The rapid and sudden outbreak of the COVID-19 pandemic brought us to reconsider many of the solid certainties that we have been accustomed as health care practitioners. The nature of our profession allows us to deal with the unknown on a regular basis. It is nonetheless a unique feature, and most probably never existed before, the swift change of paradigms that we are witnessing daily during these unforgettable months.
Our group tried from the very first moment to deal with possible suggestions for clinical practice during these dire times. Our results have ultimately produced a sort of checklist that we believe it is our duty to share with colleagues worldwide. However, some caveats are important, and the following precautions need to be adopted:
Our profession is risky due to the intimate closeness with unmasked patients. Thus, any professional must accept that there is a risk that cannot be nullified.
In this book we do not describe guidelines nor recommendations, but a sum of suggestions deriving from the available knowledge and the clinical experience of the authors. Current evidence is still lacking proper randomized clinical trials.
Please follow your government and ministry of health recommendations. These suggestions should not in anyway interfere with the former.
The suggestions may change swiftly as this is the nature of the ongoing clinical knowledge.
Normally, in reading such comments we would be tempted to dismiss the book or, worse, being hit by an attack of grey pessimism. However, we must remind the reader that in no time in history the world has been better prepared to face a global challenge like this one. These are complex and difficult days, but soon humanity will prove its value as treatments and vaccines will arrive at unknown speed for the contemporary, now former, medical science. We are facing history and we have no doubt that the medical and the dental community are ready for that.
Filippo Graziani
Rossana Izzetti
Lisa Lardani
Maria Lucrezia Biancarini
Mario Gabriele
TABLE OF CONTENTS
AUTHORS LIST
Preamble
Table of Contents
The Checklist and the procedures
Coronaviruses and SARS-CoV-2
Coronaviruses
SARS-COV-2
Transmission routes
Epidemiology
Clinical features
Airborne generated procedures: professional risk in Dentistry
Bioaerosols and types of transmission
Background
Considerations on dental practice
Suggestions
Conclusions
Aerosol generating procedures
Background
Suggestions
Conclusions
Professional hazard by SARS-CoV-2
Background
Suggestions
Conclusions
PHASE I: Pre-triage
Patient triage
Patient risk profile
Background
Objectives
Suggestions
Conclusions
ACTION 1: PHONE TRIAGE
Background
Objectives
Suggestions
Conclusions
ACTION 2: AGENDA SET-UP
Background
Objectives
Suggestions
Conclusions
ACTION 3: SELF-CERTIFICATION
Background
Objectives
Suggestions
Conclusions
PHASE II: Upon patient arrival
Background
Suggestions
ACTION 4: PRACTICE SETUP
Reception
Reception desk set-up
Waiting room set-up
ACTION 5: PATIENTARRIVAL AT THE PRACTICE
Patient reception
In-office triage
Accompanying person
ACTION 6: PREPARATION OF THE CLINICAL AREA
ACTION 7: CLINICAL STAFF PROTECTION
Wearing gloves
Wearing gown
Wearing cap
Wearing mask
Wearing goggles and face shield
Conclusion
PHASE III: Treatment
Background
ACTION 8: PATIENT PREPARATION
ACTION 9: TREATMENT MANAGEMENT
Conclusion
PHASE IV: Post-treatment management
ACTION 10: PATIENT EXITING
Background
Suggestions
Conclusion
ACTION 11: CLINICAL AREA SANITIZATION
Instruments and materials management
Background
Suggestions
Conclusion
Ventilation
Background
Suggestions
Conclusions
Surfaces disinfection
Background
Suggestions
Conclusions
ACTION 12: PPE REMOVAL
Background
Suggestions
Conclusions
Useful links
