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1.
J Am Dent Assoc ; 155(6): 515-525.e1, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38839239

RESUMEN

BACKGROUND: Dental unit waterline (DWL) infection control is critical to infection prevention. Identifying challenges and barriers to its implementation is a first step toward understanding how to improve engagement. METHODS: A survey was distributed to dentists, dental hygienists, and dental assistants via the Qualtrics XM platform (Qualtrics). Responses were analyzed to quantify engagement in practices contrary to Centers for Disease Control and Prevention guidance and identify avenues to improve engagement. RESULTS: Although oral health care providers recognized DWL infection control was important, there was a lack of clarity about appropriate routine engagement (eg, what lines should be tested), what should be noted in practice infection control records, and steps to be taken in response to a failed test result (ie, ≥ 500 colony-forming units/mL), such as taking a chair out of service. CONCLUSIONS: Survey results showed there were considerable gaps in knowledge and practice that could lead to patient harm. Oral health care provider training may not prepare personnel adequately to engage in, let alone supervise, DWL infection control. DWL infection control, like other aspects of infection control, requires action informed via an understanding of what needs to be done. Although good intentions are appreciated, better approaches to DWL infection control information dissemination and strategies to engage dental assistants, dental hygienists, and dentists in best practices are needed. PRACTICAL IMPLICATIONS: Evolving standards of care, including infection control, should be reflected in the provision of dental treatment. Improvements in communicating and ensuring engagement in best practices are needed when it comes to DWL infection control.


Asunto(s)
Control de Infección Dental , Humanos , Control de Infección Dental/métodos , Higienistas Dentales , Encuestas y Cuestionarios , Odontólogos , Equipo Dental , Contaminación de Equipos/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Asistentes Dentales
2.
Pediatr Dent ; 46(3): 199-203, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38822496

RESUMEN

Purpose: The purposes of this in vitro study were to evaluate the effect of three isolation methods to mitigate bioaerosols during stainless steel crown (SSC) preparations and assess the distribution of Streptococcus mutans by aerosolization in closed-room operatories. Methods: Melamine teeth coated in laboratory-grown S. mutans biofilm were prepared for SSCs using three different isolation methods. Agar plates were placed in five locations throughout the operatory and opened during each preparation as well as for 10 minutes immediately following to collect aerosolized S. mutans. Bacterial colonies were counted after incubating plates for 48 hours. Data were analyzed for differences between the isolation method and plate locations. Results: Bacterial colony counts for teeth prepared using high-volume evacuation suction (HVE) with dental dam (DD) isolation were statistically significantly higher than for those prepared using HVE with a DryShield®(DS) and HVE with no isolation at the assistant (A) (P<0.001), operator face shield (FS) (P<0.001), and patient (Pt) (P=0.002) locations. No significant differences were found among isolation methods for parent (Pa) or rear delivery (RD) locations. The location that produced the most bacterial colony counts using HVE with DD isolation was FS (P<0.001), followed by A (P=0.04), Pt (P<0.001), and RD and Pa (P<0.001). Counts produced from teeth prepared with DS isolation were significantly higher at the Pt location than the A (P<0.001), FS (P=0.002), RD (P<0.001), and Pa (P=0.008) locations. Conclusion: The use of dental dam with high-volume evacuation suction during stainless steel crown preparations increased bioaerosols near the procedure, while dental evacuation systems (DryShield®) may effectively limit their spread.


Asunto(s)
Aerosoles , Streptococcus mutans , Humanos , Streptococcus mutans/aislamiento & purificación , Acero Inoxidable , Coronas , Técnicas In Vitro , Microbiología del Aire , Recuento de Colonia Microbiana , Biopelículas , Carga Bacteriana , Succión/instrumentación , Control de Infección Dental/métodos
3.
Rev. ADM ; 79(4): 193-197, jul.-ago. 2022. ilus, tab
Artículo en Español | LILACS | ID: biblio-1393292

RESUMEN

Introducción: la prevención y control de infecciones (PCI) pretenden prevenir, detener y propagar enfermedades infecciosas en pacientes y trabajadores de la salud. Este enfoque debe comenzar con la formación y capacitación del profesional de la salud, inmunizaciones recomendadas y ejecución de medidas universales de protección. Objetivos: evaluar conocimientos, actitudes y prácticas en la prevención y control de infec- ciones de los estudiantes y pasantes de servicio social de la licenciatura en Estomatología de la UAM-X. Material y métodos: se realizó un estudio descriptivo, transversal y observacional mediante una encuesta anónima como instrumento para recolección de datos a una muestra de 108 alumnos y pasantes. Resultados: se encontró que al contestar el interrogatorio sobre «prevención y control de infecciones¼, 59.3% tuvo un nivel de conocimientos aceptable y 40.7% tuvo un nivel muy bueno. De los encuestados, 87% desinfecta y cambia las barreras de protección entre cada paciente, 9.3% al comenzar y finalizar el día; el restante 3.7%, cuando está visiblemente sucio o cuando hay derrame de sustancias de líquidos corporales. Conclusión: los encuestados tienen adecuados conocimientos y prácticas, lo que infiere que tienen el sustento teórico y habilidades para enfrentarse a la etapa postpandemia para la atención de pacientes (AU)


ntroduction: infection prevention and control (IPC) efforts to prevent, stopping and spreading infectious diseases in patients and healthcare workers. This approach should begin with education and training of the health professional, recommended immunizations and implementation of universal protective measures. Objectives: to evaluate knowledge, attitudes and practices in infection prevention and control stomatology career's students and social service interns UAM-X. Material and methods: a descriptive, cross-sectional and observational study was carried out using an anonymous survey as an instrument for data collection from a sample of 108 students and interns. Results: it was found that when answering the questionnaire on «infection prevention and control¼, 59.3% had an acceptable level of knowledge and 40.7% had a very good level. 87% of the respondents disinfect and change the protective barriers between each patient, 9.3% at the beginning and end of the day; the remaining 3.7% when visibly dirty or when there is spillage of body fluids. Conclusion: respondents have adequate knowledge and practices, inferring that they have the theoretical support and skills to face the post-pandemic stage of patient care (AU)


Asunto(s)
Control de Enfermedades Transmisibles , Conocimientos, Actitudes y Práctica en Salud , Control de Infección Dental/métodos , Ropa de Protección , Facultades de Odontología , Estudiantes de Odontología/psicología , Epidemiología Descriptiva , Estudios Transversales , Encuestas y Cuestionarios , Interpretación Estadística de Datos , Internado y Residencia , México
4.
Rev. ADM ; 79(3): 152-155, mayo-jun. 2022. ilus, tab
Artículo en Español | LILACS | ID: biblio-1378580

RESUMEN

La llegada del COVID-19 generó diversos cambios significativos en el área de la salud y particularmente en el área odontológica, donde se priorizaron los tratamientos de urgencia relegando los procedimientos menores y atención de citas a la vía virtual. Otras modificaciones se concentraron en el uso de equipos de protección personal y logística de atención tanto para el paciente como para el profesional, siguiendo las indicaciones de las normas diseñadas para esta función; adicionalmente se hicieron adecuaciones en las áreas de recepción y práctica odontológica, y se capacitó a los profesionales en temas relativos a la enfermedad. El objetivo del presente artículo es analizar las implicaciones generadas en la práctica odontológica durante la pandemia por COVID-19 en los ámbitos de triaje, infraestructura, normativa y capacitación (AU)


The arrival of COVID-19 produced a series of significant changes in the health area and particularly in the dental area where emergency treatments were prioritized, relegating minor procedures and appointment care to the virtual route, other modifications focused on the use of personal protective equipment and care logistics for both the patient and the professional following the indications of the standards designed for this function, additionally adjustments were made in the reception and dental practice areas, and professionals were trained on issues related to the disease. The objective of this article is to analyze the implications generated in dental practice during the COVID-19 pandemic in the areas of triage, infrastructure, regulations and training (AU)


Asunto(s)
Humanos , Triaje , Control de Infección Dental/métodos , Infraestructura , COVID-19 , Protocolos Clínicos , Atención Odontológica/normas , Consultorios Odontológicos , Comunicación por Videoconferencia , Capacitación de Recursos Humanos en Salud , Diseño Interior y Mobiliario
5.
J Contemp Dent Pract ; 23(9): 953-961, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37283004

RESUMEN

AIM: The aim of this article is to discuss the infection control measures with focus on those related to prosthodontic work. BACKGROUND: The risk of transmission of several infectious microorganisms during dental procedures and the increased awareness and knowledge of infectious diseases have led to an increased attention to the importance of infection control. Prosthodontists and dental personnel are exposed directly or indirectly to a significant risk of acquiring healthcare-associated infections. REVIEW RESULTS: High standards of occupational safety and dental infection control must be applied by dental personnel for the safety of patients and dental healthcare workers. All reusable items (critical and semicritical instruments) that come in contact with the patient's saliva, blood, or mucous membranes must be heat-sterilized. Proper disinfectants should be used to disinfect nonsterilizable instruments (e.g., wax knifes, dental shade plastic mixing spatula, guides, fox bite plane, articulators, and facebows). CONCLUSION: In prosthodontics, items potentially contaminated with patient's blood and saliva are transported between dental clinics and dental laboratories. Such fluids may contain microorganisms with high potential for transmission of several diseases. Therefore, sterilization and disinfection of all items used during prosthodontic work should be part of infection control protocol in dental care setting. CLINICAL SIGNIFICANCE: In prosthodontic practice, a strict infection prevention plan should be implemented to minimalize the risk of infectious diseases transmission among prosthodontists, dental office, dental laboratory personnel, and patients.


Asunto(s)
Enfermedades Transmisibles , Prostodoncia , Humanos , Clínicas Odontológicas , Control de Infecciones/métodos , Esterilización , Desinfección/métodos , Control de Infección Dental/métodos
6.
Rev. Fac. Odontol. (B.Aires) ; 37(86): 1-12, 2022. ilus, tab
Artículo en Español | LILACS | ID: biblio-1412391

RESUMEN

Una enfermedad infecciosa es aquella producida por un agente infeccioso (bacterias, hongos, virus, etc.) que ingresa y se desarrolla en el organismo de un hospedero. Posteriormente, puede trasmitirse de un individuo a otro directamente por contacto entre ambos, o bien, indirectamente, por medio de un vec-tor biológico (de naturaleza animal o vegetal), o de un fómite (objeto inanimado). Las vías por las que un agente infeccioso puede ingresar a un hospedero son: inhalación (respiración de aerosoles), ingestión (salpicaduras de gotas), penetración de mucosas (na-sal, ocular y bucal) o lesiones en la piel o mucosas. Las fuentes de infección pueden ser los pacientes, el personal del consultorio o laboratorio, las superficies e instrumental contaminados y las prótesis o com-ponentes de éstas. Para evitar la propagación de los agentes microbianos se debe interrumpir el proceso de transmisión de los mismos. Todo profesional debe fortalecer y readecuar normas y protocolos de biose-guridad en la tarea diaria, para minimizar el riesgo de transmisión directa y cruzada entre el profesional, su equipo auxiliar, el laboratorista y los pacientes (AU)


An infectious disease is one caused by an infectious agent (bacteria, fungi, virus, etc.) that enters and develops in a host. Then it can be transmitted from one individual to another directly by contact between the two or, indirectly through a biological vector (an animal or plant nature), or a fomite (an inanimate object). The routes by which an infectious agent can enter a host are: inhalation (breathing of aerosols), ingestion (splash of droplets), penetration of mucous membranes (nasal, ocular and oral) and skin or mucous lesions. Sources of infection can be patients, office or laboratory personnel, contaminated surfaces and instruments and the prosthesis or component thereof. To prevent the spread of microbial agents, the process of their transmission must be interrupted. Every professional must strengthen and readjust biosafety standards and protocols in daily work to minimize the risk of direct and cross-transmission between the professional, his auxiliary team, the laboratory technician and the patients (AU)


Asunto(s)
Control de Infección Dental/métodos , Laboratorios Odontológicos/normas , Ropa de Protección , Hipoclorito de Sodio/uso terapéutico , Materiales Biomédicos y Dentales/normas , Protocolos Clínicos , Descontaminación/métodos , Eliminación de Residuos Sanitarios , Desinfectantes/uso terapéutico , Etanol/uso terapéutico , Equipo de Protección Personal
7.
Rev. ADM ; 78(3): 162-166, mayo-jun. 2021.
Artículo en Español | LILACS | ID: biblio-1254811

RESUMEN

La enfermedad COVID-19 fue declarada pandemia por la Organización Mundial de la Salud el 11 de marzo de 2020. El síndrome respiratorio agudo severo coronavirus-2 (SARS-CoV-2) es un virus transmitido de animales a seres humanos, altamente contagioso, cuyo periodo de incubación es de uno a 14 días. Los momentos por los que atraviesan la mayoría de los países debido a la pandemia declarada del COVID-19 han llevado a la proclamación de órdenes gubernamentales y/o recomendaciones en relación a la atención dental que debe dispensarse. En el momento actual, no se dispone de protocolos específicos oficiales, ni nacionales ni internacionales, que aborden de manera clara cómo debe proceder el odontólogo en su práctica diaria en la etapa posterior al confinamiento para trabajar con las mejores garantías de protección para los pacientes y el equipo humano de la consulta odontológica. Este estudio tuvo como objetivo analizar consideraciones para la atención de tratamientos endodóncicos en el contexto de la pandemia de COVID-19. Para lograr este objetivo se realizó una revisión bibliográfica en diferentes bases de datos, como: Google Scholar, Springer Link, Scopus, PubMed, para ello se emplearon estrategias de búsqueda, utilizando descriptores como: «endodontic¼, «recomendations¼, «odontology¼, «COVID-19¼, «pandemic¼ y operadores booleanos, con la finalidad de obtener información relevante y precisa. Contribuyendo a la práctica de la endodoncia con un protocolo general para el manejo de emergencias que muestre el fundamento del diagnóstico, los procedimientos clínicos y el uso de equipos de protección personal y barreras en el consultorio odontológico durante el brote de COVID-19 (AU)


The COVID-19 disease was declared a pandemic by the World Health Organization on March 11, 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a virus transmitted from animals to humans, highly contagious, whose incubation period is one to 14 days. The times that most countries are going through due to the declared COVID-19 pandemic have led to the proclamation of government orders and/or recommendations regarding the dental care that should be provided. At the present time, there are no specific official national or international protocols that clearly address how the dentist should proceed, in their daily practice, in the post-confinement stage, to work with the best guarantees of protection for the patients and the human team of the dental practice. The objective of this study was to analyze considerations for the care of endodontic treatments in the context of the COVID-19 pandemic. To achieve this objective, a bibliographic review was carried out in different databases, such as: Google Scholar, Springer Link, Scopus, PubMed, for this, search strategies were used, using descriptors such as: «endodontic¼, «recommendations¼, «odontology¼, «COVID-19¼, «pandemic¼ and Boolean operators, in order to obtain relevant and accurate information. Contributing to the practice of endodontics a general protocol for emergency management that shows the rationale for diagnosis, clinical procedures and the use of personal protective equipment and barriers in the dental office during the COVID-19 outbreak (AU)


Asunto(s)
Humanos , Tratamiento del Conducto Radicular/normas , COVID-19 , Esterilización , Control de Enfermedades Transmisibles , Protocolos Clínicos , Desinfección , Bases de Datos Bibliográficas , Control de Infección Dental/métodos , Consultorios Odontológicos/normas
10.
Rev. ADM ; 78(1): 13-21, ene.-feb- 2021. ilus, tab
Artículo en Español | LILACS | ID: biblio-1152240

RESUMEN

Existe una creciente preocupación sobre el tema de la infección cruzada en clínicas y laboratorios dentales. El laboratorio odontológico debe seguir normas de bioseguridad que garanticen a todo el equipo de salud la prevención de estas infecciones. Los técnicos que allí laboran corren el riesgo de exponer su cara a salpicaduras, así como a rocíos de sangre y saliva. Este estudio fue diseñado para saber si los laboratorios a los que recurrimos cumplen con estas normas de bioseguridad, y qué tan confiados podemos estar de la desinfección por parte de ellos, ya que las prótesis deberían estar desinfectadas correctamente antes de colocarlas en boca (AU)


There is growing concern about the issue of cross infection in dental clinics and laboratories. The dental laboratory must follow biosafety standards that guarantee the prevention of these infections to the entire health team. The technicians who work there run the risk of exposing their face to splashes and spray of blood and saliva. This study was designed to find out if the laboratories we use comply with these biosafety standards, and how confident we can be of their disinfection by them, since the prostheses should be properly disinfected before placing them in the mouth (AU)


Asunto(s)
Desinfección , Infecciones por Bacterias Grampositivas , Infecciones por Bacterias Gramnegativas , Prótesis Dental/efectos adversos , Control de Infección Dental/métodos , Laboratorios Odontológicos , Recuento de Colonia Microbiana , Estudios Transversales , Análisis de Varianza , Consultorios Odontológicos/normas , Técnicas de Cultivo
12.
Rev. Ateneo Argent. Odontol ; 64(1): 56-63, 2021. tab, graf
Artículo en Español | LILACS | ID: biblio-1252711

RESUMEN

A partir de una propuesta del Comité de Investigaciones del Ateneo Argentino de Odontología se realizó una encuesta anónima transversal para conocer el estado de los odontólogos en relación con la infección provocada por la covid-19 ya que los afecta de una manera especial debido a las características del virus SARS-CoV-2 y su forma de trasmisión (AU)


From a proposal of the Research Committee of the Argentine Athenaeum of Dentistry, an anonymous cross-sectional survey was conducted to know the status of dentists in relation to the infection caused by covid-19 and that particularly affects dentists due to the characteristics of the SARS-CoV-2 virus and its form of transmission (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Infecciones por Coronavirus/transmisión , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Odontólogos , Argentina , Facultades de Odontología/estadística & datos numéricos , Sociedades Odontológicas/normas , Control de Enfermedades Transmisibles/métodos , Estudios Transversales , Encuestas Epidemiológicas , Infecciones por Coronavirus/prevención & control , Control de Infección Dental/métodos , Distribución por Edad y Sexo , Betacoronavirus , American Dental Association/organización & administración , Odontología del Trabajo
13.
PLoS One ; 15(12): e0244020, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33320905

RESUMEN

AIM: To assess the distribution and deposition of aerosols during simulated periodontal therapy. METHODS: A manikin with simulated fluorescein salivation was treated by four experienced dentists applying two different periodontal treatment options, i.e. air-polishing with an airflow device or ultrasonic scaling in the upper and lower anterior front for 5 minutes, respectively. Aerosol deposition was quantitatively measured on 21 pre-defined locations with varying distances to the manikins mouth in triplicates using absorbent filter papers. RESULTS: The selected periodontal interventions resulted in different contamination levels around the patient's mouth. The highest contamination could be measured on probes on the patient's chest and forehead but also on the practitioner's glove. With increasing distance to the working site contamination of the probes decreased with both devices. Air-polishing led to greater contamination than ultrasonic. CONCLUSION: Both devices showed contamination of the nearby structures, less contamination was detected when using the ultrasonic. Affirming the value of wearing protective equipment we support the need for universal barrier precautions and effective routine infection control in dental practice.


Asunto(s)
Aerosoles/química , Pulido Dental/instrumentación , Control de Infección Dental/métodos , Periodoncia/instrumentación , Terapia por Ultrasonido/instrumentación , Humanos , Maniquíes , Seguridad del Paciente , Equipo de Protección Personal/normas , Saliva/química
14.
Rev. ADM ; 77(6): 301-305, nov.-dic. 2020.
Artículo en Español | LILACS | ID: biblio-1151065

RESUMEN

A finales de 2019 se identificó el virus SARS-CoV-2 (por su significado en inglés Severe Acute Respiratory Syndrome Coronavirus 2) como agente etiológico de la COVID-19 (por su significado en inglés coronavirus disease 2019) en la ciudad de Wuhan, China. Debido a su rápida propagación al resto del mundo durante el primer trimestre del año 2020, la Organización Mundial de la Salud (OMS) la declaró pandemia mundial en marzo del mismo año. Por el potencial de contagio de COVID-19 se ha considerado que el entorno clínico en el que se desenvuelve la odontología puede ser de alto riesgo para el paciente, el odontólogo y sus asistentes si no se tienen las medidas de bioseguridad adecuadas. En un principio se vieron suspendidas las consultas regulares; sin embargo, al volver a la actividad laboral se han adaptado protocolos para el control de infecciones como reforzar el uso de barreras de protección y minimizar tratamientos que involucren aerosoles. La caries es uno de los principales motivos de consulta en la odontología pediátrica, por lo que en este escrito se sugieren algunos protocolos basados en la mínima invasión que prescinden de instrumental rotatorio para salvaguardar al paciente en riesgo de contagio, reduciendo el número de visitas y tiempo en consulta e incluso controlando algunos aspectos de salud bucal fuera de consulta clínica por medio de estrategias preventivas que pueden llevarse a cabo desde casa. Esto significa también mantener la tranquilidad por parte de los tutores del paciente ante la pandemia que se vive actualmente (AU)


At the end of 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified as the etiological agent of COVID-19 in the city of Wuhan China. Due to its rapid spread to the rest of the world during the first trimester of 2020, the WHO declared a global pandemic in March of the same year. Due to the contagion potential of COVID-19, it has been considered that the clinical environment in which dentistry operates may be in high risk for the patient if the appropriate biosafety measures are not taken, initially clinical practices were suspended. However, when returning to work, protocols have been adapted to the infection control procedures, reinforced the use of protective barriers, and minimize treatments that involve aerosols. Caries is one of the main reasons for consultation in Pediatric Dentistry, this article suggests some protocols based on minimal invasion that dispense with rotating instruments to safeguard the patient from the risk of contagion, reducing the number of visits and time in consultation and even controlling some aspects of the oral health outside the dental visit through preventive strategies that can be carried out from home. Modifications to Dental Home. This should include maintaining tranquility and calm on the part of the patient's tutors in the face of the pandemic that we are currently experiencing (AU)


Asunto(s)
Humanos , Preescolar , Niño , Infecciones por Coronavirus , Atención Dental para Niños/métodos , Aerosoles , Selladores de Fosas y Fisuras , Remineralización Dental , Protocolos Clínicos , Fluoruros Tópicos/uso terapéutico , Factores de Riesgo , Resinas Compuestas , Control de Infección Dental/métodos , Caries Dental/terapia , Placa Dental/prevención & control , Tratamiento Restaurativo Atraumático Dental
16.
Cochrane Database Syst Rev ; 10: CD013686, 2020 10 12.
Artículo en Inglés | MEDLINE | ID: mdl-33047816

RESUMEN

BACKGROUND: Many dental procedures produce aerosols (droplets, droplet nuclei and splatter) that harbour various pathogenic micro-organisms and may pose a risk for the spread of infections between dentist and patient. The COVID-19 pandemic has led to greater concern about this risk. OBJECTIVES: To assess the effectiveness of methods used during dental treatment procedures to minimize aerosol production and reduce or neutralize contamination in aerosols. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases on 17 September 2020: Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (in the Cochrane Library, 2020, Issue 8), MEDLINE Ovid (from 1946); Embase Ovid (from 1980); the WHO COVID-19 Global literature on coronavirus disease; the US National Institutes of Health Trials Registry (ClinicalTrials.gov); and the Cochrane COVID-19 Study Register. We placed no restrictions on the language or date of publication. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on aerosol-generating procedures (AGPs) performed by dental healthcare providers that evaluated methods to reduce contaminated aerosols in dental clinics (excluding preprocedural mouthrinses). The primary outcomes were incidence of infection in dental staff or patients, and reduction in volume and level of contaminated aerosols in the operative environment. The secondary outcomes were cost, accessibility and feasibility. DATA COLLECTION AND ANALYSIS: Two review authors screened search results, extracted data from the included studies, assessed the risk of bias in the studies, and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data. We assessed heterogeneity. MAIN RESULTS: We included 16 studies with 425 participants aged 5 to 69 years. Eight studies had high risk of bias; eight had unclear risk of bias. No studies measured infection. All studies measured bacterial contamination using the surrogate outcome of colony-forming units (CFU). Two studies measured contamination per volume of air sampled at different distances from the patient's mouth, and 14 studies sampled particles on agar plates at specific distances from the patient's mouth. The results presented below should be interpreted with caution as the evidence is very low certainty due to heterogeneity, risk of bias, small sample sizes and wide confidence intervals. Moreover, we do not know the 'minimal clinically important difference' in CFU. High-volume evacuator Use of a high-volume evacuator (HVE) may reduce bacterial contamination in aerosols less than one foot (~ 30 cm) from a patient's mouth (MD -47.41, 95% CI -92.76 to -2.06; 3 RCTs, 122 participants (two studies had split-mouth design); very high heterogeneity I² = 95%), but not at longer distances (MD -1.00, -2.56 to 0.56; 1 RCT, 80 participants). One split-mouth RCT (six participants) found that HVE may not be more effective than conventional dental suction (saliva ejector or low-volume evacuator) at 40 cm (MD CFU -2.30, 95% CI -5.32 to 0.72) or 150 cm (MD -2.20, 95% CI -14.01 to 9.61). Dental isolation combination system One RCT (50 participants) found that there may be no difference in CFU between a combination system (Isolite) and a saliva ejector (low-volume evacuator) during AGPs (MD -0.31, 95% CI -0.82 to 0.20) or after AGPs (MD -0.35, -0.99 to 0.29). However, an 'n of 1' design study showed that the combination system may reduce CFU compared with rubber dam plus HVE (MD -125.20, 95% CI -174.02 to -76.38) or HVE (MD -109.30, 95% CI -153.01 to -65.59). Rubber dam One split-mouth RCT (10 participants) receiving dental treatment, found that there may be a reduction in CFU with rubber dam at one-metre (MD -16.20, 95% CI -19.36 to -13.04) and two-metre distance (MD -11.70, 95% CI -15.82 to -7.58). One RCT of 47 dental students found use of rubber dam may make no difference in CFU at the forehead (MD 0.98, 95% CI -0.73 to 2.70) and occipital region of the operator (MD 0.77, 95% CI -0.46 to 2.00). One split-mouth RCT (21 participants) found that rubber dam plus HVE may reduce CFU more than cotton roll plus HVE on the patient's chest (MD -251.00, 95% CI -267.95 to -234.05) and dental unit light (MD -12.70, 95% CI -12.85 to -12.55). Air cleaning systems One split-mouth CCT (two participants) used a local stand-alone air cleaning system (ACS), which may reduce aerosol contamination during cavity preparation (MD -66.70 CFU, 95% CI -120.15 to -13.25 per cubic metre) or ultrasonic scaling (MD -32.40, 95% CI - 51.55 to -13.25). Another CCT (50 participants) found that laminar flow in the dental clinic combined with a HEPA filter may reduce contamination approximately 76 cm from the floor (MD -483.56 CFU, 95% CI -550.02 to -417.10 per cubic feet per minute per patient) and 20 cm to 30 cm from the patient's mouth (MD -319.14 CFU, 95% CI - 385.60 to -252.68). Disinfectants ‒ antimicrobial coolants Two RCTs evaluated use of antimicrobial coolants during ultrasonic scaling. Compared with distilled water, coolant containing chlorhexidine (CHX), cinnamon extract coolant or povidone iodine may reduce CFU: CHX (MD -124.00, 95% CI -135.78 to -112.22; 20 participants), povidone iodine (MD -656.45, 95% CI -672.74 to -640.16; 40 participants), cinnamon (MD -644.55, 95% CI -668.70 to -620.40; 40 participants). CHX coolant may reduce CFU more than povidone iodine (MD -59.30, 95% CI -64.16 to -54.44; 20 participants), but not more than cinnamon extract (MD -11.90, 95% CI -35.88 to 12.08; 40 participants). AUTHORS' CONCLUSIONS: We found no studies that evaluated disease transmission via aerosols in a dental setting; and no evidence about viral contamination in aerosols. All of the included studies measured bacterial contamination using colony-forming units. There appeared to be some benefit from the interventions evaluated but the available evidence is very low certainty so we are unable to draw reliable conclusions. We did not find any studies on methods such as ventilation, ionization, ozonisation, UV light and fogging. Studies are needed that measure contamination in aerosols, size distribution of aerosols and infection transmission risk for respiratory diseases such as COVID-19 in dental patients and staff.


Asunto(s)
Microbiología del Aire , Infecciones Bacterianas/prevención & control , Control de Infección Dental/métodos , Enfermedades Profesionales/prevención & control , Virosis/prevención & control , Adolescente , Adulto , Aerosoles , Anciano , Filtros de Aire , Niño , Preescolar , Recuento de Colonia Microbiana/métodos , Odontología , Desinfectantes , Humanos , Control de Infección Dental/economía , Control de Infección Dental/instrumentación , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Dique de Goma , Succión , Adulto Joven
18.
Rev. Asoc. Odontol. Argent ; 108(2): 88-94, mayo-ago. 2020. tab
Artículo en Español | LILACS | ID: biblio-1121648

RESUMEN

La pandemia de enfermedad por coronavirus de 2019 (Covid-19) se ha convertido en un importante desafío de salud pública para todos los países. Las medidas de control de infecciones son necesarias para disminuir la circulación del virus y evitar que se siga propagando mundialmente. Debido a las características de los entornos odontológicos, el riesgo de infección cruzada entre los pacientes y los odontólogos es alto. Es por esto que se requieren protocolos de control de infecciones estrictos y efectivos. Elaborar estrategias de gestión del riesgo en salud en odontología permitirá brindar un entorno de seguridad para el paciente, el profesional y su equipo (AU)


The Covid-19 pandemic has become a major public health challenge all over the world. Infection control measures are necessary to prevent the virus from spreading further and to help to control the situation worldwide. Due to the characteristics of the dental environment, the risk of cross infection is high between patients and dentists. It is important to develop strict infection control protocols to provide a safety environment for the patient and the dental staff (AU)


Asunto(s)
Humanos , Infecciones por Coronavirus/prevención & control , Control de Infección Dental/métodos , Personal de Odontología , Pandemias , Seguridad del Paciente , Gestión de Riesgos , Control de Enfermedades Transmisibles/métodos , Protocolos Clínicos , Consultorios Odontológicos/normas
19.
Rev. ADM ; 77(3): 137-145, mayo-jun. 2020. tab
Artículo en Español | LILACS | ID: biblio-1128241

RESUMEN

Catalogada su labor como Servicios de Salud Indispensables, el profesional de la odontología se ha mantenido al pendiente de sus pacientes durante la pandemia de COVID-19, brindando atención de urgencia a quien lo solicita. A su regreso a la práctica típica, el odontólogo encontrará un entorno distinto o NUEVA NORMALIDAD, viéndose obligado a hacer modificaciones clínicas pertinentes y preparar a su equipo de trabajo para continuar brindando atención de calidad con un margen de seguridad amplificado, que de igual manera proteja a pacientes y al equipo de trabajo. Ante la falta de una vacuna que brinde protección y de tratamiento específico contra el SARS-CoV-2 (COVID-19), elevar el nivel de control de infecciones en el consultorio se vuelve ineludible y posiblemente irreversible en el quehacer odontológico cotidiano. En este artículo se propone un Protocolo de Control de Infecciones en la consulta odontológica que permita brindar seguridad en la atención bucal, considerando COVID-19, útil también para control infeccioso de otros patógenos virales o bacterianos (AU)


Considered dentistry as an Indispensable Health Services, during the COVID-19 pandemic the dental professional has been providing mostly emergency care. Upon return to typical dental practice, the dentist will find a different environment or NEW NORMALLY, being forced to make relevant clinical modifications and prepare his team to continue providing quality care with an amplified safety margin, which equally protects patients and dental team. In the absence of an available vaccine that provides protection or a specific treatment against SARSCoV- 2 (COVID-19), raising the level of infection control at the dental office will become unavoidable and possibly irreversible in the future quotidian dental work. This article proposes an Infection Control Protocol for the dental consultation that allows provide safety oral care, considering COVID-19, also useful for other viral or bacterial pathogens control (AU)


Asunto(s)
Humanos , Atención Odontológica/normas , Infecciones por Coronavirus/prevención & control , Control de Infección Dental/métodos , Pandemias , Medidas de Seguridad , Control de Enfermedades Transmisibles/métodos , Equipo Dental/normas , Consultorios Odontológicos/normas , Relaciones Dentista-Paciente
20.
Rev. ADM ; 77(2): 88-95, mar.-abr. 2020. tab
Artículo en Español | LILACS | ID: biblio-1102073

RESUMEN

El surgimiento de infecciones originadas por el SARS-CoV-2 en el humano ha desencadenado una serie de conflictos de salud, económicos y sociales en el entorno mundial. El área odontológica debe poseer todo el conocimiento necesario acerca de esta pandemia debido a que, como profesionales de la salud y responsables de la condición bucal de la sociedad, es de vital importancia disminuir el riesgo que presentan las enfermedades crónicas no transmisibles, cáncer, obesidad y otras, así como de los adultos mayores para que no generen un problema de salud severo y que además puedan ser asociadas con la presencia del COVID-19. Es importante conocer cuáles son las pautas por considerar en la práctica odontológica para una atención odontológica oportuna y eficaz manteniendo la bioseguridad del personal de salud. Por lo tanto, se genera esta guía de atención odontológica basada en la evidencia científica publicada para el conocimiento y dominio del profesional de salud oral (AU)


The emergence of human infections caused by SRAS-CoV-2 has triggered a series of health, economic and social conflicts in the global environment. The dental area must have all the necessary knowledge about this pandemic because, as a health professional and responsible for the oral condition of society, it is vitally important to reduce the risk of chronic non-communicable diseases, cancer, obesity and others, as well as older adults so that they do not generate a health problem and that may also be associated with the presence of COVID-19. It is important to know the problems of the guidelines to consider in dental practice for effective dental care and biosafety of health personnel. Therefore, this dental care guide is generated based on published scientific evidence for the knowledge and domain of the oral health professional (AU)


Asunto(s)
Humanos , Masculino , Femenino , Atención Odontológica/normas , Personal de Salud , Infecciones por Coronavirus/prevención & control , Coronavirus , Control de Infección Dental/métodos , Control de Enfermedades Transmisibles , Odontología en Salud Pública
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