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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).

‚ö†ÔłŹ 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 conditionsMedicationsTreatment modification
FatigueShort appointments
Shortness of breath (dyspnea)Supplementary oxygen, systemic corticosteroids, bronchodilatorsHave supplementary oxygen and bronchodilators available
Chest painPossible nitroglycerine Monitor; if worsening, stop all treatment and administer nitroglycerine (see chest pain, medical emergencies)
Heart failureHave supplementary oxygen availableBe 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 therapyAppropriate antiplatelet and antigoagulation therapy considerations; enable the patients to stand up every 10-15 minutes (to mitigate new thrombus formation)
SeizuresMonitor for signs and symptoms
Muscles weaknessAssist patient when walking and when seating the patient in the dental chair
Postural orthostatic tachycardiaAvoid rapid changes of the chair position
Neuropathic painTriptansMay require referral to an oral pain specialist
Cognitive changesIf necessary, involve other decision makers; ascertain appropriate informed consent
Psychiatric conditionsAntianxiety and antidepressant medicationsAddress specific patient concerns; possible decreased salivary flow
Chronic painBe aware of habit-forming medicationsWhen possible, avoid opioid analgesics
Kidney impairmentAdjust medication dosage according to degree of kidney impairment (see oral health care considerations for kidney disease)
Hepatic impairmentAdjust 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 ‚Äď Long COVID#

COVID-19MCS1B
Anticipated
complication
Controlled/
stable
 HemostasisMinor
 Microbial
 susceptibility
None
 Drugs/ drug
 interactions
Minor
 Stress/traumaMinor

See Medical Complexity Status for more information.

Infection Control Guidelines#


Related Pages#

References/Websites#