COVID-19 in Dental Practice: Transmission Risk, Infection Control Challenge, and Clinical Implications

Abstract

Objective: The COVID-19 pandemic has become a worldwide, significant public health challenge. Dental care providers are at high risk due to the nature of their profession, which necessitates close proximity to the patient's oropharyngeal region and the use of droplet and aerosol-generating procedures. Methods: A review of the evolving literature on the COVID-19 pandemic was conducted. Published articles addressing SARS-CoV2 transmission modes and risks, and infection control procedures required in the dental office to protect dental patients and health care providers were assessed. Also, clinical guidelines on the management of dental patients during the pandemic were reviewed. Results: The established modes of transmission of SARS-CoV2 appear to be through respiratory droplets and through close contact with either symptomatic or asymptomatic patients. In addition to standard precautions of infection control widely followed in dental practices, extra precautionary measures are needed to control the spread of this highly infectious disease. Dental treatment during the pandemic is limited to emergent and urgent cases after a meticulous patient risk assessment and dental needs are triaged to minimize the risk of COVID-19 transmission and avoid cross-contamination. Conclusion: Dentists should be aware of the recently updated knowledge about COVID-19 modes of transmission and the recommended infection control measures in dental settings. Effective management protocols to regulate droplet and aerosol contamination in the dental clinic should be implemented to deliver dental care in a safe environment.

COVID-19 and the ethical challenges of management in Private Dental Clinics in Egypt.

“…Various variables, such as dentist fears, patient fears, restriction governmental rules, and financial concerns have been documented to impair the flow of patients during the pandemic. 6,7 From an ethical point of view, there is no definite guideline outlining what procedure is urgent in dentistry 15 . There is no distinction and dentists treated many simple non-urgent cases for financial reasons.…”

“…10 Dentists in Egypt may not be able to provide the ideal service for their patients due to many reasons such as the barriers hindering infection control. 15 In this study, we believe that infection control regulations regarding patient management are very important.…”

Efektivitas Extraoral Suction dalam Praktik Kedokteran Gigi di Masa Pandemi COVID-19

“…11 Aerosol dapat dihasilkan selama intrumentasi saluran pernafasan atas (rongga mulut dan hidung), cairan irigasi, maupun bahan lain yang bercampur dengan darah, saliva, serta bakteri yang dapat menghasilkan partikel aerosol dan berpotensi menularkan penyakit. [7][8][9][10] Partikel dengan ukuran dibawah 50 µ cukup untuk bertahan di udara selama beberapa waktu sebelum akhirnya menempel pada permukaan sekitar atau terhirup dan masuk ke saluran pernafasan. 11 Splatter/droplet didefinisikan sebagai partikel dengan diameter lebih besar dari 50 µ. Droplet bergerak secara balistik, artinya partikel dikeluarkan dengan tekanan dari sumbernya dan melesat seperti peluru hingga berkontak dengan suatu permukaan atau jatuh ke lantai.…”

“…Melalui udara, spora jamur dapat menyebar sejauh 150 m, sedangkan virus dapat berpindah hampir 200.000 km secara horizontal. [7][8][10][11][12] Profesi dokter gigi menempati urutan pertama pekerjaan paling beresiko terpapar COVID-19, dikarenakan area kerja dokter gigi berada disekitar mulut dan wajah pasien, berkontak dengan saliva serta adanya kemungkinan terjadi produksi aerosol selama perawatan (Tabel 1). 13,14,16 Gigi umumnya digunakan intraoral suction untuk mengevakuasi cairan saliva, darah, dan air dari dalam rongga mulut pasien selama proses perawatan gigi.…”

Coronavirus Disease-19 and Dentistry: A Review

“…Now, it has become a major health problem not only for China but also majority of countries around the world [3]. The World Health Organization on January 30 announced that COVID-19 outbreak is a public health emergency of international concern [2], [4].…”