COVID-19 - Oral Health Care Considerations
- All oral healthcare professionals are encouraged to become vaccinated against COVID-19.
- Consider all patients as potential SARS-CoV-2 carriers and use infection control measures accordingly (see Infection Control Guidelines below).
- Initiate telehealth triage consultation to determine oral health care needs, health status, and infection risk stratification.
- If considering COVID-19 tests and testing, be sure to select the appropriate test and be able to interpret test results (see COVID-19 Tests and Testing and Glick M. YouTube below).
⚠️ Defer all elective dental care for documented COVID-19 positive patients. Provide only emergency care with appropriate infection control measures or provide antimicrobial and/or analgesic prescriptions by telehealth.
- For long COVID patients, address specific signs and symptoms.
| Signs and symptoms associated with long COVID | ||
|---|---|---|
| Symptoms and conditions | Medications | Treatment modification |
| Fatigue | Short appointments | |
| Shortness of breath (dyspnea) | Supplementary oxygen, systemic corticosteroids, bronchodilators | Have supplementary oxygen and bronchodilators available |
| Chest pain | Possible nitroglycerine | Monitor; if worsening, stop all treatment and administer nitroglycerine (see chest pain, medical emergencies) |
| Heart failure | Have supplementary oxygen available | Be aware of possible orthostatic hypotension (see Oral Health Care Considerations for compensated and decompensated heart failure; pay attention to the patient's ability to breath when lowering the back of the dental chair |
| Venous thromboembolism (VTE) | Antiplatelet and anticoagulation therapy | Appropriate antiplatelet and antigoagulation therapy considerations; enable the patients to stand up every 10-15 minutes (to mitigate new thrombus formation) |
| Seizures | Monitor for signs and symptoms | |
| Muscles weakness | Assist patient when walking and when seating the patient in the dental chair | |
| Postural orthostatic tachycardia | Avoid rapid changes of the chair position | |
| Neuropathic pain | Triptans | May require referral to an oral pain specialist |
| Cognitive changes | If necessary, involve other decision makers; ascertain appropriate informed consent | |
| Psychiatric conditions | Antianxiety and antidepressant medications | Address specific patient concerns; possible decreased salivary flow |
| Chronic pain | Be aware of habit-forming medications | When possible, avoid opioid analgesics |
| Kidney impairment | Adjust medication dosage according to degree of kidney impairment (see oral health care considerations for kidney disease) | |
| Hepatic impairment | Adjust medication dosage according to degree of kidney impairment; when possible, avoid medications that are metabolized in the liver (see oral health care considerations for liver disease) | |
Medical Complexity Status – Long COVID#
| COVID-19 | MCS1B |
|---|---|
| Anticipated complication | Controlled/ stable |
| Hemostasis | Minor |
| Microbial susceptibility | None |
| Drugs/ drug interactions | Minor |
| Stress/trauma | Minor |
See Medical Complexity Status for more information.
Infection Control Guidelines#
- Guidance for Dental Settings Interim Infection Prevention and Control Guidance for Dental Settings During the Coronavirus Disease 2019 (COVID-19) Pandemic. Centers for Disease Control and Prevention (CDC).
- Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic. Centers for Disease Control and Prevention (CDC). September 10, 2021. Includes a special section for dental settings.
- Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination. Centers for Disease Control and Prevention (CDC). April 27, 2021.
Related Pages#
- Medical Disorders
- Oral Health Care Consideration
- Laboratory Values
References/Websites#
- References
- France K, et al. Long COVID and oral health care considerations. J Am Dent Assoc. 2021: in print.
- Websites