WHO and dentistry: moving on from misinformation
GENEVA, Switzerland: The World Health Organization’s (WHO) handling of the global pandemic has brought it more criticism than praise, and dentists are among those who have denounced public health guidance from the UN agency. According to dental associations contacted by Dental Tribune International (DTI), WHO has been the subject of unbalanced media coverage relating to its guidance on dental practice.
Much of the criticism that has been directed at WHO during the SARS-CoV-2 pandemic has been in reaction to guidance about practices that are unfamiliar to the citizens of many countries, such as the wearing of masks in public and the need to reduce social contact. Dentists around the world reacted defensively when the agency called for the delay of routine dental care in interim guidance issued on 3 August, with many fearing that further postponement of elective care would damage oral health and compound the damage that had already been done to their businesses during the first wave of the virus. Some dentists felt that it was an attack on the effectiveness of infection prevention measures within dentistry.
Florida dentist Dr Greg Prior told ABC Action News in late August that the timing of the WHO recommendation had made no sense, as dentists in the state had been allowed to resume the provision of oral care in April. Since emergency measures were put in place in the state in March, Prior has implemented even greater infection control measures at his dental practice, including the installation of air purifiers and air filters. “Dentistry is so important for people’s overall health,” Prior told the news agency. “It seems untimely they would’ve [made that recommendation], especially since we’re all coming back to work and we’re all putting in the protocols.” The American Dental Association (ADA) had said in mid-August that it “respectfully yet strongly disagrees” with the WHO guidance.
A long list of news agencies reported on the WHO recommendation, and it was also covered by publishers from the dental industry press, including DTI. In an email to dental associations on 13 August, Dr Benoit Varenne, a WHO dental officer, expressed concerns about the way that the guidance had been interpreted by the media. “Unfortunately, a number of media headlines intentionally or not—when they are referring to the WHO guidance, did not mention that the recommendation to delay routine oral healthcare is only suggested in an intense uncontrolled community transmission scenario,” Varenne wrote. He asked dental leaders to be aware of incomplete reporting, and the fact that it could heighten the concerns that many patients already had with regard to visiting their dental practice during the pandemic.
According to the British Dental Association (BDA), incomplete reporting on the WHO guidance by the media had caused confusion about the agency’s recommendations in the area of oral healthcare.
A BDA spokesperson told DTI: “Contrary to media reports, the guidance did not say categorically that all non-urgent treatments should be postponed but suggested that some treatments be delayed until there has been a sufficient reduction in SARS-CoV-2 community transmission rates. It also stated that ‘adequate ventilation in oral healthcare facilities reduces the risk of transmission in closed settings’. This principle has been taken up by the profession in order to reduce fallow time and to make it possible to see more patients.”
The spokesperson added that WHO “could not necessarily provide a one-size-fits-all solution, and it was considered inappropriate to apply this advice in the UK’s current context, where dentists already have extremely high levels of infection prevention and control in place.”
“Only a postponement of dental visits in an uncontrolled transmission scenario is recommended [by WHO]”
– German dental association
The Bundeszahnärztekammer (BZÄK) (German dental association) told DTI that it also felt that media reporting had led to the interim guidance from WHO being misunderstood. “The WHO recommendation is essentially the same as the BZÄK recommendations. Only a postponement of dental visits in an uncontrolled transmission scenario is recommended, and otherwise the official health policy recommendations at national, regional or local level should be followed,” the association said.