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Study reviews preventive SARS-CoV-2 transmission measures in Italy

By Dental Tribune International
May 19, 2020

PISA, Italy: According to the World Health Organization, Italy has 225,435 confirmed SARS-CoV-2 cases and 31,908 associated deaths as of 19 May 2020. This makes Italy the country with the second highest number of cases in Europe and one of the most severely affected in the world. A team of Italian researchers has now reviewed studies concerning preventive measures to limit the transmission of SARS-CoV-2 in dental practices.

Several papers that have been released in the past few weeks have shown that dental professionals are at high risk of infection owing to their exposure to saliva, blood and aerosol production during the majority of dental procedures, SARS-CoV-2 being a highly contagious airborne virus. The recently released review study, conducted by researchers from the University of Pisa in Italy, is aimed at raising awareness of the potential risks of SARS-CoV-2 transmission in dental practices and reports on infection control measures. Based on the findings of the review, it discusses and recommends preventive measures, such as those adopted in Italy for contagion limitation.

The main preventive measures identified were patient triage, prescription of mouthrinses prior to dental treatment, hand hygiene, personal protective equipment for dental practitioners, limitation of aerosol-producing procedures and cleaning of potentially contaminated surfaces. These measures are in line with the European Federation of Periodontology’s suggestions for the management of a dental clinic to limit transmission.

“Dentists have provided substantial support to the population”

Worldwide, dental practitioners have been advised, and in some countries required, to limit their activities to emergency treatments and postpone routine check-ups and procedures for purely aesthetic reasons as far as possible. In an interview with Dental Tribune International, professor of periodontology at the University of Pisa and co-author of the study Dr Filippo Graziani explained that Italy is slowly but surely lifting the restrictions in this regard and that all parties are working towards re-establishing a somewhat normal routine. However, what the new reality for dentists and patients will look like in the future is mostly guesswork.

At the moment, dental practitioners in the country are wearing the maximum personal protective equipment, such as masks, goggles, protective clothing and/or face shields. This may have a negative psychological effect on anxious, paediatric or geriatric patients, who could potentially suffer owing to the lack of human contact and the creation of distance from the dentist. As much as Graziani would like dental practice to return to normality as soon as possible, he explained that some of the protective measures (such as face shields) might be here to stay.

Asked whether more could have been done to limit the spread of the virus initially, he said: “More could always have been done. This lethal virus arrived so fast and was so complex to adjust to that everyone just did his or her best. Dentists have provided substantial support to the population, and their focus has definitely been on service to the community, not business.” Graziani concluded by stressing the importance of patience, since more research is being carried out and the findings released every day.

The study, titled “COVID-19 transmission in dental practice: Brief review of preventive measures in Italy”, was published in the Journal of Dental Research on 17 April 2020, ahead of inclusion in an issue.

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