School of Medicine, Dentistry, Nursing, University of Glasgow, Glasgow, UK.
Public Health Scotland, Glasgow, UK.
J Dent Res. 2021 Jun;100(6):583-590. doi: 10.1177/00220345211004849. Epub 2021 Mar 29.
Enhanced community surveillance is a key pillar of the public health response to coronavirus disease 2019 (COVID-19). Asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include preappointment and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centers across Scotland invited asymptomatic-screened patients aged over 5 y to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardized Viral Transport Medium-containing test kits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/email with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-wk period (from August 3, 2020, to October 31, 2020), 4,032 patients, largely representative of the population, were tested. Of these, 22 (0.5%; 95% CI, 0.5%-0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To our knowledge, this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing infection prevention control and PPE vigilance, which is relevant as health care team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.
加强社区监测是应对 2019 年冠状病毒病（COVID-19）的公共卫生措施的一个关键支柱。严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）的无症状携带是一个潜在的重要传播源，但仍知之甚少。牙科服务的中断仍在继续，服务能力显著下降。持续的预防措施包括预约前和/或预约时进行 COVID-19 症状筛查以及使用增强型个人防护设备（PPE）。本研究旨在调查牙科患者中 SARS-CoV-2 的感染情况，为社区监测提供信息，并增进对牙科环境中风险的了解。苏格兰的 31 家牙科护理中心邀请无症状筛查的 5 岁以上患者参加。经过口头同意并完成社会人口统计学和症状史问卷后，经过培训的牙科团队使用含标准病毒运输介质的试剂盒采集联合口咽和鼻腔拭子样本。样品由 Lighthouse Lab 处理，患者通过短信/电子邮件收到结果，如果测试呈阳性，则提供适当的自我隔离指导。所有阳性病例均由国家接触者追踪计划成功追踪。在 13 周的时间里（从 2020 年 8 月 3 日到 2020 年 10 月 31 日），共检测了 4032 名患者，这些患者在很大程度上代表了人群。其中，22 名（0.5%；95%CI，0.5%-0.8%）SARS-CoV-2 检测呈阳性。在此期间，阳性率有所上升，与所有国家检测监测数据流中确定的社区流行率上升相一致。据我们所知，这是在牙科环境中对无症状筛查患者进行 COVID-19 检测调查的第一份报告。该患者组的阳性率反映了当时社区的基本流行率。这些数据特别提醒人们，特别是当社区感染水平上升时，要注意适当的持续感染预防控制和 PPE 警惕，这是相关的，因为随着大流行的继续，医疗保健团队的疲劳感增加。牙科环境是公共卫生监测的一个有价值的场所。
