cord-013311-r10f5yb0	2020	Sir, as a Past President of the BDA I am dismayed and bemused to read frequent reports in national newspapers decrying the number of children awaiting many months for tooth extractions in hospitals. Sir, in the current pandemic, the lack of equitable oral healthcare facilities, shortfall of dental healthcare providers, shortages of equipment/materials, and inadequate management of existing services is well known in developing countries. 1 It may not be possible for such countries to upgrade the dental surgeries in their tertiary care facilities to the suggested level of ventilation, filtration, and negative pressure, due to financial limitations. 4 To prevent the transmission of infection through aerosol in the dental setting the ''protection box'' is an innovative and economical solution for performing aerosol generating procedures. Sir, I would like to thank all my colleagues who have worked so diligently to up-skill and kindly help guide others through the current COVID-19 pandemic. Frugal solutions for the operating room during the COVID-19 pandemic
cord-014337-nnuvrb6o	2020	gdc-uk.org/news-blogs/news/detail/2020/09/01/ joint-statement-on-arrangements-for-dental-educationand-training-while-measures-are-in-place-to-control-thespread-of-covid-19-(version-2-dated-1-september-2020) (accessed November 2020). To evaluate the existing curricula and reorganise them by adopting the Commission on Dental Accreditation (CODA) compliance protocols on the interruption of education and distance education to allow for a continuation of the PGRs'' hands-on and didactic learning 2. Clinical case presentations through online sessions allowed continued PGRs'' feedback to enhance their presentation and treatment planning skills as well as surgical techniques 3. 1 report that sequencing data indicate high reads for Prevotella, Staphylococcus and Fusobacterium in patients severely infected with SARS-CoV-2. Despite facing changes in a teaching format, especially in clinical training, our approaches, including the use of online portals and modules, maintained and enhanced PGRs'' hands-on and didactic experiences. One way of ensuring best practice would be that the directions for use of each new batch of product are read carefully and then stored in a centrally placed file in the clinic, easily accessible to all members of the dental team.
cord-023913-pnjhi8cu	2011	So while there has been no shortage of effort paid to improving Medicare, the one common theme in all of the recent initiatives is that dental care has been conspicuously 1 A new study by Hedlund, Jeffcoat, Genco and Tanna funded by CIGNA of patients with Type II diabetes and periodontal disease found that medical costs of patients who received maintenance therapy were $2483.51 per year lower than patients who did not. Examples of integrated care models do exist, such as that presented by (Heuer 2007 ) involving school-linked and school-based clinics with an "innovative health infrastructure." According to Heuer, "Neighborhood Outreach Action for Health (NOAH)" is staffed by two nurse practitioners and a part-time physician to provide "primary medical services to more than 3,200 uninsured patients each year" in Scottsdale, Arizona.
cord-026765-cw4rh1on	2020	authors: Dingle, M.; Irshad, H.; McKernon, S.; Taylor, K. dosing protocols as accurately as possible (to standardise the dosing), and we anticipate the that the product will be available mid-May, initially in a 5L presentation, primarily for dentists, while a nasal and throat spray will follow in late May primarily for pre-procedural use in the hospital setting. Sir, we write to inform your readers about techniques for non-surgical exodontia we have adapted to at Liverpool University Dental Hospital during the COVID-19 pandemic. As cases in our population grew the dental clinic went on an emergency only protocol and to date we have provided dental care to almost 500 patients and performed approximately over 100 dental emergency procedures. Sir, I would like to share my thoughts and experiences on how COVID-19 has affected me as a year 13 student, applying to university to study dentistry this September.
cord-029374-46okjft6	2020	Completing further training and attending courses -due to COVID-19 this hasn''t been possible, however various webinars and online CPD programmes have been created to help dental professionals continue to further their knowledge and skills from home Work appraisals with colleagues to assess competency, identify areas of further training, help develop the dental team and broaden the skill mix to deliver services in a more efficient and resilient way Having important policies on raising concerns and safeguarding and making sure the entire dental team are aware of these and adhere to them Giving staff the additional training needed so they are up-to-date with the changes that have been made to practice protocols/ policies due to COVID-19 Fit testing of the N95/FFP2/FFP3 masks should be done on all clinical team members to ensure they are safe to carry out an aerosol generating procedure (AGP) on a patient if necessary
cord-030240-c8lank21	2020	Their role is critical in controlling access for patients to the dental team and whilst they may carry out a basic form of triaging, this may vary significantly between general practices. It has been an eye-opening opportunity to gain an insight into the workings of our frontline dental team and has highlighted the role of effective triaging in management of emergency patients across the country. Formal training could be implemented for all members of the dental team which would cover a range of topics including: assessing and interpreting symptoms, assigning urgency to clinical need, management of diary pressures and patient expectations, and providing simple practical telephone advice regarding oral hygiene and analgesia. While this has been a testing time for the profession, it has provided us with an invaluable opportunity to reflect on current practices allowing us to make significant improvements so that when we return to routine dentistry, both patients and the wider dental team will benefit from streamlined services.
cord-031178-6gnjpmfy	2020	Online information available at https://bda.org/ amalgam (accessed February 2020) '' It is essential that dental schools across the UK teach students to adopt a holistic approach to dental care'' Two of the most commonly used dental restorative materials include amalgam and resin-based composites. It is essential that dental professionals remain familiar with the legislation surrounding the use of materials not only so that an improved service of care is delivered to patients, but also as a part of a greater responsibility towards global sustainability. com/collections/ djidaaddgi ¾ BDA -what they are doing to improve sustainability in practice: -https://bda.org/ news-centre/blog/whatcan-we-do-to-makedentistry-more-sustainable '' As ever, it is incumbent that dental students deliver an impactful message on prevention to their patients'' Online information available at https:// www.theccc.org.uk/tackling-climate-change/ reducing-carbon-emissions/carbon-budgets-andtargets The environmental impact of dental amalgam and resin-based composite materials
cord-031508-1l9dxc16	2020	For some people the isolation of feeling confined to their home had a severe impact on their mental health -too much worry, stress or even boredom can have an effect, and if not recognised and dealt with, could see you suffering way beyond the time a vaccine is found for COVID-19. 8, 10 She was also the lead in a BDA event in February this year, that gathered key stakeholders in UK dentistry to see how they could collaborate on improving the services and support for the mental health and wellbeing of dentists, as it has always been an important consideration, even before the pandemic hit. Bear in mind that the GDC does expect dental professionals to look after their own health in the interests of providing safe care for patients. News release: Depression and anxiety spiked after lockdown announcement, coronavirus mental health study shows
cord-032698-ev8gylpf	2020	Two recently published articles in your journal highlighted the utility of silver diamine fluoride (SDF) and potassium iodide (SDF/KI) application, and paediatric patients audit attending emergency care for irreversible pulpitis symptoms during the current coronavirus disease 19 (COVID-19) pandemic. 2 Thus, to limit bioaerosol risks, the contemporary treatment algorithm includes the use of pre-procedure oral rinse with 1% hydrogen peroxide or povidone-iodine 3 and the use of dental dam, as well as high-volume suction. potential dental team role in supporting the delivery of a flu vaccination programme. 1 In the United States, Minnesota and Illinois allow dentists to administer vaccines, but only to protect against the flu and only in adult patients. 2 In Scotland, NHS dental contractors (dentists and dental bodies corporate) can opt in to participate in the 2020/21 flu vaccination programme. Other members of the dental team will not be allowed to deliver vaccinations. https://doi.org/10.1038/s41415-020-2183-5 Authors must sign the letter, which may be edited for reasons of space.
cord-033803-79me0615	2020	'' With dental practices and many early years settings closed, Jo described how everyone involved in the programme did what they could to ensure children still got their toothbrushing packs. As in Manchester, programmes are geared to funding GDPs to provide prevention as well as building links between dental practices early years settings and health visitor and social care teams. GDP Mohsan Ahmad, Chair of the Local Dental Network, wrote the foreword to a document 4 setting out the three-year plan, stressing that dental teams would play an essential part, by engaging communities to value good oral health, driving improvement in outcomes. In January of last year, the Greater Manchester Health and Social Care Partnership (GMHSCP) launched 6 a £1.5 million programme to reduce dental decay. A key development was the Green Paper published last year 10 in which the Government committed to put prevention at the heart of all its health and social care decisionmaking.
cord-253162-lebgynsz	2020	MATERIALS AND METHODS: By means of three online symposiums, dental educators from different countries were invited to give presentation and discussion regarding to the information and experience in the innovation of dental education during the pandemic. Dental educators from different countries were invited to attend online symposiums with ZOOM software (Zoom Video Communications Inc., San Jose, California, USA) and give presentations regarding their information and experience in the innovation of dental education during the COVID-19 pandemic from their own countries. Eight scholars from The University of Sydney, Australia; The University of Hong Kong, Hong Kong; Loma Linda University, USA; International Medical University, Malaysia; National Yang-Ming University, Taiwan; Tohoku University, Japan; Chulalongkorn University, Thailand; and Columbia University, USA were invited to present the current situation of dental education during the pandemic in each own country.
cord-253682-pwrojqju	2020	title: Opinion: An Increase in Severe Late-Dental Complications May Result from Reliance on Home Dental Remedies During the COVID-19 Pandemic The global pandemic resulting from the COVID-19 outbreak has caused significant limitations in the publics access to routine dental and medical care. Availability of appointments at private medical and dental practices, particularly on the east coast, have been severely curtailed as practices have shut their doors and laid off workers in response to stay-at-home orders and reduced clinical volume. We believe this may be the direct result of decreased routine dental care, as patients begin to ignore signs of increasingly severe dental conditions in an effort to remain home. We believe that this is likely the result of a failure to directly communicate with patients the circumstances under which they should seek dental care despite the COVID-19 pandemic. In cases of severe dental pain, persistent oral bleeding, or increasing difficulty with breathing or swallowing, patients should still be urged to seek dental care.
cord-256528-sbbkqirv	2020	title: The Rapid Development of an Urgent Dental Care Hub in an Oral Surgery Unit—Key Learning Points We would like to bring to the attention of your readers working in Oral Surgery and Oral and Maxillofacial Surgery units some of the salient lessons we have learnt whilst establishing and developing an urgent dental care hub at King''s College Hospital in response to the COVID-19 crisis. King''s College Dental Institute was in the fortunate position of having an established telephone triage and appointment booking service for its existing "Acute Dental Care" service. The appointments for booked patients were spread throughout the day and we developed a new COVID-19 period standard operating procedure for use across the Dental Institute. Members of our team are assigned appropriate roles including telephone advice and triage, patient assessment in Acute Dental Care, and operating within the Oral Surgery department. Tagar Department of Oral Surgery, Kings College Dental Institute
cord-257680-ds1y3ks9	2020	BACKGROUND: The study presented here systematically examines the potential involvement of dental, oral and maxillofacial centres (ZMK) in the management of pandemia or in large-scale emergencies. Taking into account previous studies, the aim of this study was thus to systematically investigate the current rate and potential increase in integration of dental medical centres at university hospitals in the emergency response plan of the hospital as a whole. Previous contingency plans for a mass casualty scenario had foreseen the fire service, Germany''s Federal Disaster Relief Agency (THW) and the Red Cross setting up and operating treatment stations at the outpatient clinic of the MHH to support the hospital. On average, the dental medical centres feature a total of 82.5 dental treatment units and 4.9 surgical rooms, which fall into the categories of minor surgery rooms, emergency operating theatres and operating theatres.
cord-257940-12nf27j4	2020	In multi-variable analysis, social hardship status (OR: 1.14; 95% CI: 1.12-1.16), federal state (Brandenburg 0.85; 0.84–0.87; Mecklenburg-Western Pomerania: 0.80; 0.78–0.82), and age significantly affected utilization (0.95; 0.95–0.95/year), together with a range of co-morbidities according to ICD-10 and DRG. In a previous study and building on claims data, we found a disparate utilization of prosthetic services in the very old, with those aged 85 years or older, those living rural, and those with severe general health conditions utilizing prosthetic services, by large, to a lower degree than younger, urban living and only limitedly sick seniors [7] . In the present study, we used claims data from a large health insurance in northeast Germany to assess dental service utilization in the very old. We hypothesized that the utilization of dental services in the very old was associated with an individual''s age, general health status, place of living, and social status.
cord-258498-0mvxwo3w	2020	This review article informs about measures which reduce facility risk, manage symptomatic patients and protect personal health care and management with reference to paediatric dentistry. 5, 6, 7 The risk of SARS-CoV-2 transmission via aerosols generated during dental procedures cannot be eliminated when practicing in the absence of Airborne Precautions (airborne infection isolation rooms or single-patient rooms, respiratory protection program, N95 respirators). 47 Primary prevention encompasses prenatal health care, avoidance of night time bottle feed with sugary drinks or milk, restricting sugar intake and frequency for children younger than 24 months, avoiding frequent/nocturnal breast or bottle feeding after 1 year, exposure to dietary fluoridate (water, milk, salt), use of an age appropriate amount of fluoride toothpaste containing at least 1000ppm fluoride for brushing at least twice a day, dental visit in the first year of life and regular applications of 5% fluoride.
cord-262998-cugd2t1l	2020	Frequent hand washing lasting at least 20 s with soap and water, use of hand sanitizers with at least 60% alcohol, avoiding touching mucosal surfaces (mouth, nose, eyes) with unwashed hands, practicing proper cough etiquette, wearing a face mask (if symptomatic), limiting exposure to affected people and maintaining a distance of at least 2 m from others are the suggested preventive steps [1] . It is therefore imperative that guidelines and protocols are made for effectively and efficiently handling patients with COVID-19 in the dental clinic and minimizing risk of nosocomial transmissions. Patients with respiratory infections (current or in the last 48 h) and those with travel histories to COVID-19-affected regions should be reported to the health department and should be rescheduled. The International Association of Paediatric Dentistry [13] has also made recommendations for parents to maintain optimal oral health of children and avoiding dental clinic visits:
cord-270712-v6nnnzhm	2020	patients'' general medical practitioners (GMPs), funding restraints have resulted in NHS Clinical Commissioners advising against the routine prescription of high fluoride toothpaste in primary medical settings. For oncology patients without a regular GDP, or those who may have intermittent treatment in a tertiary dental centre, accessing prescriptions for high fluoride products may be particularly challenging during COVID-19. Sir, there are two reasons why the current guidelines pose an existential risk to dental practice: • The additional costs involved plus the required fallow periods make general practice dentistry unsustainable • The necessity to approach our patients while dressed like Darth Vader will raise perceived levels of fear and panic among them. It is important to reflect that we have always been an infection aware profession and have therefore often been at the forefront of infection control in the surgery for both our patients and the whole dental team.
cord-272354-pu9l36j9	2020	In this commentary, authors described this new challenge for dental education using the recent literature and experience gained in the Italian University of Catanzaro. The other students will have to recover the clinical rotation activities during the next semester, but before restarting they must be able to correctly use the personal protective equipment (PPE) in order to protect themselves and avoid a new spread of the infection. Over the past years, numerous studies have analysed the effectiveness and acceptability of e-learning in dental education with good results. Furthermore, students should be encouraged to learn independently from the scientific literature and to access the resources made available online by dental scientific societies (clinical videos, webinars, etc). However, the use of SARS-CoV-2 diagnostic tests for patients, healthcare professionals and dental students could allow the sustainable resumption of clinical activities in the next weeks. COVID-19 is a challenge for dental education-A commentary
cord-272602-rywg9mek	2020	A number of authors have used microbiological methods to study bacterial contamination from aerosol and splatter following dental procedures, either by air sampling 21, 32, 33 , swabbing of contaminated surfaces 34, 35 , or most commonly, by collection directly onto culture media [36] [37] [38] [39] . Many studies are small and report only one repetition of a single procedure, and some have only examined contamination of the operator and assistant; a number of studies which have measured spatial distribution of aerosol and splatter have only done so to a limited distance from the source. We present initial data on three dental procedures (high-speed air-turbine, ultrasonic scaler, and 3-in-1 spray use) and examine the effect of dental suction and the presence of an assistant on aerosol and splatter distribution.
cord-274305-mnyy41po	2020	The purpose of this review, therefore, is to examine (1) what is currently known regarding the physics of aerosol creation, (2) the types of environmental contaminants generated by dental procedures, (3) the nature, quantity, and sources of microbiota in these contaminants and (4) the risk of disease transmission from patients to dental healthcare workers. Well‐controlled, large‐scale, multi center studies using atraumatic air harvesters, open‐ended methods for microbial characterization and integrated data modeling are urgently needed to characterize the microbial constituents of aerosols created during dental procedures and to estimate time and extent of spread of these infectious agents. The purpose of this review, therefore, is to examine what is currently known regarding the physics of aerosol creation, the types of aerosols generated by dental procedures, the nature, quantity, and sources of microbiota in these aerosols and the probability of disease transmission from patients to dental healthcare workers.
cord-277539-xt2nt11e	2020	Despite the avalanche of information that has exploded in relation to this rapidly spreading disease, there is a lack of consolidated information to guide dentists regarding clinical management including precautions to take materials to use and postprocedure care, during and after the COVID-19 pandemic. This review aims to provide a comprehensive summary from the available literature on COVID-19, its insinuation in dentistry, recommendations that have been published, and the actual in-practice implications, so a plan can be formulated and adapted to the circumstances of each dental practice during the pandemic and the times to follow. The purpose of this review is to provide a comprehensive summary from the available literature on COVID-19, its insinuation in dentistry, recommendations that have been published, and the actual in-practice implications, so a plan of measures can be formulated and adapted according to the circumstances of each dental practice during the pandemic and the times to follow.
cord-281099-l2i7r1bp	2020	MATERIALS AND METHODS: An online anonymous questionnaire was administered to retrieve data on the dental procedures performed, the preventive measures adopted, and the predictions on the future changes in dentistry following the pandemic. Standard procedures appear insufficient in protecting from SARS-CoV-2, and thus specific measures to prevent virus transmission should be adopted to safeguard the health of both patients and oral care providers (Izzetti et al. -Post-dental treatment management of the dental office (Phase IV) A focus on highly epidemic areas, registering the higher number of cases, was also performed in order to evaluate the potential presence of differences between the regions in Northern Italy and the rest of the country. The set-up of the waiting room (non-clinical area) was adapted to the new situation by almost the totality of the sample, by providing a hydro-alcoholic solution for hand disinfection, removing objects at risk of contamination, and reorganizing the schedule in order to guarantee social distancing.
cord-285513-pkqos0s5	2020	Therefore, the aim of this case study was to investigate how urgent dental health care was managed in Norway, what additional infection prevention and control measures were employed by dental staff and to assess the dental staff perception of risk and workplace preparedness. Out of the dental staff working in clinics designated to treat patients suspected or confirmed to have COVID-19, up to 20% reported not to have available respirators FFP2 or FFP3 standard or equivalent, gowns and aprons in their workplace; there was a significant difference among the county incidence categories. Dental staff in public sector, OR 0.3 (CI 0.2; 0.5) and those working at clinics not designated to treat patients suspected or confirmed to have COVID-19, OR 0.6 (0.4; 0.9) were less positive to preparedness of their workplace regarding infection control equipment. In the present study, the majority of the dental staff working at the clinics designated to treat patients suspected or confirmed to have COVID-19, reported to follow local guidelines for additional infection prevention and control developed by county and university.
cord-287633-31pxa5rv	2004	With the advent of the droplet-spread disease severe acute respiratory syndrome, or SARS, a review of the infection control procedures for aerosols is warranted. The literature also documents that airborne contamination can be minimized easily and inexpensively by layering several infection control steps into the routine precautions used during all dental procedures. The potential routes for the spread of infection in a dental office are direct contact with body fluids of an infected patient, contact with environmental surfaces or instruments that have been contaminated by the patient and contact with infectious particles from the patient that have become airborne. Any dental procedure that has the potential to aerosolize saliva will cause airborne contamination with organisms from some or all of these sources. 13 This means that after a dental procedure, if the operator removes a protective barrier such as a face mask to talk to a patient when a procedure is completed, the potential for contact with airborne contaminated material remains.
cord-289055-6qndq7m0	2020	In hopes of properly managing dental patients who first contact them via emergency services, the medical residents requested a presentation on triaging dental emergencies and how to make appropriate dental referrals when necessary. Referencing the "American Dental Association COVID-19 Practice Resources," I developed a Pow-erPoint presentation that detailed the causes of various dental emergencies and where to refer these patients: general dentist, oral surgeon, or the emergency room if in fact a life-threatening situation had developed. Through this application, the medical team has decided to institute more dental-focused questions and oral hygiene education into their well-checks, as well as requiring dental referrals. By collaborating more with medicine through opportunities such as the one discussed, dentistry can reinforce its importance in overall patient health. Several avenues where dentists can reach out to our medical colleagues and collaborate include university and hospital-based residencies, emergency rooms, private practices, or local and national medical associations. Dental and medical collaboration during COVID-19
cord-292173-95t89yee	2020	Several authors have highlighted the importance of telephone triage and/or clinic questionnaires, body temperature measurement, usage of personal protective equipment, surface disinfection with ethanol between 62% and 71%, high-speed instruments equipped with an anti-retraction system, four-handed work, and large-volume cannulas for aspiration. The aim of this narrative review is to investigate preventive measures in dental practice by assessing the operator and patient health protection during the new COVID-19 emergency by considering past experiences in terms of prevention, as the virus was only recently discovered. In addition, a second search was made: "masks" OR "disinfectants" OR "PPE" OR "dental equipment" AND "Covid-19" OR "coronavirus" OR "SARS-CoV-2". instead obtained diametrically opposing results; they showed, through a randomized controlled clinical study on 3591 subjects, that health workers who used N95 masks continuously during the shift or in situations considered to be at high risk, presented an 85% chance of not contracting a viral infection transmitted via droplets [36] .
cord-293180-f1ulk9ce	2004	Special management protocols and modified measures that regulate droplet and aerosol contamination in a dental setting have to be introduced and may include the reduction or avoidance of droplet/aerosol generation, the disinfection of the treatment field, application of rubber dam, pre-procedural antiseptic mouthrinse and the dilution and efficient removal of contaminated ambient air. In the first part of this two-part article an account of the epidemiology, virology, pathology and management of Severe Acute Respiratory Syndrome (SARS) was provided together with public health issues and general aspects of infection control. On the other hand smaller droplets (or aerosols, generally under 10 µm in size) or small-particle residue of evaporated droplets are usually airborne and are entrained in the air for a lengthy period • SARS is a highly infectious disease and dental personnel are likely to be at risk because of the nature of their profession, working in close proximity to the patient.
cord-293784-nrumr61g	2020	Aim This narrative review aims to report on the impacts of COVID-19 on the provision of dental education in the 67 dental schools in the United States (US). Having set the scene and current challenges, it aims to suggest some strategies to overcome the issues facing dental schools going forward. Challenges The challenges identified include: protecting the health of students, faculty and staff; ensuring the continuity and quality of dental education; ensuring confidence in health and safety measures; and keeping up with guidance. Although this review is US focused the impacts on dental education in the immediate and longer term because of the COVID-19 pandemic are shared across the World. The COVID-19 pandemic: implications for dental education Practice points • Dental schools should embrace technology to support clinical and theoretical teaching • There is an urgent need for further research into the risks of dental aerosols, and mitigation of these risks
cord-295720-eeqv5xa4	2020	Our objectives were to assess the knowledge, perception, and attitude of undergraduate dental students in Nigeria to the COVID‐19 pandemic and infection control practices. [14] [15] [16] The COVID-19 pandemic presents with a new range of challenges for undergraduate dental training, not only in Nigeria, but worldwide which include infection control practices in the clinic. The aim of this study was therefore to assess the knowledge, perception and attitude to the COVID-19 pandemic and infection control practices among undergraduate clinical dental students in Nigeria. This study sought to provide an overview of dental students'' knowledge of COVID-19 and attitude to infection control during this pandemic, which could serve as guidelines in preparation for school resumption and clinical training of the students. Notwithstanding, this study has provided a national perspective on the knowledge and attitudes/perceptions of undergraduate clinical dental students towards the COVID-19 pandemic and infection control practices in Nigeria. Nigerian undergraduate dental students'' knowledge, perception, and attitude to COVID-19 and infection control practices
cord-298641-3munq51l	2020	ABSTRACT Background The use of dental handpieces produces aerosols containing microbial agents, bacteria and viruses representing a high-risk situation for airborne cross-infections. Methods Streptococcus mutans suspension was infused into the mouth of a phantom, and an operator performed standardized dental procedures using an air turbine, a contra-angle handpiece or an ultrasonic scaler. The present findings allowed to reject both null hypotheses, implying that the presence of the tracer was not uniformly detected on the dental unit and the operatory environment surfaces, and the spread of the tracer was significantly different when the tested handpieces were used. Furthermore, the area contaminated by the biological tracer via splatters and aerosols was surprisingly wide, reaching a maximum distance of 360 cm from the infection source when we operated the air turbine. Very few studies mapped the operatory room surfaces reached by aerosols produced by dental handpieces, and, to our knowledge, none are based on the use of a biological tracer under standardized conditions.
cord-302379-jh6jxwyn	2020	A patient with non-odontogenic-related infection could also present with sepsis at a dental practice. Age-specific sepsis decision support tools have been developed by the UK Sepsis Trust to help dental staff recognise and manage patients with suspected sepsis. The aim of this article is to provide an update on the management of odontogenic infections and sepsis in the dental practice. A careful history, thorough clinical examinations and a high index of suspicion will enable the GDP to diagnose and appropriately manage patients presenting with odontogenic sepsis. The ''GDP sepsis decision support tool for primary dental care'' (Fig. 3) should be applied to all adults and young people aged 12 years and over with fever (or recent fever), symptoms presenting with a source of orofacial/dental infection (including post-operative infection) or have clinical observations outside normal limits. This stresses the importance for dental teams to be familiar with sepsis and the decision tools described here for safe management of such patients.
cord-302527-n53d5en0	2020	SARS-CoV-2 is a human-to-human viral infection [4, 5] transmitted through airborne droplets from talking, coughing, or sneezing [6] or by touching or coming into contact with contaminated surfaces that are then transmitted to oral, nasal, and mucosal membranes [7] . During the coronavirus outbreak, dentists in Spain and other countries were recommended to only attend dental emergencies under strict measures wearing specific professional protection equipment to minimize the risk and maintain social distancing [12] . SARS-CoV-2 has been identified in the saliva of infected patients [14] , suggesting that the aerosols generated during dental procedures from an infected person can be extremely contagious. ese droplets can remain in the area even after the patient has left the clinic, leading to infection of dental professionals via contaminated surfaces [15] . e inhalation of airborne particles and aerosol particles during dental treatments on patients with SARS-CoV-2 is a very high-risk procedure where dentists can be exposed to the virus.
cord-302863-9e5ajbgq	2018	Our study was aimed at estimating the prevalence of dental caries and identifying key associated factors in four major risk domains, including socioeconomic factors, child oral health behavior and practices, child feeding practices, and dietary habits among primary school children in Saudi Arabia. This study aimed at estimating the prevalence of dental caries in primary teeth and identifying key associated factors in 6-8-year-old school children in Riyadh city of Saudi Arabia would contribute towards the knowledge of dental caries by enriching the baseline data and determining population-specific risk factors of such a highly prevalent and preventable condition. Our analysis is the first in Saudi Arabia to comprehensively evaluate and prioritize factors encompassing all four major risk domains for dental caries, including parental socioeconomic status, children oral health behavior and practices, child feeding practices, and dietary habits.
cord-307285-bxy0zsc7	2020	Realizing the severity of outcomes associated with this disease and its high rate of transmission, dentists were instructed by regulatory authorities, such as the American Dental Association, to stop providing treatment to dental patients except those who have emergency complaints. In vitro studies have shown that azithromycin is active against Zika and Ebola viruses, [18] [19] [20] and is able to prevent severe respiratory tract infections when administrated to patients suffering viral infection [12] However, the efficacy of azithromycin in combination with hydroxychloroquine in the treatment of COVID-19 patients has not been confirmed yet [21, 22] , and more studies are needed to further investigate its clinical effects. Following the recommended cross-infection control procedures, spreading awareness based on evidence and not misconceptions, identifying emergency cases indicated for dental treatment, and practicing effective tele-dentistry when needed can all be helpful for dental patients and community as a whole.
cord-309922-d4lor3a5	2020	title: Risk of eye infections in dental personnel and the need for its prevention: a case report A lot of dentists and dental personnel are at high risk of contracting eye infections during operative procedures involving aerosols. Certain National safety agencies, like Occupational Safety and Health Administration (OSHA), American National Standard Institute (ANSI), Centers for Disease Control and Prevention (CDC), American Dental Association (ADA) have set prompt guidelines for the proper usage of infection control measures and personal protective equipment (PPE) [5] . This case report delineates the relationship between ocular infections secondary to allergic reaction due to dental treatment among the dentists. This article aims at improving the knowledge of eye related injuries among the dental fraternity while emphasizing the need for protective measures. This case report describes acute infection of the eyelid secondary to allergic reaction due to the restorative dental procedures.
cord-310736-b31x746c	2020	Current protocols recommend preventive measures to limit SARS-CoV-2 contagion in dentistry, such as patient triage, prescription of mouth rinses before dental treatment, hand hygiene, the use of personal protective equipment (PPE) (including gloves, N95 or FFP2 masks, protective outerwear, protective surgical glasses and face shields) for dental practitioners and the oral health team, use of rubber dam isolation, limitation of aerosol-producing procedures and cleaning of potentially contaminated surfaces (Izzetti et al. Thus, this study aimed to describe the use of a new protective device to reduce aerosol dispersion in dental clinics during the COVID-19 pandemic, to be used as a low-cost complementary resource in conjunction with standard PPE. The simulated dental procedure carried out in the present study followed a standardized protocol, aiming to illustrate the dispersion of aerosol particles using a fluorescent dye.
cord-314492-483rn3aw	2020	It examined evidence on which type of full body PPE and which method of donning (putting on) or doffing (removing) are most effective, while having the least risk of contamination or infection for healthcare workers, as well as which training methods increase compliance with PPE protocols. The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, 1 has highlighted the importance of personal protective equipment (PPE) for health and social care personnel. The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, 1 has highlighted the importance of personal protective equipment (PPE) for health and social care personnel. 8 The evidence from this review is of great importance where there is a risk of highly infectious diseases, and even though COVID-19 is no longer considered to be a high consequence disease in the UK, 9 its findings remain relevant to the current pandemic 10 and continue to be updated.
cord-315116-u7btx7nt	2020	A search was conducted in the main databases of the scientific literature using the words "COVID-19, coronavirus, SARS-Cov2, biosecurity, disinfection and dentistry." We analyzed biosecurity and disinfection standards at the dental office and dental health personnel to date, and their adaptation to the needs and way of working of each. 8 In addition, in early April, the American Dental Association (ADA) published guidelines for protective measures in dental offices to maintain biosecurity and thereby minimize the risk of COVID-19 transmission before, during, and after dental care. Therefore, this literature review aims to determine the biosecurity measures required in dental offices after the appearance of COVID-19, seeking to provide dental health personnel with updates on the biosecurity and disinfection standards recommended to date, and their adaptation to the needs and ways of working of each.
cord-315246-b477kabe	2020	The recent outbreak of coronavirus disease 2019 (COVID-19) caused by the emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the declaration of pandemic by the World Health Organization have made an enormous impact on medical and dental care across the world. The current COVID-19 situation may teach dental teams a better approach and optimal ways concerning the management of patients with special needs, by bringing people together to discuss and optimize standards of care, as often happens in challenging situations. As the impact of COVID-19 on wellbeing and mental health appears to be significant, dental services will need to be able to provide some sort of ''psychological counselling and reassurance'' prior to dental care to vulnerable individuals with complex pre-existing conditions and special requirements. This is a primary role of reorganized dental services to minimize an indirect impact of COVID-19 on oral health; therefore, preparation seems to be another key word for special dental care ''evolution'' in the nearest future.
cord-316095-jzyb4jn5	2020	Sixteen English papers were enrolled to answer questions about procedures that are allowed to perform during the COVID‐19 outbreak, patients who are in priority to receive dental care services, the conditions and necessities for patient admission, waiting room and operatory room, and personal protective equipment (PPE) that is necessary for dental clinicians and the office staff. Considering the generation of high amounts of droplets and aerosols during routine dental procedures, the conventional protective measures that are routinely followed by dental clinicians are no longer efficient for prevention of COVID-19 transmission. Urgent dental treatments include management of conditions that require immediate attention such as alleviation of severe pain with/without the risk of infection and balancing the patient load in the hospital emergency departments. According to the data acquired from the screening questionnaires, patients who need emergency/urgent dental treatment can be divided into three groups of apparently healthy, suspected, and confirmed cases.
cord-318136-2skr13gc	2020	title: Using National Early Warning Score (NEWS) 2 to help manage medical emergencies in the dental practice This can be helped by using the Royal College of Physicians'' (RCP''s) National Early Warning Score (NEWS) 2, widely used by the ambulance service and in hospitals it reliably detects deterioration in adults, triggering review, treatment and escalation of care. Using NEWS2 in the dental practice will help the dental team to effectively, confidently and safely manage medical emergencies, including sepsis, should they arise. The Royal College of Physicians'' (RCP''s) National Early Warning Score (NEWS) 2, 2 widely used in the healthcare setting both in the UK and abroad, reliably detects deterioration in adults, triggering review, treatment and escalation of care. The RCP hopes that NEWS2 will be validated for use in primary care, assisting triage and communication of acute-illness severity to ambulance and hospital services.
cord-318944-13zk6cco	2020	The authors performed a narrative review on Severe Acute Respiratory SyndromeCoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (prevs post-COVID19) for the most common dental procedures. After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The precautions for infection control require wearing gloves, aprons, as well as eye and mouth protection (goggles and mask, such as medical masks and Filtering Face Piece or FPP) for each procedure involving direct contact with the patient body fluids.
cord-319297-h6ulh3y7	2020	27, 28, 37, 38 Evidence from a study on bacterial load during orthodontic procedures comparing bracket debonding followed by enamel clean-up with high-speed handpiece and water cooling versus standard orthodontic care involving archwire and/or ligature change, and replacing procedures, highlighted the increased pathogenic state of aerosols produced by the former, with a mean difference of 49.2 (95% CI, 19.4-79.0) in total CFUs. 31 This highlights the exposure hazards of orthodontists related to certain orthodontic procedures in practice and draws attention to additional prophylactic measures to be selectively taken within the dental operating office.
cord-326413-rhvsdpyk	2020	Abstract Unidentified human remains with unknown medical history can always pose biological hazards to forensic pathologists and odontologists, including hepatitis C, HIV infection, Middle East respiratory syndrome (MERS), hemorrhagic fever viruses such as Ebola, meningitis and now Sars-Cov2. This short report provides specific recommendations to forensic odontologists in terms of biosafety and infection control practices during the post mortem dental data collection of unidentified human remains without any known medical history data. Forensic odontologists and dental hygienists involved in autoptic procedures of unidentified human remains infected with COVID-19 must be well trained in infection prevention control practices and for the task of managing the dead in challenging circumstances [12, 14] . Forensic odontologists and dental hygienists involved in autoptic procedures of infectious human remains should always be well trained in infection prevention control practices and management of the dead in challenging circumstances.
cord-326961-ti6mrzxf	2020	OBJECTIVES: This study aimed to evaluate the fear of infection among Egyptian dentists practicing during the current coronavirus disease 2019 (COVID-19) pandemic and to explore the dentist''s knowledge about guidelines to fight the virus and to assess various modifications in dental practice. 7 Different practical guidelines were recommended for dental professionals by the Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), and the WHO to control the spread of COVID-19 and like other contagious infections, these recommendations include personal protective equipment, hand washing, detailed patient evaluation, rubber dam isolation, anti-retraction handpiece, mouth rinsing before dental procedures, and disinfection of the clinic. This cross-sectional study assessed the fear of infection between Egyptian dentists practicing during the present COVID-19 pandemic and to explore their knowledge about guidelines to fight the virus and various modifications in dental practice through an online survey.
cord-333588-3krh1xzx	2020	Pediatric Dentistry during Coronavirus Disease-2019 Pandemic: A Paradigm Shift in Treatment Options. Customary dental procedures that include the use of rotating instruments such as the high-speed turbine handpiece and the use of ultrasonic scalers for oral prophylaxis are allied with the production of large quantity of aerosols and droplets from the saliva and blood of the patient. Dental management of pediatric patients in the period of pandemic should be based on the severity of the case, the degree of invasiveness of the procedure, and the risk involved. Pulpectomies in primary teeth should be avoided as it might require multiple sittings depending on the clinical condition of the tooth and extensive instrumentation during biomechanical preparation shall increase patient and dentist''s contact time. In case of avulsion of primary tooth, control of bleeding should be the main mode of treatment followed by pain management of the child.
cord-335372-tncjfdtp	1998	40 This characteristic makes these microorganisms easy to distinguish from other bacteria found in dust and on skin that might also contaminate clinical surfaces, suggesting the usefulness of α-hemolytic streptococci, or AHS, as standard indicators for detecting oral contamination and for evaluating operatory asepsis. In this study, we assessed the validity of oral AHS as an indicator of oral contamination in the following manner: dassessing the consistency and abundance of AHS in mouths of a sample of patients; ddetermining the distribution of AHS in nondental environments, both clinical and nonclinical; devaluating environmental survival of AHS on operatory materials; dusing AHS as an indicator of contamination after cleaning and disinfection in private dental offices.
cord-335979-gaqa24b9	2020	Larry David, the co-creator and producer of Seinfeld, when asked by a reporter from the New York Times about what he fears the most while quarantining during the COVID 19 Epidemic, responded "Anarchy and a potential dental emergency and not necessarily in that order"(Dowd, 2020).The pandemic introduced a new layer of challenges on how to provide care, alleviate pain. Several recommendations have been laid out for the provision of oral health care, including telescreening and triaging, patient evaluation and cohorting, pharmacologic management (Ather, Patel, NB, Diogenes, & Hargreaves, 2020) . In the case of the Telehealth program of the Federal University of Rio Grande do Sul, the goal is to strengthen the coordinating role of primary care and improving health care with the use innovative telehealth applications with actions that include teleconsultation, telediagnosis and teleeducation (Harzheim et al., 2016) .
cord-338817-hxova3a0	2020	The current recommendations suggest that dental treatment of patients with suspected/confirmed coronavirus disease should be postponed for at least 14 days from the onset of symptoms (Peng et al., 2020) . The current recommendations suggest that dental treatment of patients with suspected/confirmed coronavirus disease should be postponed for at least 14 days from the onset of symptoms (Peng et al., 2020) . Dental professionals should pay attention for patients who attend the dental clinic and declare infected with COVID-19 and (Osumi, 2020) . All rights reserved be aware about the potential for reactivation of COVID-19 and this may have an implication on the right time to offer a dental treatment for patients who have recently recovered from the infection with COVID-19 virus. This is to allow sufficient time to ensure the patient is free of the virus and there is no risk of infection with COVID-19.
cord-339517-93nuovsj	2020	The one-way ANOVA showed a main effect of age group for perceived patient''s likelihood of contracting the infection (F 2,353 -Statistic = 1157, p < 0.001), and reported levels of concern about the professional future ( To the question "During clinical activity, which measures do you use to prevent COVID-19 infection?", dentists replied highlighting a good knowledge of what is reported in the most recent indications from the literature. To the question "Which aids do you think could help dental professionals during COVID-19 pandemic?", for which two preferences could be expressed, the dentists replied indicating "Economic relieves from Italian government" (65.7%), "Social security institutions support and subsidy" (44.1%)," Economic relieves from dental associations" (32.1%) and "Improvement of communication with patients" (8.1%).
cord-340138-u8hxyfml	2020	Keywords: COVID-19, dentistry, voluntary work, preparedness, infection control BACKGROUND The emergence of the highly infectious novel coronavirus has led to a global pandemic in a span of just 3 months. Thus, the robust training of clinical medicine in dentistry strengthens the candidature of dentists to volunteer services for COVID-19 control and spread. Many dentists have therefore discontinued the provision of elective dental treatment, in accordance with guidelines released by national-level government healthcare authorities such as the Centers for Disease Control and Prevention (CDC) in the US and National Health Service (NHS) in the UK. In this context, dental clinics that are well equipped with facilities to control aerosol spread of infections, such as negative pressure rooms and high-volume excavators, can offer help to augment the capacity for COVID-19 screening. Precautions when providing dental care during Coronavirus Disease 2019 (COVID-19) pandemic
cord-341661-sokoghh1	2020	The current study was conducted to assess anxiety and fear of getting infected among dentists while working during the current novel coronavirus diseases (COVID-19) outbreak. Considering the current rapid spread of infection, the American Dental Association (ADA) highlighted key steps to be taken by dentists in addition to the standard universal precautions such as taking patients'' recent travel history; assessing signs and symptoms of RTI; recording patients'' body temperature; mouth rinsing with 1% hydrogen peroxide prior to commencement of any procedure; using a rubber dam and high volume suction during procedures; and frequently cleaning and disinfecting public contact areas including door handles, chairs and, washrooms [13] . The present cross-sectional study reported the anxiety and fear of getting infected among dentists while working during the current viral outbreak.
cord-346225-dmwrm6jl	2020	This article provides recommendation on patient evaluation, treatment approach for dental emergencies and infection control protocols. Screening for COVID-19 status and triaging for dental treatments During the pandemic, it is recommended to perform exclusively emergency dental procedures to protect the medical personnel, the patients and to reduce as much as possible the consumption of personal protective equipment. Emergency dental patients that test positive for SARS-CoV-2 should be referred for emergency care where appropriate Transmission-Based Precautions are available. Oral healthcare during the COVID-19 pandemic If procedures were performed without N95 masks, both the healthcare provider and the patient are at moderate risk for SARS-CoV-2 infection/transmission. The COVID-19 pandemic represents a global challenge, given the increased contagiousness of SARS-CoV-2, dental healthcare providers have to adopt new protocols for a better infection prevention in the dental office and new working protocols aimed to prevent spreading the virus. Coronavirus disease 2019 (COVID-19): emerging and future challenges for dental and oral medicine
cord-348358-dg3sa9ho	2020	Therefore, this study aimed to evaluate the quality of dentistry-related medical information about COVID-19 on YouTube as educational resources for dental practitioners. Therefore, this study aimed to evaluate the usefulness of YouTube videos as an informative tool for dental practitioners regarding additional preventive measures that need to be taken during the COVID-19 outbreak. Therefore, it is important to inform the patients and dental practitioners about the novel coronavirus in an accurate and effective way and our study provides a detailed analysis of YouTube videos as a source of dentistry-related medical information about COVID-19. Therefore, the reliability of YouTube videos as a source of information about preventing the spread of COVID-19 for dental practitioners is very important. In the present study, we analysed the source and quality of dentistry-related scientifically based medical information given by professionals about COVID-19 on YouTube for dental practitioners as demonstrated above.
cord-348947-o6qpaa6a	2020	Sir, as a Past President of the BDA I am dismayed and bemused to read frequent reports in national newspapers decrying the number of children awaiting many months for tooth extractions in hospitals. J. Stuart Robson, York, UK https://doi.org/10.1038/s41415-020-2282-3 used a purpose built protection box during aerosol generating procedures (https://www. Sir, in the current pandemic, the lack of equitable oral healthcare facilities, shortfall of dental healthcare providers, shortages of equipment/materials, and inadequate management of existing services is well known in developing countries. 4 To prevent the transmission of infection through aerosol in the dental setting the ''protection box'' is an innovative and economical solution for performing aerosol generating procedures. Sir, I would like to thank all my colleagues who have worked so diligently to up-skill and kindly help guide others through the current COVID-19 pandemic.
cord-350990-tywbe4o2	2020	The terms used for the identification of keywords were: COVID-19, 2019-nCov, Sars-CoV-2, COVID-19 transmission, Coronavirus pneumonia, Coronavirus infection, Severe acute respiratory syndrome, Atmospheric contamination, Droplets, Aerosol, PPE/DPI, COVID-19 guidelines, Airborne contamination, Masks and respirators, and COVID-19 dental-related aspects. Therefore, dental procedures can be considered as one of the most probable causes of Sars-CoV-2 infection because such procedures require close proximity to the patient''s mouth, possess a risk of contact with saliva, blood and other biological fluids and involve the use of instrumentation that creates large aerosols 4, 19, 20 . Moreover Sars-CoV-2 demonstrates persistent adherence, for a maximum of 9 days, to various surfaces 1, 21 ; therefore, all surfaces and instruments in a dental clinic should be considered as potential sources of virus transmission because infected droplets from saliva or aerosols could land on any exposed surface 16, 19, 22 .
cord-352862-2q4h3bwj	2020	An emergent pneumonia outbreak, denoted as coronavirus disease-2019 (COVID-19) by the World Health Organization (WHO) originated in Wuhan City, in late December 2019 and spread at an alarming rate to become a pandemic affecting more than 200 countries. The transmission of virus through aerosols produced by highand low-speed handpieces, ultrasonic scalers, air/water syringes, or an infected patient coughing, and even when taking intraoral radiographs has made it difficult for dental personnel to provide even the most basic services to the needful. 18 The Indian Society of Pedodontics and Preventive Dentistry (ISPPD) also issued an advisory for oral health professionals and pediatric dentists including C (clean, cover, and confine), O (observe, online, or telephonic consultation as possible), R (restrict to emergency treatment only and all elective treatment to be postponed as far as possible), O (obey), N (no aerosol), and A (avoid).