Possible aerosol transmission of COVID-19 and special precautions in dentistry

Abstract

Since its emergence in December 2019, corona virus disease 2019 (COVID-19) has impacted several countries, affecting more than 90 thousand patients and making it a global public threat. The routes of transmission are direct contact, and droplet and possible aerosol transmissions. Due to the unique nature of dentistry, most dental procedures generate significant amounts of droplets and aerosols, posing potential risks of infection transmission. Understanding the significance of aerosol transmission and its implications in dentistry can facilitate the identification and correction of negligence in daily dental practice. In addition to the standard precautions, some special precautions that should be implemented during an outbreak have been raised in this review.

Fear and Practice Modifications among Dentists to Combat Novel Coronavirus Disease (COVID-19) Outbreak

“…A total of 650 participants from 30 countries worldwide submitted the completed questionnaire with a total of 22 questions comprising of two sections about fear or anxiety level and practice modification due to COVID-19. The responses were recorded from various countries as follows: Saudi Arabia (80); Pakistan (200); India (55); United Arab Emirates (45); People's Republic of China (67); Italy (40); United Kingdom (23); Australia (23); Malaysia (22); United States of America (21); Ireland (20); Israel (10); New Zealand (08); South Africa (05); Turkey, Germany, Kuwait, Canada, Hungary, and France recorded (02) each; and Poland, Bulgaria, Republic of the Congo, Mexico, Finland, Romania, Egypt, Switzerland, Demark, and Bahrain recorded (01) each. There were (09) responses from unidentified locations ( Figure 2).…”

“…Since it has been established that the primary route for transmission of coronavirus is through droplets and aerosols [22], this enhances the likelihood of dentists and dental healthcare workers of getting infected and further spreading the virus. The current study found that a large number of dentists fear getting infected by their patients or co-workers.…”

“…Considering the benefits, there is no excuse for not using rubber dam during dental procedures, especially while using rotary instruments that generate a large quantity of aerosols and droplets. The use of high-volume suction is also considered an essential means to control aerosols evacuation during dental procedures and should be used for the majority of patients [22].…”

“…The use of a particulate respirator such as the N-95 mask has been recommended for treating patients suspected of COVID-19. Otherwise, at least a surgical mask must be used while treating all patients when the distance between the dental healthcare worker and the patient is less than 1 m [22].…”

Learning From COVID-19: A Systems Approach for Public Health Governance

“…Additionally, acoording recent studies, the aerosol transmission route, the source origin as well as the seasonality of 2019 novel coronavirus are all poorly understood. [37][38][39][40][41][42] Besides, Feng He stated that it is still too early to develop an accurate R 0 estimate or to assess the dynamics of transmission. [43] A better scienti c understanding of the emergence and transmission of the virus in the context of demographic, climate and environmental change is needed in the future, which can help governments make long-term preparation of public health system.…”