Coronavirus guidelines for dental practitioners and students

Dental Tribune International

Thu. 19. March 2020

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WUHAN, China: The COVID-19 pandemic, which originated in Wuhan, has become a serious public health challenge of international concern. Researchers from Wuhan University School and Hospital of Stomatology have now released a paper which includes a number of recommendations for dental practitioners and dental students on how to deal with the virus SARS-CoV-2 that poses emerging and future challenges for dentistry.

Infection control measures are necessary to prevent the virus from spreading further and to help control the pandemic. Owing to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected by COVID-19, strict and effective infection control protocols are urgently needed. This article, based on experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.

Recommendations for clinical practice include the following:

During the outbreak of COVID-19, dental clinics are recommended to establish pre-check triages to measure and record the temperature of every staff member and patient as a routine procedure.
Preoperative antimicrobial mouth rinsing could reduce the number of microbes in the oral cavity.
Dental emergencies can occur and exacerbate in a short period and, therefore, need immediate treatment. Dental dams and high-volume saliva ejectors can help minimise aerosol or spatter in dental procedures. The treatment planning of tooth fracture, luxation or avulsion is dependent on the age of the patient, the traumatic severity of dental tissue, the development of the apex and the duration of tooth avulsion.
In the regions that are heavily affected by COVID-19, patients waiting in dental clinics should also be provided with medical masks. If aerosol-producing procedures are unavoidable, dental practitioners need to wear gowns and facial shields or goggles.

The paper also listed recommendations for dental education:

During the outbreak period, online lectures, case studies and problem-based learning tutorials should be adopted to avoid unnecessary aggregation of people and the associated risk of infection.
Schools should encourage students to engage in self-learning, to make full use of online resources and to learn about the latest academic developments.
During this period, it is easy for students to be affected by disease-associated fear and pressure; dental schools should be prepared to provide psychological services to those who need them.

“For dental practices and hospitals in countries/regions that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed,” said corresponding author Prof. Zhuan Bian in a press statement. “Dentists should take strict personal protection measures and avoid or minimise operations that can produce droplets or aerosols. Four-handed technique is beneficial for controlling infection. The use of saliva ejectors with low volume or high volume can reduce the production of droplets and aerosols.”

The authors called for further discussion and research on how to improve current infection control strategies and how to respond to similar contagious diseases in the future. According to the World Health Organization by 19 March 2020, COVID-19 had been diagnosed in 166 countries, totalling 207,855 laboratory-confirmed cases and 8,648 deaths.

The study, titled “Coronavirus disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine”, was published online on 12 March 2020 in the Journal of Dental Research, ahead of inclusion in an issue.

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