Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine

Modern modified aerosol box: Isolation aid for oral health care professionals during dental procedures

COVID-19 affected healthcare professionals globally, especially dentists, which is airborne and transmitted through contact. Most dental procedures are aerosol generated and these aerosols in dental practice tend to transmit acute respiratory infections like COVID-19. Recently, a few authors recommended using the aerosol box to reduce the aerosol count in a dental setting. However, the study aims to describe and recommend a reformed aerosol box desand to practice safe dentistry.

Impact of COVID-19 on dental practice and anxiety among increased risk group dentists: A cross-sectional study

BACKGROUND: The likelihood of infection with SARS-COV-2 (COVID-19) in the dental office is considered high. OBJECTIVES: Assessing the impact of the COVID-19 on dental practices and anxiety levels in risk group Brazilian dentists. METHODS: A cross-sectional study was performed using an online questionnaire. The data obtained were analyzed using the IBM SPSS 25.0 software (Pearson’s Chi-square association test, multivariate logistic regression, and Poisson multiple regression), with subsequent calculation of the odds ratio at a 95% confidence interval, with a significance level of 5%. RESULTS: Responses of 578 dentists distributed in all regions of Brazil were collected. Most of the dentists were female, with an average age of 35. Of the participants, 23.4% were part of the increased risk group for COVID-19. The professionals who belonged to the increased risk group had a greater chance of not feeling prepared to perform consultations (OR = 1.67) and were not performing any procedures during the pandemic (OR = 2.03). Belonging to the increased risk group did not influence anxiety levels among the dentists. The factors associated with increased anxiety were being female, being younger, working in the southeastern region of the country, being afraid of contracting COVID-19 while working, and being concerned for one’s professional future. CONCLUSIONS: The pandemic has had a negative impact on the professional practice of individuals at risk, but the level of anxiety was like professionals who were not part of the increased risk group for COVID-19.

Oral Adverse Events Following COVID-19 Vaccination: Analysis of VAERS Reports

Background

Oral adverse events (AEs) following COVID-19 vaccination have been sporadically reported during the previous months, warranting further investigation for their prevalence and suspected relationship with vaccine-elicited immune response.

Methods

A retrospective analysis using the Vaccine Adverse Event Reporting System (VAERS) data was conducted to evaluate AEs within the oral cavity (mucosa, tongue, lips, palate, dentition, salivary glands) and AEs involving taste and other sensations. Oral AEs reported after receiving COVID-19 vaccination (test group) and seasonal influenza vaccination (control group) were extracted and cross-tabulated to assess their relative prevalence.

Results

Among the 128 solicited (suspected) oral AEs, oral paresthesia (0.872%) was most reported after receiving COVID-19 vaccines, followed by the swelling of lips (0.844%), ageusia (0.722%), oral hypoesthesia (0.648%), swollen tongue (0.628%), and dysgeusia (0.617%). The reported prevalence of oral AEs was higher in the COVID-19 vaccine group than in the seasonal influenza group. The distribution pattern of the most reported oral AEs was similar for both COVID-19 and seasonal influenza vaccines. Female sex, older age (>39 years old), primer doses, and mRNA-based COVID-19 vaccines exhibited a higher reported prevalence of oral AEs.

Conclusion

Within the limitations of this study, COVID-19 vaccines were found to be associated with rare oral AEs that are predominantly similar to those emerging following seasonal influenza vaccines. The most commonly reported oral AEs were oral paraesthesia (mouth-tingling), lip swelling, and ageusia, representing various pathophysiologic pathways that remain unclear. Taste-related AEs should be acknowledged in the context of the COVID-19 pandemic and the public should be adequately informed about a potential taste dysfunction after receiving the COVID-19 vaccination. Dentists and dental teams need to be aware of the prevalence, severity, and prognosis of oral AEs to inform their patients and increase public confidence in vaccines.

A Review on Risk Management of Coronavirus Disease 19 (COVID-19) Infection in Dental Practice: Focus on Prosthodontics and All-Ceramic Materials

Background: A novel β-coronavirus infection (COVID-19) was first detected in Wuhan city, spreading rapidly to other countries and leading to a pandemic. Dental professionals and patients are exposed to a high risk of COVID-19 infection, particularly in the prosthodontic practice, because of the bio-aerosol produced during teeth preparation with dental handpieces and the strict contact with oral fluids during impression making. This paper aimed to provide an overview to limit the risk of transmission of COVID-19 infections during prosthetic procedures in dental offices. Methods: An electronic search was conducted on the electronic databases of PubMed/Medline, Google Scholar, Embase, Scopus, Dynamed, and Open Grey with the following queries: (COVID-19) AND/OR (SARS-CoV-2) AND/OR (Coronavirus) AND/OR (contaminated surface) AND/OR (cross-infection) AND/OR (Prosthodontics) AND/OR (dental ceramic) AND/OR (glass-ceramic). A manual search was performed as well. Results: From the 1023 collected records, 32 papers were included. Conclusions: Dental offices are at high risk of spreading SARS-CoV-2 infection due to the close contact with patients and continuous exposure to saliva during dental procedures. Therefore, pre-check triages via telephone, decontamination, the disinfection of impressions, the sterilization of scanner tips, and the use of specific personal protective equipment, dental high-speed handpieces with dedicated anti-retraction valves, and effective mouthwashes are strongly recommended.

Effects of the COVID-19 pandemic on dentists' workforce confidence and workflow

BACKGROUND

The COVID-19 pandemic has affected the US economy and workforce, including marked effects on small businesses. Researchers have evaluated workers' views of financial confidence and advancement, but there has been limited focus on the dental industry.

METHODS

To extend investigations to dentistry, the authors used published scales and pretested questions to determine workforce confidence and workflow changes among dentists. Data were evaluated using descriptive and bivariate statistics. In the wake of the pandemic, surveys were distributed to the memberships of the American Dental Association and American Association of Orthodontists (n = 656).

RESULTS

Dentists' top concern was increased cost of providing treatment (57.4%; 95% CI, 53.5% to 61.3%), associated with widely adopted workflow changes including reduced patient volumes (66.0%; 95% CI, 62.4% to 69.6%) and increased safety protocols and equipment (health screening: 75.5%; 95% CI, 72.2% to 78.8%; KN/N95 respirators: 76.7%; 95% CI, 73.5% to 80.0%). However, most respondents did not expect their personal or practice finances to be negatively affected after the pandemic, as only 18.5% (95% CI, 15.4% to 21.7%) predicted their practice's gross revenue would decrease.

CONCLUSIONS

Dentists were optimistic in the wake of vaccinations and lifting restrictions. Most expected their finances and practice performance to remain the same or grow in the short term and expected long-term improvements postpandemic.

PRACTICAL IMPLICATIONS

Results suggest that despite shutdowns and workflow changes, dentists have rebounded financially and anticipate future growth.

Dental Care and Education Facing Highly Transmissible SARS-CoV-2 Variants: Prospective Biosafety Setting: Prospective, Single-Arm, Single-Center Study

With the arrival of the highly transmissible Omicron variants (BA.4 and BA.5), dentistry faces another seasonal challenge to preserve the biosafety of dental care and education. With the aim of protecting patients, students, teachers and healthcare professionals, this paper introduces a prospective sustainable biosafety setting for everyday dental care and education. The setting developed by dental clinicians, epidemiologists, and teachers of dentistry consists of a combination of modern technologies focused on the air-borne part of the viral pathway. The introduced biosafety setting has been clinically evaluated after 18 months of application in the real clinical environment. The protocol has three fundamental pillars: (1) UVC air disinfection; (2) air saturation with certified virucidal essences with nebulizing diffusers; (3) complementary solutions including telehealth and 3D printing. A pseudonymous online smart form was used as the evaluation method. The protocol operates on the premise that everybody is a hypothetical asymptomatic carrier. The results of a clinical evaluation of 115 patient feedbacks imply that no virus transmission from patient to patient or from doctor to nurse was observed or reported using this protocol, and vice versa, although nine patients retrospectively admitted that the clinic visit is likely to be infectious. Despite these promising results, a larger clinical sample and exposition to the current mutated strains are needed for reliable conclusions about protocol virucidal efficiency in current dental environments.

Undergraduate dental students’ perspective of online learning and their physical and mental health during COVID-19 pandemic

Background and objective

COVID-19 pandemic continuously spread exacerbating global concerns. It had impacted all life aspects such as social, cultural, economic and education. This study assess the impact of COVID-19 pandemic on undergraduate dental students at Faculty of Dentistry, University of Malaya. The objective of this study is to evaluate the impact of the pandemic on physical and mental health of undergraduate dental students.

Methods

This is a cross-sectional study. An online questionnaire was administrated to 150 undergraduate dental students. The questionnaire included questions related to students’ demographic data, their concerns on academic achievement, their opinion on institution response, and the impact of the crisis on their mental and physical health. SPSS software v26.0 was used to analyse the collected data.

Results

A total of 147 respondents participated in the study. About 66% of the students felt comfortable in adapting to the new technology while 85.7% were concerned about the quality of online learning. Almost all students 98.6% expressed their doubts on the ability to pass the competency exams and to graduate on time, with only 49.7% agreed that clinical experience was effectively delivered through online classes. Most students were also concerned on the impact of the pandemic on their physical and emotional health 85.8% and 76.9% respectively.

Conclusions

The findings of our study highlight the positive adaptation of the students to online learning and using technology. On the other hand, the study indicates that the COVID-19 pandemic brings negative impacts on our students’ physical and mental health.

A cross-sectional study on COVID-19-related changes in self-medication with antibiotics

Background and aim

Dental treatments have been limited to emergency care in many countries worldwide due to the global rapid spread of coronavirus disease-2019 (COVID-19). Fear of contracting the disease in dental clinics has also altered the pattern of dental visits and self-medication. The present study compared self-medication with antibiotics (SMA) and the pattern of dental visits before and after the emergence of COVID-19 pandemic in a referral dental clinic in the north of Iran.

Materials and methods

The data for the present cross-sectional study was collected from 756 patient records retrieved from the archives of the Faculty Clinic of Rasht School of Dentistry during two separate periods: before the COVID-19 pandemic from mid-November 2019 to mid-February 2020, and after the pandemic emergence from mid-April to mid-July 2020. In addition to demographic variables namely age, gender, and place of residence of patients, their smoking status, chief complaint, and SMA were also extracted from patient records. The Chi-square test and binary logistic regression models with 95% confidence interval served for statistical analysis.

Results

In total, 756 patient records (412 records from the pre-pandemic period and 344 records from the post-pandemic period) were evaluated. SMA was significantly more prevalent after the pandemic compared to that before pandemic (OR = 3.39, 95% CI = 2.43–4.73, P<0.001). The number of patients who smoke significantly decreased after the pandemic by 6.6% compared to that in pre-pandemic period. Dental pain, pus discharge, and abscess as the chief complaints of patients were significantly more prevalent during the post-pandemic period; while, dental checkups, tooth hypersensitivity, and esthetic dental problems were significantly more frequent as the chief complaints of patients during the pre-pandemic period.

Conclusion

There is indication that during the COVID-19 pandemic, SMA and prevalence of acute dental problems in patients have increased. With regard to the consequences of SMA, there is a need to raise public awareness on this matter.

Investigation Of The Dentists' Fear Of Covid And Psychological Status During Covid-19 Pandemic

Amaç: Araştırmamızda Covid-19 salgını sürecinde hastalarıyla yakından temas ederek çalışmaya devam eden diş hekimlerinin koronavirüs korkusu, depresyon, anksiyete ve stres düzeyleri ile bunlarla ilişkili faktörlerin incelenmesi amaçlanmıştır. Yöntemler: Gözlemsel ve kesitsel tasarımda olan bu araştırma Covid-19 pandemi sürecinde aktif çalışmakta olan ve araştırmaya gönüllü diş hekimlerini kapsamaktadır. Pandemi tedbirleri nedeni ile elektronik ortamda kolayda örnekleme ile ulaşılan 376 diş hekiminin katılımı ile gerçekleşmiştir. Sosyodemografik Bilgi Formu, Covid-19 Korkusu Ölçeği ve Depresyon Anksiyete Stres-21 Ölçeği kullanılmıştır. Bulgular: Katılımcıların 226’sı (%60,1) salgın sürecinde bulaşma ve ölüm korkusu yaşamaktaydı. Covid korkusu, depresyon, anksiyete, stres ölçekleri ve DASS toplam skoru kadın grup ortalamaları erkek grup ortalamasından anlamlı derecede yüksek bulundu (p

Aerosol reduction of two dental extraoral scavenger devices in vitro

Objective

Since the outbreak of SARS-CoV-2, aerosol control in the operatory has become a key safety issue in dentistry. The utilisation of extraoral scavenger devices (EOSs) is one of the various approaches to in-treatment aerosol reduction in dentistry. The use and efficacy of EOSs in dental settings, however, are still a matter of debate in the literature and there are still open questions about their proper use. Thus, research into this area is essential to inform dental practice. The objective of this study was to examine the aerosol reduction efficacy of two different EOS in vitro.

Methods

Two commercially available EOSs were tested during modeled dental treatment in a setup that previously proved to generate high aerosol load. Measurements were done in two particle size ranges: 5.6–560 nm (the full range of the spectrometer) and 60.4–392.4 nm (a range that is especially relevant to the spread of SARS-CoV-2 with aerosol).

Results

Both devices managed to reduce the aerosol load to a statistically significant extent as compared to the scenario when only a high-volume evacuator and a saliva ejector (and no EOS) were used.

Conclusions

Within the limitations of the study, the results support the assumption that EOSs for aerosol reduction increase in-treatment safety in the dental operatory.

The SARS-CoV2 envelope differs from host cells, exposes procoagulant lipids, and is disrupted in vivo by oral rinses

The lipid envelope of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an essential component of the virus; however, its molecular composition is undetermined. Addressing this knowledge gap could support the design of antiviral agents as well as further our understanding of viral-host protein interactions, infectivity, pathogenicity, and innate immune system clearance. Lipidomics revealed that the virus envelope comprised mainly phospholipids (PLs), with some cholesterol and sphingolipids, and with cholesterol/phospholipid ratio similar to lysosomes. Unlike cellular membranes, procoagulant amino-PLs were present on the external side of the viral envelope at levels exceeding those on activated platelets. Accordingly, virions directly promoted blood coagulation. To investigate whether these differences could enable selective targeting of the viral envelope in vivo, we tested whether oral rinses containing lipid-disrupting chemicals could reduce infectivity. Products containing PL-disrupting surfactants (such as cetylpyridinium chloride) met European virucidal standards in vitro; however, components that altered the critical micelle concentration reduced efficacy, and products containing essential oils, povidone-iodine, or chlorhexidine were ineffective. This result was recapitulated in vivo, where a 30-s oral rinse with cetylpyridinium chloride mouthwash eliminated live virus in the oral cavity of patients with coronavirus disease 19 for at least 1 h, whereas povidone-iodine and saline mouthwashes were ineffective. We conclude that the SARS-CoV-2 lipid envelope i) is distinct from the host plasma membrane, which may enable design of selective antiviral approaches; ii) contains exposed phosphatidylethanolamine and phosphatidylserine, which may influence thrombosis, pathogenicity, and inflammation; and iii) can be selectively targeted in vivo by specific oral rinses.

Impact of the COVID-19 pandemic on dental hygiene students in the Italian region of Emilia-Romagna

BACKGROUND

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new coronavirus detected in China at the end of 2019. Because SARS-CoV-2 is highly infectious due to contamination in the air, there is a high risk of infection in the dental environment which is represents a serious problem for professionals and students (dentistry and dental hygiene). In Italy, since February 23, 2020, the government has suspended all teaching activities of schools and universities.

METHODS

An anonymous questionnaire was administered to the students of the degree courses in Dental Hygiene of the Emilia Romagna Region, one of the most affected regions in Italy. The survey was intended to highlight the practical and emotional consequences of the emergency of COVID-19 on educational activities and in the training of students.

RESULTS

The survey was sent to the 150 students enrolled in the universities of Bologna, Ferrara and Modena and Reggio Emilia; 141 of them completed it (94%). Since the start of the COVID-19 pandemic, several surveys have been proposed to measure the impact of this emergency situation on dental professionals; at present, however, there are still no assessments for dental hygiene degree courses, in particular aimed at assessing the psychological impact on students.

CONCLUSIONS

Students consider the dental hygienist as a risky profession, while the risk taken by patients is considered as low. Given the concern reported the students, it would be useful to address the issue of proper assessment of risk during the university training of dental hygienists.

Personal Protection Equipment and Infection Control Procedures among Health Workers during the COVID-19 Pandemic

Health workers have been particularly affected by the COVID-19 pandemic, but it is unclear which healthcare professions are more exposed. We search for information that can help identify health workers who are employed in exposure-prone professions and who, therefore, routinely wear and adopt strict infection control equipment and measures from other colleagues. Our purpose is to test the hypothesis that health professionals historically considered less exposure-prone are affected more severely by COVID-19. Taking dentists as an example of exposure-prone healthcare professionals, this study aims to analyze data on COVID-19-related deaths reported by the Italian board of doctors and dentists’ database to evaluate the number of COVID-19-related deaths of doctors and dentists in Italy from the beginning of the pandemic to 31 December 2022. As of 31 December 2021, out of 364 deaths, 38 were dentists, and of the remaining 326 doctors, 140 were general practitioners (GPs). The percentage of deaths among dentists, total doctors and GPs results in 0.06%, 0.09% and 0.33%, respectively, for the whole sample. Excluding subjects over 70 years of age, the corresponding values are 0.05%, 0.06% and 0.25%. Most of the deaths occurred in Lombardia, and the geographical distribution overlaps the trend of the corresponding general Italian population. Considering the outcome of “death”, dentists, despite being at high risk, are not particularly affected by COVID-19.

Efficacy of Combining an Extraoral High-Volume Evacuator with Preprocedural Mouth Rinsing in Reducing Aerosol Contamination Produced by Ultrasonic Scaling

The coronavirus disease pandemic has afforded dental professionals an opportunity to reconsider infection control during treatment. We investigated the efficacy of combining extraoral high-volume evacuators (eHVEs) with preprocedural mouth rinsing in reducing aerosol contamination by ultrasonic scalers. A double-masked, two-group, crossover randomized clinical trial was conducted over eight weeks. A total of 10 healthy subjects were divided into two groups; they received 0.5% povidone-iodine (PI), essential oil (EO), or water as preprocedural rinse. Aerosols produced during ultrasonic scaling were collected from the chest area (PC), dentist's mask, dentist's chest area (DC), bracket table, and assistant's area. Bacterial contamination was assessed using colony counting and adenosine triphosphate assays. With the eHVE 10 cm away from the mouth, bacterial contamination by aerosols was negligible. With the eHVE 20 cm away, more dental aerosols containing bacteria were detected at the DC and PC. Mouth rinsing decreased viable bacterial count by 31-38% (PI) and 22-33% (EO), compared with no rinsing. The eHVE prevents bacterial contamination when close to the patient's mouth. Preprocedural mouth rinsing can reduce bacterial contamination where the eHVE is positioned away from the mouth, depending on the procedure. Combining an eHVE with preprocedural mouth rinsing can reduce bacterial contamination in dental offices.

The dental office: A safe place against COVID19 and other future pandemics

Background

The pandemic caused by the spread of COVID19 generated throughout the world great changes in all areas of life. Social distancing was carried out very drastically in some countries, and even in the field of dental care, some countries prohibited the practice of dentistry.

Objective

To demonstrate that the dental office is safe regarding the possibility of contagion of Sars-Cov-2 as long as good biosecurity protocols are used.

Methods

A structured survey of 19 questions was applied to 103 patients who subsequently attended a periodontics and oral and maxillofacial surgery office in Mexico, to receive care from these specialties between April 2020 and July 2021. The questions posed in this survey were aimed at knowing the opinion of the patients regarding the measures that this establishment has for the prevention of the transmission of COVID19, as well as questions regarding the possible effects of attending this office in contagion of the disease from patients and their families.

Results

A total of 18 (17.5%) patients reported having suffered COVID19, and none reported that they fell ill after the consultation. None of the clinic's specialists and assistants have fallen ill with COVID-19 during the pandemic.

Conclusions

It is not necessary to suspend or condition dental care during times of pandemics such as what happened with COVID19, as long as strict safety protocols are observed within clinical facilities.

Did Covid-19 Pandemic Effect Orthodontic Treatment Outcome? A Clinical Evaluation Using the Objective Grading System (OGS) And Peer Assessment Rating (PAR) Index

Introduction

This study aimed to compare the treatment outcome of patients whose orthodontic treatment was completed before or during the coronavirus disease 2019 pandemic.

Methods

Pretreatment and posttreatment models of 100 patients treated with fixed orthodontic appliances were evaluated using the peer assessment rating (PAR) index. Posttreatment models and panoramic radiographs were measured and scored with the objective grading system (OGS). All patients had their treatment plans before the coronavirus disease 2019 pandemic, but the orthodontic treatment finishing date was before (prepandemic: group 1, n = 50) or during (pandemic: group 2, n = 50) the pandemic. Intergroup comparisons were tested with an independent samples t test or Mann-Whitney U test. Chi-square test statistics and Fisher exact test were used to compare categorical variables.

Results

Significant higher posttreatment weighted maxillary alignment score was found in group 2. However, no significant difference was found between the groups concerning the mean total weighted PAR reduction (29.8 ± 9.9 vs 25.6 ± 8.7) and posttreatment total weighted PAR scores (1 vs 2). The PAR index score improvement (%) was similar between the groups (93.7 ± 7.1 vs 89.9 ± 13.0). No statistically significant difference was found between the groups for the total OGS score (32 vs 33). A lower score for marginal ridge height (4 vs 3) and a higher score for buccolingual inclination (7 vs 11), and a lower score for occlusal relationship (3 vs 1) were found in group 2. Canceled appointments (1.1 ± 0.7 vs 4.8 ± 1.6) and the number of missed appointments (0.6 ± 0.5 vs 1.1 ± 0.8) were statistically higher in group 2, whereas the total number of appointments (27.3 ± 8.8 vs 21.8 ± 5.4) were statistically less. The treatment duration was comparable in both groups.

Conclusions

Reduced and irregular appointments during the pandemic resulted in significantly higher posttreatment weighted maxillary alignment and worsening of the buccolingual inclination. However, the PAR score improvement, total OGS score, and treatment duration were not affected.

Top 50 covid and oral health articles: A 2021 altmetric analysis

Objectives

There is a world of information at our disposal, and it is increasingly difficult to transform this dull amount of data into knowledge. How to be constantly actualized? This study aims to create an altmetric list of the top 50 articles related to COVID-19 and oral health.

Methods

Research of terms COVID-19 and oral health was done using Dimensions app. Results were ranked in altmetric citations and analyzed through Microsoft Excel. Some tables and graphics were created. Graphical illustration of keywords was created using VOSviewer.

Results

Some interesting facts can be seen, like growing interest in dental aerosols, perspectives, and virucidal activity of some mouthwashes.

Conclusions

Altmetric analysis is a helpful manner to scientific updates, supplementing bibliometric analysis. A terrific manner to see trends. The scientific community goes to great lengths to solve problems with dental aerosols, particularly to reduce contamination. Some adjustments to dental office and the use of barriers are recommended.

Effect of active learning and online discussions on the academic performances of dental students

BACKGROUND

COVID-19 caused significant confusion around the world, and dental education was no exception. Therefore, in line with the demands of the times, this study sought to determine the applicability of online active learning to dental education.

METHODS

This study was conducted in the second semester of 2020 at a school of dentistry in a selective university in Korea. A total of 114 dental students were recruited. Participants were assigned to four different groups (lecture and discussion [LD], lecture and discussion with instructor's worksheet [LW], self-study and discussion [SSD], and self-study and discussion with instructor's worksheet [SW]) using the random breakout room function in the Zoom video conference application. Their final test scores were then analyzed using analysis of variance and the online active learning results were compared with the offline learning results.

RESULTS

The scores were highest for the transfer type items in the SSD group, followed by the SW group and the two lecture groups, which had no significant differences. These scores and pattern differences between the groups were similar for all items. The results suggested that studying by oneself rather than simply listening to lectures enhanced the effects of the discussions and led to higher learning outcomes. In addition, the effect of the instructor's intervention in the middle of the discussion varied depending on the pre-learning activities of discussion. As with previous offline experiments, self-study followed by group discussion had higher learning outcomes for both the verbatim and transfer type items.

CONCLUSIONS

In agreement with the Interactive, Constructive, Active, and Passive (ICAP) framework and other active learning theories, the findings clearly indicated that online active learning was applicable to dental students, and when self-study precedes discussion, the learning is richer and the learning outcomes are better.

How the COVID-19 Pandemic Affects Risk Awareness in Dentists: A Scoping Review

Dentists are on the frontline of infection, especially when it comes to respiratory viruses like the new coronavirus. The purpose of this paper is to conduct a scoping review to better understand dentists' risk awareness, awareness of COVID-19 symptoms, preventive measures, and effective methods of COVID-19 infection prevention and management. This paper systematically assesses the published literature on dentistry and COVID-19. Various electronic databases including Ovid MEDLINE, Scopus, Embase, and MEDLINE via PubMed were searched up to 9 September 2021. Overall, 39 papers were included. Almost the entirety of dentists (94.5%) reported awareness of the three most common COVID-19 symptoms, and a risk awareness score of about 90% was shown, while 88.2% of dentists reported adopting preventive measures. More than 50% did not want to treat infected people. While 70.3% of dentists recommended usage of N95 masks, the rate of dentists using them was below 40%. Sufficient awareness of risks during the pandemic was found in dentists. Although they were using preventive measures, there remains upside potential for adopting all recommended measures. Further, the usage of N95 masks is improvable, even though the benefit of wearing them could not be confirmed.

Aerosol exposure of staff during dental treatments: a model study

Background

Due to exposure to potentially infectious aerosols during treatments, the dental personnel is considered being at high risk for aerosol transmitted diseases like COVID-19. The aim of this study was to evaluate aerosol exposure during different dental treatments as well as the efficacy of dental suction to reduce aerosol spreading.

Methods

Dental powder-jet (PJ; Air-Flow^®), a water-cooled dental handpiece with a diamond bur (HP) and water-cooled ultrasonic scaling (US) were used in a simulation head, mounted on a dental unit in various treatment settings. The influence of the use of a small saliva ejector (SE) and high-volume suction (HVS) was evaluated. As a proxy of aerosols, air-born particles (PM10) were detected using a Laser Spectrometer in 30 cm distance from the mouth. As control, background particle counts (BC) were measured before and after experiments.

Results

With only SE, integrated aerosol levels [median (Q25/Q75) µg/m³ s] for PJ [91,246 (58,213/118,386) µg/m³ s, p < 0.001, ANOVA] were significantly increased compared to BC [7243 (6501/8407) µg/m³ s], whilst HP [11,119 (7190/17,234) µg/m³ s, p > 0.05] and US [6558 (6002/7066) µg/m³ s; p > 0.05] did not increase aerosol levels significantly. The use of HVS significantly decreased aerosol exposure for PJ [37,170 (29,634/51,719) µg/m³ s; p < 0.01] and HP [5476 (5066/5638) µg/m³ s; p < 0.001] compared to SE only, even reaching lower particle counts than BC levels for HP usage (p < 0.001).

Conclusions

To reduce the exposure to potentially infectious aerosols, HVS should be used during aerosol-forming dental treatments.

Assessment of a Biosafety Device to Control Contamination by Airborne Transmission during Orthodontic/Dental Procedures

During the COVID-19 pandemic, dental professionals have faced high risk of airborne contamination between dentists, staff, and patients. The objective of this study was to evaluate the effect of an individual biosafety capsule in dentistry (IBCD) on reducing the dispersion of droplets and aerosols during orthodontic treatment and evaluate the clinician and patient’s perception of using the IBCD. For the in-vitro part of the study, aerosol quantification was performed with and without the IBCD, using a nonpathogenic bacterial strain and viral strain in the reservoir and high-speed dental handpiece. Petri dishes with MRS agar were positioned from the head of the equipment at distances of 0.5, 1, and 1.5 m. After 15 minutes of passive aerosol sampling, the dishes were closed and incubated using standard aerobic conditions at 37°C for 48 hours to count colony forming units (CFUs). For the clinical part of the study, a questionnaire was sent to clinicians and patients to understand their perception of orthodontically treat and receive treatment using the barrier. The use of IBCD showed an effective means to reduce the dispersion of bacterial and viral contamination around 99% and 96%, respectively, around the main source of aerosol ( $p<0.05$ ). Clinical results showed a 97% bacterial reduction during patient’s consultations ( $p<0.05$ ). The vast majority of clinicians and patients understand the importance of controlling the airborne dispersion to avoid contamination.

The Impact of the COVID-19 Pandemic on Romanian Postgraduate Periodontal Residency Teaching: Past Experience, Present Imperatives and Future Considerations in a Multicentric Evaluation

The aims of this study were to identify the challenges in periodontology postgraduate residency programs during the COVID-19 pandemic by identifying the modifications of educational instruments, to evaluate the impact of hybrid education on periodontology postgraduate programs in terms of resident-centred outcomes, and to evaluate the education efficiency of an innovative teaching approach. Resident doctors from three Romanian dental faculties were included in study groups based on the intensity of clinical training. A web-based questionnaire was used to collect information on residents’ perception about teaching activity. Important educational changes were identified. Moreover, residents learned a periodontal procedure through online training and then performed it on preclinical models three times. The working times were recorded. Statistical analysis was performed. Resident doctors were unsatisfied with clinical practice during the pandemic year, but they positively valued the development of online courses. Learning efficiency improved by repeating the same procedure on preclinical models, as proved by the significant decrease of the working times. E-learning was appreciated as an important component of the new hybrid teaching approach. Reorganization and further emphasis on both preclinical and medical practice, targeted to aid residents perform more accurate and efficient procedures, are recommended.

A survey on dental students' perception regarding online learning during the COVID-19 pandemic

Background and aims

This study aimed to assess the students' opinion about the efficiency of online teaching and also about the methods and features to be implemented even after this pandemic period would pass.

Methods

A questionnaire was formulated in order to evaluate the students' perception about the teaching methods used by the Faculty of Dentistry, which was distributed through email.

Results

The answers of 208 students were analyzed. There were 157 women and 51 men, 119 were from Cluj County, while 89 were from other Romanian counties; 102 of the students were in the 4th year of study, while 62 were still in the preclinical years (1st, 2nd, 3rd), and the rest of 44 of the subjects, were in the 5th or 6th year of study. 85.8% of the respondents were satisfied with the traditional lectures, 51.7% considered that online lectures were more useful than the traditional. 187 (88.6%) of the students were satisfied with the traditional practical activities, while 37 (16.1%) believed that online activities were more useful to them, 111 (52.6%), believed that they were able to communicate better with the teacher during the online lectures.

Conclusions

Overall positive responses were reported regarding the acceptability and usability of online learning. The students viewed online learning helpful as a supplement to their learning rather than a replacement for traditional teaching methods.

A Retrospective Study of Oral Emergency Services During COVID-19

OBJECTIVES

This study was performed to examine changes in the number of patient visits and types of oral services in an oral emergency department from the beginning to the control stage of the coronavirus disease 2019 (COVID-19) outbreak in Beijing.

METHODS

The numbers of daily oral emergency visits from January 20 to March 24, 2020, at a dental university hospital in Beijing and daily newly confirmed COVID-19 cases in Beijing during the same period were collected and analysed. All oral emergency patient information (including sex, age, and oral diagnosis) was also collected and analysed. Patients with incomplete medical data were excluded.

RESULTS

In total, 12,416 patients were included in this study. The number of daily emergency visits was negatively correlated with the number of newly confirmed local COVID-19 cases in Beijing (P < .001). The number of daily emergency visits during the COVID-19 stable period in Beijing was greater than that during the outbreak period (P < .001). Compared to those in the COVID-19 outbreak period, the percentages of females, children and adolescents, patients with acute toothache, and patients with nonurgent cases were higher in the stable period, and the numbers of patients with toothache, trauma, infection, and nonemergency conditions increased in the COVID-19 stable period (P < .001).

CONCLUSIONS

COVID-19 significantly influenced the number of patient visits and the percentages of patients with oral emergency situations in the oral emergency department. There were obvious differences in treatment seeking for oral emergencies between the COVID-19 periods in Beijing. There was an inverse relationship between daily oral emergency visits and daily confirmed COVID-19 cases in Beijing.

A scientometric analysis of Scholarly output on COVID-19 and Dentistry

Introduction

Scientometrics is a discipline that allows the analysis of the characteristics of publications in each field of knowledge using different indicators. The aim of this research was to analyse world scientific publication as to COVID-19 related to dentistry.

Methods

A specialised search strategy was used to obtain all the documents published in journals indexed in the Scopus database between December 2019 and February 2022. The study variables were exported and analysed in SciVal (Elsevier).

Results

In all, 2071 documents were retrieved; of those, Oral Diseases has the highest impact with an average of 12.3 citations per publication, and the British Medical Journal was identified as the journal with the highest scientific output (107). India (292) and the UK (287) were the countries with the most published papers. The Universidade de São Paulo in Brazil was the institution with the highest number of published papers (61) and with the highest impact.

Conclusions

During the pandemic, scientific publications on dentistry and COVID-19 have been increasing considerably. International collaboration has the highest percentage of publications whilst India and the UK are the countries with the highest scientific production.

Evaluation of fear, anxiety, and knowledge among dental providers during the COVID 19 pandemic

Background/purpose

COVID-19 has caused a global public health crisis with a major impact on the dental community. The unknown nature of the disease, close and prolonged contact between the patient and provider, aerosol-generating dental procedures in dental settings, guidelines that kept evolving are some of the factors that have alarmed the dental community. The purpose of this study was to evaluate the fear/anxiety among dental providers and assess the knowledge and related practice modification in a post-doctoral dental institution in Upstate New York.

Materials and methods

An online, anonymous, validated survey was sent to all dental faculty and trainees (n = 358) including general dentists and specialists from various departments between August and October 2020. Descriptive statistics and Chi-square goodness-of-fit test were performed.

Results

A total of 144 responded to the survey. It was reported that the majority of the dental providers (faculty (80%) and trainees (90%)) were afraid of getting infected with COVID-19 from the patient. Approximately 90% in both groups reported fear of carrying the infection home to their family and about reports of people dying. The majority of dental providers were well-versed with the Centers for Disease Control and Prevention guidelines. There was difference in knowledge about using N-95 and level 3 masks with face shields for various dental procedures.

Conclusion

The study concluded that COVID-19 related fear/anxiety among dental providers was immediate and needed to be addressed.

The Potential Impact of COVID-19 on the Chinese GDP, Trade, and Economy

COVID-19, a novel Coronavirus SARS-CoV-2, has wreaked havoc on global financial markets, economies, and societies. For example, this study looks at the impact of COVID-19 on the Chinese economy and its policy responses (fiscal, monetary, and institutional). This study also examines future issues. This study is timely and essential for policymakers and investors worldwide because of China’s size, contribution to global growth, and growing influence. The research shows that the presence of COVID-19 in China has global implications. Because of the virus threat, foreigners avoid mixing with the Chinese. Global tourists have cancelled their plans to visit China, and Chinese tourists cannot visit foreign countries. The rapid spread of the COVID-19 in China has halted normal life. The intensification of the COVID-19 may have long-term effects on China’s economy.

Role of Newly Introduced Teledentistry Service in the Management of Dental Emergencies During COVID-19 Pandemic in Qatar: A Cross-Sectional Analysis

Introduction: The lockdown imposed by the COVID-19 pandemic rendered teledentistry (TD) necessary to maintain the continuity of oral health services and avoid missing emergency dental conditions, while minimizing face-to-face visits. Our objective was to evaluate the ability of a newly introduced triage-based TD service to deliver its goals, by evaluating its processes and outcomes and assessing the demand for TD. Methods: This cross-sectional report assessed the triage processes and outcomes (triage category, referral to emergency/dental facility undertaken, remote medications prescribed, and procedures performed at the point of referral); and evaluated the demand for the newly introduced TD service during 5 months of the first wave of the pandemic. Results: Of 850 calls, about 70.6% of the samples were managed remotely; 29.4% were categorized as emergency/urgent and referred to the emergency/dental facility. Compared with other complaints, orofacial dental pain was the most common reason for the calls (41.6%, p < 0.0001). About 14.71% of callers received prescription for medications remotely. The most demanded disciplines were general dentistry, orthodontics, and oral surgery, respectively (p < 0.0001). Of those referred to a dental facility, 31.84% required no clinical intervention, 28.7% received orthodontic appliance repair, and 14.3% and 11.2% had urgent dental extractions or root canal treatments. Demand on the service fluctuated through various distinct stages of the lockdown. Conclusions: There has been continuous demand for the newly introduced TD service throughout the period of the current report despite the fluctuations, with most complaints managed remotely. TD was effective and suitable for triage, service delivery, and care during the pandemic.

Pediatric Dental Emergency Visits and Treatment during Lockdown in the COVID-19 Pandemic: A Retrospective Study

The COVID-19 pandemic has affected all the professions of life, particularly the healthcare sector. In dentistry, prevention of viral spread among healthcare professionals and patients was a substantial challenge. The virus can directly or indirectly infect dentists during dental procedures. This study focuses on the purpose of pediatric patients’ emergency visits to dental clinics and the treatments practiced during the lockdown. It compares the purpose of emergency pediatric patient visits in dental clinics and their treatments before, during, and after the lockdown periods. Computerized data for two consecutive years (2019 and 2020), between 19 March and 30 April and after the lockdown period from 1 May to 12 June 2020, were collected from five random dental clinics in Israel. The emergency visits of patients under 18 years before, during, and after the lockdown was organized into demographic characteristics, the purpose of the visits, and the treatments with medication or dental procedures. Categorical variables were compared and correlated with the chi-squared test and Pearson’s test, respectively, by using SPSS version 21. During the lockdown, emergency cases got appointments for a physical checkup. Herein, we found higher cases of emergency visits of pediatric patients with pain (n = 281, 32.6%) than trauma (n = 18, 24.7%), followed by infection (n = 31, 28.4%) and treatment continuation (n = 7, 20.6%) during the lockdown period, compared to before and after the lockdown periods. The patients treated with medication and dental procedures during lockdown were significantly different (p < 0.001) than before and after the lockdown. Extraction (n = 81, 41.5%), filling (n = 84, 50.6%), fluoride (n = 13, 92.9%), and pulp treatment (n = 92, 42.6%) were substantially practiced in pediatric patients during the lockdown. Further, this study confirmed the rapid adaptation of professional dentists to deal with non-vaccinated pediatric patients and reinforced the better preparation and requirements for such challenges in the future.

Public oral health services: impacts caused by the COVID-19 pandemic

The aim of this study was to describe the oral health services offered by the Unified Health System in the northern macro-region of Minas Gerais, Brazil, during the COVID-19 pandemic. This was an observational, cross-sectional and descriptive study. Data collection took place between August and September 2020 through the completion of online questionnaires by oral health managers in the northern municipalities of Minas Gerais and by consultation of information available in the Special Epidemiological Bulletin Coronavirus North Macro-region n° 14. After collection, data were transferred to SPSS® (Statistical Package for the Social Sciences for Windows, version 24.0). Analyses were performed using frequency, mean, standard deviation and percentages. It was found that all included municipalities suspended elective treatments and maintained emergency dental care at all levels of care. In 62.5% of municipalities there were oral health professionals contaminated by COVID-19. Oral health teams implemented specific interventions to address the pandemic,with the most frequent being tele-orientation (74.7%), use of sanitary barriers (72%), and telemonitoring (68%). At the beginning of the pandemic, 62.5% of municipalities lacked personal protective equipment. Comsidering these results, it was found that the COVID-19 pandemic impacted the supply of dental services in northern Minas Gerais due to the suspension of elective care, contamination of professionals, lack of personal protective equipment, and development of new interventions. Thus, oral health teams had to adapt to new contexts of health interventionsto face COVID-19 and maintain dental care services.

Quantitative Fit Test of a 3D Printed Frame Fitted Over a Surgical Mask: An Alternative Option to N95 Respirator

Background

COVID-19 has spread worldwide and caused severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to numerous dead cases. However, with the new COVID-19 outbreaks, there is a shortage of personal protective equipment (PPE) especially N95 masks worldwide including Thailand. This issue had placed the health professional in great need of an alternative mask.

Aim

This study aimed to measure the fit factor of 3D printed frames by quantitative fit testing (QNFT) to find an alternative facemask by using a mask fitter together with 2 different kinds of the American Society for Testing and Materials (ASTM) level 1 surgical mask.

Materials and Methods

Two commonly used surgical masks (Sultan Com-Fit Super Sensitive Ear Loop Mask or “White Mask Group,” not water-resistant, and Sultan Blue Com-Fit Super High Filtration Ear Loop Mask or “Blue Mask Group,” water-resistant) with and without 3D printed frame covering. The fit performance was measured by a quantitative fit test (QNFT) device (PortaCount, model 8048, TSI Incorporated, Minnesota, USA) accepted by the Occupational Safety and Health Administration (OSHA). The PortaCount device, which is based on a miniature continuous flow condensation nucleus counter (CNC), assesses the respiratory fit by comparing the concentration of ambient dust particles outside the surgical mask to the concentration that has leaked into the surgical mask. The ratio of these two concentrations (C_out/C_in) is called the fit factor. A fit factor of a 3D printed frame of at least 100 is required and considered as a pass level.

Results

We found that the mask fitter improves the overall performance of surgical masks significantly. The improved performance is comparable to that of N95.

Conclusion

The mask fitter improves the performance of surgical masks. The authors suggested that further study on frame material, shape, and expanded sample size would be beneficial to society.

Immune Responses in SARS-CoV-2, SARS-CoV, and MERS-CoV Infections: A Comparative Review

Coronavirus, discovered in the 1960s, is able to infect human hosts and causes mild to serious respiratory problems. In the last two decades, the severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been recognized. It has long been demonstrated that MERS-CoV binds to dipeptidyl peptidase 4 and SARS-CoV binds to angiotensin-converting enzyme 2. A "cytokine storm" is the main pathophysiology of aforementioned viruses. Infiltration of neutrophils at the site of the infection is a risk factor for the development of acute respiratory distress syndrome and death. The new coronavirus, SARS-CoV-2, has infected more people than SARS-Cov and MERS-CoV as it can easily be transmitted from person to person. Epidemiological studies indicate that majority of individuals are asymptomatic; therefore, an effective and an efficient tool is required for rapid testing. Identification of various cytokine and inflammatory factor expression levels can help in outcome prediction. In this study we reviewed immune responses in SARS-CoV, Mers-CoV, and SARS-COV-2 infections and the role of inflammatory cells.

Level of Anxiety Caused by the Coronavirus (COVID-19) Pandemic among Dentists in Poland

Background and Objectives: The early information on both the speed and high morbidity rate and, above all, mortality triggered the symptoms of COVID-19-related panic and anxiety. Dentists were listed in the top five professions with the highest risk of transmission of the virus. The aim of the present study was to investigate the correlation between the fear level of COVID-19 and sociodemographic variables in Polish dentists. Materials and Methods: A cross-sectional study was conducted via an online survey questionnaire with seven statements in the COVID-19 Fear Scale (FCV-19S). The online questionnaire was completed by 356 dentists. The SPSS and PQStat were used to analyze, validate, and assess correlations and logistic regression. Results: In the studied population of dentists, the perceived level of anxiety associated with COVID-19 should be considered relatively low. When the respondents had children, lived with the elderly, or looked after them, the observed level of anxiety was higher, and physical symptoms, such as sweating palms and increased heart rate, occurred. Conclusions: Studies concerning the anxiety level related to COVID-19 carried out among Polish dentists ascertained that the tested level of anxiety among dentists was relatively low. The COVID-19 Fear Scale (FCV-19S) adjusted to the Polish language requirements is a reliable tool that can be used effectively for analyzing the impact of any pandemic on the Polish-speaking population.

COVID-19 Pandemic Impact on Dental Practice

Introduction: The COVID-19 pandemic has had a huge impact on the dentistry industry from the initial lockdown in March 2020 to the present day, nearly one year later with dentists unable to practice during the initial lockdown, that is when revenue took the biggest hit. The study aims to examine the impact of COVID-19 on dental practices during the pandemic in Bulgaria. Material and methods: A specially developed questionnaire was distributed electronically among 138 dentists from all regions of Bulgaria. The collected primary statistical information was entered and processed with the statistical package SPSS Statistics 19.0 Results: Statistical analyzes of the questionnaire show that (62,32%±4,12) of dentists say COVID-19 made no impact on their decision to retire or continue practicing; 43% of respondents predict revenue or costs will be the biggest challenge facing their practice in 2021. Part of dentists (34.78 % ± 4,05) believe that COVID-19 allowed them to learn more about infection control. Most of the respondents (87.68% ± 2.79) agree their income was lower in April to September of 2020 compared to 2019. More than half of dentists (61.59 % ± 4.14) believe Covid 19 has not impacted the products or services they offer. The majority of the participants (84.78 % ± 3.05) did not perform non-emergency procedures during the pandemic. Conclusion: Despite the numerous disadvantages caused by the COVID-19 pandemic, our survey shows dentists have found ways to adapt and succeed. Introduction: The COVID-19 pandemic has had a huge impact on the dentistry industry from the initial lockdown in March 2020 to the present day, nearly one year later with dentists unable to practice during the initial lockdown, that is when revenue took the biggest hit. The study aims to examine the impact of COVID-19 on dental practices during the pandemic in Bulgaria. Material and methods: A specially developed questionnaire was distributed electronically among 138 dentists from all regions of Bulgaria. The collected primary statistical information was entered and processed with the statistical package SPSS Statistics 19.0 Results: Statistical analyzes of the questionnaire show that (62,32%±4,12) of dentists say COVID-19 made no impact on their decision to retire or continue practicing; 43% of respondents predict revenue or costs will be the biggest challenge facing their practice in 2021. Part of dentists (34.78 % ± 4,05) believe that COVID-19 allowed them to learn more about infection control. Most of the respondents (87.68% ± 2.79) agree their income was lower in April to September of 2020 compared to 2019. More than half of dentists (61.59 % ± 4.14) believe Covid 19 has not impacted the products or services they offer. The majority of the participants (84.78 % ± 3.05) did not perform non-emergency procedures during the pandemic. Conclusion: Despite the numerous disadvantages caused by the COVID-19 pandemic, our survey shows dentists have found ways to adapt and succeed.

COVID-19 pandemic: multilevel dental technical guidelines based on new scientific evidence

The COVID-19 pandemic imposed restrictive measures on dentistry in different regions of the world, ranging from stoppage of care to only permission for urgent and emergency dental services. Thus, new biosafety guidelines for resuming activities, whether in single dental offices, large clinics or dental education activities, are urgently required. In this sense, herein, guidelines that incorporate common points of the main protocols found in the literature for the resumption of dental activities at their different levels, whether in the scope of care or education, are presented. Furthermore, we present the incorporation of measures that allow an increase in the level of biosafety, such as the control of the dental team, the inclusion in the history of conjunctivitis as a possible alert for COVID-19, and the use of the pulse oximeter to assess the risk of silent hypoxemia, which may indicate a complication of COVID-19. In addition, new perspectives for directing research and innovation for biosafety in dentistry are discussed.

Novel impacts of saliva with regard to oral health

The maintenance of balanced oral homeostasis depends on saliva. A readily available and molecularly rich source of biological fluid, saliva fulfills many functions in the oral cavity, including lubrication, pH buffering, and tooth mineralization. Saliva composition and flow can be modulated by different factors, including circadian rhythm, diet, age, drugs, and disease. Recent events have revealed that saliva plays a central role in the dissemination and detection of the SARS-CoV-2 coronavirus. A working knowledge of saliva function and physiology is essential for dental health professionals.

[Omicron Variant of SARS-CoV-2 and Its Potential Impact on Dental Practice]

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been raging across the world for over two years, but the daily reported numbers of new infections and deaths are still increasing. The newly identified Omicron variant has significant changes in its transmissibility and pathogenicity due to the multiple mutations in the spike protein, posing new challenges to the global public health. World Health Organization has categorized Omicron as a variant of concern (VOC). The spread of SARS-CoV-2 and its variants has caused disruptions to the dental practice worldwide. During the course of diagnosis and treatment of dental care, face-to-face communication at close quarters, droplets, aerosols, and exposure to saliva and blood increase the risks of SARS-CoV-2 transmission. The emergence of new variants, especially the Omicron variant, has formed new challenges to dental healthcare provision. In addition, oral tissues, including the tongue and oral mucosa, can overexpress the angiotensin converting enzyme 2 (ACE2), which is also the binding receptors of SARS-CoV-2. As a result, the oral cavity is one of the target sites of SARS-CoV-2 infection. SARS-CoV-2 infection in oral cavity may cause different oral complications, such as loss of taste. However, there are few reports about Omicron and the other variants of SARS-CoV-2 and their impacts on dental healthcare provision. Herein we made an overview of the Omicron variant and its characteristics, including its pathogenicity and immune evasion, and its potential impact on dental practice. We also proposed some control measures with the aim of reducing the possible transmission of SARS-CoV-2 and its variants during dental care.

Oral Health among Elderly, Impact on Life Quality, Access of Elderly Patients to Oral Health Services and Methods to Improve Oral Health: A Narrative Review

Dental health is often neglected among the elderly because of the numerous comorbidities in this population, such as cardiovascular diseases. However, dental health influences general health and quality of life by impacting both the general health and the psychological state of the individual. The present review highlights the main dental comorbidities in the elderly population, their impact on the quality of life, the barriers towards access to dental care in the elderly and methods to improve their dental health. Information related to dental care and its importance must be provided both to older individuals and their caregivers in order to detect dental pathology and treat it adequately. Ensuring dental health involves the whole society of elders, caregivers, dental care providers, the public sector, health policymakers, and the private sector.

Interest in dentistry in early months of the COVID-19 global pandemic: A Google Trends approach

Background

In early the COVID‐19 pandemic, routine dental treatments have been delayed due to the risk of disease transmission. This delay may lead public to search for information on the Internet for a solution.

Objectives

This study aims to evaluate the public interest in dentistry in the early months of the COVID‐19 global pandemic in the selected countries.

Methods

The daily numbers of new COVID‐19 cases were recorded for China, South Korea, Italy, Germany, Russia, Ukraine and Turkey. For these countries, Internet search interest of the keyword ‘dentistry’, ‘coronavirus’, ‘COVID‐19’, ‘SARS‐CoV‐2’ and ‘pandemic’ in the early months of the COVID‐19 pandemic was evaluated by using Google Trends data.

Results

In most countries included the public Internet search interest in ‘dentistry+coronavirus+COVID‐19+SARS‐CoV‐2+pandemic’ peaked prior to the peak of new COVID‐19 cases. While a statistically significant positive correlation was observed between the number of new cases and Google Trends data in China, South Korea, Italy and Germany, a statistically significant negative correlation was observed in Turkey.

Conclusion

The peak public interest in dentistry has been prior to the peak of COVID‐19 new cases in most countries. The use of Internet data can provide useful information about pandemics and many other diseases.

Particle Size Analysis in Aerosol-Generating Dental Procedures Using Laser Diffraction Technique

The global outbreak of coronavirus disease 2019 (COVID-19) has raised concerns about the risk of airborne infection during dental treatment. Aerosol-generating dental procedures (AGDP) produce droplets and aerosols, but the details of the risks of COVID-19 transmission in AGDP are not well-understood. By discriminating between droplets and aerosols, we devised a method to measure particle size using laser diffraction analysis and evaluated aerosols generated from dental devices for providing a basis for proper infection control procedures. The droplets and aerosols generated from dental devices were characterized by multimodal properties and a wide range of droplet sizes, with the majority of droplets larger than 50 μm. AGDP emitted few aerosols smaller than 5 μm, which are of concern for pulmonary infections due to airborne transmission. In addition, the use of extraoral suction was found to prevent the spread of aerosols from high-speed dental engines. This study suggests that the risk of aerosol infections is considerably limited in regular dental practice and that current standard precautions, such as mainly focusing on protection against droplet and contact infections, are sufficient. While several cases of airborne transmission of COVID-19 in general clinics and emergency hospitals have been reported, cluster outbreaks in dental clinics have not yet been reported, which may indicate that AGDP does not pose a significant threat in contributing to the spread of SARS-CoV-2.

Knowledge of COVID-19 Infection Guidelines among the Dental Health Care Professionals of Jazan Region, Saudi Arabia

BACKGROUND

This study aimed to assess the knowledge about guidelines related to COVID-19 infection control procedures among dental health care professionals (DHCPs) in the Jazan region.

METHODS

A cross-sectional study involving DHCPs (dental students, interns, and dentists) of the Jazan region between January and March 2021. A questionnaire with 35 items was developed and circulated online among the DHCPs. The dimensionality of the questionnaire was assessed using exploratory factor analysis (EFA). The level of awareness (LOA) was compared across the genders, level of professional experience, and exposure to guidelines. Participants were considered to have high LOA when they responded to 26 or more items correctly.

RESULTS

A total of 363 DHCPs participated in the survey. The questionnaire was found to be valid and reliable. EFA revealed a distinct three-factor structure. Moreover, 61.2% of the respondents had high LOA related to COVID-19 infection prevention. Among those who had high LOA, dentists (65.5%) were relatively more than the students (62.5%) and interns (46.2%). Among the six guideline statements related explicitly to operative dentistry, more than 50% of the respondents were aware of 3 guideline statements, while less than 50% of the respondents were aware of the remaining statements.

CONCLUSIONS

Most DHCP had a high LOA for general COVID-19 infection prevention and control guidelines. Dentists, males, and those who read the guidelines had higher LOA than their counterparts.

Knowledge, Attitude, and Practice Toward Mask-Wearing Behaviors During Covid-19 Pandemic Among Mangalore Residents: A Cross-Sectional Study

Objectives The objective of this study is to assess the knowledge, awareness, and practice toward mask-wearing behaviors of Mangalore residents during the coronavirus disease 2019 (COVID-19) outbreak.

Materials and Methods This survey was conducted at A B Shetty Memorial Institute of Dental Sciences in Mangalore. The questionnaire consisted of 18 questions that were prepared as an online form (Google Forms), and a total of 172 responses were received among the residents of Mangalore who visited the hospital.

The questions were distributed based on knowledge, attitude, and practice regarding the mask-wearing behaviors, and the distribution of responses was presented as frequency and percentages. Prior to the inception of the study, the nature and purpose of the study were explained to each respondent, and informed consent was obtained by all participants in this study.

Statistical analysis was done using SPSS software version 23.

Results It was evident that the COVID-19 knowledge scores were found to be significantly associated with a lower likelihood of negative attitudes and potentially dangerous practices toward the COVID-19 epidemic in this study. These findings clearly indicate the importance of improving residents' COVID-19 knowledge via health education, which may also result in improvements in their attitudes and practices toward COVID-19.

Conclusion In summary, our findings suggest that Mangalore residents have fair knowledge and optimistic attitudes, despite the current lockdown measures undertaken during the second wave of COVID-19, The positivity rate in Mangalore has not reduced satisfactorily. Self-protection, testing, and vaccination would help to reduce the spread and mortality rate due to coronavirus. The residents of Mangalore should abide by the COVID -19 preventive measures and implement this knowledge into their daily practices.

Analysis of Online Consultations and Emergent Treatments of Operative Dentistry and Endodontics during the COVID-19 Epidemic

BACKGROUND

The purpose of the present study is to evaluate the characteristics of online consultations and emergent dental treatments and analyze the status of diseases related to operative dentistry and endodontics (ODE) during the COVID-19 epidemic.

METHODS

Online consultations were collected from 3 February to 21 April 2020. The electronic medical record system was accessed to collect clinical diagnoses and emergent dental treatments from 9 January to 21 April 2020.

RESULTS

A total of 2419 patients visited us and received treatments 2 weeks before the lockdown. The number of patients decreased to 537 during the 76 days of the lockdown. Among them, dental examinations accounted for the majority of visits (88.83%). After 7 April, the outpatient number increased to 36.79 ± 6.63 per day, but the proportion of dental examinations and treatments did not change significantly. A total of 1218 online consultations were completed before the lockdown. The most common dental problem was pulpitis (48.1%). After 7 April, consultations surged from 23.15 ± 8.54 to 44.43 ± 12.63 per day. Consultations related to pulpitis, apical periodontitis, or dental caries remained stable.

CONCLUSIONS

Correct understanding, active treatments, and appropriate psychological interventions for the ODE staff during the COVID-19 epidemic are necessary. Our results may provide references to arrange staff and treat patients more efficiently for future epidemics.

Status quo after one year of COVID-19 pandemic in otolaryngological hospital-based departments and private practices in Germany

PURPOSE

The COVID-19 pandemic has affected healthcare systems worldwide. Data on the impact on otolaryngological clinics and private practices is sparse. This study aimed to present data on healthcare worker (HCW) screening, status of HCW, pre-interventional testing, the use of personal protective equipment (PPE) and the economic impact of the pandemic.

METHODS

Otolaryngological private practices and hospital-based departments were surveyed nationwide using an online questionnaire. Participating facilities were recruited via the German Society for Oto-Rhino-Laryngology and the German Association for Otolaryngologists in Bavaria.

RESULTS

365 private practices (2776 employees) and 65 hospitals (2333 employees) were included. Significantly more hospitals (68.7%) than practices (40.5%) performed pre-interventional testing in their outpatients (p < 0.00). Most inpatients were tested in practices and hospitals (100.0% and 95.0%; p = 0.08). HCW screening was performed in 73.7% of practices and in 77.3% of hospitals (p = 0.54). Significantly more HCW infections were reported in private practices (4.7%) than in hospital (3.6%; p = 0.03). The private or home environment was the most frequent source of infection among HCW in hospitals (44%) and practices (63%). The use of PPE increased over the course of the pandemic. The number of procedures and the revenue decreased in 2020.

CONCLUSION

The rate of pre-interventional testing among outpatients in otolaryngological practices is low and HCW infections were found to be more frequent in practices than in hospitals. In addition, a high rate of infections in otolaryngological HCW seems to stem from the private or home environment.

Impact of COVID-19 on otolaryngology head & neck speciality and residency program in Saudi Arabia

The SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19), has rapidly swept worldwide since its identification in December 2019. As the spread of the disease accelerated both in Wuhan and elsewhere globally, the WHO declared it a pandemic. There is sound evidence to argue that otolaryngologists run high risks of occupational SARS-COV2 among health care workers due to high viral load in upper respiratory examinations. This review article was conducted to determine the effect of the COVID 19 pandemic on the otolaryngology department and residency program in Saudi Arabia. Since the pandemic outbreak, the government of Saudi Arabia has taken severe measures and issued several decisions to limit the spread of the virus. These decisions included operations, procedures, outpatient clinics by prioritizing emergency and time-sensitive cases while rescheduling all electives and routines once. As a result, the residency program was also affected by the substantial reduction of daily surgical activity and preventing endoscopic tests in the clinics, which led to a notable decrease in residents' involvement and risk of procedural skills deterioration which became a concern to many doctors of residency programs. It is difficult to deny that the epidemic will negatively impact. However, adhering to well-prepared guidelines and giving residents an excellent opportunity to overcome the defects will deliver training and patients' care while also protecting safety and health.

An Evaluation of Knowledge, Awareness, Attitudes, and Behaviors Regarding COVID-19 Among Parents of Pediatric Dental Patients

Children infected with COVID-19 have a critical part in community-based viral transmission. This study aimed to evaluate knowledge, awareness, attitudes, and behaviors of parents of pediatric dental patients on COVID-19 and to present required actions to prevent its spreading. A total of 524 parents took part in this cross-sectional study. A self-administered questionnaire was prepared for determining sociodemographic characteristics and socioeconomic status of parents, along with their COVID-19-related knowledge, awareness, attitudes, and behaviors. In total, 90.6% of parents were unaware that disease may show no symptoms; 61.1% and 32.6% did not know roles of "close contact with asymptomatic patients" and "dentistry practices" in transmission, respectively; 30.2% thought it could be transmitted to their children at dental clinics, and only 16.4% stated their children as carriers. Parents need to be informed on COVID-19 transmission through contact with asymptomatic individuals, risks associated with dentistry practices, and role of children in transmission.