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Managing dental caries against the backdrop of COVID-19: approaches to reduce aerosol generation

Original research article published in the British Dental Journal

The COVID-19 pandemic resulted in severe limitation and closure of dental practices in many countries. While dentistry has begun to be practiced again, there is emerging evidence that SARS-CoV-2 can be transmitted via airborne routes, carrying implications for dental procedures that produce aerosol. At the time this article was published, additional precautions are required when a procedure considered to generate aerosol is undertaken.

This paper aims to present evidence-based treatments that remove or reduce the generation of aerosols during the management of carious lesions. Dental caries (more commonly known as Tooth decay), is damage to a tooth that can happen when bacteria in your mouth make acids that attack the tooth's surface, or enamel. This can lead to a small hole in a tooth, called a cavity.

The researchers map aerosol generating procedures (AGPs) to alternative non-AGPs or low AGPs. This risk reduction approach overcomes the less favorable outcomes associated with temporary solutions or extraction-only approaches. After going through various alternatives including, high-viscosity glass-ionomer sealants, atraumatic restorative treatment, silver diamine fluoride, the Hall Technique and resin infiltration, the paper concludes that treatments that remove or reduce the generation of aerosols during the management of carious lesions can allow a successful risk reduction approach. Furthermore, these treatments are still effective. Even if this risk reduction approach for aerosol generation becomes unnecessary in the future, these procedures are not only suitable but desirable for use as part of general dental care post-COVID-19.

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