24 March 2020

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COVID-19: Dental Practitioners and Dental Student Guidelines

Co-author: L. Breschi

Edoardo Mancuso

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The epidemic of coronavirus disease 2019 ( COVID-19) has become a major public health challenge for the entire planet.
The World Health Organization have therefore made the assessment that COVID-19 is now characterized as a pandemic.
 As of March 16, COVID-19 has been recognized in more than 100 countries, with a total of 167511 laboratory-confirmed cases and 6606 deaths (WHO 2020). It has been stated that the virus interpersonal transmission occurs mainly via respiratory droplets and contact transmission. Therefore, due to the characteristics of the dental settings, dentists are at great risk of infection.

Recently, Z. Bian and his team have published a valuable study on the Journal of Dental Research, aiming to provide guidelines and recommendations to dental practitioners and dental students regarding the COVID-19 outbreak.  
The first recommendation in the article is that dentists should take strict personal protection measures and avoid or minimize operations that can produce droplets or aerosols, using wherever possible dental dams and saliva ejectors with high volume.  

Moreover the WHO has declared that SARS-CoV-2 can persist on surfaces from a few hours up to several days and this reinforce the need for good hand hygiene and the importance of thorough disinfection of all surfaces implementing the usage of personal protective equipment, including masks, gloves and goggles or face shields.
Since respiratory droplets are the main route of SARS-CoV-2 transmission, Prof. Bian suggest that particulate respirators (FFP2-standard masks set by the European Union) should be used for routine dental practice.  

Focusing on the dental practices, the paper strongly recommend to treat only dental emergency cases and adopt implementation of  infection prevention and control measures.

Dental clinics are advised to adopt the use of preoperative antimicrobial mouth rinse, which could reduce the number of microbes in the oral cavity, and to establish pre-check triages to measure and record the temperature of every staff and patient as a routine procedure.
The paper ends listing also some recommendations for the dental education, advising on adopting online lectures, case studies and problem-based learning (PBL) tutorials to avoid needless aggregation of people and associated risk of infection. 

In conclusion, we believe that in this situation it is fundamental to keep on researching and publishing on the matter of COVID-19 and establish further discussion on how to improve current infection control strategies and how to respond to similar contagious diseases in the future.  

For additional information:  Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine