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

Abstract

Background and Objectives: The aims of this systematic review were to identify additional infection control measures implemented in dental practice globally to prevent cross-infection and evaluate the psychological impacts of the pandemic among dental professionals. Materials and Methods: A sequential systematic literature search was conducted from December 2019 to 30 April 2020 through PubMed, CINAHL, Scopus, Google Scholar, Embase, and Web of Science databases. The search yielded the following results: “COVID-19” (n = 12,137), “Novel corona virus” (n = 63), “COVID-19 and dentistry” (n = 46), “COVID-19 and oral health” (n = 41), “Novel Corona virus and Dentistry” (n = 0), “dental health and Novel Coronavirus” (n = 26), and “dental practice and Novel Coronavirus” (n = 6). Results: After a careful review and eliminating articles based on inclusion and exclusion criteria, the final review included 13 articles. Management of infection control is discussed extensively in the literature and remains the main theme of many Coronavirus Disease 2019 (COVID-19) articles on dentistry. Telephone triage using a questionnaire, hand hygiene, personal protective equipment (PPE) for clinical and nonclinical staff, a preprocedural mouth rinse, and aerosol management have been discussed and implemented in few countries. Three studies recommended that elective treatments for patients with a temperature of >100.4 F or 38 °C should be postponed or performed in an airborne infection isolation room (AIIR) or negative-pressure room. Limiting the number of patients in the waiting area, the removal of shared objects, proper ventilation, and physical distancing were highly recommended. Psychological distress among dental professionals in relation to existing medical conditions and self-efficacy has been discussed. Conclusions: Although the COVID-19 pandemic has had a substantial impact on the dental profession worldwide, our review highlights many practice management approaches to adopt the new norm. More research highlighting evidence-based safety practices and multisectoral collaboration is required to help dental professionals make informed decisions and make the profession safe, both for the patient and dental professionals.

COVID-19 in dental care: What do we know?

“…All patients with symptoms raising suspicion of COVID-19 should use a teledentistry consultation before visiting the dental clinic [ 46 ]. Apart from identifying suspected or confirmed COVID-19 cases beforehand, another purpose of the triage is to assess the urgency of each referral [ 47 , 48 ]. In Italy, it is compulsory to carry out a telephone triage to verify whether a patient’s visit to the clinic is essential [ 49 ].…”

“…In Italy, it is compulsory to carry out a telephone triage to verify whether a patient’s visit to the clinic is essential [ 49 ]. In Slovenia, smartphone-taken pictures and videos of the affected area are used during the triage [ 48 ] to establish a more accurate diagnosis and to ultimately decide whether the patient should visit the clinic or not [ 46 ].…”

Systematic Literature Review on Coronavirus Infectious Disease-19 and Dental Masks

“…encouraged the general public to perform thorough hand hygiene; 2) banned public meetings in confined spaces; 3) advised avoidance of social contact; and 4) advocated the prevention of infection through the use of PPEs such as face masks and gloves 26) . In dental clinics, dental staff should wear PPEs, such as a face mask, during patient examination and education 27) . Long-term use or reuse of face masks is not recommended as contaminated masks increase the risk of infection 28) .…”

A Review of Prolonged Post-COVID-19 Symptoms and Their Implications on Dental Management

“…Additionally, COVID-19 acute infection, with associated therapeutic measures, could contribute to adverse oral health outcomes. The signs and symptoms in the oral cavity due to COVID-19 are taste disorders, unspecific oral ulcerations, desquamative gingivitis, petechial, and co-infections such as candidiasis [ 11 ]. Despite the many studies based on expert opinions on COVID-19 recovery, the clinical picture of the COVID-19 aftermath is still unclear.…”