Infection Control in Dental Practice During the COVID-19 Pandemic

Abstract

<jats:p>COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency from China has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim of this paper is to provide practical advice for dentists based on the recent literature, which may be useful in reducing the risk of spreading COVID-19 during clinical practice.</jats:p>

Dental care management during the COVID‐19 outbreak

“…The instruments and equipment should be disinfected according to the manufacturers’ instructions or the WHO instructions for reuse of medical and dental equipment. Since coronavirus is not able to survive more than 30 minutes at temperatures above 56°C, the common sterilization protocols are still effective for the prevention of cross‐infection 44 . These protocols suggest sterilization of critical and heat‐tolerated semicritical instrument.…”

“…Use of rubber dam in aerosol‐generating procedures (such as the use of high‐speed handpiece and ultrasonic scalers) can significantly decrease the generation of saliva‐ or blood‐contaminated aerosols. However, it should be noted that in case of placing a rubber dam, a high‐volume saliva ejector should also be used along with a conventional saliva ejector 44 . Evidence shows that use of rubber dam during cavity preparation can decrease the spread of microorganisms by 90% 51 .…”

Pivoting Dental Practice Management during the COVID-19 Pandemic—A Systematic Review

“…Telephone triage using a screening questionnaire was implemented. Emergency dental care for patients who reported symptoms of COVID-19, had contact with COVID-19-infected individuals, or traveled to regions with a high number of COVID-19 cases in the past 14 days was postponed for two weeks, and pharmacologic management of pain or infection was considered [36,41,44]. More recently, a new protocol was adopted to delay any treatment for patients with confirmed cases of COVID-19 until two consecutive negative swab tests were established taken 24 h apart [44].…”

“…Emergency dental care for patients who reported symptoms of COVID-19, had contact with COVID-19-infected individuals, or traveled to regions with a high number of COVID-19 cases in the past 14 days was postponed for two weeks, and pharmacologic management of pain or infection was considered [36,41,44]. More recently, a new protocol was adopted to delay any treatment for patients with confirmed cases of COVID-19 until two consecutive negative swab tests were established taken 24 h apart [44]. A few articles mentioned that the same questionnaire should be repeated, and body temperature should be documented using a noncontact thermometer upon the patient's arrival at the clinic [37,41,42].…”

Characteristic changes of traumatic dental injuries in a teaching hospital of Wuhan under transmission control measures during the COVID‐19 epidemic

“…9 Many dental procedures can generate an aerosol, and the risk of airborne infection is considered high for dental practitioners. 10,11 To provide clinicians with the characteristics of TDIs during the epidemic, a retrospective analysis is necessary. The aim of this study was to explore the characteristics of TDIs under the transmission control measures in Wuhan City during the COVID-19 epidemic utilizing an epidemiologic investigation.…”