A new report published in the February issue of the Journal of the American Dental Association provides modifications for the provision of oral health treatment to patients with long COVID.
Long COVID includes several symptoms prolonged in patients after initial COVID-19 infection, including shortness of breath, seizures and muscle weakness.
For their report, authors Katherine France, DMD, and Michael Glick, DMD, evaluated previously published reports on long COVID symptoms to develop a list of ways dental providers can treat patients dealing with long COVID symptoms.
Dr. France is an assistant professor of oral medicine at Penn Dental Medicine at the University of Pennsylvania in Philadelphia. Dr. Glick is the director of the Center for Integrative Global Oral Health at Penn Dental.
Here's how they recommended treating patients exhibiting 14 long COVID symptoms:
1. Fatigue: Work with patients to decide appropriate timing and length of appointments.
2. Shortness of breath: pulse oximetry monitoring, monitoring for infection and instructing patients to bring any supplemental oxygen and new inhaled medications
3. Chest pain: Monitor symptoms
4. Heart failure: Use caution with chair positioning and confirm with patients their ability to tolerate planned procedures.
5. Venous thromboembolism: Monitor homeostasis, apply local measures as needed, provide breaks and short appointments.
6. Seizures: Monitor for signs and symptoms, adjust home care.
7. Muscle weakness: Use caution with entering and exiting.
8. Postural orthostatic tachycardia: Avoid rapid chair positioning and confirm patient's tolerance of position.
9. Neuropathic pain and headache: Patient may require evaluation and treatment by orofacial pain specialists.
10. Cognitive changes: Involve other decision-makers if necessary and ensure informed consent.
11. Psychiatric illness: Treatment of patient concerns and understanding, monitoring and treatment of decreased salivary flow and resultant caries and periodontal disease
12. Chronic pain: Short appointments and adjustments to patient's needs and positioning and provide breaks as needed, avoid provisions of opioid analgesics
13. Kidney impairment: Changes in dose and timing according to kidney function
14. Liver impairment: Changes in dose and timing, avoid hepatically metabolized medications as possible