“A”—Safe Way to Orthodontic Practice During COVID Times

Introduction

Coronavirus better known as COVID-19 has emerged as a global pandemic that is affecting almost the whole world. The infection is highly contagious with carriers being symptomatic or asymptomatic, including children. The spread is majorly through droplets and aerosol. While the whole world is practicing the act of social distancing, being orthodontists and dentists it is impossible for us to do so.

One has to live with this virus but with all precautions. As orthodontists we are at risk of acquiring and transmitting the infection. So, the objective of this article is to create an environment for an orthodontist in such a way that it helps him/her to control and prevent the transmission as much as possible with quick clinical tips.

One of the time-consuming procedures for an orthodontist is bonding new cases that approximately takes 30 to 45 minutes. Simple clinical tips that can cause the maximum barrier between the patient oral cavity and the working orthodontist during bonding are what we want to provide in this article. During the curing procedure, one can use this as a barrier to reduce the direct exposure from the oral cavity.

Armamentarium Required (Figure 1)

There are some armamentarium required for treatment of orthodontic problems that are as follows:

Cheek retractor

Over Head Projector (OHP) sheet

Blade

Tape

Marker

Scissor

Procedure

First, we have to cut the OHP sheet in a rectangular fashion according to the size of the cheek retractor used (Figure 2). The size can vary as the cheek retractor used by clinicians can vary from different manufacturers. After cutting the OHP sheet in the desired dimension, it is placed on the cheek retractor as shown in Figure 3. Four marks are placed with the help of a marker as shown in Figure 4.

Then with the help of a blade, 2 vertical cuts are made as shown in Figure 5. The OHP sheet with the cut mark is placed into the cheek retractor (Figure 6). A window can be made on the OHP sheet for the orthodontist to work. This can be closed when not needed by an adhesive tape. To fix the OHP sheet properly onto the cheek retractor, we can apply the adhesive tape to the desired area. The patient is wearing the designed appliance very comfortably as shown in Figures 7 and 8. It needs maximum of 10 minutes to design the appliance. One can easily make it with simple armamentarium. A suction tube can be firmly inserted as a modification, if needed, by making a small plus-shaped cut at the lower corner of the OHP sheet (Figure 9).

Figure 1.

Armamentarium

Figure 2.

OHP sheet is cut in Rectangular Shape

Figure 3.

The OHP sheet is placed on the Cheek retraction to check the extension

Figure 4.

Four marks are placed on the OHP sheet

Figure 5.

Vertical cuts are made joining the two dots

Figure 6.

The OHP sheet is then fixed onto the cheek retractor with the help of the vertical cut on each side

Figure 7.

patient wearing the cheek retractor with ease

Figure 8.

Light curing can be done at ease

Figure 9.

A small hole can be done for the suction tube to be inserted as modification

Advantage

The advantages of the aforementioned tips are as follows:

1. Ease of modifications

2. Less time

3. Cost-effective.