Climatization systems for Brazilian dental teaching clinics
a narrative review in the context of the COVID-19 pandemic
Palavras-chave:Air purifier, COVID-19, HEPA filters, HVAC systems, Dental Schools
COVID-19 outbreack has reaffirmed the need to maintain ventilation of dental environments properly. This study was carried out to encourage a reflective analysis of the risks of air contamination in Brazilian dental clinics. A narrative review of the literature was carried out on the recommendations of heating, ventilation and air conditioning (HVAC) systems in dental environments, considering the risks of air contamination in Brazilian dental teaching clinics. The literature research was conducted in the PubMed and Google Scholar databases and the main studies that evaluated the climatization systems and portable high efficiency particulate air filtration (HEPA) units in dental environments were included. Furthermore, it were analyzed the guidelines of the Centers for Disease Control and Prevention, the Brazilian National Health Surveillance Agency, the Brazilian Ministry of Health and important institutions of the different countries. After the initial research, a review of the guidelines and articles that assess the use of HEPA units to improve air cleanliness. This analysis was done by different groups of researchers. All documents mentioned that the air quality of the dental offices must follow the protocols in current legislation to ensure the safety of the environs. They reaffirmed that the COVID-19 pandemic makes it imperative that dental environments equipped with air conditioning have mechanical air renewal devices. An alternative for Brazilian dental teaching clinics equipped with mini-splits or window air conditioning could be the installation of exhaust fans and portable HEPA filter units to exchange air and reduce aerosols inside the environments.
Mattos FF, Pordeus IA. COVID-19: a new turning point for dental practice. Braz Oral Res. 2020; 34:e085.
World Bank Group, The COVID-19 pandemic: shocks to education and policy responses; 2020. [Cited June 08, 2021]. Available from: Erro! A referência de hiperlink não é válida..
Brazilian National Institute of Educational Research and Studies Anísio Teixeira, Statistics of the tertiary education census 2018; 2020. [Cited June 21, 2021]. Available from: http://portal.inep.gov.br/web/guest/ sinopses-estatisticas-da-educacao-superior.
Brazilian Ministry of Health, Guide of orientations for dental care in the context of COVID-19; 2020. [Cited July 05, 2021]. Available from: https://www.gov.br/saude/pt-br/media/pdf/2020/novembro/17/17_12_guia-de-orientacaoes-para-atencao-odontologica-no-contexto-da-covid-19.pdf.
Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): emerging and future challenges for dental and oral medicine. J Dent Res. 2020; 99(5):481-7.
Aragão M, Gomes F, Melo LPMP, CoronaS. Brazilian dental students and COVID-19: a survey on knowledge and perceptions. EurJ Dent Educ. 2022; 26(1):93-105.
Iyer P, Aziz K, Ojcius DM. Impact of COVID-19 on dental education in the United States. J Dent Educ. 2020; 84(6):718-22.
Machado RA, Bonan P, Perez D, Martelli Júnior H. COVID-19 pandemic and the impact on dental education: discussing current and future perspectives. Braz Oral Res. 2020; 34:e083.
Center for Disease Control and Prevention (CDC), Guidance for dental settings interim infection prevention and control guidance for dental settings during the coronavirus disease 2019 (COVID-19) pandemic; 2020. [Cited Aug 11, 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html.
Brazilian Association of Technical Standards (ABNT), NBR 16401-3: Air conditioning installations - central and unitary systems. Part 3: Indoor air quality; 2008. [Cited Aug 11, 2021]. Available from: http://www.caramuru.com.br/pdf/NBR_16401-3_2008.pdf.
Santos MGC, Santos RC, Arnaud RR. Assessment of standards of biosecurity at the dental clinics Federal University of Paraíba. Rev Bras Ciênc Saúde. 2011; 14(3):7-12.
Nunes LM, Viana TS, da Silva GMC, Botelho MPJ, Capel LMM. Identification of the fungal population in air samples collected at Pediatric Dentistry teaching clinic. Rev ABENO. 2018; 18(3):84-92.
Liu Y, Ning Z, Chen Y, Guo M, Liu Y, Gali NK, et al. Aerodynamic analysis of SARSCoV-2 in two Wuhan hospitals. Nature. 2020a; 582(7813):557-60.
Dentist Advice. Collegiate Organization of Dentists of Spain, Strategic Action Plan for the Covid-19 Containment Period; 2020. [Cited Sept 09, 2021]. Available from: https://www.consejodentistas.es/comunicacion/actualidad-consejo/notas-de-prensaconsejo/item/1783-plan-estrategico-deaccion-para-clinicas-dentales-durante-elperiodo-de-desescalada.html.
Office of Chief Dental Officer England, Standard Operating Procedure Transition to Recovery - A phased transition for dental practices towards the resumption of the full range of dental provision; 2020. [Cited Oct 28, 2021]. Available from: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0575-dental-transition-to-recovery-SOP4June.pdf.
South African Dental Association (SADA), SADA Dental Protocol in Response to the COVID-19 Pandemic; 2020. [Cited Aug 22, 2021]. Available from: https://cdn.sada.co.za/files/clinical-resources/downloads/coronavirus/SADA%20DENTAL%2
Associação Brasileira de Ensino Odontológico. Consenso ABENO: biossegurança no ensino Odontológico póspandemia da COVID-19; 2020. [Cited: Aug 13, 2021]. Available from: https://abeno.org.br/abeno-files/downloads/retomada-de-praticas-seguras-no-ensinoodontologico.pdf.
Brazilian Intensive Care Medicine Association (AMIB), Brazilian Federal Council of Dentistry (CFO). AMIB / CFO recommendations for the dental care COVID- 19: AMIB / CFO Dentistry Committee of confronting the COVID-19; 2020. [Cited Sept 04, 2021]. Available from: https://www.amib.org.br/fileadmin/user_upload/amib/2020/junho/22/220620Recomendacoes_AMIB__CFO_para_atendimento_odo ntologico_COVID-19.pdf.
American Dental Association (ADA), OSHA guidance summary: dentistry workers and employers; 2020. [Cited Aug 11, 2021]. Available from: https://success.ada.org/~/media/CPS/Files/COVID/OSHA_Guidance_Summary_Dentistry_Workers_And_Employers.pdf.
Superior Council of Dentistry Faculty of the province of Buenos Aires (COSUBA), Recommendations oriented to dental practice in a health emergency situation due to COVID-19; 2020. [Cited Oct 06, 2021]. Available from: https://www.sdpt.net/obo/Recomendaciones-3-2-2021.pdf.
Royal College of Dental Surgeons of Ontario, COVID-19: Managing Infection Risks During In-Person Dental Care; 2021.
[Cited Oct 03, 2021]. Available from: https://az184419.vo.msecnd.net/rcdso/pdf/standards-of-practice/RCDSO_COVID19_Managing_In_Person_Care_Jan_2021.pdf.
Bardin L. Content Analysis. 70a ed. Sao Paulo. Published 2016. [Cited Apr 04, 2021]. Available from: https://madmunifacs.files.wordpress.com/2016/08/anc3a1lisede-contec3bado-laurence-bardin.pdf.
Brazil, National Health Surveillance Agency (ANVISA), Technical note No 04/2020 GVIMS/GGTES/ANVISA: Guidelines for
Health Services: Prevention and control measures that must be adopted during assistance to suspected or confirmed cases of infection by the new coronavirus (SARSCoV-2); 2020. [Cited Oct 10, 2021]. Available from: https://www.gov.br/ anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/notas-tecnicas/notatecnica-gvims_ggtes_anvisa-04_2020 25-
Brazil, National Health Surveillance Agency (ANVISA), Technical note No173/2020/SEI/GRECS/GGTES/DIRE1/ ANVISA: Clarifications to the Regional Council of Dentistry of the State of São Paulo about the reopening of Dental clinics; 2020. [Cited Sept15, 2020]. Available from: https://www.cristofoli.com/biosseguranca/wp-content/uploads/2020/06/ANVISA_-Nota-T%C3%A9cnica_173_CROSP.pdf.
Center for Disease Control and Prevention (CDC), Guidelines for environmental infection control in health-care facilities; 2003. [Cited Apr 23, 2021]. Available from: https://www.cdc.gov/infectioncontrol/guidelines/environmental/index.html.
Brazilian Ministry of Health; National Health Surveillance Agency, Dental services: prevention and risk control; 2006. [Cited Apr 14, 2021]. Available from: https://www.anvisa.gov.br/servicosaude/manuais/manual_odonto.pdf.
World Health Organization (WHO). Roadmap to improve and ensure good indoor ventilation in the context of COVID-19; 2021. [Cited Nov 01, 2021]. Available from: Erro! A referência de hiperlink não é válida..
Gurgel B, Borges SB, Borges R, Calderon P. COVID-19: Perspectives for the management of dental care and education. J Appl Oral Sci. 2020; 28:e20200358.
Nature. Update guidance on how coronavirus spreads; 2021; [Cited Nov 01, 2021]. Available from: https://media. nature.com/original/magazine-assets/d41586-021-00277-8/d41586-021-00277-8.pdf.
Ren YF, Huang Q, Marzouk T, Richard R, Pembroke K, Martone, P, et al. Effects of mechanical ventilation and portable air cleaner on aerosol removal from dental treatment rooms. J Dent. 2021; 105:103576.
Sarapultseva M, Hu D, Sarapultsev A. SARS-CoV-2 Seropositivity among Dental Staff and the Role of Aspirating Systems. JDR Clin Trans Res. 2021; 6(2):132-8.
Yang M, Chaghtai A, Melendez M, Hasson H, Whitaker E, Badi M, et al. Mitigating saliva aerosol contamination in a dental school clinic. BMC Oral Health. 2021; 21(52):1-8.
Ehtezazi T, Evans DG, Jenkinson ID, Evans PA, Vadgama VJ, Vadgama J, et al. SARS-CoV-2: characterisation and mitigation of risks associated with aerosol generating procedures in dental practices. Br Dent J. 2021; 7:1-7.
Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. Br Med J. 2020; 371:m3862.
Our World in Data, Statistics and Research – Coronavirus (COVID-19) Vaccinations; 2021. [Cited Jan 12, 2022]. Available from: https://ourworldindata.org/covid-vaccinations? country=BRA.
Center for Disease Control and Prevention (CDC), Omicron Variant: What You Need to Know; 2021. [Cited January 10, 2022]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/variants/omicronvariant.html.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.
Autores que publicam nesta revista concordam com os seguintes termos:
a) Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
b) Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
c) Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado (Veja O Efeito do Acesso Livre).