COVID-19 Healthcare Worker Infections in Dental Settings
Since the start of the pandemic to 14 September 2020, there has been 32 documented cases of staff working in dental settings contracting COVID-19, according to data provided by the Department of Health and Human Services.
This includes nine dentists, four allied dental (hygienists and oral health therapists), 17 dental assistants and two administrative staff. Eight of the cases were determined to be acquired in the workplace, 16 were acquired outside the workplace and eight had an unknown source.
Of the eight cases that were determined to be acquired in the workplace:
- Two were dentists through contact with a positive dental patient
- One was through contact with a positive patient but at a non-dental healthcare setting
- Five were through contact with another staff member who was working in the dental setting while infectious.
The majority of cases occurred in July (15) and August (eight), with four cases in March and one case in April. The two cases that resulted from treating a positive patient occurred in March and July. In both cases, the dentist contracted COVID-19 but the dental assistant did not.
What can we learn from this?
This data tells us that the risk of contracting COVID-19 in the dental setting is real, with two confirmed cases linked to treating positive patients. The first occurred in March at a time when national dental restrictions were just being implemented. The second case occurred in July when case numbers in Victoria were around 200–300 per day, and the ADAVB had advised dentists in metropolitan Melbourne and the Mitchell Shire to move to Level 2 dental restrictions. It is not yet known whether these cases involved aerosol-generating procedures, and whether other preventive measures such as rubber dam, pre-procedural mouth rinse and N95 masks were being used.
Given that there have been two cases of patient to dentist transmission and five cases that were acquired through contact with a staff member who was working while infectious, this highlights the importance of:
- Continuing to screen patients for symptoms prior to appointments and other precautionary measures, such as pre-procedural mouth rinse and rubber dam use
- Ensuring that staff declare that they do not have symptoms before attending work as per government guidelines, do not attend the workplace if they have any symptoms (no matter how mild), and ensuring that they are tested and shown to have a negative result and be symptom free prior to returning to work
- Ensuring that other measures are used in the workplace setting to minimise the risk of transmission, including the use of masks at all times, distancing in shared spaces (such as the waiting room, reception area and tea room), appropriate hand hygiene, minimising use of shared items (telephones, computers, EFTPOS machine) and appropriate environmental cleaning.