Caries disease treatment during COVID-19: clinical protocols for aerosol control

Abstract

The pandemic of the new disease called COVID-19 requires major changes in dental practice. The coronavirus (SARS-CoV-2) is present in nasopharyngeal secretions and in the saliva of infected patients and the routes of transmission of the virus are by direct contact with salivary droplets or by aerosols. The vast majority of conventional dental procedures generate aerosols and are a potential source of infection. Therefore, patients and dental professionals have a higher risk of contamination, especially considering the care of patients who are asymptomatic carriers or who are treated during the incubation period.

It is the task of the dental team to maintain a disinfected environment and to control the transmission of this highly contagious disease. In this sense, in addition to conventional care for the entire office and those recommended by the World Health Organization against coronavirus, additional procedures to the treatment protocols designed for paediatric patients must be implemented.

Currently, the performance of non-invasive, micro and minimally invasive procedures acquires an important connotation. These treatments have in common the fact that they are based on the most modern concepts for the treatment of caries, with a conservative and biological approach, they have a proven efficiency in the control of the disease and the most important thing for the present moment is that they do not require the use of high-speed rotary instruments or the triple syringe (both generators of bioaerosols).

Aerosols produced by the high-speed rotating turbine or ultrasound devices can contaminate any exposed surface in the dental office and depending on the type of surface, temperature and humidity of the environment, the virus can remain active for hours or even days. Therefore, all efforts should be made to avoid aerosols.