Stopping the COVID-19 pandemic in dental offices: A review of SARS-CoV-2 transmission and cross-infection prevention

Abstract

Due to the essential role of dentists in stopping the COVID-19 pandemic, the purpose of this review is to help dentists to detect any weaknesses in their disinfection and cross-contamination prevention protocols, and to triage dental treatments to meet the needs of patients during the pandemic. We used PRISMA to identify peer-reviewed publications which supplemented guidance from the center for disease control about infection control and guidelines for dentists. Dentists must triage dental treatments to meet the needs of patients during the pandemic. The ongoing pandemic has changed the practice of dentistry forever, the changes make it more cumbersome, time-consuming, and costly due to the possible pathways of transmission and mitigation steps needed to prevent the spread of COVID-19. Dental chairside rapid tests for SARS-CoV-2 are urgently needed. Until then, dentists need to screen patients for COVID-19 even though 75% of people with COVID-19 have no symptoms. Despite the widespread anxiety and fear of the devastating health effects of COVID-19, only 61% of dentists have implemented a change to their treatment protocols. As an urgent matter of public health, all dentists must identify the additional steps they can take to prevent the spread of COVID-19. The most effective steps to stop the pandemic in dental offices are to; vaccinate all dentists, staff, and patients; triage dental treatments for patients, separate vulnerable patients, separate COVID-19 patients, prevent cross-contamination, disinfect areas touched by patients, maintain social distancing, and change personal protective equipment between patients.

Keywords: COVID-19 testing; COVID-19 vaccination; Dentists; SARS-CoV-2; triage dental treatments.

Figure 1.

Detection and transmission response for COVID-19. The graph shows the SARS-COv-2 likelihood of transmission from week 1 to 4 in red, and the PCR test detectability for SARS-CoV-2 from week 1 to 4 in in orange (adapted from a Scientific Brief: SARS-CoV-2 and Potential Airborne Transmission). (A color version of this figure is available in the online journal.)

Figure 2.

Modes of transmission and cross-infection prevention. SARS-CoV-2 is transmitted by infected fluids in the air, such as droplets and aerosols, or by fomite infection of the surfaces of objects. Rigorous cross-infection prevention protocols must be used to stop the transmission of COVID-19 from dental offices. (A color version of this figure is available in the online journal.)

Figure 3.

Spreading SARS-CoV-2 by respiratory droplets and their evaporation. (A color version of this figure is available in the online journal.)

Figure 4.

SARS-CoV-2 on fomite surfaces. SARS-CoV-2 is highly contagious because it can be transmitted by touching infected fomite surfaces that have not been disinfected or are not completely dry. (A color version of this figure is available in the online journal.)