Lessons Learned

by Ben Davis, DDS, FRCD(C)

I’m sitting at my desk on a Sunday afternoon in March, contemplating the past 24 months. It was around this time in 2020 that I travelled to Malaysia for an annual academic meeting at IMU, our partner university in Kuala Lumpur.

I had a slight concern about a newly emerging respiratory virus but believed that my supply of hand sanitizer and medical masks would keep me protected. My scramble home, with airports closing or enforcing strict guidelines, was a prelude to our new reality of living with public health closures, restrictions, guidelines and personal tragedies.

At the time of writing, over 37,000 Canadians have succumbed to the coronavirus, with immeasurably more directly or indirectly harmed by the pandemic. While cases of the SARS-CoV-2 omicron variant appear to be declining in Canada, there is still much uncertainty about potential future variants and the impact they could have on our lives. Adding to this insecurity, we have the climate crisis, geopolitical instability and the many humanitarian catastrophes affecting the globe – Sudan, Syria, Somalia, Yemen, Afghanistan, and, most recently, Ukraine. Without a doubt, we are living in highly stressful and rapidly changing times.

I think we have learned many lessons from the COVID-19 pandemic. While our capacity to adapt is remarkable, not everyone can adjust at the same pace, nor does everyone manage the stress of change effectively. In our Faculty of Dentistry at Dalhousie University, we had to rethink many institutional models and ways of working, often with little ill effect. It has been a valuable lesson. Hybrid work models can be effective for certain jobs and less travel is certainly good for the planet. However, not everyone can, or wants to, work remotely.

Virtual learning has a role in our curriculum but should complement, not replace, in-person education.

The pandemic has had a negative impact on all Canadians and the long-term implications will be coming to light for years to come. For me, dealing with this public health emergency has highlighted two important issues: mental health and the need to defend science.

In the US, approximately 43 percent of adults reported symptoms of anxiety disorder and/or depressive disorder over the past two years, up from a pre-pandemic estimate of 11 percent. Without a doubt, we are in the middle of a mental health crisis, exacerbated by the many stresses associated with the pandemic and global tensions. Thankfully, many Canadians now understand the importance of mental health and there is a growing de-stigmatization of those suffering from mental illnesses. We have a long way to go, however. Our health care system needs to provide more resources, but so do our communities, workplaces, and educational institutions. As health-care providers, we need to remember this when dealing with patients, many of whom have had only limited contact with the outside world for over two years. Some will fully embrace the return to a more normal world, while others will be frightened and reluctant. It is important that we remain compassionate, empathetic, and understanding. We must also be prepared to listen and have human conversations.

One of the most unsettling aspects of the coronavirus pandemic has been the upsurge in disinformation related to science. Dr. Richard Horton, editor-in-chief of The Lancet, refers to it as the anti-science movement, which is growing despite the demonstrable triumphs of science in producing life-saving medications and vaccines. Scientific knowledge is the foundation of the oral health profession. It builds on previous ideas and is constantly evolving. Even though public health, our regulators and university faculties of dentistry have not always had evidence from multi-centre randomized controlled trials, they have always strived to use the best available evidence to inform decisions when developing and justifying protocols and guidelines.

Protocols for masking, physical distancing, vaccines and the management of critically ill patients have evolved as science has provided more information on the effectiveness of what previous researchers had concluded. Our understanding and management of disease evolves in line with scientific discovery. This new information should not be disputed, particularly by health-care providers. Fact, not social media rants, should be the basis of our treatment decisions and public health policies. It is expensive to produce quality data, but cheap to produce easily shareable disinformation. We teach our students how to critically assess the scientific literature and use evidence-based decisions in their practice for this very reason.

I look forward to the easing of pandemic restrictions and the return to some level of normalcy. At the same time, I remind myself that, as a profession, we have much work to do around mental health and the re-affirmation of the importance of science in all aspects of our work, particularly the care of our patients.

About the Author

Ben Davis is Professor and Dean of the Faculty of Dentistry at Dalhousie University. He has held positions as Chair of the Department of Oral and Maxillofacial Sciences, Division Head of Oral and Maxillofacial Surgery, and Zone Chief of Oral and Maxillofacial Surgery at the Nova Scotia Provincial Health Authority. He is the past Examiner in Chief at the Royal College of Dentists of Canada and past Chief Examiner for his specialty. He is also Past President of the Canadian Association of Oral and Maxillofacial Surgeons and the former Chair of the Foundation for Continuing Education and Research. Professor Davis obtained his D.D.S degree from the University of Western in 1992 and his Diploma in Oral and Maxillofacial Surgery and Anaesthesia from the University of Toronto in 1997. Dr. Davis undertook a surgical fellowship at Dalhousie between 1997-1998.

Oral Health is pleased to present the voices of our Editorial Advisory Board members in this forum, which allows writers to share their personal thoughts, opinions, viewpoints and experiences. We want to ensure our tradition of serving our readers the very best in clinical and editorial content continues and we thank all the members of our Editorial Advisory Board for their efforts in making this happen. We welcome your comments and feedback. Feel free to share your thoughts with us through letters to the editor (amy@newcom.ca).