Faculty of Dental Medicine, EpiUnit, Institute of Public Health, University of Porto, Porto, Portugal.
Instituto de Implantologia, Lisbon, Portugal; Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, USA.
Int Dent J. 2021 Jun;71(3):251-262. doi: 10.1016/j.identj.2021.01.015. Epub 2021 Feb 10.
Coronavirus disease 2019 (COVID-19), a viral disease declared a pandemic by the World Health Organization (WHO) in March 2020, has posed great changes to many sectors of society across the globe. Its virulence and rapid dissemination have forced the adoption of strict public health measures in most countries, which, collaterally, resulted in economic hardship. This article is the first in a series of 3 that aims to contextualise the clinical impact of COVID-19 for the dental profession. It presents the epidemiological conditions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), namely, its modes of transmission, incubation, and transmissibility period, signs and symptoms, immunity, immunological tests, and risk management in dental care. Individuals in dental care settings are exposed to 3 potential sources of contamination with COVID-19: close interpersonal contacts (<1 m), contact with saliva, and aerosol-generating dental procedures. Thus, a risk management model is propsoed for the provision of dental care depending on the epidemiological setting, the patient's characteristics, and the type of procedures performed in the office environment. Although herd immunity seems difficult to achieve, a significant number of people has been infected throughout the first 9 months of the pandemic and vaccination has been implemented, which means that there will be a growing number of presumable "immune" individuals that might not require many precautions that differ from those before COVID-19. In conclusion, dental care professionals may manage their risk by following the proposed model, which considers the recommendations by local and international health authorities, thus providing a safe environment for both professionals and patients.
2019 年冠状病毒病（COVID-19），一种于 2020 年 3 月被世界卫生组织（WHO）宣布为大流行的病毒性疾病，已对全球许多社会领域造成了巨大变化。其毒力和快速传播迫使大多数国家采取严格的公共卫生措施，这在一定程度上导致了经济困难。本文是一系列三篇文章中的第一篇，旨在为牙科专业人员提供 COVID-19 的临床影响背景。它介绍了严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的流行病学情况，即其传播方式、潜伏期和传染性期、体征和症状、免疫、免疫测试以及牙科保健中的风险管理。在牙科保健环境中的个体面临着 3 种与 COVID-19 相关的潜在污染来源：密切的人际接触（<1 米）、接触唾液和产生气溶胶的牙科程序。因此，根据流行病学环境、患者特征和在办公室环境中进行的治疗类型，提出了一种用于提供牙科保健的风险管理模型。尽管群体免疫似乎难以实现，但在大流行的前 9 个月中已经有大量人感染并实施了疫苗接种，这意味着将有越来越多的“免疫”个体可能不需要许多与 COVID-19 之前不同的预防措施。总之，牙科保健专业人员可以通过遵循该模型来管理自己的风险，该模型考虑了当地和国际卫生当局的建议，从而为专业人员和患者提供安全的环境。
