International Journal of Oral Health Dentistry 20206(2)122ndash125

Content available at iponlinejournalcom

International Journal of Oral Health Dentistry

Journal homepage wwwipinnovativecom

Original Research Article

Epidemiology of dental health A guidance to manage dental problems in novelcoronavirus (COVID-19) pandemic outbreak in India

Rahul Shrivastava1 Nivedita Mishra2 Rohit Shrivastava3 Ritu Sharma3

1Dept of Pediatric Research King Edwards Memorial Hospital Research Centre Pune Maharashtra India2Janaseva Foundation Pune Maharashtra India3Ekdanta Dental Care Bhopal Madhya Pradesh India

A R T I C L E I N F O

Article historyReceived 20-04-2020Accepted 18-05-2020Available online 21-07-2020

KeywordsCOVID-19Oral healthPandemicDental emergenciesSARS-CoV

A B S T R A C T

COVID-19 is a virus belonging to the family of coronaviridae comprising large single plus-stranded RNAas their genome Two out of four genera of coronavirus α-CoV and szlig-CoV cause infection and directlyaffects respiratory tract in humans During the global pandemic situation dental care consultation andmanagement of oral diseases is the biggest challenge for the dentist to treat their patient because of thehigh chances of transmission of this disease This article aims to provide basic guidelines for practisingduring COVID-19 in the dental care settings with preventive and control measures approved by the healthdepartment Furthermore this also encourages new researchers to explore more relation between COVID-19 and oral health by incorporating technologies practising teledentistry

copy 2020 Published by Innovative Publication This is an open access article under the CC BY-NC license(httpscreativecommonsorglicensesby-nc40)

1 Background

ldquoCorona Virus Disease (COVID-19)rdquo is the name ofexisting novel viral pneumonia which is coined by WHOin 2020 whereas the international Committee on Taxonomyof Viruses (ICTV) suggested this novel coronavirus asldquoSevere Acute Respiratory Coronavirus-2 (SARS CoV-2)rdquobased on phylogenetic and taxonomic analysis of pandemicnovel coronavirus1 This virus belongs to the family ofcoronaviridae of the order Nidovirales comprising largesingle plus-stranded RNA as their genome23

Currently there are four genera known for coronavirusesie α-CoV szlig-CoV γ-CoV and δ -CoV(45) Most of thecoronavirus is capable to cause the infectious diseases inhuman and vertebrates where two of them α-CoV andszlig-CoV mainly infect the respiratory gastrointestinal andcentral nervous system of humans and mammals while γ-CoV and δ -CoV mainly infect the birds24ndash6

Corresponding authorE-mail address rahulshrivastavamph14gmailcom (R

Shrivastava)

Novel Coronavirus disease (COVID-19) is an infectiousviral disease caused by a newly discovered virus generawhere most of the people infected with and experiencemild to moderate respiratory illness with hyperthermiadry cough sore throat increased work of breathingand muscle pain confusion etc It affects mostlythe vulnerable population including older people withcompromised immunity comorbidites such as diabetesmallitus hypertension coronary heart diseases etc It istransmitted through droplets of saliva or discharge from thenose when infected individual sneezes or coughs Althoughat point of time there is no specific vaccination available tocure this disease but many ongoing clinical trials evaluatingits potential treatment globally However its transmissioncan be controlled by protecting yourself and others frominfection by washing your hands with soap using alcohol-based hand rub and avoid touching your face eyes or mouthand use of face mask

The pandemic outbreak of (COVID-19) has become amajor public health burden globally On January 30 2020India reported its first case in its Godrsquos own country Kerala

httpsdoiorg1018231jijohd2020022395-4914copy 2020 Innovative Publication All rights reserved 122

Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125 123

state which rose to three cases within 3 days confirmed instudents who had recently returned from Wuhan China On4 March 22 new cases came to light including those ofan Italian tourist group with 14 infected members and astime passes positivity rises exponentially from 3 to 4714 byApril 9th with accounting mortality of 149 Figure 17

Fig 1 Semilog plot of the spread of SARS-CoV-2 and of COVID-19 deaths in IndiaSource MoHFW GoI

The transmission increased during March were linkedto people with a travel history to affected countries werereported Looking into the situation COVID-19 pandemicoutbreak was declared across the nation and provisionsof the Epidemic Diseases Act 1897 was invoked inthe entire country with name as ldquoJanta Curfewrdquo whereeducational institutions private multi-nation companies andmany commercial establishments were shut down Indiaeven suspended all tourist visas as the majority of theconfirmed cases were linked to other countries8 India couldhave witnessed a surge of approximately 31000 cases of adisease in a couple of weeks between March 24 and April 14without lockdown as suggested by Shiv Nadar University 9

2 What is Oral Health

Oral health is a key indicator of overall health well-beingand quality of life It encompasses a range of diseasesand conditions that include dental caries Periodontaldisease Tooth loss Oral cancer Oral manifestations of HIVinfection Oro-dental trauma Noma and birth defects suchas cleft lip and palate The Global Burden of Disease Study2017 estimated that oral diseases have affected 35 billionpeople worldwide with untreated dental caries being amongthe most prevalent non-communicable diseases Accordingto the International Agency for Research on Cancer theincidence of oral cancer was within the top three of allcancers in some Asian-Pacific countries in 201810

3 Burden of Oral Health Problem

In many developing countries access to oral health servicesis limited due to deprived public infrastructure and unethical

practices and other reasons where teeth are often leftuntreated extracted because of patientrsquos negligence InAsia the age-standardized incidence rate per 100000population ranges from 07 in China to 46 in Thailand and126 in India The high incidence rates relate directly torisk behaviours such as smoking use of smokeless tobacco(eg betel nut) and alcohol consumption At present thedistribution and severity of oral diseases vary amongdifferent parts of the world and within the same country orregion11

4 Epidemiology of COVID-19 and Oral Health

To current scenario where dentists were not allowed topractice usual dental service delivery expectations for anydental emergencies this document aims to encourage andevolve with an inductive approach for the management ofdental problems during dental emergencies It can be usedin conjunction with the state health board and other localprocedure that has been established and can encourage aconsistent managing the patients based on their Cov-19situation

One of the main aspects pointed out to epidemiology isits integration in dental public health practices There is adearth of reported dental burden in the available literaturewhere researchers can prove the spurious relationshipbetween coronavirus and dental conditions With a huge gaplies between the populationsrsquo inadequate knowledge anddecision making establishing effective preventive measuresFollowing triad would help to understand the causalrelationship between the two Figure 2

Fig 2 Epidemiological triad of COVID-19 and dental problems

5 Probable Route of Transmission in Dental Settings

An infected person visiting dental settings can be dangerousfor the doctor as well as for technicians and other dentalstaffs Probable spread of COVID-19 can be either throughsneezingcoughing of a patient or as a carrier of infectionfrom outside This can be better understood describing how

124 Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125

this infection is transmitted from one infected person toa larger group of individuals causing ldquoCommunity spreadFigure 3 This describes how this infection is transmittedfrom one infected person and can be transmitted into agroup of individuals causing ldquoCommunity spreadrdquo Dentalprofessionals can be exposed to infections that can infectthe oral cavity and respiratory tract Dental care settingsalways carry a risk of COVID-19 infection due to specificdental procedure where face-to-face communication withpatients and frequent exposure to blood saliva other bodyfluid and handling sharp dental instruments is involvedThis virus can be easily transmitted through inhalation ofairborne microorganisms that can remain for a suspendedperiod in the air for long when comes in contact withblood any fluid material or other infected patient contactof nasal conjunctival oral mucosa with the droplets and orany aerosols containing microorganisms generated from aninfected person These can be easily propelled while treatingthe patient

Once the dental professional exposed to an infection theycan turn symptomatic over the incubation period and spreadthe infection to the group where they meet others Since thereproducibility rate of COVID-19 is 2 to 3 which meanseach new case could produce 2-3 new secondary cases Thiscould lead to a community spread in the geographic area

However breaking this chain can be a possiblepreventive measure to stop further spread of the infectionin the community if an infected individual can ldquoself-quarantinerdquo and maintain ldquosocial distancingrdquo for a periodin which the infectivity rate of the virus comes down

Fig 3 Illustration of probable transmission of COVID-19 froman infected individual to community spread thrugh a dental caresettings

6 General Principles to follow

1 Dental care settings should prioritize the most urgentcare need for assessment of patient

2 As far as possible consultation should be providedeither via phone call or social platforms like telegramwhatsapp email etc practising teledentistry to avoid

transmission of COVID-19 at dental care settings3 During the clinical treatment of any emergency cases

COVID-19 status must be established and recorded asper the local health board system protocols

4 As far as possible the patient should be advised tocall back within 72 hours of the consultation if theirsymptoms have not resolved and treatment optionsshould be avoided

5 Following the local health guidelines for the pre-vention of COVID-19 transmission should be strictlyincorporated while treating emergency cases

6 Appropriate record to be maintained for such casesand report to the concerned local authority

7 Only approved ICT materials should be used fordisseminating the information

8 Liaising with local pharmacists to make surerecommended drugs are available to your patientsimmediately

7 Recommendations for Dental Practice

Due to the scarce information on approved protocols relatedto dental care settings interim guidelines on infectedperson and control during healthcare is recommended whenCOVID-19 infection is suspected (WHO 2020) Some of theprobable recommendations can be referred to prevent thespread of COVID-19 by strictly and intense use of personalprotection measures and avoid or minimize any minormajordental surgical modalities that can produce dropletsaerolsin dental settings Saliva ejectors with highlow volumecould be used for the production of droplets and aerosols12

8 Future Scope

With all facts and figures encountered it is clear thatthis COVID-19 pandemic is of major public health burdenglobally With the use of technologies like teledentistryand robotic surgeries can be very useful in handling suchsituations which has proved its efficiency in treating thepatients As a new approach in managing the preventionand control of oral diseases where prevention and controlof contagious diseases can be taken care of this couldfurther explore a new field in population-based informaticswith ease of surveillance for the risk of transmission andcontrol of this fatal COVID-19 disease in dental patients indeveloping countrie

9 Conclusion

COVID-19 is highly infectious disease causing globalpublic health burden of disease With proper preventionand control strategies the transmission can be controlledin the community Medical professionals including thedentist are more prone of getting this infection from aninfected patient while treating in the dental care settingsExtra care to be taken while treating any emergency cases

Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125 125

following the guidelines issued by Ministry of Health ampFamily Welfare Government of India and maintainingthe records and reporting to the local authority forsuch cases This article will help researchers to exploremore in the field of teledentistry where usual dentalconsultations are not possible during COVID-19 pandemicsituation With advanced technology-oriented surveillanceand management of oral disease could be helpful for wayforward for teledentistry in rural and tribal areas where thepopulation are deprived of getting even basic services

10 Source of Funding

None

11 Conflict of Interest

There is no conflict of interest declared by the author

References1 Gorbalenya AE Baker SC Baric RS Groot RJD Gulyaeva AA

Haagmans BL et al he species and its viruses ndash a statement of theCoronavirus Study Group 2020 Available from httpswwwbiorxivorgcontent10110120200207937862v1full

2 Maier HJ Bickerton E Britton P Coronaviruses Methods andprotocols Coronaviruses Methods Protoc 20151282(1)1ndash282

3 Gorbalenya AE Enjuanes L Ziebuhr J Snijder EJ NidoviralesEvolving the largest RNA virus genome Virus Res 2006117(1)17ndash37

4 Perlman S Netland J Coronaviruses post-SARS update onreplication and pathogenesis Nat Rev Microbiol 20097(6)439ndash50

5 Weiss SR Leibowitz JL Coronavirus pathogenesis Adv Virus Res20118185ndash164

6 Yin Y Wunderink RG MERS SARS and other coronaviruses ascauses of pneumonia Respirol 201823(2)130ndash7

7 MoHFW mdash Home Available from httpswwwmohfwgovin8 Coronavirus Impact India Suspends All Tourist Visas Till April 15

- 10 Available from httpswwwndtvcomindia-newscoronavirus-impact-visas-to-india-suspended-till-april-15-2193382

9 India would have seen 31000 coronavirus cases withoutlockdown Researches mdash Deccan Herald Available from httpswwwdeccanheraldcomnationalindia-would-have-seen-31000-coronavirus-cases-without-lockdown-researches-821010html

10 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1

11 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1lastaccessedonapril-20-2020

12 Meng L Hua F Bian Z Coronavirus Disease 2019 (COVID-19)Emerging and Future Challenges for Dental and Oral Medicine JDent Res 202099(5)481ndash7

Author biography

Rahul Shrivastava Project Manager Public Health Researcher (PhDMPH FAGE BDS)

Nivedita Mishra Research Associate Internal NABH auditor (MHA BDS)

Rohit Shrivastava Founder Implantologist Consultant (MHA MBABDS FAGE)

Ritu Sharma Consultant (MBA BDS FAGE)

Cite this article Shrivastava R Mishra N Shrivastava R Sharma REpidemiology of dental health A guidance to manage dental problemsin novel coronavirus (COVID-19) pandemic outbreak in India Int JOral Health Dent 20206(2)122-125

Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125 123

state which rose to three cases within 3 days confirmed instudents who had recently returned from Wuhan China On4 March 22 new cases came to light including those ofan Italian tourist group with 14 infected members and astime passes positivity rises exponentially from 3 to 4714 byApril 9th with accounting mortality of 149 Figure 17

Fig 1 Semilog plot of the spread of SARS-CoV-2 and of COVID-19 deaths in IndiaSource MoHFW GoI

The transmission increased during March were linkedto people with a travel history to affected countries werereported Looking into the situation COVID-19 pandemicoutbreak was declared across the nation and provisionsof the Epidemic Diseases Act 1897 was invoked inthe entire country with name as ldquoJanta Curfewrdquo whereeducational institutions private multi-nation companies andmany commercial establishments were shut down Indiaeven suspended all tourist visas as the majority of theconfirmed cases were linked to other countries8 India couldhave witnessed a surge of approximately 31000 cases of adisease in a couple of weeks between March 24 and April 14without lockdown as suggested by Shiv Nadar University 9

2 What is Oral Health

Oral health is a key indicator of overall health well-beingand quality of life It encompasses a range of diseasesand conditions that include dental caries Periodontaldisease Tooth loss Oral cancer Oral manifestations of HIVinfection Oro-dental trauma Noma and birth defects suchas cleft lip and palate The Global Burden of Disease Study2017 estimated that oral diseases have affected 35 billionpeople worldwide with untreated dental caries being amongthe most prevalent non-communicable diseases Accordingto the International Agency for Research on Cancer theincidence of oral cancer was within the top three of allcancers in some Asian-Pacific countries in 201810

3 Burden of Oral Health Problem

In many developing countries access to oral health servicesis limited due to deprived public infrastructure and unethical

practices and other reasons where teeth are often leftuntreated extracted because of patientrsquos negligence InAsia the age-standardized incidence rate per 100000population ranges from 07 in China to 46 in Thailand and126 in India The high incidence rates relate directly torisk behaviours such as smoking use of smokeless tobacco(eg betel nut) and alcohol consumption At present thedistribution and severity of oral diseases vary amongdifferent parts of the world and within the same country orregion11

4 Epidemiology of COVID-19 and Oral Health

To current scenario where dentists were not allowed topractice usual dental service delivery expectations for anydental emergencies this document aims to encourage andevolve with an inductive approach for the management ofdental problems during dental emergencies It can be usedin conjunction with the state health board and other localprocedure that has been established and can encourage aconsistent managing the patients based on their Cov-19situation

One of the main aspects pointed out to epidemiology isits integration in dental public health practices There is adearth of reported dental burden in the available literaturewhere researchers can prove the spurious relationshipbetween coronavirus and dental conditions With a huge gaplies between the populationsrsquo inadequate knowledge anddecision making establishing effective preventive measuresFollowing triad would help to understand the causalrelationship between the two Figure 2

Fig 2 Epidemiological triad of COVID-19 and dental problems

5 Probable Route of Transmission in Dental Settings

An infected person visiting dental settings can be dangerousfor the doctor as well as for technicians and other dentalstaffs Probable spread of COVID-19 can be either throughsneezingcoughing of a patient or as a carrier of infectionfrom outside This can be better understood describing how

124 Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125

this infection is transmitted from one infected person toa larger group of individuals causing ldquoCommunity spreadFigure 3 This describes how this infection is transmittedfrom one infected person and can be transmitted into agroup of individuals causing ldquoCommunity spreadrdquo Dentalprofessionals can be exposed to infections that can infectthe oral cavity and respiratory tract Dental care settingsalways carry a risk of COVID-19 infection due to specificdental procedure where face-to-face communication withpatients and frequent exposure to blood saliva other bodyfluid and handling sharp dental instruments is involvedThis virus can be easily transmitted through inhalation ofairborne microorganisms that can remain for a suspendedperiod in the air for long when comes in contact withblood any fluid material or other infected patient contactof nasal conjunctival oral mucosa with the droplets and orany aerosols containing microorganisms generated from aninfected person These can be easily propelled while treatingthe patient

Once the dental professional exposed to an infection theycan turn symptomatic over the incubation period and spreadthe infection to the group where they meet others Since thereproducibility rate of COVID-19 is 2 to 3 which meanseach new case could produce 2-3 new secondary cases Thiscould lead to a community spread in the geographic area

However breaking this chain can be a possiblepreventive measure to stop further spread of the infectionin the community if an infected individual can ldquoself-quarantinerdquo and maintain ldquosocial distancingrdquo for a periodin which the infectivity rate of the virus comes down

Fig 3 Illustration of probable transmission of COVID-19 froman infected individual to community spread thrugh a dental caresettings

6 General Principles to follow

1 Dental care settings should prioritize the most urgentcare need for assessment of patient

2 As far as possible consultation should be providedeither via phone call or social platforms like telegramwhatsapp email etc practising teledentistry to avoid

transmission of COVID-19 at dental care settings3 During the clinical treatment of any emergency cases

COVID-19 status must be established and recorded asper the local health board system protocols

4 As far as possible the patient should be advised tocall back within 72 hours of the consultation if theirsymptoms have not resolved and treatment optionsshould be avoided

5 Following the local health guidelines for the pre-vention of COVID-19 transmission should be strictlyincorporated while treating emergency cases

6 Appropriate record to be maintained for such casesand report to the concerned local authority

7 Only approved ICT materials should be used fordisseminating the information

8 Liaising with local pharmacists to make surerecommended drugs are available to your patientsimmediately

7 Recommendations for Dental Practice

Due to the scarce information on approved protocols relatedto dental care settings interim guidelines on infectedperson and control during healthcare is recommended whenCOVID-19 infection is suspected (WHO 2020) Some of theprobable recommendations can be referred to prevent thespread of COVID-19 by strictly and intense use of personalprotection measures and avoid or minimize any minormajordental surgical modalities that can produce dropletsaerolsin dental settings Saliva ejectors with highlow volumecould be used for the production of droplets and aerosols12

8 Future Scope

With all facts and figures encountered it is clear thatthis COVID-19 pandemic is of major public health burdenglobally With the use of technologies like teledentistryand robotic surgeries can be very useful in handling suchsituations which has proved its efficiency in treating thepatients As a new approach in managing the preventionand control of oral diseases where prevention and controlof contagious diseases can be taken care of this couldfurther explore a new field in population-based informaticswith ease of surveillance for the risk of transmission andcontrol of this fatal COVID-19 disease in dental patients indeveloping countrie

9 Conclusion

COVID-19 is highly infectious disease causing globalpublic health burden of disease With proper preventionand control strategies the transmission can be controlledin the community Medical professionals including thedentist are more prone of getting this infection from aninfected patient while treating in the dental care settingsExtra care to be taken while treating any emergency cases

Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125 125

following the guidelines issued by Ministry of Health ampFamily Welfare Government of India and maintainingthe records and reporting to the local authority forsuch cases This article will help researchers to exploremore in the field of teledentistry where usual dentalconsultations are not possible during COVID-19 pandemicsituation With advanced technology-oriented surveillanceand management of oral disease could be helpful for wayforward for teledentistry in rural and tribal areas where thepopulation are deprived of getting even basic services

10 Source of Funding

None

11 Conflict of Interest

There is no conflict of interest declared by the author

References1 Gorbalenya AE Baker SC Baric RS Groot RJD Gulyaeva AA

Haagmans BL et al he species and its viruses ndash a statement of theCoronavirus Study Group 2020 Available from httpswwwbiorxivorgcontent10110120200207937862v1full

2 Maier HJ Bickerton E Britton P Coronaviruses Methods andprotocols Coronaviruses Methods Protoc 20151282(1)1ndash282

3 Gorbalenya AE Enjuanes L Ziebuhr J Snijder EJ NidoviralesEvolving the largest RNA virus genome Virus Res 2006117(1)17ndash37

4 Perlman S Netland J Coronaviruses post-SARS update onreplication and pathogenesis Nat Rev Microbiol 20097(6)439ndash50

5 Weiss SR Leibowitz JL Coronavirus pathogenesis Adv Virus Res20118185ndash164

6 Yin Y Wunderink RG MERS SARS and other coronaviruses ascauses of pneumonia Respirol 201823(2)130ndash7

7 MoHFW mdash Home Available from httpswwwmohfwgovin8 Coronavirus Impact India Suspends All Tourist Visas Till April 15

- 10 Available from httpswwwndtvcomindia-newscoronavirus-impact-visas-to-india-suspended-till-april-15-2193382

9 India would have seen 31000 coronavirus cases withoutlockdown Researches mdash Deccan Herald Available from httpswwwdeccanheraldcomnationalindia-would-have-seen-31000-coronavirus-cases-without-lockdown-researches-821010html

10 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1

11 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1lastaccessedonapril-20-2020

12 Meng L Hua F Bian Z Coronavirus Disease 2019 (COVID-19)Emerging and Future Challenges for Dental and Oral Medicine JDent Res 202099(5)481ndash7

Author biography

Rahul Shrivastava Project Manager Public Health Researcher (PhDMPH FAGE BDS)

Nivedita Mishra Research Associate Internal NABH auditor (MHA BDS)

Rohit Shrivastava Founder Implantologist Consultant (MHA MBABDS FAGE)

Ritu Sharma Consultant (MBA BDS FAGE)

Cite this article Shrivastava R Mishra N Shrivastava R Sharma REpidemiology of dental health A guidance to manage dental problemsin novel coronavirus (COVID-19) pandemic outbreak in India Int JOral Health Dent 20206(2)122-125

124 Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125

this infection is transmitted from one infected person toa larger group of individuals causing ldquoCommunity spreadFigure 3 This describes how this infection is transmittedfrom one infected person and can be transmitted into agroup of individuals causing ldquoCommunity spreadrdquo Dentalprofessionals can be exposed to infections that can infectthe oral cavity and respiratory tract Dental care settingsalways carry a risk of COVID-19 infection due to specificdental procedure where face-to-face communication withpatients and frequent exposure to blood saliva other bodyfluid and handling sharp dental instruments is involvedThis virus can be easily transmitted through inhalation ofairborne microorganisms that can remain for a suspendedperiod in the air for long when comes in contact withblood any fluid material or other infected patient contactof nasal conjunctival oral mucosa with the droplets and orany aerosols containing microorganisms generated from aninfected person These can be easily propelled while treatingthe patient

Once the dental professional exposed to an infection theycan turn symptomatic over the incubation period and spreadthe infection to the group where they meet others Since thereproducibility rate of COVID-19 is 2 to 3 which meanseach new case could produce 2-3 new secondary cases Thiscould lead to a community spread in the geographic area

However breaking this chain can be a possiblepreventive measure to stop further spread of the infectionin the community if an infected individual can ldquoself-quarantinerdquo and maintain ldquosocial distancingrdquo for a periodin which the infectivity rate of the virus comes down

Fig 3 Illustration of probable transmission of COVID-19 froman infected individual to community spread thrugh a dental caresettings

6 General Principles to follow

1 Dental care settings should prioritize the most urgentcare need for assessment of patient

2 As far as possible consultation should be providedeither via phone call or social platforms like telegramwhatsapp email etc practising teledentistry to avoid

transmission of COVID-19 at dental care settings3 During the clinical treatment of any emergency cases

COVID-19 status must be established and recorded asper the local health board system protocols

4 As far as possible the patient should be advised tocall back within 72 hours of the consultation if theirsymptoms have not resolved and treatment optionsshould be avoided

5 Following the local health guidelines for the pre-vention of COVID-19 transmission should be strictlyincorporated while treating emergency cases

6 Appropriate record to be maintained for such casesand report to the concerned local authority

7 Only approved ICT materials should be used fordisseminating the information

8 Liaising with local pharmacists to make surerecommended drugs are available to your patientsimmediately

7 Recommendations for Dental Practice

Due to the scarce information on approved protocols relatedto dental care settings interim guidelines on infectedperson and control during healthcare is recommended whenCOVID-19 infection is suspected (WHO 2020) Some of theprobable recommendations can be referred to prevent thespread of COVID-19 by strictly and intense use of personalprotection measures and avoid or minimize any minormajordental surgical modalities that can produce dropletsaerolsin dental settings Saliva ejectors with highlow volumecould be used for the production of droplets and aerosols12

8 Future Scope

With all facts and figures encountered it is clear thatthis COVID-19 pandemic is of major public health burdenglobally With the use of technologies like teledentistryand robotic surgeries can be very useful in handling suchsituations which has proved its efficiency in treating thepatients As a new approach in managing the preventionand control of oral diseases where prevention and controlof contagious diseases can be taken care of this couldfurther explore a new field in population-based informaticswith ease of surveillance for the risk of transmission andcontrol of this fatal COVID-19 disease in dental patients indeveloping countrie

9 Conclusion

COVID-19 is highly infectious disease causing globalpublic health burden of disease With proper preventionand control strategies the transmission can be controlledin the community Medical professionals including thedentist are more prone of getting this infection from aninfected patient while treating in the dental care settingsExtra care to be taken while treating any emergency cases

Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125 125

following the guidelines issued by Ministry of Health ampFamily Welfare Government of India and maintainingthe records and reporting to the local authority forsuch cases This article will help researchers to exploremore in the field of teledentistry where usual dentalconsultations are not possible during COVID-19 pandemicsituation With advanced technology-oriented surveillanceand management of oral disease could be helpful for wayforward for teledentistry in rural and tribal areas where thepopulation are deprived of getting even basic services

10 Source of Funding

None

11 Conflict of Interest

There is no conflict of interest declared by the author

References1 Gorbalenya AE Baker SC Baric RS Groot RJD Gulyaeva AA

Haagmans BL et al he species and its viruses ndash a statement of theCoronavirus Study Group 2020 Available from httpswwwbiorxivorgcontent10110120200207937862v1full

2 Maier HJ Bickerton E Britton P Coronaviruses Methods andprotocols Coronaviruses Methods Protoc 20151282(1)1ndash282

3 Gorbalenya AE Enjuanes L Ziebuhr J Snijder EJ NidoviralesEvolving the largest RNA virus genome Virus Res 2006117(1)17ndash37

4 Perlman S Netland J Coronaviruses post-SARS update onreplication and pathogenesis Nat Rev Microbiol 20097(6)439ndash50

5 Weiss SR Leibowitz JL Coronavirus pathogenesis Adv Virus Res20118185ndash164

6 Yin Y Wunderink RG MERS SARS and other coronaviruses ascauses of pneumonia Respirol 201823(2)130ndash7

7 MoHFW mdash Home Available from httpswwwmohfwgovin8 Coronavirus Impact India Suspends All Tourist Visas Till April 15

- 10 Available from httpswwwndtvcomindia-newscoronavirus-impact-visas-to-india-suspended-till-april-15-2193382

9 India would have seen 31000 coronavirus cases withoutlockdown Researches mdash Deccan Herald Available from httpswwwdeccanheraldcomnationalindia-would-have-seen-31000-coronavirus-cases-without-lockdown-researches-821010html

10 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1

11 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1lastaccessedonapril-20-2020

12 Meng L Hua F Bian Z Coronavirus Disease 2019 (COVID-19)Emerging and Future Challenges for Dental and Oral Medicine JDent Res 202099(5)481ndash7

Author biography

Rahul Shrivastava Project Manager Public Health Researcher (PhDMPH FAGE BDS)

Nivedita Mishra Research Associate Internal NABH auditor (MHA BDS)

Rohit Shrivastava Founder Implantologist Consultant (MHA MBABDS FAGE)

Ritu Sharma Consultant (MBA BDS FAGE)

Cite this article Shrivastava R Mishra N Shrivastava R Sharma REpidemiology of dental health A guidance to manage dental problemsin novel coronavirus (COVID-19) pandemic outbreak in India Int JOral Health Dent 20206(2)122-125

Shrivastava et al International Journal of Oral Health Dentistry 20206(2)122ndash125 125

following the guidelines issued by Ministry of Health ampFamily Welfare Government of India and maintainingthe records and reporting to the local authority forsuch cases This article will help researchers to exploremore in the field of teledentistry where usual dentalconsultations are not possible during COVID-19 pandemicsituation With advanced technology-oriented surveillanceand management of oral disease could be helpful for wayforward for teledentistry in rural and tribal areas where thepopulation are deprived of getting even basic services

10 Source of Funding

None

11 Conflict of Interest

There is no conflict of interest declared by the author

References1 Gorbalenya AE Baker SC Baric RS Groot RJD Gulyaeva AA

Haagmans BL et al he species and its viruses ndash a statement of theCoronavirus Study Group 2020 Available from httpswwwbiorxivorgcontent10110120200207937862v1full

2 Maier HJ Bickerton E Britton P Coronaviruses Methods andprotocols Coronaviruses Methods Protoc 20151282(1)1ndash282

3 Gorbalenya AE Enjuanes L Ziebuhr J Snijder EJ NidoviralesEvolving the largest RNA virus genome Virus Res 2006117(1)17ndash37

4 Perlman S Netland J Coronaviruses post-SARS update onreplication and pathogenesis Nat Rev Microbiol 20097(6)439ndash50

5 Weiss SR Leibowitz JL Coronavirus pathogenesis Adv Virus Res20118185ndash164

6 Yin Y Wunderink RG MERS SARS and other coronaviruses ascauses of pneumonia Respirol 201823(2)130ndash7

7 MoHFW mdash Home Available from httpswwwmohfwgovin8 Coronavirus Impact India Suspends All Tourist Visas Till April 15

- 10 Available from httpswwwndtvcomindia-newscoronavirus-impact-visas-to-india-suspended-till-april-15-2193382

9 India would have seen 31000 coronavirus cases withoutlockdown Researches mdash Deccan Herald Available from httpswwwdeccanheraldcomnationalindia-would-have-seen-31000-coronavirus-cases-without-lockdown-researches-821010html

10 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1

11 Available from httpswwwwhointhealth-topicsoral-healthtab=tab 1lastaccessedonapril-20-2020

12 Meng L Hua F Bian Z Coronavirus Disease 2019 (COVID-19)Emerging and Future Challenges for Dental and Oral Medicine JDent Res 202099(5)481ndash7

Author biography

Rahul Shrivastava Project Manager Public Health Researcher (PhDMPH FAGE BDS)

Nivedita Mishra Research Associate Internal NABH auditor (MHA BDS)

Rohit Shrivastava Founder Implantologist Consultant (MHA MBABDS FAGE)

Ritu Sharma Consultant (MBA BDS FAGE)

Cite this article Shrivastava R Mishra N Shrivastava R Sharma REpidemiology of dental health A guidance to manage dental problemsin novel coronavirus (COVID-19) pandemic outbreak in India Int JOral Health Dent 20206(2)122-125