SARS-CoV-2 positivity in asymptomatic-screened dental patients

Conway, D.I. et al. (2021) SARS-CoV-2 positivity in asymptomatic-screened dental patients. Journal of Dental Research, 100(6), pp. 583-590. (doi: 10.1177/00220345211004849) (PMID:33779355) (PMCID:PMC8138329)

Abstract

Enhanced community surveillance is a key pillar of the public health response to COVID-19. Asymptomatic carriage of SARS-CoV-2 is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include pre- and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centres across Scotland invited asymptomatic screened patients over 5-years-old to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardised VTM-containing testkits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/e-mail with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-week period (from 3August to 31October2020) n=4,032 patients, largely representative of the population, were tested. Of these n=22 (0.5%; 95%CI 0.5%, 0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To the best of our knowledge this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing Infection Prevention Control and PPE vigilance, which is relevant as healthcare team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.

• Item Type: Articles
• Keywords: COVID-19, Severe Acute Respiratory Syndrome Coronavirus 2, asymptomatic, dentistry, outpatient, swab.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Conway, Professor David and Gunson, Dr Rory and Vansteenhouse, Dr Harper and O'Keefe, Mrs Emma and Hay, Dr Jodie and Culshaw, Professor Shauna
• Authors: Conway, D.I., Culshaw, S., Edwards, M., Clark, C., Watling, C., Robertson, C., Braid, R., O'Keefe, E., McGoldrick, N., Provan, S., VanSteenhouse, H., Hay, J., and Gunson, R.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Journal of Dental Research
• Publisher: SAGE Publications
• ISSN: 0022-0345
• ISSN (Online): 1544-0591
• Published Online: 29 March 2021
• Copyright Holders: Copyright © 2021 International and American Associations for Dental Research
• First Published: First published in Journal of Dental Research 100(6): 583-590
• Publisher Policy: Reproduced under a Creative Commons licence