An innovative risk-scoring system of dental procedures and safety protocols in the COVID-19 era
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An innovative risk‑scoring system of dental procedures and safety protocols in the COVID‑19 era M. E. Bizzoca1†, G. Campisi2† and Lorenzo Lo Muzio1,3*†
Abstract Background: The aim of this paper is to assess an innovative risk score for common dental procedures, based on the most recent contaminant SARS-CoV-2. After scoring the level of infection risk, safety procedures, advice and personal protective equipment (PPE) are recommended for the dental team in each dental practice. Methods: The authors of this research analysed 42 common dental procedures on the basis of known transmission risks. In increasing order, many consider the parameters leading to different risk scores for the dental team and patients for each procedure to be: direct contact with saliva (score 1), direct contact with blood (score 2), production of low levels of spray/aerosol via air–water syringes (score 3), the production of high levels of spray/aerosol from rotating, ultrasound and piezoelectric tools (score 4); and the duration of the procedure, which may increase the risk of procedures producing droplets and aerosols. Results: Using this innovative risk-scoring system, the authors classified the different dental procedures according to low, medium or high risk: low (1–3), medium (4–5), high (≥ 6). A safety protocol for each procedure was thereafter matched with the calculated risk level. Conclusions: The innovative risk-scoring system presented in this research permits the reclassification of dental procedures according to the infection risk level. Consequently, specific procedures, previously considered as entry level, will now merit revision. This paper also highlighted an effective and routine clinical tool for general dentists and oral medicine practitioners. Keywords: Covid-19, SARS-CoV-2, Risk-scoring system, personal protective equipment (PPE) Background The Covid-19 pandemic, caused by SARS-CoV-2, has led to a global health crisis with safety and socio-economic issues. In the field of dentistry, this pandemic has highlighted the risk of infectious diseases with a clear impact on dental team and patients. In the past *Correspondence: [email protected] † M.E. Bizzoca, G. Campisi and L. Lo Muzio have made an equal contribution to the paper. 1 Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 50, 71122 Foggia, Italy Full list of author information is available at the end of the article
the most frightening pathogens were those transmissible predominantly through blood. Nowadays, and due to the SARS-CoV-2 pandemic, global security is being reconceptualised by studying prevention from infective air-borne agents, which can be diffused by the diffusion of saliva and secretions in the form of droplets and aerosol. The same phenomenon is occurring in the field of dentistry: procedures which were previously considered as trivial have increased in risk (e.g. scaling and irrigating) due to the heightened risk of spreading highly contaminated microbial aerosol. Tod
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