Infection Risk of COVID-19 in Dentistry Remains Unknown: A Preliminary Systematic Review

Abstract

Background COVID-19 is a novel viral respiratory disease caused by a member of the coronavirus family, SARS-CoV-2, and has been declared as a pandemic on March 2020. Dental practitioners are routinely exposed to infectious bodily excretions, for example, saliva, blood, and respiratory excretions. Therefore, they are in the first line of SARS-CoV-2 infection-prone health care providers. The purposes of the current review are to trace documented cases of COVID-19 transmission inside dental settings worldwide and to explore the clinical management of these cases. Methods We searched MEDLINE and Google Scholar for all possible reported cases of COVID-19 transmission in dental practice as of December 1, 2019, until May 13, 2020. Multiple terms and combinations were used, including “coronavirus,” “COVID-19,” “SARS-CoV-2,” “dental,” “dentistry,” “transmission,” and “nosocomial.” Articles that were not written in English were excluded. Results A total of 78 articles were found from December 29, 2019, until May 13, 2020. Of these, 31 articles discussed the risks related to dental practice and recommended infection management protocols for dental health care personnel. Of these articles, only 1 had reported data on transmission of COVID-19 in dental practice. Two possible transmissions of COVID-19 to dental personnel were reported in China before its recognition as an epidemic. Conclusions Although it seems that there are almost no reported cases of infection by SARS-CoV-2 during dental treatments, occupational or nosocomial transmission could not be ruled out. Hence, further prospective assessment of COVID-19 transmission is urgently required, and careful and protective measurements are necessary to avoid infection during dental practice.

Prediction of emotional exhaustion over the course of the COVID-19 pandemic in primary care dental staff: an intensive longitudinal study

“…23 Simultaneously, the current position at the time showed no direct relationship between dental treatment or surgery and possible COVID-19 transmission. 24 Subsequently, however, evidence was reported to show increased risk of exposure and transmission of COVID-19 in the dental care workforce compared with other occupations. 25…”

Dental safety net providers’ experiences with service delivery during the first year of COVID-19 should inform dental pandemic preparedness

“…Participants' concerns about infection control among patients, staff members, and personal contacts were unsurprising, given the characteristics of the SARS-CoV-2 pathogen, the centrality of infection control in dentistry, and emerging dental PHEPR. 12,25,26,41,42 Although participants felt confident about controlling blood-borne pathogens, their excess stress related to the novel risks of a highly infectious air-and droplet-borne pathogen in the dental space was exacerbated by 2 systemslevel and 1 patient-level concerns; that is, differences in guidance from governmental and professional bodies, the unpredictability of material resource pipelines (in particular PPE), and the urgency participants felt to return patients to in-person care to manage, halt, or prevent disease.…”

“…[4][5][6][7] Oral health care delivery concerns were particularly fraught in the first year of the COVID-19 pandemic, amidst uncertainty about the microbiology of the novel pathogen; the epidemiology of infection, severity, and mortality; and effective prevention and mitigation measures. 8,9 Although emerging evidence indicates the effectiveness of dental infection control measures, [10][11][12] questions remain about future pathogen mitigation, the role of vaccinations in return to care, the appropriate use and reimbursement of teledentistry, and oral health care provider resilience, all of which can also be affected by means of ongoing changes in federal, state, and local guidelines.…”

If the Coronavirus Were Red: Unresolved Concerns on COVID-19 Transmission in Oral Health Education

“…As the COVID-19 pandemic rages on in the middle of the current “Phase 2” of reopening, dentistry continues to face its field-unique challenges (Lo Giudice, 2020). While COVID-19 transmission in dentistry has a very high, not yet validated, theoretical risk (Levit & Levit, 2020), we hypothesize that oral health education might expose dental health care providers to an additional risk. Surprisingly, to the best knowledge of the authors, concerns on COVID-19 transmission due to oral hygiene education were not yet raised in the indexed literature nor appropriate attitudes to safely accomplish such a pivotal part of oral health were suggested.…”