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Review
Published: 16-12-2021

Major considerations of dental care in COVID-19: an evidence-based on clinical studies and guidelines

University Center North Paulista (Unorp) - Sao Jose do Rio Preto, Sao Paulo, Brazil / Post graduate and continuing education (Unipos), Sao Jose do Rio Preto, Sao Paulo, Brazil
University Center North Paulista (Unorp) - Sao Jose do Rio Preto, Sao Paulo, Brazil / Post graduate and continuing education (Unipos), Sao Jose do Rio Preto, Sao Paulo, Brazil
University Center North Paulista (Unorp) - Sao Jose do Rio Preto, Sao Paulo, Brazil / Post graduate and continuing education (Unipos), Sao Jose do Rio Preto, Sao Paulo, Brazil
Dentistry Dental care Mouthwashes Prophylaxis Pandemic COVID-19 Guidelines

Abstract

Introduction: The COVID-19 pandemic has presented enormous challenges for dentists and patients. The risk of nosocomial transmission is a reality that requires the development of guidelines by the dental community to reduce the chances of infection by the new coronavirus. In this sense, it was necessary to implement alternative prophylactic techniques such as the adoption of oral rinses before dental care. Objective: To present the main considerations of clinical studies on dental care at COVID-19. Methods: The research was carried out from May 2021 to June 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: One study showed that 0.2% chlorhexidine and 1% povidone-iodine oral solutions are effective pre-procedural mouthwashes against salivary SARS-CoV-2 in dental treatments. It was observed in another study that the effect of reducing the salivary load with mouthwash with CPC and PI was maintained after 6 hours. PVP-I nasal and oral antiseptic solutions are effective in inactivating SARS-CoV-2 at a range of concentrations after exposure times of 60 seconds. There is sufficient in vitro evidence to support the use of antiseptics to potentially reduce the viral load of SARS-CoV-2. The effects against the new coronavirus in vivo still need more randomized clinical trials to prove its effectiveness. Conclusion: ACE2 receptors are highly expressed in the oral cavity, therefore, this could be a potential high-risk route for SARS-CoV-2 infection. The virus can be detected in saliva even before the appearance of symptoms of COVID-19. In this regard, randomized clinical studies have shown that some pre-procedure oral mouthwashes are effective against salivary SARS-CoV-2 in dental treatments. In addition, the American Academy of Implant Dentistry (AAID) reported on how COVID-19 impacts dental care through guidelines for general dentistry.

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References

  1. Beetstra S. Special care dentistry in the world of COVID-19. Spec Care Dentist. 2020 May;40(3):215. doi: 10.1111/scd.12467. PMID: 32463961; PMCID: PMC7283785.
  2. Kadkhodazadeh M, Amid R, Moscowchi A. Does COVID-19 Affect Periodontal and Peri-Implant Diseases? J Long Term Eff Med Implants. 2020;30(1):1-2. doi: 10.1615/JLongTermEffMedImplants.2020034882. PMID: 33389910.
  3. Becker K, Brunello G, Gurzawska-Comis K, Becker J, Sivolella S, Schwarz F, Klinge B. Dental care during COVID-19 pandemic: Survey of experts' opinion. Clin Oral Implants Res. 2020 Dec;31(12):1253-1260. doi: 10.1111/clr.13676. Epub 2020 Oct 30. PMID: 33047356; PMCID: PMC7675432.
  4. Dziedzic A. Special Care Dentistry and COVID-19 Outbreak: What Lesson Should We Learn? Dent J (Basel). 2020 May 9;8(2):46. doi: 10.3390/dj8020046. PMID: 32397499; PMCID: PMC7344557.
  5. Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. J Dent Res. 2020 May;99(5):481-487. doi: 10.1177/0022034520914246. Epub 2020 Mar 12. PMID: 32162995; PMCID: PMC7140973.
  6. Elzein R, Abdel-Sater F, Fakhreddine S, Hanna PA, Feghali R, Hamad H, Ayoub F. In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial.
  7. Seneviratne CJ, Balan P, Ko KKK, Udawatte NS, Lai D, Ng DHL, Venkatachalam I, Lim KS, Ling ML, Oon L, Goh BT, Sim XYJ. Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore. Infection. 2021 Apr;49(2):305-311. doi: 10.1007/s15010-020-01563-9. Epub 2020 Dec 14. PMID: 33315181; PMCID: PMC7734110.
  8. Gudi S.K., Tiwari K.K. Preparedness and Lessons Learned from the Novel Coronavirus Disease. Int. J. Occup. Environ. Med. 2020;11:108–112. doi: 10.34172/ijoem.2020.1977.
  9. Yang Y., Zhou Y., Liu X., Tan J. Health services provision of 48 public tertiary dental hospitals during the COVID-19 epidemic in China. Clin. Oral. Investig. 2020;24:1861–1864. doi: 10.1007/s00784-020-03267-8.
  10. Dave M., Seoudi N., Coulthard P. Urgent dental care for patients during the COVID-19 pandemic. Lancet. 2020;395:1257. doi: 10.1016/S0140-6736(20)30806-0.
  11. Coulthard P. Dentistry and coronavirus (COVID-19)—Moral decision-making. Br. Dent. J. 2020;228:503–505. doi: 10.1038/s41415-020-1482-1.
  12. Hare J., Bruj-Milasan G., Newton T. An Overview of Dental Anxiety and the Non-Pharmacological Management of Dental Anxiety. Prim. Dent. J. 2019;7:36–39.
  13. Anthonappa R.P., Ashley P.F., Bonetti D.L., Lombardo G., Riley P. Non-pharmacological interventions for managing dental anxiety in children. Cochrane Database Syst. Rev. 2017;6:CD012676. doi: 10.1002/14651858.CD012676.
  14. Karnad M.P. Dental anxiety-How would you manage it? SAAD Dig. 2015;31:26–31.
  15. Peltier B. Psychological treatment of fearful and phobic special needs patients. Spec. Care Dent. 2009;29:51–57. doi: 10.1111/j.1754-4505.2008.00062.x.
  16. Guo Y., Yuan C., Wei C. Emergency measures for acute oral mucosa diseases during the outbreak of COVID-19. Oral Dis. 2020 doi: 10.1111/odi.13350. in press.
  17. Li Y.C., Bai W.Z., Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J. Med. Virol. 2020;92:552–555. doi: 10.1002/jmv.25728.
  18. Madjid M., Safavi-Naeini P., Solomon S.D., Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiol. 2020 doi: 10.1001/jamacardio.2020.1286.
  19. Chu K.H., Tsang W.K., Tang C.S., Lam M.F., Lai F.M., To K.F., Fung K.S., Tang H.L., Yan W.W., Chan H.W., et al. Acute renal impairment in coronavirus-associated severe acute respiratory syndrome. Kidney Int. 2005;67:698–705. doi: 10.1111/j.1523-1755.2005.67130.x.
  20. Wu Y., Xu X., Chen Z., Duan J., Hashimoto K., Yang L., Liu C., Yang C. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav. Immun. 2020:S0889-1591(20)30357-3. doi: 10.1016/j.bbi.2020.03.031.
  21. Dziedzic A., Wojtyczka R. The impact of coronavirus infectious disease 19 (COVID-19) on oral health. Oral Dis. 2020:1–4. doi: 10.1111/odi.13359.
  22. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n71
  23. H Balshem H, Grade guidelines: 3 ratng the quality of evidence. Journal of Clinical Epidemiology, Maryland Heights, 64 (4) (2011) 401-406.
  24. Higgins, S Green, Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration; 2011.
  25. Brunello G, Gurzawska-Comis K, Becker K, Becker J, Sivolella S, Schwarz F, Klinge B. Dental care during COVID-19 pandemic: follow-up survey of experts' opinion. Clin Oral Implants Res. 2021 Jun 30. doi: 10.1111/clr.13783. Epub ahead of print. PMID: 34196051.
  26. Baghizadeh Fini M. Oral saliva and COVID-19. Oral Oncol. 2020 Sep;108:104821. doi: 10.1016/j.oraloncology.2020.104821. Epub 2020 May 27. PMID: 32474389; PMCID: PMC7250788.
  27. Pelletier JS, Tessema B, Frank S, Westover JB, Brown SM, Capriotti JA. Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). Ear Nose Throat J. 2021 Apr;100(2_suppl):192S-196S. doi: 10.1177/0145561320957237. Epub 2020 Sep 21. Erratum in: Ear Nose Throat J. 2020 Dec 8;:145561320977784. PMID: 32951446.
  28. Mateos-Moreno MV, Mira A, Ausina-Márquez V, Ferrer MD. Oral antiseptics against coronavirus: in-vitro and clinical evidence. J Hosp Infect. 2021 Jul;113:30-43. doi: 10.1016/j.jhin.2021.04.004. Epub 2021 Apr 15. PMID: 33865974; PMCID: PMC8046704.
  29. Rutkowski JL, Camm DP, El Chaar E. AAID White Paper: Management of the Dental Implant Patient During the COVID-19 Pandemic and Beyond. J Oral Implantol. 2020 Oct 1;46(5):454-466. doi: 10.1563/aaid-joi-D-20-00316. PMID: 32882035.

How to Cite

Zorzi, M. L., Lopes, L. S., & Kassis, E. N. (2021). Major considerations of dental care in COVID-19: an evidence-based on clinical studies and guidelines. MedNEXT Journal of Medical and Health Sciences, 2(5). https://doi.org/10.54448/mdnt21511