The IAOS has reviewed the guidance issued to the dental profession by the National Public Health Emergency Team (NPHET) and the Department of Health. This advice states that there is currently no need for change in dental practice unless patients display symptoms of COVID-19. As an Association we wish to state that we strongly disagree with this guidance and take a different position based on our interpretation of the best evidence available to us at present.
The Chief Dental Officers of Northern Ireland, England, Scotland and Wales have advised the avoidance of aerosol-generating procedures, given the potential risk of asymptomatic cases. In our opinion, this is sensible advice. We believe that continuing to provide routine dental care for patients without COVID-19 symptoms risks accelerating the spread of infection and is at odds with the general advice to limit social contact and practise social distancing. Adhering to the NPHET guidance will also result in the unnecessary consumption of scarce PPE, a resource which could be diverted to more urgent services. The content of the contingency plan devised by the National Oral Health Office for use in the HSE Dental and Orthodontic services aligns far better with the advice being given in other jurisdictions and the National Oral Health Lead is to be commended for his leadership in this regard.
It is our view that the routine practice of dentistry should be suspended and treatment restricted to the provision of emergency care only. Aerosol-generating procedures should be avoided wherever possible and, where unavoidable, should only be undertaken with an appropriate level of PPE, which includes a respirator mask. We believe that the evidence available to date supports this cautious approach and protects the health of our patients and our dental healthcare professionals. In future, as the evidence base expands, we may judge how and when a return to routine practice can be advised, but for now we have a responsibility tofirst do no harm.
We applaud, in general, the response of the NPHET to the COVID-19 pandemic in Ireland. They have been ahead of the curve in many respects and it is a matter of regret that the advice to the dental profession currently lags behind what is emerging as best practice internationally. We call on the NPHET and the Chief Dental Officer to review their guidance as a matter of urgency.
Catherine Gallagher President
Irish Association of Oral Surgery