Preprint Article Version 1 This version is not peer-reviewed

A Dental Response to the COVID-19 Pandemic – Safe Aerosol-Free Emergent (SAFE) Dentistry

Version 1 : Received: 6 May 2020 / Approved: 7 May 2020 / Online: 7 May 2020 (05:21:20 CEST)

How to cite: Benzian, H.; Niederman, R. A Dental Response to the COVID-19 Pandemic – Safe Aerosol-Free Emergent (SAFE) Dentistry. Preprints 2020, 2020050104 (doi: 10.20944/preprints202005.0104.v1). Benzian, H.; Niederman, R. A Dental Response to the COVID-19 Pandemic – Safe Aerosol-Free Emergent (SAFE) Dentistry. Preprints 2020, 2020050104 (doi: 10.20944/preprints202005.0104.v1).

Abstract

Dental services are significantly impacted by the COVID-19 pandemic. Almost all dental procedures carry a high infection risk for providers and patients due to spread of aerosols. As a consequence, national public health agencies, and dental professional associations have issued guidelines for enhanced infection control, personal protection equipment and limiting care to urgent or emergency services. However, there is no dental service concept for disaster preparedness or response that might be applied. Similarly, pathways to care provision in a post-pandemic future are missing. We propose Safe Aerosol-free, Emergent Dentistry (SAFE Dentistry) as one approach to dental services during and emerging from pandemics. The concept’s starting point is the identification of the most common patient needs. The next step is to replace common treatments relating to the most common needs with alternative interventions with less infection risk because they do not generate aerosols. SAFE Dentistry is innovative, safe, and responds to the requirements of a pandemic and post-pandemic emergence where the risk of disease transmission remains high. SAFE Dentistry thereby ensures continuity of dental services while protecting providers and patients from infectious pathogens. Moreover, SAFE Dentistry allows dental service providers to remain operational and generate income even under pandemic conditions. Implementation and policy options for SAFE Dentistry include universal availability without co-payments by patients and a uniform bundled payment scheme for providers to simplify budgeting, reimbursement and to provide easier administration during a pandemic. Adaptations and adjustments of the concept are possible and encouraged, as long as the principle of avoiding aerosol-generation is maintained.

Subject Areas

COVID-19; dental care; infection control; universal precautions; aerosol

Comments (3)

Comment 1
Received: 13 May 2020
Commenter: Dr. Shamaz Mohamed
The commenter has declared there is no conflict of interests.
Comment: The above write up synthesised the non aerosol generating dental practice as Safe dentistry, asking dental practitioners to adapt to the new normal of aerosol free dental practice during and post COVID19 phase. However It appears like this pandemic is here to stay atleast for couple of years until we learn to live along with it as we have in past during tuberculosis and pandemic flu etc. CDC envisaged standard precautions from universal precautions by incoperating preventive measures for risk of contact and airborne transmission as well as bloodborne transmission. We as dental healthcare professionals should always be following these standard precautions which may be updated regularly during our practice rather than fear of getting infected or spreading the same. SAFE dentistry may lead to increase in primary and tertiary dental care and most of existing curative dental care being neglected. Hence I feel just by propagating practice of SAFE dentistry we are in turn increasing the burden of disease and morbidity along with allowing dental diseases to progress to more debilitating stages. We should inturn encourage dental service providers to strictly follow standard precautions and other guidelines and practice without fear and alleviate dental pain and suffering. Abstaining from certain areas of practice is not apt. Protect yourself adequately and adapt to new infection control practices to minimize risk. Here ways for regularizing and provisioning for additional finances required for sourcing these protective equipments and materials for dentists can be studied and implemented. This should be the present as well as future goal or may lead to dentist being called as just palliative therapists. I feel the authors should also include the above concerns.
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Comment 2
Received: 13 May 2020
Commenter: Dr. Shamaz Mohamed
The commenter has declared there is no conflict of interests.
Comment: The above write up synthesised the non aerosol generating dental practice as Safe dentistry, asking dental practitioners to adapt to the new normal of aerosol free dental practice during and post COVID19 phase. However It appears like this pandemic is here to stay atleast for couple of years until we learn to live along with it as we have in past during tuberculosis and pandemic flu etc.
CDC envisaged standard precautions from universal precautions by incoperating preventive measures for risk of contact and airborne transmission as well as bloodborne transmission.
We as dental healthcare professionals should always be following these standard precautions which may be updated regularly during our practice rather than fear of getting infected or spreading the same. SAFE dentistry may lead to increase in primary and tertiary dental care and most of existing curative dental care being neglected. Hence I feel just by propagating practice of SAFE dentistry we are in turn increasing the burden of disease and morbidity along with allowing dental diseases to progress to more debilitating stages.
We should inturn encourage dental service providers to strictly follow standard precautions and other guidelines and practice without fear and alleviate dental pain and suffering. Abstaining from certain areas of practice is not apt. Protect yourself adequately and adapt to new infection control practices to minimize risk. Here ways for regularizing and provisioning for additional finances required for sourcing these protective equipments and materials for dentists can be studied and implemented. This should be the present as well as future goal or may lead to dentist being called as just palliative therapists.
I feel the authors should also include the above concerns.
+ Respond to this comment
Comment 3
Received: 13 May 2020
Commenter: Dr. Shamaz Mohamed
The commenter has declared there is no conflict of interests.
Comment: The above write up synthesised the non aerosol generating dental practice as Safe dentistry, asking dental practitioners to adapt to the new normal of aerosol free dental practice during and post COVID19 phase. However It appears like this pandemic is here to stay atleast for couple of years until we learn to live along with it as we have in past during tuberculosis and pandemic flu etc.
CDC envisaged standard precautions from universal precautions by incoperating preventive measures for risk of contact and airborne transmission as well as bloodborne transmission.
We as dental healthcare professionals should always be following these standard precautions which may be updated regularly during our practice rather than fear of getting infected or spreading the same. SAFE dentistry may lead to increase in primary and tertiary dental care and most of existing curative dental care being neglected. Hence I feel just by propagating practice of SAFE dentistry we are in turn increasing the burden of disease and morbidity along with allowing dental diseases to progress to more debilitating stages.
We should inturn encourage dental service providers to strictly follow standard precautions and other guidelines and practice without fear and alleviate dental pain and suffering. Abstaining from certain areas of practice is not apt. Protect yourself adequately and adapt to new infection control practices to minimize risk. Here ways for regularizing and provisioning for additional finances required for sourcing these protective equipments and materials for dentists can be studied and implemented. This should be the present as well as future goal or may lead to dentist being called as just palliative therapists.
I feel the authors should also include the above concerns.
+ Respond to this comment

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