Reviewing the Aerosol Risk in Orthodontic & Pediatric Dental Care During Pandemic

Pediatric dental and orthodontic treatment during the COVID-19 pandemic is under examination because of the risks of transmission of the virus and the danger of aerosolization of infected fluids for dental personnel and patients.

The objectives of this article are to describe the points that establish the risk of transmission to dental personnel and patients and to do the same for the counterpoints. The evidence-based approach to establishing these points and counterpoints may help the dental community understand the risks and areas for further study to improve pediatric dental and orthodontic care during respiratory disease epidemics.

The COVID-19 pandemic has caused incalculable pain and suffering including tragic loss of life, debilitating illness, widespread unemployment and financial loss. The dental community has been severely affected by the pandemic, especially due to limitations on practice. The restrictions stem from precautions to maintain social distancing, changes to disinfection protocols and concerns regarding dental aerosol.

Pediatric dental and orthodontic care poses significant differences from general dental care especially during the present pandemic. Some examples of the differences include exposure to crying patients who may be expelling the virus via aerosol, the common use of nitrous oxide sedation, and the difficulty to ensure that patients wear masks prior and after treatment. Additionally, special needs patients often reside within group care like nursing homes, that may be locations with high rates of COVID-19.¹ Orthodontic care involves similar challenges such as during the insertion or removal of appliances.