A qualitative analysis of dental professionals’ beliefs and concerns about providing aerosol generating procedures early in the COVID-19 pandemic

Abstract

Introduction In response to the COVID-19 pandemic, the Scottish Dental Clinical Effectiveness Programme (SDCEP) initiated a rapid review of the evidence related to the generation and mitigation of aerosols in dental practice. To support this review, a survey was distributed to better understand the provision of aerosol generating procedures (AGPs) in dentistry. Methods An online questionnaire was distributed to dental professionals asking about their current practice and beliefs about AGPs. Data were analysed using qualitative content analysis. Results Analysis revealed confusion and uncertainty regarding mitigation of AGPs. There was also frustration and scepticism over the risk of SARS-COV-2 transmission within dental settings, the evidence underpinning the restrictions and the leadership and guidance being provided, as well as concern over financial implications and patient and staff safety. Discussion The frustration and concerns expressed by respondents mirrored findings from other recent studies and suggest there is a need for reflection within the profession so that lessons can be learned to better support staff and patients. Conclusion Understanding the profession’s views about AGP provision contributed to the SDCEP rapid review and provides insights to help inform policymakers and leaders in anticipation not only of future pandemics but in considering the success of any large scale and/or rapid organisational change.

Aerosol reduction efficacy of different intra-oral suction devices during ultrasonic scaling and high-speed handpiece use

“…For example, Brazil and Mexico exclude powered scalers from their list of AGP instruments; whereas numerous countries, including the USA and UK, state that the use of all types of dental handpieces, powered scalers and 3-in-1 syringes should be treated as AGPs [ 2 ]. Dentists surveyed during the pandemic expressed confusion regarding the current guidance in-place, particularly in terms of what was appropriate practice to effectively mitigate AGPs, and ultimately concerns were raised regarding the impact this ongoing uncertainty may have on service provision and patient care [ 3 ]. Furthermore, despite the general shift towards remobilisation of medical and dental services after the pandemic peak, dentists in some countries are still restricted in the number of AGPs they can realistically provide due to the existing guidance regarding fallow-time [ 4 ].…”

Healthcare workers’ infection risk perceptions of aerosol-generating procedures and affective response

“…We included 16 reports in this review (Table 1). [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Publication date of the reports ranged from 1990-2022. Report settings included the United States (n = 7), Italy (n = 3), the United Kingdom (n = 2), Saudi Arabia (n = 2), Australia (n = 1), Cambodia (n = 1), Canada (n = 1), China (n = 1), India (n = 1), Indonesia (n = 1), Malaysia (n = 1), New Zealand (n = 1), Spain (n = 1), Taiwan (n = 1), Thailand (n = 1), Turkey (n = 1), and West Africa (n = 1).…”

“…For example, studies conducted in the 1990s [19][20][21] focused on HIV, whereas contemporary reports generally centered on COVID-19. [24][25][26][27][28][29][30][31][32][33][34] Similarly, Bevan and Upshur 22…”

Electrolyzed water for the microbiologic control in the pandemic dental setting: a systematic review

“…Certainly, the length of dental procedures and the proximity between patients and operators within the dental setting put dentists and their patients at high risk of COVID-19 [7]. Moreover, the constant use of water-cooled highspeed rotary hand-pieces or ultrasonic scalers during most dental procedures generates and further spreads virion-loaded aerosols [8,9]. Indeed, these aerosols can contaminate surfaces, dental instruments, impression casts, and dental unit-waterlines, among others, increasing the risk for cross-contamination [8,9].…”

“…Moreover, the constant use of water-cooled highspeed rotary hand-pieces or ultrasonic scalers during most dental procedures generates and further spreads virion-loaded aerosols [8,9]. Indeed, these aerosols can contaminate surfaces, dental instruments, impression casts, and dental unit-waterlines, among others, increasing the risk for cross-contamination [8,9].…”