Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Oct;32 Suppl 21(Suppl 21):353-381.
doi: 10.1111/clr.13784.

Summary of European guidelines on infection control and prevention during COVID-19 pandemic

Kathrin Becker  1 , Katarzyna Gurzawska-Comis  2   3 , Giulia Brunello  4   5 , Björn Klinge  6   7
Affiliations
Review

Summary of European guidelines on infection control and prevention during COVID-19 pandemic

Kathrin Becker et al. Clin Oral Implants Res. 2021 Oct.

Abstract

Objectives: The current COVID-19 pandemic highlighted the need for a review of guidelines on infection control and prevention to ensure safe delivery of dental care. However, it is not clear to what extent the rapidly published European guidelines reflect the current evidence and thus provide homogeneous recommendations.

Material & methods: Guidelines from all European Union countries, Scotland, Switzerland and United Kingdom were retrieved. Information on triage, mouth rinse, personal protective equipment (PPE) for aerosol free/ generating procedures (non-AGP/AGP) and treatment of potentially infectious patients were summarized and compared with recommendations from international organizations (WHO, ECDC, CDC).

Results: All included countries (30/30) published COVID-19 guidelines in 2020. All countries recommended triage and to postpone non-urgent treatment of potentially infectious patients. Hydrogen peroxide (1%-1.5%) was the most frequently recommended antiseptic mouth rinse to reduce viral load (24/30). PPE for non-AGP treatments included mainly surgical masks (21/30) or FFP2/FFP3/N95 masks (16/30), whereas FFP2/FFP3 masks (25/30) and face shields (24/30) were recommended for AGP by the vast majority of guidelines. For high-risk/COVID positive patients, most countries recommended maximum protection and treatment in specialized dental clinics (22/30).

Conclusion: There was general agreement among recommendations for triage, mouth rinse, and PPE during AGP and treatment of potentially infectious patients. In contrast, recommendations on PPE for non-AGP treatment varied considerably among the European countries possibly due to limited scientific evidence regarding transmission risk during non-AGP treatments.

Keywords: COVID-19 pandemic; guideline; infection control and prevention; personal protective equipment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest related to this study.

Figures

FIGURE 1
FIGURE 1
Type of mouth rinses recommended in the 30 European countries. The results represent the number of countries which recommend specific type of mouth rinse(s). H2O2, hydrogen peroxide; CPC, cetylpyridinium chloride; CHX, chlorhexidine
FIGURE 2
FIGURE 2
Type of personal protective equipment (PPE) recommended in the national guidelines of the 30 European countries for non‐aerosol generating procedure (non‐AGP). The results represent the number of countries which recommend specific type of PPE
FIGURE 3
FIGURE 3
Type of personal protective equipment (PPE) recommended in the national guidelines of the 30 European countries for aerosol generating procedure (AGP). The results represent the number of countries which recommend specific type of PPE
FIGURE 4
FIGURE 4
Type of dental setting recommended in the national guidelines of the 30 European countries for the treatment of high‐risk/COVID+patients. The results represent the number of countries which recommend specific dental settings
See this image and copyright information in PMC

References

    1. Allison, J. R. , Currie, C. C. , Edwards, D. C. , Bowes, C. , Coulter, J. , Pickering, K. , & Holliday, R. (2021). Evaluating aerosol and splatter following dental procedures: Addressing new challenges for oral health care and rehabilitation. Journal of Oral Rehabilitation, 48(1), 61–72. 10.1111/joor.13098 - DOI - PMC - PubMed
    1. Becker, K. , Brunello, G. , Gurzawska‐Comis, K. , Becker, J. , Sivolella, S. , Schwarz, F. , & Klinge, B. (2020). Dental care during COVID‐19 pandemic: Survey of experts' opinion. Clinical Oral Implants Research, 31(12), 1253–1260. 10.1111/clr.13676 - DOI - PMC - PubMed
    1. Bimbaum, W. (1991). The Control of Cross‐infection in Dentistry BDA Advice Sheet A12.
    1. Chu, D. K. , Akl, E. A. , Duda, S. , Solo, K. , Yaacoub, S. , & Schünemann, H. J. (2020). Physical distancing, face masks, and eye protection to prevent person‐to‐person transmission of SARS‐CoV‐2 and COVID‐19: A systematic review and meta‐analysis. Lancet, 395(10242), 1973–1987. 10.1016/s0140-6736(20)31142-9 - DOI - PMC - PubMed
    1. Clarkson, J. , Ramsay, C. , Richards, D. , & Robertson, C. M. A. M. (2020). Aerosol Generating Procedures and their Mitigation in International Dental Guidance Documents ‐ A Rapid Review. https://oralhealth.cochrane.org/sites/oralhealth.cochrane.org/files/publ...