References

All Wales Clinical Dental Leads COVID-19 Group. Standard operating procedure for the dental management of non-COVID-19 patients in Wales. 2020. https://tinyurl.com/yfxnuyj3 (accessed September 2021)
Joint statement on the provision of a dental prophylaxis under COVID-19 alert status. Br Dent J. 2020; 229 https://doi.org/10.1038/s41415-020-1858-2
BDA. Coronavirus weekly updates. 2020. https://bda.org/advice/Coronavirus/Pages/Updates-from-week-commencing-16-March-2020.aspx (accessed September 2021)
NHS England. NHS dental services in Luton. A report to the Luton Health Scrutiny Committee. 2016. https://tinyurl.com/6jh7kdj (accessed September 2021)
Delgado-Angulo EK, Mangal M, Bernabé E. Socioeconomic inequalities in adult oral health across different ethnic groups in England. Health Qual Life Outcomes. 2019; 17 https://doi.org/10.1186/s12955-019-1156-3
Faculty of Dental Surgery. A resumption of dental services? Dental Surgeons' experiences of delivering care since 8 June 2020. 2020. https://tinyurl.com/ybay84r8/ (accessed September 2021)

Letters to the editor

From Volume 48, Issue 9, October 2021 | Pages 796-798

Authors

Arkadiusz Dziedzic

Medical University of Silesia

Articles by Arkadiusz Dziedzic

Nigel Robb

Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow G2 3JZ

Articles by Nigel Robb

Jane Hall

Associate Dentist, Yorkshire

Articles by Jane Hall

Rabia Raza

OMFS DCT1, Bedfordshire Hospitals NHSFT

Articles by Rabia Raza

Farhat Sawhney

OMFS DCT1, Ipswich Hospital

Articles by Farhat Sawhney

Alan Parbhoo

OMFS Consultant, Bedfordshire Hospitals NHSFT

Articles by Alan Parbhoo

Article

Routine restorative treatment that was deferred in the vast majority of dental practices due to COVID-19 may inevitably lead to further complications, including dentition deterioration, primarily in the form of substantial loss of tooth structure. While there is a lack of precise recommendations regarding the basic dental intervention (eg smoothing and stoning (S&S)), ambiguous interpretation of the execution of standard operating procedures (SOP) for the dental management of non-COVID-19 patients may disrupt clinical work and escalate the overuse of personal protective equipment (PPE).

Dentists assume that, based on current guidelines, the ultra-short-lasting (a few or several seconds) S&S, using only a slow handpiece with reduced power settings, mandatory high-volume suction and, for example coarse (polishing) disks, does not substantially increase the risk of micro-aerosol or droplet generation within the oral cavity. This is particularly relevant to S&S carried out within the maxillary anterior region on single incisor or canine teeth, or even first premolars owing to the reduced salivary flow within this quadrant. According to Welsh SOP, other essential procedures, such as ‘gentle’ use of a 3-in-1 syringe, despite its use of water, would constitute a lower-risk procedure and no additional fallow time is needed.1 The additional use of dental dam isolation and pre-treatment rinses may further decrease the risk of micro-droplet contamination during S&S.

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