Ongoing advisement recently updated at end of August
In a guidance most recently updated August 31, the World Health Organization (WHO) issued recommendations for the provision of essential oral health services in the context of COVID-19.
Intended for public health decision makers and dental providers, WHO’s recommendation includes essential dental care and the delaying of nonessential dental care where COVID-19 is in an area of community transmission and not reduced to cluster cases. However, the WHO guidance also advises that oral health-care providers follow recommendations from local officials, be they on the national or community level.
The WHO has previously defined “community transmission” as “the inability to relate confirmed cases through chains of transmission for a large number of cases, or by increasing positive tests through sentinel samples (routine systematic testing of respiratory samples from established laboratories).”
“WHO advises that routine non-essential oral health care—which usually includes oral health check-ups, dental cleanings and preventive care—be delayed until there has been sufficient reduction in COVID-19 transmission rates from community transmission to cluster cases or according to official recommendations at national, sub-national or local level. 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.”
Reuters reported on the guidance after coverage of a news briefing in which Benoit Varenne, a WHO dental officer, said dental providers should “avoid or minimize procedures that may generate aerosol, prioritize a set of clinical interventions that are performed using an instrument, and of course to delay routine nonessential oral health care.”
In the United States, the WHO guidance provides an additional layer of advisement for government officials, dental boards, dental providers, and patients to consider.
Other WHO recommendations in the original August 3 guidance include the following:
- Patients should be given oral health advice through remote consults or social media on how to maintain good oral hygiene, as prevention and self-care are high priorities.
- Oral health-care workers are in close proximity to patients’ faces for long periods of time, and there is frequent exposure to saliva, blood, and bodily fluids and handling of sharp instruments. As such, dental providers “are at high risk of being infected with SARS-CoV-2 or passing the infection to patients.”
- Adequate ventilation is needed in dental settings. Facilities should “[a]void the use of split air conditioning or other types of recirculation devices and consider installation of filtration systems.”