|Year : 2020 | Volume
| Issue : 2 | Page : 51-52
Dental implantology: Time to reflect in the shadows of COVID-19
ProSmile Dental Clinic and Implant Centre, Dr L H Hiranandani Hospital, Mumbai, Maharashtra, India
|Date of Submission||09-Dec-2020|
|Date of Acceptance||09-Dec-2020|
|Date of Web Publication||18-Dec-2020|
Dr. Sharat Shetty
ProSmile Dental Clinic and Implant Centre, Dr L H Hiranandani Hospital, Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shetty S. Dental implantology: Time to reflect in the shadows of COVID-19. J Dent Implant 2020;10:51-2
Enough progress has been done since the advent of the dental implants to provide safer and more predictable outcomes to our needy edentulous patients. These devices being human-made and mechanical units need biophysical considerations, and regular evaluations have to be made to identify and intervene appropriately to avoid, delay, and manage complications. Besides, the biological responses keep changing from stable supporting tissues to gradual and rapid degeneration and breakdowns. And for edentulous patients, no implant treatment may lead to disuse and premature atrophies, leading to major unwarranted interventional therapies later.
2020 has been an unprecedented year with the COVID-19 pandemic, and the crisis has been escalating due to rapid evolution with no manageable strategies in sight. The magnitude, unpredictable progression, and fearmongering have led to bigger divides within and between communities and countries, causing unfathomable negative health and economic impacts. As there is a strong realization now that the virus is going to persist for a long time, dental practice in general and dental implant treatment, in particular, will need to follow a new normal to avoid time sensitive and premature impairments due to a lack of appropriate treatments.
The last few months have seen a considerable increase in the dental diseases except those due to trauma. This is due to infrequent dental visits compounded by irregular, improper, and inadequate care rendered in these days of fearmongered atmosphere. Preventive dentistry is almost negligible, leading to the rapid progress of dental diseases and loss of teeth and surrounding oral structures. Lack of great enthusiasm and understanding among the dental fraternity has also added to improper management and access to established care provisions.
Edentulism, partial or total, is probably the most common functional and esthetic compromised dental complaint across the globe. The past and traditional replacement solutions could not satisfy all the patient's needs and desires. But implant-based treatments have demonstrated better outcomes and prognosis. However, they need the meticulous execution of evidence-based strategies, maintenance, and postrestorative monitoring. Moreover, it has become more relevant in these days of pandemic due to changed dynamics of dental treatment. It is time to understand and modify our attitude and approach to restore the past and avoid the devastating consequences of not meeting the standard requirements. The following needs attention and pondering to overcome the current obstacles:
- Restart dental clinics with standard universal care protocols more stringently: Recognize and better understand the disease process of COVID-19 and its risks as it affects the entire operations of the clinic. As there have no proved direct effects on dental health by the virus, the treatment deliveries and conventional care protocols which are scientifically proved must be undertaken more strictly. Systematic and sequential efforts will ensure minimal risks and avoid cumulative and catastrophic consequences. This will need proper planning, preparedness, and training and ensure awareness among the support staff. Similarly, institutes, due to their large size, should also adopt effective and efficient methods of training and committed innovations and creative protocols for safe and healthy environment for teaching and treating patients. This will necessitate regular meetings for modifications which are strongly based on collaborative, cooperative, and practical principles
- Understand and adopt respiratory hygiene and prevention measures: Dentists and their chairside assistants are one of the most prone to contract the viral disease due to their proximity to patients. The current evidences show that good respiratory protections are the key measures to avoid contact spread of this lurking disease. Unless the role of vaccine or disease-induced antibodies for long-term or life-time immunity is consistently proved, the mask and hand hygiene are here to stay
- Continuing implant education and training: The challenges of achieving the goals of implant dentistry can be accomplished through the process of continuous learning and first-hand training. The pandemic has halted most of the educational models across all disciplines. Although webinars ruled the roost in the past many months, clinical training have suffered. Hence, new graduates are devoid of any skill developments putting patients at immediate risks. Furthermore, experienced dentists will suffer from a lack of interactions with the implant mentors, and all modalities of advanced implant treatment and management of complications will be threatened. In the end, it will be bad fortune and disadvantageous to the patients. Hence, there is an utmost urgency for all stakeholders of implant education to reset the knowledge and skill-sharing programs for students and practitioners. Else there will be chaos, silent decay of established implant practices, and decline in the proper use of this valuable therapeutic science
- Fulfillment by the dental industry: The technical aspect of implant dentistry is skewed due to the individualized component designs for every system with no compatibility with others. Hence, when transport and manufacturing logistics are disrupted like the way we see during this pandemic, regular supplies have been threatened due to limited stocks, almost no replenishments, and poor delivery systems. The impact of this phenomenon has been serious. Hence, there is a need to sort out this human-made vulnerable situation due to unpreparedness among the industry players. The situation will improve in future with solutions available to tackle the main cause of pandemic and the world returning to the previous pattern, but a new normal will have to be created even for the dental industry through various realistic self-assessments and be prepared to cater even in most hostile conditions so that the benefits of implant dentistry are not compromised
- Organized dental laboratory sector: Success in implant dentistry is based on a strong association between good clinical steps and superior laboratory support. The COVID pandemic has exposed the limitations of many unorganized dental laboratories to deal with safe in-house procedures to a lack of all amenities necessary for superior fabrications with reduced risks. It is a wakeup call for the dental laboratories to be streamlined and be responsibly setup with proper rigorous training and follow accepted norms
- Enhanced research specific to pandemic influence on implant practice: Like any other surgical or clinical discipline, there exists a theoretical risk of viral transmission, however low it may be. Extensive investigations are warranted to identify the potential influences of the current pandemic occupational risks and undertake modified measures to ensure safe practice of the well-established implant dentistry. A collaborative and cooperative effort across the globe will help establish comprehensive protocols to mitigate the potential risks of this contagious disease.
Like an inactive volcano which becomes active, COVID-19 experience has raised an ugly head for which no one was ready and expecting, leading to a rapid worsening of the health in particular and all aspects of work and profession. Clearly, we have a long way ahead to achieve the new normal and optimal modalities of rendering dental services. There is a strong need to work in partnerships with policy and decision-makers, industry, dental institutions, and dental health professionals to understand and undertake initiatives to halt the current trends of unorganized and slow inevitable progression of the dental health-care system. This is going to be a long and weary path, but we must tread painstakingly.
“There needs to be a shift in consciousness; there needs to be an absolute wake-up call before society can actually make the kind of incredibly significant changes that need to happen.”
- Annie Lennox