Coronavirus disease (COVID-19) transmission through aerosols in restorative and endodontic practice: Strategies for prevention

Rapid spread of coronavirus disease 2019 (COVID-19) in several countries of the world has created a state of public health emergency. COVID-19 is principally a respiratory disease, and the virus is present in respiratory secretions. Oral health-care professionals are susceptible to being infected with the disease since they work in close proximity to patient's face and oral cavity for long period of time. Restorative dentists and endodontists play a significant role in delivering "urgent" or "emergency" dental care to patients. Occupational Safety and Health Administration has categorized dentists performing aerosol-generating treatment procedures at "very high exposure risk" whereas the dentists not performing aerosol-generating procedures at "high exposure risk." Most of the restorative and endodontic treatment procedures involve generation of aerosols. Owing to the possibility of transmission of virus through aerosols, these procedures may transmit the disease to clinician or other patients. A comprehensive search of literature was conducted with the help of PubMed/MEDLINE and Scopus databases using a combination of terms, "COVID-19," "severe acute respiratory syndrome coronavirus 2," "aerosols," "restorative dentistry," and "endodontics." Along with universal precautions, some additional precautions need to be taken to prevent such transmission and cross-infection. This article reviews the research evidence about the role of aerosols in the transmission of COVID-19 and various measures which should be implemented during restorative and endodontic practice for the prevention of such transmission.