Authors: Sam Wakim, Dovid Friedman, Eva Turbiner, Shmuel Halpert, Jeffrey Kaminetzky, Sarah Christenbury.
Introduction: SARS-CoV-2 is thought to spread between individuals in close contact, primarily through respiratory droplets, including asymptomatic individuals [1,2]. The virus has been shown to persist in aerosols for hours [3]. Aerosol-generating procedures may increase the risk of transmission to healthcare providers, potentially putting dentists and patients at greater risk of exposure [3]. Current CDC guidelines for dental professionals include: N95 or higher-level respirator use during aerosol-generating procedures; COVID screening and triaging of patients; hand and respiratory hygiene best practices; facility updates; and physical distancing. The CDC also recommends considering pre-procedure testing to identify pre- and asymptomatic patients [2].
Methods: In June 2020, New Jersey health centers Zufall Health and CHEMED implemented COVID-19 testing prior to aerosol-generating dental procedures, along with other protocols, as part of the safe reopening of their facilities. They utilized screening and testing to safeguard dental staff and patients, to calm anxious front-line employees, and to facilitate patient follow-through on dental care. In September 2020, the centers undertook additional process improvements to determine the continued viability of pre-procedure COVID testing in their dental facilities.
Results: From September 2020 to March 2021, the centers found parity between their COVID testing methods. Testing results were similar, indicating very few asymptomatic dental patients tested positive. Staff treating patients later determined positive for COVID were not infected.
Conclusions: In an area of low, moderate, and high transmission, providers can feel confident that stringent adherence to recommended COVID precautions can safeguard staff and patients, including during aerosol-generating dental procedures. While testing is an important public health tool and helpful in reassuring staff and patients, one center determined it was no longer necessary to the safe and effective delivery of dental services. By the completion of the project, the other center was evaluating halting pre-procedure testing, and has since stopped testing.
View/Download pdf