Medwave 2020;20(5):e7916 doi: 10.5867/medwave.2020.05.7916
Recomendaciones odontológicas en la pandemia COVID-19: revisión narrativa
Dental recommendations in the COVID-19 pandemic: A narrative review
Juan Pablo Vargas-Buratovic, Francisca Verdugo-Paiva, Claudia Véliz-Paiva, Elizabeth López-Tagle, Alexis Ahumada-Salinas, Duniel Ortuño-Borroto
Palabras clave: COVID-19, SARS, MERS, Dentistry, Narrative Review
Abstract
Introduction
COVID-19 is a world public health problem due to its morbidity and mortality, especially in at-risk groups. The dental environment has a high risk of viral transmission; accordingly, this study aimed to identify recommendations based on the best available evidence for dental care during this pandemic.
Methods
We performed a search for scientific evidence published since 2002 to March 23th 2020 in electronic databases (MEDLINE/PubMed, EMBASE, Cochrane, and Epistemonikos) and the web pages of the American Dental Association, Centers for Disease Control and Prevention Oral Health, the Ministry of Health in Chile and scientific societies.
Results
We included nine published studies. The recommendations were the following: unrestricted use of personal protection elements, use of extraoral radiographic techniques, use of mouth rinses with 1% hydrogen peroxide or 0.2% iodine povidone, a four-hand technique with ongoing aspiration and the use of absorbable sutures. Furthermore, there is a consensus that non-urgent treatments should be postponed during periods of community transmission.
Conclusions
Dental practitioners are exposed to a high risk of cross-infection, meaning they must implement recommendations based on the best available evidence to preserve the health of team members and the population they are caring for.
No English version is available for this article.
Esta
obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.
Introduction
COVID-19 is a world public health problem due to its morbidity and mortality, especially in at-risk groups. The dental environment has a high risk of viral transmission; accordingly, this study aimed to identify recommendations based on the best available evidence for dental care during this pandemic.
Methods
We performed a search for scientific evidence published since 2002 to March 23th 2020 in electronic databases (MEDLINE/PubMed, EMBASE, Cochrane, and Epistemonikos) and the web pages of the American Dental Association, Centers for Disease Control and Prevention Oral Health, the Ministry of Health in Chile and scientific societies.
Results
We included nine published studies. The recommendations were the following: unrestricted use of personal protection elements, use of extraoral radiographic techniques, use of mouth rinses with 1% hydrogen peroxide or 0.2% iodine povidone, a four-hand technique with ongoing aspiration and the use of absorbable sutures. Furthermore, there is a consensus that non-urgent treatments should be postponed during periods of community transmission.
Conclusions
Dental practitioners are exposed to a high risk of cross-infection, meaning they must implement recommendations based on the best available evidence to preserve the health of team members and the population they are caring for.
Autores:
Juan Pablo Vargas-Buratovic
[1], Francisca Verdugo-Paiva
[2,3], Claudia Véliz-Paiva
[1], Elizabeth López-Tagle
[4], Alexis Ahumada-Salinas
[5], Duniel Ortuño-Borroto
[1]
Filiación:
[1] Escuela de Odontología, Pontificia Universidad Católica de Chile, Santiago, Chile
[2] Fundación Epistemonikos, Santiago, Chile
[3] Centro Evidencia Universidad Católica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
[4] Facultad de Odontología, Universidad Andres Bello, Santiago, Chile
[5] Dirección de Salud, Municipalidad de Recoleta, Santiago, Chile
E-mail: drortuno@uc.cl
Correspondencia a:
[1] Avenida Vicuña Mackenna 4860
Macul, Santiago
Chile
Citación:
Vargas-Buratovic JP, Verdugo-Paiva F, Véliz-Paiva C, López-Tagle E, Ahumada-Salinas A, Ortuño-Borroto D.
Dental recommendations in the COVID-19 pandemic: A narrative review. Medwave 2020;20(5):e7916 doi: 10.5867/medwave.2020.05.7916
Fecha de envío: 24/3/2020
Fecha de aceptación: 8/5/2020
Fecha de publicación: 1/6/2020
Origen: No solicitado.
Tipo de revisión: Con revisión por pares externa, por cuatro árbitros a doble ciego.
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- Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of
Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020 Mar
26;382(13):1199-1207. | CrossRef | PubMed |
- Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat
origin. Nature. 2020 Mar;579(7798):270-273. | CrossRef | PubMed |
- Hui DSC, Zumla A. Severe Acute Respiratory Syndrome: Historical,
Epidemiologic, and Clinical Features. Infect Dis Clin North Am. 2019
Dec;33(4):869-889. | CrossRef | PubMed |
- Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV
and controls in dental practice. Int J Oral Sci. 2020 Mar 3;12(1):9. | CrossRef | PubMed |
- Peiris JS, Yuen KY, Osterhaus AD, Stöhr K. The severe acute respiratory
syndrome. N Engl J Med. 2003 Dec 18;349(25):2431-41. | CrossRef | PubMed |
- Samaranayake LP, Peiris M. Severe acute respiratory syndrome and dentistry: a
retrospective view. J Am Dent Assoc. 2004 Sep;135(9):1292-302. | CrossRef | PubMed |
- Samaranayake LP; FDI Science Commission. Severe acute respiratory syndrome
(SARS): an interim information paper for dental health care workers. Int Dent J.
2003 Jun;53(3):117-8. | CrossRef | PubMed |
- Hui DS, Memish ZA, Zumla A. Severe acute respiratory syndrome vs. the Middle
East respiratory syndrome. Curr Opin Pulm Med. 2014 May;20(3):233-41. | CrossRef | PubMed |
- Seto WH, Conly JM, Pessoa-Silva CL, Malik M, Eremin S. Infection prevention
and control measures for acute respiratory infections in healthcare settings: an
update. East Mediterr Health J. 2013;19 Suppl 1:S39-47. | PubMed |
- Al-Sehaibany FS. Middle East respiratory syndrome in children. Dental
considerations. Saudi Med J. 2017 Apr;38(4):339-343. | CrossRef | PubMed |
- Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and
Future Challenges for Dental and Oral Medicine. J Dent Res. 2020
May;99(5):481-487. | CrossRef | PubMed |
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized
Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA.
2020 Feb 7;323(11):1061–9. | CrossRef | PubMed |
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of
patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb
15;395(10223):497-506. | CrossRef | PubMed |
- Wu Z, McGoogan JM. Characteristics of and Important Lessons From the
Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of
72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA.
2020 Feb 24. | CrossRef | PubMed |
- World Health Organization. Report of the WHO-China Joint Mission on Coronavirus DIsease 2019 (COVID-2019).February 16-24, 2020. [Internet] | Link |
- Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020 Mar 13. | CrossRef | PubMed |
- KCDC. Updates on COVID-19 in Korea. March 14, 2020. [Internet] | Link |
- World Health Organization. Questions and answers on coronaviruses. 2020. [Internet] | Link |
- Harrel SK, Molinari J. Aerosols and splatter in dentistry: a brief review of
the literature and infection control implications. J Am Dent Assoc. 2004
Apr;135(4):429-37. | CrossRef | PubMed |
- Vandenberghe B, Jacobs R, Bosmans H. Modern dental imaging: a review of the
current technology and clinical applications in dental practice. Eur Radiol.
2010 Nov;20(11):2637-55. | CrossRef | PubMed |
- Day M. Covid-19: ibuprofen should not be used for managing symptoms, say
doctors and scientists. BMJ. 2020 Mar 17;368:m1086. | CrossRef | PubMed |
- World Health Organization. WHO Now Doesn't Recommend Avoiding Ibuprofen For COVID-19 Symptoms. ScienceAlert. 2020. [Internet] | Link |
- Moore PA, Ziegler KM, Lipman RD, Aminoshariae A, Carrasco-Labra A, Mariotti
A. Benefits and harms associated with analgesic medications used in the
management of acute dental pain: An overview of systematic reviews. J Am Dent
Assoc. 2018 Apr;149(4):256-265.e3. | CrossRef | PubMed |
- Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19
Global Epidemic. JAMA. 2020 Mar 12. | CrossRef | PubMed |
- Institute of Medicine (US) Committee on Emerging Microbial Threats to Health
in the 21st Century. Microbial Threats to Health: Emergence, Detection, and
Response. Smolinski MS, Hamburg MA, Lederberg J, editors. Washington (DC):
National Academies Press (US); 2003. | PubMed |
- Xiao Y, Torok ME. Taking the right measures to control COVID-19. Lancet
Infect Dis. 2020 May;20(5):523-524. | CrossRef | PubMed |
- Holmes KV. SARS-associated coronavirus. N Engl J Med. 2003 May
15;348(20):1948-51. | CrossRef | PubMed |
- The Lancet. MERS-Cov: a global challenge. Lancet 381, 1960 (2013). | CrossRef |
- Khan S, Siddique R, Shereen MA, Ali A, Liu J, Bai Q, et al.
Emergence of a Novel Coronavirus, Severe Acute Respiratory Syndrome Coronavirus
2: Biology and Therapeutic Options. J Clin Microbiol. 2020 Apr
23;58(5):e00187-20. | CrossRef | PubMed |
- Larson EL, Early E, Cloonan P, Sugrue S, Parides M. An organizational climate
intervention associated with increased handwashing and decreased nosocomial
infections. Behav Med. 2000 Spring;26(1):14-22. | CrossRef | PubMed |
- American Dental Associaton. ADA: Calls Upon Dentists to Postpone Elective Procedures. 2020 Mar 16. [Internet] | Link |
- MINSAL. Recomendaciones clínicas basadas en evidencia CORONAVIRUS / COVID-19. Ministerio de Salud de Chile. Santiago, Chile.19 de Marzo. [Internet] | Link |
- National Health Commission of the People’s Republic of China. Notice of the General Office of the National Health and Health Commission on issuing the guidelines for the use of common medical protective products in the prevention and control of pneumonia infected by new coronavirus (trial). Jan 27, 2020. [Internet] | Link |
- Neumann I, Rada G. Toma de decisiones basada en evidencia: cuándo vale la
pena [Evidence-based decision-making: when it is worthwhile]. Medwave. 2014 Jun
11;14(5):e5966. | CrossRef | PubMed |
- Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for
Disease Control and Prevention. [The epidemiological characteristics of an
outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu
Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):145-151. | CrossRef | PubMed |
- Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to
dentistry and potential salivary diagnosis. Clin Oral Investig. 2020
Apr;24(4):1619-1621. | CrossRef | PubMed |
- Chang HJ, Huang N, Lee CH, Hsu YJ, Hsieh CJ, Chou YJ. The impact of the SARS
epidemic on the utilization of medical services: SARS and the fear of SARS. Am J
Public Health. 2004 Apr;94(4):562-4. | CrossRef | PubMed |
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of
Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020 Mar
26;382(13):1199-1207. |
CrossRef |
PubMed |
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat
origin. Nature. 2020 Mar;579(7798):270-273. |
CrossRef |
PubMed |
Hui DSC, Zumla A. Severe Acute Respiratory Syndrome: Historical,
Epidemiologic, and Clinical Features. Infect Dis Clin North Am. 2019
Dec;33(4):869-889. |
CrossRef |
PubMed |
Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV
and controls in dental practice. Int J Oral Sci. 2020 Mar 3;12(1):9. |
CrossRef |
PubMed |
Peiris JS, Yuen KY, Osterhaus AD, Stöhr K. The severe acute respiratory
syndrome. N Engl J Med. 2003 Dec 18;349(25):2431-41. |
CrossRef |
PubMed |
Samaranayake LP, Peiris M. Severe acute respiratory syndrome and dentistry: a
retrospective view. J Am Dent Assoc. 2004 Sep;135(9):1292-302. |
CrossRef |
PubMed |
Samaranayake LP; FDI Science Commission. Severe acute respiratory syndrome
(SARS): an interim information paper for dental health care workers. Int Dent J.
2003 Jun;53(3):117-8. |
CrossRef |
PubMed |
Hui DS, Memish ZA, Zumla A. Severe acute respiratory syndrome vs. the Middle
East respiratory syndrome. Curr Opin Pulm Med. 2014 May;20(3):233-41. |
CrossRef |
PubMed |
Seto WH, Conly JM, Pessoa-Silva CL, Malik M, Eremin S. Infection prevention
and control measures for acute respiratory infections in healthcare settings: an
update. East Mediterr Health J. 2013;19 Suppl 1:S39-47. |
PubMed |
Al-Sehaibany FS. Middle East respiratory syndrome in children. Dental
considerations. Saudi Med J. 2017 Apr;38(4):339-343. |
CrossRef |
PubMed |
Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and
Future Challenges for Dental and Oral Medicine. J Dent Res. 2020
May;99(5):481-487. |
CrossRef |
PubMed |
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized
Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA.
2020 Feb 7;323(11):1061–9. |
CrossRef |
PubMed |
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of
patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb
15;395(10223):497-506. |
CrossRef |
PubMed |
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the
Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of
72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA.
2020 Feb 24. |
CrossRef |
PubMed |
World Health Organization. Report of the WHO-China Joint Mission on Coronavirus DIsease 2019 (COVID-2019).February 16-24, 2020. [Internet] |
Link |
Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020 Mar 13. |
CrossRef |
PubMed |
KCDC. Updates on COVID-19 in Korea. March 14, 2020. [Internet] |
Link |
World Health Organization. Questions and answers on coronaviruses. 2020. [Internet] |
Link |
Harrel SK, Molinari J. Aerosols and splatter in dentistry: a brief review of
the literature and infection control implications. J Am Dent Assoc. 2004
Apr;135(4):429-37. |
CrossRef |
PubMed |
Vandenberghe B, Jacobs R, Bosmans H. Modern dental imaging: a review of the
current technology and clinical applications in dental practice. Eur Radiol.
2010 Nov;20(11):2637-55. |
CrossRef |
PubMed |
Day M. Covid-19: ibuprofen should not be used for managing symptoms, say
doctors and scientists. BMJ. 2020 Mar 17;368:m1086. |
CrossRef |
PubMed |
World Health Organization. WHO Now Doesn't Recommend Avoiding Ibuprofen For COVID-19 Symptoms. ScienceAlert. 2020. [Internet] |
Link |
Moore PA, Ziegler KM, Lipman RD, Aminoshariae A, Carrasco-Labra A, Mariotti
A. Benefits and harms associated with analgesic medications used in the
management of acute dental pain: An overview of systematic reviews. J Am Dent
Assoc. 2018 Apr;149(4):256-265.e3. |
CrossRef |
PubMed |
Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19
Global Epidemic. JAMA. 2020 Mar 12. |
CrossRef |
PubMed |
Institute of Medicine (US) Committee on Emerging Microbial Threats to Health
in the 21st Century. Microbial Threats to Health: Emergence, Detection, and
Response. Smolinski MS, Hamburg MA, Lederberg J, editors. Washington (DC):
National Academies Press (US); 2003. |
PubMed |
Xiao Y, Torok ME. Taking the right measures to control COVID-19. Lancet
Infect Dis. 2020 May;20(5):523-524. |
CrossRef |
PubMed |
Holmes KV. SARS-associated coronavirus. N Engl J Med. 2003 May
15;348(20):1948-51. |
CrossRef |
PubMed |
The Lancet. MERS-Cov: a global challenge. Lancet 381, 1960 (2013). |
CrossRef |
Khan S, Siddique R, Shereen MA, Ali A, Liu J, Bai Q, et al.
Emergence of a Novel Coronavirus, Severe Acute Respiratory Syndrome Coronavirus
2: Biology and Therapeutic Options. J Clin Microbiol. 2020 Apr
23;58(5):e00187-20. |
CrossRef |
PubMed |
Larson EL, Early E, Cloonan P, Sugrue S, Parides M. An organizational climate
intervention associated with increased handwashing and decreased nosocomial
infections. Behav Med. 2000 Spring;26(1):14-22. |
CrossRef |
PubMed |
American Dental Associaton. ADA: Calls Upon Dentists to Postpone Elective Procedures. 2020 Mar 16. [Internet] |
Link |
MINSAL. Recomendaciones clínicas basadas en evidencia CORONAVIRUS / COVID-19. Ministerio de Salud de Chile. Santiago, Chile.19 de Marzo. [Internet] |
Link |
National Health Commission of the People’s Republic of China. Notice of the General Office of the National Health and Health Commission on issuing the guidelines for the use of common medical protective products in the prevention and control of pneumonia infected by new coronavirus (trial). Jan 27, 2020. [Internet] |
Link |
Neumann I, Rada G. Toma de decisiones basada en evidencia: cuándo vale la
pena [Evidence-based decision-making: when it is worthwhile]. Medwave. 2014 Jun
11;14(5):e5966. |
CrossRef |
PubMed |
Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for
Disease Control and Prevention. [The epidemiological characteristics of an
outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu
Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):145-151. |
CrossRef |
PubMed |
Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to
dentistry and potential salivary diagnosis. Clin Oral Investig. 2020
Apr;24(4):1619-1621. |
CrossRef |
PubMed |
Chang HJ, Huang N, Lee CH, Hsu YJ, Hsieh CJ, Chou YJ. The impact of the SARS
epidemic on the utilization of medical services: SARS and the fear of SARS. Am J
Public Health. 2004 Apr;94(4):562-4. |
CrossRef |
PubMed |