Journal
FRONTIERS IN MEDICINE
Volume 8, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fmed.2021.644515
Keywords
infection control; workplace safety and health; hierarchy of risk control; airborne transmission of pathogens; dental procedure; systems thinking; dentistry; practice management dental
Categories
Funding
- NIH/National Institute on Minority and Health Disparities [R01 MD011526]
- Patient-Centered Outcomes Research Institute [R-1609-36824]
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Dental teams and workplaces are highly exposed to infectious agents, requiring them to adapt to pandemic-related changes in dental care organization. A comparative analysis of guidance issued by key U.S. agencies revealed five main areas of pandemic control in dentistry, highlighting the importance of comprehensive decision-making and integration of clinical responses with infection control protocols in dental settings.
Dental teams and their workplaces are among the most exposed to airborne and bloodborne infectious agents, and therefore at the forefront of pandemic-related changes to how dental care is organized and provided to patients. The increasing complexity of guidelines makes is challenging for clinicians to navigate the multitude of COVID-19 guidelines issued by different agencies. A comparative analysis of guidance issued for managing COVID-19 in dental settings leading U.S. agencies was conducted, including documents of the Occupational Safety and Health Administration (OSHA), an agency of the U.S. Secretary of Labor, and of the U.S. Centers for Disease Prevention and Control (CDC), an agency of the U.S. Secretary of Health and Human Services. Details of infection control and other risk mitigation measures were reviewed for consistency, overlaps and similarities, then clustered according to thematic areas covering all domains of managing a dental healthcare setting. The analysis revealed five distinct areas of pandemic control, comprising (1) planning and protocols, (2) patient screening, (3) preparation of facilities, (4) PPE and infection control, and (5) procedures and aerosol control; thereby covering systematically all aspects requiring adaptation in a pandemic context. The Pandemic-5 Framework for COVID-19 Control in Dentistry provides an opportunity to simplify comprehensive decision-making from a clinical practitioner perspective. The framework supports a comprehensive systems-driven approach by using dental clinics as a setting to integrate pandemic clinical responses with the implementation of appropriate infection control protocols. Traditionally these two aspects are addressed independently from each other in separate concepts.
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