COVID-19: The immediate response of european academic dental institutions and future implications for dental education

A bibliometric analysis of the dental scientific literature on COVID-19

Objectives

The rapid production of a large volume of literature during the early phase of the COVID-19 outbreak created a substantial burden for clinicians and scientists. Therefore, this manuscript aims to identify and describe the scientific literature addressing COVID-19 from a dental research perspective, in terms of the manuscript origin, research domain, study type, and level of evidence (LoE).

Materials and methods

Data were retrieved from Web of Science, Scopus, and PubMed. A descriptive analysis of bibliographic data, collaboration network, and keyword co-occurrence analysis were performed. Articles were further classified according to the field of interest, main research question, type of study, and LoE.

Results

The present study identified 296 dental scientific COVID-19 original papers, published in 89 journals, and co-authored by 1331 individuals affiliated with 429 institutions from 53 countries. Although 81.4% were single-country papers, extensive collaboration among the institutions of single countries (Italian, British, and Brazilian institutions) was observed. The main research areas were as follows: the potential use of saliva and other oral fluids as promising samples for COVID-19 testing, dental education, and guidelines for the prevention of COVID-19 transmission in dental practice. The majority of articles were narrative reviews, cross-sectional studies, and short communications. The overall LoE in the analyzed dental literature was low, with only two systematic reviews with the highest LoE I.

Conclusion

The dental literature on the COVID-19 pandemic does not provide data relevant to the evidence-based decision-making process. Future studies with a high LoE are essential to gain precise knowledge on COVID-19 infection within the various fields of Dentistry.

Clinical relevance

The published dental literature on COVID-19 consists principally of articles with a low level of scientific evidence which do not provide sufficient reliable high-quality evidence that is essential for decision making in clinical dental practice.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00784-021-03916-6.

Impact of COVID-19 pandemic on dental education: online experience and practice expectations among dental students at the University of Jordan

BACKGROUND

The quarantine associated with the COVID-19 pandemic forced dental schools to suspend their clinical training and to shift to distant learning methods. The aim of this study is to investigate the impact of quarantine on the self-perceived preparedness of dental graduates and to explore the efficacy of online education from students' perspectives.

METHODS

The questionnaire distributed to dental students comprised of two main sections. The first part covered the online education experience, and the second part measured the level of self-perceived preparedness for a range of cognitive, communication and professional skills.

RESULTS

The survey yielded a response rate of 72%. The majority of students (77%) agreed that they missed educational experiences as a result of the lockdown. More than half of them felt less motivated to follow-up with distant e-learning and believed that online assessment is not a good method for evaluation. A high percentage of the students (66%) thought that online group discussions had a positive value while 67% preferred online lectures compared to theatre lectures. Majority of students particularly 5th year (78.7%) (p < 0.001) stated that the quarantine increased their collaboration with their colleagues. According to 87% of students, the experience most negatively affected was their clinical training. In general, students showed satisfactory self-perceived preparedness related to a range of attributes and professional skills.

CONCLUSIONS

The data showed that students partially appreciated the online system, whereas they did not consider it a substitute for face to face clinical practice. The overall self-perceived preparedness level was promising; however students had reservations regarding independent practice following graduation.

Dental Education in the COVID-19 Era: Challenges, Solutions and Oppor- tunities

Objective:

The COVID-19 crisis has caused considerable disruption to medical education and has stimulated creative and rapid changes in the way technology is adopted and utilized for education. This change is accompanied by many challenges related to education, patient care, research, faculty development and collaboration, finances, and the psychological well-being of stakeholders.

Methods:

A review of the literature on dental education during the COVID-19 pandemic was conducted. Published articles addressing the challenges, solutions and opportunities in dental education during the COVID-19 era were assessed.

Results:

COVID-19 was a catalyst for a significant amount of change in dental education. Despite the magnitude of the challenges, this pandemic has influenced many positive solutions and opportunities in dental education.

Conclusion:

The COVID-19 pandemic forced dental educators to rethink models of curricular delivery, as it disrupted traditional delivery methods. The use of technology was adapted to ensure the continuity of education. With that, a number of challenges surfaced that were tackled creatively. Reflecting over the whole experience with COVID-19, the multiple opportunities that have been identified can improve the way we educate our students in the future.

Kobra Surgery Simulator-A Possibility to Improve Digital Teaching? A Case-Control Study

Computer-aided simulations have long been of great importance in university teaching; however, to date, there is limited use of such simulations in the dental surgical sector. For this purpose, an oral surgery simulator, "Kobra", was implemented in student training and was evaluated for dental education. Dental students (group 1, third-year and group 2, fourth-year) and dentists of the faculty (control group) were trained to use the simulator. The outcomes for group 1 (apicoectomy of an upper lateral incisor with Kobra), group 2 (removal of an impacted lower wisdom tooth with Kobra) and the control group (both procedures with Kobra) were evaluated. For evaluation purposes, subjective parameters (improvement of practical skills, comparison between conventional training and Kobra simulation, and implementation of simulation-based teaching) and objective parameters (removal of bone, tooth substance and soft tissue measured while performing the Kobra simulation) were assessed using questionnaires with a scale ranging from 1-5. A total of 49 students (third-year n = 29, with 22 women and 7 men; fourth-year n = 20, with 17 women and 3 men) and 10 dentists (women n = 5 and men n = 5) participated. Compared to the Kobra simulation, the conventional training method with plastic models was still favored (the difference was non-significant). Compared to the dentists, the simulation data showed a less precise surgical performance of the students (the difference was not significant). The Kobra simulation may offer an additional method to conventional surgery training using plastic models, with benefits for students and faculty staff.

Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p < 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = −0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.

The Challenge of Dental Education After COVID-19 Pandemic - Present and Future Innovation Study Design

The present work suggests research and innovation on the topic of dental education after the COVID-19 pandemic, is highly justified and could lead to a step change in dental practice. The challenge for the future in dentistry education should be revised with the COVID-19 and the possibility for future pandemics, since in most countries dental students stopped attending the dental faculties as there was a general lockdown of the population. The dental teaching has an important curriculum in the clinic where patients attend general dentistry practice. However, with SARS-CoV-2 virus, people may be reluctant having a dental treatment were airborne transmission can occur in some dental procedures. In preclinical dental education, the acquisition of clinical, technical skills, and the transfer of these skills to the clinic are extremely important. Therefore, dental education has to adapt the curriculum to embrace new technology devices, instrumentations systems, haptic systems, simulation based training, 3D printer machines, to permit validation and calibration of the technical skills of dental students.

Innovation of dental education during COVID-19 pandemic

BACKGROUND/PURPOSE

The impact of the pandemic of COVID-19 has a certain influence on various walks of life around the world. Because of the pandemic of this novel coronavirus in terms of COVID-19, the social life global wide has been changed a lot. To keep the social distance between human being to prevent from being infected is the most important strategy for all the countries. Many dental schools have been locked down to minimize the spread out of this coronavirus infection. Close contact between human being are required for all those learning process in traditional dental education. Learning methods should be innovated to keep on the learning process but away from being infected for dental education during pandemic. The purpose of this manuscript is to exchange the information and experience of those dental educators from different countries to prepare for the future demand for dental education during pandemic.

MATERIALS AND METHODS

By means of three online symposiums, dental educators from different countries were invited to give presentation and discussion regarding to the information and experience in the innovation of dental education during the pandemic.

RESULTS

The results showed that the impact of the pandemic of COVID-19 affects the dental education a lot. Intelligent technology has certain benefit for the learning process of dental education during the pandemic.

CONCLUSION

The impact of the pandemic of COVID-19 affects dental education a lot. The model of dental education should be innovated to suit different situations and novelty intelligent technology should be applied for future dental education.

Effectiveness of Using an Instructional Video in Teaching Light-Curing Technique

PURPOSE

To investigate dental students' ability to deliver satisfactory amounts of irradiance and radiant exposure to simulated cavities by teaching the light-curing technique using instructional video compared to verbal instructions.

METHODS

Students attended the didactic light-curing lecture explaining the light-curing technique. Participants were divided into two groups (n=60). Each participant light-cured a class III and a class I simulated cavities with sensors built-in a Managing Accurate Resin Curing-Patient Simulator (MARC-PS) system, using a multiple-emission-peak light-emitting-diode unit. Each student either 1) watched an instructional video (V) showing the light-curing technique, or 2) received individual verbal instruction (I). The light-curing performance, in terms of the mean irradiance and radiant exposure, was recorded. Each student performed light-curing again on the simulated cavities. Students' feedback for the corresponding teaching method was collected. Comparisons between before and after each instructional method were analyzed using the Wilcoxon signed-rank test. Comparisons between both instructional methods were analyzed using a Mann-Whitney U-test (α=0.05).

RESULTS

The students' light-curing performance improved after both methods, as observed on the MARC-PS laptop monitor. The mean irradiance values were anterior-V=1280.6 (183.2), anterior-I=1318.0 (143.5), posterior-V=1337.5 (181.1), posterior-I=1317.6 (248.2) mW/cm². The mean radiant exposure values were for anterior-V=13.5 (2.7), anterior-I=13.3 (1.6), posterior-V=13.7 (1.9), posterior-I=13.7 (2.5) J/cm². No significant difference was found between both instruction methods. Students reported that each method was effective.

CONCLUSION

Using V was comparable to I and an effective tool for teaching the light-curing technique per the students' ability to deliver sufficient amounts of irradiance and radiant exposure to simulated cavities.

COVID 19 and Dental Education: Transitioning from a Well-established Synchronous Format and Face to Face Teaching to an Asynchronous Format of Dental Clinical Teaching and Learning

The Covid-19 pandemic made it necessary to adopt and establish complete or partial online delivery of our clinical teaching and learning. We developed an alternative approach with a combination of Problem based Learning asynchronous fora and Teacher-facilitated synchronous online discussions. Our aim is to share our educational practice and highlight the requirements and constraints, advantages and challenges of such an approach. It allowed a more student-centred experience, but clinical simulation and face-to-face patient care remain necessary. The Covid-19 pandemic has changed the landscape of dental education for the foreseeable future, with a reduced number of patients in dental clinics. Further study is therefore necessary to understand the lived experience of students and teachers to the adopted online teaching and learning approach.

Redeployment of Dental Core Trainees in the United Kingdom due to Coronavirus Disease 2019

Objective  The coronavirus disease 2019 (COVID-19) pandemic has affected professionals in all fields; none more so than medical and dental professionals. As dental core trainees (DCT) working in hospitals, we have been at the forefront of the crisis and one of the first in line for redeployment. Therefore, we decided to investigate the impact of COVID-19 on the redeployment of DCTs across the UK.

Materials and Methods  Data for this study was collected and shared between three project researchers. All researchers were undergoing dental core training in Oral Surgery and Restorative dentistry at Guy’s Hospital, London. An online survey was sent out via email and online social media platforms to reach as many DCTs as possible in the United Kingdom. Implied consent was obtained by respondents on submission of the survey.

The survey consisted of five sections and was branched, with respondents answering different sections depending on their redeployment status. No qualitative data was collected, as all questions included in the survey were dichotomous or multiple-choice questions. The last two questions were in the form of a 5-point Likert scale, inviting respondents to rate five statements from strongly agree to strongly disagree.

Results  A total of 150 participants responded, of which 34% had been redeployed due to the pandemic. The majority of DCTs were redeployed to an intensive care unit or similar setting, and over 75% of those redeployed were working with either COVID-19 positive/suspect patients. Additionally, 23.8% of respondents had stopped patient contact due to their medical status.

Conclusion  Many DCTs have been deployed to departments outside of their specialty and expressed some anxiety as a result. Inevitably, this has resulted in disruption to their training program and education over the last few months. The response across the United Kingdom has been understandably variable due to the differing demands of the hospital trusts within which the DCTs work.

Guidelines for innovation in dental education during the coronavirus disease 2019 pandemic

During the current coronavirus disease 2019 (COVID-19) pandemic, dental education and training requiring face-to-face interaction must prioritize infection prevention and the safety of students, staff, and patients. In July 2020, the Association for Dental Education, Asia Pacific (ADEAP) published safety guidelines for safe dental education during the COVID-19 pandemic. These guidelines summarize ADEAP recommendations for classroom-based courses, reopening of simulated training courses and dental clinics, and provision of clinical skills training courses in dentistry during the COIVID-19 pandemic. They have been formulated to ensure the safety of students and teaching staff, dental auxiliary staff, and patients. However, the present guidelines are considered appropriate only when the number of COVID-19 epidemic cases has been significantly reduced, i.e. when the epidemiological curve has flattened in the area concerned. The criteria for lifting restrictions on activities should be consistent with relevant jurisdictional guidelines.

Student perspective of classroom and distance learning during COVID-19 pandemic in the undergraduate dental study program Universitas Indonesia

BACKGROUND

The COVID-19 pandemic has become a global health issue and has had a major impact on education. Consequently, half way through the second semester of the academic year 2019/2020, learning methods were delivered through distance learning (DL). We aimed to evaluate the student perspective of DL compared to classroom learning (CL) in the undergraduate dentistry study program at the Faculty of Dentistry Universitas Indonesia.

METHODS

An online questionnaire was sent at the end of the semester. A total of 301 students participated in the study.

RESULTS

Duration of study influenced student preference. Higher number of first-year students preferred DL compared to their seniors (p < 0.001). Students preferred CL for group discussion, as DL resulted in more difficult communication and gave less learning satisfaction. Only 44.2% students preferred DL over CL, although they agreed that DL gave a more efficient learning method (52.6%), it provided more time to study (87.9%) and to review study materials (87.3%). Challenges during DL included external factors such as unstable internet connection, extra financial burden for the internet quota and internal factors such as time management and difficulty to focus while learning online for a longer period of time.

CONCLUSION

Despite some challenges, dental students could adapt to the new learning methods of full DL and the majorities agreed blended learning that combined classroom and distance learning can be implemented henceforth. This current COVID-19 pandemic, changes not only the utilization of technology in education but the pedagogy strategies in the future.

Can Undergraduate Dental Education be Online and Virtual During the COVID-19 Era? Clinical Training as a Crucial Element of Practical Competencies

This article was migrated. The article was marked as recommended. The COVID-19 pandemic has brought ample challenges to clinical dental education all over the world. Dental schools had to adopt diverse strategies as a result of the exceptional circumstances, to provide a safe environment for their students, faculties, and patients. Despite the broad implementation of innovative educational tools in the form of blended learning, virtual reality simulators (VRS), and virtual learning environment, dental students expressed their willingness to restore on-site practical lessons, developing their clinical skills with patients' presence. It is believed that undergraduate dental education (UDE) during post COVID-19 pandemic lock-down might require substantial organisational changes, adequate adjustments of dental curricula and novel educational approaches in order to maintain a high level of UDE. This should be delivered by utilising the blended teaching methods, with core involvement of traditional clinical sessions and safety preventative measures arranged by dental faculties, allowing a safe return to dental schools for at least essential clinical sessions. This personal view aims to emphasis the need for re-establishment and continuity of crucial clinical and practical dental training during 'new normal' dental education era, as an integrated and unique element of UDE, which can be only partially substituted by online learning programs.

Impact of SARS-CoV-2 on orthodontic education and global practice guidance: A scoping review

The acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, has had unprecedented impact on orthodontic care and education. Dental schools and clinics have stopped their normal educational and clinical activities worldwide, while only accepting emergency cases. It is still unknown when students will return to clinics to resume patient care and receive training. This scoping review aims to examine, summarize, and reference current resources to analyze the impact of SARSCoV-2 on orthodontic practice recommendations and orthodontic education. This review summarizes recommended global guidelines to provide a better understanding of the current consensus for protocols of safe orthodontic care; this scoping review serves to help create concrete guidelines for orthodontists to deal with the current SARS-CoV-2 pandemic, and for future infectious diseases, and assessing the impact on orthodontic education. Using inclusion/exclusion criteria, 456 articles were screened by two independent screeners and data were extracted and charted from 50 relevant sources. These 50 sources conveyed similar guidelines for provider and patient safety in orthodontic practices, with some stressing certain protocols such as personal protective equipment over others. Impacts on orthodontic education conveyed changes in protocols for learning, competency, and clinical skills. As this respiratory illness progresses, the field of orthodontics needs cohesive universal clinical guidelines and further assessment of the impacts of SARS-CoV-2 on orthodontic education.