Aerosol generating procedures and their mitigation in international guidance documents

The aim of this rapid review was to assess how dental aerosol-generating procedures (AGPs) were defined in international dental guidelines and what mitigation procedures were recommended. 

The review is the work of a collaborative group of researchers and clinicians from a range of UK institutions, including the Scottish Dental Clinical Effectiveness Programme, NHS Education for Scotland, NHS Greater Glasgow and Clyde, the Universities of Aberdeen, Dundee, and Manchester, and Cochrane Oral Health.

The review can be downloaded here and should be cited as: 

Clarkson J, Ramsay C, Richards D, Robertson C, & Aceves-Martins M; on behalf of the CoDER Working Group (2020).  Aerosol Generating Procedures and their Mitigation in International Dental Guidance Documents - A Rapid Review.

Please note, this is a living document, and subject to revision.

A Spanish summary of the main text of the review can be downloaded here. A French version of the summary is available here.

A summary infographic of the review is also available in English, Spanish and French.

The review was undertaken by a group led by Professors Jan Clarkson and Craig Ramsay to support decision-makers and to inform a rapid review being undertaken by the Scottish Dental Clinical Effectiveness Programme (SDCEP).

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.