Rapid review on dental APGs published by SDCEP

A NEW report on aerosol generating procedures (AGPs) and fallow time, with recommendations to "move forward in a clear and coordinated way," has been published by the Scottish Dental Clinical Effectiveness Programme (SDCEP).

The rapid review considers evidence related to the generation and mitigation of aerosols in dental practice and the associated risk of transmission of SARS-CoV-2.

The SDCEP states that a robust process of evidence synthesis and decision making, all completed online in 13 weeks, under-pins the judgements in the review, which has been welcomed by the BDA, The Faculty of General Dental Practice UK and College of General Dentistry.

The report is not official government guidance but is intended to inform policy makers and – according to the BDA – has reached a number of agreed positions.

• High volume suction and rubber dam use is recommended to reduce the risk of COVID-19 transmission.
• The use of fallow time is recommended, the length of which varies between 10 and 60 minutes and depends on the ventilation rate, high volume suction and rubber dam use.
• Pre-procedural mouth rinses and anti-microbial coolants are not recommended for use to reduce risk of virus transmission.

The BDA comments: "These recommendations will be reviewed as more evidence emerges, as the evidence base is currently quite weak. However, the report is a thorough piece of work and valuable resource for dentists in these challenging times."

In conducting the 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.

SDCEP states that the agreed position statements presented in the document are based on the evidence available at the time of publication. "In view of the constantly evolving COVID-19 situation, this is a living document and the working group will continue to assess new evidence to maintain currency of the document in the months ahead."

Ian Mills, Dean of FGDP(UK), Trustee of CGDent and a member of the SDCEP review group, said: "SDCEP’s review of dental AGPs has been extremely thorough, and followed a rigorous and methodical approach. Its publication is potentially a very significant moment in the recovery of dental practices in the midst of the coronavirus pandemic and I commend the SDCEP Team for the hard work and dedication they have shown in producing this report."