Projects

031 – Dental practice acquired SARS-CoV-2 infections in Victoria, Australia 2020/21

• Chief Investigator A: A/Prof Matthew Hopcraft
• Chief Investigator B: Dr Nicola Wong

Introduction

From the outset of the pandemic, the perception has been that the dental profession is at increased risk of workplace acquired COVID-19, however the evidence does not appear to support this, with very few reported cases of transmission in the dental setting in Australia and internationally.

Aim

• To report on the cases of SARS-CoV-2 infection that occurred in dental practice settings in Victoria, Australia since February 2020
• To describe the circumstances of transmission to improve the understanding of whether the provision of dental care poses a risk to patients or dental practitioners and their staff during periods of uncontrolled community transmission of SARS-CoV-2.

Rationale

With the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in early 2020, guidance from the World Health Organisation suggested that transmission was predominantly droplet based, and therefore airborne precautions were recommended for aerosol-generating procedures. The early dental literature suggested that the dental profession was at increased risk of both onward transmission of virus from patient to patient, and also from patient to dental staff given that most dental procedures generate aerosols. It was thought that droplet and aerosol transmission of SARS-CoV-2 were the most important concerns in the dental environment because it is hard to avoid the generation of large amounts of aerosol and droplet mixed with patient’s saliva, as well as the potentially infected patient’s cough and breathing.

As a result, routine dental care was suspended in many countries around the world through concerns of virus transmission via aerosols generated during dental procedures, with a subsequent significant impact on the provision of dental services and ultimately oral health. However, there are very few reports in the international literature of cases of COVID-19 transmission in the dental practice setting. The Victorian Department of Health has reported on the number of health care acquired SARS-CoV-2 infections since 2020.

Methodology 

Dental practitioners practising in Victoria will be invited to participate in semi-structured interviews to determine information relevant to exposure scenario for that participant. Additional questions may flow from the responses to the questions asked, noting that each case is likely to have unique aspects to it. The intention of the questions is to determine the likely risks associated with the provision of dental treatment, and where gaps in risk mitigation may have contributed to infection.

The project also draws on a dataset collated on health care worker infections by the Victorian Department of Health. The overall analysis will be a narrative review of the cases (somewhat like a cases series report from an epidemiological perspective). It will also enable the calculation of a crude prevalence of dental practice acquired infection compared
to the general community.

What are the expected outcomes?

It is anticipated this project will provide a better understanding the risk of SARS-CoV-2 transmission in the dental setting to better inform public policy decisions that impact
on oral health.