COVID-19 pandemic and pediatric dentistry: Fear, eating habits and parent's oral health perceptions

The level of dental fear and anxiety is higher in children with both severe Molar-Incisor Hypomineralisation and active dental caries lesions compared to children without these conditions

PURPOSE

To assess levels of dental fear and anxiety (DFA) in children with and without Molar-Incisor Hypomineralisation (MIH) and dental caries lesions.

METHODS

In this cross-sectional observational study, 159 children between 8 and 12 years of age were included. For the evaluation of DFA, children responded to the validated version of the Children's Fear Survey Schedule-Dental Subscale. MIH was assessed using the MIH Index. To evaluate the activity of dental caries lesions and dental caries experience, the Nyvad criterion and the dmft/DMFT index were used, respectively. Dental hypersensitivity was evaluated using air stimulation and a Visual Analogue Scale. The association between MIH and dental caries with DFA was assessed using the generalised linear model with Poisson family, identity link function and robust variance estimation. The significance level was set at 5%.

RESULTS

The mean DFA score was 28.3 (SD = 13.4) with scores ranging from 15 to 64. Amongst children presenting both MIH and dental caries, the perception of DFA was notably higher compared to those with either MIH or dental caries alone. The activity of caries lesion in patients with MIH also influenced DFA levels (diff: 18.6; 95% CI: 12.0-25.2; p < 0.001). Dental caries experience in the primary dentition also demonstrated statistical significance concerning DFA (95% CI: 0.8-13.3; p value = 0.027).

CONCLUSION

Children with MIH exhibit higher levels of DFA than children without MIH. The experience of dental caries and the activity of caries lesions significantly influence the perception of DFA in children with MIH.

Validating Caries Risk Assessment Tools in High-Prevalence Filipino Toddlers

INTRODUCTION AND AIMS

Caries risk assessment is an essential part of the diagnostic process. Many studies have assessed these tools, proving their effectiveness in reducing future caries risk in developed countries with low caries prevalence. However, Filipino children have consistently registered high caries prevalence rates in successive official surveys. This prospective study aimed to compare the validity of available caries risk assessment tools in predicting future caries among a high-caries-prevalent population in the Philippines.

METHODS

From the vaccination registry of community health centres in Caloocan City, Philippines, children aged 4-24 months underwent oral examinations according to modified International Caries Detection and Assessment System (ICDAS) criteria, and their primary caregivers were interviewed using a structured questionnaire. Baseline caries risk categories were evaluated using 3 available tools, without biological tests. Caries incidence was recorded during the follow-up visit after 2 years.

RESULTS

Baseline oral examinations in 703 toddlers (mean age: 13.3 months, standard deviation (SD) 2.4) revealed a high caries prevalence of 29.2%. Of the 654 eligible children without cavitated caries at baseline, 323 (mean age: 35.6 months, SD 5.1) attended the 2-year follow-up visit, with a caries incidence (cavitated and non-cavitated) of 76.5%. Caries-risk Assessment Form (CrAF) demonstrated high sensitivity but low specificity scores (93.1% and 3.9%), while Caries Management by Risk Assessment (CAMBRA) showed similar patterns (71.7% and 34.2%). Conversely, Cariogram exhibited low sensitivity but high specificity (23.5% and 80.3%).

CONCLUSION

Among CrAF, CAMBRA or Cariogram, no assessment tool came close (sensitivity + specificity < 160) to effectively identify toddlers highly at risk of caries development.

CLINICAL RELEVANCE

Current CRA tools lack sufficient accuracy in predicting caries development in high-risk populations like Filipino children. Refinement or development of more valid tools is crucial for implementing effective caries prevention strategies at both individual and population levels.

Pediatric dental clinic transformations post-COVID-19 reopening in a public dental school

PURPOSE

To assess the impact of transformations in pediatric dental clinics following reopening during the COVID-19 pandemic on pediatric dentistry procedures performed by dental students.

METHODS

Data were collected from electronic clinical records of Integrated Dental Clinical disciplines (I, II, III, and IV) from 2018 to 2023. The procedures were categorized into phases: prevention/stabilization, restorative/definitive, and maintenance. The data were analyzed descriptively and by t-test considering the pre-pandemic and pandemic periods (α = 5%).

RESULTS

During the pandemic, Integrated Dental Clinics I and III saw increased prevention/stabilization procedures percentages (92.4% and 74.3%) compared to pre-pandemic (84.9% and 70%), while Integrated Dental Clinic II and IV saw a decline (76.6% and 66.1%) compared to pre-pandemic (79.1% and 67.9%). Restorative/definitive procedures decreased in Integrated Dental Clinic I and III (5.5% and 20.3%) from pre-pandemic period (10% and 24.1%) but increased in Integrated Dental Clinic II and IV (18.3% and 26.2%) from pre-pandemic (15.3% and 25%). Maintenance procedures decreased in Integrated Dental Clinic I, II, and III (2.1%, 5%, and 5.4%) compared to pre-pandemic (5.1%, 5.6%, and 6%), except for Integrated Dental Clinic IV, which saw an increase (7.8% from 7.2%). Despite the percentage changes, no significant differences were found between the periods analyzed (p > 0.05). However, when considering the total procedures across all disciplines and phases, there was a significant decrease during the pandemic in phases 1 and 3 (p < 0.05).

CONCLUSION

Despite the changes in pediatric dentistry procedures, the transformations within the dental clinic suggest tangible benefits for the teaching-learning process and safe patient care.

Impact of the COVID-19 Pandemic on Saudi Parents' Perceptions Toward Their Children's Oral Health: A Cross-Sectional Study

Background The coronavirus disease 2019 (COVID-19) markedly affected all aspects of life. Pediatric dentistry and oral health of children faced a challenging situation during the pandemic. Aim This study aimed to assess the attitude of Saudi parents toward their children's oral health and dental treatment during the COVID-19 pandemic. Methods This online-based cross-sectional study was conducted using a structured questionnaire adopted from previous studies with some modifications. It was distributed among 385 Saudi parents recruited through social media. It included questions regarding demographic data, parents' attitudes toward their children's dental care and dental visits during the COVID-19 pandemic, their fear level and willingness to take their children to dental appointments, and the parent's perception of dental clinics with regard to the COVID-19 spread. Descriptive statistics and the chi-square test were used; statistical significance was set at a p-value < 0.05. Results Different levels of fear of the pandemic were expressed by Saudi parents, with 42 (10.9%) showing maximum fear while 36 (9.3%) reported no fear. Although about half of the parents stated that their children experienced dental pain during the pandemic, only 97 (25.1%) looked for dental care and were assisted. There was a significant association (p < 0.05) between the fear level with the family income and parents' willingness to take their children to dental appointments. Conclusions COVID-19 has had a great impact on parents' attitudes towards their children's oral health. A high percentage of Saudi parents' stated that they would take their children to dental clinics during the pandemic only for urgent treatment and severe pain.

The Emotional Impact of Family Involvement during Homework in Children with Neurodevelopmental Disorders: A Systematic Review

Neurodevelopmental disorders can be studied from two distinct perspectives: an internal approach, which examines the causes and consequences of these disorders; and a contextual approach, which considers the role of the family in the lives of children and adolescents. Research has demonstrated that the most significant form of family involvement in families raising a child with NDD is through homework. This involvement has been shown to have an emotional impact on children with neurodevelopmental disorders such as ADHD or dyslexia. The objective of this study is to review published articles on homework and neurodevelopmental disorders, with particular attention to the role of the family and the emotional health of children and families.

METHOD

The review followed the PRISMA guidelines. The final sample consisted of 11 articles, with samples ranging from less than 30 participants to more than 100 at the international level.

RESULTS

The results demonstrate the complex methodological and bibliometric picture of the final sample, as well as the many emotional and contextual variables that influence the relationship between homework and neurodevelopmental disorders.

CONCLUSIONS

Future research should consider how emotional health affects the engagement of families with children with neurodevelopmental disorders.

Impact of the COVID-19 lockdown on the oral health behaviour of young children

AIM

Children up to the age of 10 are dependant primarily on their caregivers for oral care; COVID-19 lockdowns may have disrupted this care. We therefore assessed whether the COVID-19 lockdown affected routine parental oral care for their children.

METHODS

A short online survey regarding oral health behaviour and changes in the home setting during the COVID-19 lockdown was emailed to parents (n = 782, response 15%) participating in an existing study 'Healthy Teeth All Aboard (HTAA)'.

RESULTS

During the lockdown, 29% of parents reported that they skipped their children's toothbrushing more often than before the lockdown, and 49% of the children were allowed to consume sugary snacks or drinks more often. These behaviours were not significantly associated with socio-economic status, country of birth of the mother, work situation of the parents, school attendance patterns or HTAA participation status.

CONCLUSION

The COVID-19 lockdown affected the daily oral hygiene routines of children, potentially increasing caries risk.

CLINICAL RELEVANCE

Dental professionals should be aware of the potential impacts on oral health in children in the circumstance of a new lockdown. Parents should be made aware of the oral health consequences of a lockdown.

Effect of Motor Competence and Health-Related Fitness in the Prevention of Metabolic Syndrome Risk Factors

Purpose: In the last decades we have seen an increase in sedentary behaviors and a decrease in physical activity in children when compared to past generations. This lifestyle is commonly associated with the development of clustering risk factors that define metabolic syndrome (MetS). Knowing that motor competence (MC) development can influence lifelong physical activity habits, it is reasonable to assume that children's MC will directly link to clustered cardiometabolic health outcomes. The aim of this study was to analyze the role of MC in MetS risk factors. Methods: Seventy children with a mean age of 7.49 (SD = 1.28) years were evaluated on motor competence (MCA-Motor Competence Assessment instrument), cardiovascular fitness (PACER test), upper body strength (UBS; handgrip), and the components of MetS, hypertriglyceridemia, hypertension, abdominal obesity, low concentration of high-density lipoprotein cholesterol, and high fasting blood glucose. The composite value of MetS was calculated according to Burns et al. (2017). Multiple standard regressions were performed to explore the effect of different variables on MetS. Motor competence and health-related fitness (cardiovascular fitness and relative upper body strength) were used as independent variables (predictors) and MetS as dependent variable. Results: Overall, the results showed that motor competence (β = -.072; p < .05) is a significant predictor and this model explained 7,1% of the variance in MetS. Conclusion: Although more studies are needed, our results indicate that MC seems to have a positive role in children's health markers.

Caries Experience before and after COVID-19 Restrictions: An Observational Study

Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the suspension of several clinical practices globally, including dentistry. This study investigates the impact of these restrictions on dental caries experience. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University's dental hospital in the Lisbon Metropolitan Area from June 2019 to June 2021. The study involved 3380 participants who were divided into two cohorts: after and before COVID-19 restrictions. Data collection included a questionnaire, full-mouth clinical examinations, and radiographs (panoramic X-rays, bitewings). Results: Before the COVID-19 restrictions, the prevalence of dental caries was 91.8%, with an average DMFT (decayed, missing, and filled teeth) index of 12.13. Post-restrictions, the prevalence decreased to 84.5%, with a DMFT index of 10.99. There was an increase in missing teeth and a decrease in decayed and filled teeth. Additionally, the frequency of toothbrushing declined among participants. Conclusions: The COVID-19 pandemic restrictions have significantly impacted dental caries experiences and oral health, highlighting a decrease in dental caries, but also a concerning reduction in oral hygiene practices. These results emphasize the importance of customized dental healthcare during public health emergencies to reduce impacts and maintain oral health.

Systems mapping of multilevel factors contributing to dental caries in adolescents

Dental caries is a prevalent chronic disease among adolescents. Caries activity increases significantly during adolescence due to an increase in susceptible tooth surfaces, immature permanent tooth enamel, independence in pursuing self-care, and a tendency toward poor diet and oral hygiene. Dental caries in permanent teeth is more prevalent among adolescents in low-income families and racial/ethnic minority groups, and these disparities in adolescent dental caries experience have persisted for decades. Several conceptual and data-driven models have proposed unidirectional mechanisms that contribute to the extant disparities in adolescent dental caries experience. Our objective, using a literature review, is to provide an overview of risk factors contributing to adolescent dental caries. Specifically, we map the interactive relationships of multilevel factors that influence dental caries among adolescents. Such interactive multilevel relationships more closely reflect the complex nature of dental caries experience among the adolescent population. The methods that we use are two-fold: (1) a literature review using PubMed and Cochrane databases to find contributing factors; and (2) the system dynamics approach for mapping feedback mechanisms underlying adolescent dental caries through causal loop diagramming. The results of this study, based on the review of 138 articles, identified individual, family and community-level factors and their interactions contributing to dental caries experience in adolescents. Our results also provide hypotheses about the mechanisms underlying persistence of dental caries among adolescents.

Conclusions

Our findings may contribute to a deeper understanding of the multilevel and interconnected factors that shape the persistence of dental caries experience among adolescents.

Kids gone wild - Alcohol use and patient characteristics in pediatric trauma during the coronavirus disease 2019 pandemic

Importance

Reported coronavirus disease 2019 (COVID-19) pandemic effects on pediatric trauma have been variable.

Objective

We investigated the characteristics of pediatric trauma including alcohol use during the pandemic at our urban trauma center.

Methods

The trauma database of our adult level 1 trauma center was queried for all pediatric (age ≤ 18 years) patients presenting between March 1, 2020, and October 30, 2020. Data from 2017 to 2019 served as a control. Variables analyzed included demographics, mechanisms, injury severity, hospitalization characteristics, and positive blood alcohol.

Results

Pandemic pediatric trauma volumes increased by 67.5% (330/year vs. 197/year). Pandemic patients were younger (median age 13 vs. 14 years, P = 0.011), but similar in gender, ethnicity, severity, hospital length of stay, mortality, and rates of penetrating injury. Falls doubled (79/year vs. 34/year) and shifted away from high falls >6 meters (0% vs. 7.9%) to moderate falls 1-6 meters (58.2% vs. 51.5%) (P = 0.028). Transportation injury rates were similar however mechanisms shifted from motor vehicle crashes (-13.5%) towards recreational vehicles including motorcycles (+2.1%), all-terrain vehicles (+8.6%), and bicycles (+3.8%) (P = 0.018). Pediatric-positive blood alcohol was significantly higher (11.2% vs. 5.1%, P < 0.001), especially for ages 14-18 years (21.7% vs. 9.5%, P < 0.001).

Interpretation

Pediatric trauma volumes during the COVID-19 pandemic increased. Pandemic patients had more recreational vehicle injuries and higher rates of positive blood alcohol. This suggests an increased need for alcohol assessment and targeted interventions in the pediatric population during pandemics or periods of school closures.

Prevalence of anxiety, sleep bruxism and temporomandibular disorders during COVID-19 in Qatari children and adolescents: a cross-sectional study

PURPOSE

Understanding the impact of coronavirus disease-2019 (COVID-19) pandemic social restrictions on the lives of children and adolescents is of utmost importance to enable timely diagnosis and treatment. Therefore, the aim of this study was to explore the prevalence of anxiety, sleep bruxism, temporomandibular disorders (TMD) and change in dietary and brushing habits and their association with COVID-19 social restrictions.

METHODS

Parents of fit and healthy Qatari children and adolescents were recruited and interviewed by the research team, whereby validated questioners were used to assess the prevalence of children's/adolescents' anxiety, sleep bruxism and TMD. Furthermore, changes in dietary and brushing habits were also evaluated.

RESULTS

A total of 199 parents of children and adolescents (mean age = 9.3 ± 3.2 years old) were included. Overall anxiety symptoms, sleep bruxism and TMD were evident in 29.6%, 5.7% and 23.1%, respectively. An increased consumption of food, sweets and worsening of brushing habits were evident in 51.8%, 62.8% and 31.2%, respectively.

CONCLUSION

Within the limitations of this study, pandemic-related social restrictions could result in elevated levels of anxiety, specifically, social phobia, amongst children and adolescents, which could inevitably lead to unwanted dental consequences.

Barriers to the Accessibility of Emergency Pediatric Dental Care Services during the COVID-19 Pandemic: A Qualitative Study in Mashhad, Iran

Objectives: The aim of this study was to investigate barriers to the accessibility of emergency pediatric dental care services during the coronavirus disease 2019 (COVID-19) pandemic from the viewpoint of parents in Mashhad, Iran. Materials and Methods: A qualitative study was conducted on a purposive sample of parents seeking emergency dental care for their children during the COVID-19 pandemic. Data were collected through semi-structured face-to-face interviews. The participants were asked, "Were there any barriers encountered when seeking emergency dental care for your child during the COVID-19 pandemic?". If any barrier was faced, the parents were asked to explain about it. All interviews were recorded and transcribed verbatim. The thematic content analysis of the transcripts began after the first interview, and the interviews and analysis process continued until data saturation was achieved. Results: In total, 26 parents were interviewed. The thematic content analysis of the transcripts led to the recognition of three main categories of barriers: "fear of COVID-19", "financial constraints", and "dentists' less occupational activity". "fear of COVID-19" had two subcategories: "fear of contracting COVID-19" and "fear of transmitting COVID-19 to others". "financial constraints" also had two subcategories: "increased costs" and "decreased income". Conclusion: From the viewpoint of parents seeking emergency dental care for their children in Mashhad, Iran, there were various barriers to the accessibility of emergency pediatric dental care services during the COVID-19 pandemic. The barriers were not limited to the fear of COVID-19 and were partly outside the control of dentists and parents.

Factors associated with scientific production citations in dentistry: Zero-inflated negative binomial regression and hurdle modelling

Background: The global scientific literature in dentistry has shown important advances in the field, with major contributions ranging from the analysis of the basic epidemiological aspects of prevention to specialised results in the field of dental treatments. The present investigation aimed to analyse the current state of the scientific literature on dentistry hosted in the Web of Science database. Methods: The methodology included two phases in the analysis of articles and indexed reviews in all thematic areas. During the first phase, the following variables were analysed: scientific production by the publisher, the evolution of scientific output published by publishers, the factors associated with the impact of scientific production, and the modelling of the impact of scientific production on dentistry. During the second phase, associations, evolutions, and trends in the use of keywords in the scientific literature in dentistry were analysed. Results: The first phase shows that scientific production in dentistry will increase between 2010 and 2021, reaching 12,126 articles in 2021. Publishers such as Wiley and Elsevier stand out, but Quintessence Publishing has the most citations. Factors such as pages, authors, and references influence the number of citations. Phase 2 analyzes trends in the dental literature using the WoS database. Topics such as "dental education", "pediatric dentistry", and "pandemic" stand out. The intersection of technology and dentistry and the importance of evidence-based education are highlighted. Conclusions: In conclusion, the study shows that the most studied topics include the association of dental education and the curriculum, the association of pediatric dentistry with oral health, and dental care. The findings show that more recently emphasised topics also stand out, such as evidence-based dentistry, the COVID-19 pandemic, infection control, and endodontics, as well as the need for future research to expand current knowledge based on emerging topics in the scientific literature on dentistry.

Analyzing consumer behaviour towards food and nutrition labeling: A comprehensive review

Studying consumer behaviour towards food and nutrition labelling (F&NL) is increasingly becoming important across the world. Bibliometric analysis is a way to identify influential research, track trends, and understand methodologies in any field. In this paper, we used bibliometric analysis and a review of theories too to critically evaluate theories and concepts used in studying consumer behaviour towards F&NL. Using the Scopus database, we obtained 1017 articles, which were further filtered to perform various analyses like Co-occurrence and co-authorship network analysis. We found limited East and Southeast Asia-based research. Personal beliefs, attitudes, and past experiences were identified as influencers of consumer behaviour regarding food labelling. Trending topics were food waste, purchase intention, and sustainability labels.

Diet, Oral Hygiene Habits, and Approach to Dental Visits of Early School-Aged Children during the COVID-19 Pandemic and Possible Long-Term Health Consequences

INTRODUCTION

Early school-aged children are in a transitional phase from primary to permanent dentition. Established dietary and oral hygiene habits will influence the condition of the oral cavity in the future.

AIM

This study aimed to evaluate alterations in early school children's dietary and oral hygiene practices during the COVID-19 pandemic and to anticipate potential long-term health implications.

MATERIAL AND METHODS

This cross-sectional online study involved guardians of Polish children aged 6-10 years, living in Western Poland, who were socially isolated at home during the COVID-19 pandemic. A total of 180 guardians were invited to participate in this study. The questionnaire included 17 questions divided into four different sections-the child's anthropometric data, dietary habits, oral health, and attitude to dental visits.

RESULTS

The survey was completed by 106 guardians. The mean (standard deviation) age of the children was 8.12 (0.93) years (range 6-10 years). Overall, 24.5% of the surveyed individuals reported buying healthy products (fresh vegetables, fruit) more frequently during the pandemic. Furthermore, 35.8% admitted to snacking between meals more frequently and 16.0% less frequently. Almost one-quarter of the parents acknowledged that their children were less motivated to maintain oral hygiene during the pandemic and 28.3% declared a lower frequency of visits to the dentist from the outbreak of the pandemic for two main reasons: a fear of coronavirus transmission and economic reasons.

CONCLUSIONS

In the group studied, the results of the assessment indicate that the COVID-19 pandemic had some effects on oral health that may lead to an increased risk of oral disease development, such as tooth decay in children. None of the respondents noticed an increase in their child's motivation about good oral hygiene despite spending more time at home. The irregularity of follow-up visits for one-third of the respondents hindered preventive measures and the continuation of dental treatment.

Oral Health Behaviors for Young Low-Income Urban Children during the COVID-19 Pandemic: A Mixed Methods Analysis

This research assessed oral health behaviors changes in urban families with young children during the stay-at-home period of the COVID-19 pandemic (Nov 2020-August 2021). Survey data on oral health behaviors were collected in homes at three points before COVID-19, and via phone during COVID-19. A subset of parents and key informants from clinics and social service agencies completed in-depth interviews via video/phone. Of the 387 parents invited, 254 completed surveys in English or Spanish (65.6%) during COVID-19. Fifteen key informant interviews (25 participants) and 21 family interviews were conducted. The mean child age was 4.3 years. Children identified as mainly Hispanic (57%) and Black race (38%). Parents reported increased child tooth brushing frequency during the pandemic. Family interviews highlighted changes in family routines that impacted oral health behaviors and eating patterns, suggesting less optimal brushing and nutrition. This was linked to changed home routines and social presentability. Key informants described major disruptions in oral health services, family fear, and stress. In conclusion, the stay-at-home period of the COVID-19 pandemic was a time of extreme routine change and stress for families. Oral health interventions that target family routines and social presentability are important for families during times of extreme crisis.

Parent's Attitudes toward Their Children's Oral Health Care during the COVID-19 Pandemic: A Cross-Sectional Study

Background

The COVID-19 pandemic has significantly impacted global health and presented challenges to maintaining oral health in children. Efficient management and prevention of oral diseases are therefore crucial in this population.

Aim

This cross-sectional study aimed to assess parents' self-reported oral and dental hygiene habits for their children during the COVID-19 pandemic.

Methods

A total of 256 parents of primary school children in Qazvin completed an online questionnaire containing demographic, general, and cardinal questions. The collected data were analyzed using SPSS 22 software, and accurate analytical tests were run to reach the results.

Results

The study found that 69.1% of parents and 87.1% of children brushed their teeth regularly during the pandemic. Additionally, 80.5% of parents monitored their children while brushing. While some parents expressed concerns about COVID-19 infection, parents from lower socioeconomic status reported a higher willingness to attend dental centers than those from more prosperous areas.

Conclusion

These findings suggest that parents' supervision and attitude toward oral health care significantly affect children's oral hygiene habits during the pandemic, possibly due to increased time spent together during lockdowns.

Impact of the COVID-19 pandemic on pediatric Medicaid dental claims in Arizona

OBJECTIVES

To examine the role COVID-19 had on access to dental services among children in Arizona by comparing paid pediatric dental claims made before and during the pandemic.

METHODS

In a retrospective descriptive study, we examined Medicaid paid claims for dental services among pediatric patients from March through December 2019 and during the outbreak in 2020. Using dental claims data obtained from the Centers for Health Information and Research at Arizona State University (ASU), we analyzed Medicaid (Arizona Health Care Cost Containment System [AHCCCS]) reimbursed dental services.

RESULTS

During the COVID-19 pandemic, paid preventive dental claims for children aged birth to 21 years decreased in 2020 compared to the same time period in 2019. Pediatric patients in Arizona utilized fewer dental services and had less access to credentialed Medicaid dental providers during the pandemic. Further, rural counties had statistically significant fewer preventive, minor restorative, major restorative, and endodontic claims compared to urban counties. Arizona rural counties also had fewer providers who were paid $10,000 or more per year during 2020 than in 2019.

CONCLUSIONS

COVID-19 has had a detrimental impact on pediatric dental service utilization. While dental services were provided during the COVID-19 pandemic, preventive and restorative dental claims dropped for rural Arizona children aged birth to 21 years. This reveals potential negative impacts on oral health. Further research should examine the direct and indirect impact the COVID-19 pandemic has had on dental service utilization and oral health for the general pediatric population.

The Impact of the COVID-19 Pandemic on Pediatric Dentistry: Insights from an Italian Cross-Sectional Survey

BACKGROUND

The COVID-19 pandemic has had a significant impact on pediatric dentistry and also dental education. This study aimed to assess the observed changes in children's oral health by pediatric dentists and also served as an educational tool for dentistry students during the pandemic.

METHODS

Postgraduate students in pediatric dentistry prepared a survey addressed to Italian pediatric dentists. Over 5476 dentists were invited to participate, and collaboration among the students took place through virtual meetings and electronic platforms. The online questionnaire was composed of 29 questions focusing on the management of pediatric patients during and after the lockdown period. A descriptive statistic was used for data analysis, and chi-square tests were performed (p < 0.05).

RESULTS

A total of 1752 pediatric dentists participated in the survey. During the lockdown, 68.3% of dentists exclusively handled dental emergencies. In the subsequent semester, a significant decrease in the number of pediatric treatments was reported. Pediatric dentists also noted a decline in children's oral hygiene practices, a deterioration in dietary habits, and an increase in anxiety during dental procedures.

CONCLUSIONS

This survey shed light on the diverse effects of the pandemic on children's oral health and also provided valuable educational insights.

Oral health behaviors for young low-income urban children during the COVID-19 pandemic: a mixed methods analysis

This research assessed oral health behaviors changes in urban families with young children during the stay-at-home period of the COVID-19 pandemic. Survey data on oral health behaviors were collected in homes at three points over one year before COVID-19, and then via phone during COVID-19. Multivariate logistic regression was used to model tooth brushing frequency. A subset of parents completed in-depth interviews via video/phone that expanded on oral health and COVID-19. Key informant interviews via video/phone were also conducted with leadership from 20 clinics and social service agencies. Interview data were transcribed and coded, and themes were extracted. COVID-19 data collection went from Nov 2020 - August 2021. Of the 387 parents invited, 254 completed surveys in English or Spanish (65.6%) during COVID-19. Fifteen key informant (25 participants) and 21 parent interviews were conducted. The mean child age was approximately 4.3 years. Children identified as mainly Hispanic (57%) and Black race (38%). Parents reported increased child tooth brushing frequency during the pandemic. Parent interviews highlighted significant changes in family routines that impacted oral health behaviors and eating patterns, suggesting less optimal brushing and nutrition. This was linked to changed home routines and social presentability. Key informants described major disruptions in their oral health services and significant family fear and stress. In conclusion, the stay-at-home period of the COVID-19 pandemic was a time of extreme routine change and stress for families. Oral health interventions that target family routines and social presentability are important for families during times of extreme crisis.

Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic

Aim

To assess oral hygiene and dietary patterns in school children participating in a school-based preventive oral health program during the COVID-19 pandemic.

Materials and methods

In this cross-sectional study, an anonymous questionnaire exploring oral hygiene and dietary patterns during the COVID-19 pandemic was completed by parents of school children. Data were compared among different schools, school years, and between genders using nonparametric tests. Associations among further nominal and categorical variables related to oral hygiene and dietary habits were also assessed using the chi-square test.

Results

Only 26% (n = 32) of parents reported that their children brushed their teeth the recommended amount of twice or more per day during the pandemic. In addition, 17.2% of the parents reported less brushing than before the pandemic. A total of 40 parents (32.8%) reported that their child consumed unhealthy beverages once a day or more. Comparison between genders revealed that male participants were drinking significantly unhealthier than female (p = 0.038). Sugary foods were consumed once a day or more by 63.1% of children. No significant differences were found between public and church schools. Significant direct associations were found between changes in dietary habits and brushing frequency (p = 0.017), between parental concern regarding the interruption of the school program and decreased brushing frequency (p = 0.005), and negative changes in dietary habits (p = 0.013).

Clinical significance

Within the limitations of this study, the present significant findings observed during the pandemic support the importance of school programs in promoting oral hygiene and healthy dietary habits of children.

How to cite this article

Agius A-M, Gatt G, Cortes ARG, et al. Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic. Int J Clin Pediatr Dent 2023;16(2):205-210.

Impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices: a global scoping review

BACKGROUND

In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families' wellbeing and health status.

AIMS

This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures.

METHODS

Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains.

RESULTS

The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices.

CONCLUSIONS

Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.

Impact of the COVID-19 lockdown on the oral health status of paediatric dental patients in Greece

BACKGROUND

Limited evidence regarding the post-COVID-19 dental status of paediatric patients is available, with most studies assessing only children's oral health habits.

AIM

To evaluate the effect of the COVID-19 lockdown on the oral health of paediatric dental patients in Greece.

DESIGN

This was a retrospective cohort study that included a questionnaire on children's oral health behavior and a clinical examination assessing dental caries and dental treatment needs using the International Caries Detection and Assessment System criteria, dmft/DMFT, and Treatment Need Index. The Wilcoxon signed-rank test was used for a statistical comparison between questionnaire and clinical data before, during, and after the lockdown.

RESULTS

A total of 102 children with a median age of 9 years were recruited from the current cohort of patients that had their last dental examination 6 months prior to the lockdown. Results from the questionnaire showed decreased brushing frequency with increased eating frequency and sugar consumption during the lockdown period (p < .001). Moreover, 16.5% had to visit the dentist for urgent care during the lockdown, 13.6% experienced dental pain, and 51.5% did not experience any dental emergencies. Clinical examination, after the lockdown, recorded significantly increased mean dmft/DMFT scores by 0.63 units in the primary dentition (p = .01) and 0.52 units in the permanent teeth (p = .002). Significantly higher treatment needs, with more carious lesions requiring extensive treatment after the lockdown, were recorded (p < .001).

CONCLUSION

The COVID-19 lockdown negatively affected children's oral health behavior: caries prevalence increased and more complex dental treatments were required.

Determining the Impact of the COVID-19 Pandemic on Dental Care in the Serbian Adult Population: An Online Questionnaire-Based Study

BACKGROUND Emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) could lead to an increase in dental anxiety, avoidance of dental visits, and general neglect of oral health. This online questionnaire-based study conducted in April and May of 2021 in Serbia aimed to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on dental care. MATERIAL AND METHODS The study included 2060 adult citizens of the Republic of Serbia who participated in an anonymous online questionnaire based on a 5-point Likert scale. Data were collected on dental care routine prior to and during the pandemic, and the fear of negative consequences for oral health. The results were statistically analyzed using descriptive statistics, Pearson's correlation coefficient, ANOVA, and the paired t test. RESULTS Approximately one-fifth of the respondents postponed dental visits during the pandemic. Concern about postponing dental treatment was expressed by more than one-half of the respondents (57.1%), while 21.4% thought that they were already experiencing the consequences. Avoidance of preventive examinations and improvement of oral hygiene are more common among the elderly compared to younger respondents (P=.000). CONCLUSIONS The COVID-19 pandemic did not significantly affect the habit of avoiding dental interventions due to fear, but it did lead to part of the population completely avoiding even urgent dental interventions during the peak of the pandemic, and opting for tooth extraction rather than treatment. The strongest impact on dental care in the pandemic was among people over 64 years old.

COVID-19 Related Information on Pediatric Dental Care including the Use of Teledentistry: A Narrative Review

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people's health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned.

Psychological Impact of COVID-19 in the Setting of Dentistry: A Review Article

The worldwide pandemic has exposed healthcare professionals to a high risk of infection, exacerbating the situation of uncertainty caused by COVID-19. The objective of this review was to evaluate the psychological impact of the COVID-19 pandemic on dental professionals and their patients. A literature review was conducted using Medline-Pubmed, Web of Science, and Scopus databases, excluding systematic reviews, narratives, meta-analyses, case reports, book chapters, short communications, and congress papers. A modified version of the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected studies. The search retrieved 3879 articles, and 123 of these were selected for the review (7 longitudinal and 116 cross-sectional studies). Elevated anxiety levels were observed in dental professionals, especially in younger and female professionals. Except for orthodontic treatments, patients reported a high level of fear that reduced their demand for dentist treatment to emergency cases alone. The results suggest that the COVID-19 pandemic has had psychological and emotional consequences for dental professionals and their patients. Further research is necessary to evaluate the persistence of this problem over time.

COVID-19 Lockdown: Impact on Oral Health-Related Behaviors and Practices of Portuguese and Spanish Children

This study aimed to assess and compare the impact of COVID-19 pandemic lockdowns on the oral health attitudes, dietary habits and access to dental care of Portuguese and Spanish children. A cross-sectional observational study involving caregivers of 3−17-year-old children who had cohabited during a COVID-19 pandemic lockdown in Spain and Portugal was conducted. Caregivers completed an online anonymous questionnaire. Aiming groups comparison, chi-square test was used for qualitative variables. 770 surveys were obtained. Significant changes in the children’s routine were higher in Portugal (p < 0.001). Both countries showed a large percentage of children who had between 2−3 snacks between meals (p < 0.001) and a higher consumption of snacks was particularly noticed among Spanish children with untreated dental caries during the lockdown (p = 0.003). Most caregivers reported children’s oral hygiene habits did not suffer noteworthy alterations (p = 0.417), although parental supervision of toothbrushing was associated with dental attendance during the lockdown. The majority of the sample had no dental attendance during confinement. Confinement appears to have not markedly affected the oral health status and habits of the majority of these children, although an important impact of some demographic and behavioral factors upon dietary and oral care/habits was detected.

The impact of COVID-19 on individual oral health: a scoping review

BACKGROUND

Poor oral health due to dental caries is one of the most prevalent non-communicable diseases worldwide. It has a significant impact on individuals across the lifespan and is a leading cause of preventable hospitalizations. The impacts of COVID-19 on oral health at the practice level are well documented, but gaps in understanding the impact on individual oral health remain. This review addresses this gap.

METHODS

Using a JBI scoping review process we mapped and summarized the evidence to identify the impact of COVID-19 on individual oral health. Key search terms were developed, and searches were undertaken by an experienced research librarian.

RESULTS

The 85 included studies were conducted in 23 countries from 5 regions across the world classified using the United Nations Geoscheme system. The majority (82/85) were quantitative, 2 were reviews and there was one qualitative interview study. Cross-sectional surveys were the most common data collection approach followed by an analysis of clinical data, analysis of internet trends and other online methods. Five key areas were identified including changes to the provision of emergency dental services, provision of routine oral health services, oral hygiene maintenance at home, changes in dietary preferences, alternative models of dental provision and help-seeking and attitudes towards dental care in the future.

CONCLUSIONS

This scoping review has demonstrated that the pandemic has impacted on oral health at the individual level. It is important that we are aware of these impacts and ensure that support systems are in place to overcome future periods where access to dental care might be compromised. The provision of preventive care remains a vital first step in ensuring good overall oral health as is paramount during periods where access to dental treatment might be limited.

Influence of COVID-19-Related Restrictions on the Prevalence of Overweight and Obese Czech Children

Apart from influencing the health of the worldwide population, the COVID-19 pandemic changed the day-to-day life of all, including children. A sedentary lifestyle along with the transformation of eating and sleep habits took place in the child population. These changes created a highly obesogenic environment. Our aim was to evaluate the current weight in the child population and identify the real effects of the pandemic. Height and weight data were collected by pediatricians from the pre-COVID-19 and post-COVID-19 periods from 3517 children (1759 boys and 1758 girls) aged 4.71 to 17.33 years. We found a significant rise in the z-score BMI between pediatric visits in the years 2019 and 2021 in both sexes aged 7, 9, 11, and 13 years. Especially alarming were the percentages of (severely) obese boys at the ages of 9 and 11 years, which exceed even the percentages of overweight boys. With the use of statistical modeling, we registered the most dramatic increment at around 12 years of age in both sexes. Based on our research in the Czech Republic, we can confirm the predictions that were given at the beginning of the pandemic that COVID-19-related restrictions worsened the already present problem of obesity and excess weight in children.

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.

Possible Relationship Between the Oral and Gut Microbiome, Caries Development, and Obesity in Children During the COVID-19 Pandemic

The COVID-19 pandemic has brought health damage and socioeconomic disruptions, together with lifestyle disorders around the world. Children are one of the most commonly affected, mainly due to social isolation and changes in eating habits and physical activities. This way, the risk of weight gain and obesity is possibly enhanced, as well as poor oral hygiene conditions and early childhood caries (ECC) development during the lockdown. In children under 6 years of age, ECC is defined as carious lesions in one or more primary teeth, with or without cavitation. Importantly, alterations in the oral microbiome caused by changes in children lifestyles have much more than a local impact on oral tissues, interplaying with the gut microbiome and influencing systemic environments. Recent studies have been exploring the oral health conditions, eating habits, and weight gain in the childhood population during the COVID-19 pandemic; however, there is a lack of information concerning the association among oral and gut microbiome, dental caries, and obesity in the COVID-19 era. In this context, this review aimed at analyzing a possible relationship between the oral and gut microbiome, caries, and obesity in children during the COVID-19 pandemic.

Impact of the COVID-19 pandemic on therapy compliance and lifestyle factors of patients with growth hormone deficiency

OBJECTIVES

To recognize and assess treatment compliance in children and adolescents with growth hormone deficiency during the cronavirus disease-2019 (COVID-19) pandemic along with other lifestyle factors that might have been affected by the pandemic, such as diet, physical activity, sleep pattern, and screen time.

METHODS

This descriptive, cross-sectional study was carried out between March 2020-2021 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Data were collected through clinical interview questions.

RESULTS

The total sample size was 130 patients, 54 (41.5%) of whom were males and 76 (58.5%) were females. The mean age of the patients was 12.56±3.44 years. Comparisons of before and during the COVID-19 pandemic revealed significant changes in growth hormone therapy compliance (p=0.007), dietary changes (p=0.002) with an increase in vegetables and fruit consumption, a significant decrease in physical activity time (p<0.001), an increase in sleep time (p<0.001), and screen time (p<0.001).

CONCLUSION

The COVID-19 crisis had an impact on growth hormone therapy compliance, with a significant impact on other lifestyle factors such as dietary habits, physical activity, sleep time, and leisure screen time.

Development and validation of the Italian version of the 'Parental Perceptions of Silver Diamine Fluoride Dental Color Changes' questionnaire

BACKGROUND

The original English version of the questionnaire 'Parental Perceptions of SDF Dental Color Changes' was used among parents in the New York City metropolitan area.

AIM

To develop an Italian version of the questionnaire and to assess its validity.

DESIGN

The construct validity and the internal consistency were assessed in a convenience sample of Italian parents of 251 young healthy children seen at the University of Bologna and Pisa. Forward-backward technique was carried out for the translation of the questionnaire. Kaiser-Meyer-Olkin measure of sampling adequacy was equal to 0.91, and Bartlett's test of sphericity was statistically significant (P = .001), so the items were treated with the exploratory principal component analysis (PCA).

RESULTS

Cronbach's alpha ranged from 0.69 to 0.95. PCA demonstrates that all the items load on the first component (87% of explained variance). All the Spearman correlation coefficients between each subscale (positive scenario: 0.563; negative scenario: 0.665) and the general acceptability showed significant correlation (P = .0001). Different age, educational level, and family income of the parents did not produce statistically significant different scores on any of the subscales (P > .05; Mann-Whitney test).

CONCLUSION

The Italian version of the questionnaire showed high internal consistency and construct validity and was appropriate to be used in an Italian population.

Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review

BACKGROUND

The hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting.

METHODS AND FINDINGS

The selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning).

CONCLUSION

Apart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.

Knowledge, Attitudes, and Perception of Parents toward Dental Treatment of Children during the COVID-19 Outbreak

This study aimed to evaluate the knowledge of parents regarding the coronavirus outbreak and to assess the change in attitude and perception toward dental treatment during the coronavirus (COVID-19) pandemic. A structured questionnaire (on google format) containing 13 questions was used, and each question had 2 or 3 possible answers. The parents/guardians of children (aged 3–14 years) who were school-going were eligible to participate in this study. A total of 800 parents/guardians were interviewed on google reporting format from June to December 2020. A simple random sampling technique was used to select 800 parents/guardians of children, aged 3–14 years, studying in different schools in Chandigarh. According to the survey, a total of 86% of respondents said that they paid high attention to COVID-19 and explained it to their children; 97% reported that they emphasized the importance of hand hygiene and sanitation during the outbreak; 72% admitted that the outbreak has made them more conscious of the importance of maintaining good oral health and hygiene, to avoid visiting the dentist and 84% felt that the routine dental check-ups and appointments should be avoided during the COVID-19 outbreak; almost half of the respondents (47%) thought that the dental environment was a potential source of infection to their kids; 37% felt getting treatment at a dental setup may expose their child to risks of COVID-19; 71% said they would take their child to a dental department if he/she had a severe toothache. Approximately 46% of the respondents expressed confidence about the preventive measures taken in the dental department to ensure safe treatment for their children. In conclusion, all respondents were concerned about COVID-19 and most of them had talked about it with their children often. In addition, a considerable percentage of them showed apprehensions about the preventive measures being taken at the dental operatory and thought that the dental environment could be more dangerous than other environments.

Parental involvement in homework of children with learning disabilities during distance learning: Relations with fear of COVID-19 and resilience

The present study investigated parental involvement in the homework of children with learning disabilities, during distance learning due to the coronavirus disease 2019 (COVID-19) pandemic. Also, the role of parents' fear of COVID-19 and resilience in their involvement in homework was examined. The study involved 271 parents (140 mothers and 131 fathers) of children with learning disabilities, who studied in the fifth and sixth grade from4 schools of Thessaloniki (Greece). Parents completed a set of self-reported questionnaires, which included a scale on parental involvement in homework, a scale on fear of COVID-19, and a scale on resilience. According to the results, both mothers and fathers expressed a high fear of COVID-19, a low sense of resilience, and were involved in homework mostly in terms of parental control. Parental involvement in homework was not significantly differentiated by children's gender and grade. Furthermore, the path analysis model showed that parents' fear of COVID-19 predicted, indirectly and positively, parental control through the mediating role of resilience. The findings show how parents' current emotional state affects their involvement in the homework of children with learning disabilities. Finally, the findings imply the need for parental counseling during the pandemic, to feel more resilient and consequently supportive towards children's learning.

From Lockdown to Slow Release: Pediatric Dental Services during COVID-19 Pandemic-Emergency Preparedness and Impact on Future

Introduction

The emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has led to global pandemic raising significant challenges to the healthcare professionals due to its high transmission rate via droplet spread or direct contact. Pediatric dentists play an important role in the healthcare system by managing dental emergencies in children while taking special measures to practice universal infection control in this COVID-19 pandemic. However, data are limited pertaining to the prevalence, etiology, and treatment provided to children at pediatric dental emergency services during the COVID-19 lockdown period.

Aim and objective

To assess the effect of the COVID-19 pandemic lockdown period on Pediatric Dental Emergency Services.

Materials and methods

A retrospective study was conducted using data of patients aged 0-14 years who visited the Pediatric Dental Emergency Services, during the COVID-19 lockdown period from March 23, 2020, to August 31, 2020. Information regarding age, gender, time of presentation, chief complaint, and treatment were collected and analyzed.

Results

This study revealed that dental emergencies in the pediatric dental services were predominantly related to dental pain (54.49%) followed by an abscess (12.35%), traumatic dental injuries (8.42%), and swelling (8.42%). A 5-year-old was the most prevalent age-group who reported dental emergencies.

Conclusion

Dental pain was the most common chief complaint of patients reporting during the COVID-19 pandemic. However, the recent state of affairs obligates the need to strike a balance between the safety of the healthcare professionals and providing optimum dental care to the patients requiring emergency intervention. While dental emergencies are unforeseeable, increasing community awareness about proper at-home care routines and utilizing regular dental preventive measures can potentially reduce the number of emergency visits.

How to cite this article

Goswami M, Gogia M, Bhardwaj S. From Lockdown to Slow Release: Pediatric Dental Services during COVID-19 Pandemic-Emergency Preparedness and Impact on Future. Int J Clin Pediatr Dent 2021;14(3):398-402.

Oral health practice and health-related quality of life of a group of children during the early stage of the COVID-19 pandemic in Istanbul

BACKGROUND

During the pandemic period of coronavirus disease, appropriate oral health management and disease prevention of children are very important for children's oral and general health. The aim of this study was to survey to better understand in children's dental health and dietary habits and to learn about parents' attitudes toward dental treatment and clinical factors associated with their QoL using the Turkish version of KIDSCREEN-10 during the initial stage of the COVID-19 pandemic in the general public.

MATERIALS AND METHODS

A two-part questionnaire, namely Part 1 addressed topics regarding changes in general and dental health, dietary habits of children under quarantine, and sociodemographic characteristics of the family and Part 2 impact of QoL was assessed by the KIDSCREEN-10 scale with 10 questions. The questionnaire was sent online using WhatsApp to a convenience sample of mothers with children between the age group of 8 and 18 years, who lived in Istanbul. Variables were statistically analyzed using the Student's t-test for independent samples and Univariate F-test, ANOVA according to the characteristics of variables which were analyzed.

RESULTS

This study included 328 from 557 mothers with 58% respondent rate. The consumption of fast food, packaged food, and carbonated beverages decreased during the COVID-19 outbreak. Half of the mothers of children reported that they were anxious or fearful about their children visiting dentists during the pandemic and 64.2% of the children missed routine dental visits. The KIDSCREEN-10 scores for 13 years old or older children were influenced more by the COVID-19 pandemic than those for the 8-12 years old, who had a better QoL (P = 0.008).

CONCLUSIONS

The results of this study emphasize the importance of oral health and QoL of children during the initial phase of the COVID-19 outbreak. The general perception of QoL in this group of Turkish children seemed to be substantially affected by COVID-19 outbreak.

Impact of COVID-19 on Dental Care during a National Lockdown: A Retrospective Observational Study

The coronavirus disease 19 (COVID-19) has challenged dental health professions. This study analyzes its impact on urgent dental care in the Department of Conservative Dentistry and Periodontology, University Hospital Munich and Bavaria, Germany. Patient numbers without and with positive/suspected COVID-19 infection, their reasons for attendance, and treatments were retrospectively recorded (February–July 2020) and linked to local COVID-19 infection numbers, control measures, and numbers/reasons for closures of private dental practices in Bavaria, Germany. Patient numbers decreased within the urgent care unit and the private dental practices followed by a complete recovery by the end of July. While non-emergency visits dropped to almost zero during the first lockdown, pain-related treatments were administered invariably also in patients with positive/suspected COVID-19 infections. Reasons for practice closures were lack of personal protective equipment (PPE), lack of employees, staff’s increased health risks, and infected staff, which accounted for 0.72% (3.6% closures in total). Pain-driven urgent dental care remains a constant necessity even in times of high infection risk, and measures established at the beginning of the pandemic seem to have provided a safe environment for patients as well as oral health care providers. PPE storage is important to ensure patients’ treatment under high-risk conditions, and its storage and provision by regulatory units might guarantee a stable and safe oral health care system in the future.

Effects of the COVID-19 Lockdown on Portuguese Children's Motor Competence

During long periods without school, children are more susceptible to unhealthy behaviors, such as an increase in sedentary behaviors, which has a negative impact on children’s motor competence (MC). The COVID-19 lockdown offered us a unique opportunity to test, in a quasi-experimental setting, the impact of lockdown movement restrictions on children’s MC. We assessed the motor competence of 114 children aged 6–9 years using the motor competence assessment. All children were tested before and after the COVID-19 lockdown. Chi-square and 2 × 2 ANOVA (sex by moment) were used to further analyze the data. Regardless of sex, motor performances in all tests (except for jumping sideways in boys) were lower when compared with performances before lockdown. There was a marked decreasing trend in children’s levels of MC, shifting from an upper to a lower quartile in different tests. The results after the lockdown were always significantly inferior to the results before lockdown in all motor tests (except jumping sideways), in the three components of MC, and in global MC. Children’s global MC score decreased by an average of 13 points in boys and 16 points in girls. The imposed movement restrictions had a negative effect on children’s motor competence development.

The clinical practice of Pediatric Dentistry post-COVID-19: The current evidences

The Severe Acute Respiratory Syndrome (SARS) caused by SARS-CoV-2 virus has quickly spread all over the world, directly affecting the dentistry practice. This study aimed to perform a literature review about the current evidences on biosafety practices and clinical recommendations regarding the return to the elective dental care in the practice of Pediatric dentistry. An electronic search was performed in PubMed, Scopus, Web of Science and Grey literature databases using the terms "Pediatric dentistry" and "COVID-19". Initially, 38 studies were retrieved. After title and abstract were read, it was identified that 22 studies referred specifically to children's dental practice. A total of 19 studies were included in this study. The COVID-19 pandemic will imply significant changes in the reorientation of dental practices, from biosafety issues to technical procedures. Greater rigor in the use of Personal Protective Equipment (PPE) may cause strangeness for children. Consequently, an improvement in the management of patient's behavior before and during the treatment and new approaches to perform the procedures will be demanded. Non-aerosol techniques and minimally invasive procedures will be preferable whenever possible. Professionals will need to be constantly updated based on what the scientific literature recommends. The moment is suitable for the use of preventive practice and minimally invasive techniques.

Mothers' Knowledge, Attitudes, and Fears About Dental Visits During the COVID-19 Pandemic: A Cross-sectional Study

OBJECTIVES

This study aimed to assess mothers' knowledge of coronavirus disease 2019 and to evaluate their attitudes and fears about dental visits during the pandemic.

MATERIALS AND METHODS

A structured questionnaire, developed in English and Arabic, adapted from previous questionnaires was remotely applied to a sample of 833 mothers of children aged 17 years and younger, from different socioeconomic backgrounds. Eligible participants were encouraged to invite others. The questionnaire collected information on knowledge about COVID-19, dental visit patterns, willingness of mothers to take their children to the dentist, and factors affecting it during the pandemic. Frequencies and percentages of categorical variables were presented, and predictors of willingness to visit a dentist during the pandemic were examined by logistic regression.

RESULTS

Mothers who perceived the dental clinic to be of less or similar danger to public places were more willing to take their children to the dentist during the pandemic than were those who perceived it to be more dangerous (odds ratio [OR] = 2.9, 95% confidence interval [CI]: 1.2-7.0; OR = 2.3, 95% CI: 1.1-4.8, respectively). Mothers who were willing to go to the dentist during the pandemic were more likely to take their children to the dentist compared with mothers who were not willing to go themselves, OR = 16.9 (6.0-47.1). The most commonly reported barrier to visiting the dental clinic was fear of contracting the virus from someone there (80%). Most parents did not take their child to the dentist during the pandemic (83%), and 24% of those who had an appointment did not allow their children to attend.

CONCLUSION

Mothers were unlikely to take their children to the dentist except for an emergency and perceived the dental clinic as a risky place for contracting the virus. More reassuring information about infection control measures at dental clinics should be delivered to this population.