COVID-19 RT-PCR testing in dentistry

As a dentist, seeing patients during this pandemic of COVID-19 is a challenge. The measures put forth by the CDC and updated guidelines for infection control have added a sense of security for the entire team, along with present and future patients. Personal protective equipment (PPE) aids in protecting the clinical team. However, we now know that the droplets generated from aerosol-generating procedures (AGP), which are inherent to dentistry, stay in the room for longer than originally thought and is dependent on the treatment room’s air exchange rate. Waiting until all AGP droplets have settled before the room is cleaned, prepped and the next patient is seated is a crucial step for infection control. Regular testing of team members with a Real-Time Polymerase Chain Reaction COVID-19 (RT PCR COVID-19) test will enhance the increased infection control measures.

Along with stringent universal precautions, when we see patients for surgical procedures, we recommend the patient to preoperatively test with an RT PCR COVID-19 test. Each time a dental surgical patient is seen without prior testing, there is a bright yellow banner in the medical record stating the COVID-19 status is unknown. With that banner comes a subtle increase of anxiety. When there is a confirmed timely COVID-19 negative status, it does perceptively make us feel more comfortable about the safety of our patients and our entire team.

Preoperative testing of symptomatic and asymptomatic patients is a measure many hospitals and surgery centers have adopted. If dentistry can accomplish the same as our medical colleagues, we will be taking great strides forward in the everyday practice of dentistry to provide COVID-19 safer workplaces. Importantly, we can also make a difference in the public health surveillance measures needed during this pandemic. We in the dental field can be involved in data collection and sharing with our public health authorities to advance the fight against this novel and very infective virus. The Minnesota Department of Health advised us in May that we, all health care providers, should be testing patients for SARS CoV-2 if undergoing aerosol-generating procedures including dental procedures. It is my opinion that it is important to get on board with COVID testing in our dental community. We in dentistry have a high risk of exposing clinicians, team members, and patients to the virus. If we test before aerosol-generating procedures, we may significantly reduce the risk of COVID-19 transmission.

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R Bruce Templeton DMD
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