Safe protocol of resuming routine dental procedures in a tertiary care hospital setting post COVID-19 lockdown. 2022

Saadia Manzar, and Farhat Kazmi, and Anas Imran Arshad, and Faiza Awais, and Hanna Abdul Majeed, and Hazik Bin Shahzad, and Mohammad Khursheed Alam
Oral and Maxillofacial Surgery Department, Rashid Latif Dental College, Rashid Latif Medical Complex, Lahore, Pakistan.

BACKGROUND The outbreak of the COVID-19 pandemic greatly affected dentistry. Dental procedures are considered one of the modes of transfer of COVID-19 infection due to generation of aerosols. To prevent transmission of this virus through dental procedures, guidelines were issued by the World Health Organisation (WHO), Centers for Disease Control and Prevention (CDC) and Ministry of Health of each country. OBJECTIVE The aim of this study is to establish a safe protocol for performing dental procedures in a crisis capacity situation of personal protective equipment (PPE). METHODS A strategy for performing the dental procedures was formulated in accordance with the guidelines provided by the Ministry of Health, Pakistan before vaccination of HCPs against COVID-19. These guidelines also accorded the strategies provided by the WHO and CDC. 40 health care professionals (HCPs) participated in the study and were divided in two groups. Group A performed non-aerosol generating procedures (non- AGPs) and group B performed aerosol generating procedures (AGPs). A total of 6372 aerosol generating procedures were performed from 1 August 2020 to 31 March 2021. The safety of this protocol was established by the number of HCPs contracting COVID-19 infection. RESULTS Only 1 HCP contracted COVID-19 infection preceding the AGPs from group B following the formulated strategy. CONCLUSIONS Reported strategy based on the dental system in Pakistan is considered safe to be implemented worldwide during the COVID-19 pandemic.

UI MeSH Term Description Entries
D003140 Communicable Disease Control Programs of surveillance designed to prevent the transmission of disease by any means from person to person or from animal to man. Flatten the Curve of Epidemic,Flattening the Curve, Communicable Disease Control,Parasite Control,Control, Communicable Disease,Control, Parasite
D003813 Dentistry The profession concerned with the teeth, oral cavity, and associated structures, and the diagnosis and treatment of their diseases including prevention and the restoration of defective and missing tissue.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000067393 Personal Protective Equipment Specialized clothing or equipment worn for protection against health hazards. Personal Protective Equipment may include MASKS; RESPIRATORY PROTECTIVE DEVICES; HEAD PROTECTIVE DEVICES; EYE PROTECTIVE DEVICES; EAR PROTECTIVE DEVICES; PROTECTIVE CLOTHING; and protective footwear. PPE Personal Protective Equipment,Equipment, Personal Protective,Personal Protective Equipments,Protective Equipment, Personal
D000086382 COVID-19 A viral disorder generally characterized by high FEVER; COUGH; DYSPNEA; CHILLS; PERSISTENT TREMOR; MUSCLE PAIN; HEADACHE; SORE THROAT; a new loss of taste and/or smell (see AGEUSIA and ANOSMIA) and other symptoms of a VIRAL PNEUMONIA. In severe cases, a myriad of coagulopathy associated symptoms often correlating with COVID-19 severity is seen (e.g., BLOOD COAGULATION; THROMBOSIS; ACUTE RESPIRATORY DISTRESS SYNDROME; SEIZURES; HEART ATTACK; STROKE; multiple CEREBRAL INFARCTIONS; KIDNEY FAILURE; catastrophic ANTIPHOSPHOLIPID ANTIBODY SYNDROME and/or DISSEMINATED INTRAVASCULAR COAGULATION). In younger patients, rare inflammatory syndromes are sometimes associated with COVID-19 (e.g., atypical KAWASAKI SYNDROME; TOXIC SHOCK SYNDROME; pediatric multisystem inflammatory disease; and CYTOKINE STORM SYNDROME). A coronavirus, SARS-CoV-2, in the genus BETACORONAVIRUS is the causative agent. 2019 Novel Coronavirus Disease,2019 Novel Coronavirus Infection,2019-nCoV Disease,2019-nCoV Infection,COVID-19 Pandemic,COVID-19 Pandemics,COVID-19 Virus Disease,COVID-19 Virus Infection,Coronavirus Disease 2019,Coronavirus Disease-19,SARS Coronavirus 2 Infection,SARS-CoV-2 Infection,Severe Acute Respiratory Syndrome Coronavirus 2 Infection,COVID19,2019 nCoV Disease,2019 nCoV Infection,2019-nCoV Diseases,2019-nCoV Infections,COVID 19,COVID 19 Pandemic,COVID 19 Virus Disease,COVID 19 Virus Infection,COVID-19 Virus Diseases,COVID-19 Virus Infections,Coronavirus Disease 19,Disease 2019, Coronavirus,Disease, 2019-nCoV,Disease, COVID-19 Virus,Infection, 2019-nCoV,Infection, COVID-19 Virus,Infection, SARS-CoV-2,Pandemic, COVID-19,SARS CoV 2 Infection,SARS-CoV-2 Infections,Virus Disease, COVID-19,Virus Infection, COVID-19
D000086402 SARS-CoV-2 A species of BETACORONAVIRUS causing atypical respiratory disease (COVID-19) in humans. The organism was first identified in 2019 in Wuhan, China. The natural host is the Chinese intermediate horseshoe bat, RHINOLOPHUS affinis. 2019 Novel Coronavirus,COVID-19 Virus,COVID19 Virus,Coronavirus Disease 2019 Virus,SARS Coronavirus 2,SARS-CoV-2 Virus,Severe Acute Respiratory Syndrome Coronavirus 2,Wuhan Coronavirus,Wuhan Seafood Market Pneumonia Virus,2019-nCoV,2019 Novel Coronaviruses,COVID 19 Virus,COVID-19 Viruses,COVID19 Viruses,Coronavirus 2, SARS,Coronavirus, 2019 Novel,Coronavirus, Wuhan,Novel Coronavirus, 2019,SARS CoV 2 Virus,SARS-CoV-2 Viruses,Virus, COVID-19,Virus, COVID19,Virus, SARS-CoV-2,Viruses, COVID19
D000336 Aerosols Colloids with a gaseous dispersing phase and either liquid (fog) or solid (smoke) dispersed phase; used in fumigation or in inhalation therapy; may contain propellant agents. Aerosol
D058873 Pandemics Epidemics of infectious disease that have spread to many countries, often more than one continent, and usually affecting a large number of people. Pandemic
D062606 Tertiary Care Centers A medical facility which provides a high degree of subspecialty expertise for patients from centers where they received SECONDARY CARE. Tertiary Hospital,Tertiary Referral Center,Tertiary Referral Hospital,Care Center, Tertiary,Care Centers, Tertiary,Center, Tertiary Care,Center, Tertiary Referral,Centers, Tertiary Care,Centers, Tertiary Referral,Hospital, Tertiary,Hospital, Tertiary Referral,Hospitals, Tertiary,Hospitals, Tertiary Referral,Referral Center, Tertiary,Referral Centers, Tertiary,Referral Hospital, Tertiary,Referral Hospitals, Tertiary,Tertiary Care Center,Tertiary Hospitals,Tertiary Referral Centers,Tertiary Referral Hospitals

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