Recommendations for the re-opening of dental services

Posted by: Gregor Preston - Posted on:

Coronavirus

A rapid review of recommendations for re-opening dental services following the closure or reduction of dental services across the world as a result of the COVID-19 pandemic has now been published.

The reivew is not a guidance document but summarises recommendations from the various sources identified within five themes relevant to the re-opening of dental services: practice preparation, personal protective equipment, management of the clinical area, cleaning and disinfection and dental procedures.

The review group comprised researchers and clinicians from a range of UK institutions including the Scottish Dental Clinical Effectiveness Programme, NHS Education for Scotland, the Universities of Aberdeen, Dundee and Manchester, and Cochrane Oral Health.

Key messages:

  • This review reports on national recommendations for the re-structuring and reopening of dental services from 11 countries
  • There is a highly variable level of detail given across international sources
  • Most sources recommend patient triage by telephone; some recommend temperature screening at reception 
  • Most sources recommend avoiding aerosol generating procedures (AGPs), if possible 
  • Filtering facepiece class 2 (FFP2, equivalent to N95) masks are recommended by the majority of international sources for both COVID-19 and non-COVID-19 confirmed cases undergoing AGPs.
  • A minority of sources recommend use of a filtering facepiece class 3 (FFP3, equivalent to N99) mask for AGPs 
  • Sources include recommendations on how to reduce the risk of transmission (e.g. use of pre-operative mouthwashes; high volume suction; rubber dam; and Personal Protective Equipment [PPE])
  • In the majority of sources, there is no referenced, underpinning evidence and some areas are unlikely to ever have strong (or any) research evidence
  • All sources emphasise the need to focus on activities that minimise risk (to staff/patients/public) but still support high quality clinical care
  • There is a need to consider the inter-relationship between the appropriate use of PPE (including donning and doffing), AGPs and interventions to reduce aerosol generation
  • Clarity is required on effective cleaning and disinfection processes, including the impact on patient scheduling and practice workflow.

The full review is available on the Cochrane Oral Health website

Photo Credits

Photo by Fusion Medical Animation on Unsplash