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A Dental Response to the COVID-19 Pandemic-Safer Aerosol-Free Emergent (SAFER) Dentistry.

ABSTRACT: Dental services are significantly impacted by the COVID-19 pandemic. Almost all dental procedures carry a high infection risk for providers and patients due to the spread of aerosols. As a consequence, public health agencies and professional associations have issued guidelines for enhanced infection control and personal protection equipment and have also limited care to urgent or emergency services. However, there is no dental service concept for pandemic disaster preparedness or response that might be applied. Moreover, pathways to dental care provision in a post-pandemic future with persisting risks are needed. We propose Safer Aerosol-Free Emergent Dentistry (SAFER Dentistry) as one approach to dental services during and emerging from the pandemic. The concept's starting point is the identification of the most common patient needs. The next step is to replace common treatments addressing the most frequent needs with alternative interventions involving a lower infection risk because they do not generate aerosols. SAFER Dentistry is innovative, avoids risk, and responds to the requirements of a pandemic and post-pandemic emergency where the risk of airborne disease transmission remains high. SAFER Dentistry thereby ensures continuity of dental services while protecting providers and patients from infectious pathogens. Moreover, SAFER Dentistry allows dental service providers to remain operational and generate income even under pandemic conditions. Potential implementation and policy options for SAFER Dentistry include universal availability without co-payments by patients and a uniform bundled payment scheme for providers to simplify budgeting, reimbursement, and administration during a pandemic. Adaptations and adjustments of the concept are possible and encouraged as long as the principle of avoiding aerosol-generating procedures is maintained.

SUBMITTER: Benzian H

PROVIDER: S-EPMC7434942 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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A Dental Response to the COVID-19 Pandemic-Safer Aerosol-Free Emergent (SAFER) Dentistry.

Benzian Habib H Niederman Richard R

Frontiers in medicine 20200812

Dental services are significantly impacted by the COVID-19 pandemic. Almost all dental procedures carry a high infection risk for providers and patients due to the spread of aerosols. As a consequence, public health agencies and professional associations have issued guidelines for enhanced infection control and personal protection equipment and have also limited care to urgent or emergency services. However, there is no dental service concept for pandemic disaster preparedness or response that m ...[more]

PMID: 32903453

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Project description:Background: The recent pandemic outbreak has created a huge impact on dentistry. Dental students and dental professionals are at a higher risk because dental practice comprises close communication and widespread exposure to blood, saliva, and other body fluids. It is imperative to evaluate the knowledge and perceptions regarding Coronavirus (COVID-19) among budding dentists. Aim: To assess the knowledge, attitude, and practices of dental students regarding dental practices during COVID-19. Materials and methods: A cross-sectional questionnaire-based study was conducted among undergraduate students in Riyadh, Saudi Arabia. An online questionnaire consisting of demographic, knowledge, and attitude-based questions were circulated among the study population, and the responses for the knowledge and attitude were scored. Their mean scores were then calculated. Chi-square test and nonparametric tests were computed using SPSS version 21 software, and p-values < 0.05 were considered statistically significant. Results: 388 undergraduate dental students have participated in the study from Saudi Arabia. 68% of the respondents believed that they had sufficient knowledge regarding COVID-19. The mean score for knowledge was 5.84 out of 7. Females (6.24) scored statistically significantly higher than males (5.55, p < = 0.001). The mean attitude score was 6.34 out of 9. 93% were using PPE models, while 95% maintained social distancing. Out of all the participating dental students, only 16% were willing to treat patients during the pandemic, and 28% did not want to treat patients, 28% preferred teledentistry. The majority (44%) of dental undergraduates were willing to handle only emergency cases. Conclusion: Accurate knowledge and attitude regarding COVID-19 and diversified opinion on preventive practices during the pandemic period among budding dental professionals evident from Saudi Arabia. Mixed opinions were witnessed among them in seeking help from professional societies. The majority of dental undergraduates were willing to handle only emergency cases.

Project description:BackgroundThe COVID-19 pandemic challenged all healthcare providers including dental practitioners. This cross-sectional study aimed to investigate the dental practitioners' perceptions and attitudes towards the impacts of COVID-19 on their professional practice, career decision and patient care.MethodsData was collected from dental practitioners registered in New South Wales (NSW), Australia using an online survey.Results and conclusionResponses received from 206 dental practitioners revealed their perceptions and attitudes towards COVID-19 infection risk, clinical guidelines, and measures adopted to deliver patient care. Majority of participants perceived the risk of infection in dentistry was higher compared with other health professionals. Most dental practices have followed guidelines received from professional associations and adopted multiple measures such as providing hand sanitizer, social distancing, and risk screen, to ensure safe delivery of oral health care. Over 80% of dental practitioners raised concerns on patients' accessibility to dental care during the pandemic. Despite tele-dentistry was introduced, almost half of the participants did not recognize tele-dentistry as an effective alternative. Moreover, negative impacts of COVID-19 pandemic on dental practitioner's professional career have been reported, including lower practice safety, reduction in working hours and income. Noteworthy, one quarter of participants even considered changing their practice environment, moving sectors or even leaving their career in dentistry. However, majority of the dental practitioners are willing to stay in their current practice environment and continue their career in dentistry. Our observations demonstrate the systematic disruption to dental practice faced in Australia due to the COVID-19 pandemic. Providing dental practitioners with timely educational training and support is important to minimise negative impacts of the challenges and to optimise dental care.

Project description:ObjectivesIdentify splatter/aerosol distribution from dental procedures in an open plan clinic and explore aerosol settling time after dental procedures.MethodsIn two experimental designs using simulated dental procedures on a mannequin, fluorescein dye was introduced: (1) into the irrigation system of an air-turbine handpiece; (2) into the mannequin's mouth. Filter papers were placed in an open plan clinic to collect fluorescein. An 8-metre diameter rig was used to investigate aerosol settling time. Analysis was by fluorescence photography and spectrofluorometry.ResultsContamination distribution varied across the clinic depending on conditions. Unmitigated procedures have the potential to deposit contamination at large distances. Medium volume dental suction (159 L/min air) reduced contamination in the procedural bay by 53%, and in other areas by 81-83%. Low volume suction (40 L/min air) was similar. Cross-ventilation reduced contamination in adjacent and distant areas by 80-89%. In the most realistic model (fluorescein in mouth, medium volume suction), samples in distant bays (≥5 m head-to-head chair distance) gave very low or zero readings (< 0.0016% of the fluorescein used during the procedure). Almost all (99.99%) of the splatter detected was retained within the procedural bay/walkway. After 10 min, very little additional aerosol settled.ConclusionsCross-infection risk from dental procedures in an open plan clinic appears small when bays are ≥ 5 m apart. Dilution effects from instrument water spray were observed, and dental suction is of benefit. Most settled aerosol is detected within 10 min indicating environmental cleaning may be appropriate after this.Clinical significanceAerosols produced by dental procedures have the potential to contaminate distant sites and the majority of settled aerosol is detectable after 10 min. Dental suction and ventilation have a substantial beneficial effect. Contamination is likely to be minimal in open plan clinics at distances of 5 m or more.

Dataset Information

A Dental Response to the COVID-19 Pandemic-Safer Aerosol-Free Emergent (SAFER) Dentistry.

Publications

A Dental Response to the COVID-19 Pandemic-Safer Aerosol-Free Emergent (SAFER) Dentistry.

Similar Datasets

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