The World Health Organisation (WHO) has released guidance on measures to be taken by dental teams and patients to limit the risk of COVID-19 transmission.

Whilst acknowledging that during the COVID-19 pandemic, effective prevention of oral problems and self-care remain a high priority, it advises that routine non-essential oral health care can be delayed 'until there has been sufficient reduction in COVID-19 transmission rates from community transmission to cluster cases'.

It notes: 'The same applies to aesthetic dental treatments. However, urgent or emergency oral health care interventions that are vital for preserving a person's oral functioning, managing severe pain or securing quality of life should be provided.'

The WHO added in its interim guidance that patients should be remotely screened before appointments.

It reports: 'In settings with widespread community transmission during the COVID-19 pandemic, an essential oral health service concept is warranted. Oral health care involving AGPs should be avoided or minimised, and minimally invasive procedures using hand instruments should be prioritised.

Pre-examination antiseptic mouth rinse is essential, and visual/tactile examination should be performed, without intraoral X-ray.

The BDA said: '

It is inappropriate to apply this advice in the UK’s current context, where dentists already operate extremely high levels of decontamination. At present the authorities have mandated dentists to use full PPE - as used in ICUs - for AGPs combined with a 60 minute fallow period between patients. Approaches vary by country, with many not operating a fallow period, and some are as short as two minutes. The UK’s approach is highly cautious by international comparison and is currently under review.

It also suggested that patients should be given advice through remote consultation or social media channels on maintaining good oral hygiene.

Additionally, maintaining physical distancing and wearing masks before and between dental sessions to prevent and reduce the risk of transmission is advised.

Urgent or emergency oral health care may include interventions that address acute oral infections; swelling; systemic infection; significant or prolonged bleeding; severe pain not controllable with analgesia; oral health care interventions that are medically required as a pre-intervention to other urgent procedures; and dental/orofacial trauma. If an oral health care professional is in doubt, referral to a specialised treatment facility must be ensured.

Timely management of urgent or emergency oral health care interventions helps patients avoid seeking treatment at hospital emergency departments, thereby ensuring that they remain available to serve individuals seeking COVID-19-related care.

For more information and to download the document Considerations for the provision of essential oral health services in the context of COVID-19, visit https://www.who.int/publications/i/item/who-2019-n...

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