The Line · the University of Alberta Alumni Association

Episode 7: Covid and Cavities With Dr. Paul Major, ‘88 DDS

May 14, 2020·21 min·1 clip

Dr. Paul Major explains how dental drills create virus-carrying aerosols, a new danger beyond standard infection control.

Host Matt Ray opens by noting Alberta's phased reopening plan, which includes resuming some dental services, and frames dentistry as a uniquely high-risk profession because practitioners work directly inside patients' mouths. Dr. Paul Major, a 40-year veteran orthodontist and 35-year University of Alberta faculty member, explains that all Alberta dental practices were restricted to emergency care only from March onward, following strict definitions set by the Alberta Dental Association College. Starting May 4th, the scope expanded to urgent care, which includes ongoing orthodontic treatment, cementing pre-prepared crowns, and completing unfinished root canals. Dr. Major describes his first week of urgent-care patients as positive — patients were grateful and showed no hesitation — but notes that staff risk tolerance varies widely, with some employees reluctant to return. He outlines Alberta's longstanding infection control framework, which has treated all patients as potentially infectious for roughly a decade, but identifies aerosol production as a new and under-researched concern. Dental drills spray water, creating a fine mist that can carry virus particles, and existing level-one masks are likely insufficient to protect against airborne transmission. Dr. Major draws a parallel to aerosol risks at meat-packing plants. He describes the PPE supply chain as severely strained, with N95 masks difficult to obtain even for hospitals, and notes that Alberta Health Services provided only limited emergency-care PPE allocations every two weeks — insufficient for the expanded urgent-care workload. At the University of Alberta's large Edmonton dental clinic, students have been barred from all clinical and simulation training since March, with faculty handling emergency cases. Dr. Major hopes students can return in July but acknowledges uncertainty. He discusses the Boyle-McCauley Health Centre dental clinic partnership, which provides free care to inner-city patients including youth through the SHINE program, noting it follows the same regulatory standards. On future changes, Dr. Major expects long-term adjustments to aerosol management protocols once research catches up, but says the fundamental need for dental care will not diminish. He then recounts his personal COVID experience: a planned two-week cruise from Argentina became a five-week ordeal when ports closed worldwide, passengers fell ill, and the ship — the Zaandam — had to negotiate Panama Canal transit before finally docking in Fort Lauderdale. Canadian passengers were bused under police escort to a chartered flight back to Canada. Dr. Major closes by saying his greatest concern is ensuring dental students receive the clinical education they need, and that he is actively reviewing research at both the Alberta Health Services and national levels to determine safe practice standards.

As heard by us

A careful look at reopening dentistry when routine care meets COVID-era risk.

The piece treats Alberta's relaunch as a practical public-health problem: what changes when optometrists, therapists, physiotherapists, and some dental appointments return before the risk feels settled? Dr.

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Why you'd press play

When your dentist's chair starts to feel like a public-health problem.

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