Akshay Govind,
Ethical Calculus for the Provision of Dental Care during and after the COVID-19 Pandemic of 2020
Journal of Dentistry Open Access
2020
2674-4155
http://dx.doi.org/10.31487/j.JDOA.2020.01.02
https://www.sciencerepository.org/ethical-calculus-for-the-provision-of-dental-care-during-and_JDOA-2020-1-102 
Abstract: Background: Due to its high rate of spread and unpredictable course, the COVID-19 virus has limited
dentistry to providing only urgent treatment through the pandemic of 2020. With time, the burden of
untreated dental disease will slowly rise, but too early a return to elective treatment will contribute to the
spread of coronavirus and under-utilize much needed PPE, causing undue morbidity and mortality.
Methods: A theoretical framework is proposed for calculating a safe return to work for dental providers in
the United States after the COVID-19 pandemic. Clinical, ethical, economic, and mathematical principles
are utilized.
Results: A model is offered using the concept of QALYs and DALYs to calculate benefits and risks of
dental care. The model includes a 13-variable formula that takes into account the prevalence and impact of
dental disease and the novel coronavirus.
Practical Implications: Organized dentistry groups are encouraged to couple clinicians and policymakers
to calculate the optimal timing for a measured return to work. Specifically, a safe return will balance PPE
supply and efficacy with hospital capacity to find an optimal prevalence of COVID-19 and dental disease
where it would be most responsible for dentists to return to providing elective care. Lastly, a call is made to
lobby for government support for dentists, as dental care is a vital service to the public provided almost
entirely by a private sector workforce in the United States.Keywords: COVID-19, ethics, dental care, morbidity