Dentistry and the danger of the coronavirus in Israel

There is no profession more at risk from the corona virus than dentistry. The Ministry of Health has let dentists go back to work at the end of April. Even with all of the regulations they publicized the result is that all dental health care workers and their patients are at high risk to contract the virus. During dental treatment the virus is aerosolized. The CDC in the US claims that the virus can stay in aerosol form for up to three hours. They insist on at least 15 minutes between patients so most of the aerosol will settle. They also say that an air purifier with a HEPA filter system (which removes 99% of viruses from the air) should be present in the treatment room and they recommend the use of an AV system that kills the viruses in the room. They also recommend postponing most dental treatment, only performing treatment necessary to prevent immediate deterioration of dental health. Here in Israel the Health Ministry requires checking the patients temperature and the use of PPE (personal protective equipment) by the dental personnel. Other than that ,routine dentistry is being performed in all of the kupot cholim dental clinics and in most private clinics. I am not aware of any of the kupot clinics installing air purifier systems in their treatment rooms. Some private clinics have, probably most have not. Certainly in the kupot clinics there is no 15 minute break between patients.

This situation is dangerous to the dental staff and the patients. If an asymptomatic virus carrying patient is treated in the dental chair, it is very likely the virus will be transmitted to other patients and perhaps the dental staff, even if all the regulations of the Israeli health ministry department of dental health are followed.

Recent studies have shown that perhaps 2% of the population already have the virus. Statistically the odds of asymptomatic carriers receiving dental treatment is quite high, It is inevitable that in this situation that many dentists and auxiliary personnel as well as patients will be infected in dental clinics.

The only way dental clinics can be maintained as safe environments for both personnel and patients is with a system of rigorous testing. The technology exists for highly accurate  covid-19 tests that give results within 20 minutes. Every dental patient should be required to undergo such a test on the day of treatment or the day prior. The tests could be administered by the kupot cholim. Those that test negative will be given a certificate that clears them for dental treatment for the next few days.

This week I wrote to Minister of Health Edelstein and the head of the dental health department at the Ministry of Health explaining my opinion on this matter. I have yet to receive any response.

It is the responsibility of the Ministry of Health to protect the health of dental care workers and their patients. Currently it is failing in this task.