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According to the findings of a recent study, U.S. dentists continue to have a lower infection rate than other front-line health professionals, which could be credited to close adherence to infection prevention and control guidelines. (Image: Anna Jurkovska/Shutterstock)

COVID-19 misconceptions: Disease prevalence among US dentists remains low

By Iveta Ramonaite, Dental Tribune International
June 03, 2021

CHICAGO, U.S.: Since the beginning of the pandemic, dentistry has been deemed unsafe as dental professionals run a high risk of SARS-CoV-2 spread through aerosol contamination during dental procedures. Nevertheless, no confirmed COVID-19 cases among patients receiving dental care have been reported to date. Adding to a growing body of evidence that challenges the initial perception, a recent study highlighted that dental professionals in the U.S. have successfully adopted the recommended infection control practices and continue to show an extremely low prevalence of the disease.

The study is a continuation of an earlier report published in November 2020. At the beginning of the pandemic, when access to dental care was severely restricted, dentistry topped the list of the most dangerous jobs. However, the previous cross-sectional study reported that the prevalence of COVID-19 among U.S. dentists was lower than 1%, and the results showed that dentists followed strict interim safety guidance and were prepared to resume their practice.

In the present study, the researchers aimed to determine the cumulative incidence of COVID-19 among U.S. dentists from June through November 2020. To that end, the participants were asked to take part in a monthly web-based survey and to answer questions regarding symptoms associated with COVID-19, SARS-CoV-2 infection, and mental and physical health conditions.

The scientific community has long established that aerosol-generating procedures (AGPs) put dental professionals at an increased risk of COVID-19, which is why they were advised to follow strict infection prevention and control guidelines and use enhanced personal protective equipment. To ascertain whether these requirements had been met, the researchers also inquired into the infection control procedures used in the primary dental practices of the participants.

In total, 785 participants responded to all six surveys. Over the course of half a year, the cumulative COVID-19 infection prevalence rate was 2.6% (57 dentists) and the incidence rates ranged from 0.2% through 1.1% each month. According to the results, increasingly more dentists were tested every month, in line with the uptake in performing aerosol-generating procedures. Almost all dentists reported that their dental practice adhered to enhanced infection prevention and control strategies, which included screening patients and staff members for COVID-19, complying with strict disinfection practices, and maintaining a safe distance.

“We’re pleased to see that dentists have demonstrated continued low monthly incidence of disease despite several regional and national COVID-19 rate spikes during the study period,” senior author Dr. Marcelo Araujo, chief science officer at the American Dental Association (ADA), said in a press release. “This study shows high rates of pre-appointment screening of patients and appropriate infection control measures throughout the study period, demonstrating that adhering to very strict protocols for enhanced infection control helps protect their patients, their dental team and themselves,” he continued.

“This study reinforces that the dental care sector is up and running safely”
— Dr. Marko Vujicic, ADA

However, despite limited PPE supplies, the data showed that dental professionals gradually decreased the optimization of PPE, and most of them changed their face masks after each patient. Additionally, dentists reportedly wore N95 or equivalent masks and eye protection during AGPs less frequently over time, from 92.4% in the first survey to 88.0% in the final survey. This shift in the use of PPE could be explained by access to the equipment, clinical judgment, schedule planning, and other measures that dentists had implemented since the reopening of dental practices, the researchers noted.

Commenting on the findings, Dr. Marko Vujicic, chief economist and vice president of the ADA Health Policy Institute, was quoted as saying: “This study reinforces that the dental care sector is up and running safely.”

“Nowhere is this proof point more evident than by the fact that more than 90% of patients surveyed indicate they have already visited the dentist or soon will,” he concluded.

The earlier study, titled “Estimating COVID-19 prevalence and infection control practices among US dentists,” was published in the November 2020 issue of the Journal of the American Dental Association.

The present study, titled “COVID-2019 among dentists in the United States: A 6-month longitudinal report of accumulative prevalence and incidence,” was published in the June 2021 issue of the Journal of the American Dental Association.

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