Gurzawska-Comis Katarzyna, Becker Kathrin, Brunello Giulia, Gurzawska Agata, Schwarz Frank
Department of Oral Surgery, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham B5 7EG, UK.
Department of Orthodontics, Universitätsklinikum Düsseldorf, Moorenstr. 5, Building 18.21, 40225 Düsseldorf, Germany.
J Clin Med. 2020 Jun 12;9(6):1833. doi: 10.3390/jcm9061833.
Dental clinics were suspected to be a hotspot for nosocomial transmission of coronavirus disease 19 (COVID-19), yet there has been no clear recommendation about emergency dental care and appropriate personal protective equipment during pandemics. In this paper, we aim to summarize recommendations for (i) patient risk assessment, (ii) patient triage, and (iii) measures to prevent infection of health professionals and nosocomial transmission in dental clinics. The available evidence was collected by performing searches on PubMed, Embase, and Cochrane databases. We reviewed papers on COVID-19, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, and related respiratory viral diseases. Legal and ethical frameworks, as well as international (e.g., World Health Organization (WHO)) and national (e.g., public health institutes, dental associations) guidelines were screened to summarize recommendations related to dental emergency care. To assess the patient risk, a questionnaire was developed to classify patients at unknown, high, and very high risk. Patient triage recommendations were summarized in a flow chart that graded the emergency level of treatments (i.e., urgent, as soon as possible, and postpone). Measures to prevent disease transmission based on current evidence were grouped for dental health professionals, dental clinics, and patients. The present recommendations may support health professionals implement preventative measures during the pandemic.
牙科诊所被怀疑是新型冠状病毒肺炎(COVID-19)医院感染传播的热点,但对于大流行期间的急诊牙科护理和适当的个人防护设备,尚无明确的建议。在本文中,我们旨在总结关于(i)患者风险评估、(ii)患者分诊以及(iii)牙科诊所预防医护人员感染和医院感染传播措施的建议。通过在PubMed、Embase和Cochrane数据库中进行检索来收集现有证据。我们回顾了关于COVID-19、严重急性呼吸综合征(SARS)、中东呼吸综合征(MERS)、流感及相关呼吸道病毒疾病的论文。筛选法律和伦理框架以及国际(如世界卫生组织(WHO))和国家(如公共卫生机构、牙科协会)指南,以总结与牙科急诊护理相关的建议。为评估患者风险,编制了一份问卷,将患者分为未知风险、高风险和极高风险类别。患者分诊建议总结在一个流程图中,该流程图对治疗的紧急程度进行分级(即紧急、尽快和推迟)。根据现有证据,针对牙科医护人员、牙科诊所和患者,对预防疾病传播的措施进行了分类。本建议可能有助于医护人员在大流行期间实施预防措施。