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LitCovid-PubTator

LitCovid-PD-FMA-UBERON

LitCovid-PD-UBERON

LitCovid-PD-MONDO

LitCovid-PD-CLO

LitCovid-PD-CHEBI

{"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T20","span":{"begin":6770,"end":6777},"obj":"Chemical"},{"id":"T21","span":{"begin":7794,"end":7807},"obj":"Chemical"},{"id":"T22","span":{"begin":8079,"end":8092},"obj":"Chemical"},{"id":"T23","span":{"begin":8299,"end":8316},"obj":"Chemical"},{"id":"T24","span":{"begin":8299,"end":8307},"obj":"Chemical"},{"id":"T25","span":{"begin":8308,"end":8316},"obj":"Chemical"},{"id":"T26","span":{"begin":8544,"end":8550},"obj":"Chemical"},{"id":"T28","span":{"begin":9649,"end":9654},"obj":"Chemical"},{"id":"T29","span":{"begin":10946,"end":10948},"obj":"Chemical"},{"id":"T30","span":{"begin":11692,"end":11694},"obj":"Chemical"}],"attributes":[{"id":"A20","pred":"chebi_id","subj":"T20","obj":"http://purl.obolibrary.org/obo/CHEBI_18379"},{"id":"A21","pred":"chebi_id","subj":"T21","obj":"http://purl.obolibrary.org/obo/CHEBI_33281"},{"id":"A22","pred":"chebi_id","subj":"T22","obj":"http://purl.obolibrary.org/obo/CHEBI_3614"},{"id":"A23","pred":"chebi_id","subj":"T23","obj":"http://purl.obolibrary.org/obo/CHEBI_16240"},{"id":"A24","pred":"chebi_id","subj":"T24","obj":"http://purl.obolibrary.org/obo/CHEBI_49637"},{"id":"A25","pred":"chebi_id","subj":"T25","obj":"http://purl.obolibrary.org/obo/CHEBI_44785"},{"id":"A26","pred":"chebi_id","subj":"T26","obj":"http://purl.obolibrary.org/obo/CHEBI_28798"},{"id":"A27","pred":"chebi_id","subj":"T26","obj":"http://purl.obolibrary.org/obo/CHEBI_53405"},{"id":"A28","pred":"chebi_id","subj":"T28","obj":"http://purl.obolibrary.org/obo/CHEBI_15377"},{"id":"A29","pred":"chebi_id","subj":"T29","obj":"http://purl.obolibrary.org/obo/CHEBI_73694"},{"id":"A30","pred":"chebi_id","subj":"T30","obj":"http://purl.obolibrary.org/obo/CHEBI_73694"}],"text":"Infection controls for dental practice\nDental professionals should be familiar with how 2019-nCoV is spread, how to identify patients with 2019-nCoV infection, and what extra-protective measures should be adopted during the practice, in order to prevent the transmission of 2019-nCoV. Here we recommend the infection control measures that should be followed by dental professionals, particularly considering the fact that aerosols and droplets were considered as the main spread routes of 2019-nCoV. Our recommendations are based on the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition) (http://www.nhc.gov.cn/yzygj/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440.shtml), the Guideline for the Prevention and Control of Novel Coronavirus Pneumonia in Medical Institutes (the 1st edition) (http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml), and the Guideline for the Use of Medical Protective Equipment in the Prevention and Control of Novel Coronavirus Pneumonia (http://www.nhc.gov.cn/yzygj/s7659/202001/e71c5de925a64eafbe1ce790debab5c6.shtml) released by the National Health Commission of the People’s Republic of China, and the practice experience in West China Hospital of Stomatology related to the outbreak of 2019-nCoV transmission.\n\nPatient evaluation\nFirst of all, dental professionals should be able to identify a suspected case of COVID-19. To date that this paper was drafted, the National Health Commission of the People’s Republic of China has released the 5th edition of the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia. In general, a patient with COVID-19 who is in the acute febrile phase of the disease is not recommended to visit the dental clinic. If this does occur, the dental professional should be able to identify the patient with suspected 2019-nCoV infection, and should not treat the patient in the dental clinic, but immediately quarantine the patient and report to the infection control department as soon as possible, particularly in the epidemic period of 2019-nCoV.\nThe body temperature of the patient should be measured in the first place. A contact-free forehead thermometer is strongly recommended for the screening. A questionnaire should be used to screen patients with potential infection of 2019-nCoV before they could be led to the dental chair-side. These questions should include the following: (1) Do you have fever or experience fever within the past 14 days? (2) Have you experienced a recent onset of respiratory problems, such as a cough or difficulty in breathing within the past 14 days? (3) Have you, within the past 14 days, traveled to Wuhan city and its surrounding areas, or visited the neighborhood with documented 2019-nCoV transmission? (4) Have you come into contact with a patient with confirmed 2019-nCoV infection within the past 14 days? (5) Have you come into contact with people who come from Wuhan city and its surrounding areas, or people from the neighborhood with recent documented fever or respiratory problems within the past 14 days? (6) Are there at least two people with documented experience of fever or respiratory problems within the last 14 days having close contact with you? (7) Have you recently participated in any gathering, meetings, or had close contact with many unacquainted people?\nIf a patient replies “yes” to any of the screening questions, and his/her body temperature is below 37.3 °C, the dentist can defer the treatment until 14 days after the exposure event. The patient should be instructed to self-quarantine at home and report any fever experience or flu-like syndrome to the local health department. If a patient replies “yes” to any of the screening questions, and his/her body temperature is no less than 37.3 °C, the patient should be immediately quarantined, and the dental professionals should report to the infection control department of the hospital or the local health department. If a patient replies “no” to all the screening questions, and his/her body temperature is below 37.3 °C, the dentist can treat the patient with extra- protection measures, and avoids spatter or aerosol-generating procedures to the best. If a patient replies “no” to all the screening questions, but his/her body temperature is no less than 37.3 °C, the patient should be instructed to the fever clinics or special clinics for COVID-19 for further medical care.\n\nHand hygiene\nFecal–oral transmission has been reported for 2019-nCoV, which underlines the importance of hand hygiene for dental practice. Although appropriate hand hygiene is the routine prerequisite for dental practice, hand-washing compliance is relatively low, which imposes a great challenge to the infection control during the epidemic period of 2019-nCoV transmission. Reinforcement for good hand hygiene is of the utmost importance. A two-before-and-three-after hand hygiene guideline is proposed by the infection control department of the West China Hospital of Stomatology, Sichuan University, to reinforce the compliance of hand washing. Specifically, the oral professionals should wash their hands before patient examination, before dental procedures, after touching the patient, after touching the surroundings and equipment without disinfection, and after touching the oral mucosa, damaged skin or wound, blood, body fluid, secretion, and excreta. More caution should be taken for the dental professionals to avoid touching their own eyes, mouth, and nose.\n\nPersonal protective measures for the dental professionals\nAt present, there is no specific guideline for the protection of dental professionals from 2019-nCoV infection in the dental clinics and hospitals. Although no dental professional has been reported to acquire 2019-nCoV infection to the date the paper was drafted, the last experience with the SARS coronavirus has shown vast numbers of acquired infection of medical professionals in hospital settings57. Since airborne droplet transmission of infection is considered as the main route of spread, particularly in dental clinics and hospitals, barrier-protection equipment, including protective eyewear, masks, gloves, caps, face shields, and protective outwear, is strongly recommended for all healthcare givers in the clinic/hospital settings during the epidemic period of 2019-nCoV.\nBased on the possibility of the spread of 2019-nCoV infection, three-level protective measures of the dental professionals are recommended for specific situations. (1) Primary protection (standard protection for staff in clinical settings). Wearing disposable working cap, disposable surgical mask, and working clothes (white coat), using protective goggles or face shield, and disposable latex gloves or nitrile gloves if necessary. (2) Secondary protection (advanced protection for dental professionals). Wearing disposable doctor cap, disposable surgical mask, protective goggles, face shield, and working clothes (white coat) with disposable isolation clothing or surgical clothes outside, and disposable latex gloves. (3) Tertiary protection (strengthened protection when contact patient with suspected or confirmed 2019-nCoV infection). Although a patient with 2019-nCoV infection is not expected to be treated in the dental clinic, in the unlikely event that this does occur, and the dental professional cannot avoid close contact, special protective outwear is needed. If protective outwear is not available, working clothes (white coat) with extra disposable protective clothing outside should be worn. In addition, disposable doctor cap, protective goggles, face shield, disposable surgical mask, disposable latex gloves, and impermeable shoe cover should be worn.\n\nMouthrinse before dental procedures\nA preoperational antimicrobial mouthrinse is generally believed to reduce the number of oral microbes. However, as instructed by the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition) released by the National Health Commission of the People’s Republic of China, chlorhexidine, which is commonly used as mouthrinse in dental practice, may not be effective to kill 2019-nCoV. Since 2019-nCoV is vulnerable to oxidation, preprocedural mouthrinse containing oxidative agents such as 1% hydrogen peroxide or 0.2% povidone is recommended, for the purpose of reducing the salivary load of oral microbes, including potential 2019-nCoV carriage. A preprocedural mouthrinse would be most useful in cases when rubber dam cannot be used.\n\nRubber dam isolation\nThe use of rubber dams can significantly minimize the production of saliva- and blood-contaminated aerosol or spatter, particularly in cases when high-speed handpieces and dental ultrasonic devices are used. It has been reported that the use of rubber dam could significantly reduce airborne particles in ~3-foot diameter of the operational field by 70%58. When rubber dam is applied, extra high-volume suction for aerosol and spatter should be used during the procedures along with regular suction59. In this case, the implementation of a complete four-hand operation is also necessary. If rubber dam isolation is not possible in some cases, manual devices, such as Carisolv and hand scaler, are recommended for caries removal and periodontal scaling, in order to minimize the generation of aerosol as much as possible.\n\nAnti-retraction handpiece\nThe high-speed dental handpiece without anti-retraction valves may aspirate and expel the debris and fluids during the dental procedures. More importantly, the microbes, including bacteria and virus, may further contaminate the air and water tubes within the dental unit, and thus can potentially cause cross-infection. Our study has shown that the anti-retraction high-speed dental handpiece can significantly reduce the backflow of oral bacteria and HBV into the tubes of the handpiece and dental unit as compared with the handpiece without anti-retraction function60. Therefore, the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19. Anti-retraction dental handpiece with specially designed anti-retractive valves or other anti-reflux designs are strongly recommended as an extra preventive measure for cross-infection59. Therefore, the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19. Anti-retraction dental handpiece with specially designed anti-retractive valves or other anti-reflux designs are strongly recommended as an extra preventive measure for cross-infection.\n\nDisinfection of the clinic settings\nMedical institutions should take effective and strict disinfection measures in both clinic settings and public area. The clinic settings should be cleaned and disinfected in accordance with the Protocol for the Management of Surface Cleaning and Disinfection of Medical Environment (WS/T 512-2016) released by the National Health Commission of the People’s Republic of China. Public areas and appliances should also be frequently cleaned and disinfected, including door handles, chairs, and desks. The elevator should be disinfected regularly. People taking elevators should wear masks correctly and avoid direct contact with buttons and other objects.\n\nManagement of medical waste\nThe medical waste (including disposable protective equipment after use) should be transported to the temporary storage area of the medical institute timely. The reusable instrument and items should be pretreated, cleaned, sterilized, and properly stored in accordance with the Protocol for the Disinfection and Sterilization of Dental Instrument (WS 506-2016) released by the National Health Commission of the People’s Republic of China. The medical and domestic waste generated by the treatment of patients with suspected or confirmed 2019-nCoV infection are regarded as infectious medical waste. Double-layer yellow color medical waste package bags and “gooseneck” ligation should be used. The surface of the package bags should be marked and disposed according to the requirement for the management of medical waste."}

LitCovid-PD-GO-BP

{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T2","span":{"begin":2602,"end":2611},"obj":"http://purl.obolibrary.org/obo/GO_0007585"},{"id":"T3","span":{"begin":5377,"end":5398},"obj":"http://purl.obolibrary.org/obo/GO_0007589"},{"id":"T4","span":{"begin":5389,"end":5398},"obj":"http://purl.obolibrary.org/obo/GO_0046903"},{"id":"T5","span":{"begin":11427,"end":11438},"obj":"http://purl.obolibrary.org/obo/GO_0006810"},{"id":"T6","span":{"begin":11456,"end":11463},"obj":"http://purl.obolibrary.org/obo/GO_0051235"}],"text":"Infection controls for dental practice\nDental professionals should be familiar with how 2019-nCoV is spread, how to identify patients with 2019-nCoV infection, and what extra-protective measures should be adopted during the practice, in order to prevent the transmission of 2019-nCoV. Here we recommend the infection control measures that should be followed by dental professionals, particularly considering the fact that aerosols and droplets were considered as the main spread routes of 2019-nCoV. Our recommendations are based on the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition) (http://www.nhc.gov.cn/yzygj/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440.shtml), the Guideline for the Prevention and Control of Novel Coronavirus Pneumonia in Medical Institutes (the 1st edition) (http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml), and the Guideline for the Use of Medical Protective Equipment in the Prevention and Control of Novel Coronavirus Pneumonia (http://www.nhc.gov.cn/yzygj/s7659/202001/e71c5de925a64eafbe1ce790debab5c6.shtml) released by the National Health Commission of the People’s Republic of China, and the practice experience in West China Hospital of Stomatology related to the outbreak of 2019-nCoV transmission.\n\nPatient evaluation\nFirst of all, dental professionals should be able to identify a suspected case of COVID-19. To date that this paper was drafted, the National Health Commission of the People’s Republic of China has released the 5th edition of the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia. In general, a patient with COVID-19 who is in the acute febrile phase of the disease is not recommended to visit the dental clinic. If this does occur, the dental professional should be able to identify the patient with suspected 2019-nCoV infection, and should not treat the patient in the dental clinic, but immediately quarantine the patient and report to the infection control department as soon as possible, particularly in the epidemic period of 2019-nCoV.\nThe body temperature of the patient should be measured in the first place. A contact-free forehead thermometer is strongly recommended for the screening. A questionnaire should be used to screen patients with potential infection of 2019-nCoV before they could be led to the dental chair-side. These questions should include the following: (1) Do you have fever or experience fever within the past 14 days? (2) Have you experienced a recent onset of respiratory problems, such as a cough or difficulty in breathing within the past 14 days? (3) Have you, within the past 14 days, traveled to Wuhan city and its surrounding areas, or visited the neighborhood with documented 2019-nCoV transmission? (4) Have you come into contact with a patient with confirmed 2019-nCoV infection within the past 14 days? (5) Have you come into contact with people who come from Wuhan city and its surrounding areas, or people from the neighborhood with recent documented fever or respiratory problems within the past 14 days? (6) Are there at least two people with documented experience of fever or respiratory problems within the last 14 days having close contact with you? (7) Have you recently participated in any gathering, meetings, or had close contact with many unacquainted people?\nIf a patient replies “yes” to any of the screening questions, and his/her body temperature is below 37.3 °C, the dentist can defer the treatment until 14 days after the exposure event. The patient should be instructed to self-quarantine at home and report any fever experience or flu-like syndrome to the local health department. If a patient replies “yes” to any of the screening questions, and his/her body temperature is no less than 37.3 °C, the patient should be immediately quarantined, and the dental professionals should report to the infection control department of the hospital or the local health department. If a patient replies “no” to all the screening questions, and his/her body temperature is below 37.3 °C, the dentist can treat the patient with extra- protection measures, and avoids spatter or aerosol-generating procedures to the best. If a patient replies “no” to all the screening questions, but his/her body temperature is no less than 37.3 °C, the patient should be instructed to the fever clinics or special clinics for COVID-19 for further medical care.\n\nHand hygiene\nFecal–oral transmission has been reported for 2019-nCoV, which underlines the importance of hand hygiene for dental practice. Although appropriate hand hygiene is the routine prerequisite for dental practice, hand-washing compliance is relatively low, which imposes a great challenge to the infection control during the epidemic period of 2019-nCoV transmission. Reinforcement for good hand hygiene is of the utmost importance. A two-before-and-three-after hand hygiene guideline is proposed by the infection control department of the West China Hospital of Stomatology, Sichuan University, to reinforce the compliance of hand washing. Specifically, the oral professionals should wash their hands before patient examination, before dental procedures, after touching the patient, after touching the surroundings and equipment without disinfection, and after touching the oral mucosa, damaged skin or wound, blood, body fluid, secretion, and excreta. More caution should be taken for the dental professionals to avoid touching their own eyes, mouth, and nose.\n\nPersonal protective measures for the dental professionals\nAt present, there is no specific guideline for the protection of dental professionals from 2019-nCoV infection in the dental clinics and hospitals. Although no dental professional has been reported to acquire 2019-nCoV infection to the date the paper was drafted, the last experience with the SARS coronavirus has shown vast numbers of acquired infection of medical professionals in hospital settings57. Since airborne droplet transmission of infection is considered as the main route of spread, particularly in dental clinics and hospitals, barrier-protection equipment, including protective eyewear, masks, gloves, caps, face shields, and protective outwear, is strongly recommended for all healthcare givers in the clinic/hospital settings during the epidemic period of 2019-nCoV.\nBased on the possibility of the spread of 2019-nCoV infection, three-level protective measures of the dental professionals are recommended for specific situations. (1) Primary protection (standard protection for staff in clinical settings). Wearing disposable working cap, disposable surgical mask, and working clothes (white coat), using protective goggles or face shield, and disposable latex gloves or nitrile gloves if necessary. (2) Secondary protection (advanced protection for dental professionals). Wearing disposable doctor cap, disposable surgical mask, protective goggles, face shield, and working clothes (white coat) with disposable isolation clothing or surgical clothes outside, and disposable latex gloves. (3) Tertiary protection (strengthened protection when contact patient with suspected or confirmed 2019-nCoV infection). Although a patient with 2019-nCoV infection is not expected to be treated in the dental clinic, in the unlikely event that this does occur, and the dental professional cannot avoid close contact, special protective outwear is needed. If protective outwear is not available, working clothes (white coat) with extra disposable protective clothing outside should be worn. In addition, disposable doctor cap, protective goggles, face shield, disposable surgical mask, disposable latex gloves, and impermeable shoe cover should be worn.\n\nMouthrinse before dental procedures\nA preoperational antimicrobial mouthrinse is generally believed to reduce the number of oral microbes. However, as instructed by the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition) released by the National Health Commission of the People’s Republic of China, chlorhexidine, which is commonly used as mouthrinse in dental practice, may not be effective to kill 2019-nCoV. Since 2019-nCoV is vulnerable to oxidation, preprocedural mouthrinse containing oxidative agents such as 1% hydrogen peroxide or 0.2% povidone is recommended, for the purpose of reducing the salivary load of oral microbes, including potential 2019-nCoV carriage. A preprocedural mouthrinse would be most useful in cases when rubber dam cannot be used.\n\nRubber dam isolation\nThe use of rubber dams can significantly minimize the production of saliva- and blood-contaminated aerosol or spatter, particularly in cases when high-speed handpieces and dental ultrasonic devices are used. It has been reported that the use of rubber dam could significantly reduce airborne particles in ~3-foot diameter of the operational field by 70%58. When rubber dam is applied, extra high-volume suction for aerosol and spatter should be used during the procedures along with regular suction59. In this case, the implementation of a complete four-hand operation is also necessary. If rubber dam isolation is not possible in some cases, manual devices, such as Carisolv and hand scaler, are recommended for caries removal and periodontal scaling, in order to minimize the generation of aerosol as much as possible.\n\nAnti-retraction handpiece\nThe high-speed dental handpiece without anti-retraction valves may aspirate and expel the debris and fluids during the dental procedures. More importantly, the microbes, including bacteria and virus, may further contaminate the air and water tubes within the dental unit, and thus can potentially cause cross-infection. Our study has shown that the anti-retraction high-speed dental handpiece can significantly reduce the backflow of oral bacteria and HBV into the tubes of the handpiece and dental unit as compared with the handpiece without anti-retraction function60. Therefore, the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19. Anti-retraction dental handpiece with specially designed anti-retractive valves or other anti-reflux designs are strongly recommended as an extra preventive measure for cross-infection59. Therefore, the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19. Anti-retraction dental handpiece with specially designed anti-retractive valves or other anti-reflux designs are strongly recommended as an extra preventive measure for cross-infection.\n\nDisinfection of the clinic settings\nMedical institutions should take effective and strict disinfection measures in both clinic settings and public area. The clinic settings should be cleaned and disinfected in accordance with the Protocol for the Management of Surface Cleaning and Disinfection of Medical Environment (WS/T 512-2016) released by the National Health Commission of the People’s Republic of China. Public areas and appliances should also be frequently cleaned and disinfected, including door handles, chairs, and desks. The elevator should be disinfected regularly. People taking elevators should wear masks correctly and avoid direct contact with buttons and other objects.\n\nManagement of medical waste\nThe medical waste (including disposable protective equipment after use) should be transported to the temporary storage area of the medical institute timely. The reusable instrument and items should be pretreated, cleaned, sterilized, and properly stored in accordance with the Protocol for the Disinfection and Sterilization of Dental Instrument (WS 506-2016) released by the National Health Commission of the People’s Republic of China. The medical and domestic waste generated by the treatment of patients with suspected or confirmed 2019-nCoV infection are regarded as infectious medical waste. Double-layer yellow color medical waste package bags and “gooseneck” ligation should be used. The surface of the package bags should be marked and disposed according to the requirement for the management of medical waste."}

LitCovid-sentences

LitCovid-PD-HP

2_test

{"project":"2_test","denotations":[{"id":"32127517-12737864-53455648","span":{"begin":5981,"end":5983},"obj":"12737864"},{"id":"32127517-2681303-53455649","span":{"begin":8918,"end":8920},"obj":"2681303"},{"id":"32127517-17230392-53455650","span":{"begin":9980,"end":9982},"obj":"17230392"},{"id":"T52852","span":{"begin":5981,"end":5983},"obj":"12737864"},{"id":"T47163","span":{"begin":8918,"end":8920},"obj":"2681303"},{"id":"T5544","span":{"begin":9980,"end":9982},"obj":"17230392"}],"text":"Infection controls for dental practice\nDental professionals should be familiar with how 2019-nCoV is spread, how to identify patients with 2019-nCoV infection, and what extra-protective measures should be adopted during the practice, in order to prevent the transmission of 2019-nCoV. Here we recommend the infection control measures that should be followed by dental professionals, particularly considering the fact that aerosols and droplets were considered as the main spread routes of 2019-nCoV. Our recommendations are based on the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition) (http://www.nhc.gov.cn/yzygj/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440.shtml), the Guideline for the Prevention and Control of Novel Coronavirus Pneumonia in Medical Institutes (the 1st edition) (http://www.nhc.gov.cn/yzygj/s7659/202001/b91fdab7c304431eb082d67847d27e14.shtml), and the Guideline for the Use of Medical Protective Equipment in the Prevention and Control of Novel Coronavirus Pneumonia (http://www.nhc.gov.cn/yzygj/s7659/202001/e71c5de925a64eafbe1ce790debab5c6.shtml) released by the National Health Commission of the People’s Republic of China, and the practice experience in West China Hospital of Stomatology related to the outbreak of 2019-nCoV transmission.\n\nPatient evaluation\nFirst of all, dental professionals should be able to identify a suspected case of COVID-19. To date that this paper was drafted, the National Health Commission of the People’s Republic of China has released the 5th edition of the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia. In general, a patient with COVID-19 who is in the acute febrile phase of the disease is not recommended to visit the dental clinic. If this does occur, the dental professional should be able to identify the patient with suspected 2019-nCoV infection, and should not treat the patient in the dental clinic, but immediately quarantine the patient and report to the infection control department as soon as possible, particularly in the epidemic period of 2019-nCoV.\nThe body temperature of the patient should be measured in the first place. A contact-free forehead thermometer is strongly recommended for the screening. A questionnaire should be used to screen patients with potential infection of 2019-nCoV before they could be led to the dental chair-side. These questions should include the following: (1) Do you have fever or experience fever within the past 14 days? (2) Have you experienced a recent onset of respiratory problems, such as a cough or difficulty in breathing within the past 14 days? (3) Have you, within the past 14 days, traveled to Wuhan city and its surrounding areas, or visited the neighborhood with documented 2019-nCoV transmission? (4) Have you come into contact with a patient with confirmed 2019-nCoV infection within the past 14 days? (5) Have you come into contact with people who come from Wuhan city and its surrounding areas, or people from the neighborhood with recent documented fever or respiratory problems within the past 14 days? (6) Are there at least two people with documented experience of fever or respiratory problems within the last 14 days having close contact with you? (7) Have you recently participated in any gathering, meetings, or had close contact with many unacquainted people?\nIf a patient replies “yes” to any of the screening questions, and his/her body temperature is below 37.3 °C, the dentist can defer the treatment until 14 days after the exposure event. The patient should be instructed to self-quarantine at home and report any fever experience or flu-like syndrome to the local health department. If a patient replies “yes” to any of the screening questions, and his/her body temperature is no less than 37.3 °C, the patient should be immediately quarantined, and the dental professionals should report to the infection control department of the hospital or the local health department. If a patient replies “no” to all the screening questions, and his/her body temperature is below 37.3 °C, the dentist can treat the patient with extra- protection measures, and avoids spatter or aerosol-generating procedures to the best. If a patient replies “no” to all the screening questions, but his/her body temperature is no less than 37.3 °C, the patient should be instructed to the fever clinics or special clinics for COVID-19 for further medical care.\n\nHand hygiene\nFecal–oral transmission has been reported for 2019-nCoV, which underlines the importance of hand hygiene for dental practice. Although appropriate hand hygiene is the routine prerequisite for dental practice, hand-washing compliance is relatively low, which imposes a great challenge to the infection control during the epidemic period of 2019-nCoV transmission. Reinforcement for good hand hygiene is of the utmost importance. A two-before-and-three-after hand hygiene guideline is proposed by the infection control department of the West China Hospital of Stomatology, Sichuan University, to reinforce the compliance of hand washing. Specifically, the oral professionals should wash their hands before patient examination, before dental procedures, after touching the patient, after touching the surroundings and equipment without disinfection, and after touching the oral mucosa, damaged skin or wound, blood, body fluid, secretion, and excreta. More caution should be taken for the dental professionals to avoid touching their own eyes, mouth, and nose.\n\nPersonal protective measures for the dental professionals\nAt present, there is no specific guideline for the protection of dental professionals from 2019-nCoV infection in the dental clinics and hospitals. Although no dental professional has been reported to acquire 2019-nCoV infection to the date the paper was drafted, the last experience with the SARS coronavirus has shown vast numbers of acquired infection of medical professionals in hospital settings57. Since airborne droplet transmission of infection is considered as the main route of spread, particularly in dental clinics and hospitals, barrier-protection equipment, including protective eyewear, masks, gloves, caps, face shields, and protective outwear, is strongly recommended for all healthcare givers in the clinic/hospital settings during the epidemic period of 2019-nCoV.\nBased on the possibility of the spread of 2019-nCoV infection, three-level protective measures of the dental professionals are recommended for specific situations. (1) Primary protection (standard protection for staff in clinical settings). Wearing disposable working cap, disposable surgical mask, and working clothes (white coat), using protective goggles or face shield, and disposable latex gloves or nitrile gloves if necessary. (2) Secondary protection (advanced protection for dental professionals). Wearing disposable doctor cap, disposable surgical mask, protective goggles, face shield, and working clothes (white coat) with disposable isolation clothing or surgical clothes outside, and disposable latex gloves. (3) Tertiary protection (strengthened protection when contact patient with suspected or confirmed 2019-nCoV infection). Although a patient with 2019-nCoV infection is not expected to be treated in the dental clinic, in the unlikely event that this does occur, and the dental professional cannot avoid close contact, special protective outwear is needed. If protective outwear is not available, working clothes (white coat) with extra disposable protective clothing outside should be worn. In addition, disposable doctor cap, protective goggles, face shield, disposable surgical mask, disposable latex gloves, and impermeable shoe cover should be worn.\n\nMouthrinse before dental procedures\nA preoperational antimicrobial mouthrinse is generally believed to reduce the number of oral microbes. However, as instructed by the Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition) released by the National Health Commission of the People’s Republic of China, chlorhexidine, which is commonly used as mouthrinse in dental practice, may not be effective to kill 2019-nCoV. Since 2019-nCoV is vulnerable to oxidation, preprocedural mouthrinse containing oxidative agents such as 1% hydrogen peroxide or 0.2% povidone is recommended, for the purpose of reducing the salivary load of oral microbes, including potential 2019-nCoV carriage. A preprocedural mouthrinse would be most useful in cases when rubber dam cannot be used.\n\nRubber dam isolation\nThe use of rubber dams can significantly minimize the production of saliva- and blood-contaminated aerosol or spatter, particularly in cases when high-speed handpieces and dental ultrasonic devices are used. It has been reported that the use of rubber dam could significantly reduce airborne particles in ~3-foot diameter of the operational field by 70%58. When rubber dam is applied, extra high-volume suction for aerosol and spatter should be used during the procedures along with regular suction59. In this case, the implementation of a complete four-hand operation is also necessary. If rubber dam isolation is not possible in some cases, manual devices, such as Carisolv and hand scaler, are recommended for caries removal and periodontal scaling, in order to minimize the generation of aerosol as much as possible.\n\nAnti-retraction handpiece\nThe high-speed dental handpiece without anti-retraction valves may aspirate and expel the debris and fluids during the dental procedures. More importantly, the microbes, including bacteria and virus, may further contaminate the air and water tubes within the dental unit, and thus can potentially cause cross-infection. Our study has shown that the anti-retraction high-speed dental handpiece can significantly reduce the backflow of oral bacteria and HBV into the tubes of the handpiece and dental unit as compared with the handpiece without anti-retraction function60. Therefore, the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19. Anti-retraction dental handpiece with specially designed anti-retractive valves or other anti-reflux designs are strongly recommended as an extra preventive measure for cross-infection59. Therefore, the use of dental handpieces without anti-retraction function should be prohibited during the epidemic period of COVID-19. Anti-retraction dental handpiece with specially designed anti-retractive valves or other anti-reflux designs are strongly recommended as an extra preventive measure for cross-infection.\n\nDisinfection of the clinic settings\nMedical institutions should take effective and strict disinfection measures in both clinic settings and public area. The clinic settings should be cleaned and disinfected in accordance with the Protocol for the Management of Surface Cleaning and Disinfection of Medical Environment (WS/T 512-2016) released by the National Health Commission of the People’s Republic of China. Public areas and appliances should also be frequently cleaned and disinfected, including door handles, chairs, and desks. The elevator should be disinfected regularly. People taking elevators should wear masks correctly and avoid direct contact with buttons and other objects.\n\nManagement of medical waste\nThe medical waste (including disposable protective equipment after use) should be transported to the temporary storage area of the medical institute timely. The reusable instrument and items should be pretreated, cleaned, sterilized, and properly stored in accordance with the Protocol for the Disinfection and Sterilization of Dental Instrument (WS 506-2016) released by the National Health Commission of the People’s Republic of China. The medical and domestic waste generated by the treatment of patients with suspected or confirmed 2019-nCoV infection are regarded as infectious medical waste. Double-layer yellow color medical waste package bags and “gooseneck” ligation should be used. The surface of the package bags should be marked and disposed according to the requirement for the management of medical waste."}

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