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Precautions and recommendations for orthodontic settings during the COVID-19 outbreak: A review

  • Khadijah A. Turkistani
    Correspondence
    Address correspondence to: Khadijah A. Turkistani, Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, PO Box 80209, Jeddah 21589, Saudi Arabia.
    Affiliations
    Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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      Highlights

      • Coronavirus disease 2019 is a highly contagious global pandemic.
      • It could transmit by asymptomatic carriers via person-to-person contact, aerosol, and droplets.
      • Strict infection control and aerosol containment are required in orthodontic settings.

      Introduction

      Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). It emerged as a global pandemic in early 2020, affecting more than 200 countries and territories. The infection is highly contagious, with disease transmission reported from asymptomatic carriers, including children. It spreads through person-to-person contact via aerosol and droplets. The practice of social distancing—maintaining a distance of 1-2 m or 6 ft—between people has been recommended widely to slow or halt the spread. In orthodontics, this distance is difficult to maintain, which places orthodontists at a high risk of acquiring and transmitting the infection. The objective of this review is to report to orthodontists on the emergence, epidemiology, risks, and precautions during the disease crisis. This review should help increase awareness, reinforce infection control, and prevent cross-transmission within the orthodontic facility.

      Methods

      A comprehensive literature review of English and non-English articles was performed in March 2020 using COVID-19 Open Research Dataset (CORD-19 2020), PubMed, MEDLINE, Scopus, and Google Scholar to search for infection control and disease transmission in orthodontics.

      Results

      This review emphasizes minimizing aerosol production and reinforcing strict infection control measures. Compliance with the highest level of personal protection and restriction of treatment to emergency cases is recommended during the outbreak. Surface disinfection, adequate ventilation, and decontamination of instruments and supplies following the guidelines are required.

      Conclusions

      Reinforcing strict infection control measures and minimizing personal contact and aerosol production are keys to prevent contamination within orthodontic settings. Although no cases of COVID-19 cross-transmission within a dental facility have been reported, the risk exists, and the disease is still emerging. Further studies are required.
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      Linked Article

      • COVID-19 precautions and recommendations
        American Journal of Orthodontics and Dentofacial OrthopedicsVol. 158Issue 3
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          We read with great interest the recent article by Turkistani (Turkistani KA. Precautions and recommendations for orthodontic settings during the COVID-19 outbreak. Am J Orthod Dentofacial Orthop 2020;158:175-81). Because of challenges imposed by the current coronavirus disease 2019 (COVID-19) pandemic on the world, we are all trying to maintain balance in a clinical and academic environment of unpredictability and uncertainty. We would like to emphasize and discuss the possible approaches for clinical care in the extended period of COVID-19 crisis and beyond:This will be done by the development of low cost intraoral scanner to take a digital impression, development of freely available robust software for 3D treatment planning for aligner therapy, and low cost 3D printers with accuracy to print sequential treatment model for thermoforming to integrate aligner orthodontic therapy not only in university-based teaching institutions but also in small to medium size orthodontic offices.
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          We congratulate Dr Turkistani for the well-elucidated precautions and recommendations for orthodontic settings during the coronavirus disease 2019 pandemic (Turkistani KA. Precautions and recommendations for orthodontic settings during the COVID-19 outbreak: a review. Am J Orthod Dentofacial Orthop 2020;158:175-81). Representing a second layer of defense, prophylactic preprocedural use of oxidative mouth rinse and throat spray formulations have been suggested as an indispensable risk reduction measure for decreasing the number of viable microorganisms in dental aerosols during the current outbreak.
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        American Journal of Orthodontics and Dentofacial OrthopedicsVol. 158Issue 5
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          We read with great interest the recent article by Khadijah A. Turkistani published online in May 2020 (Turkistani KA. Precautions and recommendations for orthodontic settings during the COVID-19 outbreak: a review. Am J Orthod Dentofacial Orthop 2020;158:175-81). The author aimed to help increase awareness and control cross-contamination among orthodontists, assistants, office staff, and patients during the coronavirus disease 2019 crisis.
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