A review of infection prevention and control guidelines for dental offices during the COVID-19 pandemic in mid-2020
Canadian Journal of Infection Control
; 36(3):129-137, 2021.
Article
in English
| EMBASE | ID: covidwho-2246388
ABSTRACT
Background:
The COVID-19 pandemic was a challenge for all dental professionals who had to rapidly update infection prevention and control (IPAC) guidelines and protocols due to increased risk of SARS-CoV-2 transmission during common aerosol-generating procedures (AGPs), and a lack of consensus on how best to mitigate the risk of transmission in a dental office. Thus, the purpose of this descriptive study was to compare the variance in IPAC guidelines for dental offices that emerged, and to assess practice consistency from early to mid-2020.Methods:
A comprehensive literature search was conducted from May 26 to July 8, 2020 for IPAC documentation specific to the dental office during the COVID-19 pandemic. Documents that met the inclusion criteria were independently reviewed. Data was extracted using a framework based on the following IPAC domains pre-appointment, waiting room, personal protective equipment (PPE) selection, treatment room, and post-dismissal.Results:
A total of 67 IPAC documents specific to dental offices were reviewed in this study. Included documents originated from 22 dental associations, 17 peer-reviewed articles, 13 dental regulators, 11 government bodies, two public health units, and two dental corporations. There was a great degree of variance with IPAC guidelines from the pre-appointment stage, during treatment, and post-treatment. Recommendations that emerged with some level of consistency involved pre-screening patients for COVID-19 symptoms (97%), staggering appointments (84%), social distancing, minimizing occupants in the waiting room, wearing a face shield over protective eyewear for AGPs (92%), and preprocedural rinses (84%). There was less consistency with recommendations for consolidating multiple appointments (36%), waiting room ventilation (46%), N95 masks (47%) versus FFP2/FFP3 masks (30%) use for AGPs, fit-testing respirators (37%), enclosing open operatories for AGPs (28%), prioritizing minimally invasive procedures (30%), and using third-party laundry companies (32%).Conclusions:
The risk of SARS-CoV-2 transmission, lack of consensus on mode of spread, and need for rapid action resulted in a significant variation in most downstream IPAC interventions in the hierarchy of controls, including choice of PPE, treatment room, and post-dismissal domains. Upstream interventions, including pre-appointment and waiting room domains, were relatively consistent in practices in early to mid-2020.
adult; aerosol; aerosol generating procedure; article; consensus; controlled study; coronavirus disease 2019; dental facility; dentistry; documentation; eye protective device; face shield; female; government; human; infection control; infection prevention; laundry; male; minimally 94 percent efficient filtering facepiece respirator; minimally 99 percent efficient filtering facepiece respirator; minimally invasive procedure; nonhuman; pandemic; practice guideline; protective equipment; public health; Severe acute respiratory syndrome coronavirus 2; social distancing; systematic review; ventilator; waiting room
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Canadian Journal of Infection Control
Year:
2021
Document Type:
Article
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