EpiUnit, Faculty of Dental Medicine, Institute of Public Health, University of Porto, Porto, Portugal.
Faculty of Dental Medicine, University of Porto, Porto, Portugal.
Int Dent J. 2021 Jun;71(3):263-270. doi: 10.1016/j.identj.2021.01.007. Epub 2021 Jan 18.
Facing the coronavirus disease 2019 (COVID-19) challenge on a global level, dental care professionals are encouraged to optimize universal precautions and adopt measures that ensure protection against infection by contaminated aerosols and droplets. Although aerosol transmission is possible, direct contact through large droplets is probably responsible for the vast majority of transmissions.
This paper is the second of a series of 3 on the management of COVID-19 in clinical dental care settings and aims to describe the selection and use of personal protection equipment (PPE) by dental care professionals (DCP), with consideration of the level of risk associated with the planned procedures. PPE selection depends directly on the local epidemiological setting, the patient's characteristics, and the level of risk of the planned procedures. The procedures performed in the office environment are classified as low-, moderate-, or high-risk. Moderate risk includes 2 further sublevels associated with the cleaning, disinfection, and sterilization of materials for clinical procedures that do not generate aerosols. The training of DCP on how to properly don (put on) and doff (remove) PPE is as important as choosing the appropriate PPE because it can be associated with a risk of infection.
When there is limited availability of PPE, measures should be adjusted to the risk associated with the intervention. Assuming that an effective COVID-19 vaccine will be developed, once it becomes widely available for DCP, PPE requirements will likely be different.
The proper use of PPE, together with the adoption of other operational procedures, can provide effective protection against microorganisms being transmitted via body fluids or in the air.
面对全球层面的 2019 年冠状病毒病（COVID-19）挑战，鼓励牙科保健专业人员优化通用预防措施，并采取措施确保防止受污染的气溶胶和飞沫感染。尽管气溶胶传播是可能的，但通过大飞沫的直接接触可能是绝大多数传播的原因。
本文是关于临床牙科保健环境中 COVID-19 管理的 3 篇系列文章中的第 2 篇，旨在描述牙科保健专业人员（DCP）选择和使用个人防护设备（PPE），并考虑与计划程序相关的风险水平。PPE 的选择直接取决于当地的流行病学环境、患者的特征以及计划程序的风险水平。在办公室环境中进行的程序被分类为低、中或高风险。中度风险包括与不产生气溶胶的临床程序的材料的清洁、消毒和灭菌相关的另外 2 个亚级别。DCP 关于如何正确穿戴和脱下 PPE 的培训与选择适当的 PPE 一样重要，因为它可能与感染风险有关。
当 PPE 供应有限时，应根据干预措施相关的风险进行调整。假设将开发出有效的 COVID-19 疫苗，一旦它广泛用于 DCP，PPE 的要求可能会有所不同。
正确使用 PPE 以及采用其他操作程序，可以为防止通过体液或空气传播的微生物提供有效保护。
