Impact of COVID-19 on Pediatric Dental Practice During First, Second And Third Wave.

On the 11th of March, 2020, COVID-19 (SARS-CoV-2) was declared as a pandemic by the World
Health Organization. SARS-CoV-2 is an unpredictable virus that is rapidly transmitting from
one country to another, and unfortunately as of today, there is no effective medication or
vaccine for the disease control. This virus has gone on to cause one of the most rapidly
expanding pandemics with over 9 million people being infected worldwide including the
pediatric population.

Due to the unique nature of dentistry, most dental procedures generate significant amounts of
droplets and aerosols, posing potential risks of infection transmission. Recent studies have
demonstrated the role of the oral mucosa in COVID-19 infection, in addition to expressing the
ACE2 receptor in salivary glands in the asymptomatic process in infected saliva, thus being
one of the main sources of viruses.

Clinical features of COVID-19 in children include fever and cough, but a large proportion of
infected children appears to be asymptomatic and may contribute significantly to
transmission. Therefore, it can be assumed that, at this stage in the pandemic, all children
and their parents/carers are potentially infective with the potential of cross-infection to
dental stuff, parents and the public. This has, in theory, an impact on medical and dental
procedures that are Aerosol Generating Procedures.