Biosafety in Dental Practices Versus COVID-19 Outbreak

Santos, Ingrid Garcia; Souza, Vívian Gonçalves Carvalho; Silva, Guilherme Thomaz Verly da; Lourenço, Aneliese Holetz de Toledo; Laxe, Laísa Araujo Cortines; Apolônio, Ana Carolina Morais

doi:10.1590/pboci.2021.034

Ingrid Garcia Santos

School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

https://orcid.org/0000-0001-6117-853X

Vívian Gonçalves Carvalho Souza

Postgraduate Program in Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

https://orcid.org/0000-0002-4371-8894

Guilherme Thomaz Verly da Silva

School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

https://orcid.org/0000-0002-8724-7422

Aneliese Holetz de Toledo Lourenço

Department of Dental Clinic, School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

https://orcid.org/0000-0002-1579-2456

Laísa Araujo Cortines Laxe

Postgraduate Program in Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

Department of Restorative Dentistry, School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

https://orcid.org/0000-0002-1785-7903

Ana Carolina Morais Apolônio Correspondence: Ana Carolina Morais Apolônio, Universidade Federal de Juiz de Fora, Department of Parasitology, Microbiology, and Immunology, Institute of Biological Sciences, Juiz de Fora, MG, Brazil. 36036-900, E-mail: carolina.apolonio@ufjf.edu.br

Postgraduate Program in Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

Department of Parasitology, Microbiology, and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

https://orcid.org/0000-0001-9049-7660

Correspondence: Ana Carolina Morais Apolônio, Universidade Federal de Juiz de Fora, Department of Parasitology, Microbiology, and Immunology, Institute of Biological Sciences, Juiz de Fora, MG, Brazil. 36036-900, E-mail: carolina.apolonio@ufjf.edu.br

Academic Editor: Alessandro Leite Cavalcanti

Authors’ Contributions

IGS - Methodology, Investigation, Data Curation and Writing - Original Draft.

VGCS - Methodology, Investigation, Data Curation and Writing - Original Draft.

GTVS - Methodology, Investigation and Data Curation.

AHTL - Methodology and Writing - Original Draft.

LACL - Methodology, Formal Analysis and Writing - Review and Editing.

ACMA - Conceptualization, Methodology, Formal Analysis, Writing - Original Draft and Writing - Review and Editing.

All authors declare that they contributed to critical review of intellectual content and approval of the final version to be published.

Conflict of Interest

The authors declare no conflicts of interest.

Figures (5)
Tables (1)

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Figure 1 (A-C)
Characterization of the study scenario considering the study participants (A), deaths for COVID-19 (B), and positive cases for COVID-19 (C) per 10.000 registered dentists among Brazilian regions.

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Figure 2 (A-H)
There were no significant statistical differences among Brazilian regions (p>0.05) for the following questions: knowledge about Sars-CoV-2 transmission routes (A); use of specific questions about COVID-19 symptoms during anamnesis (B); use of 70% alcohol gel, liquid hand soap, and visual alerts as precautions for receiving patients (C); placement of mechanical barriers (D); adequacy performed in office waiting room considering the alternatives: none, magazines and handling artifacts removed, schedule distant times between patients and office cleanliness at each patient change (E); presence of assistants in dental teams and guidelines for them (F); use of gloves to remove and wash instruments after patient assistance (G); and, use of 70% alcohol solution as a first chemical agent to disinfect surfaces (H).

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Figure 3 (A-H)
Dental professionals' conduct related to patients with suspect or positively tested for COVID-19, considering elective (A; p>0.05) and urgent (B; p=0.05) appointments. Antisepsis was not performed equally all over Brazil (C; p<0.05). Clinical adaptations as use of turbine without water spray or in low speed, hand instruments, rubber dam, and others were not associated to Brazilian regions (D; p>0.05). The temperature screening (E), specific anamnesis to track history of possible COVID-19 symptoms (F), guidelines for patients (G), and choice divergences for patient care before appointments (H) were associated to different Brazilian regions (p<0.05).

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Figure 4 (A-F)
The kind of mask used in appointments by dental professionals was not associated to Brazilian region (A; p>0.05). Reuse times of N95 (B). Factors that can damage the N95 sealing (C), and the moment which professionals remove their masks (D) were similar among Brazilian regions (p>0.05). The no utilization of face shield was associated to North region (E; p<0.05). The sequence applied to remove all PPEs were similar among Brazilian regions (F; p>0.05).

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Figure 5 (A-F)
There was an association between the groups of dental specialties and oral antisepsis performed (A; p<0.05). Clinical adaptations to avoid spread aerosols (B) and the kind of mask used in appointments (C) were associated to groups of dental specialties (p<0.05). Reuse times of N95 was not associated to groups (D; p>0.05). The moment of removing the mask was most improperly associated to group 1 (E; p<0.05). Knowledge and action of shave and makeup on the N95 sealing were more associated to group 3 (F; p<0.05).

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Table 1
Demographic data of the participants.

Variables	Participants N (%)
Sex	Male	Female	Rather not Answer
	127 (30.75)	285 (69.01)	1 (0.24)
Age (in Years)	18-25 years	26-35 years	36-45 years	46-55 years	56-75 years
	64 (15.50)	166 (40.19)	108 (26.15)	42 (10.17)	33 (7.99)
Groups of Dental Specialty	Group 1	Group 2	Group 3	Group 4	Group 5
	202 (48.91)	110 (26.63)	8 (1.93)	70 (16.95)	23 (5.57)
Brazilian Regional Division	Southeast	Northeast	South	Midwest	North
	219 (53.03)	97 (23.49)	9 (2.18)	21 (5.08)	67 (16.22)
Work Condition	Individual Private Practice	Private Clinic	Private Practice with Multiple Users	Public Settings
	134 (32.45)	130 (31.48)	53 (12.83)	96 (23.24)
Years in Practice	0-5 Years	6-10 Years	11-20 Years	21-30 Years	31-45 Years
	165 (39.95)	63 (15.25)	100 (24.22)	48 (11.63)	37 (0.06)
Specialty Group by Brazilian's Region	Group 1	Group 2	Group 3	Group 4	Group 5
Southeast	105 (47.95)	67 (30.59)	3 (1.37)	35 (15.98)	9 (4.11)
Northeast	48 (49.48)	20 (20.62)	1 (1.03)	17 (17.53)	11 (11.34)
South	2 (22.22)	2 (22.22)	1 (11.11)	3 (33.33)	1 (11.11)
MidWest	5 (23.81)	9 (42.86)	3 (14.29)	3 (14.29)	1 (4.76)
North	42 (62.69)	12 (17.91)	0 (0.00)	12 (17.91)	1 (1.49)

[1] Correspondence: Ana Carolina Morais Apolônio, Universidade Federal de Juiz de Fora, Department of Parasitology, Microbiology, and Immunology, Institute of Biological Sciences, Juiz de Fora, MG, Brazil. 36036-900, E-mail: carolina.apolonio@ufjf.edu.br

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Biosafety in Dental Practices Versus COVID-19 Outbreak

ABSTRACT

Objective:

Material and Methods:

Results:

Conclusion: