Title: Role of the hospital dentist in the repair of oral lesions of serious patients with COVID-19 in intensive care units: A multidisciplinary approach
The New Coronavirus, responsible for the pandemic of the disease COVID-19, with epicenter in Wuhan, China, since December 2019, has caused a disease whose main symptoms include fever, cough, myalgia, fatigue, dyspnea and abnormal computed tomography images of chest. Of the total number of infected patients, 5% of these can develop severe forms of the disease, requiring treatment in the Intensive Care Unit. These patients can more easily develop the so-called Acute Respiratory Insufficiency Syndrome and about 2/3 of the patients require ventilatory support, and includes people over 60, patients in morbid conditions such as diabetes, heart disease, previous respiratory diseases and children in perinatal age. During orotracheal intubation, some pathological changes such as mechanical trauma to the oral mucosa, xerostomia, immunosuppression and adverse effects of medications, combined with poor dental condition, can cause oral lesions, which can become a gateway for other viruses, bacteria and pathogens fungal and aggravate the patient’s state of health, and can even lead to death. A literature review was carried out in July 2020 on international bibliographic bases, with the objective of retrieving the most up-to-date evidence in the approach to care in patients with severe Covid-19 undergoing Orotracheal Intubation who had lesions and infections in the oral cavity. Through mechanical oral antisepsis, laser therapy and minor surgical procedures at the bedside, there was a reduction in infectious foci in the oral cavity and oropharynx, reducing the parameters of leukocytosis and RTPCR. The proposed approach could contribute to the management of critically ill patients with Covid-19 in Intensive Care Units, improving the patient’s oral condition and, consequently, the clinical evolution parameters, anticipating the discharge from the Intensive Care Units, favoring care other critically ill patients awaiting care, increasing the number of patients seen. In addition, the impact of this dental care, minimizes hospital costs and anticipates hospital discharge, thus improving the prognosis of the disease and increasing the survival of these patients.