Journal of Indian Association of Public Health Dentistry

EDITORIAL
Year
: 2020  |  Volume : 18  |  Issue : 4  |  Page : 277--278

Dental public health: Fallout of the COVID-19 pandemic


Venkitachalam Ramanarayanan, Vineetha Karuveettil, Chandrashekar Janakiram 
 Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

Correspondence Address:
Vineetha Karuveettil
Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi - 682 041, Kerala
India




How to cite this article:
Ramanarayanan V, Karuveettil V, Janakiram C. Dental public health: Fallout of the COVID-19 pandemic.J Indian Assoc Public Health Dent 2020;18:277-278


How to cite this URL:
Ramanarayanan V, Karuveettil V, Janakiram C. Dental public health: Fallout of the COVID-19 pandemic. J Indian Assoc Public Health Dent [serial online] 2020 [cited 2021 Jan 17 ];18:277-278
Available from: https://www.jiaphd.org/text.asp?2020/18/4/277/303633


Full Text



Arguably, the COVID-19 pandemic has been a watershed moment for dentistry. There has been a near-total suspension of general dental practice in clinics and dental schools globally. Given the high degree of risk of exposure, dental and allied professionals are subjected to in the face of COVID-19 outbreak, an increased emphasis on infection control protocols may be mandated. Resuming dental practice and other related activities in the current COVID-19 times is bound to bring in a “new-normal” situation.

Public health has gained enormous attention post outbreak of Covid-19 with concepts such as quarantine, isolation, social distancing, flattening of the curve, and mass masking becoming local lore. The practice of dental public health, essentially a subspecialty of public health focussing on oral health is expected to undergo drastic changes in the coming times. The wide ambit of this field has resulted in it being practiced in ways more than one across the world. Regional influencers such as prevailing health conditions and sociopolitical factors determine the scope of activities undertaken in this field. In developing countries like India, to a great extent, dental public health focuses on academics, research, health promotional activities, dental outreach programs, and preventive oral care. Dental public health is taught as a part of graduate programs in dentistry and several dental schools offer residency programs (postgraduate) also. In this article, we discuss the changes that are expected to happen in the field of Dental public health in India due to the COVID-19 pandemic.

 Dental Outreach Programs



Dental outreach programs (also known as screening camps and check-up programs) are routine activities and main source of clinical material for student learning in dental schools in India. Provision of free check-up for oral problems and on-field basic dental treatments are provided in these outreach programs. Usually, such programs are attended by the public (patients) in large numbers and basic dental treatments are provided in portable dental units or mobile dental vans. In the wake of COVID-19, this system of providing oral care is bound to be affected for the need to ensure the safety of health professionals and patients maintain social distancing. As these programs are a part of dental safety net and cater to the dental needs of many people, especially the underprivileged, lack of care due to practical difficulties in implementing strict infection control measures is a possibility.[1] A new or alternate interface needs to be developed to ensure the dental safety net in the country.

 Prevention of Oral Diseases



Graduate and residency programs in dental public health mandates training in performing basic and preventive dental procedures. Restarting dental practice may confront us with two possible scenarios. On one hand, we may need to clear the existing backlog of patients requiring elective dental procedures created as a result of temporary suspension of dental practice while on the other hand, with additional expenditure on personal protective equipment's and measures, the cost of dental treatments is expected to rise further deterring patients from availing timely dental care.

However, the provision of preventive dental procedures which mainly include application of pit and fissure sealants, topical fluoride therapies, and oral prophylaxis may be augmented. These procedures are routinely performed in dental schools and its satellite centers at discounted rates and the beneficiaries include economically disadvantaged groups. While curative dental treatments depend to a large extent on aerosol-generating procedures, most preventive procedures are not aerosol-generating and can be safely performed with basic infection control practices. Hence, the present scenario can be viewed as a window of opportunity to place greater emphasis on the prevention of oral diseases.

 Health Promotion



One of the avenues where dental public health specialists can contribute immensely to the control of this pandemic is through health promotion. Despite COVID-19 being a global phenomenon, there is still a growing need to educate the public to adopt healthy lifestyle practices and bring about a positive behavior change. Organized awareness campaigns focusing on public health measures such as personal hygiene, mass masking, cough etiquettes, and social distancing need to be undertaken under the aegis of dental schools or professional bodies. They may also be clubbed with activities such as tobacco cessation and oral health promotion. At the institution level, dental public health specialists and trainees can effectively contribute to screening and telephone triaging which are also key gateways to raise awareness among patients. Alternatively, independent dental public health specialists may volunteer with the government to provide their services in helpline centers, medicine distribution, and fieldwork.

 Academics and Teaching



The dental undergraduate and postgraduate education in the current pandemic situation needs major remodeling. This can be an opportunity to upgrade the syllabus and curriculum to the need of the hour, keeping in mind the future of our young graduates. Most of the public health concepts taught during the training days in dental schools were theory oriented with very little scope for practical application. Currently, students can relate these concepts to real-world situations. Therefore, teaching public health aspects of disease and health could be a more rewarding experience. With the adoption of virtual mode of learning among dental students worldwide, training of e-learning for both students, and faculties need to be implemented.[2] The specialty can take up lead in remote triaging using teledentistry to serve underprivileged Communities, with students managing the platform.[3]

 Research



As extensive field visits and outreach activities are suspended given the current situation, the research projects will be facing challenges in data collection which can lead to temporary halting of many projects. This predisposes the need to explore alternate methods of collecting data through online survey forms, online focus group discussions, in-depth interviews, telephonic surveys, and Delphi technique. Research projects with a focus on new topics in emergence such as remote triaging, advanced infection control measures, online learning, disease surveillance, and most importantly inventing cost-effective methods for dental disease prevention may be encouraged. Of another concern, with the exponential increase in the number of research articles published and availability of new information almost on a daily basis, is the global threat of excessive and misinformation (infodemics) affecting the decision-making process.[4] Dental public health specialists who are generally well trained with evidence appraisal can render their expertise in promoting quality evidence and guide other specialties in adopting evidence-based clinical practice.

References

1Abdul Salam TA, Shenoy RP, Shenoy Panchmal G. Dental safety net: To reach the underserved. IOSR J Dent Med Sci 2015;14:13-6.
2Iyer P, Aziz K, Ojcius DM. Impact of COVID-19 on dental education in the United States. J Dent Educ 2020;84:718-22.Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/jdd. 12163. [Last accessed on 2020 Jun 04].
3Giudice A, Barone S, Muraca D, Averta F, Diodati F, Antonelli A, et al. Can teledentistry improve the monitoring of patients during the Covid-19 dissemination? A descriptive pilot study. Int J Environ Res Public Health 2020;17:3399.
4Zarocostas J. How to fight an infodemic. Lancet 2020;395:676.