TABLE 2.

Summary of the studies included in their aerosol virus transmission dentistry

Risks and forms of viral transmission in dental offices
Title	Authors	Periodic (year)	Study/design	Population/intervention	Considerations
Biosafety conducts adopted by orthodontists.	Gonçalves C, Monteiro J, Martins M	Dental Press J Orthod (2018).	Observational	It evaluates the biosafety conducts adopted by orthodontists and possible differences regarding training time.	90 orthodontists answered the questionnaires. 63.23% use an autoclave to sterilize orthodontic pliers. All use an autoclave to sterilize instruments and 95.6% of the interviewees carry out previous cleaning with chemical products. 65.56% sterilize the bands in an autoclave and associate disinfection methods. For items such as rubber bands, accessories, bandages, metal springs and bows, there was a high “nothing” response rate. All respondents wear gloves and masks, while 78.92% wear aprons, 58.92% wear goggles and 50.01% wear hats.
Cross‐transmission in the dental office: does this make you ill?	Volgenant CMC, Soet JJ De	Curr Oral Health Rep (2018).	Descriptive	It provides the most recent information on the risks related to the transmission of (pathogenic) microorganisms in the dental office.	The risk of transmission of pathogens in a dental office is still unknown, but it cannot be considered insignificant. Thus, infection control in the dental office must be considered an essential item.
The severe acute respiratory syndrome coronavirus‐2 (SARS CoV‐2) in dentistry. Management of biological risk in dental practice.	Giudice R Lo	Int J Environ Res Public Health (2020).	Descriptive	It suggests more appropriate procedures in all aspects of dental practice to reduce the risk of infection.	Considering the route of transmission of the virus, a specific protocol must be applied to reduce the risk of infection, in addition to measures that prevent the spread of infection from a patient to another person or medical tools and equipment (cross‐infection).
Saliva is a non‐negligible factor in the spread of COVID‐19.	Li Y, Ren B, Peng X, et al	Mol Oral Microbiol (2020).	Descriptive	It suggests some protective measures that can help to reduce the risk of saliva‐related transmission, in order to prevent the possible spread of SARS‐CoV‐2 among patients, visitors, and dentists.	The control of saliva‐related transmission in the dental clinic is essential, especially in the epidemic period of COVID‐19.
COVID‐19: present and future challenges for dental practice.	Odeh ND, Babkair H, Abu‐hammad S, Borzangy S	Int J Environ Res Public Health (2020).	Descriptive	It addresses several issues related to the COVID‐19 pandemic that are directly related to dental practice in terms of prevention, treatment, and orofacial clinical manifestations.	Dentists must always competently follow the cross‐infection control protocols, but especially during this critical period, they must do their utmost to decide on the emergency cases indicated for dental treatment. Dentists should also be updated on how this pandemic is related to their profession, in order to be well oriented and prepared
Role of respirators in controlling the spread of novel coronavirus (Covid‐19) among dental health care providers: a review.	F. Umer, Z. Haji KZ	Int Endod J (2020).	Descriptive	Discuss respirators, their purpose, types, clinical efficiency and appropriate placement and removal techniques to prevent infection in times of COVID‐19 pandemic.	As the most common route of transmission is via aerosols and droplet inhalation, it is essential that healthcare professionals have the correct personal protective equipment (PPE), including clothing, masks, and goggles.
Precautions and recommendations for orthodontic settings during the COVID‐19 outbreak: a review	Turkistani KA	Am J Orthod Dentofacial Orthop (2020).	Descritivo	It reviews the literature in the period of March 2020, using the word set (CORD‐19 2020), infection control and disease transmission in orthodontics.	Emphasizes the minimization of aerosol production and the reinforcement of strict infection control measures. Reinforces strict infection control measures and minimizes personal contact and aerosol production are essential to avoid contamination in orthodontic configurations.
Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents	Kampf G, Todt D, Pfaender S, Steinmann E	J Hosp Infect (2020).	Descriptive	Reviews the literature on all available information on the persistence of human and veterinary coronavirus on inanimate surfaces, as well as inactivation strategies with biocidal agents used for chemical disinfection, for example, in health facilities.	Analysis of 22 studies reveals that viruses can persist on inanimate surfaces such as metal, glass, or plastic for up to 9 days, but can be effectively inactivated by surface disinfection procedures with 62‐71% ethanol, 0% hydrogen peroxide, 5% or 0.1% sodium hypochlorite in 1 minute. Other biocidal agents, such as 0.05‐0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate, are less effective.
Transmission routes of 2019‐nCoV and controls in dental practice	Peng X, Xu X, Li Y, et al	Int J Oral Sci (2020).	Descriptive	Recommendations for infection control measures during dental practice to block transmission routes from person to person in dental clinics and hospitals.	The 2019‐nCoV person‐to‐person transmission routes included direct transmission, such as coughing, sneezing, droplet inhalation transmission, and contact transmission, such as contact with the oral, nasal and ocular mucous membranes. 2019‐nCoV can also be transmitted via saliva, and oral‐fetal routes can also be a potential route of transmission from person to person. Dental practice participants are exposed to a tremendous risk of infection by 2019‐nCoV due to face‐to‐face communication and exposure to saliva, blood, and other body fluids and the handling of sharp instruments.
Rapid detection of SARS‐CoV‐2 in saliva: can an endodontist take the lead in point‐of‐care COVID‐19 testing?	Sidhartha Sharma, Vijay Kumar, Amrita Chawla AL	Int Endod J (2020).	Descriptive	It exposes the desire for alternative, fast, and prompt diagnostic tools (POC) and sensitive to COVID‐19, which can be used routinely by endodontists, using saliva as a sample before starting an emergency procedure.	There are still few diagnostic tools proposed in the literature. All the methods mentioned, need further research so that their sensitivity and validity are used with a salivary sample. If approved, it can offer an opportunity to allow detection of salivary viruses in an endodontic facility without the need for a complex diagnostic infrastructure. The chair test would help to reduce the waiting period and allow immediate intervention. In addition, patients with a negative test can be treated routinely after the emergency restrictions have ended.
Being a front‐line dentist during the Covid‐19 pandemic: a literature review	Fallahi HR, Keyhan SO, Zandian D, et al	Maxillofac Plast Reconstr Surg (2020).	Descriptive	Information collected so far about the virus, according to the guidelines of international health institutions, and provides a comprehensive protocol to manage possible exposure to patients or suspected of having coronavirus.	Face‐to‐face communication and consistent exposure to body fluids, such as blood and saliva, predispose dental care professionals to serious health problems. risk of infection 2019‐nCoV. Dental practice can be a potential risk for the dental team and there is a high risk of cross infection.
Possible aerosol transmission of COVID‐19 and special precautions in dentistry.	Ge Z, Yang L, Xia J, et al	J Zhejiang Univ Sci B (2020).	Descriptive	It was a survey of the works showing the forms of viral transmission in the dental offices.	So far, there is no report of infection in dental offices. She reports that the oral cavity is a place of high risk of transmission of the Sars‐Cov‐2 virus and that the best way to avoid cross‐infection is the use of personal protective equipment, washing hands, using absolute isolation, in addition to indicating strategies for some dental specialties.
H1N1 influenza: assessment of knowledge and awareness of private dental health professionals of a Tricity.	Singh I, Munjal S, Kumar M, Jha M GR, BT	J Family Med Prim Care (2019).	Observational	Cross‐sectional study among 255 private dentists who work at Tricity. A self‐administered, anonymous and multiple choice questionnaire was applied to collect information. The questionnaire contained 12 questions about knowledge and awareness about the maintenance of swine flu, given the time constraints.	Awareness about the mode of transmission of swine flu was positively reported by 88.5% of individuals. About 24.6% of individuals reported having met a patient with swine flu at their clinic. Preventive measures to prevent the spread of swine flu were known to 71.2% of individuals.
A scoping review on bio‐aerosols in healthcare and the dental environment.	Zemouri C, Soet H De, Crielaard W, Laheij A	PLoS One (2017).	Descriptive	Reviews evidence of bio‐aerosols in the health and dental fields.	The search resulted in 5823 studies, of which 62 were included. Dental parts of the hands were found to generate aerosols in dental configurations. Another 30 sources of human activities, interventions and daily cleaning at the hospital also generate aerosols. 55 bacterial species, 45 genera of fungi and 10 viruses in a hospital environment and 16 bacterial and 23 fungal species in the dental environment were identified. Patients with certain risk factors were more likely to acquire Legionella in hospitals. Such infections can lead to irreversible septic shock and death. Only a few studies have found that bio‐aerosol generation procedures have resulted in the transmission of infectious diseases or allergic reactions.
Cough aerosol in healthy participants: fundamental knowledge to optimize droplet‐spread infectious respiratory disease management.	Zayas G, Chiang MC, Wong E, et al	BMC Pulm Med (2012).	Observational	It characterizes the aerosol pattern of human cough in order to develop a standard bioaerosol model for human cough for the control of the influenza pandemic.	The voluntary cough generated droplets ranging from 0.1 to 900 microns. Drops smaller than 1 μm represent 97% of the total number of measured droplets contained in the cough aerosol. Age, sex, weight, height, and body mass have no statistically significant effect on the composition of the aerosol in terms of size and number of droplets.
Analysis of reported work accidents involving healthcare workers and exposure to biological materials.	Soares RZ, Schoen AS, Da Rocha Gomes Benelli K, et al	Rev Bras Med Trab (2019).	Observational	It presents the epidemiological profile of health professionals victims of accidents involving biological materials in Canoas, Rio Grande do Sul, Brazil, in 2017.	There were 121 occupational accidents with exposure to biological materials in 2017. Accidents prevailed among women (93.4%), whites (69.4%) and workers aged 20 to 30 years (40.5%). Percutaneous exposure was associated with 76.8% of accidents, blood was the most prevalent biological material involved (90%) and hollow needles were the main causative agent (64.5%). Gloves were the most used personal protective equipment (PPE) (75.2%). About 93.4% of the sample was vaccinated against hepatitis B.