COVID-19 incidence rates among Canadian dentists as they return to work: a cohort study

Since the COVID-19 pandemic emerged in Canada, in March 2020, dental regulatory authorities (DRAs) in provinces and territories across Canada obliged dentists to close their offices to routine care and provide emergency care only. The guidelines for dentists on the use of personal protective equipment or high-risk procedures (e.g., aerosol-generating procedures; AGPs), during the pandemic, vary between jurisdictions. Recently, some provinces have started allowing dentists to reopen their offices. However, guidelines on infection control, treatment and other procedures as dentists return to work have minimal evidence to support them. The overarching goal of this project is to estimate the incidence rate of COVID-19 among dentists and its risk associated with AGPs and N95 masks during the reopening phase of dental care services across jurisdictions in Canada. We are proposing a prospective cohort study of dentists during the reopening phase of dental services in Canada. An online questionnaire, adopted from WHO Unity Study protocols for assessment of COVID-19 risk among healthcare workers, will be used to collect information on socio-demographics, details of dental care provided to patients in the previous week, as well as symptoms related to COVID-19 and viral status (e.g., COVID-19 positive test). Saliva samples for detecting COVID-19 cases will also be collected at baseline and every four weeks. Participants will be followed on their viral status, clinical activities and COVID-19 status every two weeks post-baseline for a period of 12 months. Statistical analysis of the collected data will allow for the estimations of the incidence and prevalence of COVID-19 cases among Canadian dentists, and to identify the risk associated with AGPs and N95 masks. Our results will help the DRAs to monitor disease occurrence among dentists as they return to work and in developing evidence-based clinical practice guidelines and, as a result, prevent further spread of COVID-19.