Aerosol generating procedures and their mitigation in international guidance documents

Aerosol generating procedures and their mitigation in international guidance documents

The aim of this rapid review of international guidance was to assess how dental aerosol-generating procedures (AGPs) were defined in international dental guidelines and what mitigation procedures were recommended to support decision making concerning the planned re-opening and restructuring of dental services during the COVID-19 pandemic. The rapid review was conducted by the COVID-19 Dental Services Evidence Review (CoDER) Working Group; a collaborative group of researchers and clinicians from a range of UK institutions, led by Professors Jan Clarkson (University of Dundee) and Craig Ramsay (University of Aberdeen).

This rapid review collated and summarised 63 guidance recommendations from international sources. The level of detail reported in the guidance documents varied greatly and most of the documents did not provide evidence in support of their recommendations. 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, and 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-19 patients advised the same mitigation as for non-COVID patients.

Further information, including Spanish and French summaries of the main text of the review, and a summary infographic available in English, Spanish and French, are available to download here





Robertson C, Clarkson JA, Aceves-Martins M, Ramsay CR, Richards D, Colloc T.  A Review of Aerosol Generation Mitigation in International Dental Guidance. International Dental Journal, Volume 72, Issue 2, 2022, Pages 203-210,