Special Precautions in Dental Emergency

94 views 2 04/05/2020

  1. Patient screening is critical: epidemiological risk factors and clinical symptoms (fever and respiratory tract symptoms) should be asked.
    1. Measuring the temperature with contact-free forehead thermometer is recommended.
  2. Standard protective measures (universal precautions) are not effective enough to prevent the spread of COVID-19. Special precautionary measures should also be taken.
    1. Level 2 PPE is required for AGPs (Aerosol Generating Procedures): N95 respirator (fit-tested) + fluid repellent gown + head cover including neck protection + double gloves + eye protection
    2. Level 1 PPE is sufficient for non-AGPs: Surgical mask + gown + gloves + eye protection
  3. Emergency procedures known to be AGPs include:
    1. Caries removal and pulpectomy using high- or low-speed handpiece
    2. Surgical extraction using surgical handpiece
  4. The use of air-water syringe generates aerosols and should be avoided if possible.

 

These statements are based on several review articles recently published in the International Journal of Environmental Research and Public Health, the International Journal of Oral Science and the Journal of Dental Research. The recommendations proposed by these guidelines are primarily based on the previous experiences from SARS and the previous studies in infection control of dental setting.

 

Sources:

  1. Zi-yu GE, Lu-ming YANG, Jia-jia XIA, Xiao-hui FU, Yan-zhen ZHANG. (Februrary 26, 2020). Possible aerosol transmission of COVID-19 and special precautions in dentistry. Journal of Zhejiang University.
    https://doi.org/10.1631/jzus.B2010010
  2. Gianrico Spagnuolo, Danila De Vito, Sandro Rengo, and Marco Tatullo. (March 18, 2020). COVID-19 Outbreak: An Overview on Dentistry, Yokohama, Japan, 2020. Int. J. Environ. Res. Public Health.
    https://doi.org/10.3390/ijerph17062094
  3. Xian Peng, Xin Xu, Yuqing Li, Lei Cheng, Xuedong Zhou and Biao Ren. (March 3, 2020). Transmission routes of 2019-nCoV and controls in dental practice. International Journal of Oral Science.
    https://doi.org/10.1038/s41368-020-0075-9
  4. L. Meng, F. Hua , and Z. Bian. (March 3, 2020). Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. Journal of Dental Research
    https://doi.org/71/00.10127270/030425220304951240294146246
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