COVID-19 Management in Clinical Dental Care Part II: Personal Protective Equipment for the Dental Care Professionals

Melo, Paulo; Afonso, Americo; Monteiro, Luis; Lopes, Otilia; Alves, Ricardo Castro

Facing the COVID-19 challenge on a global level, dental care professionals are encouraged to optimize universal precautions and adopt measures that ensure protection against infection by contaminated aerosols and droplets. Although aerosol transmission is possible, direct contact through large droplets is probably responsible for the vast majority of transmissions.[1, 2] This paper is the 2nd of a series of three on the management of COVID-19 in clinical dental care settings and aims to describe PPE selection and use by DCP, with consideration of the level of risk associated with the planned procedures. PPE selection depends directly on the local epidemiological setting, the patient's characteristics, and the level of risk of the planned procedures. The procedures performed in the office environment are classified as low-, moderate-, or high-risk. Moderate risk includes two further sublevels associated with the cleaning, disinfection, and sterilization of materials for clinical procedures that do not generate aerosols. The training of DCP on how to properly don (put on) and doff (remove) PPE is as important as choosing the appropriate PPE since it can be associated with a risk of infection. When there is limited availability of PPE, measures should be adjusted to the risk associated with the intervention. Assuming that an effective vaccine will be developed, once it becomes available for DCP, PPE requirements will likely be different. The proper use of PPE, together with the adoption of other operational procedures, can provide effective protection against microorganisms being transmitted via body fluids or in the air