Dentistry will be different once dental practice resumes

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Dr. Leslie Fang holds the John R. Gallagher III and Katherine A. Gallagher Endowed Chair in Clinical Excellence at Massachusetts General Hospital and Harvard Medical School, U.S. He has established a unique position as a lecturer bridging medicine and dentistry. (Image: Leslie Fang)
Claudia Duschek, DTI

By Claudia Duschek, DTI

Thu. 28. May 2020


Dr. Leslie Fang is a world-renowned physician, educator and businessman who has been lecturing extensively about the implications of SARS-CoV-2 for dentistry over the past weeks. Fang is also on the speaker roster for 3Shape’s upcoming 24-hour online symposium, during which he will outline practical recommendations for dental professionals to help them return safely to work.

Dr. Fang, what have been the greatest challenges for dentists in the past months?
I have given ten webinars over the past three months to over 20,000 participants globally. It is clear that dental professionals want to do the correct things for their patients, their staff, their families and themselves. The science is evolving so rapidly that most feel that they are trying to drink from a fire hydrant. They want correct information to guide them regarding good practice.

Dental professionals are mainly concerned about three things: access to personal protective equipment, costs of making the practice environment safe and necessary restructuring measures for the new normal.

As dental practices worldwide start to reopen after lockdowns, dental professionals are struggling to keep staff and patients safe. Do you think that dentists are prepared for practice under the restrictions imposed by a SARS-CoV-2 reality?
The fortunate part of this pandemic is that most of dentistry has been closed globally. This allows time for people to reflect upon how they are to return to work safely. There is no lack of information or guidelines, and I think that the dental professionals are now sitting on an average of at least 30 hours of information on what the dental visit should look like in the changed environment. The guidelines are, in general, well thought out. However, some solutions are difficult and expensive to implement, while others would negatively impact the workflow. There is clearly no lack of guidelines, and one just needs to adopt the best practice that is feasible within the given environment.

In the upcoming webinar, I will describe all of the modalities that have been proposed to optimize the safety of patients, dentists and staff, and their families.

“Things will look alien during the initial phases, reflecting ongoing concerns about infection with SARS-CoV-2 by both the patient and the dental professional”

Aerosols are a particular problem in dental practice. How can this be addressed?
There are 19 different suggestions that have been proposed to address this issue, including

  • minimizing aerosol-generating procedures;
  • pre-rinsing with a mouthwash or oral spray;
  • the use of disinfectants in the reservoir for instruments;
  • the use of mechanical barriers such as dental dams;
  • the use of absorbents to minimize saliva in the operative field;
  • the use of high-volume evacuators;
  • four-hand procedures;
  • the use of at-source aerosol vacuum devices;
  • the use of air purification systems, ranging from simple air purifiers to expensive use of ultraviolet-C in heating, ventilating and air conditioning systems; and
  • the use of chemical fogging for aerosolized viruses.

I have detailed all of these in a manual titled The Dental Response to COVID-19 Guidelines, which addresses the implications of SARS-CoV-2 for dental practice, covering what dentists will need to do to prepare for dental visits going forward. While not all options are practical for all dental professionals alike, most will find satisfactory solutions in their practices to address this vexing issue. I will be delineating these options in the upcoming webinar.

In your opinion, what will the new normal in dental practices look like?
In the webinar, I will highlight changes that will define what a dental visit would look like in future. Things will look alien during the initial phases, reflecting ongoing concerns about infection with SARS-CoV-2 by both the patient and the dental professional.

I believe that the new normal will evolve over time, depending upon the viral presence in any given community. However, the scientific principles do not change, and one can therefore always lean on these pillars to allow them to adapt to an evolving scenario.

Editorial note: Dr. Leslie Fang’s webinar, titled “Life after COVID: The new normal,” will be broadcast live on June 20 at 6 a.m. EDT. Participants will be able to earn a continuing education credit by answering a questionnaire after the lecture. Dental professionals who would like to join the webinar may register free of charge at

COVID 19 Dentistry

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