Enhanced Infection Control Keeps Infection Rate Below 1%

A recent study published in The Journal of the American Dental Association reported that fewer than one percent of dentists tested positive for COVID-19.


The Research

The report’s findings were released in October and based on a June 2020 survey of more than 2,000 dentists from every U.S. state and Puerto Rico. According to the American Dental Association (ADA), “when the results were weighted according to age and location to approximate all U.S. dentists, only 0.9% were estimated to have a confirmed or probable COVID-19 infection, with a margin of error of 0.5%.”

Additionally, a similar study was published by Oral Diseases on September 3, 2020. This earlier and much smaller examination of infection among dental professionals focused on the 11 dentists and 13 “dental nurses” of the Territorial Health and Social Services Authority in the southeastern area of Milan, Italy. The research for this group was gathered during February and March of 2020, a time when Italy was considered the epicenter of the pandemic. The results from this study found these dental professionals’ occupational risk of COVID-19 infection to be zero.

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How Did Dentists Beat the Odds?

Dentists’ impressively low rate of infection may come as surprising news to some, considering that in March, The New York Times listed dentists as one of the most at-risk professions for COVID-19 infection. The logic being that dentists would not only be required to be in close proximity to their patients, but also forced to perform procedures that could produce potentially deadly viral aerosol particles from an infected patient. And yet, both the ADA and Italian studies discovered that the infection rate for dentists was far below that of other health professionals.

So how did dentists — who were thought to be so vulnerable — actually end up being even less affected by the virus than other healthcare workers? Marko Vujicic, Ph.D., chief economist and vice president of the ADA Health Policy Institute offers this explanation, “The fact that dentistry was named one of the most at-risk professions for infection, but has a far lower prevalence of infection compared to other health professions, is not a coincidence," he said. "The profession has taken this issue extremely seriously, and it shows.”

The ADA’s findings seem to support Vujicic’s claim. Of the dentists who were surveyed, 99.7% reported implementing enhanced infection prevention and control procedures. These efforts included disinfecting all equipment and surfaces that are commonly touched, checking staff and patient temperatures, screening patients for COVID-19, encouraging distance between patients while waiting, and providing face masks to staff. Additionally, despite the fact that there was a limited supply of PPE (especially, N95 masks), 99.6% of dentists used PPE when treating patients, and 72.8% used PPE following the CDC guidelines.

The study of the Italian dental professionals reached a similar conclusion, showing that “relatively simple infection control procedures implemented prevented COVID-19 development in dental staff.” The report ends by saying, “These measures seem enough to minimize the occupational risk of COVID‐19.” 

Dr. Marcelo Araujo, the senior author of the ADA report, had this comment, "This is very good news for dentists and patients. This means that what dentists are doing — heightened infection control and increased attention to patient and dental team safety — is working." Mia Geisinger, a co-author of the ADA report adds, “Because of these findings and because we have no known reports of transmission of COVID-19 during the provision of dental care, we feel that resuming dental visits is important,” Geisinger said.

The report from the ADA was the first large-scale collection and publication of U.S. dentists’ infection rates and infection control practices related to COVID-19. The authors of the study are continuing to collect infection-rate data, and they have added dental hygienists to their ongoing survey, in collaboration with the American Dental Hygienists Association. Vujicic promises that the researchers “will continue to track the rate of COVID-19 among dentists and other facets of the pandemic affecting dentistry so it can help inform the dental profession and other industries as well.”

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