Overview of transnational recommendations for COVID-19 transmission control in dental care settings

Abstract

On 11 March 2020, the World Health Organization (WHO) declared the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) as a pandemic. Until an effective treatment or a vaccine is developed, the current recommendations are to contain the disease, and control its transmission. It is now clear that the primary mode of SARS-CoV-2 transmission is aerosol/droplet spread, and by contacting virus-contaminated surfaces acting as fomites (inanimate vectors). Furthermore, recent data indicate that the live virus particles are present in saliva, and, more alarmingly, asymptomatic individuals may transmit the infection. By virtue of the nature of the practice of dentistry where intrinsically, a high volume of aerosols is produced, as well as the close proximity of dentists and patients during treatment, dentists and allied health staff are considered the highest risk health professional group for acquiring SARS-CoV-2 during patient management. Therefore, several organizations and specialty associations have proposed guidelines and recommendations for limiting the transmission of SARS-COV-2 from carriers to dentists and vice versa. This paper aims to provide a review of these guidelines, and concludes with a brief look at how the practice of dentistry may be impacted by COVID-19, in the post-pandemic era.

Keywords: COVID-19; SARS-CoV2; coronavirus; dentistry; oral health; transmission.

Figure 1

Scanning electron micrograph showing budding SARS‐CoV‐2 particles from the surface of an infected cell after 24 hr of laboratory culture. The numerous small, white spheres are the viral particle on the cell surface (Magnification 18,000×) (Image courtesy of: Professors J Nicholls LKS Faculty of Medicine, and Department of Electrical and Electronic Engineering (K. Tsia, K. Lee and Q. Lai), and Electron Microscopy Unit, The University of Hong Kong)

Figure 2

Pseudo‐colour scanning electron micrograph of SARS‐CoV‐2 in human cell culture. Figure shows the large numbers of viral particles (orange) budding from the cell surfaces (blue) Image courtesy of: Professors J. Nicholls LKS Faculty of Medicine, and Department of Electrical and Electronic Engineering (K. Tsia, K. Lee and Q. Lai), and Electron Microscopy Unit, The University of Hong Kong