Rapid - Review - of - Agps - in - International - Dental - Guidance - SDCEP Documents

Aerosol Generating Procedures and their
Mitigation in International Dental Guidance

Documents - A Rapid Review
24 July 2020
COVID-19 Dental Services Evidence Review (CoDER) Working Group
How to cite this document:

Clarkson J, Ramsay C, Richards D, Robertson C, & Aceves-Martins M, on behalf of the CoDER Working
Group. Aerosol Generating Procedures and their Mitigation in International Dental Guidance Documents
- A Rapid Review
https://oralhealth.cochrane.org/news/aerosol-generating-procedures-and-their-mitigation-international-
guidance-documents
Aerosol Generating Procedures and their Mitigation in International Dental Guidance Documents - A Rapid Review
24 July 2020
Purpose
The aim of this rapid review was to assess how dental aerosol generating procedures
(AGPs) were defined in international dental guidelines, what mitigation processes were
advised and whether they were linked to COVID-19 epidemiology. The specific objectives
were:
• Assess how aerosol generating procedures (AGPs) are defined and classified in
international guidelines
• Identify what AGP mitigation is advised for both COVID and non-COVID patients
• Report recommended time gaps (fallow periods) between treating COVID and non-
COVID patients in the same surgery following provision of AGPs
• Identify any mitigating factors that allow reductions in the length of fallow periods.
• (Assess whether there is a relationship between COVID-19 epidemiology and World
Bank income status with PPE provision – to be reported later).
• (Assess the quality of linked evidence to recommendations – currently in progress to
be reported later).
The review was undertaken to inform the Scottish Dental Clinical Effectiveness Programme
(SDCEP) Aerosol Generating Procedures in Dental Practice Rapid Review.
https://www.sdcep.org.uk/published-guidance/covid-19-practice-recovery/rapid-review-of-
agps/
Key Messages
• This review reports on national recommendation for AGPs and their mitigation
from 58 countries.
• There is a highly variable level of details provided across international resources.
• Just over half of the documents (56%) provide a definition of AGPs.
• 98% of countries state that AGPs can be provided for non-COVID patients.
• 94% of countries recommend the use of a face mask and goggles or a face shield
for non-COVID patients.
• Surgical masks are advised by 21 countries (33%) for non-COVID patients while
44 countries (70%) recommend the use of FFP2/N95 masks and 12 countries
(19%) recommend the use of FFP3 masks.
• 82% of documents recommend the use of a pre-procedural mouthwash for non-
COVID patients.
• 48% of documents suggest a fallow period after the providing AGP treatment for
non-COVID patients, with times ranging from 2 to 180 minutes.
• Most countries making recommendations for COVID patients advised the same
mitigation as for non-COVID patients.
• There is a lack of evidence provided to support the majority of recommendations
in the documents.
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24 July 2020
The World Health Organization (WHO) declared the coronavirus disease (COVID-19) a
global pandemic on 11 March 2020. Since then dental services in affected countries have
been severely curtailed. Though many practices have reopened following the initial
outbreak guidance continues to be reviewed particularly concerning aerosol generating
procedures (AGP’s). Until very recently the primary mode of spread of the virus has been
considered to be via droplets and fomites. However, the potential for airborne transmission
has now been raised.1 This is important in relation to the safe remobilisation of dental
services as it impacts on the uncertainty that exists regarding the risk from and the use of
aerosol generating procedures in dentistry and any associated risk of the transmission of
SARS-CoV-2.
Process
In the first week of July 2020, we commenced a rapid review of recently produced guidance
and reports containing recommendations from international organisations and professional
bodies on the current requirements for safe remobilisation of dental services. Our methods
are based on the proposed approach for rapid reviews by the World Health Organisation
(WHO) and the Alliance for Health Policy and Systems Research.2
This review is supplementary to the previous CoDER Rapid Review of Reopening of Dental
Services (16 May 2020). It summarises only the recommendations associated with the
provision of AGP’s. We conducted a grey literature search to identify relevant guidance
documents and liaised with the information scientist from Cochrane Oral Health (COH), who
last updated the regular Cochrane search for dental guidelines on 13 July 2020. We also
contacted an international network of oral health researchers and decision makers through
the Global Evidence Ecosystem for Oral Health (GEEOH). The GEEOH was founded to
reduce duplication of effort and create direct routes from evidence to policy and clinical
practice and is currently coordinated by COH. Through this network World Dental
Federation (FDI) have shared a database of recently collated national guidance which
provided additional documents. Following publication of the Rapid Review of Reopening of
Dental Services we were contacted by individuals and groups to assist with the
identification of documents for this review. The relationship between COH, the Scottish
Dental Clinical Effectiveness Programme (SDCEP) and our research group resulted in rapid
communication and assistance from several Chief Dental Officers and worldwide dental
policy leaders.
No language restrictions were applied to the searches and members of our research group
were able to translate documents published in Dutch, French, German, Portuguese and
Spanish with Google translate being used for other languages when necessary. Searches
continued to 13th July 2020 with data being extracted up to 15th July 2020.
Using a data extraction form developed a priori, information relating to specific AGP
recommendations and evidence linked to recommendations was extracted by a single
1
https://apps.who.int/iris/bitstream/handle/10665/333114/WHO-2019-nCoV-Sci_Brief-Transmission_modes-
2020.3-eng.pdf?sequence=1&isAllowed=y).
2 https://www.who.int/alliance-hpsr/resources/publications/rapid-review-guide/en/
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24 July 2020
reviewer. Data items included definitions of AGPs, recommendations on personal protective

equipment (PPE) and any procedural and environmental aerosol mitigation processes.
Findings
A total of 74 guidance documents from 72 countries, including four from the UK and two
each from Kenya and the United States, were identified. Five documents were excluded
(Hong Kong, South Korea, the Latin American Paediatric Association Guideline, Sweden
and Kenya) as they provided no information relevant to our objectives. We were unable to
source quickly or obtain translations of documents from seven countries (Albania, Bosnia
Herzegovina, Israel, Moldova, Nepal, Palestine, Turkey) before our deadline. Data relevant
to the objectives were extracted from 63 guidance documents by members of the CoDER
working group. The main findings for each main objective are summarised below and a
detailed summary of the documents from each of the countries is available in Appendix 1.
AGPs definition and list of procedures
Twenty one of the 63 documents (33%) provided a definition of aerosol generating

procedures (AGPs), with 35 documents (56%) providing a list of procedures considered to
be AGPs. Eight documents provided references relative to AGP definitions with five
providing references for AGP procedures. Those procedures identified by more than 20% of
the documents as AGPs were high-speed handpieces (56%), 3-in-1 syringes (56%),
powered (sonic/ultrasonic) scalers (43%), slow speed handpieces (29%) and surgical
handpieces (22%).
With the exception of Scotland, which at the time of writing did not permit AGPs in non-
COVID patients, all other documents (98%) indicate that AGPs can be performed in non-
COVID patients. However, a number suggest caveats to their use. Many recommend
limiting the use of AGPs where possible, with 13 documents (21%) only recommending
performing AGPs for dental emergencies. Only four documents provide references related
to the provision of AGPs. Additional information comparing AGP procedures for COVID and
non-COVID patients is available on a country by country basis in Appendix 2. Fifty-eight
(92%) of the documents suggested providing treatment for suspected of confirmed COVID
patients. Of these, 22 suggested treating emergencies only, with 16 indicating these
patients should be seen in specialised clinics or hospital and not a general dental practice.
None of the recommendations for confirmed COVID patients were based on evidence.
PPE Recommendations
For the management of AGPs in non-COVID patients, five documents (Bolivia, Ecuador,
Philippines, Portugal and Spain) recommend double gloving. Fifty nine of 63 countries
(94%) specify the use of a face mask, with 91% specifying the use of goggles or a face
shield. All of those countries specifying goggles or a face shield also specified the use of a
face mask. Five countries (Costa Rica, Dominican Republic, Myanmar, Portugal and the
Ukraine) do not specify a particular type of mask for use with non-COVID patients. Surgical
masks are advised by 21 countries (33%) for non-COVID patients while 44 countries (70%)
recommend the use of FFP2/N95 masks and 12 (19%) the use of FFP3 masks. Of the 21
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24 July 2020
countries recommending a surgical mask, 10 suggest the use of FFP2/N95 masks if

available. Nine of the 44 countries that advise FFP2 masks for non-COVID patients suggest
the use of FFP3 masks where available. Only 19 documents make specific reference to the
need for fit testing of FFP2/3 masks. The use of surgical gowns is advised by 42 countries
(67%) and surgical caps/hats by 32 countries (51%), with 21 countries (33%)
recommending using disposable aprons and 11 countries (17%) also recommending the
use of shoe covers.
Of the documents providing recommendations for the treatment of COVID-19 patients, a

majority (54%) recommended the same level of facemask as when treating non-COVID
patients, with only 12 documents suggesting the specification should be upgraded.
Procedural mitigation
Aerosol mitigation procedures included mouthwashes, rubber dam and high-volume

suction. 82% of documents recommend the use of a pre-procedural mouthwash with a view
to reducing bio-aerosols for non-COVID patients. The two most commonly recommended
mouthwashes were hydrogen peroxide (38 documents) and povidone iodine (30
documents), with many documents recommending the use of either of these two
mouthwashes. Three documents recommend cetyl pyridinium mouthwash and three
recommend a mouthwash without stipulating the type. Ten documents provide links to
references for this question and while both Paraguay and South Africa recommend
mouthwash use, they indicate that there is no evidence for the effectiveness of
mouthwashes.
The use of rubber dam was recommended for non-COVID patients by 46 (73%)
documents, with just six (10%) documents (China, France, Italy, Malaysia, the Philippines
and South Africa) providing evidence to support the recommendation.
While the use of high-volume suction is often a routine practice during dental treatment,
only 46 (73%) documents recommend use of high-volume suction for non-COVID patients.
Six (10%) documents (China, France, Italy, Malaysia, the Philippines and South Africa)
provide links to evidence for this recommendation.
Environmental mitigation
The general ventilation of the dental clinic for non-COVID patients is mentioned in 33 (52%)
of the included documents. The most common advice, provided in 15 documents that
mention ventilation, is to ensure that the room is well ventilated, including the opening of
(exterior) windows and use of air conditioning. The Argentinian document recommends
turning the air conditioning off while others indicate that it can be used but not in the
recirculating air mode. Six documents suggest the use of a negative pressure room or
unidirectional air flow, while the use of HEPA filtration is recommended by Guatemala,
Honduras, India, Italy, Malaysia, Paraguay, Philippines, Poland and South Africa. Only the
Canadian document provides specific details on air changes per hour, including a detailed
table of the impact of different numbers of air changes. Of the 33 documents providing
information on general ventilation, only six provide any references.
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Fallow period
Thirty of the 63 documents (48%) refer to a fallow period after providing AGP treatment for
non-COVID patients, with only two documents providing links to any references. Where
specific times are provided, these range from 2 to 180 minutes. Documents from eight
countries (Belgium, Canada, China, Croatia, England, Malaysia, Malta, Northern Ireland)
provide some possible mitigation factors to enable reduction of the fallow period. These
include opening windows, increasing the number of air changes per hour, the use of HEPA
filters and negative pressure room and minimising AGPs.
Of the documents reporting recommendations for the treatment of COVID-19 patients, most
(21/30) recommended the same duration of fallow period as when treating non-COVID
patients. Only 5 documents suggested that the time should be longer, with the Canadian
document recommending 3 hours if information on air change per hour is unavailable.
Conclusion
This rapid review provides an overview of recommendations on AGPs and their mitigation
from international guidance documents. It summarises specific elements of the identified
documents and highlights several key messages to assist policy and decision makers.
Across these international documents, for most of the statements there was limited or no
referenced, underpinning evidence.
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Working Group Members
Jan Clarkson, Professor of Clinical Effectiveness, University of Dundee;

Clinical Lead Director of SDCEP, NHS Education for Scotland (NES); Joint-
Coordinating Editor, Cochrane Oral Health, University of
Manchester
Craig Ramsay, Professor and Director, Health Services Research Unit
Methods Lead (HSRU), University of Aberdeen
Magaly Aceves-Martins Research Fellow, HSRU University of Aberdeen
Miriam Brazzelli Reader, HSRU, University of Aberdeen
Gareth Calvert Consultant NHS Greater Glasgow and Clyde
Thibault Colloc Dental Core Trainee, Oral and Maxillo-facial Surgery,
Aberdeen Royal Infirmary, NHS Grampian
Manas Dave NIHR Academic Clinical Fellow in Oral and Maxillofacial
Pathology, University of Manchester
Anne-Marie Glenny Professor of Health Sciences, Joint-Coordinating Editor,
Cochrane Oral Health, Division of Dentistry, University of
Manchester
Beatriz Goulão Statistical Research Fellow, HSRU, University of Aberdeen
Thomas J Lamont Clinical Research Fellow/Hon. StR in Restorative Dentistry,
School of Dentistry, University of Dundee
Derek Richards Specialist Advisor, SDCEP, University of Dundee
Philip Riley Cochrane Oral Health, Division of Dentistry, University of
Manchester
Clare Robertson Research Fellow, HSRU, University of Aberdeen
Tanya Walsh Cochrane Oral Health, Division of Dentistry, University of
Manchester
Gavin J Wilson Chief Dental Officer’s Clinical Fellow, NHS England and NHS
Improvement; StR in Oral Surgery, Leeds Dental Institute
Helen Worthington Cochrane Oral Health, Division of Dentistry, University of
Manchester
The COVID-19 Dental Services Evidence Review Working Group would like to thank and
acknowledge the contribution of the following individuals for providing the advice and
access to the international guidance documents necessary for this rapid review:
Colette Bridgman, Chief Dental Officer, Wales; Alonso Carrasco-Labra, Director, ADA
Science & Research Institute; Riana Clarke, National Clinical Director Oral Health, New
Zealand; Michael Donaldson, Chief Dental Officer, Northern Ireland; Tom Ferris, Chief
Dental Officer, Scotland; Sara Hurley, Chief Dental Officer, England; Paulo Melo, COVID-
19 Task Team Chair, FDI World Dental Federation; Timothy Ricks, Chief Dental Officer, US
Public Health Service; James Taylor, Chief Dental Officer, Canada; Benoit Varenne, Dental
Page 7 of 69
24 July 2020
Officer, World Health Organization. Thanks also to Tif Qureshi for providing access to some
international guidance documents.
The COVID-19 Dental Services Evidence Review Working Group are grateful to for the help
and support provided by Shona Floate, University of Glasgow; Anne Littlewood, and Laura
MacDonald from Cochrane Oral Health; David Felix, Postgraduate Dental Dean, NES and
colleagues from NES’s Clinical Effectiveness workstream: Samantha Rutherford; Douglas
Stirling; Michele West; Linda Young.
Page 8 of 69
24 July 2020
Appendix 1. AGPs summary table by country
Country AGP details COVID-19 Personal protective Procedural mitigation Environmental Fallow time Linked
status equipment mitigation evidence
Country Definition Non COVID-19 Face mask - surgical Mouthwash - 30 General ventilation. 60 minutes Yes
Argentina Many of the dental mask, or N95 or FFP2 if seconds with Povidone- AGPs procedures
procedures produce available Iodine (10%) of a should be
Source aerosols representing a concentration between undertaken in
Ministry of Health - potential route for the Fit test required 0.2 - 2%, or hydrogen closed places,
Ministerio de Salud transmission of peroxide (10 vol) half especially in
Argentina COVID-19 Goggles/face visor
infectious diseases. with warm water. Spit community clinics.
Recomendaciones Para Surgical gown without rinsing Air conditioning is
Odontologia List of AGP prohibited
instruments and Disposable apron High volume suction
Date of first publication procedures
10/06/2020 High speed COVID-19 Face mask - N95 or As non COVID-19 As non COVID-19 As non COVID-19
handpieces, slow FFP2
Latest update
No update speed drill, 3-in-1
Fit test required
syringe, powered
https://www.fdiworlddent scalers Goggles/face visor
al.org/sites/default/files/
media/documents/covid- Permitted treatment Surgical gown
19_recomendaciones_p Non COVID-19
patients: suggests Surgical cap/hat
ara_odontologia.pdf
emergency treatment
should be prioritised
but treatment is not
limited to emergencies
COVID-19 patients:
suggests only urgent
treatments and
avoiding AGPs as
much as possible.
Unclear if patients are
treated in regular
practice or a dedicated
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - Fluid- Treat under standard Social distancing in Not reported Yes
Australia COVID-19 is spread via resistant surgical mask precautions the waiting room
respiratory droplets that block particles of 3
Source when an infected microns or less Pre-procedural Limit high-touch
Australian Dental person sneezes or mouthwash items that cannot be
Association coughs, (within 1m) of Protective eyewear
(reusable or disposable)
Page 9 of 69
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Date of first publication another or via contact conform to AS/NZS ABHR for patients easily cleaned (e.g.
Various publication dates routes, where the 1337 Toys, Magazines)
and updates droplets land on a
surface and are Face shields are an
https://www.ada.org.au/ transferred by touch. alternative to protective
Covid-19-Portal/Dental- There's a risk that eyewear but do not
Professionals airborne transmission protect from inhaled
may occur if the microorganisms and
droplets are must be worn in
aerosolised when conjunction with a
certain procedures are surgical mask
performed. Surgical gown
List of AGP Disposable apron
instruments and
procedures COVID-19 Face mask - Level 2/3 Rubber dam - Only Confirmed cases: Not reported
Use of high-speed surgical mask or provide treatment that For provision of
handpieces, 3-in-1 P2/N95 respirator does not generate urgent/emergency
syringe, powered aerosols or where treatment ensure
scalers, lasers Fit test required aerosols are controlled airborne
Protective eyewear by using dental dam precautions which
Permitted treatment
(reusable or disposable) include treatment in
Non COVID-19: High-level evacuation
conform to AS/NZS a negative pressure
suggest taking
1337 Pre-procedural room.
standard precautions
mouthwash 1% Social distancing in
COVID-19: suggests Face shields are an hydrogen peroxide
alternative to protective the waiting room
AGPs are avoided for
suspected COVID-19 eyewear but do not ABHR for patients Limit high-touch
patients. Urgent or protect from inhaled items that cannot be
emergency treatment microorganisms and easily cleaned (e.g.
only for confirmed must be worn in Toys, Magazines)
patients in a dedicated conjunction with a
COVID-19 centre or surgical mask
hospital
Surgical gown
Disposable apron
Country Definition Non COVID-19 Face mask - Surgical Mouthwash - 1% Regular general Not reported No
Austria Not reported mask hydrogen peroxide ventilation of the
surgical room is
List of AGP Goggles/face visor advised
instruments and
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Source procedures COVID-19 Face mask - FFP1, As non COVID-19 As non COVID-19 Not reported
Austrian Dental Not reported FFP2, or FFP3
Chamber
Permitted treatment Goggles/face visor
Date of first publication Non COVID-19:
03/04/2020 Suggests providing Surgical gown
care with no further Surgical cap/hat
Latest update specification
04/05/2020
COVID-19: Suggests
https://stmk.zahnaerztek providing care with no
ammer.at/zahnaerztinne further specification
n/informationen-corona-
virus/
Country Definition Non COVID-19 Face mask - Surgical Mouthwash - 1% Rubber dam Ensure room is well Yes
Belgium Not reported mask or FFP2 for hydrogen peroxide ventilated between
patients with medical High volume suction appointments
Source List of AGP conditions at increased
Conseil de l’Art Dentaire instruments and risk Fallow times can be
on behalf of the Service procedures mitigated by size of
Public Fédéral de Santé Not reported Goggles or face visor the room, number of
Publique doors and windows,
Permitted treatment Surgical gown wind and
Date of first publication Non COVID-19: temperature, any
19/04/2020 suggests providing General ventilation
care with no further system available,
Latest update specifications
24/05/20 any ventilator or
COVID-19: suggests airing system
https://5199.f2w.fedict.be treating patients in a
/sites/default/files/docum COVID-19 Not reported Not reported Not reported Not reported
dedicated COVID-19
ents/2020-04-19_covid- centre or hospital
19_modification_202005
24_-
protocole_soins_dentaire
s.pdf
Country Definition Non COVID-19 Double gloving Mouthwash - rinse with General ventilation 2 mins after No
Bolivia Not reported 1% hydrogen peroxide disinfecting the
Face mask - N95 or or a 0.2% povidone- Disinfect surfaces room
Source List of AGP triple layer mask iodine mouthwash for 1 after treatment
College of Dentists of La instruments and minute, (after iodine
Paz procedures Goggles/face visor
allergy screening)
High speed Surgical gown
handpieces, slow Rubber dam
Page 11 of 69
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Date of first publication speed drill, 3-in-1 Surgical cap/hat High volume suction
01/05/2020 syringe
Disposable apron
Latest update Permitted treatment
No update Non COVID-19: COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
suggests emergency
https://www.fdiworlddent treatment
al.org/sites/default/files/
media/documents/protoc COVID-19: suggests
olo_de_bio- emergency treatment
seguridad_para_la_aten only. COVID-19
cion_a_pacientes_y_pre patients should ideally
vencion_del_covid- be treated in a high
19_en_clinicas_y_consul level health institution
torios_odontologicos.pdf (hospital)
Country Definition Non COVID-19 Face mask - FFP2 or Mouthwash - 0.12% Avoid any extra or 15 minutes No
Brazil Not reported N95 masks or superior. chlorhexidine unnecessary
Do not use surgical digluconate; or, equipment
Source List of AGP masks hydrogen peroxide 10
Biosafety Working Group instruments and vol, diluted in aqueous
of the São Paulo procedures Fit test required solution (1%)
Regional Dentistry High speed
Council handpieces, surgical Goggles/face visor Rubber dam
handpieces, slow Surgical cap/hat
Date of first publication speed drill, 3-in-1 High volume suction
01/04/2020 syringe Disposable apron
Latest update Permitted treatment COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
No update Non COVID-19:
http://www.crosp.org.br/u suggest providing care
ploads/arquivo/747df5ff5 with no further
05e7beff33c1a5ff5d6f12 specification. Treat all
a.pdf patients as suspected
COVID-19
COVID-19: suggests
providing care with no
further specification
Country Definition Non COVID-19 Face mask - FFP2 or Mouthwash - 1% General ventilation 60 minutes No
Bulgaria Not reported FFP3 mask depending hydrogen peroxide
on availability specific mouthwash not
Source List of AGP CHX
Recommendations/instru instruments and Goggles/face visor
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ctions from the crisis procedures Surgical gown

headquarters of the Not reported
Bulgarian Dental Union Surgical cap/hat
Permitted treatment
Date of first publication Non COVID-19: COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
03/06/2020 suggest providing care
with no further
Latest update specification.
No update
COVID-19: suggests
https://bzs.bg/препоръки providing care with no
-инструкции-от- further specification
кризисния-ща/
Country Definition Non COVID-19 Face mask - Surgical Mouthwash - hydrogen Not reported Not reported No
Burkino Faso Not reported mask or FFP2 peroxide 1% or
povidone-iodine
Source List of AGP Goggles/face visor solution 0.2%
Ordre National des instruments and mouthwash the day
Chirurgiens Dentistes du procedures Surgical gown – if
available before and/or on the
Burkina Not reported day of treatment
Ministère de la Santé Surgical cap/hat
Permitted treatment High volume suction
Date of first publication Non COVID-19: Wear rubber boots
Not reported emergency treatment
only COVID-19 As non COVID-19 As non COVID-19 Not reported Not reported
Latest update
Not reported COVID-19: emergency
treatment only. Unclear
URL not available if COVID-19 patients
are treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - Level 2 or Not reported Not reported Not reported No
Canada Any dental procedure 3 surgical mask or N95
where aerosolised respirator
Source particles are expected
Royal College of Dental to be generated by Fit-test required
Surgeons of Ontario dental instrumentation
COVID-19: Managing Eye protection OR face
shield
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Infection Risks During In-

person Dental Care List of AGP Protective gown
instruments and (optional)
Date of first publication procedures
15/03/2020 high-speed, low-speed
and other rotary COVID-19 Face mask - N95 Must avoid AGPs The operatory must Depends on ACH
Latest update handpieces, powered respirator whenever possible and be left empty (with but if information
31/05/2020 scalers, and 3-in-1 use the lowest aerosol- the door closed) to not available
syringes. Fit-test required generating options permit the minimum fallow
https://www.rcdso.org/en when necessary. clearance and/or period is 3 hrs.
-ca/rcdso- Eye protection AND
Permitted treatment settling of aerosols.
members/2019-novel- face shield Mouthwash - 1% -
Non COVID-19: length of time that
coronavirus/covid-19-- provide in-person care Protective gown 1.5% hydrogen the operatory must
managing-infection-risks- for all deferred, non- peroxide or 1% be left empty (the
during-in-person-care essential, and elective povidone-iodine for 60 fallow time) is
services, in addition to seconds determined by the
emergency and urgent (acknowledges the lack air changes per
care. of documented hour (ACH). The
evidence) aim is to achieve
COVID-19: patients 99.9% removal of
who need urgent and Rubber Dam
airborne
emergency care that contaminants
High volume suction
cannot be delayed (Detailed ACH table
provided)
Country Definition Non COVID-19 Face mask - FFP2 or Mouthwash - 1% Avoid any extra or Not reported No
Chile Aerosol-generating N95 hydrogen peroxide for unnecessary
procedures in dental 30 seconds prior to equipment
Source practice are those that Fit test required dental care
Division of Disease involve the use of high-
Prevention and Control | Goggles/face visor Rubber dam
speed handpieces, 3-
Oral Health Department in-1 syringes and Surgical gown
powered scalers
Date of first publication COVID-19 As non COVID-19 As non COVID-19 Treat suspected or Not reported
Not reported List of AGP confirmed COVID-
instruments and 19 patients in an
Latest update procedures isolated room that
Not reported High speed limits filtration of air
handpieces, 3-in-1 to the rest of the
http://www.colegiodentist syringe, powered clinic
as.cl/inicio/wp- scalers
content/uploads/2020/04
/orientaciones-atencion- Permitted treatment
Non COVID-19:
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odontologica-covid- suggests providing

19.pdf care with no further
specification
COVID-19: Suggests
emergency treatment
only. Unclear if patients
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - N95, N99 Mouthwash – type not If spatter exists 30-90 minutes Yes
China During dental practice, specified. Avoid using during practice, it
large quantities of Goggles/face visor the spittoon. Instead, should be
Source droplets and aerosols instruct the patient to performed in an
Chinese Stomatological Surgical gown
can be produced (disposable isolation cover mouth with the independent room
Association - Chinese through the oral power disposable mouthwash
Response to COVID-19 suits) Maintain airflow and
device from patients' cup and then spit
in Dental Field saliva, blood and Disposable surgical mouthwash into the make fresh air
secretions, which cap/hat cup, then the nurse infuse ceaselessly
Date of first publication poses high risk of a should immediately use indoor by opening a
Not reported disease transmission strong suction to window or using air
environment between reduce the generation purification device
Latest update dentists and patients of droplets and
06/05/2020 Twice daily (noon
aerosols and end of day),
List of AGP
instruments and Rubber dam disinfection by
URL not available procedures irradiation with
High speed High volume suction ultraviolet lamp for
handpieces, powered 30-60 minutes, then
scalers open the window for
General ventilation
Permitted treatment for at least 30
Non COVID-19: minutes
suggests emergency
treatment only Surface disinfection
after each
COVID-19: suggests treatment.
AGPs are not provided
500 mg/L-1000 mg
/L chlorine-
containing
disinfectant, (non-
Page 15 of 69
24 July 2020
corrosion resistant
surfaces) or, 75%
ethanol and
disposable
disinfection wipes
COVID-19 Not reported Not reported Not reported Not reported
Country Definition Non COVID-19 Face mask - FFP2 or Mouthwash - Not reported Not reported No
Colombia Not reported N95 respirator chlorhexidine (0.2%) or
Povidone Iodide (2.0%)
Source List of AGP Fit test required or hydrogen peroxide
Ministry of Health and instruments and (1.5%) for one to two
Social Protection procedures Goggles/face visor
minutes
(Ministerio de Salud y High speed Surgical gown
Protección Social handpieces, slow Rubber dam
Bogotá) speed drill, 3-in-1 Surgical cap/hat
syringe
Date of first publication Disposable apron
May 2020 Permitted treatment
Non COVID-19: COVID-19 As non COVID-19 As non COVID-19 Not reported Not reported
Latest update suggests providing
No update care with no further
specification
https://www.minsalud.go COVID-19: Suggests
v.co/Ministerio/Institucion emergency treatment
al/Procesos%20y%20pro only. Unclear if patients
cedimientos/GIPS31.pdf are treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask (type not Mouthwash - pre- Not reported Not reported Yes
Costa Rica Not reported reported) procedure mouthwash
with 1% hydrogen
Source List of AGP Goggles/face visor peroxide (10 cubic
Ministry of Health instruments and Surgical gown centimetres diluted in
(Ministerio de Salud procedures one litre of water)
Costa Rica) High speed Surgical cap/hat
handpieces, surgical Rubber dam
Date of first publication handpieces, slow
27/03/2020 speed drill, 3-in-1
syringe
Latest update
Page 16 of 69
24 July 2020
No update Permitted treatment

Non COVID-19:
https://www.ministeriode suggest providing care
salud.go.cr/sobre_minist with no further
erio/prensa/docs/lineami specification
entos_odontologos_v2_2
7032020.pdf COVID-19: Suggests
emergency treatment
only in a dedicated
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - N95 or Procedures that Keep windows open Not reported No
Croatia Not reported FFP2 generate large amounts to ventilate the area
of aerosols (e.g. high and / or turn on
Source List of AGP Goggles/face visor speed handpieces, 3- General ventilation
Croatian Chamber of instruments and in-1 syringes, powered
Dental Medicine procedures Surgical cap/hat scalers) should be Disinfect clinic with
High speed avoided UV air disinfection
Date of first publication handpieces, 3-in-1 system if fitted
04/05/2020 syringes, powered Mouthwash - (wavelength 254
scalers, chlorhexidine 0.20% nm). Protect
Latest update solution rinse for 60 s materials and
Permitted treatment and gargle for 15 s liquids sensitive to
No update Non COVID-19: Hydrogen peroxide UV radiation. Use
suggests providing (H2O2) 1% (one percent only at night when
https://www.hkdm.hr/nov care with no further
ost/1836/Smjernice-i- hydrogen peroxide) - there are no people
specification gargling for 15 seconds in the premises
protokoli-za-otvaranje-i-
rad-ordinacija-dentalne- COVID-19: Suggests and rinsing for 30
medicine-i-dentalnih- providing care with no seconds
laboratorija further specification. Rubber dam
treated in regular COVID-19 Face mask - FFP3 Not reported Not reported Not reported
practice or a dedicated Goggles/face visor
COVID-19 centre or Surgical cap/hat
hospital Shoe covers
Country Definition Non COVID-19 Face mask - The mask In order to prevent the At the end of Not reported No
Denmark Aerosols are formed by must retain at least 98% spread of infection from treatment, the
procedures using of microorganisms (type asymptomatic patients treatment room
Source instruments with water II), but does not have to requiring an AGP, a must be briefly
SUNDHEDSSTYRELSE and air be R type. Must be test for SARS-CoV-2 ventilated before
N, Danish Health Board changed regularly and may be prescribed in the next patient
List of AGP advance of the
instruments and procedure. The
Page 17 of 69
24 July 2020
Date of first publication procedures always after each procedure must be

18/04/20 High speed patient scheduled so that test
handpieces, slow responses are available
Latest update speed drill, 3-in-1 Goggles/face visor - before performing the
22/04/20 syringe, powered Visor or goggles can be AGP
scaler multiple use, cleaned
https://www.sst.dk/da/ud and disinfected Rubber dam
givelser/2020/haandterin Permitted treatment (according to the
g-af-covid-19_-kritisk- Suggests testing every manufacturer's
funktioner-i-tandplejen patient for COVID-19 instructions) between
before providing care each patient. In case of
and postponing any supply difficulties, full-
appointment while the face visors can be used
patient is COVID-19 alone (except for
positive surgical procedures).
Ordinary glasses and
magnifying glasses can
be used if they are
designed for protection.
Surgical gown - long-
sleeve disposable coat
and long-sleeve cuff
Disposable apron
Country Definition Non COVID-19 Face masks – type not Mouthwash - 1% General ventilation 5-10 minutes No
Dominican Republic Not reported specified but should be hydrogen peroxide
according to treatment mouthwash, 0.2%
Source List of AGP Povidone iodine or
Ministry of Health instruments and Fit test required Avoid wearing
cetylpyridinium or any jewellery and
procedures other effective
Date of first publication Slow speed drill, 3-in-1 Goggles/face visor accessories
Not reported mouthwash. Keep in
syringe, intra-oral Surgical gown mouth 30 seconds and
Latest update radiography spit
Not reported Surgical cap/hat
Permitted treatment High volume suction
https://www.fdiworlddent Non COVID-19: Disposable apron
al.org/sites/default/files/ suggests providing
care with no further Shoe covers
media/documents/recom
endaciones_para_la_gui specification
COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
a_de_apertura_de_los_s COVID-19: suggests
ervicios_odontologicos_ providing care with no
Page 18 of 69
24 July 2020
en_la_republica_dominic further specification. No

ana_debido_a_la_pande restriction for COVID-
mia_covid-19.pdf 19 patients except
triage prior to treatment
to identify higher risk
and take precautions.
Country Definition Non COVID-19 Double gloving Mouthwash – pre- General/natural 10 minutes No
Ecuador Avoid procedures that procedure 0.2% ventilation
involve the generation Face mask - N95 or Povidone or 1%
Source of aerosols, that is equivalent hydrogen peroxide for Avoid jewellery and
Ministry of Health particles generated 30 seconds accessories
Fit test required
Date of first publication while using a manual
cutting instrument, a Goggles/face visor Rubber dam
28/05/2020
rubber dam, low-speed High volume suction
Latest update rotating instruments, Surgical gown
No update little irrigation or
Surgical cap/hat
refrigeration in high-
https://www.fdiworlddent speed rotating Disposable apron
al.org/sites/default/files/ instruments, avoiding
media/documents/protoc the use of air-spray COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
olo_para_atencion_odon from the syringe triple
tologica_durante_la_em and replace it with
ergencia_sanitaria_por_ drying cotton swabs or
covid_-_19.pdf gauze.
List of AGP
instruments and
procedures
High speed
handpieces, surgical
handpieces, slow
speed drill, 3-in-1
syringe, powered
scaler, intra-oral
radiography
Permitted treatment
Non COVID-19:
suggests providing
care with no further
specification
COVID-19: Suggests
Page 19 of 69
24 July 2020
further specification.
treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - Surgical Mouthwash – one Not reported Starting from the No
Estonia Not reported mask minute mouth rinse end of the patient
prior to starting any appointment 45 min
Source List of AGP dental procedure, such
Ministry of Health instruments and as mouth rinses
procedures containing 1%
Date of first publication Not reported
07/02/2020 hydrogen peroxide or
Permitted treatment 0.2% - 1% Povidone or
Latest update Non COVID-19: 0.05% - 0.1%
21/05/2020 suggests providing cetylpyridinium chloride
URL not available care with no further 4 handed dentistry with

specification high volume suction
COVID-19: Suggests recommended
AGPs are not provided COVID-19 Not reported Not reported Not reported Not reported
Country Definition Non COVID-19 Face mask - ff AGPs Mouthwash - 1-1.5% Not reported Not reported Yes
Finland Not reported used, FFP2 or FFP3 hydrogen peroxide
respirator or surgical spray or iodine
Source List of AGP mouthpiece (class 2R) Betadine (10 mg/ml)
Sector of administration instruments and spray for 1 minute
of the Ministry of Social procedures Full face visor can be
Affairs and Health High speed used instead of goggles Rubber dam
handpieces, slow
Date of first publication speed drill with air and Surgical cap/hat High volume suction
Not reported water cooling, 3-in-1
Latest update syringe, powered
01/06/2020 scalers COVID-19 Face mask - FFP2 or PTG or KKTT Not reported Following aerosol
FFP3 examination is used for generation,
https://thl.fi/fi/web/infektio Permitted treatment
imaging. Intraoral personnel
taudit-ja- Non COVID-19: Goggles with side images are taken only if remaining in the
rokotukset/taudit-ja- suggests providing protection, face shield PTG or KKTT imaging room must wear a
torjunta/taudit-ja- care with no further
is not possible. respirator for at
taudinaiheuttajat-a- specification
least 30 minutes
o/koronavirus-covid-
Page 20 of 69
24 July 2020
19/ohje-suun- COVID-19: Suggests Surgical gown – A long- after the end of

terveydenhuollon- providing care with no sleeved disposable treatment.
yksikoille-covid-19- further specification. liquid-impervious jacket
epidemian-aikana Unclear if patients are
treated in regular Surgical cap/hat
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - FFP2 Dental air polishing is General ventilation 15 minutes window Yes
France Not reported not advised opened and door
Goggles/face visor The dentist should Do not use AGPs in closed
Source List of AGP consider the most a room without
Haute Autorité de Santé instruments and Surgical gown for AGPs windows unless
where rubber dam can’t efficient way to reduce
(HAS) procedures aerosols having a fresh air
High-speed be used, surgical handling unit
Date of first publication extraction or ultrasonic Contra-angle should be
handpieces, 3-in-1 preferred to turbine (FAHU)
14/05/2020 syringe, powered scale (high risk of body
fluid projections) Use water cooling No consensus
Latest update scaling, air polishers system to a minimum regarding air
25/05/2020 Surgical cap/hat conditioning
Permitted treatment Mouthwash
https://www.has- Non COVID-19: Disposable apron for systems
sante.fr/jcms/p_3184961 suggests providing AGPs with rubber dam Rubber dam
/fr/mesures-et- care with no further or conservative High volume suction
precautions-essentielles- specification treatment (low risk of
lors-des-soins-bucco- body fluid projections)
dentaires-apres-le- COVID-19: Suggests
deconfinement providing care with no Shoe covers
Unclear if patients are COVID-19 As non COVID-19 but As non COVID-19 As non-COVID-19 As non-COVID-19
treated in regular shoe covers not advised
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - surgical Only use of water or air Not reported General ventilation No
Germany Not reported mask on 3-in-1 syringes, use of clinical room for
of slow speed 30 mins
Source List of AGP Goggles/face visor
Institut der Deutschen instruments and Mouthwash - 30ml
Zahnärzte procedures 1.5% hydrogen
Not reported peroxide (or equivalent)
Date of first publication for 1 minute before
Not reported Permitted treatment treatment
Non COVID-19:
Page 21 of 69
24 July 2020
Latest update suggests providing Rubber dam

24/04/2020 (version 3) care avoiding AGPs
using low speed High volume suction
https://www.idz.institute/ instrumentation
publikationen/sonstiges/s COVID-19 Face mask - FFP2 As non COVID-19 Not reported As non COVID-19
ystem-von- COVID-19: Suggests
Goggles/face visor
standardvorgehensweise providing care avoiding
n-fuer-zahnarztpraxen- AGPs using low speed Surgical gown
waehrend-der- instrumentation.
coronavirus- Unclear if patients are Surgical cap/hat
pandemie.html treated in regular
Shoe covers
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - Mouthwash – 1% Not reported Not reported No
Greece Not reported FFP2/FFP3 or Peroxide for 30
N95/KN95 for up to 8-10 seconds
Source List of AGP hrs
Instructions for dental instruments and Rubber dam
employees in dentists procedures Fit test required
and patients Not reported High volume suction
Surgical cap/hat
Date of first publication Permitted treatment
Not reported Non COVID-19: Shoe covers
suggests providing
Latest update care with no further
Not reported specification COVID-19 As non COVID-19 As non COVID-19 Not reported Not reported
https://www.fdiworlddent COVID-19: Suggests
al.org/sites/default/files/ providing care with no
media/documents/odigie further specification.
s_pros_odontiatroys_erg Unclear if patients are
azomenoys_se_odontiatr treated in regular
eia_kai_astheneis_0.pdf practice or a dedicated
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - N95 or Mouthwash - 1% General ventilation Fallow period Yes
Guatemala Dental treatments FFP2 hydrogen peroxide or recommended but
involve the use of 0.2% Povidone Iodine The use of air time not reported
Source equipment that Fit test required for 1 minute renewal or filtering
Estomatologic Callege of produces aerosols devices using
Guatemala Goggles/face visor Rubber dam original HEPA filters
(drops of saliva and
blood less than 5 Surgical gown or by plasma they
can also represent
Page 22 of 69
24 July 2020
Date of first publication micrometers in Surgical cap/hat High volume suction a measure of
01/05/2020 diameter that, in a contagion control
suspected or positive Disposable apron cross between
Latest update case, are loaded with patient and patient.
No update Shoe covers
viruses The air conditioning
https://www.fdiworlddent should ideally be
List of AGP turned off, unless it
al.org/sites/default/files/ instruments and
media/documents/protoc has a filter and
procedures extractor
olo_de_bioseguridad_od High speed
ontologica_con_enfasis_ handpieces, surgical negative pressure
en_covid-19.pdf handpieces, slow room
speed drill, 3-in-1
syringe, powered Air disinfection
scaler, intra-oral treatments by air
radiography using ozone or rays
type C ultraviolet
Permitted treatment (UV-C), although
Non COVID-19: effective against
suggests emergency other coronaviruses
treatment only have not been
studied against
COVID-19: Suggests SARS-CoV-2. High
emergency treatment doses, could be
only. Unclear if patients harmful. The room
are treated in regular should be vacated
practice or a dedicated during use. Follow
COVID-19 centre or the manufacturer's
hospital recommendations in
each case. If using
UV-C sources, the
complete coverage
of all surfaces must
be ensured
Avoid jewellery and
accessories

Country Definition Non COVID-19 Face mask - N95 or Mouthwash - 1% General ventilation - Yes
Honduras Not reported FFP2 hydrogen peroxide or HEPA filters and
0.2% Povidone Iodine negative pressure
List of AGP Goggles/face visor or water with salt room
instruments and
Page 23 of 69
24 July 2020
Source procedures Surgical gown

College of Dental Not reported
Surgeons of Honduras Surgical cap/hat Avoid jewellery and
Permitted treatment accessories
Date of first publication Non COVID-19: Disposable apron
Not reported suggests providing Shoe covers
Latest update specification COVID-19 unclear if patients are treated
Not reported
COVID-19: unclear if
http://www.cop.org.pe/w patients are treated
p-
content/uploads/2020/04
/PROTOCOLO-DE-
BIOSEGURIDAD-PARA-
EL-CIRUJANO-
DENTISTA.pdf
Country Definition Non-COVID Recommended during Mouthwash - General ventilation - Not reported No
India Not reported all aerosol (preferably Preoperative 1% If possible, use
completely avoid) and hydrogen peroxide. Do directional airflow,
Source List of AGP non-aerosol based not use a spittoon. Use such as from fans,
Dental Council of India instruments and dental procedures, if the same sink that had to ensure that air
procedures carried out. been used for washing moves through staff
05/07/2020 the hands and face work areas before
Face mask - triple layer patient treatment
Permitted treatment surgical mask and N95 Rubber dams and high-
Latest update Non COVID-19: areas – not the
No update respirator volume saliva ejectors reverse. A qualified
suggests providing
care with no further Goggles/face visor (both industrial hygienist,
http://www.dciindia.gov.i General ventilation
n/Admin/NewsArchives/ specification to be used, fitting
goggles with a soft High volume suction engineer, or other
Dental%20Clinics%20Pr COVID-19: Suggests professionals can
otocols%20Final.pdf tissue seal)
treating patients in a help ensure that
dedicated COVID-19 Disposable gowns General ventilation
centre or hospital (change daily) removes, rather
than creates,
Suitable head caps workplace hazards.
Shoe covers Fumigate clinics
and other areas at
the end of the day
as per
manufacturer’s
instructions based
on the type and
Page 24 of 69
24 July 2020
area of the dental

clinical room.
Fumigation is done
on daily basis in
clinical or high
contact areas and
biweekly in non-
clinical or low
contact areas.
COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 Not reported

except FFP3 instead of
triple layer surgical
mask
Country Definition Non COVID-19 Face mask - FFP2 Mouthwash not Not reported Room clearance No
Ireland Not reported recommended time after AGP is
Fit test required not required unless
Source List of AGP Rubber dam a patient has known
Irish Dental Association instruments and Eye protection
High volume suction or suspected
procedures Disposable apron COVID-19
Not reported Surgical cap/hat and
Permitted treatment shoe covers not
Latest update Non COVID-19:
15/05/2020 recommended
suggests providing
https://www.hpsc.ie/a- care with no further COVID-19 As non COVID-19 As non COVID-19 Increased General 60 minutes after an
z/respiratory/coronavirus specification ventilation by AGP is performed
/novelcoronavirus/guidan opening window or on a patient with
COVID-19: Suggests
ce/infectionpreventionan mechanical method. known or suspected
providing care with no COVID-19 in a
dcontrolguidance/dentals further specification.
ervices/Guidance- room that is not
ManagingInfectionRisk- mechanically
treated in regular
DentalServices- ventilated the room
practice or a dedicated should be vacated
COVID19.pdf COVID-19 centre or
for 60 minutes after
hospital
completion of
treatment before
cleaning
commences.
Country Definition Non COVID-19 Face mask - FFP2 Minimise procedures Shoes must be 10-15 minutes Yes
Italy Not reported but refers that can produce cleaned and
Goggles and face visor aerosols. Prioritise
minimally invasive
Page 25 of 69
24 July 2020
Source to published protocols Single use gown (water restorative procedures disinfected at the
All major Italian dental for AGPs resistant) (hand instruments end of the day
associations – available only).
from the Italian List of AGP Single use cap/hat Natural General
government website instruments and Mouthwash - hydrogen ventilation/air
procedures peroxide solution 1% or renovation for 10-15
Date of first publication Not reported Povidone-iodine 0.2% minutes. If air
30/05/2020 for 1 minute followed by conditioning is
Permitted treatment another mouthwash used, filters need to
Latest update Non COVID-19: with chlorhexidine 0.2- be changed once a
No update suggests providing 0.3% for 1 minute week
http://www.salute.gov.it/p specification Rubber dam
ortale/news/p3_2_1_1_1
.jsp?lingua=italiano&men COVID-19: Suggests High volume suction
u=notizie&p=dalminister providing care with no
o&id=4835 further specification. COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 Not reported
Minimise procedures Reported that there is
that can produce
no evidence that double
aerosols. Prioritise
gloving is effective for
minimally invasive
the management of
restorative procedures suspected or confirmed
(hand instruments
cases
only). Unclear if
patients are treated in
regular practice or a
dedicated COVID-19
centre or hospital
Country Definition Non COVID-19 Double gloving Rubber dam Not reported Not reported No
Kenya Partially
Face masks - N95 for High volume suction
Source List of AGP hospital staff
Ministry of Health, instruments and
Director of Healthcare procedures Face shield
Services, Oral Health 3-in-1 syringe Disposable apron
Services
Permitted treatment Waterproof footwear
Date of first publication Non COVID-19:
24/03/2020 suggests emergency COVID-19 As non COVID-19 Rubber dam Not reported Not reported
treatment only
Latest update High volume suction
No update COVID-19: Suggests
emergency treatment
https://www.health.go.ke/ only. Unclear if patients
wp- are treated in regular
Page 26 of 69
24 July 2020
content/uploads/2020/06 practice or a dedicated

/Guidelines-for-Dental- COVID-19 centre or
Practicce-with-respect- hospital
to-COVID-19-
Pandemic.pdf
Country Definition Non COVID-19 Face mask - N95 Mouthwash - 1% General ventilation - Not reported No
Kosovo Not reported hydrogen peroxide for natural ventilation
Goggles/face visor 30 seconds avoid use of air
Source List of AGP conditioning
Practical guidelines for instruments and Surgical Rubber dam
dentistry professionals in procedures gown/protective clothing
the private sector during High speed High volume suction
Shoe covers
the COVID-19 virus handpieces, 3-in-1 recommended for
pandemic syringe, powered patients on entering
scaler clinic
Date of first publication
Not reported Permitted treatment
COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 Not reported
Limit use of AGPs
Latest update Non COVID-19:
Not reported suggests providing
http://osk-ks.org/wp- care with no further
content/uploads/2020/05 specification
/Rekomandimet-e-OSK-
per-ordinancat-private- COVID-19: Suggests
1.pdf providing care with no
treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - surgical Mouthwash - 1% Improve General There is a need to Yes
Malaysia Not reported masks and N95 hydrogen peroxide or ventilation in the observe a
0.2% Povidone dental surgery: reasonable turnover
Source List of AGP Goggles/face visor preoperative opening windows, time between
Malaysian Dental instruments and antimicrobial General ventilation patient and
Association Safety procedures Surgical gown
(waterproof) mouthwash fan, air cleaner, disinfection of
Advisory to Dental Not reported HEPA Room Filter clinical contact
Practitioners during the Surgical cap/hat Rubber dam surfaces
current Concern of Permitted treatment Surface disinfection
COVID - 19 Infection in Non COVID-19: High volume suction procedures with 62-
the initial relaxation suggests providing 71% ethanol, 0.5%
hydrogen peroxide
Page 27 of 69
24 July 2020
phase of Movement care with no further or 0.1% sodium

Control Order specification hypochlorite. Other
biocidal agents
Date of first publication COVID-19: Suggests such as 0.05-0.2%
Not reported providing care with no benzalkonium
further specification. chloride have also
Latest update Unclear if patients are
01/05/2020 been suggested but
treated in regular were reported by
https://mda.org.my/home practice or a dedicated some to be less
/wp- COVID-19 centre or effective
content/uploads/2020/05 hospital
/MDA_advisory_COVID1 COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
9_relaxation_phase_MC
O.pdf
Country Definition Non COVID-19 PPE requirements Mouthwash, If AGP 1% General ventilation - 20 minutes to keep No
Malta Not reported stratified based on low hydrogen peroxide, Keep windows open the window open
medium and high risk 0.2% Povidone or a during procedure if after procedure
Source List of AGP procedures. combination of no other means of prior to
Office for the Deputy instruments and Chlorhexidine (0.5- General ventilation. commencing
Prime Minister. Ministry procedures Face mask - N95 or 0.12%) + CPC (0.01- Ensure space is disinfection and
for Health High and slow speed other respirators that 1%) rinse prior to well ventilated. reprocessing of the
handpieces, powered offer a higher level of treatment. Windows must be clinical area. If no
Date of first publication scalers, 3-in-1 protection should be
Jun-20 closed if there is an General ventilation
syringes, used. If not available, a Rubber dam air purification of windows, 30
Latest update gagging/retching due to combination of a system in place minutes. If air
intra-oral radiography surgical mask and full High volume suction
No update which is turned on. purification offers 6
or an infected patient face shield/visor should air changes hourly,
https://deputyprimeminist coughing be used. Consider the use of clinic can be
er.gov.mt/en/health- upper-room disinfected after 15
promotion/covid- Permitted treatment Goggles/full face visor ultraviolet
Non COVID-19: minutes of resting
19/Documents/mitigation Surgical cap/hat for germicidal time.
-conditions-and- suggests providing irradiation as an
care with no further medium risk procedures
guidances/Guidance_De adjunct to higher
ntal- specification Disposable apron General ventilation
Practices_12Jun20.pdf COVID-19: Suggests and air cleaning
Shoes should be clinical rates
providing care with no shoes which are kept on
further specification. premises and
Unclear if patients are disinfected after every
treated in regular use, if not disposable
practice or a dedicated shoe covers should be
worn.
Page 28 of 69
24 July 2020
COVID-19 centre or COVID-19 Face mask - N95 or Schedule patient for Not reported
hospital other high level last appointment of
respirator the day and clean
surfaces after the
Goggles with side patient is dismissed
protection, face visor and before first
Surgical gown covering patient of the
full length of arms morning with
Sodium
Surgical cap/hat Hypochlorite
Country Definition Non COVID-19 Face mask - N95 Mouthwash (type not Not reported Not reported No
Mexico Not reported reported)
Goggles/face visor
Source List of AGP
Ministry of Health instruments and Surgical gown
procedures
Date of first publication COVID-19 Face mask - N95 As non COVID-19 Not reported Not reported
High speed
21/05/2020 handpieces, 3-in-1 Goggles/face visor
Latest update syringe
Surgical gown
21/05/2020 Permitted treatment
Non COVID-19: Shoe covers
https://www.fdiworlddent
al.org/sites/default/files/ emergency treatment
media/documents/recom only
endaciones_para_la_pra COVID-19: emergency
ctica_odontologica_ante treatment only. Patients
_covid-24.pdf can be treated in
practice with
appropriate PPE,
otherwise patients must
be treated in a
designated COVID-19
centre or hospital
Country Definition Non COVID-19 Face mask - N95 /FFP2 Mouthwash - 1% Not reported 60 minutes No
Montenegro Not reported hydrogen peroxide or
Goggles/face visor Povidone iodine
Source List of AGP
Dental Chamber of instruments and COVID-19 As non COVID-19 As non COVID-19 Not reported As non COVID-19
Montenegro Protocol for procedures
providing dental Not reported
treatment during the
COVID-19 epidemic Permitted treatment
Non COVID-19:
Page 29 of 69
24 July 2020
Date of first publication suggests providing

Not reported care with no further
specification
Latest update
Not reported COVID-19: Suggests
https://www.fdiworlddent further specification.
al.org/sites/default/files/ Unclear if patients are
media/documents/protok treated in regular
ol_za_pruzanje_stomatol practice or a dedicated
oskog_lijecenja_tokom_ COVID-19 centre or
epidemije_covid- hospital
19_0.pdf
Country Definition Non COVID-19 Face mask - Use slow speed drill No AGP in 15 mins following No
Morocco Not reported FFP2/N95/KN95 instead of high speed treatment room AGPs
handpieces. Limit the window unless
Source List of AGP Goggles/face visor water cooling system to adequate General
Ordre national des instruments and a minimum when using ventilation available
médecins dentists du procedures Surgical gown - for
treatments with high risk handpieces
Maroc Air cooling system
High speed of body fluid projections Mouthwash - 1% should be limited
Date of first publication handpieces, 3-in-1 hydrogen peroxide or when AGPs are
21/05/2020 syringe, powered Disposable apron - for
treatments with high risk 0.2% Povidone-iodine performed
scaling, air polishers
Latest update of body fluid projections Rubber dam
Non COVID-19: High volume suction
https://drive.google.com/f suggests providing
ile/d/1x8n1etxPIVI_rq7_ care with no further COVID-19 As non COVID-19 As non COVID-19 As non COVID-10 As non COVID-19
Z7oG_wjQIHq2BaB3/vie specification
w
COVID-19: Suggests
treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - N95 or Mouthwash - 1% Not reported Not reported No
Mozambique Not reported FFP2 hydrogen peroxide or
0.2% Povidone Iodine
Goggles/face visor or water with salt
Page 30 of 69
24 July 2020
Source List of AGP Rubber dam

Ministry of Health instruments and
procedures COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 Not reported
Date of first publication Surgical hand pieces
20/03/2020 and powered scalers
Latest update Permitted treatment
No update Non COVID-19:
https://www.fdiworlddent suggests providing
al.org/sites/default/files/ care with no further
media/documents/protoc specification
olo_de_atendimento_no COVID-19: Suggests
s_servicos_de_estomato emergency treatment
logia_covid-19.pdf only. Unclear if patients
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - medical Since intraoral Not reported Not reported No
Myanmar Not reported mask for both patients & radiographs stimulate
attendants (type not saliva and cough, use
Source List of AGP specified) extra-oral panoramic
Myanmar Dental instruments and radiography and cone
Association procedures Goggles/face visor beam radiographs
3-in-1 syringe
Date of first publication Preoperative
23/03/2020 Permitted treatment antimicrobial mouth
Non COVID-19: rinse should be given to
No update the patient before any
care with no further procedure to reduce
https://www.fdiworlddent specification microbe load
al.org/sites/default/files/ COVID-19: Suggests
media/documents/recom Rubber dam
emergency treatment
mendations_to_member only High volume suction
_dental_surgeons.pdf
COVID-19 Not reported Not reported COVID-19 Not reported
suspected should
be treated in well-
ventilated room as
the last patient to
avoid the disease
spread and
disinfection should
Page 31 of 69
24 July 2020
be done as soon as
the procedures are
finished
Country Definition Guidance does Face mask - FFP2 1% hydrogen peroxide Not reported Not reported No
Netherlands Not reported not explicitly reserved only for those for 1 minute. (3% H2O2
specify non patients with COVID-19 with water) pre-
Source List of AGP COVID-19 or symptoms or confirmed procedural rinses
The Royal Dutch Dental instruments and COVID-19 COVID-19
Association procedures patients Rubber dam
Not reported Type II/R or Type II +
Date of first publication face visor High volume suction
Suggests providing
29/06/2020 large mist vacuum
specification. Unclear if
https://www.knmt.nl/sites COVID-19 patients are
/default/files/20200629_l treated in regular
eidraad_mondzorg_coro practice or a dedicated
na_clmc_v_4.0.pdf COVID-19 centre or
hospital
Country Definition Non COVID-19 PPE recommended for Mouthwash Negative pressure Not reported Yes
New Zealand non-COVID-19 patients room
List of AGP is independent of using Rubber dam
Source instruments and AGPs
Dental council, Ministry procedures
of Health High speed Face mask - surgical
handpieces, 3-in-1 mask (level 2 or above)
Date of first publication syringe, air polishing,
05/01/2020 powered scalers Goggles/face visor
Latest update Permitted treatment Surgical gown
06/09/2020 Non COVID-19:
COVID-19 Face mask - N95 or Preferably use a slow General ventilation After treating a
https://www.dcnz.org.nz/ suggests providing
FFP2 speed handpieces that probable or COVID-
assets/Uploads/COVID/L care with no further operates at ≤ 40000 Negative pressure positive patient
evel1- specification Full face visor over room
rpm, and where when aerosol
guidelines9Jun20.pdf goggles or prescription possible turn the chip generating
COVID-19: Suggests
glasses air off, to minimise the procedures have
emergency treatment
only. Unclear if patients Long sleeve impervious aerosol generated occurred, the room
are treated in regular gowns during the procedure. should remain
practice or a dedicated closed for a stand-
Surgical cap/hat Mouthwash down period of 20
COVID-19 centre or
hospital Rubber dam
Disposable apron
Page 32 of 69
24 July 2020
Shoe covers High volume suction minutes prior to

cleaning.
Country Definition Non COVID-19 Face mask - surgical Mouthwash - 1% Not reported Not reported Yes
Norway Aerosol-generating mask type II or IIR hydrogen peroxide
procedures include (H2O2) for at least 1
Source certain procedures Goggles/face visor minute before dental
Norway Dental Health involving the patient’s treatment
Service – FHI Surgical cap/hat
airways
(Folkehelseinstituttet) Disposable apron Rubber dam/low
List of AGP suction
Date of first publication instruments and
03/12/2020 procedures High volume suction
Latest update High speed
COVID 19 Face mask - FFP2 or Minimise use of General ventilation Fallow period stated
26/05/2020 handpieces, slow
FFP3 handpieces; ultrasonic system and size of but time not
speed drill, 3-in1
scaler or aero-polishing the treatment room reported
https://www.fhi.no/nettpu syringe, powered Goggles/face visor devices should not be
b/coronavirus/helseperso scalers, air polishing
Surgical gown used, suction and
nell/rad-til- device
cotton rolls to dry
tannhelsetjenesten/#tann
Permitted treatment Surgical cap/hat
behandling-av-pasienter- Mouthwash - 1%
som-ikke-er-mistenkt- Non COVID-19:
hydrogen peroxide
sannsynlig-eller- suggests providing
(H2O2) for at least 1
bekreftet-med-covid19 care with no further
minute before dental
specification
treatment
COVID-19: Suggests
Rubber dam/
further specification. High volume suction
treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - N95, KN95 Mouthwash - General ventilation Not reported Yes
Panama Dental procedures or FPP2 mask for preparatory rinse with
which generate misting AGPs. Surgical face 1.5% hydrogen AGPs conducted in
Source of saliva outside the mask for non AGPs peroxide or 0.2% an isolated room to
Odontologic Association patients’ oral cavity are iodine-povidone for 3 avoid circulating air
of Panama considered as AGP Fit test required seconds to the rest of the
practice
Date of first publication List of AGP Goggles/face visor High volume suction
16/03/2020 instruments and Avoid jewellery and
Surgical gown accessories
procedures
Page 33 of 69
24 July 2020
Latest update High speed Surgical cap/hat

16/05/2020 handpieces, intra-oral
radiography Disposable apron
URL not available
Permitted treatment
Non COVID-19:
suggests providing
specification
COVID-19: Suggests
emergency treatment
only in a dedicated
COVID-19 centre or
hospital
Country Definition Non COVID-19 Not reported Mouthwash - 1 % General ventilation 60 minutes – low No
Paraguay Not reported hydrogen peroxide or risk AGP
0.2% Povidone Iodine HEPA filters and
Source List of AGP or water with salt negative pressure 120 minutes -
Ministry of Health instruments and room moderate risk AGP
procedures Rubber dam
Date of first publication High speed UV 180 minutes – high
Not reported handpieces, slow High volume suction light/Ozonisation/fu risk AGP
speed drill, 3-in-1 migation/ fogging
Latest update
07/05/2020 syringe, intra-oral Notes that as of the
radiography date of this report,
https://www.mspbs.gov.p none of the
y/dependencias/portal/ad Permitted treatment aforementioned has
junto/0f3634- Non COVID-19: conclusive scientific
Protocoloatencionodonto suggests urgent and evidence regarding
logica.pdf emergency treatment covid-19 in the
only dental office
COVID-19: Suggests environment and
urgent and emergency does replace the
treatment only. Unclear cleaning and
if patients are treated in disinfection
regular practice or a procedures of the
dedicated COVID-19 area.
centre or hospital
COVID-19 Not reported As non COVID-19 As non COVID-19 As non COVID-19
Page 34 of 69
24 July 2020
Country Definition Non COVID-19 Face mask - surgical Mouthwash - Hydrogen Avoid any extra Not reported Yes
Peru Aerosols are defined as mask peroxide or Povidone- equipment/accessor
particles that measure iodine ies
Source less than 50um Fit test required
Ministry of Health diameter Rubber dam
Goggles/face visor
Date of first publication List of AGP High volume suction
Not reported Surgical gown
instruments and
Latest update procedures Surgical cap/hat
Not reported High speed
handpieces, surgical Disposable apron
https://cdn.www.gob.pe/ handpieces, slow
COVID-19 As non COVID-19 but As non COVID-19 As non COVID-10 Not reported
uploads/document/file/71 speed drill, 3-in-1
wear N95 or FFP2
6209/DIRECTIVA_SANI syringe, powered
instead of surgical face
TARIA_N_100-MINSA- scaler, intra-oral
mask
2020-DGIESP.pdf radiography
Permitted treatment
Non COVID-19:
suggests urgent and
emergency treatment
only
COVID-19: Suggests
urgent and emergency
treatment only. Unclear
if patients are treated in
dedicated COVID-19
centre or hospital
Country Definition Non COVID-19 Double gloving of non- Mouthwash - 1% AGPs can only be 5 minutes (negative Yes
Philippines Dental procedures sterile examination over hydrogen peroxide or conducted in a pressure room only)
which generate misting gloves. Gloves should 0.2% Povidone is negative pressure
Source of saliva outside the be tapped to the wrists recommended at the room. AGPs can
Philippine Dental patients’ oral cavity are start and during entire only be conducted
Association Science considered as AGP Face mask - N95 or procedure, since in a negative
Committee FFP SARS-CoV-2 may be pressure room.
List of AGP vulnerable to oxidation.
Date of first publication instruments and Fit test required Air flow in the
Not reported Rinse initially for 60
procedures Goggles/face visor seconds, swab in operatory and
Latest update High speed children and patients waiting area should
31/05/2020 handpieces, 3-in-1 Surgical gown who are unable to rinse be away from you
and your staff.
Page 35 of 69
24 July 2020
https://www.fdiworlddent syringe, powered Surgical cap/hat Rubber dam Open windows or

al.org/sites/default/files/ scaler use mechanical
media/documents/interim High volume suction General ventilation
_guidelines_on_infection Permitted treatment to increase air
_prevention_during_covi Non COVID-19: changes
d-19_pandemic.pdf suggests emergency
treatment only Clinic staff should
ensure that infected
COVID-19: Suggests air to be delivered
emergency treatment out should be
only. Unclear if patients sterilized so as not
are treated in regular to infect other
practice or a dedicated individuals where
COVID-19 centre or infected air is blown
hospital out.
The US CDC
advises dental
clinics to consider
using HEPA air
filtration units
DURING and
AFTER AGP to
reduce particle and
droplet counts.
CDC advises
placing HEPA filter
beside the patient’s
chair, NOT BEHIND
the dental health
worker.
Ultra Violet
Germicidal
Irradiation (UVGI) -
an established
means of
disinfection and can
be used to prevent
the spread of
certain infectious
diseases.
Page 36 of 69
24 July 2020
Ultra Violet
Germicidal
Irradiation (UVGI) -
an established
means of
disinfection and can
be used to prevent
the spread of
certain infectious
diseases.
COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
Country Definition Non COVID-19 Face mask - FFP2 or Mouthwash - 1% HEPA 14 filters Room General Yes
Poland Not reported FFP3 (depending on the hydrogen peroxide recommended as ventilation
risk of the patient) solution, 0.2% general ventilation suggested, but no
Source List of AGP Povidone iodine method. specific time
The Polish Dental instruments and Goggle/face visor solution, or 0.2% chlor- provided.
Association procedures hexedine-alcohol UV light and Ozone
Not reported Surgical Gown mentioned as
Date of first publication solution
Surgical cap/hat optional
08/04/2020 Permitted treatment Rubber dam
Non COVID-19:
Latest update suggests providing High volume suction
NA care with no further
specification COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
https://doi.org/10.5114/jo
s.2020.94168 COVID-19: Suggests
treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Double gloving Mouthwash General ventilation Not reported No
Portugal AGPs are defined as
any procedures that Face masks (type not Rubber dam
Source involve a rotating specified)
Direcao Geral da Saude High volume suction
instrument or an air- Goggles/face visor
(Directorate General of water syringe
Health) Surgical gown
List of AGP
instruments and Surgical cat/hat
Page 37 of 69
24 July 2020
Date of first publication procedures Disposable apron

01/05/2020 Not reported
Shoe covers
Latest update List of permitted
No update treatment COVID-19 - As non COVID-19 As non COVID-19 As non COVID-19 Not reported
Non COVID-19: Urgent
https://www.omd.pt/covid suggests providing treatments only
-19/procedimentos/ care with no further
specification
COVID-19: Suggests
urgent and emergency
treatment only
Country Definition Non COVID-19 Face mask - disposable Limit use of particle and Dental interventions Open door / window No
Romania Not reported surgical mask (changed aerosol generating are provided only in for at least 15
after each patient). If a procedures and rooms with minutes, after each
Source List of AGP standard N95, FFP2, equipment automatic or natural patient
Not reported instruments and FFP3 mask or if absolutely necessary, ventilation (window)
Date of first publication procedures equivalent is used, the they are scheduled at
25/05/2020 Not reported specific rules of use the end of the working
Latest update Permitted treatment apply (change to a day
Not reported Non COVID-19: maximum of 4 hours).
Mouthwash - both
suggests providing Goggles/face visor before and at end of
https://www.dsptimis.ro/d care with no further (protective screen) will treatment for at least 30
ata_files/content/legislati specification be disinfected after seconds using 1% or
e-covid/files/ordin-873- each patient or, if they 1.5% hydrogen
2020.pdf COVID-19: Suggests
providing care with no are disposable, will be peroxide or Povidone
further specification replaced. iodine 0.2% -10 %
(watch out for allergic
Surgical cap/hat reactions)
Disposable gown Rubber dam
Shoe protection High volume
COVID-19 Face mask - FFP2 / As non Covid-19 As non Covid-19 As non Covid-19
KN95 or FFP3
(standard or equivalent)
Goggles/face visor
Surgical gown - non-
sterile waterproof long-
sleeved surgical gown
Page 38 of 69
24 July 2020
Surgical cap/hat -
disposable waterproof
cap
Disposable waterproof
apron/cape
Disposable protective
boots or disposable
waterproof coveralls
Country Definition Non COVID-19 Face mask - surgical Mouthwash - 1% Not reported 45 minutes No
Singapore Not reported mask hydrogen peroxide or
0.2% - 1% povidone or
Source List of AGP 0.05% - 0.1%
Ministry of Health instruments and cetylpyridinium chloride
Circular 132/2020 – procedures for 60 seconds
Gradual resumption of Not reported
dental services after Rubber dam
COVID-19 circuit breaker Permitted treatment
period Non COVID-19: High volume suction
suggest
Date of first publication urgent/emergency 4-handed dentistry
14/02/2020 dental care prioritised
but a wide range of
Latest update dental procedures with
21/05/2020 AGPs are permitted
https://www.healthprofes only where no other
sionals.gov.sg/docs/libra option is possible
riesprovider11/default- COVID-19: suggests
document-library/moh- AGPs are not provided
cir-no-
132_2020_21may20_de
ntal-services-after-cb-
period67b93be2bc2542d
18c675325ab75f730.pdf
Country Definition Non COVID-19 Face mask - FFP2/N95 Mouthwash – 1% General ventilation Not reported No
Slovakia Not reported Hydrogen peroxide – large extractor
Fit test required
Source List of AGP Rubber dam
Methodological instruments and Goggles/face visor
guidelines of the Chief procedures High volume suction
Surgical gown (change
Expert for the Not reported after each AGP)
Department of Dentistry
Page 39 of 69
24 July 2020
for the provision of Permitted treatment Surgical cap/hat

healthcare during the Limit use of high speed
COVID-19 pandemic handpieces, powered Shoe covers
scalers, and air
Date of first publication COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 Not reported
polishers
20/05/2020
Non COVID-19:
https://www.health.gov.s specification
k/?covid-19-metodicke- COVID-19: Suggests
usmernenia providing care with no
treated in regular
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - FFP2/N95 Not reported Not reported Not reported No
Slovenia Not reported for up to 4 hours wear
Source List of AGP Goggles/face visor
Expert recommendations instruments and
for the treatment of procedures Surgical gown – water
patients in dental clinics Not reported repellent
during the release of Surgical cap/hat
measures in the field of Permitted treatment
dentistry in the context of Non COVID-19:
COVID-19 Face mask - FFP3 or Not reported Not reported 10 minutes
COVID-19 Prioritise those with
FFP2 mask
problems or
Date of first publication undergoing a course of Goggles/face visor –
06/05/2020 treatment. Routine care disinfect after each
not obviously restricted patient
Latest update but not encouraged.
No update Limit AGPs where Surgical gown –
possible waterproof and should
https://www.gov.si/asset
be changed after each
s/ministrstva/MZ/DOKU COVID-19: patients, patient
MENTI/Koronavirus/Zob treated at selected
ozdravstvo/Strokovna- emergency dental Surgical cap/hat
priporocila-za- clinics and limited to
obravnavo-pacientov-v- emergency care
zobozdravstvenih-
ordinacijah-v-casu-
Page 40 of 69
24 July 2020
sproscanja-ukrepov-na- Shoe covers -

podrocju-zobozdrav.docx alternatively use special
disinfectable footwear
Country Definition Non COVID-19 Face mask – FFP2/N95 Utilise lowest aerosol- General ventilation Not reported Yes
South Africa Any patient and generating equipment
medical care procedure Fit test required and instrumentation Perform disinfectant
Source that results in the when delivering any fogging only for
SADA (South African Goggles, glasses with extraordinary
production of airborne side protection and face type of restorative or
Dental Association) particles (aerosols) hygiene care. circumstances and
Dental Protocol in shields. Disinfect with purposes in patient-
Response to the COVID- List of AGP 70% isopropyl after Mouthwash - the care areas.
19 Pandemic – A South instruments and each procedure. patient must rinse their Disinfectant fogging
African Private Practice procedures Surgical gown mouths immediately recommendations
Perspective 3-in-1 syringe, powered (disposable and with hydrogen peroxide refer to the spraying
scalers, high and slow reusable) and coveralls. (1% for 2 periods of 30 of chemicals, such
Date of first publication speed hand pieces with seconds each) or as formaldehyde or
May-20 Must meet the following
or without water criteria: sterile if Povidone-iodine rinses phenol-based
Latest update coolant, surgical hand reusable, long sleeves (0.23% to 1%) as well agents, to
No update pieces, high speed to cover arms and water as nasal spray. decontaminate
hand pieces, resistant. Cloth gowns Although not environmental
https://cdn.sada.co.za/fil maxillofacial and oral are not recommended, scientifically tested or surfaces or disinfect
es/clinical- surgery where high- as they are not water proven, we strongly the air in health
resources/downloads/cor speed devices are resistant. Commercially suggest that the patient care facilities.
onavirus/SADA%20DEN used, lasers. available reusable use the same rinsing Newer technologies
TAL%20PROTOCOL%2 gowns should be water procedure as before involving fogging for
0IN%20RESPONSE%20 Permitted treatment contact at the room
Non COVID-19: resistant, washable and
TO%20THE%20COVID1 sterilisable according to completion of the decontamination
9%20PANDEMIC%2020 suggests providing appointment fogging-type
care with no further manufacturer's
20.pdf?v=202006301124 recommendations. applications, such
02 specification The use of Listerine as ozone mists or
Surgical cap/hat - and chlorhexidine is not vaporised hydrogen
COVID-19: Suggests supported by the
providing care with no patient could be peroxide, have
provided with literature become available
Dentists need to disposable headwear. Rubber dam and are preferred.
assess their Additional hair cover is
environment to assure recommended when High volume suction
optimal isolation and working in a sterile or
high-risk environment Postoperative
general ventilation, and sanitation
see the patient at the with long hair and
end of the day. beards.
Otherwise, these Plastic aprons are not
patients need to be recommended for dental
seen in a specific and surgical purposes
Page 41 of 69
24 July 2020
COVID clinic or because they do not

hospital, not in a provide full body and
regular practice arm cover.
Shoe covers
Patient could be
provided with
disposable overshoes
and shoe covers. It is
suggested that
overshoes and shoe
covers should be single
patient use.
COVID-19 As non COVID-19 Keep appointments Optimal patient Not reported

short isolation
COVID-positive or General ventilation -
suspected positive Remember to factor
patients need to be in enough time for
scheduled for the end General ventilation
of the day or referred to specific attention to
areas where they can your own
be managed safely (a environment and
dedicated facility or a disinfection of the
hospital theatre treatment area
environment between cases
recommended)
Country Definition Non COVID-19 Double gloving Mouthwash - pre- General ventilation 15 minutes between Yes
Spain Interventions that procedural 1% - Although patients
generate aerosols are >2mts No face mask. hydrogen peroxide, numerous systems
Source considered riskier 0.2% Povidone iodine are available for air
Spanish National 1-2mts surgical face
including mask. <1mts FFP2 face or 0.05 cetylpyridinium filtration, none
Dentistry Council tracheotomies, all chloride. 0.1% present concrete
mask.
Date of first publication operative activity that mouthwash for 30 scientific
13/04/2020 requires high-speed If AGP, use FFP2 mask seconds. Avoid the use effectiveness
rotary instruments, and in specific cases of spittoons and use against SARS-
Latest update phases in carving in consider using FFP3 disposable cups. CoV2. Methods
01/05/2020 prosthodontics, surgery masks include:
that involves the Rubber dam - ozone purification
https://www.consejodenti generation of aerosols Fit test - After hand - purification with
stas.es/comunicacion/act wash, put on the mask, High volume suction
(implantology, chlorine dioxide
ualidad-consejo/notas- osteotomy, etc.), - use of
Page 42 of 69
24 July 2020
de-prensa- certain phases in then adjust and fit test in The usual work clothes hypochlorous acid
consejo/item/1783-plan- orthodontics (removal nose and chin. and footwear must be - purification by
estrategico-de-accion- of brackets and exclusively for work, generation of
para-clinicas-dentales- polishing) etc. Goggles/face visor - avoiding the use of hydroxyl radicals
durante-el-periodo-de- certified eye protectors street clothes or (OH)
desescalada.html AGPs are categorised based on the UNE-EN footwear in the office. It - use of UVC
by No AGPs, AGP and 166: 2002 standard for is important to avoid radiation
AGPs with high risk of protection against wearing rings, - use of negative
spillage. liquids can be integral bracelets, pendants, pressure or high
glasses against drops or watches or other items, pressure,
List of AGP face shields against
instruments and since they behave like associated with
splashes. reservoirs of COVID 19 HEPA (High-
procedures
High speed Surgical gown Efficiency
handpieces, 3-in-1 Particulate Air)
syringes, powered Surgical cap/hat filters
scalers, surgical The Spanish
handpieces, hard Society for
tissue lasers, air Environmental
polishers Health (SESA)
Permitted treatment advises against
Non COVID-19: chlorine dioxide and
suggests providing ozone in
care with no further disinfecting the air
specification. AGPs are against the
classified as low, coronavirus.
medium and high risk The Ministry of
depending on PPE Health in in Spain,
does not
COVID-19: Suggests recommend
providing care with no hypochlorous acid.
further specification. The use of UVC
Unclear if patients are rays in the dental
treated in regular field is not indicated
practice or a dedicated While hydroxyl
COVID-19 centre or radical generating
hospital systems are
effective with other
viruses, it is not yet
documented for
SARS-Cov-2
COVID-19 As non COVID-19 Avoid mouthwash As non COVID-19 Not reported
Page 43 of 69
24 July 2020
Country Definition Non COVID-19 Face mask - surgical Mouthwash - 1.5% General ventilation At least 15 minutes No
Switzerland Not reported mask or FFP2 mask if hydrogen peroxide – windows or for complete airing
rubber dam can’t be solution or Povidone- adequate General of room post AGP
Source List of AGP used iodine solution ventilation system
Swiss Dental Association instruments and mouthwash for 30 Forbidden to treat
procedures Goggles/face visor seconds patient in a room
Date of first publication Not reported without window or
17/04/2020 Rubber dam adequate General
Permitted treatment ventilation system
Latest update Non COVID-19: High volume suction
28/05/2020 suggests providing
care with no further COVID-19 - Face mask - FFP2 worn As non COVID-19 As non COVID-19 Up to 30 minutes
https://www.sso.ch/filead Only in case of for up to 30 minutes
min/upload_sso/5_Newsl specification
absolute following last AGP and
etter/2020/Covid-19- COVID-19: Suggests emergency that as long as patient is in
Positionspapier4-6-F.pdf providing care with no can’t be the room
further specification. postponed
Unclear if patients are Goggles/face visor
treated in regular
Surgical gown
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - FFP2 Use slow speed drill 15 minutes No
Tunisia Not reported instead of high speed
Goggles/face visor handpieces
Source List of AGP
Conseil National d’Ordre instruments and Surgical gown Mouthwash - hydrogen
des Médecins Dentistes procedures Surgical cap/hat peroxide or Povidone-
de la Tunisie Not reported iodine
Date of first publication Permitted treatment Rubber dam whenever
12/04/2020 Non COVID-19: possible
suggests providing
Latest update care with no further High volume suction
11/05/2020 specification
https://cnomdt.tn/docs/rel COVID-19: Suggests
atedInfo/protocole- providing care with no
covid4-cnomdt-26.pdf further specification.
treated in regular
COVID-19 centre or
hospital
Page 44 of 69
24 July 2020
Country Definition Non COVID-19 Face mask - N95 Mouthwash - 1% Designated room, 20 minutes between No
United Arab Emirates Not reported hydrogen peroxide or HEPA filter appointments
(Dubai) Goggles/face visor 0.2% Povidone iodine
List of AGP
Source instruments and Surgical gown for AGPs Rubber dam
Dubai Health Authority procedures Separate shoes for
Not reported High volume suction
Date of first publication clinical activities
Non COVID-19:
https://services.dha.gov. specification
ae/sheryan/wps/portal/ho COVID-19: Suggests
me/circular- providing care with no
details?circularRefNo=CI further specification.
R-2020- Unclear if patients are
00000236&isPublicCircul treated in regular
ar=1&fromHome=true practice or a dedicated
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - FFP3 for Windows in neutral Negative pressure No
UK - England Aerosol generating AGPs pressure rooms room: 20 minutes
procedures (AGPs) are should be opened,
Source defined as any medical Fit test required or extractor fans Neutral room: 60
Office of the Chief Dental and patient care that vent to the minutes
Officer, England Goggle/face visor
procedure that results exterior should be
Date of first publication in the production of Surgical gown used as air passing
06/04/2020 airborne particles externally will be
(aerosols). Rubber dam/low suction highly diluted and is
Latest update not considered to
List of AGP High volume suction
No update be a risk. The
instruments and greater the number
https://www.england.nhs. procedures of air changes per
uk/coronavirus/wp- High-speed handpieces hour (General
content/uploads/sites/52/ and high speed ventilation rate), the
2020/06/C0575-dental- surgical handpieces, sooner any aerosol
transition-to-recovery- powered scalers, 3-in-1 will be cleared. to
SOP-4June.pdf syringe be a risk
Permitted treatment COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19
Non COVID-19:
Suggests providing
Page 45 of 69
24 July 2020
specification. Whilst in
sustained community
transmission treat all
patients as high risk.
Treatment with extra
care and PPE,
minimise APGs
COVID-19: Suggests
emergency treatment
only in a dedicated
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - FFP3 Rubber dam General ventilation After providing an No
UK - Northern Ireland Not reported (Windows may be AGP, it is
Fit test required High volume suction opened) recommended that
Source List of AGP the room is left
Health and Social Care instruments and Goggles/face visor
vacant with the door
Board procedures Surgical gown closed for 20
High speed minutes in a
Date of first publication handpieces, powered
06/04/2020 negative pressure
scalers, 3-in-1 syringe, isolation room or 60
Latest update slow-speed drill with minutes in a neutral
22/06/2020 coolant spray (e.g. pressure room
surgical extractions), before cleaning and
http://www.hscbusiness. air abrasion and air decontamination
hscni.net/pdf/Preparation polishing
%20for%20the%20Re- If your practice has
establishment%20of%20 Permitted treatment an air flow system
the%20GDS%20Update Non COVID-19: or equivalent in
d%2022%20June%2020 suggests emergency place
20.pdf treatment only manufacturers
COVID-19: Suggests guidance should be
emergency treatment sought regarding
only. Unclear if patients the possible
are treated in regular reducing air settling
practice or a dedicated time with 6 air
COVID-19 centre or changes
hospital recommended prior
to cleaning and
decontamination
Page 46 of 69
24 July 2020
COVID-19 As non COVID-19 As non-COVID-19 As non-COVID-19 As non-COVID-19
Country Definition Non COVID-19 No AGP related advice No AGP related advice No AGP related No AGP related No
UK - Scotland Aerosol generating /recommendations /recommendations advice/recommenda advice
procedures (AGPs) are tions /recommendations
Source defined as any medical
Scottish Dental Clinical or patient care COVID-19 No AGP related advice No AGP related advice No AGP related No AGP related
Effectiveness procedure that results /recommendations /recommendations advice advice
Programme in the production of /recommendations /recommendations
Date of first publication airborne particles
25/05/2020 (aerosols).
Latest update List of AGP

06/12/2020 instruments and
procedures
http://www.sdcep.org.uk/ 3-in-1 syringe, high-
wp- speed handpieces,
content/uploads/2020/06 powered scalers
/SDCEP-Resuming-
General-Dental- Permitted treatment
Services-Following- Non COVID-19:
COVID-19-Shutdown- suggests urgent and
Update-120620.pdf routine treatment but
no AGP treatment.
COVID-19: suggests
AGP treatment in a
dedicated COVID-19
centre or hospital
Country Definition Non COVID-19 Face mask - FFP3 or Mouthwash mentioned Space 60 minutes when air Yes
UK - Wales AGPs are procedures FFP2 but document indicates appointments to changes per hour
that create aerosols (air lack of evidence ensure social (ACPH) is not
Source suspension of fine (≤ Fit test - Copies of fit regarding COVID-19 distancing. Book at known. Expert
Chief Dental Officer, 5μm) particles test certificates (where the end of a session infection control
Wales issued) and records of Rubber dam Schedule time for team advice should
List of AGP fit tests (pass and fail) procedure and time be sought when
Date of first publication instruments and for each staff member High volume suction
08/06/2020 for decontamination calculating times. If
procedures and each mask type (to include air the patient has
Latest update High speed should be retained by clearance in an evidence of
No update handpieces, air the practice. appropriate room) immunity
polishers, powered (laboratory) or of
scaler, air polishing, being non-infected
Page 47 of 69
24 July 2020
https://gov.wales/sites/de Slow speed drill, 3-in-1 Full face shield if FFP is Negative pressure (laboratory) and
fault/files/publications/20 syringe) not water resistant room with known air there is no
20-06/standard- changes per hour possibility of
operating-process-for-- Permitted treatment Surgical gown infection on the day
non-covid-19-dental- Non COVID-19: General ventilation - of treatment, the
suggests providing Disposable apron - Only Windowless
centres-providing- if gown is not water patient may be
aerosol-generating- care with no further surgeries with no air treated with
specification repellent changes should not
procedures-in-wales.pdf standard infection
be used. control measures
COVID-19: Suggests Windows should be
providing care with no with no additional
open where settle time. Leave
further specification. appropriate (this
Treat patients in a the room for 60
may not be minutes after an
dedicated COVID-19 appropriate where
centre or hospital AGP.
closed environment,
negative pressure Measurements can
systems are in be taken by health
place). and safety/ infection
Air conditioning control teams to
which recirculates determine air
air into the surgery changes per hour
should be switched for each surgery
off if it is linked to and the exact time
other practice areas needed. If this has
Air conditioning that taken place, records
removes air from of measurements
the environment and advice should
should be switched be kept.
on (venting of
extractor fans must The current
be assessed recommended time
alongside the risk of for negative
contamination of pressure rooms is
other areas) with 20 minutes. If a
notices placed at negative pressure
the vents. Seek room then with 12+
advice in relation to air exchanges leave
air conditioning as for 20 minutes
required. (Seek
advice for
windowless
surgeries as these
Page 48 of 69
24 July 2020
should not routinely

be used for AGP
Air purifiers and
devices to improve
air quality can be
considered but
there is insufficient
evidence on their
effectiveness in
relation to COVID-
19 at this time. If
practices wish to
consider these
pieces of
equipment, they
should seek advice
(contact the dental
COVID-19 lead who
will ask for advice
from the local
Infection Prevention
Control Teams).
Any decision should
be clearly
documented and
retained by the
practice for possible
future reference.
The default position
otherwise is to
follow the guidance
described above
Fogging techniques
(with e.g.
hypochlorous acid)
are not currently
recommended
Country Definition Non COVID-19 Face mask – type not 4-handed dentistry General ventilation 20-30 minutes No
Ukraine Not reported specified
Page 49 of 69
24 July 2020
Source List of AGP Goggles/face visor Mouthwash Quartz Lamps

National Academy of instruments and
Medical Sciences of procedures Surgical Rubber dam
Ukraine Not reported gown/protective suit
High volume suction
08/05/2020 Non COVID-19:
suggests providing
No update specification. Minimise
http://amnu.gov.ua/spilni- AGPs
rekomendacziyi-du- COVID-19: Suggests
instytut-stomatologiyi-ta- providing care with no
shhelepno-lyczevoyi- further specification.
hirurgiyi-namn-ukrayiny- Unclear if patients are
i-go-asocziacziya- treated in regular
stomatologiv-ukrayiny- practice or a dedicated
shhodo- COVID-19 centre or
protyepidemichnyh- hospital
zahodiv-v-
stomatologichnyh-
zakladah-ohor/
Country Definition Non COVID-19 Face mask - N95 or Mouthwash - 70% No

Uruguay The practice of FFP2 alcohol, 3% hydrogen
dentistry, as well as the peroxide or 10 volumes
Source use of dental Goggles/face visor (medical hydrogen
Ministry of Health instruments and peroxide) or
Surgical gown
Date of first publication equipment, can iodopovidone pre- and
Not reported generate aerosols that Surgical cap/hat post-treatment
contain droplets of
Latest update water particles, saliva, Disposable apron High volume suction
Not reported blood, microorganisms
and other wastes.
https://www.gub.uy/minis These biological
terio-salud- materials settle on the
publica/sites/ministerio- environment and work
salud- surfaces, dental care
publica/files/documentos personnel and the
/noticias/MSP_RECOME patient
NDACIONES_ODONTO
LOGOS_HIGIENISTAS_ List of AGP
DENTALES.pdf instruments and
procedures
Page 50 of 69
24 July 2020
High speed
handpieces, 3-in-1
syringe, intra-oral
radiography
Permitted treatment
Non COVID-19:
suggests emergency
treatment only
COVID-19: Suggests
Treat in a dedicated
COVID-19 centre or
hospital
Country Definition Non COVID-19 Face mask - surgical Rubber dam Not reported Until further No
USA Not reported face mask, N95 or evidence
KN95 High volume suction demonstrates a
Source List of AGP clear answer, the
American Dental instruments and Fit test required for N95 Use hand scaling
instead of ultrasonic ADA is not making
Association (ADA) procedures and KN95. Annual fit a recommendation
Not reported testing requirement scaling
Date of first publication on waiting for a
lifted and currently specific time period
24/04/2020 Permitted treatment unavailable
Non COVID-19: to begin cleaning
Latest update suggests providing Goggles/face visor the operatory.
06/09/2020 care with no further
specification. Surgical gown (clinical
https://success.ada.org/~ judgement)
/media/CPS/Files/Open COVID-19: Suggests
%20Files/ADA_Return_t providing care with no Surgical cap/hat (clinical
o_Work_Toolkit.pdf?utm further specification. judgement)
_campaign=covid-19- Unclear if patients are
Return-to-Work- Shoe covers (clinical
treated in regular judgement)
Toolkit&utm_medium=e practice or a dedicated
mail&_hsmi=86924194& COVID-19 centre or COVID-19 As non COVID-19 As non COVID-19 Not reported As non COVID-19
_hsenc=p2ANqtz- hospital
_HVpP4Wh9sKaPxqGZI
A1G9Ro1coYT29m3pRX
N1TDeZSaIr3__-
PzyReYsAnmYdx6fX_rJ
mFesmgepGb1_VhbsxZ
6Zu6g&utm_content=86
Page 51 of 69
24 July 2020
924194&utm_source=hs
_automation
Country Definition Non COVID-19 Face mask - N95 or a Mouthwash General ventilation - Not reported Yes
USA Not reported respirator that offers a systems that
higher level of Rubber dam provide air
Source List of AGP protection such as other movement in a
Centers for Disease instruments and High volume suction
disposable filtering face clean-to-less clean
Control and Prevention procedures piece respirators, flow direction… are
(CDC) Avoid use of dental powered air-purifying or better at protecting
handpieces, 3-in-1 elastomeric respirators. staff and patients.
Date of first publication syringe, powered
Not reported scalers Fit test – dental health- Consider the use of
Latest update care personnel should a HEPA air filtration
Permitted treatment be medically cleared unit while the
17/06/2020 Non COVID-19: and fit tested if using patient is
https://www.cdc.gov/coro suggests providing respirators with tight undergoing and
navirus/2019- care with no further fitting face pieces immediately
ncov/hcp/dental- specification. Treat all following an AGP to
settings.html patients as high risk Goggles, protective reduce aerosol
with extra care and eyewear with solid side concentrations and
PPE if necessary shields or a full face increase the
shield effectiveness of the
COVID-19: Suggests
providing care with no Gown or protective turnover time. Place
further specification. clothing the HEPA unit near
Avoid AGPs if possible. the patient’s chair
Unclear if patients are but not behind the
treated in regular DHCP.
practice or a dedicated Consider the use of
COVID-19 centre or upper-room
hospital ultraviolet
germicidal
irradiation as an
adjunct to higher
General ventilation
and air cleaning
rates
Ensure to account
for the time required
to clean and
disinfect operating
rooms between
patients when
Page 52 of 69
24 July 2020
calculating your
daily patient volume
COVID-19 Face mask - N95 or AGPs should ideally Not reported

higher level respirator take place in an
airborne infection
Fit test isolation room
Goggles/face visor
Surgical gown
Country Definition Non COVID-19 Not reported Not reported Not reported Not reported No
Zimbabwe
COVID-19 Face mask – ideally Manage emergency Not reported Not reported
Source List of AGP N95 without the generation
Zimbabwe Dental instruments and of aerosol
Association COVID-19 procedures Goggles/face visor
Dental Practice High speed Mandatory use of
Protective gown hydrogen peroxide
Recommendations/Guid handpieces, 3-in-1
elines syringe and scaler use mouth rinse before
dental procedures
Not reported Rubber dam
Non COVID-19:
22/04/2020 care with no further
specification. AGPs
https://www.fdiworlddent undertaken with
al.org/sites/default/files/ standard precautions
media/documents/covid-
19_dental_practice_reco COVID-19: Suggests
mmendations_guidelines emergency treatment
.pdf only with AGPs if
possible. If AGP
required, undertake
proper COVID-19
precautions. Unclear if
patients are treated in
dedicated COVID-19
centre or hospital
Non COVID-19 refers to patients who are presumed to have negative COVID-19 status; COVID-19 refers to patients with suspected or confirmed positive COVID-19 status.
ABHR, alcohol-based hand rub, ACH, air changes per hour; AGP, aerosol generating procedure; HEPA, high-efficiency particulate air; HVAC, heating ventilation and air
conditioning
Page 53 of 69
24 July 2020
Appendix 2. AGP reported by country
Country AGPs List of AGP Treatment Treatment

reported instruments or recommendation for recommendation for
procedures Non COVID-19 patients COVID-19 patients
Country: Argentina Yes High speed Suggests prioritising Suggests urgent treatments
Source: Ministry of Health - Ministerio de Salud Argentina COVID-19 handpieces, slow emergency treatment but only and avoiding AGPs as
Recomendaciones Para Odontologia speed drill, 3-in-1 treatment is not limited to much as possible. Unclear
Date of first publication: 10/06/2020 syringe, powered emergencies if patients are treated in
Latest update: No update scalers regular practice or a
dedicated COVID-19 centre
https://www.fdiworlddental.org/sites/default/files/media/documents/covid- or hospital
19_recomendaciones_para_odontologia.pdf
Country: Australia Yes High speed Suggests taking standard Suggests AGPS are
Source: Australian Dental Association handpieces, Surgical precautions avoided for suspected
Date of first publication: Various publication dates and updates handpieces, 3-in-1 COVID-19 cases. Urgent or
syringe, Powered emergency treatment only
https://www.ada.org.au/Covid-19-Portal/Dental-Professionals scalers (sonic/ for confirmed cases in a
ultrasonic), Air dedicated COVID-19 centre
polishers, Lasers or hospital, not in a regular
practice
Country: Austria No None reported Suggests providing care Suggests providing care
Source: Austrian Dental Chamber with no further with no further specification
Date of first publication: 03/04/2020 specification
Latest update: 04/05/2020
https://stmk.zahnaerztekammer.at/zahnaerztinnen/informationen-
corona-virus/
Country: Belgium No None reported Suggests providing care Suggest treating patients in
Source: Conseil de l’Art Dentaire on behalf of the Service Public with no further a dedicated COVID-19
Fédéral de Santé Publique specification centre or hospital, not in a
Date of first publication: 19/04/2020 regular practice
https://5199.f2w.fedict.be/sites/default/files/documents/2020-04-
19_covid-19_modification_20200524_-protocole_soins_dentaires.pdf
Page 54 of 69
24 July 2020

Country: Bolivia Yes High speed Suggests emergency Suggests emergency
Source: College of Dentists of La Paz handpieces, slow treatment only treatment only but patients
Date of first publication: 01/05/2020 speed drill, 3-in-1 should ideally be treated in
Latest update: No update syringe a high level health
institution (hospital)
https://www.fdiworlddental.org/sites/default/files/media/documents/proto
colo_de_bio-
seguridad_para_la_atencion_a_pacientes_y_prevencion_del_covid-
19_en_centreas_y_consultorios_odontologicos.pdf
Country: Brazil Yes High speed Suggests providing care Suggests providing care
Source: Biosafety Working Group of the São Paulo Regional Dentistry handpieces, surgical with no further with no further specification
Council handpieces, slow specification
Date of first publication: 01/04/2020 speed drill, 3-in-1
Latest update: No update syringe
http://www.crosp.org.br/uploads/arquivo/747df5ff505e7beff33c1a5ff5d6f
12a.pdf
Country: Bulgaria No None reported Suggests providing care Suggests providing care
Source: Recommendations/instructions from the crisis headquarters of with no further with no further specification
the Bulgarian Dental Union specification
Date of first publication: 03/06/2020
Latest update: No update
https://bzs.bg/препоръки-инструкции-от-кризисния-ща/
Country: Burkino Faso No None reported Suggests emergency Suggests emergency

Source: Ordre National des Chirurgiens Dentistes du Burkina treatment only treatment only. Unclear if
Ministère de la Santé patients are treated in
Date of first publication: Not reported regular practice or a
Latest update: Not reported dedicated COVID-19 centre
or hospital
URL not available
Page 55 of 69
24 July 2020

Country Canada Yes high-speed, low-speed in-person care for all Patients who need urgent and
and other rotary deferred, non-essential, and emergency care that cannot
Source Royal College of Dental Surgeons of Ontario COVID-19: MANAGING handpieces, powered elective services, in addition be delayed
INFECTION RISKS DURING IN-PERSON DENTAL CARE scalers, and 3-in-1 to emergency and urgent
Date of first publication 15/03/2020 syringes. care.
Latest update 31/05/20

https://www.rcdso.org/en-ca/rcdso-members/2019-novel-coronavirus/covid-19--
managing-infection-risks-during-in-person-care
Country: Chile Yes High speed Suggests providing care Suggests emergency
Source: Division of Disease Prevention and Control | Oral Health handpieces, 3-in-1 with no further treatment only. Unclear if
Department syringe, powered specification patients are treated in
Date of first publication: Not reported scalers regular practice or a
Latest update: Not reported dedicated COVID-19 centre
or hospital
http://www.colegiodentistas.cl/inicio/wp-
content/uploads/2020/04/orientaciones-atencion-odontologica-covid-
19.pdf
Country: China Yes High speed Suggests emergency Suggests AGPs are not
Source: Chinese Stomatological Association - Chinese Response to handpieces, powered treatment only provided in COVID-19
COVID-19 in Dental Field scalers patients
Date of first publication: Not reported
URL not available
Country: Colombia Yes High speed Suggests providing care Suggests emergency
Source: Ministry of Health and Social Protection - Ministerio de Salud y handpieces, surgical with no further treatment only. Unclear if
Protección Social Bogotá handpieces, slow specification patients are treated in
Date of first publication: May 2020 speed drill, 3-in-1 regular practice or a
Latest update: No update syringe dedicated COVID-19 centre
or hospital
https://www.minsalud.gov.co/Ministerio/Institucional/Procesos%20y%20
procedimientos/GIPS31.pdf
Page 56 of 69
24 July 2020

Country: Costa Rica Yes High speed Suggests providing care Suggests emergency
Source: Ministry of Health - Ministerio de Salud Costa Rica handpieces, surgical with no further treatment only treated in a
Date of first publication: 27/03/2020 handpieces, slow specification dedicated COVID-19 centre
Latest update: No update speed drill, 3-in-1 or hospital
syringe
https://www.ministeriodesalud.go.cr/sobre_ministerio/prensa/docs/linea
mientos_odontologos_v2_27032020.pdf
Country: Croatia Yes High speed Suggests providing care Suggests providing care
Source: Croatian Chamber of Dental Medicine handpieces, with no further with no further
Date of first publication: 04/05/2020 Powered scalers specification specification. Unclear if
Latest update: No update (sonic/ultrasonic) patients are treated in
https://www.hkdm.hr/novost/1836/Smjernice-i-protokoli-za-otvaranje-i- dedicated COVID-19 centre
rad-ordinacija-dentalne-medicine-i-dentalnih-laboratorija or hospital
Country: Denmark Yes High speed Suggest testing every Suggest postponing any
Source: SUNDHEDSSTYRELSEN, Danish Health Board handpieces, Surgical patient for COVID-19 appointment while patient is
Date of first publication: 18/04/20 handpieces, Slow before providing care COVID-19 positive
Latest update: 22/04/20 speed drill, 3-in-1
syringe, Powered
https://www.sst.dk/da/udgivelser/2020/haandtering-af-covid-19_-kritisk- scalers (sonic/
funktioner-i-tandplejen ultrasonic)
Country: Dominican Republic Yes Slow speed drill, 3- Suggests providing care Suggests providing care
Source: Ministry of Health in-1 syringe, intra- with no further with no further specification
Date of first publication: Not reported oral radiography specification except triage patients prior
Latest update: Not reported to treatment to identify
higher risk and take
https://www.fdiworlddental.org/sites/default/files/media/documents/reco precautions. Unclear if
mendaciones_para_la_guia_de_apertura_de_los_servicios_odontologic patients are treated in
os_en_la_republica_dominicana_debido_a_la_pandemia_covid-19.pdf regular practice or a
or hospital
Country: Ecuador Yes High speed Suggests providing care Suggests providing care
Source: Ministry of Health handpieces, surgical with no further with no further
Date of first publication: 28/05/2020 handpieces, slow specification specification. Unclear if
Latest update: No update speed drill, 3-in-1 patients are treated in
syringe, powered regular practice or a
Page 57 of 69
24 July 2020

https://www.fdiworlddental.org/sites/default/files/media/documents/proto scaler, intra-oral dedicated COVID-19 centre
colo_para_atencion_odontologica_durante_la_emergencia_sanitaria_po radiography or hospital
r_covid_-_19.pdf
Country: Estonia No None reported Suggests providing care Suggests AGPs are not
Source: Ministry of Health with no further provided in COVID-19
Date of first publication: 07/02/2020 specification patients
URL not available
Country: Finland Yes High speed Suggests providing care Suggests providing care
Source: Sector of administration of the Ministry of Social Affairs and handpieces, Slow with no further with no further
Health speed drill, 3-in-1 specification specification. Unclear if
Date of first publication: Not reported syringe, Powered patients are treated in
Latest update: 01/06/2020 scalers (sonic/ regular practice or a
ultrasonic) dedicated COVID-19 centre
https://thl.fi/fi/web/infektiotaudit-ja-rokotukset/taudit-ja-torjunta/taudit-ja- or hospital
taudinaiheuttajat-a-o/koronavirus-covid-19/ohje-suun-terveydenhuollon-
yksikoille-covid-19-epidemian-aikana
Country: France Yes High speed Suggests providing care Suggests providing care
Source: Haute Autorité de Santé (HAS) handpieces, 3-in-1 with no further with no further
Date of first publication: 14/05/2020 syringe, Powered specification specification. Unclear if
Latest update: 25/05/2020 scalers patients are treated in
(sonic/ultrasonic), Air regular practice or a
https://www.has-sante.fr/jcms/p_3184961/fr/mesures-et-precautions- polishers dedicated COVID-19 centre
essentielles-lors-des-soins-bucco-dentaires-apres-le-deconfinement or hospital
Country: Germany No None reported Suggests providing care Suggests providing care
Source: Institut der Deutschen Zahnärzte avoiding AGPs using low- avoiding AGPs using low-
Date of first publication: Not reported speed instrumentation speed instrumentation.
Latest update: 24/04/2020 (version 3) Unclear if patients are
treated in regular practice
https://www.idz.institute/publikationen/sonstiges/system-von- or a dedicated COVID-19
standardvorgehensweisen-fuer-zahnarztpraxen-waehrend-der- centre or hospital
coronavirus-pandemie.html
Page 58 of 69
24 July 2020

Country: Greece No None reported Suggests providing care Suggests providing care
Source: Instructions for dental employees in dentists and patients with no further with no further
Date of first publication: Not reported specification specification. Unclear if
Latest update: Not reported patients are treated in
https://www.fdiworlddental.org/sites/default/files/media/documents/odigie dedicated COVID-19 centre
s_pros_odontiatroys_ergazomenoys_se_odontiatreia_kai_astheneis_0.p or hospital
df
Country: Guatemala Yes High speed Suggests emergency Suggests emergency

Source: Estomatologic Callege of Guatemala handpieces, surgical treatment only treatment only. Unclear if
Date of first publication: 01/05/2020 handpieces, slow patients are treated in
Latest update: No update speed drill, 3-in-1 regular practice or a
syringe, powered dedicated COVID-19 centre
https://www.fdiworlddental.org/sites/default/files/media/documents/proto scaler, intra-oral or hospital
colo_de_bioseguridad_odontologica_con_enfasis_en_covid-19.pdf radiography
Country: Honduras No None reported Suggests providing care Unclear if patients are
Source: College of Dental Surgeons of Honduras with no further treated
Date of first publication: Not reported specification
Latest update: Not reported
http://www.cop.org.pe/wp-content/uploads/2020/04/PROTOCOLO-DE-
BIOSEGURIDAD-PARA-EL-CIRUJANO-DENTISTA.pdf
Country: India No None reported Suggests providing care Suggest treating patients in
Source: Dental Council of India with no further a specific COVID-19 centre
Date of first publication: 05/07/2020 specification or hospital, not in a regular
Latest update: No update practice
http://www.dciindia.gov.in/Admin/NewsArchives/Dental%20Centres%20
Protocols%20Final.pdf
Page 59 of 69
24 July 2020

Country: Ireland No None reported Suggests providing care Suggests providing care
Source: Irish Dental Association with no further with no further
Date of first publication: Not reported specification specification. Unclear if
Latest update: 15/05/2020 patients are treated in
https://www.hpsc.ie/a- dedicated COVID-19 centre
z/respiratory/coronavirus/novelcoronavirus/guidance/infectionprevention or hospital
andcontrolguidance/dentalservices/Guidance-ManagingInfectionRisk-
DentalServices-COVID19.pdf
Country: Italy No None reported Suggests providing care Suggests providing care
Source: All major Italian dental associations – available from the Italian with no further with no further
government website specification specification. Unclear if
Date of first publication: 30/05/2020 patients are treated in
Latest update: No update regular practice or a
http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?lingua=italiano&m or hospital
enu=notizie&p=dalministero&id=4835
Country: Kenya Yes 3-in-1 syringe Suggests emergency Suggests emergency

Source: Ministry of Health, Director of Healthcare Services, Oral Health treatment only. Treat all treatment only. Unclear if
Services patients as high risk with patients are treated in
Date of first publication: 24/03/2020 extra care and PPE if regular practice or a
Latest update: No update necessary dedicated COVID-19 centre
or hospital
https://www.health.go.ke/wp-content/uploads/2020/06/Guidelines-for-
Dental-Practicce-with-respect-to-COVID-19-Pandemic.pdf
Country: Kosovo Yes High speed Suggests providing care Suggests providing care
Source: Practical guidelines for dentistry professionals in the private handpieces, 3-in-1 with no further with no further
sector during the COVID-19 virus pandemic syringe, powered specification specification. Unclear if
Date of first publication: Not reported scaler patients are treated in
Latest update: Not reported regular practice or a
http://osk-ks.org/wp-content/uploads/2020/05/Rekomandimet-e-OSK- or hospital
per-ordinancat-private-1.pdf
Page 60 of 69
24 July 2020

Country: Malaysia No None reported Suggests providing care Suggests providing care
Source: Malaysian Dental Association Safety Advisory to Dental with no further with no further
Practitioners during the current Concern of COVID - 19 Infection in the specification specification. Unclear if
initial relaxation phase of Movement Control Order patients are treated in
Date of first publication: Not reported regular practice or a
Latest update: 01/05/2020 dedicated COVID-19 centre
or hospital
https://mda.org.my/home/wp-
content/uploads/2020/05/MDA_advisory_COVID19_relaxation_phase_M
CO.pdf
Country: Malta Yes High speed Suggests providing care Suggests providing care
Source: Office for the Deputy Prime Minister. Ministry for Health handpieces, Slow with no further with no further
Date of first publication: Jun-20 speed drill, 3-in-1 specification specification. Unclear if
Latest update: No update syringe, Powered patients are treated in
scalers (sonic/ regular practice or a
https://deputyprimeminister.gov.mt/en/health-promotion/covid- ultrasonic), Intra-oral dedicated COVID-19 centre
19/Documents/mitigation-conditions-and-guidances/Guidance_Dental- radiography or hospital
Practices_12Jun20.pdf
Country: Mexico Yes High speed Suggests treating Suggests emergency

Source: Ministry of Health handpieces, 3-in-1 emergencies only treatment only. Patients
Date of first publication: 21/05/2020 syringe can be treated in practice
Latest update: 21/05/2020 with appropriate PPE,
otherwise patients must be
https://www.fdiworlddental.org/sites/default/files/media/documents/reco treated in a designated
mendaciones_para_la_practica_odontologica_ante_covid-24.pdf COVID-19 hospital
Country: Montenegro No None reported Suggests providing care Suggests providing care
Source: Dental Chamber of Montenegro Protocol for providing dental with no further with no further
treatment during the COVID-19 epidemic specification specification. Unclear if
Date of first publication: Not reported patients are treated in
Latest update: Not reported regular practice or a
https://www.fdiworlddental.org/sites/default/files/media/documents/proto or hospital
kol_za_pruzanje_stomatoloskog_lijecenja_tokom_epidemije_covid-
19_0.pdf
Page 61 of 69
24 July 2020

Country: Morocco Yes Powered scaling, Suggests providing care Suggests providing are with
Source: Ordre national des médecins dentists du Maroc Use of handpieces, with no further no further specification.
Date of first publication: 21/05/2020 air polishing, 3-in-1 specification Unclear if patients are
Latest update: 21/05/2020 syringe treated in regular practice
https://drive.google.com/file/d/1x8n1etxPIVI_rq7_Z7oG_wjQIHq2BaB3/vi or a dedicated COVID-19
ew centre or hospital
Country: Mozambique No None reported Suggests providing care Suggests emergency

Source: Ministry of Health with no further treatment only. Unclear if
Date of first publication: 20/03/2020 specification patients are treated in
Latest update: No update regular practice or a
https://www.fdiworlddental.org/sites/default/files/media/documents/proto or hospital
colo_de_atendimento_nos_servicos_de_estomatologia_covid-19.pdf
Country: Myanmar Yes 3-in-1 syringe Suggests providing care Suggests emergency
Source: Myanmar Dental Association with no further treatment only
https://www.fdiworlddental.org/sites/default/files/media/documents/reco
mmendations_to_member_dental_surgeons.pdf
Country: Netherlands No None reported Suggests providing care Suggests providing care
Source: The Royal Dutch Dental Association with no further with no further
Date of first publication: 21/04/2020 specification specification. Unclear if
https://www.knmt.nl/sites/default/files/20200629_leidraad_mondzorg_cor dedicated COVID-19 centre
ona_clmc_v_4.0.pdf or hospital
Page 62 of 69
24 July 2020

Country: New Zealand Yes High speed Suggests providing care Suggests emergency
Source: Dental council, Ministry of Health handpieces, 3-in-1 with no further treatment only. Unclear if
Date of first publication: 05/01/2020 syringe, Powered specification patients are treated in
Latest update: 06/09/2020 scalers regular practice or a
(sonic/ultrasonic), Air dedicated COVID-19 centre
https://www.dcnz.org.nz/assets/Uploads/COVID/Level1- polishers or hospital
guidelines9Jun20.pdf
Country: Norway Yes High speed Suggests providing care Suggests providing care
Source: Norway Dental Health Service – FHI (Folkehelseinstituttet) handpieces, Slow with no further with no further
Date of first publication: 03/12/2020 speed drill, 3-in-1 specification specification. Unclear if
Latest update: 26/05/2020 syringe, Powered patients are treated in
scalers (sonic/ regular practice or a
https://www.fhi.no/nettpub/coronavirus/helsepersonell/rad-til- ultrasonic), Air dedicated COVID-19 centre
tannhelsetjenesten/#tannbehandling-av-pasienter-som-ikke-er-mistenkt- polishers or hospital
sannsynlig-eller-bekreftet-med-covid19
Country: Panama Yes High speed Suggests providing care Suggests emergency
Source: Odontologic Association of Panama handpieces, intra- with no further treatment only in a
Date of first publication: 16/03/2020 oral radiography specification dedicated COVID-19 centre
Latest update: 16/05/2020 or hospital
URL not available
Country: Paraguay Yes High speed Suggests urgent care and Suggests urgent care and
Source: Ministry of Health handpieces, slow emergency treatment only emergency treatment only.
Date of first publication: Not reported speed drill, 3-in-1 Unclear if patients are
Latest update: 07/05/2020 syringe, intra-oral treated in regular practice
radiography or a dedicated COVID-19
https://www.mspbs.gov.py/dependencias/portal/adjunto/0f3634- centre or hospital
Protocoloatencionodontologica.pdf
Country: Peru Yes High speed Suggests emergency Suggests emergency

Source: Ministry of Health handpieces, surgical treatment only treatment only. Unclear if
Date of first publication: Not reported handpieces, slow patients are treated in
Latest update: Not reported speed drill, 3-in-1 regular practice or a
https://cdn.www.gob.pe/uploads/document/file/716209/DIRECTIVA_SA syringe, powered dedicated COVID-19 centre
NITARIA_N_100-MINSA-2020-DGIESP.pdf or hospital
Page 63 of 69
24 July 2020

scaler, intra-oral
radiography
Country: Philippines Yes Hgh speed Suggests emergency Suggests emergency
Source: Philippine Dental Association Science Committee handpieces, 3-in-1 treatment only treatment only. Unclear if
Date of first publication: Not reported syringe, powered patients are treated in
Latest update: 31/05/2020 scaling regular practice or a
https://www.fdiworlddental.org/sites/default/files/media/documents/interi or hospital
m_guidelines_on_infection_prevention_during_covid-19_pandemic.pdf
Country: Poland No None reported Suggests providing care Suggests providing care
Source: The Polish Dental Association with no further with no further
Latest update: NA patients are treated in
https://doi.org/10.5114/jos.2020.94168 dedicated COVID-19 centre
or hospital
Country: Portugal No High speed Suggests providing care Suggests urgent and
Source: Direcao Geral da Saude (Directorate General of Health) handpieces, 3-in-1 with no further emergency treatment only
Date of first publication: 01/05/2020 syringe specification
https://www.omd.pt/covid-19/procedimentos/
Country: Romania No None reported Suggests providing care Suggests providing care
Source: Not reported with no further with no further specification
https://www.dsptimis.ro/data_files/content/legislatie-covid/files/ordin-873-
2020.pdf
Country: Singapore No None reported Suggests urgent and Suggests AGPs are not
Source: Ministry of Health Circular 132/2020 – Gradual resumption of emergency care is provided in COVID-19
dental services after COVID-19 circuit breaker period prioritised but a wide patients
Date of first publication: 14/02/2020 range of dental
Latest update: 21/05/2020 procedures with AGPs are
permitted where no other
option is possible
Page 64 of 69
24 July 2020

https://www.healthprofessionals.gov.sg/docs/librariesprovider11/default-
document-library/moh-cir-no-132_2020_21may20_dental-services-after-
cb-period67b93be2bc2542d18c675325ab75f730.pdf
Country: Slovakia No None reported Suggests providing care Suggests providing care
Source: Methodological guidelines of the Chief Expert for the with no further with no further
Department of Dentistry for the provision of healthcare during the specification specification. Unclear if
COVID-19 pandemic patients are treated in
Date of first publication: 20/05/2020 regular practice or a
Latest update: No update dedicated COVID-19 centre
or hospital
https://www.health.gov.sk/?covid-19-metodicke-usmernenia
Country: Slovenia No None reported Suggests prioritising Suggests patients are

Source: Expert recommendations for the treatment of patients in dental those with problems or treated at selected
centres during the release of measures in the field of dentistry in the undergoing a course of emergency dental centres
context of COVID-19 treatment. Routine care and limited to emergency
Date of first publication: 06/05/2020 not obviously restricted care
Latest update: No update but not encouraged. Limit
AGPs where possible
https://www.gov.si/assets/ministrstva/MZ/DOKUMENTI/Koronavirus/Zob
ozdravstvo/Strokovna-priporocila-za-obravnavo-pacientov-v-
zobozdravstvenih-ordinacijah-v-casu-sproscanja-ukrepov-na-podrocju-
zobozdrav.docx
Country: South Africa Yes High speed Suggests providing care Suggest providing care with
Source: SADA (South African Dental Association) Dental Protocol in handpieces, Surgical with no further no further specification.
Response to the COVID-19 Pandemic – A South African Private handpieces, Slow specification Dentists need to assess
Practice Perspective speed drill, 3-in-1 their environment to assure
Date of first publication: May-20 syringe, Powered optimal isolation and
Latest update: No update scalers (sonic/ ventilation, and see at the
ultrasonic), Lasers end of the day. Otherwise,
https://cdn.sada.co.za/files/centreal- these patients need to be
resources/downloads/coronavirus/SADA%20DENTAL%20PROTOCOL seen in a dedicated
%20IN%20RESPONSE%20TO%20THE%20COVID19%20PANDEMIC COVID-19 centre or
%202020.pdf?v=20200630112402 hospital, not in a regular
practice
Country: Spain Yes High speed Suggest providing care Suggests providing care
Source: Spanish National Dentistry Council handpieces, Surgical with no further with no further
Page 65 of 69
24 July 2020

Date of first publication: 13/04/2020 handpieces, 3-in-1 specification. AGPs are specification. Unclear if
Latest update: 01/05/2020 syringe, Powered classified as low, medium, patients are treated in
scalers (sonic/ and high risk depending regular practice or a
https://www.consejodentistas.es/comunicacion/actualidad- ultrasonic), Air on PPE dedicated COVID-19 centre
consejo/notas-de-prensa-consejo/item/1783-plan-estrategico-de-accion- polishers, Lasers or hospital
para-centreas-dentales-durante-el-periodo-de-desescalada.html
Country: Switzerland No None reported Suggests providing care Suggests providing care
Source: Swiss Dental Association with no further with no further
https://www.sso.ch/fileadmin/upload_sso/5_Newsletter/2020/Covid-19- dedicated COVID-19 centre
Positionspapier4-6-F.pdf or hospital
Country: Tunisia No None reported Suggests providing care, Suggests providing care
Source: Conseil National d’Ordre des Médecins Dentistes de la Tunisie with no further with no further
https://cnomdt.tn/docs/relatedInfo/protocole-covid4-cnomdt-26.pdf dedicated COVID-19 centre
or hospital
Country: United Arab Emirates (Dubai) No None reported Suggests providing care Suggests providing care
Source: Dubai Health Authority with no further with no further
Latest update: No update patients are treated in
https://services.dha.gov.ae/sheryan/wps/portal/home/circular- dedicated COVID-19 centre
details?circularRefNo=CIR-2020- or hospital
00000236&isPublicCircular=1&fromHome=true
Page 66 of 69
24 July 2020

Country: UK - England Yes High speed Suggests providing care Suggests emergency
Source: Office of the Chief Dental Officer, England handpieces, Surgical with no further treatment only in a
Date of first publication: 06/04/2020 handpieces, 3-in-1 specification. Whilst in dedicated COVID-19 centre
Latest update: No update syringe, Powered sustained community or hospital
scalers (sonic/ transmission, suggests
https://www.england.nhs.uk/coronavirus/wp- ultrasonic) treating all patients as
content/uploads/sites/52/2020/06/C0575-dental-transition-to-recovery- high risk. Treatment with
SOP-4June.pdf extra care and PPE.
Minimise APGs
Country: UK - Northern Ireland Yes High speed Suggests emergency Suggests emergency
Source: Health and Social Care Board handpieces, Surgical treatment only treatment only. Unclear if
Date of first publication: 06/04/2020 handpieces, 3-in-1 patients are treated in
Latest update: 22/06/2020 syringe, Powered regular practice or a
scalers (sonic/ dedicated COVID-19 centre
http://www.hscbusiness.hscni.net/pdf/Preparation%20for%20the%20Re- ultrasonic), Air or hospital
establishment%20of%20the%20GDS%20Updated%2022%20June%202 polishers
020.pdf
Country: UK- Scotland Yes High speed Suggests urgent and Suggests AGP treatment in
Source: Scottish Dental Centreal Effectiveness Programme handpieces, 3-in-1 routine treatment but no a dedicated COVID-19
Date of first publication: 25/05/2020 syringe, powered AGP treatment. centre or hospital
Latest update: 06/12/2020 scalers
(sonic/ultrasonic)
http://www.sdcep.org.uk/wp-content/uploads/2020/06/SDCEP-
Resuming-General-Dental-Services-Following-COVID-19-Shutdown-
Update-120620.pdf
Country: UK- Wales Yes High speed Suggests providing care Suggest providing care with
Source: Chief Dental Officer, Wales handpieces, Slow with no further no further specification and
Date of first publication: 08/06/2020 speed drill, 3-in-1 specification treat patients in a specific
Latest update: No update syringe, powered COVID centre or hospital,
scalers (sonic/ not in a regular practice
https://gov.wales/sites/default/files/publications/2020-06/standard- ultrasonic), air
operating-process-for--non-covid-19-dental-centres-providing-aerosol- polishers
generating-procedures-in-wales.pdf
Page 67 of 69
24 July 2020

Country: Ukraine No None reported Suggests providing care Suggest providing care with
Source: National Academy of Medical Sciences of Ukraine with no further no further specification and
Date of first publication: 08/05/2020 specification treat patients in a dedicated
Latest update: No update COVID centre or hospital,
not in a regular practice
http://amnu.gov.ua/spilni-rekomendacziyi-du-instytut-stomatologiyi-ta-
shhelepno-lyczevoyi-hirurgiyi-namn-ukrayiny-i-go-asocziacziya-
stomatologiv-ukrayiny-shhodo-protyepidemichnyh-zahodiv-v-
stomatologichnyh-zakladah-ohor/
Country: Uruguay Yes High speed Suggests emergency Suggest providing care with
Source: Ministry of Health handpieces, 3-in-1 treatment only no further specification and
Date of first publication: Not reported syringe, intra-oral treat patients in a specific
Latest update: Not reported radiography COVID centre or hospital,
not in a regular practice
https://www.gub.uy/ministerio-salud-publica/sites/ministerio-salud-
publica/files/documentos/noticias/MSP_RECOMENDACIONES_ODONT
OLOGOS_HIGIENISTAS_DENTALES.pdf
Country: USA No None reported Suggests providing care Suggests providing care
Source: American Dental Association with no further with no further
https://success.ada.org/~/media/CPS/Files/Open%20Files/ADA_Return_ dedicated COVID-19 centre
to_Work_Toolkit.pdf?utm_campaign=covid-19-Return-to-Work- or hospital
Toolkit&utm_medium=email&_hsmi=86924194&_hsenc=p2ANqtz-
_HVpP4Wh9sKaPxqGZIA1G9Ro1coYT29m3pRXN1TDeZSaIr3__-
PzyReYsAnmYdx6fX_rJmFesmgepGb1_VhbsxZ6Zu6g&utm_content=8
6924194&utm_source=hs_automation
Country: USA Yes High speed Suggest providing care Suggests providing care
Source: Centers for Disease Control and Prevention (CDC) handpieces, Slow with no further with no further
Date of first publication: Not reported speed drill, 3-in-1 specification. Treat all specification. Avoid AGPs if
Latest update: 17/06/2020 syringe, powered patients as high risk, with possible. Unclear if patients
scalers extra care and PPE if are treated in regular
https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html (sonic/ultrasonic) necessary practice or a dedicated
Page 68 of 69
24 July 2020

COVID-19 centre or
hospital
Country: Zimbabwe Yes High speed Suggests providing care Suggests emergency
Source: Zimbabwe Dental Association COVID-19 Dental Practice handpieces, 3-in-1 with no further treatment only without
Recommendations/Guidelines syringe and scaler specifications. AGPs AGPs if possible. If
Date of first publication: Not reported use undertaken with standard procedure requires AGP,
Latest update: 22/04/2020 COVID-19 precautions undertake proper COVID-
19 precautions. Unclear if
https://www.fdiworlddental.org/sites/default/files/media/documents/covid- patients are treated in
19_dental_practice_recommendations_guidelines.pdf regular practice or a
or hospital
Non COVID-19 refers to patients who are presumed to have negative COVID-19 status; COVID-19 refers to patients with suspected or confirmed positive COVID-19
status
AGP, aerosol generating procedure
Page 69 of 69

Rapid - Review - of - Agps - in - International - Dental - Guidance - SDCEP Documents

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Aerosol Generating Procedures and their

Mitigation in International Dental Guidance

COVID-19 Dental Services Evidence Review (CoDER) Working Group

How to cite this document:

reviewer. Data items included definitions of AGPs, recommendations on personal protective

AGPs definition and list of procedures

Twenty one of the 63 documents (33%) provided a definition of aerosol generating

countries recommending a surgical mask, 10 suggest the use of FFP2/N95 masks if

Of the documents providing recommendations for the treatment of COVID-19 patients, a

Aerosol mitigation procedures included mouthwashes, rubber dam and high-volume

Working Group Members

Jan Clarkson, Professor of Clinical Effectiveness, University of Dundee;

Appendix 1. AGPs summary table by country

ctions from the crisis procedures Surgical gown

Infection Risks During In-

odontologica-covid- suggests providing

COVID-19 Not reported Not reported Not reported Not reported

No update Permitted treatment

Date of first publication procedures always after each procedure must be

COVID-19 Not reported Not reported Not reported Not reported

en_la_republica_dominic further specification. No

URL not available care with no further 4 handed dentistry with

19/ohje-suun- COVID-19: Suggests Surgical gown – A long- after the end of

Latest update suggests providing Rubber dam

COVID-19 Not reported Not reported Not reported Not reported

Source procedures Surgical gown

area of the dental

COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 Not reported

content/uploads/2020/06 practice or a dedicated

phase of Movement care with no further or 0.1% sodium

Date of first publication suggests providing

Source List of AGP Rubber dam

Shoe covers High volume suction minutes prior to

Latest update High speed Surgical cap/hat

https://www.fdiworlddent syringe, powered Surgical cap/hat Rubber dam Open windows or

COVID-19 As non COVID-19 As non COVID-19 As non COVID-19 As non COVID-19

Date of first publication procedures Disposable apron

for the provision of Permitted treatment Surgical cap/hat

sproscanja-ukrepov-na- Shoe covers -

COVID clinic or because they do not

COVID-19 As non COVID-19 Keep appointments Optimal patient Not reported

COVID-19 As non COVID-19 Avoid mouthwash As non COVID-19 Not reported

COVID-19 As non COVID-19 As non-COVID-19 As non-COVID-19 As non-COVID-19

Latest update List of AGP

should not routinely

Source List of AGP Goggles/face visor Mouthwash Quartz Lamps

Country Definition Non COVID-19 Face mask - N95 or Mouthwash - 70% No

COVID-19 Face mask - N95 or AGPs should ideally Not reported

Appendix 2. AGP reported by country

Country AGPs List of AGP Treatment Treatment

Country AGPs List of AGP Treatment Treatment

Country: Burkino Faso No None reported Suggests emergency Suggests emergency

Country AGPs List of AGP Treatment Treatment

Latest update 31/05/20

URL not available

Country AGPs List of AGP Treatment Treatment

Country AGPs List of AGP Treatment Treatment

URL not available

Country AGPs List of AGP Treatment Treatment

Country: Guatemala Yes High speed Suggests emergency Suggests emergency

Country AGPs List of AGP Treatment Treatment

Country: Kenya Yes 3-in-1 syringe Suggests emergency Suggests emergency