A systematic review of contamination (aerosol, splatter and droplet generation) associated with oral surgery and its relevance to COVID-19

Gallagher, Jennifer E.; Sukriti, K C; Johnson, Ilona; Al-Yaseen, Waraf; Jones, Rhiannon; McGregor, Scott; Robertson, Mark; Harris, Rebecca; Innes, Nicola; Wade, William

doi:10.1038/s41405-020-00053-2

Cited by 37 publications

(52 citation statements)

References 32 publications

(133 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The pandemic of COVID-19 has affected the entire world, with over 150 million cases and more than 3.2 million deaths by May 2021, worldwide [25] , and an increasing infection and death rate in developing countries. The dental profession has not had universal guidelines on how to manage the virus, despite being perceived as having extremely high risk for exposure among all professions 2 , 3 , 4 . However, data from similar studies in Europe and USA showed that the prevalence and the positivity rates among dental professionals/dental hygienists was low, suggesting that current infection control recommendations against COVID-19 could be appropriate [ 8 , 9 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The COVID-19 pandemic and its global effects on dental practice. An International survey

Campus¹,

Diaz-Betancourt²,

Cagetti³

et al. 2021

Journal of Dentistry

View full text Add to dashboard Cite

Objectives A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and personal protective equipment (PPE). Methods A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) working conditions and PPE adopted after the outbreak. Countries’ data were grouped by the country positive rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items. Results A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n=27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR=1.80 95% CI=1.60/2.82 and OR=5.20 95% CI=1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR=1.09 95% CI=0.97/1.60). The same significant associations were observed in the multivariate analysis . Conclusions Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Among the many potential sources of transmission and spread of SARS-CoV-2, dental services have received high attention 2 , 3 , 4 . Dental professionals are at the front line of healthcare, working in the mouth, with a potentially increased viral exposure.…”

Section: Introductionmentioning

confidence: 99%

The COVID-19 pandemic and its global effects on dental practice. An International survey

Campus¹,

Diaz-Betancourt²,

Cagetti³

et al. 2021

Journal of Dentistry

View full text Add to dashboard Cite

show abstract

“…It is important to state that urgent procedures should have been carried out to reduce one's pain and to avoid irreversible problems on the oral health. Considering that the extent of contamination during oral procedures has not been completely elucidated, the use of personal protective equipment and initial screening is mandatory ( 38 ) and the implementation of another important infection-control practice could be the use of saliva tests to diagnose early or asymptomatic cases of COVID-19 prior to consultation ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic on oral health procedures provided by the Brazilian public health system

Santos

Pires

Saporiti

et al. 2021

Health Policy and Technology

View full text Add to dashboard Cite

Objective: The objective of this study was to assess the number of dental procedures performed in the Brazilian Public Health System (SUS) during the first wave of COVID-19 in Brazil (1 st semester of 2020) and compare it with the same period of 2019. Methods: A retrospective study was conducted based on the SUS Dataset (DATASUS). Descriptive analysis of the number of dental procedures and socio-demographic regions was presented and the number of dental procedures during the first semester of 2020 was compared to 2019, using Wilcoxon Signed Rank Test (α=0.05). The number of COVID-19 confirmed cases and deaths were also retrieved from DATASUS. Results: Dental procedures decreased from 47 million in the first semester of 2019 to 15 million in 2020, representing an overall decrease of about 66%. Statistically significant differences were observed for the numbers of procedures regarding preventive actions related to oral health (-84.53%; p <0.001), primary care (-60.69%; p <0.001), endodontic specialized care (-52.50%; p <0.001), and periodontal and oral surgery specialized care (-54.57%; p <0.001). Conclusion: The COVID-19 pandemic also reduced by half the number of oral health procedures provided by the SUS in almost all Brazilian states regardless of whether these states had a large number of confirmed cases or deaths. Future policies are recommended in order to reduce the negative impact of the suspension of dental services on the oral health of the population.

show abstract

“…The first paper reported on oral surgery. 30 This paper presents the analysis of 50 papers identified for periodontal procedures. Papers were identified though a systematic search of key databases (Medline (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS) and ClinicalTrials.gov.…”

Section: Methodsmentioning

confidence: 99%

Dental periodontal procedures: a systematic review of contamination (splatter, droplets and aerosol) in relation to COVID-19

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction The emergence of the SARS-CoV-2 virus and subsequent COVID-19 pandemic has had a significant effect on the delivery of routine dentistry; and in particular, periodontal care across the world. This systematic review examines the literature relating to splatter, droplet settle and aerosol for periodontal procedures and forms part of a wider body of research to understand the risk of contamination in relation to periodontal care procedures relevant to COVID-19. Methods A search of the literature was carried out using key terms and MeSH words relating to the review questions. Sources included Medline (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS, ClinicalTrials.Gov. Studies meeting inclusion criteria were screened in duplicate and data extraction was carried out using a template. All studies were assessed for methodological quality and sensitivity. Narrative synthesis was undertaken. Results Fifty studies were included in the review with procedures including ultrasonic scaling (n = 44), air polishing (n = 4), prophylaxis (n = 2) and hand scaling (n = 3). Outcomes included bacterial (colony-forming units e.g. on settle plates) or blood contamination (e.g. visible splatter) and non bacterial, non blood (e.g. chemiluminescence or coloured dyes) contamination. All studies found contamination at all sites although the contamination associated with hand scaling was very low. Contamination was identified in all of the studies even where suction was used at baseline. Higher power settings created greater contamination. Distribution of contamination varied in relation to operator position and was found on the operator, patient and assistant with higher levels around the head of the operator and the mouth and chest of the patient. Settle was identified 30 min after treatments had finished but returned to background levels when measured at or after an hour. The evidence was generally low to medium quality and likely to underestimate contamination. Conclusion Ultrasonic scaling, air polishing and prophylaxis procedures produce contamination (splatter, droplets and aerosol) in the presence of suction, with a small amount of evidence showing droplets taking between 30 min and 1 h to settle. Consideration should be given to infection control, areas of cleaning particularly around the patient and appropriate personal protective equipment, with particular attention to respiratory, facial and body protection for these procedures. In addition, the use of lower power settings should be considered to reduce the amount and spread of contamination.

show abstract

A systematic review of contamination (aerosol, splatter and droplet generation) associated with oral surgery and its relevance to COVID-19

Cited by 37 publications

References 32 publications

The COVID-19 pandemic and its global effects on dental practice. An International survey

The COVID-19 pandemic and its global effects on dental practice. An International survey

Impact of COVID-19 pandemic on oral health procedures provided by the Brazilian public health system

Dental periodontal procedures: a systematic review of contamination (splatter, droplets and aerosol) in relation to COVID-19

Contact Info

Product

Resources

About