Coronavirus disease (COVID-19) transmission through aerosols in restorative and endodontic practice: Strategies for prevention.

Rapid spread of coronavirus disease 2019 (COVID-19) in several countries of the world has created a state of public health emergency. COVID-19 is principally a respiratory disease, and the virus is present in respiratory secretions. Oral health-care professionals are susceptible to being infected with the disease since they work in close proximity to patient's face and oral cavity for long period of time. Restorative dentists and endodontists play a significant role in delivering "urgent" or "emergency" dental care to patients. Occupational Safety and Health Administration has categorized dentists performing aerosol-generating treatment procedures at "very high exposure risk" whereas the dentists not performing aerosol-generating procedures at "high exposure risk." Most of the restorative and endodontic treatment procedures involve generation of aerosols. Owing to the possibility of transmission of virus through aerosols, these procedures may transmit the disease to clinician or other patients. A comprehensive search of literature was conducted with the help of PubMed/MEDLINE and Scopus databases using a combination of terms, "COVID-19," "severe acute respiratory syndrome coronavirus 2," "aerosols," "restorative dentistry," and "endodontics." Along with universal precautions, some additional precautions need to be taken to prevent such transmission and cross-infection. This article reviews the research evidence about the role of aerosols in the transmission of COVID-19 and various measures which should be implemented during restorative and endodontic practice for the prevention of such transmission.

Résumé La propagation rapide de la maladie à coronavirus 2019 (COVID-19) dans plusieurs pays du monde a créé un état d'urgence de santé publique. Le COVID-19 est principalement une maladie respiratoire et le virus est présent dans les sécrétions respiratoires. Les professionnels de la santé bucco-dentaire sont susceptibles d'être infectés par la maladie, car ils travaillent à proximité du visage et de la cavité buccale du patient pendant une longue période. Les dentistes restaurateurs et les endodontistes jouent un rôle important dans la prestation de soins dentaires "urgents" ou "d'urgence" aux patients. L'Occupational Safety and Health Administration (OSHA) a classé les dentistes effectuant des procédures de traitement générant des aérosols à "Risque très élevé", tandis que les dentistes n'effectuant pas de procédures générant des aérosols à "Risque élevé d'exposition". La plupart des procédures de traitement de restauration et d'endodontie impliquent la génération d'aérosols. En raison de la possibilité de transmission du virus par les aérosols, ces procédures peuvent transmettre la maladie au clinicien ou à d'autres patients. Une recherche complète de la littérature a été menée à l'aide des bases de données PubMed/MEDLINE et Scopus en utilisant une combinaison de termes, "COVID-19", "SARS-CoV-2", "aérosols", "dentisterie restauratrice" et "endodontie". Outre les précautions universelles, certaines précautions supplémentaires doivent être prises pour prévenir une telle transmission et une infection croisée. Cet article passe en revue les preuves de la recherche sur le rôle des aérosols dans la transmission de COVID-19 et diverses mesures qui devraient être mises en œuvre lors de la pratique réparatrice et endodontique pour la prévention d'une telle transmission. Mots-clés: COVID-19, aérosols, dentisterie restauratrice, endodontie, évacuation à haut volume.

An Unusual Complication with Use of Lignocaine: A Case Report.

Allergic responses to lignocaine (amide local anaesthesia) used in dentistry is extremely rare. It is widely used by Oral Maxillofacial surgeons to carry out various procedures safely, comfortably and efficiently. It is important for the practitioners to be aware that allergic reactions though very rare, can occur after injection of lignocaine intradermally for allergy testing. A proper diagnosis and management of such allergic reaction is very essential to avoid undesired consequences. We report a case of a 50-year-old male who suffered itching and generalized skin reaction within 5 minutes after administration of test dose of lignocaine intradermally for allergy testing. Clinical presentation, Diagnosis & management of such allergic reaction are discussed. As local anaesthetic agents are commonly used drugs in day to day practice clinicians are encouraged to be familiar with the presentation of various allergic reactions and there management.