Estimation of the risk of COVID-19 transmission through aerosol-generating procedures

Abstract

Background. The outbreak of the coronavirus disease 2019 (COVID-19) pandemic was associated with the provision of multiple guidelines for the dental profession. All elective procedures were restricted, and only emergency procedures were performed. There was fear and anxiety among dentists while performing aerosol-generating procedures (AGPs), as they were considered to pose a high risk of COVID-19 transmission.Objectives. The aim of this study was to assess the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during AGPs, and to examine the association between risk severity and the number of AGPs performed per day. The efficacy of personal protective equipment (PPE) was also assessed. Material and methods.This cross-sectional cohort study was based on an online questionnaire form completed by 629 general and specialized dentists between January 1 and February 28, 2021. The collected data referred to the sources of COVID-19 infection, the type of PPE used and the number of AGPs performed each day by dental healthcare professionals (DHCPs). For each question, the absolute numbers of responses as well as percentages were calculated.Results. Among the 629 DHCPs, 113 (17.97%) contracted COVID-19. The risk of contracting COVID-19 during AGPs was the same as in the case of non-AGPs, and the infection risk was not associated with the number of AGPs performed per day. The efficacy of a surgical mask with a face shield/eye goggles was higher in comparison with all other types of PPE. Differences in the infection risk across the different types of PPE used were statistically significant (p < 0.001).Conclusions. The risk of COVID-19 transmission during AGPs is the same as in the case of non-AGPs. Thus, restrictions on the performance of elective AGPs should be lifted. On the other hand, the best protection during AGPs is provided by a surgical mask with a face shield/eye goggles.

Changes in the Utilization of Outpatient and Visiting Dental Care and Per-attendance Care Cost by Age Groups During COVID-19 Pandemic Waves in Japan: A Time-series Analysis From the LIFE Study

“…23 Although an initial report highlighted the risk of Sars-Cov-2 transmission in dental settings, 5 recent studies have reported that the actual risk of Sars-Cov-2transmission is considerably low. 24,25 There may have been no scientific reason for patients to refrain from necessary dental attendance because of COVID-19. The government and dental associations need to provide patients with up-to-date and relevant evidence-based information on dental attendance during the pandemic periods based on scientific evidence.…”

The Legacy of COVID-19 in Dentistry: Patient's Perception of Biosafety in Dental Offices: Cross-sectional Research

“…Although some authors have suggested that the aerosols generated during dental procedures do not pose a high risk compared to the non-aerosol procedure, other studies have demonstrated that aerosol reduction is significant in disease transmission during dental procedures, despite methodological limitations. 28,29 However, it is recommended that all patients be treated for potential SARS-CoV-2 infection once the infection can be asymptomatic or pre-symptomatic. 14 Therefore we recommend that dentists be careful when performing aerosol generating procedures, and avoid them whenever possible until there is further evidence on this matter.…”

Assessment of knowledge, practices and attitudes of dentists toward coronavirus disease while performing aerosol-generating procedures in dentistry: A cross-sectional survey from India

“…25,26 Manzar et al concluded that all dental operations, whether they generate an aerosol or not, can disseminate the virus. 27 As a result, all safety precautions must be used equally. Most participants knew who to report to in the event of unprotected contact with a known or suspected coronavirus-positive patient, and what to do if they developed symptoms.…”