1 |
Alharbi et al. (2020)/ Saudi Arabia [15] |
I.) Emergency Tx (fracture and infection compromising patient’s airway, uncontrolled bleeding) for all patients |
I.) Restrict Intraoral imaging |
-Lack of a guideline for patients who need dental Tx before an imminent transplant. |
II.) Preprocedural use of 0.23% povidone-iodine mouth-wash at least 15 s |
II.) Minimally invasive urgent care without aerosol generation for asymptomatic suspect, stable active and recovered patients |
-Lack of a guide on proper saliva ejectors or surgical aspiration |
III.) Single-use devices |
IV.) Use a rubber dam |
III.) Invasive urgent care with aerosol generation for asymptomatic suspect |
V.) Avoid aerosol-generating procedures |
VI.) Avoid administering Ibuprofen |
2 |
Ather et al. (2020)/ The United States [14] |
I.) Perform dental Tx if lack of travel hx/epidemiological link |
I.) Personal protective equipment and hand hygiene |
-Lack of a guideline for patients who need dental Tx before an imminent transplant. |
II.) Defer elective care for suspect at least 2 weeks |
-Lack of a guide on proper saliva ejectors or surgical aspiration |
III.) Urgent care for suspect in case of tooth pain and/or swelling using pharmacological management as the first line and emergency care as the secondary management |
II.) Preprocedural mouth rinse |
III.) single-use devices |
IV.) Avoid Intraoral radiography |
V.) Use a rubber dam |
VI.) Minimize ultrasonic instruments, high-speed handpieces, and 3-way syringes |
VII.) Dilute Naocl to 1% |
VIII.) Negative-pressure treatment rooms |
IX.) Disinfect inanimate surfaces |
3 |
Izzetti et al. (2020)/ Italy [16] |
I.) Identify potentially at-risk cases and support them in contacting the health authorities |
I.) 1-min mouth rinse with 0.2 to 1% povidone, 0.05 to 0.1% cetylpyridinium chloride, or 1% hydrogen peroxide |
-Lack of a precise guideline on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones. |
II.) Understand the real need for professional consultation and preferably address the issue with just pharmacologic prescription |
II.) Hand washing for at least 60 s and then hand rubbing with 60-70% hydroalcoholic solution before wearing a glove |
III.) Organize a contagion-reduced treatment for the subjects with unknown risk of contagion who are experiencing an acute dental problem that requires immediate treatment |
III.) Personal protective equipment |
IV.) Preparation of all instruments in advance |
V.) Total protection through disposable cover |
VI.) Avoid, when possible, use of handpieces/ultrasonic instruments |
VII.) Use a rubber dam |
VIII.) Surgical aspiration system |
IX.) If possible, prefer 4-hands technique |
X.) Limit overall Tx time if possible |
4 |
Lee and Auh (2020)/ Korea [17] |
I.) Routine pre-check the general health status and travel history to epidemic areas |
I.) Use basic personal protective equipment for potential asymptomatic carriers |
-Lack of a precise guideline on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones. |
II.) Patients with suspected or known COVID-19 should be isolated or postpone their non-emergency dental care during the COVID-19 pandemic |
II.) Hand washing is essential |
III.) Must avoid or minimize procedures producing droplets or aerosols or stimulate salivary secretion or coughing. |
IV.) Use high-volume saliva ejectors with the four-handed technique |
V.) Minimize using the three-way syringe |
VI.) Acquisition of extraoral radiographs rather than intraoral radiographs |
VII.) Use an oxidative or antimicrobial mouth rinse before dental procedures |
VIII.) Treatment in an isolated and well-ventilated environment |
IX.) Disinfect the surface of equipment with 62–71% ethanol before and after dental procedures |
5 |
Mallineni et al. (2020)/ Saudi Arabia- The United Kingdom- The United States-Brazil [18] |
I.) Contemporary minimally invasive procedures that minimize or eliminate aerosol generation should be employed where intervention is indicated throughout the pandemic |
I.) Hand hygiene |
-Lack of a precise guideline on the management of pediatric patients at various stages of the disease, from positive to asymptomatic to healed ones. |
II.) Personal protective equipment |
III.) Respiratory hygiene/cough etiquette |
II.) Once restrictions begin to be eased, continue management of dental disease with minimally interventive concepts, e.g., atraumatic restorative treatment, fissure sealants, silver diamine fluoride, selective caries removal, and the Hall Technique while viral transmission risk remains high |
IV.) Sharps safety and safe injection practices |
V.) Sterilization and disinfection of patient-care items and devices |
VI.) Environmental infection prevention and control |
VII.) Dental unit water quality |
6 |
Meng and Hua (2020)/ China [19] |
I.) In areas where COVID-19 spreads, non-emergency dental practices should be postponed. |
I.) Hand hygiene |
-Lack of a precise guideline on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones. |
II.) Personal protective equipment |
II.) Pulp exposure in symptomatic irreversible pulpitis could be made with chemomechanical caries removal. |
III.) Thorough disinfection of all surfaces |
IV.) Particulate respirators (e.g., N-95 masks or FFP2) |
III.) If a tooth needs to be extracted, an absorbable suture is preferred. |
IV.) For patients with facial soft tissue contusion, debridement, and suturing should be performed. |
V.) The 4-handed technique is beneficial |
VI.) Use saliva ejectors with low or high volume |
V.) Life-threatening cases with oral and maxillofacial compound injuries should be admitted to the hospital immediately. |
VII.) Preoperative antimicrobial mouth rinse |
VIII.) Minimize aerosol-generating procedures, such as the use of a 3-way syringe |
IX.) Acquisition of extraoral radiographs rather than intraoral radiographs |
X.) Rubber dam |
XI.) Isolated and well-ventilated room or negatively pressured rooms if possible |
7 |
Peng et al. (2020)/ China [20] |
I.) If a patient replies “yes” to screening questions, and body temperature is below 37.3 °C, the dentist can defer the treatment until 14 days after the exposure event. |
I.) Hand Hygiene |
Lack of a precise guideline as to which dental treatments can be performed in case the patient replies “no” to all screening questions and his/her body temperature is below 37.3 °C |
II.) Personal protective measures for the dentists |
II.) If a patient replies “yes” to screening questions, and body temperature is no less than 37.3 °C, the patient should be immediately quarantined and reported to the infection control department. |
III.) A Preprocedural mouth rinse containing oxidative agents such as 1% hydrogen peroxide or 0.2% povidone especially when a rubber dam cannot be used |
III.) If a patient replies “no” to all screening questions, and his/her body temperature is below 37.3 °C, the dentist can treat the patient with extra- protection measures and avoids spatter or aerosol-generating procedures. |
IV.) If using a rubber dam, use extra high-volume suction for aerosol and spatter along with regular suction with a four-hand operation |
IV.) If a patient replies “no” to all screening questions, but his/her body temperature is no less than 37.3 °C, the patient should be instructed to specialized clinics for COVID-19. |
V.) If a rubber dam isolation is not possible, manual devices, such as Carisolv and hand scaler, are recommended for caries removal and periodontal scaling |
VI.) the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19 |
VII.) Disinfection of the clinic settings |
8 |
Prati et al. (2020)/ Italy [21] |
I.) Triaging patients to detect by history and with a respiratory infection, flu, acute respiratory illness, conjunctivitis, and cardiovascular abnormalities |
I.) Regular, meticulous and effective hand wash |
The study provides a guideline for dental school; however, more precise guides on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones, are required. |
II.) Separation of patients with respiratory symptoms to limit their contact with the dental staff, students and patients |
II.) Use face masks |
III.) Decontamination of all surfaces with 0.1% sodium hypochlorite or 70% ethanol or 0.5% hydrogen peroxide |
III.) Avoiding dental treatment if at all possible |
IV.) Respiratory hygiene/cough etiquette |
V.) Isolate the patient in a dedicated single-patient room (with closed door) |
VI.) Use a rubber dam |
VII.) Application of powerful air/water surgical suction pump (aspirator) close to the tooth and a second suction close to the nose to prevent aerosol and saliva droplet diffusion |
VIII.) Use high-speed handpiece with no exhaust |
IX.) Decontamination of equipment, surgeries/ operatories after each patient |
9 |
Spagnuolo et al. (2020)/ Italy [22] |
I.) Dentists should avoid the scheduling of any patient: only such urgent dental diseases can be considered during the COVID-19 outbreak. |
I.) Staff should work at an adequate distance from patients |
-Lack of a precise guideline as to which dental Tx should be considered as urgent dental disease |
II.) Handpieces must be equipped with anti-reflux devices to avoid contaminations |
III.) Avoid or minimize operations that can produce droplets or aerosols |
IV.) Use of saliva ejectors with a low volume or high volume |