The document provides guidance on oral health management of children during the COVID-19 pandemic. It recommends maintaining good oral hygiene and emphasizes preventing non-emergency dental visits. For acute dental issues, it advises providing advice, analgesics, and antibiotics if needed via telehealth. Only emergency cases involving infection, swelling restricting breathing, or uncontrolled pain/bleeding should be referred to urgent dental care centers.

1. “We cannot say this loudly enough or clearly
enough or often enough: All countries can still
change the course of this pandemic”
COVID-19

2. COVID-19 is an infectious disease caused by the recently found virus
known as SARS-CoV-2 (or coronavirus). Before the outbreak originated in
Wuhan, China on December 2019, there was no information about this
virus.
1. Oral Health Management of Children
during the Pandemic Period of Coronavirus
Disease 2019
2. Non-urgent dental treatments that can
be postponed.

3. Introduction
 Since December 2019, the popular novel coronavirus
pneumonia (coronavirus disease 2019, COVID-19 ) has
become a major national and global public health events.
 Due to the particularity of the diagnosis and treatment of oral
diseases, COVID-19 can easily spread during the diagnosis and
treatment process.
 In order to prevent cross-infection and prevent the spread of the
epidemic, most dental clinics across the country have suspended
routine oral clinics.
 With this, how to do a good job in oral management of children, prevent and deal
with children's oral emergency has become a matter of great concern to the public.
WANG Yan, ZHOU Chen-chen, SHU Rui, et al . Oral Health Management of Children during the Epidemic Period of Coronavirus Disease
2019 [J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION) , 2020, 51 (2): 151- 154

4. Based on the characteristics of the current COVID-19 epidemic the
management strategy mainly focuses upon:
WANG Yan, ZHOU Chen-chen, SHU Rui, et al . Oral Health Management of Children during the Epidemic Period of
Coronavirus Disease 2019 [J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION) , 2020, 51 (2): 151- 154
Risk factors Diagnosis Treatment
Oral
Management

5.  Spreading of respiratory droplets: coughing and sneezing
 Indirect contact transmission: Instruments and items that
are involved in the oral diagnosis and treatment
 Aerosol transmission: High-speed turbine handpiece,
ultrasonic dental scaler and three-purpose spray gun
 Children and adolescents wearing active appliances,
invisible appliances or rubber bands need to take the
appliance and rubber bands multiple times, and the risk
of indirect contact with new coronavirus is greater.
 Due to the peculiarity of the child patient, there are
some other risks of transmission: the child cannot wear
personal protective equipment as required on the way to
the hospital or during the visit.
Risk factors:

6. ‘General Principles’ for the Management of Acute Dental Problems
During COVID-19 Pandemic
Assessment of patients should take account of patient and staff safety, the
best interests of the patient, professional judgement, local urgent dental care
center arrangements and prioritization of the most urgent care needs.
During the assessment, each patient’s COVID-19 status must be established
and recorded using your health board or local health system protocol. This will
determine how their care is managed at the designated urgent dental care
centers if referral is required.
Primary care dental triage should focus on the provision of the three A’s:
a. Advice;
b. Analgesia;
c. Antimicrobials (where appropriate).
SDCEP Management of Acute Dental Problems During COVID-19 Pande

7. Patients should be advised that treatment options are severely
restricted at this time and to call back in 48-72 hours if their
symptoms have not resolved.
It is advisable to mediate with local pharmacy to ensure that the
products recommended are available to patients.
Appropriate records should be kept of all patient contacts, including
care management and onward referrals.

8. A. Routine measures:
 Maintain effective oral hygiene and cleaning measures.
 Effectively brush and floss.
 Remove plaque, soft dirt and food debris.
 Quit bad feeding habits, such as night milk.
 Parents should reasonably arrange children's diet and avoid high frequency
consumption of foods with high sugar content.
 In addition, children are more at home and playing during the epidemic,
prone to deciduous teeth and young permanent teeth trauma, parents should take
good protection and care.
Children's oral management measures during the
COVID-19 pandemic

9. At the same time, parents should always remind their children to maintain
hand hygiene.
Before and after eating, before and after taking the appliance, need to wash
hands with liquid soap or soap running water, or use alcohol-free hand-
washing liquid to scrub hands.
Avoid letting hands touch nose, mouth, and eyes; show child to sneeze or
cough How to cover nose and mouth with a tissue.
Keep child's nutrition balanced and avoid overeating.
Guide the child to develop the habit of the law of life, to get enough sleep,
drink plenty of water, exercise properly, and maintain a good attitude to
enhance the child's own resistance.

10. Treatment of children's oral diseases in the non-emergency period
 Most children's oral diseases can be treated on an elective basis.
 In principle, they should go to the hospital as little as possible or not, unless
there is an oral emergency such as tooth trauma, maxillofacial infection,
severe swelling, severe oral or dental pain that must be treated
immediately.
 Due to the special nature of dental clinics, high-speed turbines, ultrasonic
dental scalers, etc. produce a lot of water mist droplets and aerosols.
 If there are patients with incubation period without medical knowledge and
oral medical treatment, it will easily lead to epidemic outbreak spread.
 Therefore, for children with non-emergency oral diseases, it is
recommended that they should be treated at home and selected or
postponed to the oral medical institution.
WANG Yan, ZHOU Chen-chen, SHU Rui, et al . Oral Health Management of Children during the Epidemic Period of Coronavirus Disease 2019 [J]. JOURNAL OF
SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION) , 2020, 51 (2): 151- 154

11. Is there swelling?
Yes/No
Does swelling restrict swallowing or
extend to the eye?
Yes/No
1.Is patient in pain
Or,
2.Has patient suffered trauma to the teeth
Or,
3.Is there bleeding following an extraction
Yes/No
Provide self help advice on:
1.Pain relief(check previous analgesics used)and
possible antibiotics for swelling due to infection
Or,
2.Dental trauma
Or,
3.Post extraction bleeding
If bleeding is
uncontrolled
If pain is severe and uncontrolled
Or,
spreading ,recurrent or continuing infection
Or,
avulsed permanent tooth
Or,
severe trauma
If mild or moderate pain
Or,
Swelling
Or,
minor dental trauma including exposed
dentine
Or,
avulsed primary tooth
Emergency care
Designated urgent dental
care
Self help & advice

12. Non-urgent dental treatments that can be
postponed:
 Initial or periodic oral examinations and recall visits, including routine
radiographs.
 Routine dental cleaning and preventive therapies.
 Orthodontic procedures other than those to address acute issues (e.g. pain,
infection, trauma) or other issues critically necessary to prevent harm to the
patient .
 Extraction of asymptomatic teeth.
 Restorative dentistry including treatment of asymptomatic carious lesions.
 Aesthetic dental procedures.
American Dental Association Guidance for Covid-19 Pandemic. Updated on
3/31/20

13. Thank You