197 Safety recommendations for dentists and maxillofacial surgeons during COVID-19 pandemic SMA SADAT a , MH SHAIKH b , M ATTYGALLA c , NR RAO d , T NAGAO e , S WARNAKULASURIYA f , SN RITA g Abstract: Oral health professionals are at high risk of developing COVID-19 infection due to their practice of close proximity to the patients. Patients in daily dental practice can be seen with basic protection protocol. Routine and elective dental procedures should be cancelled during this pandemic situation and could be rescheduled when the situation eases. In practice, as of universal prevention strategy, all patients should be assumed as COVID-19 infected and treated accordingly. Adequate standards of hygiene and protection should be adopted for all patients to avoid potential transmission risks. During the COVID-19 pandemic, it would be crucial to categorize oral and maxillofacial surgery cases into: emergency case, urgent case, intermediate case and low priority cases. While there has been a growing literature suggesting the aspect of critical care associated in treating these patients, ample of evidence indicates how this COVID-19 pandemic will affect surgical practice. Here we highlight the current unfavorable situation due to COVID -19 and offer recommendations for changes to dental and maxillofacial surgical practices. Key Words: Bangladesh, COVID-19, Dentist, Maxillofacial Surgeon, Recommendation (J Bangladesh Coll Phys Surg 2020; 38: 197-204) DOI: https://doi.org/10.3329/jbcps.v38i4.48981 Introduction: The first case of a COVID-19 was reported in Wuhan, Hubei Province, China on 31 st December 2019. 1 The patient admitted to the hospital with pneumonia of unknown origin, and later tested positive for the β-coronavirus.The novel β-coronavirus was isolated and declared as the causative pathogen on 7 th January, 2020 2 . The virus was named officially as “Severe Acute Respiratory Syndrome Coronavirus 2” (SARSCoV-2) (Coronaviridae, 2020). The World Health Organization (WHO) declared the 2019–20 coronavirus outbreak as a Public Health Emergency of International Concern (PHEIC) on 30 th January 2020 3 , and later as a pandemic on 11 th March 2020 4 . As of July 29 th a total of 169, 36,074 detected cases and 664402 deaths have been reported worldwide. In Bangladesh the total number of affected person is 321615 with total death is 4412 (as of 3 rd September 2020) (webometre). There is no specific treatment or vaccine yet for COVID- 19. Health care providers, especially the oral health professionals, are at high risk of developing COVID-19 infection due to their practice of close proximity to the patients. The attendants can also be a source of carrying the virus without having any symptoms. In Bangladesh, as of August 10, 7442 health workers including 2542 physicians, 1860 nurses and 3040 other health workers have been infected with the corona virus, reported by Bangladesh Medical Association (BMA) in a statement. They also confirmed death of 77 physicians within this Covid situation as of 10 th August. While the transmission of COVID-19 via human exhaled droplets and direct contact is clear, the potential for aerosol transmission is a significant risk particularly for dental practices 5 . COVID-19 spreads very rapidly. Though still not clearly concluded, at present, the respiratory droplet transmission mode and the contact transmission a. Dr. S. M. Anwar Sadat, Associate Professor, Dept of Oral & Maxillofacial Surgery, Dhaka Dental College, Dhaka, Bangladesh, Consultant, Square Hospitals Ltd, Dhaka b. Dr. Mushfiq H. Shaikh, Postdoctoral Fellow, Department of Otolaryngology – Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. c. Dr. Manjula Attygalla, Prof in Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka d. Dr. Naman R. Rao, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA e. Dr. Toru Nagao, Professor and Chairman, Department of Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, 2-11, Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan f. Dr. Saman Warnakulasuriya, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK g. Dr. Sufia Nasrin Rita, Professor and Head, Dept of Orthodontics, Sapporo Dental College, Dhaka, Bangladesh. Consultant, Square Hospitals Ltd, Dhaka Address of Correspondence: Dr. S. M. Anwar Sadat, Associate Professor, Dept of Oral & Maxillofacial Surgery, Dhaka Dental College, Dhaka, Bangladesh. Consultant, Square Hospitals Ltd, Dhaka. Cell: +8801711156023. E-mail: an_sadat@yahoo.com Received: 04 August, 2020 Accepted: 10 September, 2020 Journal of Bangladesh College of Physicians and Surgeons Vol. 38, No. 4, October 2020