Facing the COVID-19 pandemic, how should the dentist perform the procedures using high-speed?

In the face of the COVID-19 pandemic, dental care should only be performed in patients who require urgent or dental emergencies, with all professionals duly attired with PPE (cap, goggles, N95 / PFF2 mask or equivalent, face shield, apron) waterproof and procedure gloves). In procedures where aerosols will be generated, the mask that offers greater protection, such as the N95 or PFF2, should be used, and must be changed every 4 hours of use, or at the time instructed by the manufacturer. If the use of a high-speed pen is essential, it is advisable to plan and perform the service in the last period, to have a longer time to dissipate the aerosols generated and thus reduce the risk of contamination to patients.

During dental care, measures must be taken to minimize the generation of aerosols and salivary and blood spatter, such as: placing the patient in the most appropriate position possible, using high-power suction / aspiration to reduce the amount of saliva in the oral cavity and stimulus when coughing, use a rubber dam to reduce the dispersion of droplets and aerosols, avoid the use of a triple syringe, mainly in its mist form (spray), pressing both buttons simultaneously; regulating the cooling water outlet, whenever possible, it is recommended to use manual devices, such as dentine diggers to remove lesions (avoid high and low rotation pens) and periodontal curettes for periodontal scraping. Do not use devices that generate aerosols, such as bicarbonate jet and ultrasound. In cases of endodontic procedures, prefer to expose the pulp by means of chemical-mechanical removal of the affected tissue, and whenever possible, use absolute isolation (rubber dam) and continuous aspiration. These recommendations are given by the Brazilian Association of Intensive Care Medicine and Health Surveillance for public and private dental care.

Source: BVS – Biblioteca Virtual em Saúde. Available at: https://aps.bvs.br/aps/diante-da-pandemia-de-covid-19-como-o-dentista-deve-realizar-os-procedimentos-com-uso-da-alta-rotacao/. Acess on: 08/05/2020.
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