Relooking at Routine Daily Procedures


MDA President Dr Leong Kei Joe (right) pictured with President of Malaysian Orthodontic Practitioners Association Dr Kathiravan Perumal (left) at a radio recording on 23rd January 2020 about fake braces and direct-to-consumer self-aligners for the purpose of educating the general public

President of the Malaysian Dental Association (MDA) Dr Leong Kei Joe reminds all members to continue to update themselves through verified sources and advisories released pertaining to the escalating concern of COVID-19 outbreak in their country.

“As part of the healthcare system that deals, most of time, directly at oral cavity with most of our treatment being aerosol producing procedures, we need to relook at our routine daily procedures, and explore the possibility to modify our practices in this difficult time,” said Dr Leong.

As part of the healthcare system (classified as essential services), private dental clinics can continue to operate. MDA proposes the following measures and precautions to be observed:

1.           Reduce their workload by only seeing emergency cases. Patients need to be informed early. All cases should be by appointments only if possible.

2.           Avoid overcrowding the waiting area.

3.           Even in the event of an emergency, it is preferable to call the clinic on the appropriate time to come in advance.

4.           Avoid or limit aerosol generating procedures, and the mandatory use of high-volume suction, with personal protective equipment (PPE).

5.           Dentists and assistants should be adequately protected from water droplets with facemasks, faceshields or goggles, headcovers, and gloves.

6.           Any non-emergency or elective cases need to be rescheduled.

7.           Patients should be screened as per previous advisories before being seated at the waiting area or entry into the surgical room for treatment.

8.           Adhere to the Codes of Professional Conduct when rejecting patients or refusing treatments.

9.           Cutting tools and instruments must be autoclaved and equipment surfaces disinfected before and after each patient. The dental chair and surrounding surfaces must be disinfected and left for 10 minutes before and after each patient.

10.         Pre-operative antimicrobial mouth-rinse, such as 0.12% or 0.2% chlorohexidine.

Ref. 1. Hong Kong Dental Association’s Recommended Precaution under Emergency Response Level Associated with the Novel Coronavirus (2019-nCoV) for Dentists and Clinic Staff.
Ref.2. Meng et. al.Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. Journal of Dental Research (2020) 00(0)

Other recommendations quoted is the use 1% hydrogen peroxide and 0.2% povidone.

Ref: Peng et. al. Transmission routes of 2019-nCoV and controls in dental practice. 2020. International Journal of Oral Science (2020)12:9

11.         All public areas of the clinic should be regularly disinfected 3-4 times a day.

MDA will continue to monitor and advice on the situation.