31 March 2020

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Covid-19: recommendations to be adopted in dental practices and university dental schools

Authors: S. Chirico, L. Breschi

Simona Chirico

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In these days of emergency, in which the epidemic of Coronavirus disease has dramatically affected not only Italy (the country in which we live), but the whole world, Prof. Breschi and I have decided to summarize the guidelines provided by the studies published in the International Scientific Journals in these last weeks, for dental practices and for University dental schools.  
We know that Covid-19 virus can persist on surfaces from a few hours up to several days and that the main routes of transmission are: respiratory droplets, contact transmission and oral-fecal transmission. 
  

To avoid the risk of transmission, these are the recommendations to be adopted in dental practices :  
 
- limit the interventions to urgent cases only: to establish this, call the patient by telephone and investigate the present problem. If confirmed, investigate his general health and contacts in the last 14 days: fever >37.3 ° C, coughs, breathing difficulties, muscle pains, headaches in the last 14 days. 

- hand hygiene: wash your hands frequently with an alcohol-based hand rub or wash them with soap and water.  

- disinfection of all surfaces and clinical settings  

- mouth rinse: 1% hydrogen peroxide or 0.2% povidone is recommended, for the purpose of reducing the salivary load of oral microbes, including potential Covid-2019 carriage.  

- use rubber dam: the use of rubber dams can significantly minimize the production of saliva- and blood-contaminated aerosol or spatter. When rubber dam is applied, extra high-volume suction for aerosol and spatter should be used during the procedures along with regular suction  

- personal protective devices: wearing disposable doctor cap, protective goggles, face shield, working clothes (white coat) with disposable isolation clothing or surgical clothes outside, disposable gloves and FFP2-standard masks set by the European Union.  

Recommendations for dental schools :

- online lectures,  

- online case studies,  

- problem-based learning (PBL) online tutorials .

In conclusion, Prof. Breschi and I strongly believe that in this period of emergency, all of us, as dentists, must contribute to reduce the risk of Covid-19 infection, safeguarding the health of our patients, our collaborators and ourselves, respecting the rules that are given to us and staying at home.

  For additional information:
           -       Transmission routes of 2019-nCoV and controls in dental practice
           -       Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine