Editorial
DENTAL MEDICINE OFFICES AFFECTED WITH CORONAVIRUS
Coming from the vast basin of South Asia, the
new Coronavirus, or COVID-19, has been rapidly
disseminated in the whole world, as a result of
its huge catching potential, of its extraordinary
pathogeneity and, not less, of the incredible
globalization level attained all over our planet,
in which human mobility is overwhelming. Since
its outburst in Wuhan - China, the viral attack
became rapidly endemic and, equally rapid,
pandemic. The entire world has been astonished
by such a rapid dissemination of this unknown
calamity of genetic nature, by the extremely
dangerous extent of human organism affection,
all these in the absence of some optimum
therapies of vaccinal immunization, etc.
Quite naturally, the pandemy induced panic
in the population, by the high ratios of deceases,
bringing about epidemiological and economic
consequences, seriously unbalancing social
life, while also modifying the individual and
collective psycho-social behaviour. Initially
completely disorganised in both polyclinics
and hospitals, the medical activity should be
entirely reseted according to the epidemiological
principles assuring individual and collective
protection, which required immense efforts for
re-establishing the health condition of the
infected ones.
Under such circumstances, the private and
public assistance provided by dental medicine
clinics has been considerably affected, if
considering the astonishment it caused and,
especially, the scarcity of available protection
means and of disinfecting biocides. Even more
seriously than the unsufficient offer of such
products on the market was – in our opinion –
the unsuitable antiepidemiological education of
the medical staff and the absence of protocols of
procedures recommended in dental medicine for
cases of epidemy.
The above-described conditions and the panic
installed in human collectivities practically
paralysed, in some countries, stomatological
medical assistance, while substantially
International Journal of Medical Dentistry
diminishing, in others, patients requirements for
treatments. The consequences of such a drastic
reduction of praxis activities had at least two
effects: one reffering to the statistical increase of
the unsolved applications, the other one bringing
about the economic decline of the dental offices,
caused by reduced or absent receipts.
For assuring the continuity of stomatological
assistance, some essential measures should be
taken, as follows:
A. The rapid training of the whole medical
staff of the dental medicine offices by intensive
theoretical and practical courses teaching the
material means and the protocol of their
utilization for disinfection of the medical spaces,
instruments sterlization, protection of the staff
with specific materials, as well as of the patients
subjected to treatments, and reorganization of
the medical circuits for both groups.
B. The recommendation that all subjects
addressing the clinic should pass a coronavirus
test, a situation in which endowment of the
medical offices with primary testing tools
becomes a must. If no test had been made, the
patient will be treated as a contaminated person.
Accordingly, from now on, the following
categories of patients should be considered:
- the contaminated ones, who develop the
disease, are sent to hospital units, where they
will receive specific therapies.
- the infected ones are sent either at home or in
quarantine and isolation for 14 days, after
which, in the absence of any symptoms, they
may be treated in the dental office.
- the virus carriers may be cautiously treated in
the dental office.
- the uncontaminated ones follow the normal
circuit.
C. Following selection of patients needs, two
categories of subjects remain:
1. The former category includes the healthy,
non-infected patients.
2. The latter one refers to virus carriers.
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With a view to assuring corrresponding
protection measures, two separate circuits will
be established: for the infected and, respectively,
for the non-infected ones. If the available space,
the equipments and the medical staff do not
permit this, different days of treatment will be
decided for the two types of patients. It goes
without saying that both circuits will be
disinfected after each visit.
D. Organization of the treatment sessions
differ, as a function of the complex therapy
applied, and solving in only one visit as many
problems as possible, with a view to restricting
the traffic of too numerous appointments. This
is mainly necessary because of the laborious and
costly preparation of both space and medical
staff, who will wear masks, visors, glasses,
gloves, overalls, etc. The patient will also receive
a disposable coat, slippers, gloves, yet not a
mask. After each session, disinfection and
aeration will be made for at least 30 minutes, as
well as mechanical, chemical, biocide and
ultraviolet cleaning, according to the protocols
recommended by antiepidemic authorities.
E. The costs of the treatment will increase,
if considering the longer time needed for
Prof. Vasile Burlui, PhD
Editor-in-chief
International Journal of Medical Dentistry
124
disinfection and the new difficulties caused by
the realization of therapeutical techniques with
the protection equipments. Also, one should
consider the material efforts made for additional
disinfection, for overalls, masks, visors, gloves,
sprayed materials used by both medical staff
and patients. Some clinics will have to invest
in disinfection tunnels and in devices for rapid
testing. The coronavirus epidemy will force
even the universities to modify their curricula,
by introducing compulsory modules of
theoretical and practical antiepidemic training,
while dentists associations will have to organize
work-shops for a continuously updating
training. The medical authorities, the medical
assurance services will create new offers and
will elaborate new regulations, in relation to
the level of relaxation of the anti-epidemic
measures.
All these aspects will definitely and rapidly
modify the parameters of everyday life and the
conditions of medical practice. However, I am
confident that both the medical authorities and
the trade-unions, the banks, the medical
associations will cooperate for annihilating the
pandemic effects manifested in dental offices,
which will be of real support for our patients.
Volume 24 • Issue 2 April / June 2020 •