Precautions and recommendations for orthodontic settings during the COVID-19 outbreak: A review

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). It emerged as a global pandemic in early 2020, affecting more than 200 countries and territories. The infection is highly contagious, with disease transmission reported from asymptomatic carriers, including children. It spreads through person-to-person contact via aerosol and droplets. The practice of social distancing-maintaining a distance of 1-2 m or 6 ft-between people has been recommended widely to slow or halt the spread. In orthodontics, this distance is difficult to maintain, which places orthodontists at a high risk of acquiring and transmitting the infection. The objective of this review is to report to orthodontists on the emergence, epidemiology, risks, and precautions during the disease crisis. This review should help increase awareness, reinforce infection control, and prevent cross-transmission within the orthodontic facility. Methods: A comprehensive literature review of English and non-English articles was performed in March 2020 using COVID-19 Open Research Dataset (CORD-19 2020), PubMed, MEDLINE, Scopus, and Google Scholar to search for infection control and disease transmission in orthodontics. Results: This review emphasizes minimizing aerosol production and reinforcing strict infection control measures. Compliance with the highest level of personal protection and restriction of treatment to emergency cases is recommended during the outbreak. Surface disinfection, adequate ventilation, and decontamination of instruments and supplies following the guidelines are required. Conclusions: Reinforcing strict infection control measures and minimizing personal contact and aerosol production are keys to prevent contamination within orthodontic settings. Although no cases of COVID-19 cross-transmission within a dental facility have been reported, the risk exists, and the disease is still emerging. Further studies are required.

Panorama of Orthodontics after COVID-19: A critical literature review

“…There are concerns regarding the appearance, epidemiology, risks and precautions during the disease crisis (Turkistani, 2020) and implications of coronavirus infection for orthodontic treatment (Sunjay Suri et al, 2020). Preventive strategies for infection control (Guo et al, 2020) and aerosol reduction (Maspero et al, 2020) have been reported.…”

“…Due to the pandemic caused by the coronavirus, dental professionals must be aware of the occupational risks caused by COVID-19, and stay up to date on infection control guidelines. It is the orthodontist's responsibility to ensure the safety of his/her team and prevent cross-contamination within the dental office (Sunjay Suri et al, 2020;Turkistani, 2020).…”

Impact of SARS-CoV-2 on orthodontic education and global practice guidance: A scoping review

“…[29] Simple procedures such as bonding/debonding and bracket repositioning carry risks of producing aerosols. [30] As the infection and death rates have decreased, some clinics have reopened for routine care at reduced capacities with new protocols. It is essential that all the practitioners should adapt their practices with new recommendations to protect themselves and patients until a vaccine is developed.…”

Customized Orthodontic Triage During COVID-19 Pandemic

“…It may possibly be found on scrubs, nose, and chest of doctors and even contaminate the waterline. 2 Common guidelines issued by regional health regulatory bodies for orthodontic treatment during the pandemic 1,2 :…”