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EDITORIAL
Year : 2020  |  Volume : 10  |  Issue : 1  |  Page : 1-2

COVID-19 and maxillofacial surgery


Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, 30, KB Dasan Road, Teynampet, Chennai - 600 018, Tamil Nadu, India

Date of Web Publication8-Jun-2020

Correspondence Address:
Dr. S M Balaji
Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, 30, KB Dasan Road, Teynampet, Chennai - 600 018, Tamil Nadu
India
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DOI: 10.4103/ams.ams_126_20

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How to cite this article:
Balaji S M. COVID-19 and maxillofacial surgery. Ann Maxillofac Surg 2020;10:1-2

How to cite this URL:
Balaji S M. COVID-19 and maxillofacial surgery. Ann Maxillofac Surg [serial online] 2020 [cited 2020 Aug 15];10:1-2. Available from: http://www.amsjournal.com/text.asp?2020/10/1/1/286132




The pandemic of novel coronavirus disease (COVID-19) has impacted on all spheres of life including all economic activity, travel, governance, education, and the like.[1],[2] Dentistry and oral surgery are also not spared.[1] As like most of the governments, India is also progressing with new norms such as physical distancing, lockdowns, and quarantine of suspected cases, aggressive testing to fight against the COVID-19.[3],[4] The COVID-19 is known to spread through contact, aerosol, mucosal/respiratory droplets, and possibly by fomite spreads.[5] Owing to this form of spread, dentists and maxillofacial surgeons are particularly vulnerable to transmission of COVID-19 due to the need for close patient proximity and the type of instrumentations used in the field.[6] The unclear incubation periods of COVID-19 as well as virus shedding by asymptomatic patients expose oral maxillofacial surgeons (OMFS) to COVID-19.[1],[2] Owing to COVID-19 stigma, patients may conceal their flu-like symptoms or carrier status.

In this situation, OMFS need to revisit our infection control procedures before fulfilling our professional and moral obligation. Before encouraging treatment, globally advocated COVID-19 sterilization and disinfection protocol need to be followed. In addition, hand hygiene practices, barrier techniques, the use of personal protective equipment (PPE), disinfection of surfaces, and sterilization of equipment need to be ensured.

The triaging of patients, taking exposure history, classifying procedures as emergency, urgency, and elective, as per the guidelines is the need of the hour. For elective and condition that can be managed with remote contact like pharmacological telephonic consultation can be done.[7],[8]

All elective and avoidable procedures can be postponed in India, till COVID-19 is contained. Procedures that require airway management, arresting bleeding, patients who need drainage of infections that is resistant to antibiotics, oncosurgery procedures where a delay in surgery can have an impact on survival period can be performed. If the procedure requires immediate treatment, it would be safer to assume them to be COVID-19 positive till proven otherwise and use appropriate guidelines. Besides the safety measures, conservative treatment should be considered, provided mucosal contact or aerosol generation would be eliminated. Suspected COVID-19 cases shall be treated if at all, at negative pressure theaters or airborne infection isolation rooms. During surgery, all aerosols shall be avoided.[7],[8]

As a part of the anesthetic fitness and patient preparation, the patient may be admitted at least 48 hours prior to procedures. Patients and caregivers may be subjected to the COVID-19 screening test. Additionally patient shall undergo imaging study of lungs (Computed Tomogram). Once admitted, they may be refrained from moving out of the hospital premises. The admitted rooms shall be subjected to regular sanitization as per local authorities' instruction. Visitors, if any, may be temporarily prevented from visiting patients as their interaction may increase the risk of COVID-19 infection. At any point in time, patients and attender should practice social distancing and wear masks continuously. After discharge, the patient's health status may be followed at regular intervals for at least a month to ensure that they remain free of COVID-19.

At the same time, the COVID-19 situation also provides a novel opportunity to learn, update our knowledge, and update ourselves such that we continue to save lives and recreate more face and smiles.



 
  References Top

1.
Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. J Dent Res 2020;99:481-7.  Back to cited text no. 1
    
2.
Dave M, Seoudi N, Coulthard P. Urgent dental care for patients during the COVID-19 pandemic. Lancet 2020;395:1257.  Back to cited text no. 2
    
3.
Gupta N, Praharaj I, Bhatnagar T, Thangaraj J, Giri S, Chauhan H, Kulkarni S, et al. ICMR COVID Team. Severe acute respiratory illness surveillance for coronavirus disease 2019, India, 2020. Indian J Med Res 2020;151:2. [DOI: 10.4103/ijmr.IJMR_1035_20].  Back to cited text no. 3
    
4.
Raffle A, Gray J, MacDonald HR. Letter:First-aid treatment of poisoning. Br Med J 1976;1:93.  Back to cited text no. 4
    
5.
Guo ZD, Wang ZY, Zhang SF, Li X, Li L, Li C, et al. Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis 2020;26:7.  Back to cited text no. 5
    
6.
Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci 2020;12:9.  Back to cited text no. 6
    
7.
Ather A, Patel B, Ruparel NB, Diogenes A, Hargreaves KM. Coronavirus disease 19 (COVID-19): Implications for clinical dental care. J Endod 2020;46:584-95. doi: 10.1016/j.joen.2020.03.008.  Back to cited text no. 7
    
8.
Martelli-Júnior H, Machado RA, Martelli DRB, Coletta RD. Dental journals and coronavirus disease (COVID-19): A current view. Oral Oncol. 2020:104664. doi: 10.1016/j.oraloncology.2020.104664.  Back to cited text no. 8
    




 

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