A Pan-Canadian narrative review on the protocols for reopening dental services during the COVID-19 pandemic
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REVIEW
A Pan‑Canadian narrative review on the protocols for reopening dental services during the COVID‑19 pandemic Mario Brondani1* , Denise Cua2, Tala Maragha1, Melody Shayanfar3, Kavita Mathu‑Muju1, HsingChi von Bergmann1, Fernanda Almeida1, Jeannie Villanueva4, Alexis Armando Vides Alvarado5, Stephen Learey6 and Leeann Donnelly2
Abstract The current coronavirus disease 2019 (COVID-19) pandemic is impacting the way in which dental services are provided. The aim of this narrative review was twofold: to summarize key areas from the Canadian protocols avail‑ able for the reopening and restructuring of dental services across the country and to critically review these protocols based on existing evidence. A narrative review of the existing Canadian protocols, written in English and French, was undertaken between April 15 and July 13, 2020. The protocols were obtained by searching through regulatory bodies and websites from professional organizations, and from personal contacts through academic institutions and policy leaders. The data extraction form focused only on protocols related to dentistry, and the information was compiled by a hired assistant. Content was categorized via group discussions with the research team on eight areas: office man‑ agement and procedures, patient and staff screening, treatment procedures, office layout, risk reduction, personal protective equipment, supporting information, and length and readability. Thirteen protocols were identified and offered substantial variation in the level of details provided. All but two protocols specified proper donning/doffing of personal protective equipment, while all protocols recommended daily monitoring of COVID-19 related signs and symptoms in staff and patients. They varied in terms of recommended mask types, eye and face shield protection, and head coverings. While all protocols aimed at restructuring emergency dental services, their recommendations were often not based on the published evidence. This narrative review summarized key areas from 13 provincial and territorial protocols in Canada to help oral health care providers plan the reopening of their services. The information conveyed across all documents was clear, but variance highlights the need for a coordinated effort to develop an evidence-based document for dental practitioners. Keywords: Oral health care, Protocols, COVID-19, SARS-CoV-2, Narrative review, Evidence-based, Canada Background The World Health Organization (WHO) declared the novel coronavirus disease 2019 (COVID-19) a global pandemic on March 11, 2020. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), *Correspondence: [email protected] 1 Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 116/2199 Wesbrook Mall, Vancouver V6T 1Z3, Canada Full list of author information is available at the end of the article
first identified in Wuhan, China in December 2019 [1, 2]. As of October 10, 2020, COVID-19 has spread to more than 200 coun
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