Biosafety practices in Brazilian dentistry after the COVID-19 public health emergency: Persistence and discontinuation of protective measures

The COVID-19 pandemic disrupted dental services worldwide, requiring rapid adaptation of biosafety measures. In Brazil, emergency protocols were widely implemented across public and private dental care. This nationwide cross-sectional study investigated which biosafety practices adopted during the COVID-19 pandemic were maintained by Brazilian dentists and analysed factors associated with continued respirator use in the post-emergency period. Data were collected between March and October 2023 using non-probabilistic snowball sampling through an online questionnaire based on Brazilian biosafety guidelines and international recommendations. Descriptive statistics, chi-square and Fisher's exact tests, and simple and multiple logistic regression models were used (α=0.05). Among 1,136 dentists, most were female (71.2%), aged 41-50 years (33.6%), and had ≥12 years of professional experience (76.1%). Difficulties obtaining personal protective equipment during the pandemic were reported by 80.2% of participants, mainly involving masks and gloves, with significant associations according to work setting (p<0.05). Respirator use became widespread during the pandemic, with 45.6% reporting use only during the emergency phase and 39.6% continuing its use in the post-emergency period. In the adjusted model, sex and work setting remained associated with maintenance of respirator use (p<0.05). Fatigue (47.7%) and respiratory discomfort (27.3%) were the most frequently reported adverse effects. The pandemic changed dental biosafety practices in Brazil: traditional infection-control measures remained routine, whereas enhanced measures were partly sustained. These findings may inform preparedness planning for future public health emergencies.