Coronavirus disease 2019 and dental care for older adults: New barriers require unique solutions

Impact of COVID-19-Related Personal Protective Equipment Changes on Dental Education: A Qualitative Study to Explore Faculty and Student Perspective

Background

COVID-19 pandemic and its related personal protective equipment have impacted all aspects of dental education. The qualitative study assesses the impact of COVID-19-related changes and their effects on students' clinical learning from student and faculty perspectives.

Methods

This qualitative study involved third- and fourth-year predoctoral dental students and full-time dental clinical faculty. A semistructured interview guide was used. The interview guide consisted of seven open-ended questions about the impact of the new COVID-19-related infection control procedures on students' learning experience in the dental clinic. Interviews were recorded, transcribed verbatim, and analyzed using a basic interpretative approach by two independent researchers. Emerged themes were identified.

Results

Twelve faculty members and 21 students participated in six focus groups. Three major themes emerged from the analysis: learning challenges, learning opportunities, and long-term impact. Students identified four categories of learning challenges: communication, visualization, clinical exposure, and heat. Five learning challenges identified by faculty were: faculty burnout, service delivery challenges, material wastage, teaching difficulties, and lack of comprehensive care. The five learning opportunities students identified were autonomy, preparedness, efficiency, safety, and personalized feedback. Learning opportunities identified by faculty were time management, autonomy, and preparedness. Three categories of long-term impact on students identified were future opportunities, adaptation, and postgraduation plans. Faculty identified apathy, career re-evaluation, and adaption as the long-term impact of COVID-19-related changes.

Conclusion

Although the new COVID-19-related infection control procedures and regulations in the dental school clinical setting come with learning challenges, students and faculty also saw learning opportunities through increased autonomy, preparedness, and efficiency. The impact of COVID-19 extends beyond the current learning experiences as it may modify students' long-term plans.

Impact of the COVID-19 pandemic on the timing of dental care in elderly peruvians

In Peru, there is low dental service use among older adults, in addition to a social gradient for use. Furthermore, the COVID-19 pandemic triggered complex scenarios characterized by inadequate access to health services, with greater impact on vulnerable population groups such as the elderly. The aim of this study was to determine the impact of the COVID-19 pandemic on the time since last dental care visit among elderly Peruvians. It was a cross-sectional study conducted on a population of 5247 respondents in 2019, and 5066 respondents in 2020. The study considered the answers of people who responded to the question on the last time they had received dental care, extracting a total 4045 subjects for 2019 and 3943 for 2020. The dependent variable was time since last dental care measured in years, while the variables on health, geographic and sociodemographic characteristics were grouped within three dimensions. A descriptive bivariate and multivariateanalysiswasapplied by means of multiple linear regression to analyze the behavior of the variables. Time since the last dental care visit was 7.93 years (SD=8.03) in 2019 and 7.94 years (SD=7.28) in 2020. A hierarchical multiple linear regression analysis was performed, where no variable in the 2019 model was significant; while for 2020, health, geographic, and sociodemographic characteristics variables were significant. In the analysis where the 'year' variable becomes independent, only model 4, which considers all variables, was valid (p=0.018). The variables 'area of residence' and 'wealth index' were also significant. To conclude, the 2020 pandemic year for COVID-19 had no impact on the time since last dental care visit among elderly Peruvians, though factors such as area of residence and wealth index were found to be associated with the time since last dental care visit.

The Impact of COVID-19 on the Oral Health of Patients with Special Needs

In March 2020, the World Health Organization declared a global public health emergency due to the spread of COVID-19, and medical and dental elective care was suspended, disproportionally affecting persons with special needs. As many of the special needs population live in a communal environment, they were at higher risk of being infected with and dying of COVID-19. Consequently, their access to medical and dental services was limited to emergency care. A method of reaching these populations evolved by the expansion of telehealth, including dentistry, to provide diagnosis, management, prevention, and provision of psychosocial support for patients.

Dose-dependent association between xerostomia and number of medications among older adults

PURPOSE/AIM

To investigate factors associated with self-reported dry mouth (xerostomia) among older adults seeking dental care at a University clinic.

MATERIALS AND METHODS

A query was performed in the electronic records database and de-identified data were collected from patients aged 65 + recorded on the date that the initial health history was entered. Among these patients, data about patients' medications, gender, age, BMI, tobacco use, alcohol addiction, diabetes, heart disease, joint replacement, allergies to medications, hypertension, and mental disorders were obtained. Evaluation of potential risk factors for dry mouth was performed using univariate and multivariable logistic regression analyzes (alpha = 0.05).

RESULTS

A total of 11,061 subjects were included in the analysis, 51.5% of whom were women. The mean age in years was 74.2 ± 7.0, the median number of medications was 7 (IQR = 4-11), and 38.5% of the participants reported dry mouth. The multivariable logistic regression analysis revealed that the odds of xerostomia for subjects who took 11 +, 7-10, or 4-6 medications were 3.34, 2.07, or 1.38 times those of subjects who had took 0-3 medications, respectively.

CONCLUSION

Number of medications showed a strong and dose-dependent association with xerostomia.

Oral health clinical training and dental referral program for nurses: An interprofessional collaborative project

INTRODUCTION

The overall objective of this study was to establish an interprofessional oral health training program for nursing personnel at Oregon Health & Science University.

METHODS

Fifteen registered nurses participated in didactic and clinical training and screened the oral health of patients. Nurses completed confidence assessments and patients completed satisfaction surveys. Data analysis included descriptive statistics and non-parametric tests for comparisons of mean scores.

RESULTS

Pre- and post-training surveys demonstrated significant increases in nurses' knowledge, confidence in discussing dental problems, performing dental screenings, and referring patients to dentists (p < 0.05). Patient satisfaction surveys (n = 89) denoted satisfaction with oral screenings and willingness for nurses to perform them.

CONCLUSIONS

Nurses participating in oral health and clinical screening training programs supervised by dentists significantly increased their confidence in providing dental referrals. Longitudinal studies are needed to determine the impact of such training programs on patient health.