Emergency Management in a Dental Clinic During the Coronavirus Disease 2019 (COVID-19) Epidemic in Beijing

The Response of the Indonesian Dental Community to the COVID-19 Pandemic

OBJECTIVE

The aim of this study was to assess the response of dental health care workers in Indonesia to the COVID-19 pandemic through (1) a countrywide web-based, questionnaire survey of their knowledge, attitude, and infection control (IC) practices during the pandemic and (2) a focus group discussion (FGD) on the latter aspects with infected personnel, as well as (3) archival data collection on the epidemiology of COVID-19 amongst dentists in Indonesia.

METHODS

A questionnaire survey using a web platform was conducted in May 2020 using a simple random sample of 3586 dentists working in different regions of Indonesia. The questionnaire attempted to elicit their knowledge and attitudes towards COVID-19, implementing IC measures, and providing dental care during the outbreak. The questionnaire comprised sections assessing participants' knowledge, awareness, and IC practice. In this study, the data were subjected to analysis through descriptive statistics and one-way analysis of variance (ANOVA) with a predetermined significance level of <.05. The study's second phase involved an FGD with dentists who had contracted the disease to discuss the impediments they faced during dental practice. We collected data on the number of dentists with COVID-19 from May 2020 to March 2022.

RESULTS

The questionnaire survey revealed that the dentists had a satisfactory understanding of COVID-19 spread and the IC measures required to curb disease spread in the dental clinic. Of note, some dentists lacked knowledge of the incubation period of 5 days (21.19%). The vast majority of the respondents (>80%) were aware of the nature of the SARS-CoV-2 virus. Community health centres and the personnel who served there were the most exposed health care providers.

CONCLUSIONS

Results suggest that the vast majority of the dental care professionals in Indonesia had adequate knowledge and awareness of COVID-19. However, some aspects of practice need to be improved in IC and related aspects.

Effects of Chlorhexidine and Povidone-Iodine on the SARS-CoV-2 Load: A Systematic Review and Meta-analysis

The efficacy of mouthwash for reducing the viral load in patients with the novel coronavirus disease 2019 (COVID-19) remains unclear. This systematic review and meta-analysis comprehensively examined the effects of chlorhexidine (CHX) and povidone-iodine (PVP-I) on the viral load in patients with COVID-19. We performed methodological analysis, systematic review, and meta-analysis of included studies using the Comprehensive Meta-analysis Software. PubMed, EMBASE, Cochrane Library, and ProQuest were searched from December 1, 2019, to December 2, 2021. In total, we included 10 studies of 1,339 patients with COVID-19. Compared with the control group, both CHX and PVP-I significantly reduced the number of negative reverse-transcription polymerase chain reaction (RT-PCR) results (p<0.001) among COVID-19 patients. The CHX and PVP-I were effective on reducing the number of negative RT-PCR results in COVID-19 patients. Additional studies using adequate randomization methods and larger samples are warned.

Dentists' Perspective on the Impact of COVID-19 on the Utilization of Emergency Dental Services in Kuwait: A Cross-Sectional Study

This cross-sectional study intends to evaluate dentists' perceptions of COVID-19's effects on the use of emergency dental care both during and after Kuwait's lockdown periods. A convenience sample of dentists employed by the Ministry of Health's various emergency dental clinics and School Oral Health Programs (SOHP) throughout Kuwait's six governorates were invited to take part in this study. To determine the impact of various demographic and occupational characteristics on the mean perception score of the dentist, a multi-variable model was developed. The study was conducted between June-September 2021, and a total of 268 dentists (61% males and 39% females) participated in this study. When compared to pre-lockdown periods, the overall number of patients seen by dentists had significantly decreased after the lockdown period. After lockdown, there were significantly more cases of acute pulpitis with apical periodontitis, abscesses, and pericoronitis than there were before lockdown (p < 0.05). After the lockdown, a significantly higher percentage of dentists (p < 0.05) reported using fewer droplets-generating procedures to manage patients with dental emergencies. After correcting for the other variables in the model, female dentists (β = 0.146; 95% CI = 0.071 to 1.451) and non-Kuwaiti dentist (β = 0.012; 95% CI = 0.234 to 1.854) had a significantly (p < 0.05) more positive perception of the utilization of dental services than others after adjusting for the other variables in the model. The majority of dentists perceive that the COVID-19 pandemic has had a negative impact on Kuwait's use of emergency dental services.

The detection of SARS-CoV-2 RNA in indoor air of dental clinics during the COVID-19 pandemic

In the indoor environment of dental clinics, dental personnel and patients are exposed to a risk of infection because of the transmission of SARS-CoV-2 via particles or droplets. This study investigated the presence of SARS-CoV-2 RNA in indoor air of dental clinics in Tehran, Iran. Air sampling was done (n = 36) collecting particulate samples on PTFE filters at flow rates of 30 to 58 L/min. The samples were analyzed with novel coronavirus nucleic acid diagnostic real-time PCR kits. Only 13 out of 36 samples were positive for SARS-CoV-2 RNA. Logistic regression showed that sampling site's volume, PM_2.5 concentration, number of people, and number of active patient treatment units were significantly positively related with the presence of SARS-CoV-2 RNA. Thus, strategies to control the spread of COVID-19 should include reducing the number of infected people in dental clinics, adding filtration systems, and/or improving ventilation conditions.

The COVID-19 outbreak on dental practice in State of São Paulo, Brazil

Brazil has become the epicenter of coronavirus disease, and the São Paulo State has the worst scenario. This study evaluated the effect of the COVID-19 in dentists of São Paulo State, Brazil. A self-administered web-based survey with 33 multiple-choice questions was sent to dentists. Descriptive statistics were used to assess the 302 valid responses. Data were analyzed by Chi-square, McNemar and Wilcoxon tests (α = 0.05). Most of the participants aged until 34 years (61.6%) and were female (74.5%). They reduced work to less than 20 h per week. Monthly remuneration was reduced (86.8%). Personal protective equipment at the office was changed (p < 0.05). A few dentists (7.6%) had COVID-19, and more than 99% were aware of the disease. Most of the participants (90.2%) were insecure about being contaminated. The dentists of São Paulo State had coronavirus knowledge and have adopted strict biosafety protocols, but the pandemic affected their financial and psychological features.

The impact of the COVID-19 pandemic on the dental-maxillofacial emergency service of a German university hospital in the year 2020

Objectives

COVID-19 is considered one of the most serious pandemic in history and has posed major challenges to the world’s health care. Dentistry and oral and maxillofacial surgery (CMFS) are particularly affected due to direct exposure to the respiratory tract, as the reservoir of SARS-CoV-2. In this study, the impact of the COVID-19-pandemic on a dental and CMFS emergency services in Germany in 2020 was first time investigated and correlated with governmental restriction measures in public life.

Materials and methods

Epidemiological data of a German University Hospital were analysed from a total of 8386 patients in 2019 and 2020. Parameters included information on demographics, time, weekday and reason for presentation, as well as diagnosis and therapy performed. Data from 2020 were compared with those from 2019, taking into account the nationwide periods of public life restrictions.

Results

In 2020, 22% fewer patients presented via dental and CMFS emergency service. In a monthly comparison, there were negative peaks of up to − 41% in November, but also a plus of 26% in July. The largest decreases were recorded during the lockdown periods in spring (− 33%) and winter (− 39%). Further, a threefold increase in actual emergencies and inpatient admissions revealed during these time periods (p < 0.001).

Conclusions

COVID-19 pandemic had a significant impact on the dental and CMFS emergency service in 2020 resulting in more severe cases.

Clinical relevance

This study underlines the importance of maintaining an emergency service system and basic outpatient care in these specialities, which requires uniform recommendations from the medical-dental societies and politics.

A Review of Prolonged Post-COVID-19 Symptoms and Their Implications on Dental Management

The available data regarding the short and long-term consequences of COVID-19 is still insufficient. This narrative review aims to provide information on the prolonged COVID-19 symptoms in recovered patients and their implications during dental management. Additionally, this manuscript highlights the oral manifestations of COVID-19 and its management. A systematic search was conducted in PubMed, Embase, Cochrane Library and Web of Science databases, WHO and CDC websites, and grey literature was searched through Google Scholar. Clinical articles (clinical trials, case-reports, cohort, and cross-sectional studies) were included, reporting prolonged post-COVID-19 symptoms. Although COVID-19 is an infectious disease primarily affecting the lungs, its multi-organ involvement is responsible for several prolonged symptoms, including oral implications. In recovered patients with prolonged COVID-19 symptoms, considerations for providing dental treatment has to be made as they can present with assortment of symptoms. These prolonged post-COVID-19 symptoms can affect the delivery of the required dental treatment. Hence, the recommendations proposed in this narrative review can be a useful starting point to aid dental teams providing adequate care for such recovered patients.

Assessing SARS-CoV-2 Infection Rate among Romanian Dental Practitioners

Due to the impact of the Covid-19 pandemic on dental treatments, the present research aimed to assess the infection rate among dental practitioners from Romania and to analyze the economic impact of Covid-19 on dental offices. We designed a web-based survey distributed to dental practitioners from Romania. The survey included questions that assessed demographic data from the dentists who completed the questionnaire, along with economic aspects and epidemiological aspects related to the impact of the COVID-19 pandemic on dental practitioners. Five hundred and seven dentists completed the survey. Three-quarters of the assessed dental offices reported a decrease in the income and patient volume compared to 2019. More than half of the patients visiting the dental office paid more attention to the risk of infection and to prevention methods. Most dental offices implemented specific protective equipment for doctors. Three thousand seven hundred thirty-five dental practitioners were working in the 507 assessed dental offices, and among them, 238 COVID-19 cases of contamination were recorded. High contamination rates were registered in October (48, 20.1%), November (66, 27.7%), and December 2020 (52, 21.85%). Contamination mostly took place at home (114 cases, 47.8%) or resulted from event attendance. This study underlines an overall greater level of safety and an increased patient addressability in dental offices.

Impact of COVID-19 on Dental Emergency Services in Cluj-Napoca Metropolitan Area: A Cross-Sectional Study

This study aimed to assess dental care needs in Cluj region during the State of Emergency, declared due to the COVID-19 pandemic, compared to the same period of the year 2019. A descriptive retrospective analysis was conducted, which retrieved patients seeking emergency dental services at the Emergency Department of County General Hospital and “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania, the only dental service available in April 2020. Recorded data cover the month of April 2020 and is compared with the same period of 2019. During April 2020, 724 patients received dental care, whereas only 160 patients were treated in April 2019 in the same facility. The number of patients with acute apical periodontitis, abscess, and acute pulpitis was significantly higher in 2020. The percentage of patients receiving sedative filling for the treatment of acute pulpitis in 2020 was significantly higher than in 2019, while the proportion of patients receiving pulpectomy was higher in 2019. The percentage of patients receiving endodontic drainage for the treatment of acute periapical periodontitis in 2020 was higher. This study demonstrates that the COVID-19 pandemic impacted the use of medical care services and could further impact the oral health and quality of life of patients.