Routes of Transmission and Control Protocols of COVID-19 in Dental Clinics: An Overview
Objectives: The aim of this overview was to identify the possible routes of transmission of SARS-CoV-2 in dental clinics and the different control protocols proposed to prevent its further spreading.
Methods: We searched for studies on the electronic databases of PubMed (MEDLINE) and Ebscohost (EBSCO) using a combination of selected keywords from February to May 2020. An additional search was made on Google Scholar using the same keywords. Data extraction and quality valuation of articles were performed by two reviewers.
Results: Sixty-three articles were the results of the search and based on the inclusions and exclusions criteria, 15 articles were included in the final review: 13 literature reviews and 2 experimental studies. The main findings from available data concluded that the virus spreads through respiratory droplets and direct or indirect contact, however, airborne transmission in dental offices has been highlighted because of the inevitable generation of tremendous amounts of aerosol and droplet mixed with patient’s saliva or other body fluids during dental procedures. Hence, aerosol transmission needs further studies. 2 studies identified SARS-CoV-2 in the saliva of patients suggesting saliva as a route of transmission and diagnosis and they concluded that the presence of COVID-19 in oral fluids and its effect on the transmission of this virus needs further investigation. Moreover, besides standard precautions, special prevention control such as postponing routine appointments and wearing personal protection equipment can prevent the transmission of the disease, especially by asymptomatic carriers.
Conclusion: Dental procedures generate aerosols and droplets that can be highly contaminated with SARS-CoV2 and explain additional preventive measures during the COVID-19 pandemic. Studies investigating aerosol transmission and saliva transmission in dental clinics are highly needed.