The COVID 19 pandemic has fundamentally altered the way the world behaved. It has wrecked the global economy and has caused untold pain and suffering humanity as a whole. As we in India discuss relaxing the lockdown gradually and are coming up with strategies to restore some semblance of normalcy, some professions will be affected significantly more as compared to others.
Dentistry is a highly specialized branch of medicine and is a key facet of general public health. The Dental community has responded by coming up with new protocols and SOPs to deal with the fallout of the novel coronavirus. The regulatory bodies and the Dental Council of India have issued guidelines on the nature of the procedures that can be conducted and the measures that are to be taken while conducting them. These guidelines are sacrosanct and must be diligently adhered to.
This is an evolving situation and the entire community is dealing with an unprecedented challenge that has caught the practitioners off guard. While dentists as a part of their training are exhaustively oriented towards various sterilization and disinfection techniques in dental school, most follow the highest standards of sterilization and protocols in their practices. However this is a challenge of a tiny virus hitherto unknown, and dealing with this will require an exhaustive and systematic intervention.
The impact of the coronavirus pandemic on the dental fraternity can be categorized into three types: Financial, professional and social.
On the professional front private dental practitioners receive almost no support from the government. This leaves the new practitioners especially vulnerable to a catastrophic financial situation especially when the income from practice suddenly stops.
On average, a dental clinic employs at least a couple of individuals as the staff who carry out the duties of a chairside assistant and receptionist. Dental material suppliers and dental laboratories are directly dependent on the dentist for their livelihood. In the scenario when the practices have all but stopped all these individuals become jobless. A dental practice requires a significant amount of investment that most newcomers can’t afford. They are burdened with the educational loan, loan on the equipment, rentals for the clinic, etc. It involves eight years of intensive training for a dental surgeon to become a consultant. A significant amount of money and time is also invested in updating dental education. Most dentists depend exclusively on their practices for their income. Sudden and complete stoppage of income in a context where the margins are particularly thin makes that segment of practitioners extremely vulnerable.
On the professional front, there are no clear timelines on when the practices will start and the kind of changes that are required to accommodate these new requirements. To comply with the standards of infection control and significant further investment will be required in each dental practice. Arranging for funds in these circumstances will be excruciatingly difficult if not impossible.
Change in clinic layouts and designs and procurement of instruments for asepsis and social distancing will be very difficult for individuals practicing in metro cities where space is at a premium. Such practitioners might have to relocate to a different location or quit practice altogether. That is a scary prospect for most. The costs of dental treatment will naturally go up significantly as the dentists will have to recover the charges for the upgradations and PPEs form the patients. This will put uninsured and poor patients at a disadvantage.
On the personal front, the stress of meeting the financial obligations towards their family and staff will put tremendous strain on the dentists. Dentists are particularly meticulous people with keen attention to detail and passion for their work. Suddenly being put out of their job for an indefinite period can cause a tremendous psychological impact on the fraternity. This is often not discussed but is an important aspect of the lockdown.
Also, indefinite closing down of practices can lead to a public health emergency, particularly if patients with severe oral complications are not attended to and the dentists can’t deliver dental treatment without adequate precautions as it can put the entire community at risk.
The regulatory agencies, the Dental Council of India, the Ministry of Health, and the state governments must brainstorm and seriously look into this issue and must come up with definite strategies to assist dental practitioners and help create a roadmap for gradual restarting of practices.
Dr. Aniruddh Bhaidkar is a Masters in Healthcare Management from the University of Manchester, UK and is a guest faculty for MBA Healthcare And Hospital Management at the DY Patil University, Pune
