Letter to the Editor

Cuban stomatology during Covid-19. Other considerations

Marisol Cuyac Lantigua¹ 
http://orcid.org/0000-0001-9721-5806

Joel Díaz Guerra^{1  *} 
http://orcid.org/0000-0002-9034-4485

¹Universidad de Ciencias Médicas de Matanzas, Matanzas, Cuba.

Mr. Editor:

The journal Gaceta Médica Espirituana, vol.23(3) 2021, published the editorial "Covid-19 and its impact on dental care in Sancti Spíritus", it reflected that 17627 patients in this pandemic period needed attention of dental care services so there was a directly proportional growth of emergency care and confirmed cases with Covid-19. ¹

In March, 2020 the World Health Organization (WHO) determined that Covid-19 could be characterized as a pandemic, caused by SARS-CoV-2, a virus discovered in Wuhan, China, in late December 2019. Since then, WHO is facing a pandemic with lethal characteristics and a spread never seen before in human history. ²

Procedures in dental care encompasses frequent exposure to saliva, blood and other body fluids, and the handling of sharp instruments, including the use of a high-speed handpiece or ultrasonic instruments. ³

Infections can occur through direct contact between mucous membranes and contaminated hands; or by contact with contaminated surfaces; ⁴ due to this situation, stomatologists are considered the first line of diagnosis, since there is continuous exposure to microorganisms and direct contact with patients.

At the beginning of 2020, in view of the new epidemiological situation, Cuba designed a national strategic plan to challenge Covid-19. Hospital and dental care services were reorganized and the latter were made available on an emergency basis; from March onwards, medical science students and dental care professionals were incorporated into active research work in different health areas with the aim of identifying patients with respiratory infection. ⁵

Stomatologists are a component of the Cuban health system and perform their work in different situations, either directly with the patient´s care in clinics or hospitals or as an active part of the basic health team in preventive or extra types of work. Confronting this new pandemic, it is important to be well informed, to serve as health promoters in the communities and to comply with protective measures to avoid infection by the virus.

The characteristics of the new coronavirus require the reinforcement of protocols and the incorporation of new guidelines to protect health personnel. Dental care context is extremely risky, taking into account the proximity between the patient and the stomatologist also the aerosols resulting from the treatments to be performed. It is a duty the professional to be constantly updated and to guarantee a responsible attitude in the dental care clinic to avoid turning this place into an unfortunate focus of transmission. Each patient attending the dental office should be evaluated as a possible infected by the virus, so disinfection protocols cannot be minimized. The patient deserves a consultation without the risk of cross-infection; this will only be achieved with coordinated, timely and effective actions.

The number of dental care emergencies attended during this pandemic period suggests the respect of the existing measures and the implementation of some others of strict compliance by the dental care personnel and patients; the following should be considered:

• To modify the circulation of patients and clinical staff, the physical position of work areas and create space to keep adequate distance.

• Moistened matting with a sodium hypochlorite solution at the entrance of the clinic, in addition to antibacterial gel or an alcohol-based antiseptic solution.

• Acrylic screens and physical barriers will be placed at the reception desk to allow only the exchange of documents.

• The personnel, prior protection protocol, will clean the work surfaces in each working area with sodium hypochlorite.

• Elimination of contaminating objects; magazines, newspapers, brochures, etc. that can be touched in the waiting room should be removed.

• The personnel should protect themselves using surgical gown, mask and cap; hair should be tied, earrings, rings and watches should be removed. As for the patient, only remove the protective mask at the precise moment of care and do not enter with companions whenever possible.

• When opening the clinic, it should be considered to check the state of health of the personnel that will be working.

• A pair of gloves and a protective mask should be used per patient and the mask and protective glasses should be cleaned at the end of each appointment.

Strict and responsible compliance with all care protocols established during Covid-19 by the personnel working at the dental care services will allow maintaining and improving the results that the country presents today for the pandemic control and elimination, as well as avoiding the risk and maintaining the quality of care needed by the patient.

REFERENCIAS BIBLIOGRÁFICAS

1. Mursulí Sosa MZ, Fernández González A, García Lizama J. Covid-19 y su repercusión en la atención estomatológica en Sancti Spíritus. Gac Méd Espirit [Internet]. 2021 [citado 9 Ene 2022];23(3):22-7. Disponible en: Disponible en: http://revgmespirituana.sld.cu/index.php/gme/article/view/2283/pdf_1

2. WHO. Coronavirus disease 2019 (COVID-19). Situation Report Ð 70 [Internet]. Ginebra: WHO; 2020. [cited 2021 Mar 18]. Available from: Available from: http://www.who.int/docs/default-source/coronaviruse/situation-reports/20200330-sitrep-70-covid-19.pdf?sfvrsn=7e0fe3f8_2

3. Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci [Internet]. 2020 [cited 2021 Mar 18];12(1):9. Available from: Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054527/pdf/41368_2020_Article_75.pdf

4. Morales Navarro D. Riesgos y retos para los profesionales de las disciplinas estomatológicas ante la COVID-19. Rev haban cienc méd [Internet]. 2020 [citado 10 Oct 2021];19(2). Disponible en: Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3256/2529

5. Cuba. Minsap. Protocolo vs COVID-19 [Internet]. La Habana: Minsap; 2020. [citado 10 Oct 2021]. Disponible en: Disponible en: https://covid19cubadata.github.io/protocolos/protocolo-version-2.pdf

Received: August 24, 2021; Accepted: October 12, 2021