Rapid Review of Aerosol Generating Procedures in Dentistry
Published in September 2020 and last updated 19 April 2021
No further updates planned
SDCEP published Mitigation of Aerosol Generating Procedures in Dentistry – A Rapid Review and subsequently continued to assess new evidence to maintain currency of the document post-publication.
The rapid review informed the recommendations within national COVID-19 infection prevention and control guidance issued in October 2020. which was relevant to the context of the pandemic at that time.
Since then, the level of SARS-COV-2 immunity within the UK population has markedly increased due to community infection rates and the rapid vaccination programme, COVID-19 testing is more widespread and there is greater confidence that procedural mitigation of dental aerosols is effective in minimising the risk of infection. Meanwhile, the reduced capacity within dental services is resulting in an increasing unmet need for dental care and the viability of some dental services is under threat. Given this substantial change in the context of the pandemic and the related decision-making that the rapid review aimed to inform, SDCEP has decided that continuing to review the evidence or update the rapid review further is no longer beneficial. However, the rapid review remains available here for reference.
- Mitigation of Aerosol Generating Procedures in Dentistry – A Rapid Review (PDF) – includes a new appendix
- 19 April 2021 Update (PDF) – a standalone version of the new appendix
- Report on Recent Published Evidence 19 April 2021 (PDF) – review of new evidence to 2 March 2021
About these resources
SDCEP, with the support of Cochrane Oral Health, conducted a rapid review of the evidence related to the mitigation of aerosol generating procedures in dentistry and the associated risk of transmission of SARS-CoV-2 (COVID-19).
It is important to stress that this document did not have the status of guidance. The aim of this rapid review was to identify and appraise the evidence related to several pre-determined key questions about AGPs in dentistry and to use a process of considered judgement of this evidence and other relevant factors to reach agreed positions that may be used to inform policy and clinical guidance.
To conduct this review, SDCEP convened a multidisciplinary Working Group comprising subject specialists from disciplines including particle physics, aerobiology and clinical virology, in addition to those performing multiple roles within dentistry. Representatives from all four of the devolved UK nations participated in the work of the Group.
The methodology used for the development of this guidance, including details of the scope, evidence search strategy, evidence appraisal and the considered judgement process can be found in the Rapid Review Methodology (PDF) document.
The agreed position statements presented in this document were based on the evidence available at the time of publication. In view of the constantly evolving COVID-19 situation, the Working Group has continued to assess new evidence to maintain currency of the document for six months post-publication. A separate report of the more recently published evidence up to 2 March 2021 was provided.
SDCEP has also compiled a summary of currently available information on ventilation, with a focus on advice and information that has relevance for dental facilities. This resource is available via the COVID-19: Practice Recovery webpage.
The development of the rapid review is summarised in a poster, which was presented at the NHS Education for Scotland Annual Conference in May 2021.
Related relevant work carried out by others, includes:
NSS Technical Report on ventilation in dental surgeries
NHS National Services Scotland (NHS NSS) has published “SBAR Ventilation, water and environmental cleaning in dental surgeries relating to COVID-19“. The document examines the current evidence base for requirements for ventilation as a control strategy and the modeling of AGPs. NHS NSS state that it is not intended as specific formal guidance in itself, but to provide recommendations to help inform future policy and the development of guidance. This document had been produced by a short life working group led by Health Facilities Scotland that included representation from all four UK nations. SDCEP was not part of this group.
COVID-19 Dental Services Evidence Review (CoDER) Working Group rapid review of AGPs and their mitigation in international guidelines.
The CoDER group has now published a rapid review to assess how dental aerosol-generating procedures (AGPs) are defined in international dental guidelines and what mitigation procedures are recommended. Aerosol Generating Procedures and their Mitigation in International Dental Guidance Documents – A Rapid Review is available on the Cochrane Oral Health website.
SDCEP has contributed to the CoDER’s work, which is a multi-agency collaboration involving Cochrane Oral Health, the Universities of Aberdeen, Dundee and Manchester, NHS Greater Glasgow and Clyde and NHS Education for Scotland.