Enhanced Verifiable CPD from the
University of Birmingham

COVID19 in Primary Dental Care

In the UK, dentists and their staff are designated as key workers during the pandemic according to the British Dental Association.

This video shows how to safely don (put on) the Personal Protective Equipment for Aerosol Generating Procedures (AGPs) specific to COVID-19. This guidance outlines infection control for healthcare providers assessing possible cases of COVID-19.

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Standard Operating Procedures

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A useful journal article has come from China, published by the International Association for Dental Research (IADR) .

Researchers at Wuhan University School & Hospital of Stomatology have proposed a number of recommendations for dental practitioners and dental students in light of the coronavirus disease (COVID-19) that was first reported in Wuhan, China.

“For dental practices and hospitals in countries / regions that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed,” Prof. Zhuan BIAN and coauthors stated. “Dentists should take strict personal protection measures and avoid or minimize 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.”

Additional recommendations for clinical practice are provided:

During the outbreak of COVID-19, dental clinics are recommended to establish pre-check triages to measure and record the temperature of every staff and patient as a routine procedure.
Preoperative antimicrobial mouth rinse could reduce the number of microbes in the oral cavity.

Due to the unique characteristics of dental procedures where a large number of droplets and aerosols could be generated, the standard protective measures in daily clinical work are not effective enough to prevent the spread of COVID-19, especially when patients are in the incubation period, are unaware they are infected, or choose to conceal their infection.

Aerosol procedures should be avoided if possible. As respiratory droplets are the main route of SARS-CoV-2 transmission, particulate respirators (e.g., N-95 masks authenticated by the National Institute for Occupational Safety and Health or FFP2-standard masks set by the European Union) are recommended for routine dental practice.

Dental emergencies can occur and exacerbate in a short period of time, and therefore need immediate treatment. Rubber dams and high-volume saliva ejectors can help minimize aerosol or spatter in dental procedures. The treatment planning of tooth fracture, luxation, or avulsion is dependent on the age, the traumatic severity of dental tissue, the development of the apex, and the duration of tooth avulsion.

In the regions that are heavily affected with COVID-19, patients waiting in dental clinic should also be provided with medical masks. If aerosol producing procedures are unavoidable, dental practitioners need to wear gowns, facial shield or goggles.

The paper also listed recommendations for dental education:

View the complete paper here

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