Prevention and safety in the dental office after Novel Human Coronavirus outbreak: Unresolved questions and future directions

Abstract

Aim Since the outbreak of the Novel Human Coronavirus epidemic, researchers around the world focused their efforts on tackling this global emergency. Research labs are joining forces to find a therapy and a preventive vaccine. Preventive and extraordinary safety measures are crucial to reduce the spread of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) among Health-Care Professionals (HCP). HCP performing or assisting aerosol-generating procedures are classified as “very high exposure risk” workers. New findings suggest that saliva delivered through cough, droplets released through normal breathing and oral mucosa represents a vector of SARS-CoV-2 transmission. Consequently, viruses can be easily vehiculated by most of dental procedures and it is essential for dental offices to change the operating modes. The present narrative review aimed to gather evidence in order to propose operative guidelines to reduce the risk of SARS-CoV-2 transmission in the dental offices. Emphasis was also given to unresolved questions about COVID-19 (Coronavirus Disease 2019) diagnostics and future directions to improve the preventive and safety measures in daily dental practice. Results Operative guidelines aimed to reduce the risk of transmission in the dental office are drawn and described. Conclusion A rapid and reliable diagnostic test detecting COVID-19 positive patients upon arrival at the dental office could allow dental HCP to work in “semi-ordinary” conditions; infected or suspected patients would be postponed or treated only in case of a real emergency employing high-level PPE and extraordinary preventive strategies.