Dentistry and Covid-19 and some thoughts on our world…

Written by Dr Marco Maiolino










1 June 2020 the app IMMUNI has been released in Italy. it’s an app developed for tracking people and to help control the spread of COVID 19, on the website we can read “ living a normal life once again is possible. IMMUNI helps us reach this goal faster and without compromising privacy” “.

Normal life..they say. I just have a different concept of what a normal life is actually. Let’s do a small recollection of this year so far.
This year has been quite a peculiar one..2020 will be remembered as the year of the CORONA or COVID 19. Most of the world has experienced in different degrees this pandemic or supposed one.
Italy has been one of the country taking into consideration some rigid measures. All activities have been closed starting from the 9th of march. People were forced to stay at home without even being able to walk outside.
I’ve been there….. locked at home, for more than 2 months, listening every single day to the government about how dreadful and perilous this virus is.

Yet, this virus, in my country, Sicily, the small island in the south of Italy, has done a negligible number of deaths. Nevertheless, people were scared, panic spread among a lot of families. Still, nowadays I see people scared of being too close to outsiders. Me, being a dentist, we work in a way that social distancing is impossible. The patient has to remove their mask and, last but not least, working with our instruments we are covered with the so-called aerosol, An aerosol (an abbreviation of “aero-solution”) is a suspension of fine solid particles or liquid droplets in the air. Mixing the water from our instruments with the saliva of the patient we potentially have to deal with the nebulization of the virus itself in the air surrounding us.
From a theoretic point of view, this sort of reasoning is fair but …….what’s going on in real life?
It seems we are not aware of all the “hidden” cost from a social, economical, and health-related point of view.
Economical activities have been shut off, many businesses have been closed indefinitely, 500.000 Italians have lost their work, the consumption of antidepressants, anxiolytic drugs has skyrocketed.
Yesterday I talked with a psychologist whose work during this period has increased. Many suffer from sleep disorders, anxiety, depression and fear, related to the decreasing or lost work. The dentist has to work with different kinds of mask-like ffp2, and a lot of them experience problems of breathing, problems of headache. Using these masks you end up breathing your carbon dioxide affecting your oxygen saturation. For some of them, especially those with some cardio circulator issue, this can lead to major health consequences in due time.
I would be able to go on for many pages describing all the “hidden” costs of these decisions, even on long term …just think about small children separated by their peers, forced at home for such a long time. and last but not the least, let’s remember that we have evolved in the last ten thousands of years together with viruses and bacteria (think to the microbiome in the gut ), most of them live in perfect harmony with us .we need, to be healthy and playing with all these sorts of “protective measures “ affect also the good ones on the long term.
But the main point I want to highlight is one: where is the balance? We live in a less than ideal world, every kind of decision has consequences. We have to find that sweet spot over which our “good and safety measures “ start to be harmful or not.
To do this we have to understand the exact rate of risk we are facing…so now I just want to compare some activities we do just to make a fair comparison.
It seems that smoking alone kills approximately 800.000 persons/year only in Europe (3.500.000 in the whole world ). Its the main factor involved in 95% of lung cancer, 80-85% of chronic bronchitis and emphysema,20-25% of cardiovascular accidents.

Road accidents claim approximately 5-15 deaths every 100.000 people ( multiply this for all your life and end up with a risk of one chance over 400/500 in the best scenario), most of these deaths are from the young population in the 15-44 age group. We can go on talking about obesity, lack of exercise, cardiovascular accidents, diabetes-induced by chronic abuse in our daily lifestyle.
Yet most of the people smoke, eat, stay on the sofa looking Netflix, drive without any kind of concern or fear.
And finally came COVID 19 …with a mortality rate not greater than these and it’s able to lock the entire world, and scare millions of people.
We have been able to change our social habits, force people to stay at home, to separate whole families but we are not able to stop smoking or stop eating poison.
And ……… do we even want to speak about malnutrition? In a world where food is trashed away, still, 200 millions of children are suffering and we have millions and millions of deaths every year without a single word spent so vigorously like coronavirus.
I think we have a lot to think about ourselves and our world.
In this period a lot of colleagues contacted me about how do I manage my office against coronavirus.
Honestly, I feel normal. I would be able to work like last year, 2019, without any concern. I just use some stuff and devices specifically for patient protection, and some others in order not to seem negligent and not be annoyed by the government.
If I would be scared of coronavirus, I think I would have to start being scared every time I use my car, even worst my motorbike or something else……and I am not.
Life is a balance and living itself is a risk. But we have to decide if the value of life is just in his length or in HOW we live it, enjoying it.
I accept 1000 times more to LIVE a full life without anxiety or fear than live with thousands of protections, with an app on my mobile that tracks my every movement, with a thermic scanner and face recognition technology, in a place where people are scared to say goodbye using their hands.
I prefer to live decently.
The other one is not to live, is more a sort of slow prolonged death.
Choose yours.
Choose life.




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