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Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment

OBJECTIVES: Heightened anxiety among dental healthcare professionals (DHPs) during the COVID-19 pandemic stems from uncertainties about the effectiveness of personal protective equipment (PPE) against dental aerosols and risk levels of asymptomatic patients. Our objective was to assess the risks for...

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Autores principales: Ren, Yanfang, Feng, Changyong, Rasubala, Linda, Malmstrom, Hans, Eliav, Eli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368403/
https://www.ncbi.nlm.nih.gov/pubmed/32693111
http://dx.doi.org/10.1016/j.jdent.2020.103434
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author Ren, Yanfang
Feng, Changyong
Rasubala, Linda
Malmstrom, Hans
Eliav, Eli
author_facet Ren, Yanfang
Feng, Changyong
Rasubala, Linda
Malmstrom, Hans
Eliav, Eli
author_sort Ren, Yanfang
collection PubMed
description OBJECTIVES: Heightened anxiety among dental healthcare professionals (DHPs) during the COVID-19 pandemic stems from uncertainties about the effectiveness of personal protective equipment (PPE) against dental aerosols and risk levels of asymptomatic patients. Our objective was to assess the risks for DHPs providing dental care during the pandemic based on available scientific evidence. METHODS: We reviewed the best available evidence and estimated the annualized risk (p=d(a)s(1−1-p(0)p(1)(1-e)(y)(n)) for a DHP during the COVID-19 pandemic based on the following basic parameters: p(0), the prevalence of asymptomatic patients in the local population; p(1), the probability that a DHP gets infected by an asymptomatic patient; e, the effectiveness of the PPE; s, the probability of becoming symptomatic after getting infected from asymptomatic patient; d(a), the probability of dying from the disease in age group a; n, number of patients seen per day; and y, number of days worked per year. RESULTS: With the assumption that DHPs work fulltime and wear a N95 mask, the annualized probability for a DHP to acquire COVID-19 infection in a dental office, become symptomatic, and die from the infection is estimated at 1:13,000 (0.008 %) in a medium sized city in the US at the peak of the pandemic. The risk estimate is highly age-dependent. Risk to DHPs under the age of 70 is negligible when prevalence of asymptomatic cases is low in the local community. CONCLUSIONS: Risk of COVID-19 transmission in dental office is very low based on available evidence on effectiveness of PPE and prevalence of asymptomatic patients. Face shields and pre-procedure oral rinses may further reduce the risks. CLINICAL SIGNIFICANCE: DHPs should follow guidelines on pre-appointment protocols and on PPE use during dental treatments to keep the risk low.
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spelling pubmed-73684032020-07-20 Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment Ren, Yanfang Feng, Changyong Rasubala, Linda Malmstrom, Hans Eliav, Eli J Dent Article OBJECTIVES: Heightened anxiety among dental healthcare professionals (DHPs) during the COVID-19 pandemic stems from uncertainties about the effectiveness of personal protective equipment (PPE) against dental aerosols and risk levels of asymptomatic patients. Our objective was to assess the risks for DHPs providing dental care during the pandemic based on available scientific evidence. METHODS: We reviewed the best available evidence and estimated the annualized risk (p=d(a)s(1−1-p(0)p(1)(1-e)(y)(n)) for a DHP during the COVID-19 pandemic based on the following basic parameters: p(0), the prevalence of asymptomatic patients in the local population; p(1), the probability that a DHP gets infected by an asymptomatic patient; e, the effectiveness of the PPE; s, the probability of becoming symptomatic after getting infected from asymptomatic patient; d(a), the probability of dying from the disease in age group a; n, number of patients seen per day; and y, number of days worked per year. RESULTS: With the assumption that DHPs work fulltime and wear a N95 mask, the annualized probability for a DHP to acquire COVID-19 infection in a dental office, become symptomatic, and die from the infection is estimated at 1:13,000 (0.008 %) in a medium sized city in the US at the peak of the pandemic. The risk estimate is highly age-dependent. Risk to DHPs under the age of 70 is negligible when prevalence of asymptomatic cases is low in the local community. CONCLUSIONS: Risk of COVID-19 transmission in dental office is very low based on available evidence on effectiveness of PPE and prevalence of asymptomatic patients. Face shields and pre-procedure oral rinses may further reduce the risks. CLINICAL SIGNIFICANCE: DHPs should follow guidelines on pre-appointment protocols and on PPE use during dental treatments to keep the risk low. Elsevier Ltd. 2020-10 2020-07-18 /pmc/articles/PMC7368403/ /pubmed/32693111 http://dx.doi.org/10.1016/j.jdent.2020.103434 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Ren, Yanfang
Feng, Changyong
Rasubala, Linda
Malmstrom, Hans
Eliav, Eli
Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment
title Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment
title_full Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment
title_fullStr Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment
title_full_unstemmed Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment
title_short Risk for dental healthcare professionals during the COVID-19 global pandemic: An evidence-based assessment
title_sort risk for dental healthcare professionals during the covid-19 global pandemic: an evidence-based assessment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368403/
https://www.ncbi.nlm.nih.gov/pubmed/32693111
http://dx.doi.org/10.1016/j.jdent.2020.103434
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