The new normal of paediatric dental practice post COVID-19: A review

Abstract

Background: Novel coronavirus disease (COVID-19) is one of the worst pandemics known to mankind. It affects all the age groups but children present with milder symptoms and may also be asymptomatic. In the current scenario paediatric dentists pose high risk of the disease due to close contact with not just children but also with their parents. Additionally, majority of paediatric dental procedures advocate the use of handpiece which generates immense aerosol increasing the transmission risk by manifold. Objective: This review aims to highlight the transmission of COVID-19 in dental setting, its impact on paediatric dental setting and dental education and the new normal of paediatric dental practice. Modification in Dental Practice: With health authorities predicting that the novel coronavirus may become an endemic in the community, it necessitates modification in dental practice to adapt to the new normal. It requires modification in behaviour management techniques, tele-triaging of patients, stringent infection control, minimising AGPs and replacing them with minimally invasive techniques along with use of adequate isolation. The ongoing pandemic has also severely impacted the dental education therefore advocating modifications in the same with the advent of online teaching and webinars. Conclusion:Paediatric dentists are at high risk of acquiring the infection, hence it is the need of the hour to adapt to the new normal of practice at the earliest. We are an important part of the community; hence it is our foremost duty to contain the spread of this virus and not act as an aid in its transmission.

Impact of COVID-19 pandemic on pediatric dentistry treatment procedures

“…Another reason for the reduced number of restorative procedures in pediatric dentistry may be due to negative behaviour patterns developed by younger pediatric patients' vis-a-vis the physical appearance of clinicians donned with personal protective equipment and hence rejecting treatment (7,17).…”

“…In order to avoid aerosol-generating procedures, it is noted that noninvasive and minimally-invasive techniques for dental caries treatment will be a suitable option, especially during the pandemic (24). It is reported that treatment options based on non-invasive and minimally-invasive treatment philosophy and remineralization treatment such as silver diamine fluoride application, fissure sealant applications, resin infiltration methods, Hall technique, and Atraumatic Restorative Treatment (ART) should be preferred (7,24,28). It is reported that they are suitable alternatives during the pandemic, with the advantages of short chair-time and quick application as well as avoidance of rotating tools (24,36).…”

“…Considering the transmission modes, it is accepted that the specific procedures of dental treatment services, which include face-to-face contact with patients, frequent exposure to saliva, blood, and other body fluids, and the use of sharp instruments may lead to an elevated infection risk (2,4,5). It has been reported that since the first confirmed case in the pediatric age group, a clearlydefined pediatric transmission pattern in children has not been established (7,8). However, it is accepted that the disease often progressed asymptomatically in children who, as silent spreaders, may thus play a major role in viral transmission (7).…”

“…It has been reported that since the first confirmed case in the pediatric age group, a clearlydefined pediatric transmission pattern in children has not been established (7,8). However, it is accepted that the disease often progressed asymptomatically in children who, as silent spreaders, may thus play a major role in viral transmission (7).…”

“…In the triage stage, it was recommended that symptoms associated with emergency dental incidents should be alleviated first by the use of analgesics and antibiotics (22). When symptoms cannot be contained without further action, treatment procedures that require minimal intervention and minimum time with the least aerosol generation and number of sessions are recommended (7,(23)(24)(25)(26)(27)(28). In pediatric dentistry, alternative treatments that offer non-invasive and minimallyinvasive methods have been used for quite a long time.…”