Background Children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are usually asymptomatic but contagious . The authors investigated the positivity rate of asymptomatic SARS-CoV-2 infection in pediatric dental patients. Methods The authors reviewed consecutive medical records of children under 18 years of age scheduled for elective dental procedures from April 1, 2020 to August 1, 2020. All patients were examined for signs and symptoms of SARS-CoV infection. 2. Asymptomatic patients scheduled for dental procedures underwent polymerase chain reaction (PCR) testing for SARS-CoV-2. Sociodemographic characteristics were summarized and positivity rates were calculated. Variables were compared for patients who were SARS-CoV-2 positive and SARS-CoV-2 negative using Fisher’s exact and Mann-Whitney U tests. Results The sample size was 921. The median age was 6 years and 50.9% were children. The overall positivity rate for SARS-CoV-2 was 2.3%. Age, insurance status, medical history, and dental diagnosis were comparable in patients who were SARS-CoV-2 positive and SARS-CoV-2 negative. Positivity rates were statistically higher for Hispanic or Latino patients than for other groups (p = 0.038). Conclusions Although testing yield was low, systematic evaluation of asymptomatic pediatric dental cases using PCR resulted in the identification of SARS-CoV-2 carriers who may have been infectious. In this study, Hispanics or Latinos had a higher positivity rate than other demographic groups. Practical implications PCR testing for SARS-CoV-2 of asymptomatic patients in pediatric dentistry adds value to the use of screening questionnaires for the identification of infected individuals who may be contagious. |
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Study shows 2% of asymptomatic pediatric dental patients test positive for COVID-19
University of Illinois at Chicago
A study by a pediatric dentist at the University of Illinois at Chicago has demonstrated a novel way to track possible cases of COVID-19: testing children who visit the dentist. The study also showed a positivity rate greater than 2% for the asymptomatic children tested.
Dr. Flavia Lamberghini, a UIC clinical assistant professor in the department of pediatric dentistry, is co-author of the article "Severe acute respiratory syndrome coronavirus 2 infection in asymptomatic pediatric dental patients," in the April 2021 issue of the journal Journal of the American Dental. Association. Co-authors are Dr. Fernando Testai, professor of neurology and rehabilitation at UIC, and Dr. Gabriela Trifan, assistant professor of neurology and rehabilitation at UIC.
The study looked at pediatric patients who visited UIC dental clinics for emergency dental procedures between April 1 and August 1, 2020. Children with COVID-19 are generally asymptomatic, but have the potential to carry viral loads substantial and be a source of infection. Patients were screened by telephone before their scheduled visits and were asymptomatic when they arrived for their appointments. At their visit, they were administered a polymerase chain reaction, or PCR, test to detect SARS-CoV-2 infection, Lamberghini said.
"The children tolerated the test well. We were trained by a pediatrician on how to perform the test. We used the nasal swab. We told the children, ’We are putting a butterfly on your nose,’" Lamberghini said.
Patients, between the ages of 2 and 18 years , with a median age of 6, were evaluated. Sociodemographic characteristics were summarized and positivity rates were calculated. With the sample size of 921 patients, the overall SARS-Co-V-2 positivity rate was 2.3%. Positivity rates were statistically higher for Latino patients (3.1%) and 63% of children studied were Latino.
Lamberghini notes that the study was not extended to include variables and no questions were asked about social distancing and exposure to the virus. However, when a child tested positive for COVID-19, researchers followed up with the child’s pediatrician and caregivers and encouraged them to follow the recommended advice.
"For most of them, it was a surprise to learn that their child tested positive. It was good for the families to know because these children can spread the virus, especially in communities where extended families tend to live together," Lamberghini said.
It’s also important information for oral health care providers, he added.
"As dentists, we are more exposed to the COVID-19 disease because we work close to the mouth and our tools generate aerosols that can infect the dentist and the dental assistant, whoever is nearby," Lamberghini said.
Before the study, children receiving dental procedures were not required to undergo PCR testing. The study concluded that PCR testing for COVID-19 of asymptomatic patients in pediatric dentistry adds value to the use of screening questionnaires for the identification of infected individuals who could be contagious.
The study, the first to look at the prevalence of COVID-19 in pediatric dentistry, also serves as a reference for pediatric dentists who closed during the pandemic and are considering reopening, Testai said.
"Even though these children are COVID positive, we did not observe transmission to clinic staff , which supports the idea that personal protective equipment works," Testai said.
Conclusions Dental offices resuming care should consider adding SARS-CoV-2 testing to the use of screening tools, personal protective equipment, and source control strategies before using aerosol-generating procedures. This may be particularly important to reduce exposure in areas of high regional prevalence of SARS-CoV-2. |
