December 2020

The COVID-19 pandemic has affected the delivery of health services across the world. The World Health Organisation (WHO) declared the COVID-19 outbreak to be a global pandemic on 11th March 2020, prompting the closure of dental services worldwide. The main reason for this was the infection risk associated with Aerosol Generating Procedures (AGP), such as the use of highspeed drills (Al-Halabi et al., 2020). During this period, even access to emergency dental care has been limited. A review of the current guidance issued by international organisations and professional bodies regarding the re-opening of dental services showed considerable variation in the safety procedures required. Most sources recommended triage of patients and an emphasis on only emergency and urgent care; wearing filtering facepiece class 2 masks; reducing the risk of transmission; and avoiding AGP. All sources stressed the need to focus on activities that minimise risk to staff, patients and the public, and to support high quality clinical care (CoDER, 2020). The implementation of these guidelines in conventional dentistry may cause a significant financial burden for providers, compromising their financial sustainability. The investment necessary to equip practices to ensure that they are fit for purpose now includes specific COVID-19 concerns; Personal Protective Equipment for practice personnel; management of the clinical room, including post-operative cleaning and disinfection and waste disposal (CoDER, 2020). This will dramatically increase the cost of conventional dentistry. Accordingly, patients will be less able to afford dental treatment because it is already very expensive; further excluding the less fortunate from accessing dental treatment. By contrast, Minimum Intervention Dentistry (MID) (Innes et al., 2017), the modern biological approach to the control of dental caries, offers a cost-effective solution to the delivery of dental services during and after the COVID-19 pandemic. This should be adopted comprehensively worldwide.