| Going to work in oral healthcare can make a lot of us anxious these days. The global pandemic is still evolving and there are still many unknowns about the behavior of the COVID-19 virus. Dental health providers are directly in the line of fire, with close proximity to patients and aerosols from common procedures. So what is the risk of contracting COVID-19, during work, for members of our high-risk profession? To give an accurate and evidence based answer, we have to account for the following factors: the effectiveness of PPE, prevalence of asymptomatic cases, rate of transmission from asymptomatic patients, and age-adjusted infection fatality rate of symptomatic COVID-19 patients. The facts: When wearing appropriate PPE including an N95 mask; the risk for a dental health professional of contracting COVID-19 from asymptomatic patients and dying from the disease is approximately 1:13,000 or 0.008% – in all age groups. To put this in context – the annual risk of dying in a motor vehicle accident is 1:8,000. Considering the age of the dental health provider, a dentist older than 90 years of age still has a 99.9% chance of avoiding COVID-19 even when working full time in the dental office.However, having underlying medical conditions such as diabetes, cardiovascular disease or lung disease does increase the risk of death by 12 times. There is a relatively low viral load of SARS CoV-2 in human saliva even in the severely ill patient. In one study, only 31% of COVID-19 positive patients showed presence of the virus in their saliva. Therefore, there is an extremely low chance of expelled aerosol containing viable viruses. Extra protection at work: There is new evidence that highlights the effectiveness of pre-procedural antimicrobial rinses done by the patients. SARS CoV-2 is sensitive to common disinfectants such as povidone iodine and hydrogen peroxide that are common in mouth rinses. It has been shown that povidone iodine and chlorhexidine mouth rinses could rapidly inactivate SARS CoV-2 found in the saliva. Rest assured for now. The current scientific evidence shows that the risk of a dental health professional contracting COVID-19 at work is extremely low. As long as you use the correct PPE, especially an N95 mask. |
| Dr. Kasra Eghbaldar – Toronto, Canada |