this pandemic by human to human transmission. So it is suggested that only Emergency cases should be performed by following strict protocols.

How is coronavirus spread

Image credit: Centers for Disease Control and Prevention (CDC) Alissa Eckert, MS, and Dan Higgins, MAM.

Essential or Emergency Dental Procedures: Which can be performed during Coronavirus outbreak

Restorative procedures:

Fillings and Restorations of Moderate to Severe Decay should be attended to by Interim restoration techniques

Fracture of Tooth:

Only if there is pain, if there is no pain postpone the appointment

Crowns:

  • RCT treated tooth which is brittle with severe decay should be given a crown
  • Replacement of Crowns for decayed tooth or missing teeth should be postponed

Laminates and Veneers:

Postponed

Cosmetic Procedures: Bleaching, etc

Should be postponed

Endodontics:

  • Active infection with Pus and swelling associated with pain
  • Swelling or cellulitis – Only access opening and medication has to be administered and appointment needs to be scheduled for a later date
  • Change of Interim restoration in case of sever pain in pts with Access opening

Oral Surgery:

  • Extractions or Pus drainage should only be performed in patients with Active infection associated with pain and Swelling or Cellulitis.
  • Suture Removals can be done
  • Pericoronitis or Third molar pain
  • Post operative Osteitis or Dry Socket treatment
  • Tooth Avulsion or Luxation
  • Asymptomatic Third molar surgeries should be avoided and postponed

Orthodontics:

  • Bracket or Wire fracture or loosening should be addressed only
  • New patients for bondings, recall, consultations need to be postponed

Periodontics:

Scaling and Root Planning should only be done in patients with risk factors such as Diabetes and Cardiac Disease, appointments for all other patients need to be postponed

Prosthodontics:

  • Patients who need Crowns and Bridges should be postponed
  • Geriatric patients requiring Complete Dentures or Removable dentures need to be attended on a need basis
  • Denture adjustments for oncology or radiation patients

Any Dental procedure or just Outpatient or Consultations need to be done following strict protocols. Every patient coming into the clinic needs to be seen as a potential contaminant and cleaning and sterilization protocols need to be followed strictly. Emergency vs Non-Emergency Dental Procedures must be properly categorized and sorted out to make sure that unnecessary exposure to infected patients is not done.