We are in the mid of a very difficult time, the whole world is unfortunately gripped in the garb of a pandemic caused by the novel Coronavirus. The rapid and unexpected spread of the virus has caught the best of nations off-guard causing unforeseen casualties and other associated comorbidities. Keeping the health of the public in the highest regard, several meetings, academic, and sporting events have either been canceled or postponed. Several of the IOS workshops, and the annual session of the American Association of Orthodontists (AAO) being just a few of them that affect our profession directly.
In addition to this, as newer information kept pouring every day, it was realized that our dental profession was at one of the highest if not the highest risked profession in the current scenario.
Another key point to mention is the fact that quite a few of our procedures end up aerosolizing the pathogen increasing the risk of spread. Therefore, keeping the grave situation at hand and available published recommendations,2 the Dental Council of India (DCI) along with several dental profession organizations including the IOS, have recommended the deferment of elective procedures and practice “social distancing” barring emergency procedures.
The following could be considered as an emergency for orthodontists: significant oral pain (that cannot be managed by wax or sectioning an archwire with cuticle cutters/nail clippers in a worst case scenario), an oral infection, complaint of limited orofacial function, and a physically traumatic event that may cause any of the aforementioned cases.
All of this is done with the purpose of “breaking the chain of spread” and “flattening the curve.” Here the “curve” refers to the projected number of people who will contract COVID-19 over a given period of time. It could be either a steep curve, in which the virus spreads exponentially, thereby overloading our volatile health care infrastructure as currently seen in countries like Italy, wherein a flatter curve assumes the same number of people get infected, but over a longer period of time, this allows for the health care system to absorb the stress gradually, which in the given scenario is the better choice of the two evils at hand. We are in the middle of the unprecedented nationwide lockdown of 21 days in an attempt to flatten our country’s infection curve, which was recently extended to an additional 19 days to limit the spread within now identified clusters.
A taskforce of the IOS has also prudently given out relevant and useful history and screening forms to assist us in the screening newer patients in the coming months and further decrease of spread not only to ourselves but to our other patients as well.
Patients with any foreign travel history and reports of fever, coughing, dyspnea and myalgia and fatigue should be ruled out at the telephonic stage itself. Additionally, while treating emergencies, use of adequate barrier during procedures, along with proper pre- and post-operative sterilization and cleanup should be kept to an exemplary standard especially for the metallic and plastic surfaces as current evidence indicate the survival of the virus in such surface for up to 12 hours.
All of these steps may come at a personal and somewhat financial discomfort to us, the greater good of the country’s population and to some extent, the world’s populace must be kept in the mind and the highest regard. Like all adverse things, I am sure this too shall pass, and normalcy would return.
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