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A second lockdown in Israel has put many things on hold, but not dental care. (Image: StockStudio Aerials/Shutterstock)

Let dentists keep working—lessons from the second Israeli lockdown

By Jeremy Booth, Dental Tribune International
September 24, 2020

TEL AVIV, Israel: Dental clinics in Israel are operating as usual this week, despite a government-imposed lockdown that has been implemented to curb the spread of SARS-CoV-2. Dental Tribune International (DTI) spoke with an Israeli dentist, who commented that the strict health protocols that are in place within dentistry justify the continued provision of elective care.

Israel has started the Jewish calendar year in its second general lockdown, making it the first wealthy country to return to a period of strict government-mandated business closures and restrictions on movement.

Implemented to slow the spread of SARS-CoV-2, the new lockdown began on 18 September and is set to continue for a period of three weeks, ending on 9 October. Widely unpopular, it confines people to within a 1 km radius of their homes and shuts schools, day care centres, and many private businesses, such as restaurants, hairdressers and gyms. Like the country’s first lockdown—which forced dental practices to close for a period of five to six weeks from mid-April—it coincides with a Jewish holiday period and aims to prevent the rate of infections soaring as a consequence of family gatherings and religious ceremonies. This time, however, dental clinics remain open, together with doctors’ offices and other health service providers.

Dr Alon Schifter, who practises as a periodontist in the Tel Aviv area, told DTI that this second lockdown is more flexible. Some private businesses are allowed to remain open, and medical and dental treatments can continue to be carried out according to the rigorous restrictions and health measures that have already been implemented in the country to combat the spread of the virus. 

The second lockdown does not include dental clinics,” Schifter confirmed. “We are open, we are working, and we are very cautious and careful.”

He explained that the strict health measures in place at dental clinics in Israel meant that there was no need to restrict dentists to performing emergency procedures only. “According to government statistics, there have been almost no new infections in dental clinics in Israel. Owing to the good infection control protection, due to the measures that are taken, there have been no new infections reported in either staff or patients in dental clinics.”

He continued: “Based on the responsibility of the dental practitioners—whether this is the dentists themselves, or the hygienists and the administrators who are working in the clinics—we are very aware of the importance of infection protection. We were actually doing this on a daily basis before the coronavirus outbreak.”

Schifter echoed the sentiment of dental associations around the world, who have emphasised that dentists are instructed in infection prevention during their studies. “We were taught that every patient is a potential carrier of hepatitis or any other infectious disease,” he explained. “You have to take measures to protect yourself, your staff and your patients.” He added that, since the onset of the pandemic, Israeli dentists had been even more careful to maintain their high standards and that many had invested in additional infection control measures, such as air filtration devices.

Israel’s lockdown: How is it affecting dental patients?

Schifter had just returned home from his clinic when DTI spoke with him on 21 September—three days into the lockdown period—and he commented that patient numbers were as high as they had been several weeks before. “Patients are displaying a degree of confidence and trust in us. They trust us that we are taking the maximum possible measures to protect them, and ourselves, and as a result of this, they are coming and having their dental work done as usual—routine work, not only emergency care.”

“We are very aware of the importance of infection protection. We were actually doing this on a daily basis before the coronavirus outbreak”
– Dr Alon Schifter, periodontist, Tel Aviv

But Schifter said that the lockdown was having an effect on dental treatment, particularly for patients. “It is because some of our patients are elderly—especially if you are a periodontist like me and you treat periodontal disease, which often occurs in the elderly. Then there are the maintenance and hygienic treatments, which are very important, but also result in the largest generation of aerosol.” He added that some patients have been reluctant to attend their appointments and have preferred to postpone treatments for a period of three to four weeks after the lockdown is due to end.

Minister of Health Yuli Edelstein said in mid-September that a second lockdown in Israel was inevitable, owing to what he said had been a lack of aggressive and effective enforcement of the government’s health measures. “The coronavirus is neither a matter of politics nor of populism. This is a matter of life and death. I suggest that anyone who claims that it is possible to do otherwise will go on a tour of the hospitals, of the coronavirus wards, and see the situation for themselves,” Edelstein told the Knesset, the Israeli parliament, on 13 September.

Israel reported more than 4,000 new daily cases of COVID-19 over three consecutive days in mid-September, and hospital facilities were reportedly nearly stretched to capacity in some areas. On 17 September—the day prior to the start of the lockdown—active cases of COVID-19 in Israel had passed 46,000 and 1,165 people had died from the virus, according to local newspaper Haaretz. By the same date, there were 10,433 active cases and 246 associated deaths recorded in the West Bank, and 1,688 active cases and 15 associated deaths in Gaza, Haaretz reported.

The total number of infections recorded in Israel by 24 September was 206,332, according to the Johns Hopkins University tracker.

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