Air disinfection procedures in the dental office during the COVID-19 pandemic.

The outbreak of coronavirus disease 2019 (COVID-19) generated a huge pressure on health care systems worldwide and exposed their lack of preparation for a major health crisis. In the times of a respiratory disease pandemic, members of the dental profession, due to having a direct contact with the patients' oral cavity, body fluids and airborne pathogens, are exposed to a great occupational hazard of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The authors carried out a systematic literature search using the main online databases (PubMed, Google Scholar, MEDLINE, UpToDate, Embase, and Web of Science) with the following keywords: "COVID-19," "2019-nCoV," "coronavirus," "SARS-CoV-2," "dental COVID-19," "dentistry COVID-19," "occupational hazards dentistry," "ventilation," "air disinfection," "airborne transmission," "hydrogen peroxide disinfection," "UV disinfection," "ozone disinfection," "plasma disinfection," and "TiO2 disinfection." They included publications focused on COVID-19 features, occupational hazards for dental staff during COVID-19 pandemic, and methods of air disinfection. They found that due to the work environment conditions, if appropriate measures of infection control are not being implemented, dental offices and dental staff can become a dangerous source of COVID-19 transmission. That is why the work safety protocols in dentistry have to be revised and additional methods of decontamination implemented. The authors specifically advise on the utilization of wildly accepted methods like ultraviolet germicidal irradiation with additional disinfection systems, which have not been introduced in dentistry yet, like vaporized hydrogen peroxide, non-thermal plasma and air filters with photocatalytic disinfection properties. Due to its toxicity, ozone is not the first-choice method for air decontamination of enclosed clinical settings. Med Pr. 2021;72(1):39-48.

The utilization of rapid serological tests in COVID-19 diagnostics - a high risk of false-negative results in outpatient care, with particular emphasis on dental treatment.

In order to mitigate the spread of COVID-19, in the early stages of the pandemic outbreak, postponing elective procedures was recommended all around the world. Outpatient care and dental care were limited to telephone advice and emergency services. Dental staff is particularly vulnerable to SARS-CoV-2 contraction, because of the inevitable contact with patients' body fluids during aerosol-generating procedures. The implementation of diagnostic tests among ambulatory patients could improve the occupational safety among outpatient care personnel. The aim of this review was to introduce information regarding COVID-19 diagnostics with a particular focus on the methods which can be utilized in an outpatient and dental care setting. An online PubMed database review of articles on COVID-19 diagnostics, published on February 12-May 15, 2020, was conducted. Reverse transcription polymerase chain reaction is the gold standard in COVID-19 diagnostics, which determines if a person has an active infection. Unfortunately, its utilization in outpatient care is limited. Serological enzyme-linked immunosorbent assays identify people who were infected, including those who have had an asymptomatic infection, but they do not give sufficient information about the acute infection. Rapid serological assays developed to facilitate testing outside of laboratories, especially in dental offices, are not recommended by the World Health Organization to be used outside research settings, and they should not constitute the basis for clinical decision-making because of frequent false-negative results which may consequently contribute to personnel infections. Out of all available COVID-19 diagnostic methods, rapid serological assays seemed to be a method of choice in outpatient medical care. Unfortunately, their results turned out to be unreliable. The best methods to ensure the occupational safety of medical staff and to avoid cross-infections in outpatient care facilities include a thorough epidemiological interview, temperature measurement to rule out patients with an active infection, and the implementation of strict infection control procedures. Med Pr. 2021;72(2):155-62.

The Attitudes and Professional Approaches of Dental Practitioners during the COVID-19 Outbreak in Poland: A Cross-Sectional Survey.

The coronavirus infectious disease 2019 (COVID-19) pandemic has put enormous pressure on health care systems around the world. Dentistry has had to adjust to the new epidemic situation to not only bring relief to suffering patients but also to avoid becoming a source of SARS-CoV-2 transmission. METHODS: A comprehensive, cross-sectional survey was conducted between April 6 and 16, 2020 among 875 Polish dental practitioners. The aim of the research was to assess dentists' attitudes and professional approaches resulting from the COVID-19 pandemic. RESULTS: 71.2% of dentists who responded to the questionnaire decided to suspend their clinical practice during that particular time. The main factors for this fact were the shortage of personal protective equipment (PPE), the respondents' subjective perceptions of the risk of COVID-19 contraction and a general feeling of anxiety and uncertainty regarding the COVID-19 situation. The authors observed a significant decrease in the number of patients admitted weekly in April 2020 (12.06; SD, 11.55) in comparison to that in the time before the state of pandemic was declared on March 11, 2020 (49.21; SD, 24.97). CONCLUSIONS: Due to the unpreparedness of the dental sector, both in national health and private settings, most of the Polish dentists decided to voluntarily suspend their clinical practice in order to mitigate the spread of the disease. The COVID-19 outbreak has revealed numerous shortcomings in the dental care system, especially regarding the insufficient coordination of health services related to the pandemic and lack of advanced PPE. This has led to an overwhelming feeling of fear, confusion and anxiety among dental professionals in Poland and a sudden decrease in the number of performed dental procedures. Hopefully enriched with the recent experience and due to the implementation of proper strategic and long-term measures, dental practitioners will be better prepared and adapted to global health care disruptions in the future.

Dental Care Provision during Coronavirus Disease 2019 (COVID-19) Pandemic: The Importance of Continuous Support for Vulnerable Patients.

As a result of the ongoing 2019 coronavirus disease (COVID-19) pandemic, the medical and dental services across the world have to tackle unprecedented situations, providing essential care and professional support. The global health care crisis caused directly by the vast number of severe COVID-19 cases, and indirectly by reduced access to health care, as well as by limited secondary care provision, had a major impact on specialist services, and subsequently the deterioration of medical and dental conditions, particularly in vulnerable persons. In particular, at present, special care dentistry seems to play a unique role, dealing with a wide range of patients with underlying medical conditions and co-morbidities, phobic individuals, and persons with learning/physical disabilities. The effective adaptation of health services to the current new reality, based on an empathetic approach and recent guidelines, would allow us to maintain an adequate care provision, minimizing the long-term impact of the pandemic.