Major considerations of dental care in COVID-19: an evidence-based on clinical studies and guidelines

Milena Lazaro Zorzi,Leonardo Santos Lopes,Elias Naim Kassis

doi:10.54448/mdnt21511

Milena Lazaro Zorzi, Leonardo Santos Lopes + Show 1 more

Open Access

https://doi.org/10.54448/mdnt21511

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Abstract

Introduction: The COVID-19 pandemic has presented enormous challenges for dentists and patients. The risk of nosocomial transmission is a reality that requires the development of guidelines by the dental community to reduce the chances of infection by the new coronavirus. In this sense, it was necessary to implement alternative prophylactic techniques such as the adoption of oral rinses before dental care. Objective: To present the main considerations of clinical studies on dental care at COVID-19. Methods: The research was carried out from May 2021 to June 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: One study showed that 0.2% chlorhexidine and 1% povidone-iodine oral solutions are effective pre-procedural mouthwashes against salivary SARS-CoV-2 in dental treatments. It was observed in another study that the effect of reducing the salivary load with mouthwash with CPC and PI was maintained after 6 hours. PVP-I nasal and oral antiseptic solutions are effective in inactivating SARS-CoV-2 at a range of concentrations after exposure times of 60 seconds. There is sufficient in vitro evidence to support the use of antiseptics to potentially reduce the viral load of SARS-CoV-2. The effects against the new coronavirus in vivo still need more randomized clinical trials to prove its effectiveness. Conclusion: ACE2 receptors are highly expressed in the oral cavity, therefore, this could be a potential high-risk route for SARS-CoV-2 infection. The virus can be detected in saliva even before the appearance of symptoms of COVID-19. In this regard, randomized clinical studies have shown that some pre-procedure oral mouthwashes are effective against salivary SARS-CoV-2 in dental treatments. In addition, the American Academy of Implant Dentistry (AAID) reported on how COVID-19 impacts dental care through guidelines for general dentistry.

Highlights

The COVID-19 pandemic has presented enormous challenges for dentists and patients
The risk of nosocomial transmission is a reality that requires the development of guidelines by the dental community to reduce the chances of infection by the new coronavirus
ACE2 receptors are highly expressed in the oral cavity, this could be a potential high-risk route for SARS-CoV-2 infection

Summary

Introduction

The risk of nosocomial transmission is a reality that requires the development of guidelines by the dental community to reduce the chances of infection by the new coronavirus In this sense, it was necessary to implement alternative prophylactic techniques such as the adoption of oral rinses before dental care. The virus can be detected in saliva even before the appearance of symptoms of COVID-19 In this regard, randomized clinical studies have shown that some preprocedure oral mouthwashes are effective against salivary SARS-CoV-2 in dental treatments. The "3R" principle, (R)edefinition, (R)econsideration, and (R)eflections, addresses these challenges well in the dental sector [4]

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