COVID-19 Risk Factors

Last Updated: 19 March 2020

The following information is designed to provide additional information for dental practitioners when considering risk factors for the contraction and severity of COVID-19 and infection.

The ADA remains focused on ensuring that its members have up to date information to protect themselves, their teams and their patients during this challenging period.
Most of the data currently being used to draw conclusions about risk factors is derived from a large study conducted in China on 44,672 confirmed cases. This, and subsequent research would appear to indicate that:

1) The highest risk factor for increasing the severity of the infection is age. Case fatality increases significantly after age 60 and peaks at around 15% for those over 80 years of age.

2) Children can contract the virus. However, they are more likely to be asymptomatic or to have only mild symptoms.

3) Co-morbidities that appear to be associated with susceptibility include:

- Hypertension
- Diabetes
- Coronary heart disease

4) There appears to be a correlation between smoking status and infection susceptibility.

5) An increased infection susceptibility related to pregnancy has not been established.

Dentists should consider the emerging evidence as it arises when deciding how to best protect themselves, their teams and their patients, using a risk-based approach. Some examples of how this could be applied include:

- Reducing the exposure risk for persons over the age of 60

- Staggering appointments so those at higher risk of contraction and progression of the disease do not intermingle with likely carriers in shared areas such as waiting rooms

- Appointment book co-ordination to see people with co-morbidities (but no COVID-19 symptoms or contact) at the start of the day

- Appointment book co-ordination to see cohorts at highest risk of transmission with no or low symptoms at the end of the day

It is acknowledged that the existing literature on this condition is new and there are challenges with the quality of information currently available based on the rapid spread of COVID-19. The ADA will endeavour to keep members updated on any major developments in risk factors that emerge so that its members can continue to make well-informed decisions.
In the meantime, the ADA recommends keeping up to date with emerging epidemiological updates via

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