Mateos Moreno María Victoria, Lenguas Silva Ana Leticia, Pastor Ramos Victoria, García Ávila Irene, García Vázquez María Trinidad, García Vicent Germán, Lamas Oliveira Marta, Rodríguez Alonso Elías, Tapias Perero Víctor Francisco, Terán de Agustín Ana Isabel, Valdepeñas Morales Javier, Vivas Mefle Carlos Alberto
Centro de Salud Argüelles. Dirección Asistencial Noroeste. Comunidad de Madrid. España.
Centro de Salud La Marazuela. Dirección Asistencial Noroeste. Comunidad de Madrid. España.
Rev Esp Salud Publica. 2020 Nov 12;94:e202011148.
The COVID-19 respiratory manifestations go from mild symptoms similar to those of a common cold to severe pneumonia with respiratory distress syndrome, septic shock and multiorgan failure. The disease is caused by the SARS-CoV-2 virus, whose transmission mechanism most relevant to dentistry is through respiratory droplets and possibly also aerosols, as well as direct contact with mucous membranes of the nose, mouth or eye via contaminated hands or objects. The professionals of the dental health units have a high risk exposure since they work at short distances (less than 1 m from the head of the patient) in the oral cavity, where a maximal expression of possible cell receptors for the virus has been reported. Also, most procedures in the dental cabinet imply aerosol generation. Cross-infection is possible during dental care, not only with diagnosed COVID-19-positive patients but also with patients who remain undetected due to asymptomatic or presymptomatic disease. For all these reasons, dental care in the primary health setting has had to change in order to adapt to the pandemic. The changes affect both the appointment scheduling and the care itself and imply the establishment of general and specific barrier protections as well as measures related to ventilation, cleaning, disinfection and sterilization, reinforced with additional infection prevention and control measures. This article summarizes the available scientific evidence about this adaptation.
新冠病毒病的呼吸道表现从类似普通感冒的轻微症状到伴有呼吸窘迫综合征、感染性休克和多器官功能衰竭的重症肺炎不等。该疾病由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒引起,其与牙科最相关的传播机制是通过呼吸道飞沫,也可能通过气溶胶传播,以及通过受污染的手或物体直接接触鼻、口或眼的黏膜。牙科保健机构的专业人员面临高风险暴露,因为他们在口腔内近距离(距患者头部不到1米)工作,据报道口腔内存在该病毒可能的细胞受体的最大表达。此外,牙科治疗台的大多数操作都会产生气溶胶。在牙科护理过程中可能发生交叉感染,不仅会感染确诊的新冠病毒病阳性患者,还会感染因无症状或症状前疾病而未被发现的患者。出于所有这些原因,基层医疗环境中的牙科护理不得不做出改变以适应疫情。这些改变既影响预约安排,也影响护理本身,意味着要建立一般和特定的屏障保护措施以及与通风、清洁、消毒和灭菌相关的措施,并辅以额外的感染预防和控制措施。本文总结了有关这种适应措施的现有科学证据。