COVID-19 pandemic: What changes for orthodontists? A review of approaches to infection control

This narrative review provides a comprehensive summary of the implications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) on orthodontic treatment and a review of treatment protocols recommended for control of spread of this infection, using currently available data and literature.  Relevant sources of information were searched using electronic databases including PubMed and Google Scholar and current reports from major health bodies such as Centers of Disease Control and Prevention, World Health Organization, Nigeria Centre for Disease Control, and major national orthodontic associations. The SARS-CoV-2 virus may be transmitted through direct or indirect contact with infected people through infected secretions such as saliva and respiratory secretions or through their respiratory droplets. Aerosol generating procedures often carried out in the orthodontic clinic can become a source of its spread as well as cross-infection. The asymptomatic patients and patients in their incubation period are also carriers of SARS-CoV-2 and can be infectious. Elective orthodontic treatment should be delayed until there has been sufficient reduction in COVID-19 transmission rates from community transmission to cluster cases or according to official recommendations at national, sub-national or local level while urgent or emergency interventions that are vital for preserving a person's oral functioning, managing severe pain or securing quality of life should be provided. Treatment advice should be delivered remotely first when possible, and where necessary, in-person treatment can be performed in a well-prepared operatory following the necessary precautions and infection prevention and control (IPAC) protocol.