Bulletin of Dental Education

Study Shows Dental Practitioners Did Not Face an Increased Risk of Contracting COVID-19 During Clinical Activities

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At the height of the COVID-19 pandemic, many dental clinics faced temporary closure or capacity restrictions due to what was believed to be an increased risk associated with aerosol procedures. Because dental procedures require clinicians to be in close proximity to a patient’s mouth and nose, practicing dentistry was considered a high risk for transmission of COVID-19.

A new paper published in JAMA Network Open reveals that clinical activities did not increase the risk of COVID-19 when performed in a clinical care setting with practitioners wearing standard personal protective equipment and participating in comprehensive COVID-19 surveillance testing.

The study was conducted at Harvard School of Dental Medicine (HSDM), an academic clinical care setting, between August 2020 and February 2022. HSDM is the only graduate school at Harvard University that offers direct patient care within university-operated facilities. As part of Harvard University’s mandatory testing program, all onsite HSDM faculty, staff and students participated in regular surveillance testing with a cadence that varied from one to three times per week depending on risk status. This provided a pool of individuals in both clinical and nonclinical roles who were tested for COVID-19 on a frequent basis.  

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Photo Credit: Steve Gilbert

“Our study found that the overall asymptomatic test positivity rate remained low at 0.27%. Being involved in clinical activities did not increase the risk of COVID-19; while individuals involved in clinical activities performed a higher number of tests per week on average, test positivity rate remained lower than nonclinical individuals, ensuring safety of both patients and practitioners at clinical settings,” said Sung Choi, Ph.D., HSDM Instructor in Oral Health Policy and Epidemiology, and an author of the study.

According to the study, the mean test positivity rate was 0.25% among individuals involved in patient-facing clinical activities, compared with 0.36% among nonclinical individuals, revealing that faculty, students and staff working in nonclinical roles contracted COVID-19 infections slightly more often than those in clinical-facing roles.

“We were pleased that the comprehensive COVID-19 surveillance program at Harvard kept our community safe,” said Giang T. Nguyen, M.D., M.P.H., M.S.C.E., Associate Provost for Campus Health and Wellbeing, Executive Director of Harvard University Health Services and contributor to the study. “The work done at the dental school during the pandemic demonstrated that the school delivered clinical care in a safe manner, even in a setting with relatively high density of students, staff and faculty on campus.”

The findings suggest that implementing an adaptive testing cadence, based on risk status of individuals, can be an effective measure for institutions to assist in timely detection of COVID-19 and reduce the risk of infection within academic clinical care settings. It may also provide a blueprint of how clinical care can be performed safely in academic settings when faced with future virus outbreaks.  

“The results of this study underscore that a dental academic setting is safe for students, clinicians and staff,” said William Giannobile, D.D.S., HSDM Dean. “Furthermore, the delivery of dental care to patients during the pandemic was safe with no documented transmission of COVID-19 from doctor to patient.”

Courtesy of Harvard School of Dental Medicine

Published on January 11, 2023 

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