An innovative risk-scoring system of dental procedures and safety protocols in the COVID-19 era

BMC Oral Health. 2020 Nov 4;20(1):301. doi: 10.1186/s12903-020-01301-5.


Background: The aim of this paper is to assess an innovative risk score for common dental procedures, based on the most recent contaminant SARS-CoV-2. After scoring the level of infection risk, safety procedures, advice and personal protective equipment (PPE) are recommended for the dental team in each dental practice.

Methods: The authors of this research analysed 42 common dental procedures on the basis of known transmission risks. In increasing order, many consider the parameters leading to different risk scores for the dental team and patients for each procedure to be: direct contact with saliva (score 1), direct contact with blood (score 2), production of low levels of spray/aerosol via air-water syringes (score 3), the production of high levels of spray/aerosol from rotating, ultrasound and piezoelectric tools (score 4); and the duration of the procedure, which may increase the risk of procedures producing droplets and aerosols.

Results: Using this innovative risk-scoring system, the authors classified the different dental procedures according to low, medium or high risk: low (1-3), medium (4-5), high (≥ 6). A safety protocol for each procedure was thereafter matched with the calculated risk level.

Conclusions: The innovative risk-scoring system presented in this research permits the reclassification of dental procedures according to the infection risk level. Consequently, specific procedures, previously considered as entry level, will now merit revision. This paper also highlighted an effective and routine clinical tool for general dentists and oral medicine practitioners.

Keywords: Covid-19; Risk-scoring system; SARS-CoV-2; personal protective equipment (PPE).

MeSH terms

  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Dentistry / methods*
  • Dentistry / standards*
  • Humans
  • Pandemics / prevention & control
  • Personal Protective Equipment
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Risk Assessment / methods*
  • SARS-CoV-2
  • Safety Management*