key: cord-0845505-y0064uv8
authors: Gugnani, Neeraj; Gugnani, Shalini
title: Safety protocols for dental practices in the COVID-19 era
date: 2020-06-26
journal: Evid Based Dent
DOI: 10.1038/s41432-020-0094-6
sha: 62302d61edf7a6bfb56c6abc00b20ef99349729a
doc_id: 845505
cord_uid: y0064uv8

Aim Aim of this paper was to provide safety and operatory protocols for providing dental care during the COVID19 pandemic. Data sources The protocol is based on summarising the existing literature, published on different aspects of dealing with the pandemic situation. This protocol was established as an international collaboration among three dental universities: Hadassah School of Dental Medicine Israel, the University of Rochester Medical Centre USA, and the University of Pennsylvania USA. The details of the virus-transmission and its impact on dental care are discussed. Additionally, safety and operatory protocols for urgent and emergency dental care are detailed with a special focus on endodontic and surgical dental care. Conclusions A protocol detailing the safety and operatory measures to be taken while giving the dental care in the COVID-era is provided. The primary aim is to prevent any cross-contamination while allowing the provision of urgent and emergency dental care. Aerosol-producing and other elective procedures should be avoided.

Covid-19 pandemic, due to a novel coronavirus (or SARS-CoV-2 Virus) has swamped the whole world and has led to enormous human morbidity and mortality. The virus is known to exhibit a very fast transmission rate and may get transferred from person to person through coughing or sneezing droplets or by touching virus impregnated inanimate objects and subsequently transmitting it to the oro-nasal passage. The clinical symptoms of the disease vary from being totally asymptomatic to having flu-like symptoms which vary from fever, cough etc, to severe pneumonia. Approximately 5% of patients become critically ill or die due to this SARS like disease. 1 Dental care providers have been considered to be at high risk of infection due to novel coronavirus, owing to their face-to-face communication with the patients, exposure to saliva and blood during dental treatment, and due to procedures that generate aerosols. 2 In order to 'break this chain' of virus transmission it is advised that dentists should act wisely and limit their practices to urgent and emergency procedures only. This will help them to protect themselves, their relatives and also avoid passing of the infection from one patient to another. 2 Moreover, these emergency procedures should also be done using stricter measures of safety, personal protection and infection control.

This new situation has made it imperative for the dentists to learn and adopt these newer treatment protocols. This commentary is an attempt to do the same and aims to inform and guide clinicians in the evolution of their practices during this pandemic. The researchers from three different universities from Israel and USA collaborated and have provided an overview on both the safety and operatory protocols that should be followed during this COVID era. Firstly, the authors rightly emphasised usage of tele-consultations. These help to screen patients and minimise avoidable visits to the clinic. Though it is also argued that tele-consultation has its own limitations, including no provision for physical examination, it is recommended that tele-consultation augmented with sharing of photographs should be practiced as first step. 3 investigating the efficacy of safety and treatment protocols in the dental operatory. Hence, in the COVID-era it has become imperative for dentists to keep themselves updated with the newest evidencebased guidelines, which are being revised faster than ever before.

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