Oral cancer screening suspended due to Covid-19 risk
Dental clinics in the containment zones have also been directed to remain closed, as most dental procedures require close contact with the patient’s oral cavity, saliva, blood, and respiratory tract secretions, increasing the risk for dentists of contracting the viral infection.
The Union health ministry has temporarily suspended oral cancer screening under its National Cancer Screening Programme due to high risk associated with the examination of the oral cavity as saliva is high in Sars-Cov-2 viral load that causes coronavirus disease (Covid-19).
“Due to the high risk associated with the examination of the oral cavity, oral cancer screening under National Cancer Screening program should be deferred until new policy/guidelines are issued,” said health ministry in a directive issued on Tuesday.
An official from the government confirmed, on condition of anonymity, said, “The door-to-door screening of people above 30 years of age as part of the national programme has been currently suspended. However, if there is an emergency case requiring biopsy that will be addressed as per protocol. These are temporary guidelines subject to revision depending on change in overall situation.”
Dental clinics in the containment zones have also been directed to remain closed, as most dental procedures require close contact with the patient’s oral cavity, saliva, blood, and respiratory tract secretions, increasing the risk for dentists of contracting the viral infection.
All routine and elective dental procedures need to be deferred for a later review until new policy or guidelines are issued.
“Dental operations should be restricted to emergency and urgent treatment procedures only. However, clinics in containment zone are allowed to provide tele-consultation, and patients in need of emergency treatment can use ambulance services to travel to the nearby Covid hospital providing dental facility,” the directive says.
In the red zone, only emergency procedures are allowed, but dental clinics in orange and green zone can remain open for consultation also.
Emergency procedures have been classified as those that if not attended to increase the patient’s death risk, and urgent cases are those requiring priority care but do not increase the patient’s death risk.
“Urgent procedures should be undertaken only after teleconsultation, tele-triage, consent, and through pre-fixed appointment,” says the directive. The ministry has also issued a detailed list of procedures that fall under emergency dental procedures such as procedures for patients going in for cardiac surgery, radiation therapy or organ transplantation surgery or those patients undergoing treatment in hospital for any acute conditions. If infection in dental pulp has reached a stage wherein painkillers and other medicines are ineffective, then an emergency procedure can be performed to relieve the symptoms.
Also, there is a list of dos and don’ts to modify dental clinic setting to minimise risk of infection.
Experts say it is good to have these guidelines in place for better clarity on the matter.
“There are two things why dentists can be at high risk: one is that saliva is very rich in covid causing virus, and second is that the contact with a patient during dental procedures is comparatively longer and closer. Therefore, it makes sense to put on hold elective, aesthetic or rehabilitative procedures for time being, and concentrate on only life-threatening and urgent procedures,” says Dr Mahesh Verma, former director, Delhi government-run Maulana Azad Institute of Dental Sciences.
