Quality of biosafety guidelines for dental clinical practice throughout the world in the early COVID-19 pandemic: a systematic review

Abstract

Objectives: To conduct a systematic review of coronavirus disease 2019 (COVID-19)-related biosafety guidelines for dental clinical practice in the early stage of the pandemic, focusing on quality assessment.

Methods: Electronic (via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, and Cochrane Library) and gray literature searches were performed for documents published up to May 12, 2020. Guidelines updated until April 17, 2021 were identified. Documents were included as guidelines if they (1) consisted of a set of statements, directions, or principles presenting current or future rules or policy; (2) were developed by government agencies, institutions, organizations, or expert panels; and (3) were related to the general conduct of healthcare activities rather a particular condition. Two researchers, using the Appraisal of Guidelines for Research & Evaluation II, independently extracted the recommendations and evaluated the quality of the guidelines.

Results: Twenty-seven documents from 19 countries were included in the review. These documents presented 122 recommendations related to (1) professional biosafety; (2) patients'/companions' safety; (3) the organization and biosafety of the physical dental facility environment; and (4) the work process in dental care. Overall, the scientific quality of the guidelines was considered low. Some recommendations presented in these guidelines would require further research to establish their effectiveness.

Conclusions: We found a wide variety of biosafety guidelines for dental practice regarding COVID-19 in the early months of the pandemic, but their quality was low. Biosafety recommendations should be frequently updated.

Keywords: Biosafety; COVID-19; Dentistry; Guidelines; SARS-CoV-2.

Figure 1.

Flowchart of the systematic review search process. LILACS, Latin American and Caribbean Health Sciences Literature database; BBO, Brazilian Library in Dentistry.

Figure 2.

Combined Appraisal of Guidelines for Research and Evaluation II assessment for all the coronavirus disease 2019 biosafety guidelines for dental practice (n=27). Vertical lines indicate range (% adequacy¹); horizontal line represents mean adequacy score¹ for each domain. ¹Percentage of maximum possible score per domain.