Reopening of Dental Clinics during SARS-CoV 2 Pandemic: An Evidence Based Recommendations before starting Clinical Interventions

Abstract

Following the severe acute respiratory syndrome coronavirus (SARS-CoV-1) and Middle East respiratory syndrome coronavirus (MERS-CoV), another pathogenic coronavirus called SARS-CoV-2 emerged in December 2019 in Wuhan, China. This virus has similarities with SARS-CoV-1 and causes acute pneumonia. The most characteristic symptom of patients with SARS-CoV-2 is respiratory distress, and most of the patients could not breathe spontaneously. Additionally, some patients with SARS-CoV-2 also show neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also influence the central nervous system (1). SARS-CoV-2 transmits via droplets and contact routes, but some doubt about airborne, fecal, or intrauterine transmission should be solved. Its’ fatality rate is about 6.3%, but it varies in different ages and counties, and it could be over 15% (2). Sneezing, coughing, and application of rotary instruments can result in the production of airborne particles (0.001 to 10 000 μm). It has been shown that airborne particles produced during dental procedures decrease to baseline levels within 10 to 30 minutes