key: cord-0965517-y921gdlq
authors: Kaur, Harneet; Kochhar, Anuraj Singh
title: Aerosol anguish in dentistry in COVID-19 pandemic: A hypotheses or reality?
date: 2020-09-19
journal: Med Hypotheses
DOI: 10.1016/j.mehy.2020.110281
sha: 613dee809780ded15431a13886c7d4bf104c412f
doc_id: 965517
cord_uid: y921gdlq

nan

Impact of Covid-19 pandemic has been appalling and calamitous, affecting the economic, psychosocial, and social lives of all. The causal virus SARS-CoV2 is a highly infectious contagion with multiple modes of transmission, including aerosols and droplets, where it may persist up to 3 hours. [1] Aerosol-generating procedures, widely performed in varied health care settings, particularly in dentistry, pose a high biologic risk of COVID-19 inhalation as well as fomite transmission. Dental aerosols include droplets and droplet nuclei that may contaminate surfaces up to 3 feet and may remain airborne for 30 minutes to 2 hours. [2] Globally, dental practices have started adhering to the standard precautions along with transmission-based precautions that include use of protective barriers, particulate respirators (equivalent to US National Institute for Occupational Safety and Health (NIOSH)-certified N95 or European Union (EU) standard FFP2) and additional amendments such as the use of dental handpieces with anti-retractive or anti-reflux valves, high-volume surgical aspirators, rubber

However, routinely updating guidelines have caused a precariousness to dominate the clinical decision-making process. On one hand, the authorities are trying to issue regulations to limit dental services for only emergency procedures, most dentists "strongly disagree" with the guidance and argued that with the appropriate personal protective equipment, patients and professionals can safely operate. A disagreement has been raised regarding the evidence for the spread of SARS-CoV2 despite the adoption of strict preventive measures. [5] Also, when 90% of dental aerosols produced are extremely small (< 5 µm), their potential to transport SARS-CoV2 and virulence in dental clinical settings is yet to validated. Consequently, as aerosols in dental practice remain a clinical conundrum, further research should be done to come to a definite conclusion.

Possible aerosol transmission of COVID-19 and special precautions in dentistry

Dental aerosols: A silent hazard in dentistry!

World Health Organization. Considerations for the provision of essential oral health services in the context of COVID-19

Dentistry and coronavirus (COVID-19) -moral decision-making

Dental procedure aerosols and COVID-19. The Lancet Infectious Diseases