A commentary on

Iyer P, Aziz K, Ojcius D M.

Impact of COVID19 on dental education in the United States. J Dent Educ 2020. DOI: 10.1002/jdd.12163.

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GRADE rating


Although this review is US focused the impacts on dental education in the immediate and longer term because of the COVID-19 pandemic are shared across the World.1 The introduction and background sets the scene well and the current understanding of risks associated with aerosols.2 The point that is not emphasised is that dental schools are different to primary care dental practices and non-teaching secondary care institutions, because they have large open clinics and a need for supervising dentists to move between patients. Both this review and the paper from Wuhan, China discuss strategies to deliver emergency care during the pandemic, such as patient screening, remote consultations and appropriate use of personal protective equipment (PPE).3

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© Paul Biris/Getty Images Plus

However, there is no discussion of how to deliver clinical dental education in the future, particularly on open clinics, assuming there continues to be an infection risk for the foreseeable future. Fortunately infection levels among dental personnel appear currently to be relatively low probably because of the use of PPE, high volume suction etc. Even if this is the case and staff are protected, what is the risk to adjacent patients on open clinics if AGP are being produced? Currently, there is very limited evidence relating to dental aerosol and viral transmission.4 Bacterial studies suggest two meters around the chair is a safe zone.5

The review correctly identifies that although technology provides many opportunities particularly in the field of distance learning, staff and perhaps students as well will need significant professional development to utilise it effectively. Similarly, the need to utilise the most appropriate educational methodologies is well made.

The attention to student and staff wellbeing is commendable, as there will be understandable anxiety and confusion. There is therefore a need for excellent communication of roles, responsibilities, policies and support structures.

Although this review has flaws, for example its lack of focus on the future of clinical teaching, it does have many positives. The COVID-19 pandemic undoubtedly presents many challenges but also the opportunity to revolutionise dental education. As Winston Churchill is reported to have said, 'never let a good crisis go to waste'.