COVID-19 Testing In the Dental Office:
Note: Excerpts for this blog were referenced from an article which appeared in: Perio Implant Advisory, Author: Vicki Cheeseman, Jun 1st, 2020
How, when, and why? Is it really necessary to test patients for COVID-19 in the dental office? What do those tests tell us, and why are they so important to our patients and the pandemic as a whole?
Daily the Centers for Disease Control and Prevention (CDC) report the number of cases of SARS-CoV-2 (COVID-19) in the United States and of those cases, the number of people who have died.1
One chart dated May 31, 2020 on the CDC website gives us a graphic to visualize COVID-19 cases by age1:
- Age 0–17: 54,921 cases
- Age 18–44: 560,226 cases
- Age 45–64: 485,373 cases
- Age 65–74: 143,545 cases
- Age 75+: 170,100 cases
These statistics show that the population group with the highest risk of contracting the virus is also the smallest segment. What does this mean for dental offices? Dental professionals need to be aware of the trends in viral contraction and identify their patients who have COVID-19 symptoms and/or those who may be asymptomatic but still carrying the virus.
Several studies have suggested that mortality rates of COVID-19 are lower than many previously predicted.2 For us screening patients for COVID-19 in the dental office is routine. Certainly the outcome of testing would be helpful in determining how to provide further treatment of infected patients in a way that keeps uninfected patients healthy.
What do COVID-19 tests tell us?
Currently there are two types of tests for SARS-CoV-2: antibody tests and viral tests.3 Both test results yield different findings because they test different things. Antibody tests can tell us if individuals have previously had an infection, since the body produces antibodies one to three weeks after contagion. Viral tests, on the other hand, can determine whether an infection currently exists.
Why is testing so important?
Our World in Data says it best: Without testing there is no data. Testing is our window onto the pandemic and how it is spreading.4 In areas without testing, the true number of COVID-19–infected individuals is likely to be much higher than the number of confirmed cases.
Scott Froum, DDS, editorial director of Perio-Implant Advisory, adds this:
“What the new CDC data shows is that a small segment of the overall population is the one with the greatest risk of disease severity and case fatality. If we can identify those patients who have greater risk, we could limit hospital visits.
In addition to all the controls implemented in Dr. Chan’s office, our screening questions ask about co-morbidities associated with COVID-19. Those patients who fall into this category are treated at times during the least office traffic.”
In our office we use this form to screen each patient twice—once before the dental appointment and next during the in-office visit. Screenings at these two times allow us to monitor any medical changes that may have occurred between checks.
Infection control in the dental office
With our dental office reopening, the infection control protocols we use are the same that we employ for influenza. Until a COVID-19 vaccine is developed and more information becomes available, our patients can rest assured in knowing that the infection control steps we employ for influenza also help protect our patients and staff from COVID-19.5 Further, by screening our patients as described above, we are able to better protect all of our patients and contribute in a positive way toward the pandemic as a whole.