News and Views

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Dental providers must be prepared to encounter monkeypox in clinical practice

Thursday, September 1, 2022 | Posted in GEHA Connection Dental Network News

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Source: https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html

Dental providers must be prepared to encounter monkeypox in clinical practice, considering that Lakshman et al. observed oral manifestations of monkeypox in 70% of cases.¹ Therefore it is important that dental providers understand infection prevention and control of monkeypox in a healthcare setting. Dentistry follows guidelines for infection control in healthcare settings set by the CDC, and state and local regulations. The ADA Council on Scientific Affairs Chair, reassured readers that “the COVID-19 pandemic further strengthened the existing infection control protocols that dentists have followed for several years and will continue to uphold that standard with the Monkeypox disease”.² The latest guidance on infection control for monkeypox can be found on the CDC website.³

The CDC updated their guidance 8/11/2022 with the following:

• Added recommendations on how to monitor exposed patients and when they should be isolated.
• Added recommendations for assessing the risk of healthcare personnel (HCP) with monkeypox virus exposures, including how to monitor HCP and when to apply work restrictions
• Updated the risk assessment table for HCP.
• Described why self-monitoring remains recommended for these HCP.
• Changed intact skin contact with potentially infectious materials or surfaces from higher risk to intermediate risk.

Information about human-to-human transmission of monkeypox virus is described in How it Spreads | Monkeypox | Poxvirus | CDC.  Transmission in healthcare settings has been rarely described.

Infection prevention and control recommendations for healthcare settings are provided in the Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007). Recommendations and practices described in this 2007 guideline are intended to be used when providing care for any patient in a healthcare setting, including those with monkeypox infection.  Additional supporting infection prevention and control information is provided below.

Guidance addressing isolation for people with monkeypox infection outside of healthcare settings is available at: Duration of Isolation Procedures | Monkeypox | Poxvirus | CDC.

For more information visit the CDC Website. [CDC Website]

 

REFERENCES

 

• Lakshman Samaranayake, Sukumaran Anil, The Monkeypox Outbreak and Implications for Dental Practice, International Dental Journal, 2022, ISSN 0020-6539 https://doi.org/10.1016/j.identj.2022.07.006.

• CDC urges health care providers to be on lookout for monkeypox symptoms, including oral lesions: https://www.ada.org/publications/ada-news/2022/august/cdc-urges-health-care-providers-to-be-on-lookout-for-monkeypox-symptoms-including-oral-lesions.

 

• Infection Control: Healthcare Settings | Monkeypox | Poxvirus | CDC

• Murphy, S. Monkeypox. Br Dent J 232, 760 (2022). https://doi.org/10.1038/s41415-022-4358-8. 4
• 2022 U.S. Map & Case Count. CDC. August 17, 2022. https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html
• Infectious Disease Experts Call on Dentists to be Alert for Monkeypox: https://www.dentistrytoday.com/infectious-disease-experts-call-on-dentists-to-be-alert-for-monkeypox/

 

Other sources:

• Rizk JG, Lippi G, Henry BM, Forthal DN, Rizk Y. Prevention and Treatment of Monkeypox. Drugs. 2022;82(9):957-963. doi:10.1007/s40265-022-01742-y https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244487/

• Patel A, Bilinska J, Tam JCH, et al. Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series. BMJ. 2022;378:e072410. Published 2022 Jul 28. doi:10.1136/bmj-2022-072410 https://pubmed.ncbi.nlm.nih.gov/35902115/

 

• https://www.beckersdental.com/clinical-leadership-infection-control/39124-infectious-disease-experts-call-on-dentists-to-monitor-monkeypox-symptoms-6-notes.html?origin=DentalE&utm_source=DentalE&utm_medium=email&utm_content=newsletter&oly_enc_id=8397J4314567E3M

• Oral Health Professionals Well-Positioned to Spot Monkeypox Lesions - Dimensions of Dental Hygiene | Magazine

 

• https://pubmed.ncbi.nlm.nih.gov/35934521/

• https://www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html