respiratory protection C D A J O U R N A L , V O L 4 8 , Nº 1 0
literature review
COVID -19: New Considerations for Respiratory Protection in Dental Practice Bruce L. Whitcher, DDS
a b s t r a c t Dentistry has been identified as a “very high-risk” occupation due to
the risk of SARS-CoV-2 transmission via aerosol-generating procedures, which are integral to the practice of dentistry. This makes respiratory protection a concern for every practicing dentist, their staff and their patients.
AUTHOR Bruce L. Whitcher, DDS, practices oral and maxillofacial surgery in Paso Robles, Calif. He served as a member of the Dental Board of California from 2009 to 2019, serving on the licensing, enforcement and anesthesia committees as well as on the Dental Assisting Council. Dr. Whitcher is a past CDA trustee and a past member of the California Association of Oral and Maxillofacial Surgeons board of directors, serving as president in 2007. Conflict of Interest Disclosure: None reported.
O
n July 13, 2020, Gov. Gavin Newsom announced statewide restrictions to again halt all indoor dining and close bars, movie theaters, zoos and museums. In addition to these restrictions, more than 25 counties, including Los Angeles, were forced to close gyms, places of worship, hair salons, malls and nail salons. On Aug. 22, 2020, California reported 644,751 confirmed positive cases of COVID-19, the most of any state.1 This includes 5,920 new cases representing a 0.9% increase. California’s positivity rate — a key indicator of community spread (the positivity rate is the percent of tests that come back positive) — is at the time of this writing 5.7% and decreasing. Hospitalization rates are also decreasing in the 14-day average, with 4,890 new hospitalizations reported for a 3.3% decrease and a 2.1% decrease in ICU patients. As of Aug. 21, 2020, a total of 11,686 deaths were attributed to COVID-19 in the state. There is currently no vaccine
to prevent COVID-19. The best way to prevent illness is to avoid being exposed to this virus. The virus spreads mainly from person to person between people who are in close contact with one another (within about 6 feet). This occurs by respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or can possibly be inhaled into the lungs. Surfaces can also transmit infection. Older adults and people who have severe underlying medical conditions such as hypertension, obesity (BMI > 30), heart or lung disease, diabetes, chronic kidney disease, sickle cell disease or immunocompromised systems seem to be at higher risk for developing more serious complications from the COVID-19 illness.2 The differences in health outcomes related to COVID-19 are most stark in COVID-19 deaths. We have nearly complete data on race and ethnicity for COVID-19 deaths, and we are seeing the following trends: Latinos, African OC TOBER 2 0 2 0 539
