Corona virus (COVID-19) entered our lives as a disease that emerged in Wuhan, China, in the last months of 2019 and turned into a pandemic around the world. This new type of Corona virus was named "COVID-19" because it was first seen in 2019. Corona virus 2019 (COVID-19) is also called Severe Acute Respiratory Syndrome (SARS-CoV-2). Similar to SARS-CoV seen in 2002 and the Middle East Respiratory Syndrome (MERS-CoV) virus in 2012, COVID-19 is also a zoonotic virus. In other words, it is a type of virus that mutates and passes from animals to humans. However, there is no case report regarding the carriage and spread of COVID-19 regarding our pet friends.
The incubation period of the virus from the first contact with the human body without showing any symptoms of disease is estimated to be between 2-14 days. However, some sources report that the incubation period can be up to 24 days. The most common symptoms of COVID-19; Fever, body weakness, dry cough, shortness of breath, decreased sense of taste and smell. All of these symptoms may not be seen at the same time. In cases where the disease is seen, one or more of the symptoms may occur together, or the disease may not show any symptoms at all. It has a mild course in more than 80% of cases, and those in this class experience the disease at home or outpatient without the need for hospital treatment. However, 15% of the cases are classified as severe and seriously ill, and the remaining 5% are classified as critically ill. Most of the last group are intubated patients. In severe and critical cases, acute respiratory disease can lead to pneumonia. Death due to kidney failure and even multiple organ failure may occur. In severe and severe cases, the immune system reacts and attacks the cells, and the infection can cause death with pneumonia as a result of acute respiratory failure.
The virus is very contagious, and each patient with the infection can infect an average of 1.6-2.4 people. While the death rate of people over the age of 65 is 3-4 times higher than other age groups, the death rate for people under the age of 40 drops below 0.2%. Men can be affected twice as much as women.
COVID-19 enters the body through the nose, mouth and cornea and spreads to the upper respiratory tract and lungs. It holds on. It is transmitted directly through cough, sneezing and droplets. It is transmitted indirectly through contact, by touching a surface that has been touched by a sick person and contaminated with the virus, and by touching our mouth, nose and eyes with our hands. There are reports that the virus can reach up to 8 meters through coughing and sneezing.
In order to protect ourselves and avoid contracting the disease during the COVID-19 epidemic, we can take some personal precautions to both protect ourselves and keep our immune system strong. In clinical applications; There are very important points that need to be taken into consideration for the health of both the patient and the clinic staff, from the moment the patient enters the clinic during his visit to the dentist until the moment his treatment is completed. According to “The New York Times”, dentists are one of the professional groups at the highest risk of contamination. Dentists, along with ENT and Ophthalmologists, are in the high risk group as they are in close contact with patients who are COVID-19 positive and do not show any symptomatic signs. There are publications reporting that dentists have a high risk of COVID-19 infection due to their close face-to-face contact with their patients. It is known that COVID-19 is transmitted through aerosols generated during medical procedures or indirectly through saliva. Although the "Situation Management Guide for Emergency Situations and Emergency Service Needs in Dentistry During the COVID-19 Pandemic" published by the Turkish Dental Association and the regulations published by the Ministry of Health are guiding for dentists, they also recommend that people who are suspected of having a disease or have a disease be referred to an Emergency Department with the possibility of dentist consultation. TDB made a recommendation decision saying "refer to the service".
As dentists, it is very important for us to be more conscious about how we should work during this pandemic caused by COVID-19 in order to protect both our patients and ourselves. To date, there is no universal protocol or guide written and used for dentists to perform dental treatment in active or suspected COVID-19 cases. Another reality is that we will probably be living with this disease for a long time and we need to take precautions accordingly. Because this does not seem to be a process that will take a very short time. this is sick We need to learn to live with light. For the health of both our patients and dentistry staff, it is inevitable that we take precautions to protect ourselves from the disease.
BASIC RULES TO BE CONSIDERED IN PATIENT ADMISSION:
Maximum Protective Precautions (For Patients, Dentists, auxiliary personnel)
The patient should come to the clinic alone and no companion should be allowed. If the patient needs a companion due to age or physical disability, a maximum of 1 companion should be allowed. The patient and his/her companion must be admitted to the examination room with a mask. If patients need to wait in the waiting room, a seating arrangement should be provided in accordance with the social distance rule, leaving a seating distance of 1-1.5 meters between them.
The dentist and his assistant wear surgical and breathing masks (N 95) during examination and treatment in the patient's mouth. should use. It is not appropriate and sufficient for dentists to use surgical masks alone during these pandemic processes such as the virus outbreak.
Tooth cutting, filling, surgical cutting, etc. In order to reduce surface contamination in aerosol-generating processes that require the use of aerators and micromotors, such as respirators, a respiratory mask must be used with protective glasses or a face shield.
Maximum Protective Measures (For all clinical venues and unit surfaces)
The seats on which patients will sit in the waiting room must be made of easily cleanable materials such as plastic, artificial leather or leather. .
Door handles and electrical switches should be disinfected regularly. Clinic entrance doors, room and toilet doors, and door handles should be disinfected after each patient.
No glasses, tea makers, etc. lying open in the common areas used by patients in the waiting room. Items such as these should be removed and tea and coffee should not be served.
After each patient, the unit, cuspidor, patient chair, physician stool and other parts of the unit and plastic pipes should be disinfected.
Patients' appointment intervals should be kept long, and sufficient time should be allocated between patients to prepare the environment. patient appointments It may be sufficient to give the treatment every 1/2 hour.
The clinic should be ventilated for 20-30 minutes during the 1/2 hour intervals between patient appointments.
Efforts should be made to create and keep the aerosol environment at a minimum in the patient examination room in the clinic.
Just as what we will experience in every aspect of our lives from now on will not be the same before and after the COVID-19 Pandemic, big changes will be waiting for us in Dentistry. Due to taking personal protection measures, the number of times we see patients has decreased and the time we spend on patients has increased, which has brought the term "SLOW DENTISTRY" to our language. There will be serious changes in dentistry practices due to this disease, which we have not experienced before, or the pandemics we are likely to experience in the future.
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