Letters to the editor

Routine restorative treatment that was deferred in the vast majority of dental practices due to COVID-19 may inevitably lead to further complications, including dentition deterioration, primarily in the form of substantial loss of tooth structure. While there is a lack of precise recommendations regarding the basic dental intervention (eg smoothing and stoning (S&S)), ambiguous interpretation of the execution of standard operating procedures (SOP) for the dental management of non-COVID-19 patients may disrupt clinical work and escalate the overuse of personal protective equipment (PPE).

Dentists assume that, based on current guidelines, the ultra-short-lasting (a few or several seconds) S&S, using only a slow handpiece with reduced power settings, mandatory high-volume suction and, for example coarse (polishing) disks, does not substantially increase the risk of micro-aerosol or droplet generation within the oral cavity. This is particularly relevant to S&S carried out within the maxillary anterior region on single incisor or canine teeth, or even first premolars owing to the reduced salivary flow within this quadrant. According to Welsh SOP, other essential procedures, such as ‘gentle’ use of a 3-in-1 syringe, despite its use of water, would constitute a lower-risk procedure and no additional fallow time is needed.¹ The additional use of dental dam isolation and pre-treatment rinses may further decrease the risk of micro-droplet contamination during S&S.