1
|
Senthilkumar A, Ravindran V, Arthanari A, Ramalingam K. Evaluation of Forensic Luminol in Detection of Blood Stains in Instruments Following Dental Treatment. Cureus 2024; 16:e57676. [PMID: 38707075 PMCID: PMC11070201 DOI: 10.7759/cureus.57676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 05/07/2024] Open
Abstract
Background Saliva and blood, being biological materials with a high potential for infectious transmission in dental environments, pose significant risks to dental professionals, assistants, and patients alike. Therefore, practitioners must adopt stringent security measures to ensure patient care, considering all parties as potential carriers of microorganisms capable of causing infectious diseases. Currently, various methods of disinfection and sterilization are employed to maintain the aseptic chain effectively. Having reliable methods for detecting substances in liquids, particularly body fluids, is crucial and highly convenient. Luminol, a chemiluminescent agent widely used in forensic science for detecting minute traces of blood that are invisible to the naked eye, presents itself as a valuable tool. Blood, a major bodily fluid often present in instruments following dental procedures, underscores the importance of its detection. Hence, in this study, luminol was utilized to detect blood traces in dental instruments following dental treatment, both before and after sterilization or disinfection. Objective Blood and saliva splashes, together with highly contagious aerosols, are always a part of dental procedures. The objective of the current study is to detect traces of blood stains on face shields, surgical instruments, and endodontic files using luminol before and after sterilization. Materials and methods Sample size calculation was done with G*Power software (Version 3.1.9.4, Düsseldorf, Germany), and a total of 30 instruments were selected for the study. In the present study, a total of 30 items were collected and utilized, including 14 instruments used after implant placement, 12 endodontic files employed after root canal treatment, and four face shields utilized during these procedures. Meanwhile, a freshly prepared luminol solution was applied to these instruments, and they were viewed in a dark environment both before and after sterilization procedures. Luminescence generated by luminol was observed in the instruments, indicative of the presence of blood not visible to the naked eye. Statistical analysis for both groups was done with IBM SPSS Statistics for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, IL, USA). Intragroup comparison was done using the Friedman test, and intergroup comparison was done using the Wilcoxon signed-rank test. Results Blood stains and chemiluminescence were visualized in two out of 10 endodontic files (one #15 K-file and #20 K-files) and two out of four face shields. The intragroup comparison was done using the Friedman test, and it was found to be statistically significant (p < 0.05). Intergroup comparison was done using the Wilcoxon signed-rank test and was found to be statistically insignificant (p > 0.05). Conclusion Following sterilization and disinfection, there were no visual blood stains or chemiluminescence. Therefore, luminol was found to be effective in detecting blood stains in endodontic files, surgical instruments, and face shields, as well as in validating the sterilization and disinfection processes. Hence, sterilization in dentistry stands as a critical measure to guarantee patient safety, halt the dissemination of infections, and uphold exemplary clinical care standards.
Collapse
Affiliation(s)
- Akshai Senthilkumar
- Forensic Odontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Vignesh Ravindran
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Abirami Arthanari
- Forensic Odontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| |
Collapse
|
2
|
Ghoneim A, Proaño D, Kaur H, Singhal S. Aerosol-generating procedures and associated control/mitigation measures: Position paper from the Canadian Dental Hygienists Association and the American Dental Hygienists' Association. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2024; 58:48-63. [PMID: 38505316 PMCID: PMC10946320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/29/2023] [Accepted: 09/25/2023] [Indexed: 03/21/2024]
Abstract
Background Since the outbreak of COVID-19, how to reduce the risk of spreading viruses and other microorganisms while performing aerosolgenerating procedures (AGPs) has become a challenging question within the dental and dental hygiene communities. The purpose of this position paper is to summarize the evidence of the effectiveness of various mitigation methods used to reduce the risk of infection transmission during AGPs in dentistry. Methods The authors searched 6 databases-MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, and Google Scholar-for relevant scientific evidence published between January 2012 and December 2022 to answer 6 research questions about the risk of transmission, methods, devices, and personal protective equipment (PPE) used to reduce contact with microbial pathogens and limit the spread of aerosols. Results A total of 78 studies fulfilled the eligibility criteria. The literature on the risk of infection transmission including SARS-CoV-2 between dental hygienists and their patients is limited. Although several mouthrinses are effective in reducing bacterial contaminations in aerosols, their effectiveness against SARS-CoV-2 is also limited. The combined use of eyewear, masks, and face shields is effective in preventing contamination of the facial and nasal region while performing AGPs. High-volume evacuation with or without an intraoral suction, low-volume evacuation, saliva ejector, and rubber dam (when appropriate) have shown effectiveness in reducing aerosol transmission beyond the generation site. Finally, the appropriate combination of ventilation and filtration in dental operatories is effective in limiting the spread of aerosols. Discussion and Conclusion Aerosols produced during clinical procedures can pose a risk of infection transmission between dental hygienists and their patients. The implementation of practices supported by available evidence will ensure greater patient and provider safety in oral health settings. More studies in oral health clinical environments would shape future practices and protocols, ultimately to ensure the delivery of safe clinical care.
Collapse
Affiliation(s)
| | - Diego Proaño
- Faculty of Dentistry, University of Toronto, Toronto, ON Canada
| | - Harpinder Kaur
- Faculty of Dentistry, University of Toronto, Toronto, ON Canada
| | - Sonica Singhal
- Faculty of Dentistry, University of Toronto, Toronto, ON Canada
| |
Collapse
|
3
|
Watanabe J, Iwamatsu-Kobayashi Y, Kikuchi K, Kajita T, Morishima H, Yamauchi K, Yashiro W, Nishimura H, Kanetaka H, Egusa H. Visualization of droplets and aerosols in simulated dental treatments to clarify the effectiveness of oral suction devices. J Prosthodont Res 2024; 68:85-91. [PMID: 36823102 DOI: 10.2186/jpr.jpr_d_23_00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
PURPOSE The hazards of aerosols generated during dental treatments are poorly understood. This study aimed to establish visualization methods, discover conditions for droplets/aerosols generated in simulating dental treatments and identify the conditions for effective suction methods. METHODS The spreading area was evaluated via image analysis of the droplets/aerosols generated by a dental air turbine on a mannequin using a light emitting diode (LED) light source and high-speed camera. The effects of different bur types and treatment sites, reduction effect of intra-oral suction (IOS) and extra-oral suction (EOS) devices, and effect of EOS installation conditions were evaluated. RESULTS Regarding the bur types, a bud-shaped bur on the air turbine generated the most droplets/aerosols compared with round-shaped, round end-tapered, or needle-tapered burs. Regarding the treatment site, the area of droplets/aerosols produced by an air turbine from the palatal plane of the anterior maxillary teeth was significantly higher. The generated droplet/aerosol area was reduced by 92.1% by using IOS alone and 97.8% by combining IOS and EOS. EOS most effectively aspirated droplets/aerosols when placed close (10 cm) to the mouth in the vertical direction (0°). CONCLUSIONS The droplets/aerosols generated by an air turbine could be visualized using an LED light and a high-speed camera in simulating dental treatments. The bur shape and position of the dental air turbine considerably influenced droplet/aerosol diffusion. The combined use of IOS and EOS at a proper position (close and perpendicular to the mouth) facilitated effective diffusion prevention to protect the dental-care environment.
Collapse
Affiliation(s)
- Jun Watanabe
- Division of Dental Safety and System Management, Tohoku University Hospital, Sendai
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Yoko Iwamatsu-Kobayashi
- Division of Dental Safety and System Management, Tohoku University Hospital, Sendai
- Liaison Centre for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai
| | - Kenji Kikuchi
- Biological Flow Studies Laboratory, Department of Finemechanics, Graduate School of Engineering, Tohoku University, Sendai
| | - Tomonari Kajita
- Division of Oral and Maxillofacial Oncology and Surgical Sciences, Tohoku University Graduate School of Dentistry, Sendai
| | - Hiromitsu Morishima
- Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, Sendai
| | - Kensuke Yamauchi
- Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, Sendai
| | - Wataru Yashiro
- Next-Generation Detection System Smart Lab, International Center for Synchrotron Radiation Innovation Smart (SRIS), Tohoku University, Sendai
- Frontier Quantum-beam Metrology Laboratory, Institute of Multidisciplinary Research for Advanced Materials (IMRAM), Tohoku University, Sendai
- Department of Applied Physics, School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, National Hospital Organization, Sendai
| | - Hiroyasu Kanetaka
- Liaison Centre for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai
| | - Hiroshi Egusa
- Division of Dental Safety and System Management, Tohoku University Hospital, Sendai
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
- Liaison Centre for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai
| |
Collapse
|
4
|
Tsuchiya H, Takai Y. COVID-19 in Dental Practice Is Prevented by Eugenol Responsible for the Ambient Odor Specific to Dental Offices: Possibility and Speculation. Med Princ Pract 2023; 33:83-89. [PMID: 38147833 PMCID: PMC11095613 DOI: 10.1159/000535966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/20/2023] [Indexed: 12/28/2023] Open
Abstract
Dental professionals routinely work in proximity to patients even when either or both of them have suspected or confirmed COVID-19. The oral cavity also serves as a reservoir for SARS-CoV-2 because the virus is present in and replicates in oral secretions (saliva and gingival crevicular fluid), oral tissues (salivary gland and periodontal tissue), and oral microenvironments (gingival sulcus and periodontal pocket). Despite a high risk of SARS-CoV-2 infection, the prevalence of COVID-19 in dentists, dental hygienists, dental assistants, and their patients was similar to that in the general population even during the pandemic. We propose that eugenol, which is responsible for the ambient odor specific to dental offices, could contribute to prevention of COVID-19 in dental settings. Eugenol is not only released from dental materials (filling, cement, and sealer) but is also aerosolized by dental procedures (grinding, polishing, and restoration). Such eugenol has been suggested to possess the potential to inhibit the infectivity and replication of SARS-CoV-2, the entry of SARS-CoV-2 into human cells by binding specifically to the viral spike protein, and the protease indispensable for SARS-CoV-2 replication. It has been shown that aerosolized eugenol acts on airborne viruses to reduce their loads. This review highlights a hypothesis that the environment of dental offices impregnated with eugenol suppresses SARS-CoV-2 airborne transmission and SARS-CoV-2 contagion between dental professionals and patients, preventing COVID-19 in dental practice. Anti-COVID-19 eugenol might give insights into the safe delivery of dental treatment and oral care in the COVID-19 era.
Collapse
Affiliation(s)
| | - Yoshiaki Takai
- Gifu University of Health Sciences, School of Rehabilitation, Gifu, Japan
| |
Collapse
|
5
|
Khanna M, Allison P, Farmer J, Quiñonez C, Glogauer M, Siqueira WL, Rock LD, McNally M, Madathil S. Personal protective equipment during COVID-19: A natural history of dental and dental hygiene regulatory guidance in Canada. J Am Dent Assoc 2023; 154:1077-1086.e8. [PMID: 38008525 DOI: 10.1016/j.adaj.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/12/2023] [Accepted: 09/02/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Due to the evolving nature of COVID-19, there is evidence that COVID-19-specific infection prevention and control guideline (IPCG) documents formulated for oral health care settings are also changing rapidly. To better inform future policies, a comprehensive review of all IPCG documents across different phases of restrictions for oral health care practitioners is required. TYPES OF STUDIES REVIEWED A search was performed for documents shared from March 2020 through January 2022 on websites of oral health regulatory authorities in Canada's 10 provinces and 3 territories. The authors performed a narrative review of the identified IPCG documents for dentists (n = 78) and dental hygienists (n = 57). RESULTS Overall findings from more than 100 IPCG documents distributed during a period of 23 months revealed that the frequency of these updates differed among jurisdictions and between the 2 oral health care practitioners (ie, dentists and dental hygienists) within the same jurisdiction. The most notable observation was the different face-covering recommendations for dentists and dental hygienists within the same jurisdiction during the same timeframe. A common document was sometimes observed for dentists and dental hygienists, however, most jurisdictions had separate IPCG documents. CONCLUSIONS AND PRACTICAL IMPLICATIONS The different approaches could have been justified on the basis of prevalence of COVID-19 and availability of personal protective equipment; however, there was a risk of creating confusion about IPCG best practices. The findings of this review will support decision makers when planning future development and dissemination of regulations for all oral health care practitioners.
Collapse
|
6
|
Campus G, Jenni MML, Betancourt MD, Cagetti MG, Giacaman RA, Manton DJ, Douglas GVA, Carvalho JC, Wolf TG. The COVID-19 Pandemic and Dental Professionals' Infection Risk Perception: An International Survey. J Clin Med 2023; 12:6762. [PMID: 37959228 PMCID: PMC10650638 DOI: 10.3390/jcm12216762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
A global survey among dentists was used to identify the various impacts of the COVID-19 pandemic on this professional group. Special attention was given to perception and assessment of infection risk. From May to August 2020, the questionnaire was delivered in 36 countries by respective research groups and was completed by 52,491 dental professionals. The survey was designed as a cross-sectional survey based on a previously standardized questionnaire. This study focuses on the part of the questionnaire that deals with the perception of the infection risk of COVID-19 by dentists and their patients. A logistic regression model was used, which consisted of four Likert items as response options and the additional self-reported routine or emergency treatment as the dependent variable. Analysis by continent found that European and Asian dentists were particularly likely to be infected at work (OR = 1.45 95%CI = 1.02/1.84 and OR = 2.68, 95%CI = 1.45/3.22, respectively), while it was likely that Australian dentists did not feel particularly at risk due to low infection rates. Three quarters of Americans treated only emergencies during this survey period, while Europeans (64.71%) and Asians (66.67%) provided mostly routine care. This could affect the Europeans' confidence that they would not be able to protect themselves from infections in the long-term. The COVID-19 pandemic and its impact on dental professionals' infection risk perception is determined by the geographical origin of dentists. This study shows that, especially in high-incidence countries, infection risk perception was higher when dentists tried to provide routine dental procedures to their patients. Dental professionals can offer themselves and their patients good protection by maintaining high standards of hygiene. However, their concerns should be taken seriously and the dental professionals' group that is of great importance for oral health care and prevention, should not be neglected in the future, even in the event of emerging pandemics.
Collapse
Affiliation(s)
- Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro, 07100 Sassari, Italy
| | - Magdalena Marie-Luise Jenni
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Marcela Diaz Betancourt
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Science, University of Milan, 20142 Milan, Italy
| | - Rodrigo A. Giacaman
- Cariology and Gerodontology Units, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca 3460000, Chile
| | - David J. Manton
- Cariology, Centrum voor Tandheelkunde en Mondzorgkunde, Universitair Medisch Centrum Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Gail V. A. Douglas
- Department of Dental Public Health, School of Dentistry, University of Leeds, Leeds LS2 9JT, UK
| | - Joana C. Carvalho
- Faculty of Medicine and Dentistry, UCLouvain, 1200 Brussels, Belgium
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| |
Collapse
|
7
|
Guzmán-Flores EC, Fuentes-Ayala AR, Martínez-Martínez AC, Aguayo-Félix DE, Arellano-Osorio MV, Campuzano-Donoso M, Román-Galeano NM, Llerena-Velásquez M, Vásquez-Tenorio Y. Reduction of aerosol dissemination in a dental area generated by high-speed and scaler ultrasonic devices employing the "Prime Protector". PLoS One 2023; 18:e0278791. [PMID: 37535637 PMCID: PMC10399923 DOI: 10.1371/journal.pone.0278791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/19/2023] [Indexed: 08/05/2023] Open
Abstract
The use of an external dome aerosol containment device (Prime Protector) is proposed to reduce the spread of particles within the dental office. Hence, the aim of our study was to compare the spread of bioaerosols generated by a High-speed Handpiece (HH) and an Ultrasonic Prophylaxis Device (UPD), with and without the Prime Protector dome (PP) by counting Colony Forming Units (CFU) of Lactobacillus casei Shirota, at different distances on the x and y axis. The PP was located considering the parallelism between the base of the dome and the frontal plane of the simulator, aligning the center of the mouth with the center of the dome. The PP dome measurements are 560.0mm x 255.0mm x 5mm. Petri dishes were placed at 0.5 m, 1 m and 1.5 m respectively. Aerosol generation in the laboratory environment was done three times with the following experimental groups 1) HH, 2) HH-PP, 3) UPD, 4) UPD-PP. Each dental device activation (HH and UPD) had a time frame of 2 minutes on the upper anterior teeth of the dental phantom with a liquid suspension containing Lactobacillus casei Shirota (YAKULT 0836A 0123; 1027F 0407). Air pressure and ventilation were parameterized. No separate high-volume evacuation used, nor was there any air removal attached to the dome. Results showed no significant difference between distance and axis in the CFU count. When means for devices and distances were compared between each of them all showed significant differences except for UPD and UPD-PP (p <0,004). In conclusion, external devices like Prime Protector could help decrease aerosol diffusion during high-speed handpiece activation. However, this dome does not replace the use of PPE inside dental clinics.
Collapse
Affiliation(s)
| | | | | | | | | | - Martín Campuzano-Donoso
- School of Dentistry, Faculty of Medical Sciences, International University of Ecuador, Quito, Ecuador
| | | | - Melanie Llerena-Velásquez
- School of Dentistry, Faculty of Medical Sciences, International University of Ecuador, Quito, Ecuador
| | - Yajaira Vásquez-Tenorio
- School of Dentistry, Faculty of Medical Sciences, International University of Ecuador, Quito, Ecuador
| |
Collapse
|
8
|
Weber J, Bonn EL, Auer DL, Kirschneck C, Buchalla W, Scholz KJ, Cieplik F. Preprocedural mouthwashes for infection control in dentistry-an update. Clin Oral Investig 2023:10.1007/s00784-023-04953-z. [PMID: 37079156 PMCID: PMC10116478 DOI: 10.1007/s00784-023-04953-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/17/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dental practice. This review article aims to summarize the clinical (and, if insufficient, preclinical) evidence on preprocedural mouthwashes containing antiseptic agents and to draw conclusions for dental practitioners. METHODS Literature on preprocedural mouthwashes for reduction of bacterial or viral load in dental aerosols was searched and summarized. RESULTS Preprocedural mouthwashes, particularly those containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (EO), can significantly reduce the bacterial load in dental aerosols. With respect to viruses such as HSV-1, there are too little clinical data to draw any clear recommendations. On the other hand, clinical data is consolidating that CPC-containing mouthwashes can temporarily reduce the intraoral viral load and infectivity in SARS-CoV-2 positive individuals. Nevertheless, potential risks and side effects due to regular antiseptic use such as ecological effects or adaptation of bacteria need to be considered. CONCLUSIONS The use of preprocedural mouthwashes containing antiseptics can be recommended according to currently available data, but further studies are needed, particularly on the effects on other viruses besides SARS-CoV-2. When selecting a specific antiseptic, the biggest data basis currently exists for CHX, CPC, EO, or combinations thereof. CLINICAL RELEVANCE Preprocedural mouthwashes containing antiseptics can serve as part of a bundle of measures for protection of dental personnel despite some remaining ambiguities and in view of potential risks and side effects.
Collapse
Affiliation(s)
- Johanna Weber
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany
| | - Eva L Bonn
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - David L Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | | | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| |
Collapse
|
9
|
Coker MO, Subramanian G, Davidow A, Fredericks-Younger J, Gennaro ML, Fine DH, Feldman CA. Impact of DHCWs' Safety Perception on Vaccine Acceptance and Adoption of Risk Mitigation Strategies. JDR Clin Trans Res 2023; 8:188-197. [PMID: 35191352 PMCID: PMC10029133 DOI: 10.1177/23800844211071111] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To estimate the association between safety perception on vaccine acceptance and adoptions of risk mitigation strategies among dental health care workers (DHCWs). METHODS A survey was emailed to DHCWs in the New Jersey area from December 2020 to January 2021. Perceived safety from regular SARS-CoV-2 testing of self, coworkers, and patients and its association with vaccine hesitancy and risk mitigation were ascertained. Risk Mitigation Strategy (RiMS) scores were computed from groupings of office measures: 1) physical distancing (reduced occupancy, traffic flow, donning of masks, minimal room crowding), 2) personal protective equipment (fitted for N95; donning N95 masks; use of face shields; coverings for head, body, and feet), and 3) environmental disinfection (suction, air filtration, ultraviolet, surface wiping). RESULTS SARS-CoV-2 testing of dental professionals, coworkers, and patients were perceived to provide safety at 49%, 55%, and 68%, respectively. While dentists were least likely to feel safe with regular self-testing for SARS-CoV-2 (P < 0.001) as compared with hygienists and assistants, they were more willing than hygienists (P = 0.004; odds ratio, 1.79 [95% CI, 1.21 to 2.66]) and assistants (P < 0.001; odds ratio, 3.32 [95% CI, 1.93 to 5.71]) to receive the vaccine. RiMS scores ranged from 0 to 19 for 467 participants (mean [SD], 10.9 [2.9]). RiMS scores did not significantly differ among groups of DHCWs; however, mean RiMS scores were higher among those who received or planned to receive the COVID-19 vaccine than those with who did not (P = 0.004). DHCWs who felt safer with regular testing had greater RiMS scores than those who did not (11.0 vs. 10.3, P = 0.01). CONCLUSIONS Understanding DHCWs' perception of risk and safety is crucial, as it likely influences attitudes toward testing and implementation of office risk mitigation policies. Clinical studies that correlate risk perception and RiMS with SARS-CoV-2 testing are needed to demonstrate the effectiveness of RiMS in dental care settings. KNOWLEDGE TRANSFER STATEMENT Educators, clinicians, and policy makers can use the results of this study when improving attitudes toward testing and implementation of risk mitigation policies within dental offices, for current and future pandemics.
Collapse
Affiliation(s)
- M O Coker
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - G Subramanian
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - A Davidow
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - J Fredericks-Younger
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - M L Gennaro
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Public Health Research Institute and New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - D H Fine
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - C A Feldman
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
| |
Collapse
|
10
|
Boccia G, Di Spirito F, D’Ambrosio F, De Caro F, Pecora D, Giorgio R, Fortino L, Longanella W, Franci G, Santella B, Amato M. Microbial Air Contamination in a Dental Setting Environment and Ultrasonic Scaling in Periodontally Healthy Subjects: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032710. [PMID: 36768076 PMCID: PMC9916071 DOI: 10.3390/ijerph20032710] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 05/14/2023]
Abstract
The risk of microbial air contamination in a dental setting, especially during aerosol-generating dental procedures (AGDPs), has long been recognized, becoming even more relevant during the COVID-19 pandemic. However, individual pathogens were rarely studied, and microbial loads were measured heterogeneously, often using low-sensitivity methods. Therefore, the present study aimed to assess microbial air contamination in the dental environment, identify the microorganisms involved, and determine their count by active air sampling at the beginning (T0), during (T1), and at the end (T2) of ultrasonic scaling in systemically and periodontally healthy subjects. Air microbial contamination was detected at T0 in all samples, regardless of whether the sample was collected from patients treated first or later; predominantly Gram-positive bacteria, including Staphylococcus and Bacillus spp. and a minority of fungi, were identified. The number of bacterial colonies at T1 was higher, although the species found were similar to that found during the T0 sampling, whereby Gram-positive bacteria, mainly Streptococcus spp., were identified. Air samples collected at T2 showed a decrease in bacterial load compared to the previous sampling. Further research should investigate the levels and patterns of the microbial contamination of air, people, and the environment in dental settings via ultrasonic scaling and other AGDPs and identify the microorganisms involved to perform the procedure- and patient-related risk assessment and provide appropriate recommendations for aerosol infection control.
Collapse
Affiliation(s)
- Giovanni Boccia
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Igiene Ospedaliera, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Largo Città di Ippocrate, 84131 Salerno, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Federica Di Spirito
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco De Caro
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Igiene Ospedaliera, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Largo Città di Ippocrate, 84131 Salerno, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Domenico Pecora
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Riccardo Giorgio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Luigi Fortino
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | | | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Biagio Santella
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
- Correspondence: (B.S.); (M.A.)
| | - Massimo Amato
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
- Correspondence: (B.S.); (M.A.)
| |
Collapse
|
11
|
Salgado-Peralvo ÁO, Fernández-Cerero D, Garcia-Sanchez A, Kewalramani N, Velasco-Ortega E, Jiménez-Guerra Á, Ortiz-García I, Moreno-Muñoz J, Núñez-Márquez E, López-López J, Monsalve-Guil L. State of the Oral Implantology Practice in Spain during the COVID-19 Pandemic: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1743. [PMID: 36767124 PMCID: PMC9914189 DOI: 10.3390/ijerph20031743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
At the beginning of the COVID-19 pandemic, strict measures of confinement and social distancing were taken. Dentists were considered essential personnel and their activity was restricted to emergency treatment. The present observational study aims to determine the situation of oral implantology practice in Spain during the initial period of the COVID-19 pandemic. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of three blocks of questions was sent to all members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 237 participants (14.3%) responded to the questionnaire. The majority of participants (60.8%) only attended emergencies during the first 9 months of the pandemic. Despite this, 77.2% reported having performed dental implant surgeries and 75.5% indicated that they performed non-essential treatments. The activity was fully recovered by 64.1% of the surveyed dentists. The majority of dentists (90.7%) considered that sufficient/adequate preventive measures were carried out at their workplace, which possibly contributed to the fact that 49.3% were not afraid of becoming infected. This concern was significantly and directly proportionally associated with the age of the surveyed dentists. The oral implant practice was affected to a greater extent during the first 9 months of the pandemic, especially in urban areas, with a greater impact on the workload of professionals with less specialised training in oral implantology.
Collapse
Affiliation(s)
- Ángel-Orión Salgado-Peralvo
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Daniel Fernández-Cerero
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Alvaro Garcia-Sanchez
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Naresh Kewalramani
- Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Álvaro Jiménez-Guerra
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Iván Ortiz-García
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Jesús Moreno-Muñoz
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Enrique Núñez-Márquez
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Dentistry, University of Barcelona, 08907 Barcelona, Spain
| | - Loreto Monsalve-Guil
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| |
Collapse
|
12
|
Tsuchiya H. The Oral Cavity Potentially Serving as a Reservoir for SARS-CoV-2 but Not Necessarily Facilitating the Spread of COVID-19 in Dental Practice. Eur J Dent 2022. [DOI: 10.1055/s-0042-1757909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AbstractIntraoral tissues, secretions, and microenvironments may provide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with the conditions necessary for viral cellular entry and inhabitation. The aim of the present study is to overview the oral cavity that potentially serves as a reservoir for SARS-CoV-2, and then discuss the possibility that such oral cavity facilitates the spread of coronavirus disease 2019 (COVID-19) in dental practice. Articles were retrieved from PubMed/Medline, LitCovid, ProQuest, Google Scholar, and preprint medRxiv databases. Results of the literature search indicated that SARS-CoV-2 host cell entry-relevant receptor and virus/cell membrane fusion mediators are expressed in major and minor salivary glands, tongue, taste bud, periodontal tissue, and dental pulp, which would be a target and reservoir for SARS-CoV-2. SARS-CoV-2 is present in saliva and gingival crevicular fluid of COVID-19 patients. These secretions would contaminate dental aerosol and droplet with SARS-CoV-2. SARS-CoV-2 inhabits periodontal pocket, gingival sulcus, and dental caries lesion, which could provide SARS-CoV-2 with a habitat. SARS-CoV-2 ribonucleic acid is preserved in dental calculus, which may inform of the previous infection with SARS-CoV-2. Despite involvement of the oral cavity in SARS-CoV-2 transmission and infection, to date, there have been no clusters of COVID-19 in dental practice. Dental settings are much less likely to facilitate the spread of COVID-19 compared with general medical settings, which may be explained by the situation of dentistry that the number of patients to visit dental offices/clinics was decreased during the COVID-19 pandemic, the characteristics of dentistry that dental professionals have maintained high awareness of viral infection prevention, adhered to a strict protocol for infection control, and been using personal protective equipment for a long time, the experimental results that dental devices generate only small amounts of aerosol responsible for the airborne viral transmission, irrigant from the dental unit contributes to the aerosol microbiota much rather than saliva, and the commonly used evacuation or suction system effectively reduces aerosol and droplet generation, and the possibility that human saliva exhibits the antiviral activity and the property to inhibit SARS-CoV-2 infection. It is considered that dental treatment and oral health care can be delivered safely in the COVID-19 era.
Collapse
Affiliation(s)
- Hironori Tsuchiya
- Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu, Japan
| |
Collapse
|
13
|
Effects of housing environments on COVID-19 transmission and mental health revealed by COVID-19 Participant Experience data from the All of Us Research Program in the USA: a case-control study. BMJ Open 2022. [PMID: 36535714 DOI: 10.1101/2022.04.05.22273358v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES To examine the association between housing types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the large-scale individual-level All of Us Research Program COVID-19 Participant Experience (COPE) survey data. We hypothesise that housing types with a shared component are associated with elevated COVID-19 infection and subsequent mental health conditions. DESIGN A retrospective case-control study. SETTING Secondary analysis of online surveys conducted in the USA. PARTICIPANTS 62 664 participant responses to COPE from May to July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure is the self-reported COVID-19 status, and the secondary outcome measures are anxiety or stress. Both measures were applied for matched cases and controls of the same race, sex, age group and survey version. RESULTS A multiple logistic regression analysis revealed that housing types with a shared component are significantly associated with COVID-19 infection (OR=1.19, 95% CI 1.1 to 1.3; p=2×10-4), anxiety (OR=1.26, 95% CI 1.1 to 1.4; p=1.1×10-6) and stress (OR=1.29, 95% CI 1.2 to 1.4; p=4.3×10-10) as compared with free-standing houses, after adjusting for confounding factors. Further, frequent optional shopping or outing trips, another indicator of the built environment, are also associated with COVID-19 infection (OR=1.36, 95% CI 1.1 to 1.8; p=0.02), but not associated with elevated mental health conditions. Confounding factors are controlled in the analysis such as ethnicity, age, social distancing behaviour and house occupancy. CONCLUSION Our study demonstrates that houses with a shared component tend to have an increased risk of COVID-19 transmission, which consequently leads to high levels of anxiety and stress for their dwellers. The study also suggests the necessity to improve the quality of the built environment such as residential housing and its surroundings through planning, design and management, ensuring a more resilient society that can cope with future pandemics.
Collapse
|
14
|
Luo W, Baldwin E, Jiang AY, Li S, Yang B, Li H. Effects of housing environments on COVID-19 transmission and mental health revealed by COVID-19 Participant Experience data from the All of Us Research Program in the USA: a case-control study. BMJ Open 2022; 12:e063714. [PMID: 36535714 PMCID: PMC9764101 DOI: 10.1136/bmjopen-2022-063714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To examine the association between housing types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the large-scale individual-level All of Us Research Program COVID-19 Participant Experience (COPE) survey data. We hypothesise that housing types with a shared component are associated with elevated COVID-19 infection and subsequent mental health conditions. DESIGN A retrospective case-control study. SETTING Secondary analysis of online surveys conducted in the USA. PARTICIPANTS 62 664 participant responses to COPE from May to July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure is the self-reported COVID-19 status, and the secondary outcome measures are anxiety or stress. Both measures were applied for matched cases and controls of the same race, sex, age group and survey version. RESULTS A multiple logistic regression analysis revealed that housing types with a shared component are significantly associated with COVID-19 infection (OR=1.19, 95% CI 1.1 to 1.3; p=2×10-4), anxiety (OR=1.26, 95% CI 1.1 to 1.4; p=1.1×10-6) and stress (OR=1.29, 95% CI 1.2 to 1.4; p=4.3×10-10) as compared with free-standing houses, after adjusting for confounding factors. Further, frequent optional shopping or outing trips, another indicator of the built environment, are also associated with COVID-19 infection (OR=1.36, 95% CI 1.1 to 1.8; p=0.02), but not associated with elevated mental health conditions. Confounding factors are controlled in the analysis such as ethnicity, age, social distancing behaviour and house occupancy. CONCLUSION Our study demonstrates that houses with a shared component tend to have an increased risk of COVID-19 transmission, which consequently leads to high levels of anxiety and stress for their dwellers. The study also suggests the necessity to improve the quality of the built environment such as residential housing and its surroundings through planning, design and management, ensuring a more resilient society that can cope with future pandemics.
Collapse
Affiliation(s)
- Wenting Luo
- Biosystems Engineering, The University of Arizona, Tucson, Arizona, USA
- Mathematics, The University of Arizona, Tucson, Arizona, USA
| | - Edwin Baldwin
- Biosystems Engineering, The University of Arizona, Tucson, Arizona, USA
| | - Anna Yi Jiang
- Biomedical Engineering, The University of Arizona, Tucson, Arizona, USA
| | - Shujuan Li
- School of Landscape Architecture and Planning, The University of Arizona, Tucson, Arizona, USA
| | - Bo Yang
- School of Landscape Architecture and Planning, The University of Arizona, Tucson, Arizona, USA
| | - Haiquan Li
- Biosystems Engineering, The University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
15
|
Cicek T, van der Tas J, Dodson T, Buchbinder D, Fusetti S, Grant M, Leung YY, Roethlisberger E, Aniceto GS, Schramm A, Strong EB, Mast G, Wolvius E. The Global Impact of COVID-19 on Craniomaxillofacial Surgeons: A Follow-Up Survey After One Year. Craniomaxillofac Trauma Reconstr 2022; 15:350-361. [PMID: 36387316 PMCID: PMC9647383 DOI: 10.1177/19433875211057877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Study Design Comparative cross-sectional. Objective To measure the impact that COrona VIrus Disease-19 (COVID-19) has had on craniomaxillofacial (CMF) surgeons after 1 year and compare it with 2020 data by (1) measuring access to adequate personal protective equipment (PPE), (2) performance of elective surgery, and (3) the vaccination status. This should be investigated because most CMF surgeons felt that hospitals did not provide them with adequate PPE. Methods The investigators surveyed the international AO CMF membership using a 30-item online questionnaire and compared it to a previous study. The primary predictor variable was year of survey administration. Primary outcome variables were availability of adequate personal protective equipment (adequate/inadequate), performance of elective surgery (yes/no), and vaccination status (fully vaccinated/partly vaccinated/not vaccinated). Descriptive and analytic statistics were computed. Binary logistic regression models were created to measure the association between year and PPE availability. Statistical significance level was set at P < .05. Results The sample was composed of 523 surgeons (2% response rate). Most surgeons reported access to adequate PPE (74.6%). The most adequate PPE was offered in Europe (87.8%) with the least offered in Africa (45.5%). Surgeons in 2021 were more likely to report adequate PPE compared to 2020 (OR 3.74, 95% CI [2.59-4.39]). Most of the respondents resumed elective surgery (79.5% vs 13.3% in 2020) and were fully vaccinated (59.1%). Conclusions Most CMF surgeons now have access to adequate PPE, resumed elective surgery, and are either fully or partly vaccinated. Future studies should investigate the long-term impact of the fast-evolving COVID-19 pandemic on CMF surgeons.
Collapse
Affiliation(s)
- Tevfik Cicek
- Department of Oral and
Maxillofacial Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - Justin van der Tas
- Department of Oral and
Maxillofacial Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - Thomas Dodson
- Department of Oral and
Maxillofacial Surgery, School of Dentistry, University of
Washington, Seattle, WA, USA
| | - Daniel Buchbinder
- Department of Otolaryngology, Head
and Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA
| | - Stefano Fusetti
- Department of Maxillofacial
Surgery, Unit, Dept. of Neuroscience, University of Padova Medical
School, Padova, Italy
| | - Michael Grant
- Department of Plastic,
Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of
Medicine, and Johns Hopkins University School of Medicine Baltimore,
MD, USA
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery,
Faculty of Dentistry, The University of Hong
Kong, Hong Kong
| | | | | | - Alexander Schramm
- Department of Oral and Plastic
Maxillofacial Surgery, University and Military Hospital
Ulm, Ulm, Germany
| | | | - Gerson Mast
- Department of Oral and
Maxillofacial Radiology, Clinic for Oral and Craniomaxillofacial Surgery, Ludwig Maximilians University of
Munich (LMU), Munich, Germany
| | - Eppo Wolvius
- Department of Oral and
Maxillofacial Surgery, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
16
|
Bachmann E, Zellmer S, Kahn M, Muzalyova A, Ebigbo A, Al-Nawas B, Ziebart T, Meisgeier A, Traidl-Hoffmann C, Eckstein F, Messmann H, Schlittenbauer T, Römmele C. One year of COVID-19 pandemic: Health care workers' infection rates and economical burden in medical facilities for oral and maxillofacial surgery. J Craniomaxillofac Surg 2022; 50:831-836. [PMID: 36402637 PMCID: PMC9637287 DOI: 10.1016/j.jcms.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 07/26/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to create an overview on the COVID-associated burdens faced by the oral and maxillofacial surgery (OMS) workforce during 1 year of the pandemic. OMS hospitals and private practices nationwide were surveyed regarding health care worker (HCW) screening, infection status, pre-interventional testing, personal protective equipment (PPE), and economic impact. Participants were recruited via the German Society for Oral and Maxillofacial Surgery. A total of 11 hospitals (416 employees) and 55 private practices (744 employees) participated. The HCW infection rate was significantly higher in private practices than in clinics (4.7% vs. 1.4%, p<0.01), although most infections in HCW occurred in private environment (hospitals 88.2%, private practice 66.7%). Pre-interventional testing was performed significantly less for outpatients in private practices than in hospitals (90.7% vs. 36.4%, p<0.01). Polymerase chain reaction (PCR) was used significantly more for inpatients in hospitals than in private practices (100.0% vs. 27.3%, p<0.01). FFP2/3 use rose significantly in hospitals (0% in second quarter vs. 46% in fourth quarter, p<0.05) and private practices (15% in second quarter vs. 38% in fourth quarter, p<0.01). The decrease in procedures (≤50%) was significantly higher in hospitals than in private practices (90.9% vs. 40.0%, p<0.01). Despite higher infection rates in private practices, declining procedures and revenue affected hospitals more. Future COVID-related measures must adjust the infrastructure especially for hospitals to prevent further straining of staff and finances.
Collapse
Affiliation(s)
- Ella Bachmann
- Department of Oral and Maxillofacial Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179, Augsburg, Germany,Corresponding author. Department of Oral and Maxillofacial Surgery, University Hospital Augsburg – Sauerbruchstraße 6, 86179, Augsburg, Germany
| | - Stephan Zellmer
- Department of Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Maria Kahn
- Department of Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Anna Muzalyova
- Department of Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Alanna Ebigbo
- Department of Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Ziebart
- Department of Oral and Maxillofacial Surgery, University Hospital Marburg UKGM GmbH, Marburg, Germany
| | - Axel Meisgeier
- Department of Oral and Maxillofacial Surgery, University Hospital Marburg UKGM GmbH, Marburg, Germany
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Neusäßer Straße 47, 86156, Augsburg, Germany
| | - Fabian Eckstein
- Department of Oral and Maxillofacial Surgery, University Hospital Hannover, Hannover, Germany
| | - Helmut Messmann
- Department of Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Tilo Schlittenbauer
- Department of Oral and Maxillofacial Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179, Augsburg, Germany
| | - Christoph Römmele
- Department of Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| |
Collapse
|
17
|
Al-yaseen W, Jones R, McGregor S, Wade W, Gallagher J, Harris R, Johnson I, KC S, Robertson M, Innes N. Aerosol and splatter generation with rotary handpieces used in restorative and orthodontic dentistry: a systematic review. BDJ Open 2022; 8:26. [PMID: 36068221 PMCID: PMC9447949 DOI: 10.1038/s41405-022-00118-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/04/2022] [Accepted: 07/09/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction The COVID-19 pandemic has caused major disruptions in dental care globally, in part due to the potential for contaminated aerosol to be generated by dental activities. This systematic review assesses the literature for changes in aerosol-contamination levels when rotary instruments are used, (1) as distance increases from patient’s mouth; (2) as time passes after the procedure; and (3) when using different types of handpieces. Methods The review methods and reporting are in line with PRISMA statements. A structured search was conducted over five platforms (September 2021). Studies were assessed independently by two reviewers. To be eligible studies had to assess changes in levels of aerosol contamination over different distances, and time points, with rotary hand instruments. Studies’ methodologies and the sensitivity of the contamination-measurement approaches were evaluated. Results are presented descriptively. Results From 422 papers identified, 23 studies were eligible. All investigated restorative procedures using rotary instruments and one study additionally looked at orthodontic bracket adhesive material removal. The results suggest contamination is significantly reduced over time and distance. However, for almost all studies that investigated these two factors, the sizes of the contaminated particles were not considered, and there were inconclusive findings regarding whether electric-driven handpieces generate lower levels of contaminated particles. Conclusion Aerosol contamination levels reduce as distances, and post-procedure times increase. However, there was sparce and inconsistent evidence on the clearing time and no conclusions could be drawn. High-speed handpieces produce significantly higher levels of contamination than slow-speed ones, and to a lesser extent, micro-motor handpieces. However, when micro-motor handpieces were used with water, the contamination levels rose and were similar to high-speed handpiece contamination levels.
Collapse
|
18
|
Engsomboon N, Pachimsawat P, Thanathornwong B. Comparative Dissemination of Aerosol and Splatter Using Suction Device during Ultrasonic Scaling: A Pilot Study. Dent J (Basel) 2022; 10:dj10080142. [PMID: 36005240 PMCID: PMC9406455 DOI: 10.3390/dj10080142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 02/06/2023] Open
Abstract
Objective: This study compared the aerosol and splatter diameter and count numbers produced by a dental mouth prop with a suction holder device and a saliva ejector during ultrasonic scaling in a clinical setting. Methodology: Fluorescein dye was placed in the dental equipment irrigation reservoirs with a mannequin, and an ultrasonic scaler was employed. The procedures were performed three times per device. The upper and bottom board papers were placed on the laboratory platform. All processes used an ultrasonic scaler to generate aerosol and splatter. A dental mouth prop with a suction holder and a saliva ejector were also tested. Photographic analysis was used to examine the fluorescein samples, followed by image processing in Python and assessment of the diameter and count number. For device comparison, statistics were used with an independent t-test. Result: When using the dental mouth prop with a suction holder, the scaler produced aerosol particles that were maintained on the upper board paper (mean ± SD: 1080 ± 662 µm) compared to on the bottom board paper (1230 ± 1020 µm). When the saliva ejector was used, it was found that the diameter of the aerosol on the upper board paper was 900 ± 580 µm, and the diameter on the bottom board paper was 1000 ± 756 µm. Conclusion: There was a significant difference in the aerosol and splatter particle diameter and count number between the dental mouth prop with a suction holder and saliva ejector (p < 0.05). Furthermore, the results revealed that there was a statistically significant difference between the two groups on the upper and bottom board papers.
Collapse
|
19
|
Air Quality in Dental Care Facilities: Update to Current Management and Control Strategies Implementing New Technologies: A Comprehensive Review. Vaccines (Basel) 2022; 10:vaccines10060847. [PMID: 35746455 PMCID: PMC9227829 DOI: 10.3390/vaccines10060847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/05/2023] Open
Abstract
The quality of indoor air in healthcare facilities, with an emphasis on dental offices, attracted the attention of the scientific community in the late 1960s. Since then, it has become evident that the indoor air quality is critical in modern dental care facilities for limiting the spread of airborne infections, including vaccine-preventable diseases, and a key component of safety for healthcare personnel and patients. In the past decades, the role of indoor air quality has also been recognized in non-healthcare facilities, given the increasing time spent indoors by humans. During the provision of dental care services, mainly in the field of restorative dentistry, high-speed dental handpieces emitting air and water are used, producing large quantities of aerosol and hovering inside the operations area. In modern dental offices, new devices emitting air/powder for cavities improvement and cleaning as well as for periodontal prophylactic cleaning and aesthetics are used. In addition, a new therapeutic protocol for the removal of bacterial biofilm, targeting treatment for peri-implant diseases and conditions using air-abrasive decontamination technology, has been introduced in daily dental practice. The aim of this non-systemic review is to present the current state of knowledge on the nature and dynamics of air splatters and to provide an update to management and control strategies in dental care facilities, focusing on air purification and ultraviolet devices proposed and used. The findings arising from the limited number of related published articles documenting the reduction in levels of particular matter 2.5 (PM2.5), PM10 and volatile organic compounds, allow us to conclude that the continuous operation of air purifiers during and after treatment, contributes considerably to the improvement of the indoor air quality in dental care facilities. Moreover, the utilization of air purifiers is highly recommended in dental practice to mitigate spread of infections, including vaccine-preventable diseases. Frequent cleaning and maintenance of the purifier sieves and filters and frequent renovation of the indoor air through physical ventilation by mean of open windows is imperative. More research on environmental contamination and particularly on viral contamination under real dental care conditions is needed.
Collapse
|
20
|
SARS-CoV-2 IgG Among Dental Workers During the COVID-19 Pandemic. Int Dent J 2022; 72:353-359. [PMID: 35249702 PMCID: PMC8828433 DOI: 10.1016/j.identj.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives Since the SARS-CoV-2 outbreak in 2019, special safety protocols have been introduced in dentistry. Dental professionals were determined to be mostly at risk for contracting the virus due to aerosol-generating procedures used. This preliminary study starts the cycle of the laboratory protocols describing the quality and efficacy of laboratory tests in the SARS-CoV-2 immunoglobulin G (IgG) detection in the serum of asymptomatic dental personnel during the last quarter of 2020. Methods IgG levels were measured with the use of a semi-quantitative enzyme-linked immunosorbent assay (ELISA) in vitro diagnostic kit in the serum of a study group that consisted of 127 employees of the dental clinic divided into 3 subgroups: SUB1: dentists (n = 67); SUB2: dental assistants, dental hygienists, nurses, laboratory workers (n = 40); SUB3: administrative workers (n = 20). Pearson analysis of results from the questionnaires attached to the study protocol were provided to assure that the results compare to the participants’ impressions about their general health. Results Positive ELISA IgG results were found in 6% (n = 4) of the SUB1 group, 7.50% (n =3) of the SUB2 group, and 5% of the SUB3 group. The percentage of participants without work interruption from the beginning of the pandemic was 54% of dentists and 60% of chairside assistants. Conclusions Serum IgG prevalence with the use of a semi-quantitative test was low, and further research on the biobanked samples should follow to determine the levels of IgG with quantitative methods and/or to evaluate the presence of neutralising antibodies in dental personnel. Because of the low representation of seropositivity studies in this group, it will be crucial to confirm the risk of COVID-19 transmission in dental offices.
Collapse
|
21
|
Zellmer S, Bachmann E, Muzalyova A, Ebigbo A, Kahn M, Traidl-Hoffmann C, Frankenberger R, Eckstein FM, Ziebart T, Meisgeier A, Messmann H, Römmele C, Schlittenbauer T. One Year of the COVID-19 Pandemic in Dental Medical Facilities in Germany: A Questionnaire-Based Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:175. [PMID: 35010434 PMCID: PMC8750787 DOI: 10.3390/ijerph19010175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
(1) Background: The COVID-19 pandemic forced healthcare workers to adapt to challenges in both patient care and self-protection. Dental practitioners were confronted with a potentially high possibility of infection transmission due to aerosol-generating procedures. This study aims to present data on healthcare worker (HCW) screening, infection status of HCWs, pre-interventional testing, the use of personal protective equipment (PPE) and the economic impact of the pandemic in dental facilities. (2) Methods: Dental facilities were surveyed nationwide using an online questionnaire. The acquisition of participants took place in cooperation with the German Society for Dentistry, Oral and Maxillofacial Medicine. (3) Results: A total of 1094 private practices participated. Of these, 39.1% treated fewer than 600 patients per quarter and 59.9% treated over 600 patients per quarter. Pre-interventional testing was rarely performed in either small (6.6%) or large practices (6.0%). Large practices had a significantly higher incidence of at least one SARS-CoV-2-positive HCW than small practices (26.2% vs.14.4%, p < 0.01). The main source of infection in small practices was the private environment, and this was even more significant in large practices (81.8% vs. 89.7%, p < 0.01). The procedure count either remained stable (34.0% of small practices vs. 46.2% of large practices) or decreased by up to 50% (52.6% of small practices vs. 44.4% of large practices). Revenue remained stable (24.8% of small practices vs. 34.2% of large practices) or decreased by up to 50% (64.5% of small practices vs. 55.3% of large practices, p = 0.03). Overall, employee numbers remained stable (75.5% of small practices vs. 76.8% of large practices). A vaccination readiness of 60-100% was shown in 60.5% (n = 405) of large practices and 59.9% (n = 251) of small practices. (4) Conclusion: Pre-interventional testing in dental practices should be increased further. Economic challenges affected small practices as well as large practices. Overall, a steady employee count could be maintained. Vaccination readiness is high in dental practices, although with some room for improvement.
Collapse
Affiliation(s)
- Stephan Zellmer
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Ella Bachmann
- Department of Oral and Maxillofacial Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179 Augsburg, Germany;
| | - Anna Muzalyova
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Alanna Ebigbo
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Maria Kahn
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Neusäßer Straße 47, 86156 Augsburg, Germany;
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany;
| | - Fabian M. Eckstein
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, 30625 Hannover, Germany;
| | - Thomas Ziebart
- Department of Oral and Maxillofacial Surgery, Campus Marburg, Philipps University Marburg and University Medical Center Giessen and Marburg, Baldingerstr, 35033 Marburg, Germany; (T.Z.); (A.M.)
| | - Axel Meisgeier
- Department of Oral and Maxillofacial Surgery, Campus Marburg, Philipps University Marburg and University Medical Center Giessen and Marburg, Baldingerstr, 35033 Marburg, Germany; (T.Z.); (A.M.)
| | - Helmut Messmann
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Christoph Römmele
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Tilo Schlittenbauer
- Department of Oral and Maxillofacial Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179 Augsburg, Germany;
| |
Collapse
|
22
|
Abstract
BDJ Open is the open access sister journal to the British Dental Journal, and this paper aims to explore the various different articles that BDJ Open has published between 2019 and 2020, in order to highlight which areas authors felt were important to publish open access. Furthermore, this article will investigate the advantages of open access publishing to both authors and readers, as well as the scientific community in general, and will examine how open access publishing has allowed the BDJ Portfolio to publish a wide range of research, both in terms of topic and geography. Examines papers published in BDJ Open between 2019 and 2020 to highlight which areas researchers felt were important to publish open access. Discusses the advantages of open access publishing to authors, readers and the scientific community. Explores how open access publishing has allowed the BDJ Portfolio to publish a far wider range of research both geographically and subject-wise.
Collapse
|
23
|
Shenoy N, Ballal V, Rani U, Kotian H, Lakshmi V. Assessment of knowledge, attitude and practices among dental practitioners on methods of infection control while carrying out dental procedures during novel coronavirus (COVID-19) pandemic. Pan Afr Med J 2021; 39:265. [PMID: 34707766 PMCID: PMC8520406 DOI: 10.11604/pamj.2021.39.265.29003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction dental procedures produce bio-aerosols that can carry the highly contagious COVID-19 virus. Hence, the entire dental care team has to follow the current COVID-19 related infection control protocols. The study aims to assess the knowledge, attitude, and practices associated with infection control methods during dental procedures among dental practitioners during the COVID-19 pandemic in India. Methods the online questionnaire consisted of four sections namely, demographic details, eight questions on knowledge, four questions on attitude and eight questions on the practice of dentists during COVID-19 pandemic. One point was attributed for a correct response and zero point for an incorrect response. The study used descriptive statistics and binary logistic regression models in Jamovi 1.8.1 to establish relationships between knowledge, attitude, and practices among dental professionals and their demographic characteristics. Results among 384 dentists, 294 (76.6%) were aware of the hand hygiene methods, 372 dentists (96.9%) were aware of the Personal Protective Equipment (PPE), 343 dentists (89.3%) recorded the body temperature of the patients. One hundred and thirty eight (138) dentists (35.9%) did not use rubber dam and 158 dentists (41.1%) were not aware of the four-handed dentistry. Among the study participants, 57.8% displayed adequate knowledge, 63.8% possessed good attitude and 93.5% followed good practices on COVID-19 appropriate infection control measures during dental procedures. The mean knowledge, attitude, and practice scores were found to be 6.61, 2.04, and 3.38 respectively. Based on multivariable binary logistic regression analysis, it is observed that males (aOR: 0.55, 95% CI 0.35-0.87; p=0.011) have a lower likelihood of having a good knowledge when compared with females after adjusting for the other independent variables in the model. Also, individuals with higher qualifications (aOR: 0.57, 95% CI 0.36-0.92; p=0.022) appear to have lower likelihood of having good knowledge on COVID-19 infection control methods during dental procedure. Conclusion the study concludes that participants possess sound knowledge, attitude and practice on hand hygiene, PPE, patient triage and waiting area modifications at the workplace. However, poor response was noted on the use of rubber dam, remote telephonic screening and four-handed dentistry practice.
Collapse
Affiliation(s)
- Neetha Shenoy
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Usha Rani
- Department of Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Himani Kotian
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education Mangalore, Manipal, India
| | - Vani Lakshmi
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
24
|
Dispersion of Aerosols Generated during Dental Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111279. [PMID: 34769795 PMCID: PMC8583477 DOI: 10.3390/ijerph182111279] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/24/2022]
Abstract
The novel coronavirus pandemic has resulted in an urgent need to study the risk of infection from aerosols generated during dental care and to conduct a review of infection controls. However, existing studies on aerosol particles related to dental treatment have mainly evaluated only the scattering range. Few studies have been conducted on the specifics of the generation of aerosol particles in clinical settings, their mechanisms and patterns of distribution throughout open or enclosed spaces, the duration that they remain suspended in air, and the amount and size of particles present. To minimize the influence of background particles, laser lights, a high-sensitivity camera, and particle counters were used in a large super clean laboratory to investigate the dynamics of aerosols generated during the operation of dental micromotors. The results indicate that aerosols tend to scatter upward immediately after generation and then gradually disperse into the surroundings. Most of the particles are less than 5 µm in size (only a few are larger), and all particles are widely distributed over the long term. Our research clearly elucidates that aerosols produced in dental care are distributed over a wide area and remain suspended for a considerable time in dental clinics before settling.
Collapse
|
25
|
The COVID-19 pandemic and its global effects on dental practice. An international survey. J Dent 2021; 114:103749. [PMID: 34280498 PMCID: PMC8285212 DOI: 10.1016/j.jdent.2021.103749] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and Personal Protective Equipment (PPE). Methods A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) Personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) Working conditions and PPE adopted after the outbreak. Countries’ data were grouped by the Country Positive Rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items. Results A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n = 27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR = 1.80 95%CI = 1.60/2.82 and OR = 5.20 95%CI = 1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR = 1.09 95%CI = 0.97/1.60). The same significant associations were observed in the multivariate analysis. Conclusions Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events.
Collapse
|
26
|
Effects of Natural Ventilation and Saliva Standard Ejectors during the COVID-19 Pandemic: A Quantitative Analysis of Aerosol Produced during Dental Procedures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147472. [PMID: 34299930 PMCID: PMC8308059 DOI: 10.3390/ijerph18147472] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 12/19/2022]
Abstract
The novel Coronavirus Disease 2019 (COVID-19) pandemic has renewed attention to aerosol-generating procedures (AGPs). Dental-care workers are at high risk of contamination by SARS-CoV-2. The aim of this study was to evaluate the efficacy of standard saliva ejectors and natural ventilation in reducing particulate matter (PM) concentration during different routine dental procedures in the pandemic period. The DustTrak monitor was used to measure PM1, PM2.5, PM10, and breathable (<4 microns) total dust during 14 procedures performed with and without the presence of natural ventilation in a dental unit. Moreover, measurements were performed near the practitioners or near the standard saliva ejectors during the different procedures. In the latter condition, reduced levels of PM10 were recorded (82.40 ± 9.65 μg/m3 vs. 50.52 ± 0.23 μg/m3). Moreover, higher levels of PM (53.95 ± 2.29 μg/m3 vs. 27.85 ± 0.14 μg/m3) were produced when the dental unit's windows were open. At the same time, the total level of PM were higher during scaling than during other procedures (data suggest not to adopt natural ventilation-both window and door opened-during dental procedures). It was also demonstrated that the use of standard saliva ejectors can considerably reduce the total released amount of PM10.
Collapse
|
27
|
Çelik OE, Cansever İH. Evaluation of the effects of the COVID-19 pandemic on dentistry. Clin Exp Dent Res 2021; 7:943-950. [PMID: 34196128 PMCID: PMC8427031 DOI: 10.1002/cre2.466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 01/01/2023] Open
Abstract
Objectives The aim of this study is to evaluate dentists' working conditions and the policies implemented for dentistry during the COVID‐19 pandemic. In addition, effects of working in private practice or governmental practice in terms of pandemic are also evaluated in the manuscript. Methods A questionnaire was prepared to elicit dentists' working conditions during the pandemic and analyze and evaluate the policies implemented for dentistry. The questionnaires were sent to the dentists registered in the Turkish Dental Association (TDA) via e‐mail, and collected between September 30, 2020, and October 20, 2020. Descriptive statistical methods, validity and reliability analysis, and regression analysis were applied for data analysis. Results Seven hundred thirty‐four dentists registered in the Turkish Dental Association took part in the study. 47% of respondents examined five or fewer patients per day during the pandemic. Dentists working in private practice examine more patients per day during the pandemic. 80.8% of the respondents experienced anxiety while examining patients during the pandemic. While the dentist's anxiety level increased with increasing the number of patients examined per day (β: 0.399), it decreased with increasing the dentist's age (β: −0.065). Respondents were not satisfied with the pandemic's management, with the decisions taken regarding dentistry, and with the supports provided to the dentists. 85.8% of the respondents were concerned about their professional future, which is higher among dentists who work in governmental practice (p < 0.05, ANOVA). Conclusions Increasing dentists' representation in the management of the pandemic and the future policy‐making process, taking steps for the future by creating planning processes will eliminate the uncertainties and dissatisfaction and ensure to be ready for new pandemics.
Collapse
Affiliation(s)
- Osman Evren Çelik
- Department of Oral and Dental Health, Davraz Yaşam Hospital, Isparta, Turkey
| | - İbrahim Hüseyin Cansever
- Faculty of Economics and Administrative Sciences, Department of Health Management, Süleyman Demirel University, Isparta, Turkey
| |
Collapse
|
28
|
Johnson IG, Jones RJ, Gallagher JE, Wade WG, Al-Yaseen W, Robertson M, McGregor S, K C S, Innes N, Harris R. Dental periodontal procedures: a systematic review of contamination (splatter, droplets and aerosol) in relation to COVID-19. BDJ Open 2021; 7:15. [PMID: 33762575 PMCID: PMC7988384 DOI: 10.1038/s41405-021-00070-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/20/2021] [Accepted: 03/01/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The emergence of the SARS-CoV-2 virus and subsequent COVID-19 pandemic has had a significant effect on the delivery of routine dentistry; and in particular, periodontal care across the world. This systematic review examines the literature relating to splatter, droplet settle and aerosol for periodontal procedures and forms part of a wider body of research to understand the risk of contamination in relation to periodontal care procedures relevant to COVID-19. METHODS A search of the literature was carried out using key terms and MeSH words relating to the review questions. Sources included Medline (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS, ClinicalTrials.Gov . Studies meeting inclusion criteria were screened in duplicate and data extraction was carried out using a template. All studies were assessed for methodological quality and sensitivity. Narrative synthesis was undertaken. RESULTS Fifty studies were included in the review with procedures including ultrasonic scaling (n = 44), air polishing (n = 4), prophylaxis (n = 2) and hand scaling (n = 3). Outcomes included bacterial (colony-forming units e.g. on settle plates) or blood contamination (e.g. visible splatter) and non bacterial, non blood (e.g. chemiluminescence or coloured dyes) contamination. All studies found contamination at all sites although the contamination associated with hand scaling was very low. Contamination was identified in all of the studies even where suction was used at baseline. Higher power settings created greater contamination. Distribution of contamination varied in relation to operator position and was found on the operator, patient and assistant with higher levels around the head of the operator and the mouth and chest of the patient. Settle was identified 30 min after treatments had finished but returned to background levels when measured at or after an hour. The evidence was generally low to medium quality and likely to underestimate contamination. CONCLUSION Ultrasonic scaling, air polishing and prophylaxis procedures produce contamination (splatter, droplets and aerosol) in the presence of suction, with a small amount of evidence showing droplets taking between 30 min and 1 h to settle. Consideration should be given to infection control, areas of cleaning particularly around the patient and appropriate personal protective equipment, with particular attention to respiratory, facial and body protection for these procedures. In addition, the use of lower power settings should be considered to reduce the amount and spread of contamination.
Collapse
Affiliation(s)
- Ilona G Johnson
- Cardiff University School of Dentistry, Applied Clinical Research and Public Health, College of Biomedical and Life Sciences, Heath Park, Cardiff, UK.
| | - Rhiannon J Jones
- Cardiff University School of Dentistry, Dental Education, Scholarship & Innovation, College of Biomedical and Life Sciences, Heath Park, Cardiff, UK
| | - Jennifer E Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Denmark Hill Campus, Bessemer Road, London, UK
| | | | - Waraf Al-Yaseen
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, UK
| | - Mark Robertson
- School of Dentistry, Child Dental and Oral Health, University of Dundee, Dundee, UK
| | - Scott McGregor
- Library and Learning Centre, University of Dundee, Dundee, UK
| | - Sukriti K C
- Faculty of Dentistry, Oral & Craniofacial Surgery, King's College London, Centre for Host Microbiome Interactions, Denmark Hill Campus, Bessemer Road, London, UK
| | - Nicola Innes
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, UK
| | - Rebecca Harris
- Department of Public Health, Policy & Systems, University of Liverpool, Room 124, 1st Floor, Block B, Waterhouse Building, Liverpool, UK
| |
Collapse
|
29
|
Impact of COVID-19 pandemic on oral health procedures provided by the Brazilian public health system: COVID-19 and oral health in Brazil. HEALTH POLICY AND TECHNOLOGY 2021; 10:135-142. [PMID: 33585171 PMCID: PMC7864786 DOI: 10.1016/j.hlpt.2021.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective The objective of this study was to assess the number of dental procedures performed in the Brazilian Public Health System (SUS) during the first wave of COVID-19 in Brazil (1st semester of 2020) and compare it with the same period of 2019. Methods A retrospective study was conducted based on the SUS Dataset (DATASUS). Descriptive analysis of the number of dental procedures and socio-demographic regions was presented and the number of dental procedures during the first semester of 2020 was compared to 2019, using Wilcoxon Signed Rank Test (α = 0.05). The number of COVID-19 confirmed cases and deaths were also retrieved from DATASUS. Results Dental procedures decreased from 47 million in the first semester of 2019 to 15 million in 2020, representing an overall decrease of about 66%. Statistically significant differences were observed for the numbers of procedures regarding preventive actions related to oral health (-84.53%; p < 0.001), primary care (-60.69%; p < 0.001), endodontic specialized care (-52.50%; p < 0.001), and periodontal and oral surgery specialized care (-54.57%; p < 0.001). Conclusion The COVID-19 pandemic also reduced by half the number of oral health procedures provided by the SUS in almost all Brazilian states regardless of whether these states had a large number of confirmed cases or deaths. Future policies are recommended in order to reduce the negative impact of the suspension of dental services on the oral health of the population.
Collapse
|