COVID-19 Management in Clinical Dental Care. Part I: Epidemiology, Public Health Implications, and Risk Assessment

Melo, Paulo; Barbosa, João Malta; Jardim, Luis; Carrilho, Eunice; Portugal, Jaime

COVID-19, a viral disease declared as a pandemic by the World Health Organization in March 2020, has posed great changes to many sectors of society across the globe. The virulence and rapid dissemination have forced the adoption of strict public health measures in most countries, which, collaterally, resulted in economic hardship. This paper is the first in a series of three and aims to contextualize the COVID-19 clinical impact for the dental profession. It presents the epidemiological conditions of SARS-CoV-2, namely, its modes of transmission, incubation and transmissibility period, signs and symptoms, immunity, immunological tests, and risk management in dental care. Individuals in dental care settings are exposed to three potential sources of contamination with COVID-19: close interpersonal contacts (<1 meter), contact with saliva, and aerosol-generating dental procedures. Thus, we propose a risk management model for the provision of dental care, depending on the epidemiological setting, the patient's characteristics, and the type of procedures performed in the office environment. Although herd immunity seems hard to achieve, a significant number of people has been infected throughout the first 9 months of the pandemic and the vaccination has been implemented, which means that there will be a growing number of presumable “immune” individuals that might not require precautions that differ from those before COVID-19. In conclusion, dental care professionals may manage their risk by following the proposed model, which considers the recommendations by local and international health authorities, thus providing a safe environment for both professionals and patients.