Considerations for Oral and Maxillofacial Surgeons in COVID-19 Era: Can We Sustain the Solutions to Keep Our Patients and Healthcare Personnel Safe?

Radhika Chigurupati; Neeraj Panchal; Andrew M Henry; Hussam Batal; Amit Sethi; Richard D'innocenzo; Pushkar Mehra; Deepak G Krishnan; Steven M Roser

doi:10.1016/j.joms.2020.05.027

Considerations for Oral and Maxillofacial Surgeons in COVID-19 Era: Can We Sustain the Solutions to Keep Our Patients and Healthcare Personnel Safe?

J Oral Maxillofac Surg. 2020 Aug;78(8):1241-1256. doi: 10.1016/j.joms.2020.05.027. Epub 2020 May 24.

Authors

Radhika Chigurupati¹, Neeraj Panchal², Andrew M Henry³, Hussam Batal⁴, Amit Sethi⁵, Richard D'innocenzo⁶, Pushkar Mehra⁷, Deepak G Krishnan⁸, Steven M Roser⁹

Affiliations

¹ Associate Professor, Department of Oral and Maxillofacial Surgery, Boston University Medical Center, and Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA. Electronic address: rchiguru@bu.edu.
² Assistant Professor and Section Chief, Department of Oral and Maxillofacial Surgery, Philadelphia Veterans Affairs Medical Center, Penn Presbyterian Medical Center, University of Pennsylvania School of Dental Medicine, Philadelphia, PA.
³ Assistant Professor, Department of Oral and Maxillofacial Surgery, Boston University Medical Center and Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA.
⁴ Clinical Associate Professor and Clinical and Financial Director, Department of Oral and Maxillofacial Surgery, Boston University and Boston Medical Center, Boston, MA.
⁵ Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA.
⁶ Clinical Professor and Vice Chairman, Departments of Dentistry and Oral and Maxillofacial Surgery, and Director, Predoctoral Education, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA.
⁷ Professor, Chair, and Chief, Department of Oral and Maxillofacial Surgery, Boston Medical Center, and Associate Dean of Hospital Affairs, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA.
⁸ Associate Professor, Department of Surgery; Chief and Residency Program Director, Section of Oral and Maxillofacial Surgery, University of Cincinnati Medical Center; and Chief, Section of Oral and Maxillofacial Surgery, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH.
⁹ DeLos Hill Chair and Professor of Surgery, and Chief, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.

Abstract

Several uncertainties exist regarding how we will conduct our clinical, didactic, business, and social activities as the coronavirus disease 2019 (COVID-19) global pandemic abates and social distancing guidelines are relaxed. We anticipate changes in how we interact with our patients and other providers, how patient workflow is designed, the methods used to conduct our teaching sessions, and how we perform procedures in different clinical settings. The objective of the present report is to review some of the changes to consider in the clinical and academic oral and maxillofacial surgery workflow and, allow for a smoother transition, with less risk to our patients and healthcare personnel. New infection control policies should be strictly enforced and monitored in all clinical and nonclinical settings, with an overall goal to decrease the risk of exposure and transmission. Screening for COVID-19 symptoms, testing when indicated, and establishing the epidemiologic linkage will be crucial to containing and preventing new COVID-19 cases until a vaccine or an alternate solution is available. Additionally, the shortage of essential supplies such as drugs and personal protective equipment, the design and ventilation of workspaces and waiting areas, the increase in overhead costs, and the possible absence of staff, if quarantine is necessary, must be considered. This shift in our workflow and patient care paths will likely continue in the short-term at least through 2021 or the next 12 to 24 months. Thus, we must prioritize surgery, balancing patient preferences and healthcare personnel risks. We have an opportunity now to make changes and embrace telemedicine and other collaborative virtual platforms for teaching and clinical care. It is crucial that we maintain COVID-19 awareness, proper surveillance in our microenvironments, good clinical judgment, and ethical values to continue to deliver high-quality, economical, and accessible patient care.

Publication types

Review

MeSH terms

Betacoronavirus
COVID-19
Coronavirus Infections / epidemiology*
Coronavirus Infections / prevention & control
Humans
Occupational Exposure / prevention & control
Oral and Maxillofacial Surgeons
Pandemics / prevention & control
Personal Protective Equipment
Pneumonia, Viral / epidemiology*
Pneumonia, Viral / prevention & control
SARS-CoV-2
Surgery, Oral / organization & administration*
Workflow