SARS-CoV-2 Positivity in Asymptomatic-Screened Dental Patients

Abstract

Enhanced community surveillance is a key pillar of the public health response to coronavirus disease 2019 (COVID-19). Asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include preappointment and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centers across Scotland invited asymptomatic-screened patients aged over 5 y to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardized Viral Transport Medium–containing test kits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/email with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-wk period (from August 3, 2020, to October 31, 2020), 4,032 patients, largely representative of the population, were tested. Of these, 22 (0.5%; 95% CI, 0.5%–0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To our knowledge, this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing infection prevention control and PPE vigilance, which is relevant as health care team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.

COVID-19: Seroprevalence and Vaccine Responses in UK Dental Care Professionals

“…The overall baseline seroprevalence in this study of 16.3% exceeded that of the general population in the West Midlands region (6%-7%) in June 2020 (Public Health England 2020a). Between August and October 2020, during the early stages of the second wave of the UK pandemic, the percentage of patients attending general dental practices who were asymptomatically or presymptomatically infected with SARS-CoV-2 peaked at 1.7% (Conway et al 2021), providing evidence that dental care professionals are directly exposed infected individuals during the course of their work. The observation that the seroprevalence among dental practice receptionists (6.3%), who have no direct patient contact, was comparable to the general population supports the hypothesis that the increased occupational risk we have observed arose from close, clinical exposure to patients.…”

Dentist Related Factors Associated with Implementation of COVID-19 Protective Measures: A National Survey

“…One may question the uncertainty associated with assessing the true rate of infection among dentists due to the presence of asymptomatic SARS-COV-2 infection [8], the sensitivity as well as the specificity of various testing systems [23], and, simply, due to the limited availability of testing systems at the time of the survey. While we acknowledge these uncertainties, we consider that they were equally present when estimating COVID-19 infection rates in the general population and in other healthcare workers, which makes their comparison acceptable.…”

Impact of the Coronavirus on Providing Oral Health Care in the Netherlands

“…These patients require ventilation in intensive care units and some cases have a fatal outcome, mainly affecting people over 68 years old with co-morbidity 1 . Not everyone infected with the virus develops symptoms or develops symptoms immediately or recognizes their symptoms immediately 2 , and these asymptomatic and presymptomatic individuals can be infectious 3 , 4 . Asymptomatic, presymptomatic and symptomatic people can carry similar numbers of virus particles 5 .…”