COVID-19. Clinical Guidelines Dentistry

Abstract

Em Dezembro de 2019, o mundo assistiu à emergência de uma zoonose provocada por um novo tipo de Corona vírus o SARS CoV 2. Esta infeção rapidamente evoluiu para uma disseminação pandémica com consequências pesadas em todos os planos civilizacionais. O SARS CoV 2 e a Covid 19 persistem presentemente sem previsões para a sua eliminação, com grande incerteza sobre a sua evolução e extensão quer das consequências sanitárias quer do impacto económico. Desta forma importa desenvolver estratégias que possibilitem o funcionamento das estruturas produtivas, combatendo o congelamento económico e social enquanto consequências absolutamente nefastas no contexto pandémico. A Medicina Dentária, pela sua natureza, nomeadamente a produção de aerossóis, foi classificada como sendo uma atividade no topo do risco de aquisição/disseminação da doença por parte dos profissionais que a exercem. Muitos países suspenderam o exercício de Medicina Dentária como medida preventiva. Importa, pois, agora e na perspetiva de regresso criar mecanismos que permitam o exercício profissional em segurança. No entanto existe uma lacuna extensa sobre a própria definição de segurança no exercício profissional em Medicina Dentária no contexto SARS CoV 2 /Covid 19. O objetivo destas Normas de Orientação Clínica (NOC) foi compilar de forma sistematizada a evidência existente sobre esta temática e conferir a maior robustez possível à decisão clínica no pré per e pós consulta.

Dispersion of Aerosols Generated during Dental Therapy

“…In simulations, combining face masks and face shields reportedly provides 63% to >99.9% protection against infection in medical practice [30]. Therefore, using personal protective equipment such as masks, face shields, or aprons, is important for preventing infections [11,31,32]. Dental practitioners should implement fundamental infection controls, such as taking standard precautions [11][12][13]17,[31][32][33], diligently setting up ventilation [16], and using air purifiers.…”

“…It is believed that COVID-19 is mainly spread by droplet-borne transmission or through contact infection; however, airborne transmission is also possible [1][2][3][4][5]. Because the daily tasks of dental practitioners involve examination and treatment in and around the mouth, dental practitioners are in danger, as they can be exposed to saliva or aerosols that contain SARS-CoV-2 [6][7][8][9][10][11]. Insufficient data have been collected regarding the risk of COVID-19 infection among healthcare professionals involved in dental therapy.…”

“…Insufficient data have been collected regarding the risk of COVID-19 infection among healthcare professionals involved in dental therapy. It has been noted that the use of high-speed rotary cutting tools, ultrasonic scalers, and other frequently used tools in dental care settings can increase this risk [9,[11][12][13], as aerosols can permeate wide areas [14].…”

“…It has, however, been reported that many fine particles are typically suspended in the air in dental clinic settings, and it is necessary to accurately investigate the fine particles produced purely by the use of dental treatment equipment [11,15,16]. In this study, laser light and a high-sensitivity camera were utilized to visualize the aerosols that were generated when a high-speed rotating cutting tool (driven by a micromotor) was used in a large super clean laboratory (SCL).…”

The Impact of the First Wave of the COVID-19 Pandemic on Providing Special Care Dentistry: A Survey for Dentists

“…Accordingly, numerous international organizations and professional bodies released specific clinical practice guidelines for reducing the risk of transmitting SARS-CoV-2 in the dental setting. Although their recommendations were heterogeneous, at that time, most agreed on limiting care to emergency procedures, performing patient triage, wearing class 2 filtering facepiece masks and avoiding aerosol-generating procedures [11,12].…”