Written by;
Dr. Kajal Chandra Paul, FCPS
Associate professor, Department of Orthodontics, Dhaka Dental College
Organizing Secretary, Bangladesh Orthodontic Society (BOS)
Please describe how Covid19 has affected orthodontic practice in Bangladesh.
The first 3 confirmed cases of COVID-19 were reported in March 2020. Since then, Bangladesh is the second most affected country in South Asia, after India. In the absence of vaccination or an effective treatment, many countries including Bangladesh had adopted quarantine measures and a nationwide lockdown to control the spread of COVID-19. This included not only general dentistry but also orthodontic practices in both the public and private sectors.
In Bangladesh most patients seek orthodontic care from government-based hospital. During the period of lockdown, although dental treatment in private practices were not suspended by law, most dental procedures were temporarily halted to reduce mobility amongst the population and consumption of personal protective equipment (PPE). Orthodontic patients were assisted virtually by means of telephone calls and other online methods.
By the end of May, the infection rate started to fall, the Government of Bangladesh ended the countrywide lockdown and mandated restrictions such as social distancing and wearing of masks. When orthodontic practice could resume, the orthodontists were very strict about taking proper infection control measures according to the guideline by the Ministry of Health and family welfare (MOHFW), Bangladesh Dental Society (BDS) and Bangladesh Orthodontic Society (BOS). Patients’ history of traveling, fever and family history of COVID-19 infection are being asked over the telephone prior to confirmation of any appointment. During the appointment, the temperature of the patient including any attendant were checked and proper social distance is being maintained at the waiting area. It is also ensured that masks are being worn by both the patients and the staff in the practice, and proper hand disinfection using sanitizers were provided. The number of appointments per day were reduced and full PPE wear was mandatory. Most importantly, most orthodontists and their staff in the practices began their vaccinations as soon as possible.
How have the members of your Society coped with the changes?
Bangladesh Orthodontic Society (BOS) including the executive committee members have not met in person since the beginning of the pandemic. However, we have utilized the online platforms such as Zoom to meet virtually on a regular basis. During the meetings, we discussed and proposed methods to tackle the challenging Covid 19 situation. We tried to boost up the affected members and offered them moral support. Webinars and online lectures on better management of the orthodontic patients were arranged.
What government support and guidelines have been implemented?
The government of Bangladesh has not only ensured adequate provision of PPE including masks and eye-wear for the government hospitals but also exempted any taxation to allow the private sectors to import them. This increased the availability of PPE locally and made them more accessible. MOHFW guidelines helped us to treat our patients with proper precautions. Bangladesh Dental Society arranged webinars to form a guideline where the president of BOS, Professor Zakir Hossain instructed about careful orthodontic management in the pandemic situation. Honorable president described the guidelines and discussed about its implementation to all the members.
How has your Society +/- Ministry of Health helped its members during this difficult period?
BOS offered help to their members who required extra support during this difficult period. BOS provided financial assistance to help with payment to practice staff for those orthodontists who needed support. The government of Bangladesh also requested revision in rent and offered loans with reduced rates to help overcome hefty clinic rentals.
How has Covid19 impacted the lives of Bangladeshis?
Covid-19 significantly changed the lifestyle of the Bangladeshi population. People have become more aware of infection control and practised better hygiene in their daily lives to curb the spread of the disease. It has become a norm for us to wear masks, ensure proper handwashing and use hand sanitizers. Since all the educational institutes have temporarily suspended in-person classes, the students have already adapted to online education. The public have also turned to online platforms for shopping, banking, doctor appointments and other utilities.
Moving forwards, how do you think orthodontic practice will change?
Change is a normal phenomenon of life and regular changes of concept and technique is essential to keep orthodontic practice vibrant. Though Covid-19 was an unexpected twist but in course of time most orthodontists adapted to this new norm. Covid-19 has its mark on all strata of society and upholds the importance of self-hygiene and this awareness encourages the orthodontists to maintain a germfree environment as best as possible. The interval between patients which was limited to changing of instruments previously, is now changed to making the air ‘virus free’ through radiation or chemical agents. This has decreased the number of appointments and adds a further financial burden to any orthodontic practice. Orthodontists may have to increase their working hours or see fewer patients. Many devices were introduced for self-protection from N95 masks to face shield, eye protecting glass and Covid-19 protecting helmets and isolation of patient in a capsule with its separate air supply. At first it became a challenge for the practitioner as vision and accessibility was impaired, however, most clinicians learnt to adapt with this situation.
Please write a message to all APOS members from BOS.
BOS prays and hope for this situation to resolve very soon. At the current moment, the Executive committee is trying to arrange a National and International orthodontic congress in Bangladesh for 2022. Considering the current situation, it may be held online. However, we are still hoping if it can be arranged in person in the presence of our members, and national and international friends. Please be with us on www.bosbangladesh.com.
Article has been revised by Dr. Mahmood Sajedeen, FCPS, Associate professor, Department of Orthodontics, Bangabandhu Sheikh Mujib Medical University Joint Secretary, Bangladesh Orthodontic Society, Bangladesh and acknowledged by Professor Dr. Zakir Hossain, PhD, FCPS, Principal University Dental College, Ex. Principal and Head, Department of Orthodontics, Dhaka Dental College President, Bangladesh Orthodontic Society, Bangladesh