-by Dr Muattar Hanif

Dr Adil Bin Irfan graduated from the Fatima Jinnah Dental College in 2011. Following graduation, he worked as a Registrar and later appointed as Head of Hospital Safety at Altamash Institute of Dental Medicine.

After completing his post-graduation degree of MCPS in Health
Care Systems Management, Dr Adil focused more on healthcare quality management,
patients’ and health personnel safety, infection prevention and control.

Dr Adil’s areas of interest include community-based awareness
outreach programs, public health, hospital and healthcare management and
research methodology.

Aside from involvement in academia, he is also a private practitioner. 

Dental News: Take us through your journey
from dental school to your current position.

Dr Adil: I graduated from Fatima Jinnah Dental College in 2011 and did my
house job from the parent institute in 2012. Just after getting done with house
job, I got an opportunity to work as Registrar in the Department of
Prosthodontics at Altamash Institute of Dental Medicine. Till date, I am working
there as Registrar and OPD Incharge. In 2018, I did my post-graduation in MCPS
in Health Care Systems Management. Due to my special interest in Healthcare
Quality Management, Patients’ and Health Personnel Safety, Infection Prevention
and Control, I did several courses.

Life begins out of your comfort zone always have a passion for keeping growing and learning new skills

Notable ones are ‘One Year Diploma in Occupational Health and
Safety Environment’ from Sindh Board of Technical Education, One Year
Certificate Program in ‘Hospital Infection Prevention and Control’, IOSH
Certification UK, a short course in ‘Epidemiology and Biostatistics’ from AKUH,
training in Fire Safety and various certifications from Aga Khan University.
Due to my intellectual post-grad qualifications, I have been appointed as Head
of Hospital Safety at AIDM. Dr Adil is also an experienced Dental Surgeon and
Specialist Trainer in Infection Prevention and Control in Karachi.

I conducted a first-ever specialized one-day hands-on workshop
in Infection Prevention and Control in Dentistry with CODE-M in March 2020 and
Facebook live session with YDC in June on the same topic. I am the first
dentist in Sindh to earn this honour. I also run my practice with the name
Dental Solutions Clifton where he is working as Managing Director and
Consultant Dentist. During this pandemic, I started my Instagram page with the
name of @dentistwithhumour, where I share hilarious and funny posts regarding
dentistry to cheer up his fraternity during these tensed times.

DN: How are you looking at the current
pandemic situation and its impact on the dental community?

ABI: The absolute clinical
picture of COVID-19 is still yet to be discovered, and we as a part of the
dental industry are suffering from its devastating effects. Sadly, due to the
irresponsible attitude and behaviour of our people, this pandemic’s effect is
still on the rise in our country, and it is difficult to predict the extent and
severity of its long-term impact on us and world over. There is a dubious
future of dentists, especially the fresher graduates and the sustainability of
dental practices is also a serious concern.

If I talk about private clinics, which are mostly run on a
rental basis, including their staff’s salaries compounded by zero income,
causes a huge socio-economic impact on our profession. Patients are also afraid
of visiting dental clinics as dentists are declared as high-risk professionals
due to proximity between doctors and patients which is one of the reasons.

DN: What are your recommendations for
dental practices during COVID-19?

ABI: There is a need for a paradigm shift in our dental practices to
keep everyone safe from this pandemic, including patients, their attendants,
auxiliary staff, management team and of course, oneself being the dentist.
Dental practice norms are transforming very differently within these few months
since pandemic started to adapt to this changing situation. Before trying to
adapt to that change completely, we should keep in mind that we belong to the
category of a developing country, and this shift will demand a huge investment.
We, as dental professionals, know all the guidelines provided by the CDC, ADA
and NHS.

There is no comparison between virtual classes and hands-on experience

I will give recommendations according to the real picture of our
field, but many of my colleagues might disagree with my recommendations. In my
opinion, only a few well-settled dental practices can adapt that change
completely the rest of them cannot. My recommendations are simple. There should
be the use of proper personal protective equipment (PPE) by both dentists and

There’s no need of changing surgical gown or hazmat suit on every patient; they can be washed or sprayed by 5% hypochlorite solution until they are soiled or contaminated and same for the surgical mask. Use N95 respirator mask on top if possible. A combination of a surgical mask and a full-face shield can be used in situations when a respirator is not available. Use rubber dams where possible and high volume suction systems while using high-speed handpiece and ultrasonic scaling devices. Dental chairs and critical contaminated surfaces should be sprayed before and after treating every patient, wash your hands with normal soap before and after wearing gloves. Ensure proper ventilation and keep at least 20 to 30 minutes’ gap between appointments. Using barrier films on critical surfaces, but again it’s an expensive idea. Pre-procedural mouth rinse with 0.5–1% hydrogen peroxide for its nonspecific virucidal activity against viruses or with 0.2% povidone-iodine is recommended as it may reduce a load of coronavirus in saliva.

I will not apologize for being against teledentistry, as speaking to patients without clinical examination in person to me is unethical

For patients, asking travel history is a must. Limit appointments in a day, not more than 4 patients. Be mindful of aerosol generation in a day. No patients will be allowed without masks and hand sanitization is a must when patients walk into your practice. Coughing etiquettes, respiratory and hand hygiene and COVID-19 precautionary signs should also be posted on walls of your waiting area.

Lastly, I will not apologize for being against teledentistry, as
speaking to patients without clinical examination in person to me is unethical.
It’s like providing substandard diagnosis and care over the phone without
proper investigation, and multiple instruments and aids are required like bite
tests for fractured teeth, X Rays for bone integrity and hot and cold tests for
pulp integrity.

As there is no hope of revival of this pandemic anytime soon and
we have to work in this condition to prevent ourselves from further financial
constraints and for the sustainability of our practices.

DN: What is your take on online classes and
their continuity?

ABI: In my opinion, it’s a
necessity due to the current pandemic situation. As, you see due to COVID19
since march our government had ordered to close all schools, colleges and
universities until we win the battle against this pandemic. So, due to this
current situation, we are left with this as the means of teaching modality.
It’s not just us who’s using this modality, almost every country in the world
has now transformed to this. It may be new to most of us here in Pakistan, but
if we talk about western countries, they have been conducting online
courses/degree programs since long. To bring this innovation, it’s a privilege
for me, my Department and Institute to introduce ‘Live Demonstration of Teeth
Setup’ to the Undergraduate Students during this lockdown situation, by making
the most of the Virtual Platform we have, and as per my knowledge, it was the
first time in Pakistan that any of institute conducts the online undergraduate
demonstration. The fate of the COVID-19 crisis is unclear shortly, so we have
taken this step to keep our students updated to the clinical processes in
Prosthodontics. It’s just the beginning; we will be conducting live demonstrations
of all procedures on patients gradually, Insha Allah.

DN: Do you agree that virtual classes can
be a suitable alternative for dental education, which specifically relies on
hands-on experience?

ABI: In my opinion, there is
no comparison between virtual classes and hands-on experience. However, we can
compare online classes with the traditional form of regular classes and
demonstrations we usually do in labs and OPDs. As extraordinary times calls for
extraordinary measures – it is the birth of an emerging trend of E-learning.
The world has to take emergency measures and codes to replace traditional
learning in the form of regular classrooms to E-learning in the face of this
COVID -19 pandemic. But yes, we can say virtual classes are not the absolute
replacement of traditional ones for dental education; they can be used as
adjuvant until all these things get better.

DN: How much can dental workshops and
symposiums play a role in the development of clinical skills?

ABI: These workshops,
symposiums and seminars provide learning opportunities for fresh graduates,
especially. They get to meet new people, make collaborations, learn new skills
and procedures which are usually not being taught at the undergraduate level.
They also get a chance to learn different methodologies from international and
national speakers. This broadens their mind with different aspects of
problem-solving, and critical thinking skills, and ultimately it will help them
to progress in a unique way. It also helps in polishing and sharpening their
practical skills and be up to date on new and current advancement in different
treatment modalities.

DN: Lastly, what is your message for young

ABI: I will give two messages
to my young/ fresh dental graduates. Firstly, follow your passion, dream and
break the stereotype. This means if you are now a dentist, you don’t have to do
dentistry and nothing else. Forget about what your family or society assumes.
If you don’t have mental peace in doing dentistry, don’t do it, find alternate
ways, everyone should always have a plan B or C in their mind. But once you
leave dentistry stick to your plan B wholeheartedly because that profession is
chosen by yourself. Secondly, if you have the passion and have the dream of
being a dentist, do out of box things don’t just run after FCPS, MDS or MSc
just in clinical subjects, there is an open field of Basic Dental Sciences, Public
Health, Hospital and Healthcare Management in Pakistan explore it!

There is a need for a paradigm shift in our dental practices to keep everyone safe from this pandemic, including patients

Since our field has now become so saturated, it will be really
hard to survive by doing dentistry alone. We have to do at least two things or
invest in some business; otherwise, survival in these times is questionable.

Last but not least, make your hand clinically strong after all,
you will have to earn your bread and butter from your clinical practice. Do
attachments and internships at clinics or dental OPDs, until you find yourself
confident enough to run your practice alone. Life begins out of your comfort
zone always have a passion for keeping growing and learning new skills.

The post The absolute clinical picture of COVID-19 is still yet to be discovered; Dr Adil Bin Irfan appeared first on Dental News Pakistan.


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