Ever since the advent of HIV in the 1980s, U.S. dental practices have followed state-of-the-art infection control standards. These are designed to protect patients and dental providers from infectious and contagious diseases, and they are very effective.
COVID-19 has presented the opportunity to revisit and amplify those standards. Even when routine care was suspended, several of our School of Dentistry clinics have continuously provided urgent care. We have compiled a great deal of expertise on providing safe, high-quality care during the pandemic and shared it with dental professionals via free webinars. We have continuously updated our clinical protocols as we learn more about this virus and how to prevent its spread. We know the dental community more broadly is doing the same.
Patients should know that there has not been one single reported case of COVID-19 transmission associated with dental care — none from patient to patient, patient to provider or provider to patient. Community-based transmission of COVID-19 remains the primary risk — and a U.S. dental office is one of the safest places to be.
Unfortunately, the World Health Organization (WHO) recently issued guidance on dental care during the pandemic that advised delaying routine preventive care. While WHO did provide some good information related to COVID-19 and transmission of the virus, its guidance unfortunately does not account for the high infection control standards in the United States and many other countries.
I greatly respect WHO and the work it does. However, WHO gives guidance to countries with varying degrees of resources and infrastructure. Readers should note that several of the 15 experts who contributed to this guidance are from developing countries. In such countries, infection control standards, testing capacity and public-health priorities do not match ours. In addition to the advice to delay routine care, WHO also fails to account for the quality of care and infection control in our country on several other points.
∙ WHO advises patients to avoid recall visits. No. Regular care maximizes prevention and avoids more serious problems requiring more complex care.
∙ WHO suggests that patients should be screened before appointments, if possible. Seattle-area dentists already require this in every case, both the day before and day of the appointment.
∙ WHO says ventilation, air recirculation and air filters can reduce risk. These devices are more complex than WHO assumes. They can complicate air flow and increase aerosol transmission, not reduce it.
∙ WHO advises dentists to avoid aerosol-generating procedures in areas with high community transmission of COVID-19. No. Instead, patients should be screened and COVID-tested if community spread is high and an aerosol-generating procedure is needed. Ours was the first U.S. dental school to implement this standard, and now others are following our lead.
There is more, but rather than pick a fight with WHO, I encourage Washington’s dental patients to follow the guidance of the Centers for Disease Control and Prevention, the American Dental Association, and dental schools including ours.
I join my dental colleagues in urging people not to delay routine dental care. Dentistry is a profession focused on prevention. In most instances, care for dental decay is less costly and less invasive if addressed early. Preventive exams should not be delayed, particularly for children and for those who are pregnant or have a medical condition which puts them at higher risk for dental problems.
Routine preventive care has another benefit: Careful exams of the teeth, gums and tongue can spot signs of arthritis, diabetes, diet deficiencies, liver disease and even some autoimmune diseases. Neglecting regular care — for yourself and your children — can put your overall health at risk at a time when staying healthy is more important than ever.
I just visited my own dentist recently for a dental hygiene appointment and to see whether I might need a crown. And I could not have been more confident in the safety of this care.