PPE and Infection Control Protocols Work!

There has been a lot of discussion over the last 7 months regarding the safety of dental providers during the COVID-19 pandemic.  Do standard precautions and our “regular” PPE protect us and reduce the risk of acquiring the SARS-CoV-2 virus? Do we need to incorporate transmission-based precautions into our daily practice when delivering dental care to our patients?  Does following the CDC Interim Guidance provide sound protocols for protecting dental providers against COVID-19 infections?  Recently, there have been some studies published to begin answering these questions!


One study published in the September 2020 issue of Oral Diseases looked at dentists and dental assistants providing dental care to patients from February to April 2020 in Lombardy, Italy.  In Lombardy, COVID‐19 incidence and mortality were among the highest ever seen in the world; in June 2020, 6% of all the global COVID‐19 associated deaths occurred in this region.  The aim of this study was to investigate the effectiveness of a SARS‐CoV‐2 infection control protocol implemented in a public dental clinic where resources were limited.  This study showed that the relatively simple infection control procedures implemented during the COVID‐19 outbreak were effective in preventing COVID‐19 development to dental staff involved in the treatment of SARS‐CoV‐2‐infected patients. 

https://onlinelibrary.wiley.com/doi/full/10.1111/odi.13632


Earlier this month, a study published in JADA provided good news as well. The study showed the prevalence of COVID-19 among U.S. dentists is estimated to be approximately 1% (0.09%), indicating that infection control measures likely are enough to cut exposure risk at practices. Beefing up infection control practices is believed to be the game changer in curbing the spread of SARS-CoV-2. In this study, 99.7% of dentists enhanced their protocols by increasing disinfection, screening patients, implementing social distancing, and requiring the use of face masks. Approximately 73% of practicing dentists used personal protective equipment (PPE) according to interim guidance issued by the CDC. 


About 0.9% of the respondents were found to be confirmed or probable COVID-19 cases. This figure had a margin of error of 0.5%. The dentists' infection rate was not only low but also on par with healthcare workers in the Netherlands (0.9%) and China (1.1%), according to the study authors.


The source of SARS-CoV-2 transmission was identified via a health agency or clinic's contact tracing in five cases. The dental practice was NOT the source of transmission in those cases. The other COVID-19-positive dentists could have contracted the virus from numerous activities.

The dentists reported engaging in the following activities during the study period:

  • Provided emergency dental care or elective care
  • Attended a healthcare visit for themselves or companions
  • Met with a person outside their households
  • Met with a group of 10 or more people in a social setting
  • Attended a public event with 50 or more people
  • Traveled by taxi, rideshare, or public transportation
  • Had contact with someone suspected or confirmed to have COVID-19


These rates support that use of the CDC's currently recommended infection prevention and control procedures in dental offices will contribute to the reduced risk of infection during the delivery of dental care, while risks associated with nonclinical activities and community spread may pose the most significant risks for the exposure of dentists to COVID-19. 

https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/adaj/S0002817720306589.pdf?dgcid=%3Csource%3E_%3Cmedium%3E_%3Ccampaign%3E


PPE works! Keep up the good work!!!


Updated on

January 13, 2021

Authored by:

Dr. Kathy Schrubbe | Dir. of OSHA and infection control

Katherine Schrubbe BSDH MEd PhD is an adjunct professor at Marquette University School of Dentistry and Director of Quality Assurance for Dental Associates. With 30+ years in dental education Schrubbe is a regular speaker of continuing education courses on infection control and Occupational Safety and Health Administration regulations. She was the 2003 recipient of the American Association of Dental Research William B. Clark Award for Clinical Research.