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South African Dental Journal

versión On-line ISSN 0375-1562
versión impresa ISSN 0011-8516

S. Afr. dent. j. vol.75 no.7 Johannesburg ago. 2020




We are allowed to change our minds



NH Wood

Managing Editor of the SADJ Email:




During this lockdown period, we saw the development and implementation of various policies and procedures that have probably changed the face of the dental practice for the future. Many facets of the dental practice have been influenced by this pandemic. These range from the obvious infection control, to patient communication and billing, and even staff interactions in our clinics.

How do we know what we did was right, or enough? Have we asked the right questions to provide our patients with the best available care under the most constraining circumstances?

Evidence-based outcomes derived from scientific observation form the foundation for the development of most opinions, policies and procedures. It is in this dynamic process that we find recommendations and innovation being put forward, withdrawn, re-worked, and published again.

We rely on our observations between cause-and-effect to narrow our focus to be able to advise more accurately and to inform on policies like infection control procedures. We then label this as "current best practice" and continue to improve thereon through continued observation. We will therefore change our minds on different approaches or procedures, and this is a manifestation of good science.

Traditionally, research is conducted in a controlled environment, where the researcher has already designed the project and made every effort to control for confounding factors, variables, and any bias. There are times, such as for this pandemic, when policies must be formed hurriedly and be put into practice at large.

In these circumstances we integrate our observations of similar situations from the past, published resources, and empirical knowledge of peers, to generate a form of surrogate policy that is applicable to the current situation.

As the system develops, changes may be required based on real-time observations. We have seen this play out on the COVID-19 stage. We can also agree that there is no policy that can be uniformly applied "as is" to every dental setting in our country, and some leave room for interpretation.

Therefore, the final decision-making lies with the operator who takes responsibility for analysing risk, and for the safety and well-being of all who enter the premises, and also on every clinician individually, who will engage a patient. The decision is taken on available knowledge and evidence to the practitioner in that moment in time.



Some may argue that we were too paranoid during lockdown. I put it to those that everything that was done to prevent any further spread of SARS-CoV-2 infection was well worth the effort. We have gathered an immense amount of data and experience, and therefore learnt a great deal about our own systems management and policy implementation in practice. Over and above, we have saved many lives.

Five months after the first announcement by President Cyril Ramaphosa that South Africa will enter into a national lockdown due to the COVID-19 pandemic, we find ourselves at level 2. For most of us this was an intensely trying time, and many of us have breathed a sigh of relief when the level 2 lockdown announcement came. Although national government has relaxed our lockdown level, I'd like to remind you that this action was due to our healthcare system being able to cope with cases of COVID-19. Therefore, do not relax your own personal protection and that of those around you. More than ever, we need to remain vigilant and be aware of our personal space.

On a happier note, the South African Dental journal will shortly be hosted online embracing the fourth industrial revolution, and become more oriented in technological advances. Our online platform will feature a manuscript-tracking ability from author submission to the final publication. We hope these advances prove beneficial for authors and reviewers alike in our effort to make our journal systems more efficient. The editorial team looks forward to working with you on this new platform which will soon be officially launched, and we hope that our authors and contributors take full advantage of this platform.

We are pleased to present you with the August edition of the South African Dental Journal and thank our reviewers and contributors for their hard work to make this continued output a success.

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