[STUDY] Post-Pandemic Dental Practice: COVID-19, Oral Health & Infection Control

infection control before covid

Focuses on bloodborne diseases

• Blood / OPIM

Standard precautions

Transmission based precautions

• Direct

• Indirect

• Airborne

Now shift to airborne pathogens

Public health measures

• Quarantine

• Physical distancing

• Good hygiene

• Vaccination

Offices

• Enhanced PPE

• Better disinfection

• Patient screening

• Follow up

Dental office changes

• Better ventilation

• Extraoral suction

• Respirators

• Patient screening before appointments

These are engineering and adminsitrative controls

Hierarchy of controls (OSHA)

• Risk elimination

• Engineering controls

• Administrative control

• PPE

Staff protocols

Self monitoring

Isolation when sick

Screening mechanisms

• Screen dentist before appointments

• Identify high risk patients

• Delay treatment if needed

• Provide remote consultation or offer emergency advice

Oral manifestations of COVID 19

• Mouth

• Tongue

• Salivary glands

= Many ACE2 receptors for covid to bind to

Oral findings

• fissure tongue, papules, bad breath, oral ulcers, blisters, edema, redness, dry mouth

  • More commonly found in older patients,poor oral hygiene, severe covid

Dysosmia

Loss of smell

Dysgeusia

Loss of taste

Severe covid and periodontitis associated with

• Smoking

• Old age

• Obesity

• Diabetes

• Cardiovascular disease

Why periodontal disease worsens COVID

Periodontal pockets acts as reservoirs

• Pockets harbor sarcov2

• Pathway into bloodstream

Systemic inflammation

• Increases inflammatory cytokines

• Cytokine storm

Bacterial aspiration

• Bacterial pocket aspirate into lungs

• Increase respiratory infections