I.D. |
Author (Year)/Country |
Guidelines offered |
Procedural considerations |
Authors' comments on the literature gap |
1 |
Alharbi et al. (2020)/Saudi Arabia [15] |
I.) Emergency Tx (fracture and infection compromising patient's airway, uncontrolled bleeding) for all patients II.) Minimally invasive urgent care without aerosol generation for asymptomatic suspect, stable active and recovered patients III.) Invasive urgent care with aerosol generation for asymptomatic suspect |
I.) Restrict Intraoral imaging II.) Preprocedural use of 0.23% povidone-iodine mouth-wash at least 15 s III.) Single-use devices IV.) Use a rubber dam V.) Avoid aerosol-generating procedures VI.) Avoid administering Ibuprofen |
-Lack of a guideline for patients who need dental Tx before an imminent transplant. -Lack of a guide on proper saliva ejectors or surgical aspiration |
2 |
Ather et al. (2020)/The United States [14] |
I.) Perform dental Tx if lack of travel hx/epidemiological link II.) Defer elective care for suspect at least 2 weeks III.) Urgent care for suspect in case of tooth pain and/or swelling using pharmacological management as the first line and emergency care as the secondary management |
I.) Personal protective equipment and hand hygiene II.) Preprocedural mouth rinse III.) single-use devices IV.) Avoid Intraoral radiography V.) Use a rubber dam VI.) Minimize ultrasonic instruments, high-speed handpieces, and 3-way syringes VII.) Dilute Naocl to 1% VIII.) Negative-pressure treatment rooms IX.) Disinfect inanimate surfaces |
-Lack of a guideline for patients who need dental Tx before an imminent transplant. -Lack of a guide on proper saliva ejectors or surgical aspiration |
3 |
Izzetti et al. (2020)/Italy [16] |
I.) Identify potentially at-risk cases and support them in contacting the health authorities II.) Understand the real need for professional consultation and preferably address the issue with just pharmacologic prescription III.) Organize a contagion-reduced treatment for the subjects with unknown risk of contagion who are experiencing an acute dental problem that requires immediate treatment |
I.) 1-min mouth rinse with 0.2 to 1% povidone, 0.05 to 0.1% cetylpyridinium chloride, or 1% hydrogen peroxide II.) Hand washing for at least 60 s and then hand rubbing with 60–70% hydroalcoholic solution before wearing a glove III.) Personal protective equipment IV.) Preparation of all instruments in advance V.) Total protection through disposable cover VI.) Avoid, when possible, use of handpieces/ultrasonic instruments VII.) Use a rubber dam VIII.) Surgical aspiration system IX.) If possible, prefer 4-hands technique X.) Limit overall Tx time if possible |
-Lack of a precise guideline on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones. |
4 |
Lee and Auh (2020)/Korea [17] |
I.) Routine pre-check the general health status and travel history to epidemic areas II.) Patients with suspected or known COVID-19 should be isolated or postpone their non-emergency dental care during the COVID-19 pandemic |
I.) Use basic personal protective equipment for potential asymptomatic carriers II.) Hand washing is essential III.) Must avoid or minimize procedures producing droplets or aerosols or stimulate salivary secretion or coughing. IV.) Use high-volume saliva ejectors with the four-handed technique V.) Minimize using the three-way syringe VI.) Acquisition of extraoral radiographs rather than intraoral radiographs VII.) Use an oxidative or antimicrobial mouth rinse before dental procedures VIII.) Treatment in an isolated and well-ventilated environment IX.) Disinfect the surface of equipment with 62–71% ethanol before and after dental procedures |
-Lack of a precise guideline on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones. |
5 |
Mallineni et al. (2020)/Saudi Arabia- The United Kingdom- The United States-Brazil [18] |
I.) Contemporary minimally invasive procedures that minimize or eliminate aerosol generation should be employed where intervention is indicated throughout the pandemic II.) Once restrictions begin to be eased, continue management of dental disease with minimally interventive concepts, e.g., atraumatic restorative treatment, fissure sealants, silver diamine fluoride, selective caries removal, and the Hall Technique while viral transmission risk remains high |
I.) Hand hygiene II.) Personal protective equipment III.) Respiratory hygiene/cough etiquette IV.) Sharps safety and safe injection practices V.) Sterilization and disinfection of patient-care items and devices VI.) Environmental infection prevention and control VII.) Dental unit water quality |
-Lack of a precise guideline on the management of pediatric patients at various stages of the disease, from positive to asymptomatic to healed ones. |
6 |
Meng and Hua (2020)/China [19] |
I.) In areas where COVID-19 spreads, non-emergency dental practices should be postponed. II.) Pulp exposure in symptomatic irreversible pulpitis could be made with chemomechanical caries removal. III.) If a tooth needs to be extracted, an absorbable suture is preferred. IV.) For patients with facial soft tissue contusion, debridement, and suturing should be performed. V.) Life-threatening cases with oral and maxillofacial compound injuries should be admitted to the hospital immediately. |
I.) Hand hygiene II.) Personal protective equipment III.) Thorough disinfection of all surfaces IV.) Particulate respirators (e.g., N-95 masks or FFP2) V.) The 4-handed technique is beneficial VI.) Use saliva ejectors with low or high volume VII.) Preoperative antimicrobial mouth rinse VIII.) Minimize aerosol-generating procedures, such as the use of a 3-way syringe IX.) Acquisition of extraoral radiographs rather than intraoral radiographs X.) Rubber dam XI.) Isolated and well-ventilated room or negatively pressured rooms if possible |
-Lack of a precise guideline on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones. |
7 |
Peng et al. (2020)/China [20] |
I.) If a patient replies "yes" to screening questions, and body temperature is below 37.3 °C, the dentist can defer the treatment until 14 days after the exposure event. II.) If a patient replies "yes" to screening questions, and body temperature is no less than 37.3 °C, the patient should be immediately quarantined and reported to the infection control department. III.) If a patient replies "no" to all screening questions, and his/her body temperature is below 37.3 °C, the dentist can treat the patient with extra- protection measures and avoids spatter or aerosol-generating procedures. IV.) If a patient replies "no" to all screening questions, but his/her body temperature is no less than 37.3 °C, the patient should be instructed to specialized clinics for COVID-19. |
I.) Hand Hygiene II.) Personal protective measures for the dentists III.) A Preprocedural mouth rinse containing oxidative agents such as 1% hydrogen peroxide or 0.2% povidone especially when a rubber dam cannot be used IV.) If using a rubber dam, use extra high-volume suction for aerosol and spatter along with regular suction with a four-hand operation V.) If a rubber dam isolation is not possible, manual devices, such as Carisolv and hand scaler, are recommended for caries removal and periodontal scaling VI.) the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19 VII.) Disinfection of the clinic settings |
Lack of a precise guideline as to which dental treatments can be performed in case the patient replies "no" to all screening questions and his/her body temperature is below 37.3 °C |
8 |
Prati et al. (2020)/Italy [21] |
I.) Triaging patients to detect by history and with a respiratory infection, flu, acute respiratory illness, conjunctivitis, and cardiovascular abnormalities II.) Separation of patients with respiratory symptoms to limit their contact with the dental staff, students and patients III.) Avoiding dental treatment if at all possible |
I.) Regular, meticulous and effective hand wash II.) Use face masks III.) Decontamination of all surfaces with 0.1% sodium hypochlorite or 70% ethanol or 0.5% hydrogen peroxide IV.) Respiratory hygiene/cough etiquette V.) Isolate the patient in a dedicated single-patient room (with closed door) VI.) Use a rubber dam VII.) Application of powerful air/water surgical suction pump (aspirator) close to the tooth and a second suction close to the nose to prevent aerosol and saliva droplet diffusion VIII.) Use high-speed handpiece with no exhaust IX.) Decontamination of equipment, surgeries/operatories after each patient |
The study provides a guideline for dental school; however, more precise guides on the management of patients at various stages of the disease, from positive to asymptomatic to healed ones, are required. |
9 |
Spagnuolo et al. (2020)/Italy [22] |
I.) Dentists should avoid the scheduling of any patient: only such urgent dental diseases can be considered during the COVID-19 outbreak. |
I.) Staff should work at an adequate distance from patients II.) Handpieces must be equipped with anti-reflux devices to avoid contaminations III.) Avoid or minimize operations that can produce droplets or aerosols IV.) Use of saliva ejectors with a low volume or high volume |
-Lack of a precise guideline as to which dental Tx should be considered as urgent dental disease |
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