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 their patient’s mouth and nose, practicing dentistry was considered to be a high risk for transmission of SARS-CoV-2 infection. A new paper “Evaluation of Comprehensive COVID-19 Testing Program outcomes in a US Dental Clinical Care Academic Setting” published in JAMA Network Open reveals that in fact 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 SARS-CoV-2 surveillance testing.
The study was conducted at Harvard School of Dental Medicine (HSDM), an academic clinical care setting, between August 2020 and February 2022. 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 non-clinical roles who were tested for SARS-CoV-2 on a frequent basis.
“Our study found that the overall asymptomatic test positivity rate remained low at 0.27 percent. 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 non-clinical individuals, ensuring safety of both patients and practitioners at clinical settings, said Sung Choi, 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 percent among nonclinical individuals, revealing that faculty, students, and staff working in non-clinical roles contracted SARS-CoV-2 infections slightly more often than those in clinical-facing roles.
“We were pleased that the comprehensive SARS-CoV-2 surveillance program at Harvard kept our community safe,” said Giang T. Nguyen, 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 take to assist in timely detection of the SARS-CoV-2 infection 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 HSDM Dean William Giannobile. “Furthermore, the delivery of dental care to patients during the pandemic was safe with no documented transmission of SARS-CoV-2 from doctor to patient.”
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