Difference in Disinfection Protocols in Dental Institutions and Private Dental Practice Pre and Post COVID - A Questionnaire-Based Study

Abstract

Background: Aerosols (< 50μm) containing microorganisms are generated from an infected individual and propelled a short distance by coughing and talking without a mask. Combined with a closed environment such as a dental clinic, it can cause a greater degree of transmission. It has been found that virus can survive upto 72 hrs on plastics, fabrics and metals. Microorganisms in blood, oral fluid, conjunctival, nasal droplets can thrive for even 29 days. Thus, proper disinfection especially in a clinical setting that caters to sick patients becomes a must. The challenge for a dentist is more because it involves multiple people in a chain starting from the doctor, assistant, runner, supervisor, laboratory technician to runner and doctor again.

Objective: to create an awareness of the importance of disinfection among dental practitioners in the pandemic situation by answering if there is a change in disinfection protocol in the current clinical setting.

Methods: A questionnaire involving closed end multiple choice questions on the different disinfectants used, the frequency and concentration of disinfectant used on different materials, equipment, surfaces pre and post COVID was distributed electronically to 300 private dental practitioners in Tamilnadu. The responses were collected and tabulated. Descriptive and inferential statistics were done.

Results: The survey revealed that the fumigation frequency has increased to 43% participants. In our survey there has been an enormous 87% increase in use of PPE especially filter face pieces and gowns fierce the pandemic. There is an increased usage of sodium hypochlorite for disinfection of surfaces and a reduction in the usage of alcohol-based products. As for the disinfection of skin and oral mucosa povidone iodide is still most predominantly used disinfectant followed by alcohol-based products. Solutions used for instrument disinfection have also been increased. UV has become a better option for many dentists after the pandemic for disinfecting impressions, dentures, instruments, casts etc. Impression disinfection has also seen a 22% surge with gluteraldehyde being the most regularly used solution. There is a total percentage increase in disinfection of dentures and casts too. The survey also revealed a drastic increase in concentration and duration of disinfection too.

Conclusion: From the survey conducted among 300 dentists in Tamilnadu it may be concluded that the pandemic has caused an increased fear of contraction of the virus and thus their need to use disinfectants more intensively eventhough it is not necessary in most cases. One must keep in mind the possible health hazards and environmental pollution too. One must be aware of the indication, Pros and cons of using a particular disinfectant. More research is needed on producing disinfectants that are less toxic and environment friendly and the long-term side effects of usage of newer disinfectants that are currently in the market.