Relevance and paucity of evidence: a dental perspective on personal protective equipment during the COVID-19 pandemic

The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, has highlighted the importance of personal protective equipment (PPE) for health and social care personnel. This is a really important issue for dentistry, where we place great emphasis on infection control and universal precautions, given the nature of care provided. Cochrane have recently updated their review of PPE for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. It examined evidence on which type of full body PPE and which method of donning (putting on) or doffing (removing) are most effective, while having the least risk of contamination or infection for healthcare workers, as well as which training methods increase compliance with PPE protocols. The objective of this paper is to raise awareness of the above review of PPE, its findings and their relevance to dentistry as outlined in the Cochrane Oral Health website. The available evidence comes from healthcare generally, mostly involving simulation exercises, and is of low or very low certainty. None of the evidence specifically comes from dentistry. The findings in relation to the nature of PPE, methods of donning and doffing, and the importance of training are all of practical relevance to dentistry. Research is critically important to provide evidence for future decision making in support of patients and staff.