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COVID-19 prevalence and test positivity rates among U.S. dentists were low
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Highlights In a web-based survey of American dentists practicing SARS-CoV-2 and infection control practices, the weighted prevalence of COVID-19 was 0.9%. Among dentists, symptoms depression (8.6%) and anxiety (19.5%) were significantly lower than in the same month in the general US population. Improved infection prevention and control efforts were reported in 99.7% of cases and included surface disinfection, COVID-19 detection, social distancing, and the use of facials. Only 12% of respondents used mouthwashes on patients before the procedure, and 99.6% of dentists reported using PPE to treat patients. This is the first large-scale report on COVID-19 data monitoring indicators and concurrent infection prevention and control practices among American dentists. The limited amount of PPE (especially N95 respirators) encouraged dentists to follow the CDC’s interim guidelines for wearing the highest level surgical mask with full face protection during aerosol-generating dental procedures. The authors conclude that COVID-19 prevalence and test positivity rates were low among practicing American dentists, noting that current infection control recommendations may be sufficient to prevent dental infection. As the number of patients in dental practice continues to grow across the country, the authors advocate efforts to address the shortage of PPE supplies before COVID-19 cases reappear. |
Summary
Background
To improve patient and patient safety, it is important to understand the risks associated with the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during oral health care and to evaluate strategies to reduce dental practices. access to oral health care.
Methods
The authors invited licensed U.S. dentists, who are primarily engaged in private practice or public health, to participate in an online survey in June 2020.
Dentists in each US state (N = 2195) answered questions about COVID-19 (associated symptoms, SARS-CoV) 2 infections, physical and mental health conditions, and the infection control procedures used in their dental practice. primary.
Results
The majority of dentists (82.2%) were asymptomatic 1 month before the survey; 16.6% reported having been tested for SARS-CoV-2; and 3.7%, 2.7%, and 0% were positive using respiratory and salivary blood samples, respectively.
Among the underestimated, 0.3% of physicians received a possible diagnosis of COVID-19. A total of 20 of 2195 respondents were infected with SARS-CoV-2; Weighted by age and location to approximate all US dentists, 0.9% (95% confidence interval 0.5-1.5) was COVID-19 confirmed or possible.
Dentists reported symptoms of depression (8.6%) and anxiety (19.5%).
Improved infection control procedures were implemented in 99.7% of primary dental visits, most commonly during disinfection, COVID-19 detection, social distancing, and face mask use.
The majority of dentists (72.8%) wore personal protective equipment according to the interim guidelines of the Centers for Disease Prevention and Control (CDC).
Conclusions
The prevalence of COVID-19 and test positivity rates among practicing American dentists were low. This indicates that current infection control recommendations may be sufficient to prevent infections in dental settings.
Practical implications
Dentists have improved infection control practices in response to COVID-19 and can benefit from increased availability of personal protective equipment.
Discussion
Our study is the first we know to evaluate SARS-CoV-2 infections in the U.S. dental community and to evaluate the prevention of dental infections and the efforts of dentists to control them. In addition, this description of the dental practice of American dentists and the simultaneous use of PPE may be useful to understand the future dental response to the pandemic and to evaluate the results of further monitoring of COVID-19 prevalence. .
We assess the level of SARS-CoV-2 infection in American dentists. As of June 2020, approximately 0.9% (95% confidence interval, 0.5-1.5) of U.S. dentists have or have had COVID-19. This is similar to infection rates reported for healthcare workers in the Netherlands (0.9%) and China (1.1%), but lower than in Seattle, Washington (5.3%).
In addition, 3.7% of nasal or throat swabs in our sample were positive, which is less than 10.3% positivity in respiratory specimens from the general U.S. population from March 1 to March 13, 2020. June 2020.
This could reflect the higher socio-economic status of many dentists and their future ability to take advantage of social distancing and reduce viral exposure.
Responses to our survey indicated that 99.7% the dental practice used advanced infection protection and control practices, and many of them had also adopted advanced PPE. Dental reports of mask reuse or combined use of surgical masks and respirators may reflect current CDC guidelines for PPE optimization due to delivery problems.
As of June 29, 2020, the number of patients in dental practices across the country is estimated to be 70% of pre-COVID-19 levels, and is growing steadily.
The use of disposable products for the control of PPE and infection could increase as the number of patients increases, leading to a shortage of dental offices or a change in practices based on availability. In addition, changes in local and regional regulations and infection rates in the future could also change practices in dental offices, especially as COVID-19 cases are recurring in many countries.
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Conclusions This survey was conducted to initiate surveillance by dental practitioners and licensed public health dentists to determine the prevalence of COVID-19 before 12 June 2020, as well as infection and behavior prevention and control practices. dentists from 8 May to June 2020. February 12, 2020 To the best of our knowledge, this is the first study to assess the prevalence of COVID-19 among American dentists. The weighted prevalence of COVID-19 for this sample of dentists was 0.9%. Among the analyzed breath samples, the positive results were 3.7%. These indicators support that the use of CDC-recommended infection prevention and control procedures in dental practices will help reduce the risk of developing infection during oral health care and the risks associated with non-clinical activities. and spread to the general public could pose the most significant risks to dental exposure to COVID-19. Future studies will evaluate current dental COVID-19 rates in American dentists, and modifiable risk factors for SARS-CoV-2 transmission and the development of COVID-19 disease may be assessed in addition to morbidity. from the disease. |
ClinicalTrials.gov: NCT04423770
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