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

Distribution characteristics of microbial aerosols and optimization of protective methods during ultrasonic scaling procedure

This study aimed to explore microbial aerosol distribution characteristics in the dental clinic during ultrasonic scaling and evaluate the effects of three different interventions on aerosol distribution and protective effects. For twenty minutes, ultrasonic scaling was carried out in a standardized operatory room. A blank control group and three intervention groups were created: high-volume evacuator (HVE), plasma purification (PP), and fenestrated ventilation (VT). The mass concentration of PM1.0, PM2.5, and PM10.0 aerosol particles was tracked in real time, and colony counts were calculated using air deposition. After ultrasonic scaling, there was a significant increase in aerosol dispersion of various particle sizes and distribution within a 1.5-m radius of the core area (P < 0.05). The number of colonies in each group varied over time at 0.5 and 1.0 m from the patient's head, but there was no significant difference at 1.5 m (P > 0.05). The PP group demonstrated the greatest decrease in aerosol mass concentration difference. The VT group initially had the lowest aerosol mass concentration difference, but with a slight decrease. The aerosol mass concentration difference between the HVE groups grew with distance. Traditional ultrasonic scaling poses a risk of aerosol contamination during and after treatment. The operatory room's air can be efficiently purified by plasma purification, which maintains lower levels of aerosol particle size than other groups. Microbial aerosols created by ultrasonic scaling can be quickly reduced by ventilation. At close range, the high-volume evacuator can lower the risk of infection while the benefit diminishes as the distance increases.Trial registration: This study was registered on the website of China Clinical Trial Registration Center (ChiCTR2400090751) (12/10/2024).

Oral hygiene influence on the incidence and severity of oral manifestations in Coronavirus Disease 2019

INTRO

The aim of this study was to evaluate the incidence, severity, duration of oral manifestations in individuals with Coronavirus Disease 2019 (COVID-19) and the association of these manifestations with the severity of COVID-19 and the patient's oral hygiene.

METHODS

This study included 820 patients with confirmed COVID-19. A questionnaire form including oral hygiene habits, the severity of Covid-19, the presence, severity and durations of oral manifestations was prepared, and a web-based survey was performed using Google-forms. Obtained data was analysed with Pearson chi-square and Fisher's exact tests with statistical significance set at P < 0.05.

RESULTS

The most commonly reported manifestations were taste dysfunction (63.4%), xerostomia (59.9%), halitosis (31.1%), dysphagia (27.8%), hypersensitive teeth (27.2%) and gingival bleeding (14.3%). The incidence of the oral manifestations was found significantly associated with severity of COVID-19 (P = 0.000 V = 0.151), presence of systemic diseases (P = 0.034, V = 0.074) and age (P = 0.023, V = 0.099). Tooth brushing decreased the incidence of aphthous like lesions of tongue during Covid-19 (p < 0.05).

CONCLUSION

Maintenance of oral hygiene was associated with a reduced incidence of aphthous-like lesions, underscoring the protective role of routine oral care. These findings highlight the need to integrate oral health assessment and hygiene education into COVID-19 management protocols, which may also be important for potential future pandemics.

Job stressors and their impact on dental hygienists' job satisfaction and intention to leave practice

BACKGROUND

Job stress and demand were known to contribute to physical and psychological distress, poor job satisfaction, and burnout among dental hygienists prior to the pandemic. Added stress from the COVID-19 pandemic likely influenced these factors. Little research has been conducted to examine the influence of these factors on dental hygienists.

OBJECTIVE

The purpose of this study was to characterize job stressors, physical distress factors, and psychological distress factors for dental hygienists working during the COVID-19 pandemic. It aimed to assess if these factors were directly associated with job satisfaction and intention to leave practice.

METHODS

A survey was distributed through social media to a convenience sample of dental hygienists (n = 397). The survey consisted of the Brief Job Stress Questionnaire, nine demographic questions, and five questions on intention to leave practice.

RESULTS

Quantitative job overload, job suitability, intrinsic reward, poor physical environment, anger, and depression were significant predictors of job satisfaction among dental hygienists working during the COVID-19 pandemic. Burnout, work environment, and physical discomfort were the primary reasons dental hygienists planned to reduce clinical workload or leave the clinical dental hygiene field.

CONCLUSIONS

The findings of this study identified specific stressors, physical, and psychological distress factors dental hygienists reported during the COVID-19 pandemic that influenced their job satisfaction and intention to leave practice. Employers could consider this information to mitigate any concerns, fears, and stress experienced by their employees to promote positive job satisfaction and decrease turnover.

Restorative and endodontic clinical strategies during COVID-19 (SARS-CoV-2) pandemic: a revision of the literature

The aim of this study was to analyze clinical strategies supported by validated references during two of the most frequent dental emergencies (i.e. restorative and endodontic treatment) in the COVID-19 pandemic. Coronavirus disease 2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of an emergency in the health system worldwide and a potentially fatal disease. Person-to-person transmission of SARS-CoV-2 through aerosol and droplets led to extensive preventive measures to contain COVID-19 outbreak. Dental care providers have been exposed to a high risk of SARS-CoV-2 infection, due to the face-to-face communication and the exposure to saliva, blood, and other body fluids during routine interventions; this can also contribute to a high risk for cross-infection, even though dentist usually cope with those situations in everyday practice. Restorative and endodontic emergencies represented a high proportion of dental emergencies, with prolonged exposure time for dentists/endodontists in contact with suspected or confirmed infected patients. Lack of knowledge and undefined progression controlled the decision-making in clinical dentistry. The dynamicity of the situation determined change of views and recommendations in dental setting. The implementation of strict restorative and endodontics protocols are aimed at preventing circumstances similar to those observed with COVID-19.

Accuracy of teledentistry versus clinical oral examination for aged-care home residents: A pilot study

OBJECTIVES

The aim of this pilot study is to assess the feasibility of using the mobile photographic method (m-health) of teledentistry for oral screening and triaging of older patients living in aged care homes.

METHODS

The study took place in 2023 in four aged care facilities in Egypt. Three trained dentists performed clinical oral examinations of the participants and filled in the World Health Organization (WHO) oral health assessment form. Afterwards, five intraoral photographs were taken for each participant and independently examined by three calibrated dentists for caries detection and decision on intervention urgency for proper dental referral. Agreement between the testing modalities was analyzed using Cohen's kappa coefficient, and the significance level was set at p < 0.05 within all tests.

RESULTS

The results indicated that teledentistry had higher specificity than sensitivity in caries detection compared to clinical examination. The level of agreement between the teledentistry examination and the clinical oral examination for caries assessment ranged from (k = 0.36) to (k = 0.58) showing fair to moderate agreement. Also, all teledentistry examiners showed almost perfect statistically significant intra-rater and inter-rater agreement for caries detection (K ≥ 0.82, p < 0.001). Moreover, intervention urgency scoring showed moderate to substantial agreement between the testing modalities with kappa values ranging from (k = 0.48) to (k = 0.65).

CONCLUSIONS

The mobile photographic method of teledentistry offers a feasible model that helps in oral examination and triaging dental treatment of older patients living in aged care facilities. However, larger studies with proper sample size are required which will allow better generalizability of the results.

Sociodemographic factors associated with dental students knowledge and attitudes regarding disinfection as a control measure to reduce the spread of COVID-19

Despite maintaining a lower mortality rate and greater control of victims infected by COVID-19, the world's population and science are still confronted with this coronavirus. Therefore, the aim was to assess the association between sociodemographic factors and the level of knowledge and attitudes of dental students regarding disinfection as a control measure to reduce the spread of COVID-19. This cross-sectional study evaluated 503 dental students from the capital city and one Peruvian province between February and June 2022. A validated 13-item questionnaire was used. A Poisson regression model with robust variance was used to evaluate the influence of the variables sex, age, year of study, marital status, place of origin, death of a family member due to COVID-19, and history of COVID-19, with the level of knowledge and attitudes of the dental students, considering a significance level of p < 0.05. Of the total participants, 14.3% showed sufficient knowledge, and 89.3% showed positive attitudes regarding disinfection as a control measure to reduce the spread of COVID-19. Furthermore, those from the capital city were 52% less likely to have sufficient knowledge regarding disinfection as a control measure to reduce the spread of COVID-19, compared to those from the province (APR = 0.48; 95% CI: 0.31-0.75). Moreover, none of the variables considered in this study were significantly associated with attitudes toward this topic (p > 0.05). A minority of dental students presented sufficient knowledge, while the majority presented positive attitudes regarding disinfection as a control measure to reduce the spread of COVID-19. In addition, being from the capital city was a limiting factor for sufficient knowledge. The variables sex, age, year of study, marital status, place of origin, death of a family member due to COVID-19, and history of COVID-19 were not influential factors for positive attitudes on this topic.

Remote Real-Time Training for Sustainable Cleft Operation in Rural Region of West Africa: Effective Webinar in the COVID-19 Pandemic

INTRODUCTION

The surgical requirement for cleft lip and palate repair remains unmet in many developing areas of the world, including remote regions of Ghana. This article reviews the utilization of Internet education and online consultation for cleft lip and palate surgical training in Sunyani Regional Hospital (SRH), Ghana.

METHODS

The cleft lip and palate treatment was promoted to patients in remote areas of Sunyani, Ghana region, through a charitable outreach program. These basic designs and settings were managed by local participants such as doctors, residents, nurses, and staff in SRH, Ghana.

RESULTS

From November 2014 to December 2020, the authors collaborated in surgical treatment for 84 cases that were diagnosed with unilateral cleft lip, bilateral cleft lip, hard and soft palate cleft, and microstomia. The type of surgery has varied and has included cheiloplasty, palatoplasty, and others. The average scores of esthetic outcome evaluation were nasal form=2.4, symmetry of the nose=2.9, and vermillion border=2.9. Through the program, the surgeons and residents became significantly more proficient at cleft lip and palate surgery. The seminar topics have covered essential and sustainable topics based on SRH's current needs and showed the effectiveness in the current coronavirus disease-19 pandemic situation.

CONCLUSIONS

The shortage of orofacial cleft surgeons working in rural areas like Sunyani, Ghana, remains an obstacle that poses a challenge to any effort to improve health care quality in these rural communities. Sustainable remote education is essential for the training of local cleft surgeons to fill this local need; our collaborative and charitable program could be a recommended education design for cleft surgeons and institutes for their sustainable education.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Exogenous dsRNA-Mediated RNAi: Mechanisms, Applications, Delivery Methods and Challenges in the Induction of Viral Disease Resistance in Plants

The increasing challenges posed by plant viral diseases demand innovative and sustainable management strategies to minimize agricultural losses. Exogenous double-stranded RNA (dsRNA)-mediated RNA interference (RNAi) represents a transformative approach to combat plant viral pathogens without the need for genetic transformation. This review explores the mechanisms underlying dsRNA-induced RNAi, highlighting its ability to silence specific viral genes through small interfering RNAs (siRNAs). Key advancements in dsRNA production, including cost-effective microbial synthesis and in vitro methods, are examined alongside delivery techniques such as spray-induced gene silencing (SIGS) and nanocarrier-based systems. Strategies for enhancing dsRNA stability, including the use of nanomaterials like layered double hydroxide nanosheets and carbon dots, are discussed to address environmental degradation challenges. Practical applications of this technology against various plant viruses and its potential to ensure food security are emphasized. The review also delves into regulatory considerations, risk assessments, and the challenges associated with off-target effects and pathogen resistance. By evaluating both opportunities and limitations, this review underscores the role of exogenous dsRNA as a sustainable solution for achieving viral disease resistance in plants.

Validation of a Questionnaire on COVID-19 Knowledge and Attitude for Dental Patients

Objectives: The current study aimed to develop a valid and reliable questionnaire in both English and Persian to assess dental patients' knowledge and attitude during the COVID-19 outbreak. Materials and Methods: Through a comprehensive literature review, we designed the primary questionnaire in English and then translated it into Persian. The questionnaire consisted of six sections covering background information, knowledge of emergency dental treatments, transmission routes of disease, required preparation, source of information, and attitude. To evaluate the validity of the questionnaire, the researchers obtained expert opinions using the Item Content Validity Index (I-CVI) and Scale Content Validity Index (S-CVI/Ave). They distributed online versions of the questionnaire to a total of 60 English-speaking adults in Nigeria and the United States, and 60 Persian-speaking adults in Iran to measure its reliability using Cronbach's alpha. Results: I-CVI score, S-CVI/Ave, and Cronbach's alpha of the questionnaire ranged from 0.29-1, 0.62-0.99, and 41.1-87.6%, respectively. After reviewing the scores and comments received on each item, taking into account the opinions of the research team, a decision was made to remove, merge, modify, or retain certain items. This led to a final version of the questionnaire consisting of nine questions in the background section and 46 items in the remaining five sections. Conclusion: Overall, the developed questionnaire appears to be valid and reliable for assessing the knowledge and attitude of dental patients toward COVID-19 in dental settings. It can potentially serve as an appropriate scale in future infectious disease epidemics across diverse populations.

Data on the effects of COVID-19 pandemic on the quantity, quality and management of solid wastes in babol hospitals

Medical wastes is about 1-2 % of urban wastes, which is very important in terms of health. The aim of this study is to analyze the effects of the COVID-19 epidemic on the quantity, quality and management of hospital waste data (infectious, general, sharp objects, and chemical wastes) in the two periods before and during the COVID-19 epidemic in Babol hospitals. In this regard, all 6 government hospitals were selected and investigated. Data were collected by the researcher using the standard checklist of the environmental and labor health center of the ministry of health. finally, the obtained data were analyzed using excel. The total solid wastes produced by the studied hospitals before COVID-19 pandemic was 3019.9 kg/day, of which 51.7 % was general wastes, 43.25 % was infectious wastes, 3.11 % was chemical wastes, and 1.93 % was sharp pointed wastes. The total solid wastes produced in 2021 was 3053.2 kg/day, of which 35 % was general wastes, 59.31 % was infectious waste, 3.35 % was dangerous chemical medical waste and 2.3 % was sharp pointed waste. Given the large amount and the danger of infectious wastes in the hospital, careful and continuous monitoring of the management of such waste will be necessary to ensure, maintain and increase the level of health of the personnel, patients and all those referring to hospitals.•This study investigates the impact of the outbreak of COVID-19 on quantity, quality and also it shows the types of medical wastes (infectious, normal, sharp and chemical) in three consecutive years before and after the corona epidemic.•The impact of the spread of COVID-19 on the management of all types of medical wastes has been investigated in this study.•The results of this study can be used to improve the management of wastes production practices in hospitals, medical clinics and other similar centers.

Online Learning in Dental Education: Comparison of Perspectives of Lecturers and Undergraduate Students Between a Public and Private University: A Mixed-Method Study

Objective: This study aimed to assess the undergraduates' and lecturers' perspectives on the implementation of online learning and to compare perspectives between private and public universities. Materials and methods: The study followed a mixed-method design and involved dental undergraduates and lecturers from two study settings in Malaysia: International Medical University (IMU), a private university, and Universiti Teknologi MARA (UiTM), a public university. All undergraduates and lecturers were invited to complete an online questionnaire with evaluative statements regarding three domains: handling, didactic benefit, motivation, and an overall assessment. The comparison of perception between the private and public universities was analyzed using Mann-Whitney test. Focus group discussions (FGDs) were carried out for undergraduates and lecturers. Each FGD consisted of six people. The audio-recorded conversations were transcribed verbatim. Results: Mean scores of perceptions regarding the domains, handling, and motivation were higher among undergraduates from public universities (p  < 0.05), while there were no differences for the didactic domain. There was no difference in perception of any of the three domains between private and public university lecturers. Mean scores for perceptions on the optimal amount of online learning in the future domains were higher among undergraduates from a public university (p  < 0.05), while lecturers' perceptions showed no difference. Thematic analysis of FGDs revealed that both groups from private and public universities felt that flexibility and a student-centered approach are the advantages of online learning. The inadequacy to cover the entire curriculum and lack of student engagement and interaction were highlighted as limitations. Conclusion: Regardless of the university background, the undergraduates and lecturers were able to adjust to the online learning environment, which mainly reflected a positive perspective on the implementation of online learning. There were modest differences in the perceptions of dental undergraduates between private and public universities, while the perception of the lecturers did not show any difference.

Mapping Worldwide Antibiotic Use in Dental Practices: A Scoping Review

Antibiotic resistance is a critical issue today, necessitating the monitoring of antibiotic usage across various sectors. To determine the defined daily doses (DDDs) of antibiotics prescribed by dentists globally, a comprehensive search was conducted in PubMed, ProQuest, ScienceDirect, Web of Science, Scopus, and EBSCOhost, resulting in the inclusion of 15 documents in this scoping review. The DDD per 1000 inhabitants per day (DID) for oral antibiotics prescribed by dentists for the studied countries was generally below 2.11, with the exception of South Korea, which had a DDD per 1000 patients per day (DPD) of less than 6.97. Most countries, except Croatia and Belgium, demonstrated a decreasing trend in DID before the COVID-19 pandemic, but restrictions during the pandemic led to an increase in these numbers. Penicillin-derived antibiotics were the most commonly prescribed antibiotic among dentists in most countries. This study highlights significant gaps and missing data regarding antibiotics prescribed by dentists worldwide. However, it also indicates that the publication of guidelines, education, and evaluation of antibiotic use can lead to more controlled and appropriate prescriptions among dental professionals.

Physical and psychological changes of the COVID-19 infodemic by the older adult population

OBJECTIVE

to analyze the physical and psychological changes of the COVID-19 infodemic for the older adult population of Rio de Janeiro.

METHOD

a cross-sectional, web-based survey to find out about access to news and information about COVID-19 among older adult in Rio de Janeiro, between July and December 2020. Univariate analysis and bivariate analysis were carried out using non-parametric statistical methods.

RESULTS

390 older adults took part, predominantly female (75.1%), aged between 66 and 75 (35.4%), married (51.0%), white (60.3%), owning their own home (81.8%), located in urban areas (91%), with complete or incomplete primary education (31.8%) and retired or pensioners (79.2%). Younger people were significantly affected both physically and psychologically by social networks when compared to television (<0.001).

CONCLUSION

Physical and psychological changes from exposure to information about COVID-19 have affected the lives of the older adult, having an impact on this population.

Are protective measures against Covid-19 still active in orthodontic practices? A cross-sectional online survey of French orthodontists three years on from the pandemic

PURPOSE

The Covid-19 epidemic has imposed profound changes on the practice of orthodontics. It was in this anxiety-inducing context that drastic measures were imposed on orthodontists. The main aim of this online survey is to highlight the measures that are still in place in French orthodontic practices three years after the emergence of the pandemic.

METHODS

A cross-sectional online survey was distributed to French orthodontists from march to June 2023. The questionnaire, consisting of 32 questions, was divided into five sections covering habits before and after the pandemic, and the feelings of professionals.

RESULTS

In this survey 230 complete answers were recorded. Three years later, the daily pace had returned to its pre-crisis level. Disinfection and aeration times were still present (p < 0.001). Orthodontists maintained and generalized the use of protective glasses (p = 0.17) and visors (p < 0.001). The same was true for the FFP2 mask and its frequency of change, as well as rigorous hand washing. Finally, the dedicated layout of the practices was maintained: protective screen, filtration system, supply of SHA, travel paths, removal of magazines (for all, p < 0.001).

CONCLUSION

This study shows that the professional practices imposed by the Covid-19 crisis have been adopted by the majority of French orthodontists, and now appear to be anchored in their routine practice.

TRIAL REGISTRATION NUMBER

opinion n°2023-004, dated 01.25.2023.

Effects of the COVID-19 Pandemic on College Students in Brazil

The implementation of restrictive measures during the pandemic drastically changed the routine and habits of the population. In the academic sphere, the sudden closure of universities difficulted any advance planning. The objective of this study was to verify the effects of the pandemic on the routine, physical and mental health of students at a public university in southern Brazil. This is a cross-sectional study that applied a questionnaire from May to August 2020. The target population comprised 528 undergraduates. The questionnaire addressed questions about sociodemographic characteristics, physical and mental health. A response was obtained from 406 participants. During the quarantine period evaluated, the main results were: 66.2% reported worsening of anxiety symptoms; 57.6% declared that their physical health was "reasonable" to "bad". As for the quality of sleep there was an increase in 98.8% in the responses "bad sleep quality" and "very bad sleep quality"; increase in 26.6% for presence bruxism; 12.5% for orofacial pain, 3.8% for headache. It is concluded that there were several negative effects, among these effects, it was observed higher levels of anxiety, worsening physical health and quality of sleep, increase in the prevalence of bruxism, as well as the presence of orofacial pain and headache.

Factors associated with dental clinic use by clients in Nigeria during the COVID-19 pandemic

BACKGROUND

Nigeria, like many other countries, faced challenges in dental care provision during the COVID-19 pandemic, necessitating limited care to emergencies only. However, the impact of restricted access to dental services on oral health remains a concern, particularly with preventive maintenance care. This study aims to identify the factors associated with dental service utilization during the COVID-19 pandemic among patients attending dental clinics in Nigeria, and their sources of information about COVID-19.

METHODS

This cross-sectional study recruited 500 participants who had visited dental clinics before and during the pandemic. Data were collected through telephone interviews and online questionnaires between September and December 2021. Inferential analyses were conducted using ordered logistic regression models to assess the association between the independent (awareness of emergency dental treatments, knowledge of COVID-19 transmission routes in dentistry, awareness of required preparations in dental practice settings, fear of COVID-19 infection in dental settings), and dependent (utilization of dental services during the pandemic) variables after adjusting for confounding variables (age, sex, educational status, COVID-19 vaccinations status and COVID-19 status of live-in residents). The sources of COVID-19 information by dental patients was also identified. Statistical significance was established at 95% confidence level with a p value < 0.05.

RESULTS

Many participants were males (51.2%) and had tertiary education (61.6%). Fear of COVID-19 infection in dental settings was significantly associated with lower odds of utilizing dental care services during the pandemic (Adjusted Odds Ratio: -0.06, 95% Confidence Interval: -0.08, -0.01). The main sources of COVID-19 information were mass media and social networks, with only 42% receiving information from dental professionals.

CONCLUSION

Fear of COVID-19 infection in dental settings significantly influenced dental service utilization during the pandemic. Strategies to address fear and improve communication channels between dental professionals and patients are essential for promoting oral health during similar crises.

Management of SARS-CoV-2 Prevention Methods in Dental Offices-A Cross-Sectional Study in Bucharest, Romania

We compared the managing of prevention methods for SARS-CoV-2 infections in dental offices before and immediately after the COVID-19 pandemic. The purpose of this study was to find out the varieties of infection prevention methods used by dentists before and during the pandemic and compare them. We designed a digital transversal questionnaire with 15 closed questions that was sent to 150 dentists in Bucharest, Romania. We received n = 112 valid answers during July-August 2021 from dentists of all age groups (25-60 years), with a sex ratio of 0.36, which agreed to anonymously participate in this study. The results showed an increase in types and amount of personal protection equipment (i.e., ocular/facial protection, supplemental gown, and upgrading the FFP1 masks to FFP2 or FFP3). Ocular protection showed statistical significance by gender but not by age group. Vaccination rate against SARS-CoV-2 was at 80% of the participant dentists at the time of the survey and had statistical significance. However, vaccination status of the patients did not alter dentists' protection protocol.

Study on the disinfection effect of chlorine dioxide disinfectant (ClO2) on dental unit waterlines and its in vitro safety evaluation

BACKGROUND

Ensuring the safety of dental unit waterlines (DUWLs) has become a pivotal issue in dental care practices, focusing on the health implications for both patients and healthcare providers. The inherent structure and usage conditions of DUWLs contribute to the risk of biofilm formation and bacterial growth, highlighting the need for effective disinfection solutions.The quest for a disinfection method that is both safe for clinical use and effective against pathogens such as Staphylococcus aureus and Escherichia coli in DUWLs underscores the urgency of this research.

MATERIALS

Chlorine dioxide disinfectants at concentrations of 5, 20, and 80 mg/L were used to treat biofilms of S. aureus and E. coli cultured in DUWLs. The disinfection effectiveness was assessed through bacterial counts and culturing. Simultaneously, human skin fibroblast cells were treated with the disinfectant to observe changes in cell morphology and cytotoxicity. Additionally, the study included corrosion tests on various metals (carbon steel, brass, stainless steel, aluminum, etc.).

RESULTS

Experimental results showed that chlorine dioxide disinfectants at concentrations of 20 mg/L and 80 mg/L significantly reduced the bacterial count of S. aureus and E. coli, indicating effective disinfection. In terms of cytotoxicity, higher concentrations were more harmful to cellular safety, but even at 80 mg/L, the cytotoxicity of chlorine dioxide remained within controllable limits. Corrosion tests revealed that chlorine dioxide disinfectants had a certain corrosive effect on carbon steel and brass, and the degree of corrosion increased with the concentration of the disinfectant.

CONCLUSION

After thorough research, we recommend using chlorine dioxide disinfectant at a concentration of 20 mg/L for significantly reducing bacterial biofilms in dental unit waterlines (DUWLs). This concentration also ensures satisfactory cell safety and metal corrosion resistance.

Global oral health policies and recommendations for children with special health care needs and their applicability and effectiveness during the COVID -19 pandemic: a systematic review

AIM

This systematic review aims to assess effectiveness of oral health policies, recommendations and guidelines in safeguarding oral health of children with special healthcare needs during COVID-19.

BACKGROUND

This systematic review evaluated the adaptation of global oral health policies for children with special healthcare needs (SHCN) during the COVID-19 pandemic, to provide evidence-based insights to inform policymakers and healthcare providers amid the ongoing global health crisis. The study focused on assessing the effectiveness of these adaptations in ensuring equitable access to quality dental care for this vulnerable group.

METHODS

A PRISMA guided online search through LILIACS, PubMed, Scopus, COCHRANE and grey literature was conducted. The search strategy incorporated a combination of subject headings (MeSH terms) and free-text terms related to "oral health," "dental health," "policy," "effectiveness," "dental practice guidelines," "oral health policies," and "special care needs children." Eligibility criteria included oral health policies, recommendations and guidelines targeting individuals/children with special care needs. Both qualitative and quantitative studies published in English from 2008 to 2023 were included.

RESULTS

Sixteen guidelines, recommendations and policies, from six authorities were identified. These documentations addressed six different areas mentioned broadly as comprehensive care, ethical considerations, preventive and therapeutic measures, equity, patient-centric treatment, and reducing disparities signaling a paradigm shift. International collaborations and standardization of guidelines indicated a unified approach. The review also emphasized on a commitment to continuous improvement through quality measurement, systematic referral management, and needs assessment. With the exception of two documents, the remaining guidelines did not address COVID-19 or provide specific adaptations for it. The lack of emphasis on individual condition was notable, as the guidelines generally took a more generalized approach toward individuals with special healthcare needs.

CONCLUSIONS

In conclusion, this review assessed the impact of COVID-19 on oral healthcare for individuals with special needs. It underscores global and local efforts for equitable access, patient-centric care, and preventive measures. The lessons learned advocate for a resilient, inclusive healthcare framework capable of meeting diverse needs.

PROSPERO REGISTRATION

CRD 42023452475.

A Comparative Investigation of Aerosol Generation and Exposure Risk During Access Cavity Preparation With or Without Rubber Dam Application

BACKGROUND

Aerosols generated during dental procedures have taken the forefront of discussion in dentistry. Due to the nature of their work, dental professionals face a significant risk of exposure to various biological hazards, such as saliva, blood, aerosols, and droplets. Aerosols, which are tiny particles with a diameter of less than 50µm, have a unique property that allows them to stay suspended in the air for extended periods. This is primarily due to their small size and lightweight nature which makes them highly susceptible to air currents and prevents them from quickly settling down. As a result, these aerosols can linger in the atmosphere, creating a potential risk for respiratory infections.

AIM

The aim is to evaluate and compare the efficacy of rubber dams in preventing aerosols generated cross-contamination.

METHODS AND MATERIAL

This in-vivo experimental study comprised 60 individuals who were suggested for root canal treatment in the mandibular first permanent molar tooth. The passive air sampling technique using "settle plates" was applied to investigate microbial fallout during access opening with and without rubber dam application. Sheep blood agar plates were used to do the colony forming unit (CFU) count. All patients were randomly divided into two groups comprising 30 patients each based on usage of rubber dam application or not, i.e., Group I: Without rubber dam application and Group II: With rubber dam application.

RESULTS

Using a rubber dam while performing an endodontic procedure significantly impacts decreased aerosol generation at 0.5-m and 2-m distances than its counterpart with a p-value < 0.01.

CONCLUSION

Using a rubber dam during endodontic procedures reduces the likelihood of aerosol generation, thereby decreasing the risk of cross-contamination and lowering the susceptibility of dental professionals to respiratory illnesses.

Evaluation of dental emergency during the COVID-19 pandemic in the Social Rehabilitation Centre of San Francisco Kobén (Campeche, Mexico)

INTRODUCTION

During the COVID-19 pandemic, access to dental treatment by persons deprived of their liberty (PPL) was affected due to dentist-patient proximity and the risk of generation of aerosols in dental procedures and treatments. The risks of infection for oral health personnel are considered high, mainly from cross-infection between patients.

OBJECTIVES

Differentiate between a true and false dental consultation emergency during the SARS-CoV-2 outbreak for a better and effective screening of inmates of the Social Rehabilitation Center (CERESO) of San Francisco Kobén (Campeche, Mexico).

MATERIAL AND METHOD

An observational, cross-sectional, descriptive, and prospective study was designed for a sample of 100 inmates of the CERESO San Francisco Kobén, the data was collected in the prison's dental office, the participants signed a letter of informed consent to be voluntarily included in the study during the SARS-CoV-2 outbreak. The questionnaire "Assessment of a true Dental Emergency" previously validated for the Mexican population was applied, the personnel was standardized and an intra- examiner and inter-examiner reliability of k = 0.98 was obtained. To prepare the database and the analysis of the information collected, the Statistical Package for Social Science v. 21 (SPSS v.21) was used.

RESULTS

When evaluating emergencies at the dental clinic, 84% were determined according to the instrument as a false emergency and 16% were a true emergency.

DISCUSSION

In the population of CERESO of San Francisco Kobén, the figures for medical-dental care show that inmates face a proportionally low dental morbidity-mortality.

Effects of disinfectants on physical properties of denture base resins: A systematic review and meta-analysis

STATEMENT OF PROBLEM

The disinfection of removable dental prostheses and orthodontic appliances is essential to preventing transmission of pathogens. However, whether different disinfection solutions and durations affect the physical properties of denture base resins is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to statistically analyze the influence of disinfectants on the physical properties of denture base resins.

MATERIAL AND METHODS

A systematic search in Medline, Embase, PubMed, and Cochrane Library databases was conducted to evaluate the effects of chemical disinfection on the physical properties of denture base resins such as surface morphology, roughness, hardness, and flexural strength. Of 1909 studies, 44 studies were included in the systematic review and 41 in the meta-analysis. Heterogeneity was analyzed by using I2 statistics. The influence of different disinfection solutions and durations on the physical properties was further analyzed, and the risk of bias evaluated. Statistical analyses were performed by using the RevMan 5.4 software program with the standardized mean differences (SMDs) and 95% confidence intervals (CIs).

RESULTS

Of the 44 included studies, 40 studies were assessed as having a low risk of bias, and 4 had an unclear risk of bias. Meta-analysis results showed that compared with the control, disinfection could not significantly affect surface roughness and hardness within 60 minutes of immersion in disinfectant solutions or flexural strength within 30 minutes (roughness: P=.79, I2=0%; flexural strength: P=.08, I2=0%; hardness: P=.05, I2=19%). In addition, the physical properties were not significantly affected when glutaraldehyde, chlorhexidine, and peracetic acid were repeatedly used for more than 30 minutes.

CONCLUSIONS

Most of the disinfectants did not reduce the physical properties of denture base resin within 30 minutes of immersion. Glutaraldehyde, chlorhexidine, and peracetic acid are recommended if longer immersion or repeated disinfection is required.

Occurrence of COVID-19 in cystic fibrosis patients: a review

Cystic fibrosis (CF) is a genetic ailment caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This autosomal recessive disorder is characterized by diverse pathobiological abnormalities, such as the disorder of CFTR channels in mucosal surfaces, caused by inadequate clearance of mucus and sputum, in addition to the malfunctioning of mucous organs. However, the primary motive of mortality in CF patients is pulmonary failure, which is attributed to the colonization of opportunistic microorganisms, formation of resistant biofilms, and a subsequent decline in lung characteristics. In December 2019, the World Health Organization (WHO) declared the outbreak of the radical coronavirus disease 2019 (COVID-19) as a worldwide public health crisis, which unexpectedly spread not only within China but also globally. Given that the respiration system is the primary target of the COVID-19 virus, it is crucial to investigate the impact of COVID-19 on the pathogenesis and mortality of CF patients, mainly in the context of acute respiratory distress syndrome (ARDS). Therefore, the goal of this review is to comprehensively review the present literature on the relationship between cystic fibrosis, COVID-19 contamination, and development of ARDS. Several investigations performed during the early stages of the virus outbreak have discovered unexpected findings regarding the occurrence and effectiveness of COVID-19 in individuals with CF. Contrary to initial expectancies, the rate of infection and the effectiveness of the virus in CF patients are lower than those in the overall population. This finding may be attributed to different factors, including the presence of thick mucus, social avoidance, using remedies that include azithromycin, the fairly younger age of CF patients, decreased presence of ACE-2 receptors, and the effect of CFTR channel disorder on the replication cycle and infectivity of the virus. However, it is important to notice that certain situations, which include undergoing a transplant, can also doubtlessly boost the susceptibility of CF patients to COVID-19. Furthermore, with an increase in age in CF patients, it is vital to take into account the prevalence of the SARS-CoV-2 virus in this population. Therefore, ordinary surveillance of CF patients is vital to evaluate and save the population from the capability of transmission of the virus given the various factors that contribute to the spread of the SARS-CoV-2 outbreak in this precise organization.

The Relationship between Professional Variables and Burnout Syndrome in Brazilian Dentists during the COVID-19 Pandemic

Burnout syndrome (BS) is a highly prevalent occupational disease among dentists who, during the COVID-19 pandemic, have been at greater risk of contracting the disease, generating stress and distancing. The aim of this study was to assess the association of social conditions, professional factors and perceptions of COVID-19 with Burnout Syndrome. This was a cross-sectional study of 302 Brazilian dentists working in the clinical and private sectors. The professionals completed the Oldenburg Burnout Inventory online and answered sociodemographic and professional questions and questions related to their perception of the pandemic. Poisson regression with unadjusted and adjusted robust variance was used to estimate the association between burnout syndrome (dependent variable) and the independent variables. The presence of BS was strongly associated with age, training in a private institution, professionals who claimed to have sufficient protective knowledge and fear of being contaminated by SARS-CoV-2 during patient care (p < 0.05). The findings of this study show that there has been an impact of the COVID-19 pandemic on the occurrence of Burnout syndrome in dentists, especially, those who worked in the public sector and those who were afraid to work with other health professionals.

Effect of 1% H2O2 on Three Salivary Stress Biomarkers, Cortisol, Alpha-Amylase, and sIgA

BACKGROUND

Due to the COVID-19 pandemic, several associations worldwide have been recommending the use of 1% hydrogen peroxide solution as a preprocedural mouth rinse before dental treatments to reduce viral load in saliva. This protocol is also employed in stress studies, especially in the context of dental treatment that uses salivary biomarkers as an indicator. However, the effect of 1% hydrogen peroxide as mouth rinse on salivary biomarkers remains unclear.

OBJECTIVE

This study aims to investigate the effects of 1% hydrogen peroxide solution as a preprocedural mouth rinse on 3 salivary stress biomarkers-salivary cortisol, salivary secretory IgA, and salivary α-amylase-both on chemical influence and mechanical irrigation.

MATERIALS AND METHODS

Ninety healthy participants with confirmed negative Reverse Transcription Polymerase Chain Reaction results for COVID-19 at most 2 days prior to the experiment were included in this study. All participants were randomly allocated into 3 groups: experimental (1% hydrogen peroxide solution), positive control (distilled water), and negative control (no mouth rinse). Saliva samples were collected before and after mouth rinsing with the respective solutions. Salivary biomarkers were analysed using specific enzyme-linked immunosorbent assay kits.

RESULTS

Salivary cortisol and salivary α-amylase did not significantly differ before and after rinsing, whilst salivary sIgA levels decreased in all 3 groups. Nonetheless, there were no significant differences in the changes of these biomarkers across the 3 groups.

CONCLUSIONS

This study shows that using 1% hydrogen peroxide solution as a preprocedural mouth rinse for universal precaution does not alter the levels of these 3 salivary biomarkers.

The usage of dental cone-beam computed tomography during the COVID-19 pandemic (from 2020 to 2022): A survey of a regional hospital in the northern Taiwan

Background/purpose

In Taiwan, cone-beam computed tomography (CBCT) has already widely used in dentistry. This study explored preliminarily the usage of dental CBCT during the COVID-19 pandemic (from 2020 to 2022) through a survey of a regional hospital in the northern Taiwan.

Materials and methods

This study used purposeful sampling to select a regional hospital in the northern Taiwan to survey its usage of dental CBCT during the COVID-19 pandemic.

Results

In the surveyed hospital, the number of patients' visits for the usage of dental CBCT increased from 355 in 2020 to 449 in 2021 and further to 488 in 2022 with a growth rate of 37.46 %, while the growth rates compared to the previous year were 26.48 % in 2021 and 8.69 % in 2022, respectively. There were a total of 1292 patients' visits for the dental CBCT. The ages of the 1292 patients (573 males and 719 females) ranged from 4 to 89 years. The 50-59-year age group had the highest number of patients' visits (371, 28.72 %), followed in a descending order by the 60-69-year (293, 22.68 %) and 40-49-year (206, 15.94 %) age groups. The dental CBCT was used mainly for the assessment of dental implants, accounting for 1148 (78.85 %) of the total 1456 irradiations.

Conclusion

During the COVID-19 pandemic, the medical services for dental care and treatments in Taiwan are still maintained normally, and the dental CBCT is also used widely and popularly by the dental patients of all ages, various dental procedures, and various dental specialties.

Dental radiographic changes in individuals with COVID-19: a controlled retrospective study

OBJECTIVE

The aim of this study is to compare the pre-COVID-19 and post-COVID-19 dental radiological findings of individuals with positive rRT-PCR test results and with healthy controls using the apical periodontitis grade scale (APGS), radiographic-based periodontal bone loss (R-PBL), and radiographic DMFT indices, and to investigate the relatively long-term dental effects of COVID-19.

METHODS

This study included people who had two panoramic radiographs taken between 2018 and 2022. There are 52 patients with positive rRT-PCR tests in the study group. The control group included 50 individuals. Study and control groups were compared using the apical periodontitis grade scale (APGS), radiographic-based periodontal bone loss (R-PBL), and radiographic DMFT indices.

RESULTS

Although results showed a significant difference in percentage R-PBL value and R-PBL types in the study group, there was no significant difference in percentage R-PBL value and R-PBL types in the control group. Also, both groups showed a significant difference in the DMFT index.

CONCLUSIONS

According to the results of this study, it can be said that COVID-19 increases the incidence of periodontitis, and it can be interpreted that the pandemic may adversely affect the general oral health of all people.

Impact of COVID-19 spread on visit intervals and clinical parameters for patients with periodontitis in supportive periodontal therapy: a retrospective study

PURPOSE

This study investigated the relationship between the number of days that hospital visits were postponed and changes in clinical parameters due to the spread of coronavirus disease 2019 (COVID-19), after the Japanese government declared a state of emergency in April 2020.

METHODS

Regarding the status of postponement of appointments, we analyzed the patients who had visited the Nihon University Hospital at Matsudo for more than 1 year for supportive periodontal therapy (SPT) and classified them into low-, moderate- and high-risk subgroups according to the periodontal risk assessment (PRA). Clinical parameters for periodontal disease such as probing depth (PD), full-mouth bleeding score (FMBS), full-mouth plaque score, periodontal inflamed surface area (PISA), and periodontal epithelial surface area (PESA) were analyzed in 2 periods, from October 2019 to March 2020 and after April 2020. Correlation coefficients between days of deferral and the degree of changes in clinical parameters were calculated.

RESULTS

The mean age of the 749 patients was 67.56±10.85 years, and 63.82% were female. Out of 749 patients, 33.24% deferred their SPT appointments after April 2020. The average total of postponement days was 109.49±88.84. The number of postponement days was positively correlated with changes in average PD (rs=0.474) and PESA (rs=0.443) in the high-risk subgroup of FMBS, and average PD (rs=0.293) and PESA (rs=0.253) in the high-risk subgroup of tooth number (TN). Patients belonging to the high-risk subgroups for both FMBS and TN had a positive correlation between postponement days and PISA (rs=0.56).

CONCLUSIONS

The findings, the spread of COVID-19 appears to have extended the visit interval for some SPT patients. Moreover, longer visit intervals were correlated with the worsening of some clinical parameters for SPT patients with high PRA.

Impact of COVID-19 on emergency oral health care in New Jersey

BACKGROUND

The COVID-19 pandemic led to reduced services of private dental practices. The public emergency clinic of Rutgers School of Dental Medicine (RSDM) (Newark, NJ) faced changing demands during various periods of the pandemic.

METHODS

Records of patients visiting the emergency clinic at RSDM during 3 distinct periods (prelockdown, lockdown, teledentistry) from January 10, 2020, through June 30, 2020, were retrospectively reviewed. Qualitative and quantitative attributes pertaining to patient encounters were reviewed and analyzed.

RESULTS

A total of 1,799 records were included in this study. Patient visits increased during the early lockdown but were reduced after the implementation of teledentistry. Trends were noted in patient volume, reasons for visits, treatment needs, symptoms, diagnostic methodology, prescription use, and final disposition of patients.

CONCLUSIONS

The lockdown affected emergency dental clinic services at RSDM. Teledentistry visits played a key role in screening patients and in facilitating the delivery of oral health care and timely follow-ups to patients who needed urgent in-person emergency visits.

PRACTICAL IMPLICATIONS

Data gathered will lead to a better understanding of patients seen in the emergency clinic and can help with long-term planning for both institutional and smaller outpatient clinics during public health emergencies.

Generalized anxiety disorder in Brazilian undergraduate dental students during the COVID-19 pandemic: A cross-sectional study

OBJECTIVE

Explore the prevalence of generalized anxiety disorder (GAD) and associated factors in undergraduate dental students during the first wave of the COVID-19 pandemic in Brazil.

MATERIALS AND METHODS

Cross-sectional study. A semi-structured questionnaire addressing the variables of interest was shared with dental students between July 8 and 27 2020. The outcome was determined using the seven-item generalized anxiety disorder (GAD-7) scale. A 'positive' diagnosis was defined as a total of ≥10 points on the scale. Statistical analysis involved descriptive, bivariate and multivariate analyses, with the significance level set at 5%.

RESULTS

Among the 1050 students evaluated, 53.8% had a positive diagnosis for GAD. The multivariate analysis revealed that the prevalence of symptoms was higher among individuals who resided with more than three people, those enrolled at teaching institutions that suspended all clinical and laboratory activities, those who did not have an adequate home situation to maintain distance learning, those who had been diagnosed with COVID-19, those who felt anxious about having to see patients with a suspicion or diagnosis of COVID-19 and those who preferred to interrupt in-person academic activities until the population is vaccinated for the COVID-19 virus.

CONCLUSION

The prevalence of GAD was high. Aspects related to the composition and organization of the home, the suspension of academic activities, a history of COVID-19 contamination, feelings of anxiety in providing dental care to patients with symptoms/suspected of COVID-19 infection and the preference to interrupt in-person academic activities until the population is vaccinated for COVID-19 were factors predisposing the students to anxiety during the first wave of the pandemic.

Effects of self-efficacy on the intention to take preventive actions against infectious diseases: Focusing on dental hygiene students in South Korea

OBJECTIVE

This study aimed to determine the impact of self-efficacy on the intention to take preventive actions against infectious diseases, focusing on dental hygiene students during the COVID-19 pandemic.

METHODS

A survey was conducted through a questionnaire distributed to 300 dental hygiene students at the Department of Dental Hygiene, Gangneung Yeongdong College in South Korea. In total, 251 students completed the survey (response rate: 83.6%). The survey data were analysed via exploratory and confirmatory factor analyses, path analysis and structural equation modelling.

RESULTS

The analysis showed that self-efficacy positively affected students' intentions to take preventive actions against infectious diseases.

CONCLUSIONS

This study confirmed that self-efficacy positively affected dental hygiene students' intentions for preventive actions against infections. Furthermore, it suggested that self-efficacy should be classified into psychological (confidence and judgement) and behavioural (drive and task challenge) categories, and a systematic survey to formalize the concept of self-efficacy should be developed. The results of this study should enable a better understanding of the impact of self-efficacy on the intention to take preventive actions against infectious diseases.

Aerosol-generating procedures and associated control/mitigation measures: Position paper from the Canadian Dental Hygienists Association and the American Dental Hygienists' Association

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.

Bibliometric analysis and visualization of top papers in dentistry from 2012 to 2022 based on essential science indicators

OBJECTIVES

This study aims to analyze and visualize the top dental papers from 2012 to 2022 using data from essential science indicators (ESIs).

MATERIALS AND METHODS

The present study was conducted using library and retrospective bibliometric analysis methods. Additionally, a science map has been created. Web of Science was searched on January 18, 2023. The results were limited to the top papers in ESIs. The bibliometric information of the top papers was evaluated. Next, the VOSviewer was used to perform a co-occurrence analysis and visualize data.

RESULTS

The findings showed that Mariano Belén Sanz and Maurizio S. Tonetti were the top two authors. The University of London and the University of Bern had the highest number of articles. These articles were published in 55 journals. According to the analysis of keyword co-occurrence, the most frequently used keywords in the field of dentistry include "periodontitis," "dental implants," "periodontal disease," "mechanical properties," "peri-implantitis," "oral health," "dental caries," "dental materials," "3D printing."

CONCLUSION

The findings of this study enable readers to pinpoint the authors, organizations, countries, and journals that have made the biggest contributions to the list of the most often cited dentistry papers. In medicine, bibliometric citation analysis is frequently used to assist researchers in learning the fundamentals of a subject and pinpoint subtopics of broad interest for additional study.

Visualization of droplets and aerosols in simulated dental treatments to clarify the effectiveness of oral suction devices

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.

A Comparison of the Effects of Chlorhexidine and Sodium Bicarbonate Mouthwashes on COVID-19-Related Symptoms

BACKGROUND

Some studies have reported that mouthwashes can decrease the viral load in the mouth, but there is not much information about the effectiveness of mouthwashes on coronavirus disease 2019 (COVID-19). This study was conducted to compare the impact of using two types of mouthwash, chlorhexidine and sodium bicarbonate, on COVID-19 symptoms and infection.

MATERIALS AND METHODS

The present three-group, double-blind clinical trial examined 116 operating room nurses and anesthesia personnel of certain hospitals of Isfahan University of Medical Sciences, Isfahan, Iran. The participants were randomly assigned to three groups: intervention group 1 (chlorhexidine mouthwash), intervention group 2 (sodium bicarbonate mouthwash), and the control group (placebo). Mouthwash was used twice a day (morning and night) for 2 weeks. The participants were monitored in terms of COVID-19-related symptoms for 4 weeks, from the first day of mouthwash use.

RESULTS

Fisher's exact test indicated a significant difference between the chlorhexidine and control groups in terms of the onset of COVID-19-related symptoms (p = 0.02). There was no significant difference in the symptoms of COVID-19 between the groups, but the groups were significantly different in terms of all symptoms at a 4-week interval (p = 0.04). Furthermore, headache was less observed in the chlorhexidine (p = 0.007) and sodium bicarbonate (p = 0.03) groups compared to the control group.

CONCLUSIONS

The use of 0.2% chlorhexidine mouthwash can decrease the onset of COVID-19-related symptoms in health-care workers. In addition, this mouthwash can partially reduce the symptoms of this disease in comparison to the control and sodium bicarbonate groups.

Face-to-face and e-learning during the COVID-19 pandemic: A Pakistani dental undergraduates perspective

BACKGROUND

Globally, educational institutes have been obliged to make a quick transition from traditional face-to-face teaching to e-learning during the coronavirus disease 2019 (COVID-19) pandemic, which has purportedly created various barriers to achieving desired learning outcomes.

OBJECTIVE

The aim of our study was to assess the perceptions of undergraduate dental students regarding online and physical learning in Pakistan.

METHODS

This cross-sectional study was conducted from January to March 2022. The study comprised dental students from 1st to 4th years who were above the age of 18 and of either gender. The Google Forms questionnaire was created to evaluate the quality and efficiency of online and physical learning among dentistry undergraduates.

RESULTS

In a survey of 246 students, 70.3% strongly agreed that they would prefer face-to-face instruction over e-learning. There was a statistically significant difference in the improvement of students' technical skills (p = 0.01), accessibility to instructors (p = 0.01) and classmates (p = 0.02), value of technology (p = 0.03), improvement of oral communication skills (p = 0.01), promotion of hybrid model learning after the pandemic (p = 0.01), and utilization of tutorial services (p = 0.04) between different year of study.

CONCLUSION

Pakistani dental students indicated satisfaction with numerous aspects of e-learning, such as technical skills, accessibility to instructors and classmates, the value of technology, improvement of oral communication skills, promotion of hybrid model learning, and utilization of tutorial services compared to face-to-face education concerning the year of study.

Dentists' Perceptions of Personal Infection Control Measurements in Response to COVID-19

OBJECTIVE

To explore through focus groups (FGs) the perceptions of dental practitioners (DPs) from different countries of the challenges of implementing coronavirus disease 2019 (COVID-19) related biosafety measures, especially personal protection equipment (PPE), during the COVID-19 pandemic period.

METHODS

DPs from Colombia, Germany, the United Kingdom, and the United States were invited to participate in country-based FGs. These were facilitated by an experienced moderator who explored the factors that guided the implementation of COVID-19 related biosafety measures and PPE use. Data were analyzed through thematic analysis on the basis of categories defined by the researchers deductively and inductively.

RESULTS

A total of 25 DPs participated in 3 FGs (Colombia:n = 8; United Kingdom: n = 7; United States: n = 9) and 1 in an in-depth interview (Germany). DPs described using several processes to judge which guidance document to adopt and which aspects of the guidance were important in their practice. These included making judgments concerning the views of any indemnity organization to which the DPs were responsible, the staff's views in the practice, and the views of patients. In the absence of a single overarching guidance document, DPs filtered the available information through several considerations to find a level of PPE that they deemed "implementable" in local practice.

CONCLUSIONS

The findings suggest that the implementation of evidence-based practice is subject to modification through a lens of what is "feasible" in practice.

KNOWLEDGE TRANSFER STATEMENT

Clinicians, educators, and policy makers can use the results of this study to understand the process through which guidance is transformed into implementable patient care pathways in the dental practice.

Assessment of infection control in oral radiology during the COVID-19 outbreak: An international collaborative study

PURPOSE

In the context of COVID-19, studies evaluating the adherence of dentists and dental students to infection control are relevant due to their high occupational exposure and risk, as well as their responsibility for disseminating information and good practices. This study evaluated the adherence of dentists and dental students to infection control in the oral radiology field in the setting of the COVID-19 pandemic on different continents.

MATERIALS AND METHODS

This cross-sectional observational study involved individuals who performed intraoral radiographic examinations during the COVID-19 pandemic. The Questionnaire on Infection Control in Oral Radiology was administered virtually using a Google Form. Participants from different continents (the Americas, Africa, Europe, Asia, and Oceania) were recruited. Data were subjected to descriptive analysis and simple and multiple binary regression (5%).

RESULTS

There were 582 valid answers, and 68.73% of the participants were from the Americas, 18.90% from Europe, and 12.37% from Asia. The median score for infection control protocols was 94 points for dental students and 104 points for dentists, and participants below the median were considered to have low adherence to infection control in oral radiology. Low access to infection control was found for 53.0% of dentists in the Americas, 34.0% from Europe, and 26.9% from Asia.

CONCLUSION

The adherence to infection control protocols in oral radiology was low even in the face of the COVID-19 pandemic. The results may help improve the awareness of students and professionals, since oral radiology routines have the potential for transmitting COVID-19.

Effect of a Total Extract and Saponins from Astragalus glycyphyllos L. on Human Coronavirus Replication In Vitro

Members of the family Coronaviridae cause diseases in mammals, birds, and wildlife (bats), some of which may be transmissible to humans or specific to humans. In the human population, they can cause a wide range of diseases, mainly affecting the respiratory and digestive systems. In the scientific databases, there are huge numbers of research articles about the antiviral, antifungal, antibacterial, antiviral, and anthelmintic activities of medicinal herbs and crops with different ethnobotanical backgrounds. The subject of our research is the antiviral effect of isolated saponins, a purified saponin mixture, and a methanol extract of Astragalus glycyphyllos L. In the studies conducted for the cytotoxic effect of the substances, CC50 (cytotoxic concentration 50) and MTC (maximum tolerable concentration) were determined by the colorimetric method (MTT assay). The virus was cultured in the MDBK cell line. As a result of the experiments carried out on the influence of substances on viral replication (using MTT-based colorimetric assay for detection of human Coronavirus replication inhibition), it was found that the extract and the purified saponin mixture inhibited 100% viral replication. The calculated selective indices are about 13 and 18, respectively. The obtained results make them promising for a preparation with anti-Coronavirus action.

Dental unit waterline testing practices: an 11-Year retrospective study

OBJECTIVES

This retrospective study examined the dental unit waterline (DUWL) testing practices of Saskatchewan dental clinics over a period of 11 years, with an emphasis on their responses after identification of high microbial levels.

MATERIALS AND METHODS

Dental clinics (n = 137) aseptically collected samples of output water from their air/water syringes, handpieces, and ultrasonic scaler lines using Sigma-Aldrich® waterline test kits and delivered them to a quality assurance laboratory. Tests were incubated for seven days at room temperature, and those with heterotrophic plate counts > 500 CFU/mL were reported as failures. Statistical analyses were performed on a database containing 4,093 test results.

RESULTS

Participating clinics submitted an average of 11 DUWL tests per year. Overall, 21% of tests failed, and a moderate positive association (rs=.52, p < 0.001) was found between clinics' DUWL testing frequency and failure rate. Only 7% of failed DUWL tests were followed up by collection of a subsequent test within two weeks, of which 47% still exceeded the 500 CFU/mL threshold.

CONCLUSIONS

Our findings demonstrate an association between DUWL testing frequency and detection of unacceptable microbial levels, along with infrequent retesting and often-inadequate intervention after a failed test. This suggests the need for further efforts at the regulatory and educational levels to maintain adequate water quality during dental treatment.

CLINICAL RELEVANCE

Procedural water can become contaminated in DUWLs and endanger patients. Regular DUWL monitoring and evidence-based interventions to treat contaminated systems are necessary to safeguard patient health.

COVID-19 and changes in dental practices in the Brazilian Public Health System: perception of the oral health team

The aim of this study was to verify the perception of the oral health team regarding work safety and aspects related to changes in dental practices during the COVID-19 pandemic. A descriptive, exploratory, quantitative, and qualitative cross-sectional study was conducted using an electronic questionnaire sent via email to health professionals (n = 197) affiliated with the Brazilian Public Health System (SUS), from December 2020 to September 2021, in a municipality located in the northeast of the state of São Paulo, Brazil. The variables of interest were sociodemographic characteristics and those related to the professionals' perception of oral health care during the pandemic and its impact on these workers' occupational safety. Descriptive statistics were performed, and the absolute and relative frequencies of quantitative variables were calculated, whereas lexical analysis was performed for textual content using the descending hierarchical classification (CHD). Out of the total sample, elective and urgent/emergency care was provided by 58.95% (n = 56); physical barriers were absent between the teams in 54.74% (n = 52); minimally invasive techniques were applied in 71.58% (n = 68); personal protective equipment (PPE) was replaced in 81.05% (n = 77) between appointments; and occupational safety was reported by 49.47% (n = 47). Textual analysis showed a decrease in appointments and consultations, with a longer interval between appointments. The professionals noticed changes in dental practices during the pandemic, mainly regarding the use of PPE, the type of treatment performed, the number of treated patients, and the greater time interval between consultations. The physical infrastructure of health units and the availability of PPE to patients needed some adjustments. A significant number of workers felt safe in providing dental care during the pandemic.

Impact of COVID-19 Dentistry-Related Literature: An Altmetric Study

INTRODUCTION

Scientific literature on COVID-19 has grown rapidly during the pandemic. The aim of this study was to provide a comprehensive overview of the popularity on the web of the available dental publications on COVID-19 and to examine associations amongst article characteristics, online mentions, and citations.

MATERIALS AND METHODS

An Altmetric Explorer search was conducted for COVID-19 articles published in dental journals using 3 keywords: COVID-19, SARS-CoV-2, and pandemic. The following Altmetric data were collected: Altmetric attention score (AAS), mentions by news outlets, tweets, Mendeley readers, and Web of Science citations. Additionally, article title, type, topic, origin and open access status, journal title, quartile of impact factor (IF) distribution, and time lapse between COVID-19 pandemic onset and publication date were analysed.

RESULTS

In all, 253 articles published in 48 dental journals were eligible for the study. AAS was significantly influenced by article topic, type, origin, and journal IF quartile. There was a negligible correlation between AAS and Web of Science citations. Mendeley was the only Altmetric source highly correlated with citations.

CONCLUSIONS

There was substantial online interest in COVID-19 dentistry-related literature, as depicted by the AAS of the reviewed articles and social media metrics. Mendeley reader counts were highly correlated with citations, and they may therefore be valuable in research impact evaluation.

Effectiveness of interventions to reduce aerosol generation in dental environments: A systematic review

Certain dental procedures produce high levels of aerosols containing pathogenic microorganisms, posing a risk for the transmission of infections in dental settings. This study aimed to assess the effectiveness of various aerosol mitigation interventions during clinical dental procedures in real-world environments. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Embase for English studies up to March 2023 according to the PRISMA guidelines. Only peer-reviewed controlled clinical trials (CCT) or randomized controlled trials (RCT) studies involving human subjects were included. The risk of bias of selected researches were evaluated by two independent authors using the Cochrane Collaboration tool. The literature search yielded 3491 articles, of which 42 studies met the inclusion criteria and were included in this study. Most studies evaluated bacterial contamination in bio-aerosols, while the viral and fungal contamination was assessed in only three studies. Overall, various approaches have been applied in reducing aerosol contamination in clinical scenarios, including high-volume evacuators (HVE), mouse rinses and rubber dams, air cleaning systems, and high-efficiency particulate air (HEPA) filters. The available evidence suggests that various aerosol mitigation strategies could be implemented to decrease the risk of cross-infection during clinical dental procedures in real-world environments. However, further clinical trials are necessary to establish statistical validity in measuring aerosol contamination and mitigation, as well as to evaluate the risk of infection transmission for viral and fungal contamination.

A systematic review of dentists' psychological wellbeing during the COVID-19 pandemic

Background The COVID-19 pandemic presented significant challenges to healthcare workers worldwide, including the effect on the psychological wellbeing of dentists.Aims To evaluate the impact of the early phases of the pandemic on the psychological health, long-term wellbeing and clinical service provision of dentists, as well as the identification of the key risk and protective factors for adverse mental health outcomes (MHOs) in this group.Methods A systematic review of cross-sectional studies (n = 53) from public and private dentistry sectors was employed to delineate the risk and protective factors for adverse MHOs.Results Self-reports from these studies (1 December 2019 to 31 December 2021), involving 45,671 dentists worldwide were analysed. Study findings were classified according to their psychological impact (as risk or protective factors), categorised as 'operational' or 'organisational' and subdivided into 'psychosocial', 'occupational', 'sociodemographic' and 'environmental' elements. A GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) certainty of evidence score was calculated for all the identified factors.Conclusions This review confirmed the negative impact of the pandemic on the MHOs of dentists worldwide. Pivotal risk factors included fear of infection, transmission to families, lack of personal protective equipment and possible direct contact with infected patients. Enhanced infection control protocols, individual resilience and organisational support were identified as important protective factors.

PM, Sundareswaran S, Parayaruthottam P, Jisha B. Orthodontic urgencies and their management during COVID-19 pandemic-A web-based survey

OBJECTIVES

This investigation aimed to evaluate the most common orthodontic urgencies, their management, and changes in routine biosafety measures and the total income of the dental office in South India during the COVID-19 pandemic.

METHODS

A questionnaire was drafted using Google Forms with questions in four domains pertaining to orthodontic urgencies, biosafety measures, treatment duration, and income. After validation, this questionnairewas sent to 750 orthodontists via WhatsApp messenger (WhatsApp Inc, Menlo Park, Calif) over a period of 14 days.Descriptive statistics and comparisons were performed using independent t- and Chi-square tests.

RESULTS

Majority of the orthodontists (62.3%) had closed their clinics only during the first lockdown. Many (63%) had scheduled urgent appointments along with routine limited patients per day. The most frequent urgencies were related to the breakage of brackets, archwires, molar tubes, bands, and temporary anchorage devices. Aligners were the least problematic. The treatment time was also prolonged. Telephonic advice and virtual assistance via WhatsApp messages/videos were found to be successful in the management of urgencies.Most orthodontists had strengthened their routine biosafety measures.The financial impact of this pandemic was considerable, with nearly 50% reduction in total income.

CONCLUSIONS

Urgencies linked to preadjusted edgewise appliances, such as breakage of brackets and tubes, and archwire-related injuries were the most common. Prolongation of treatment time and negative financial impact were the other problems encountered during this pandemic. Drastic changes had occurred in routine biosafety measures, which prevented the spread of infection among orthodontists and patients.

Particle generation and dispersion from high-speed dental drilling

OBJECTIVE

To investigate the characteristics of particle generation and dispersion during dental procedure using digital inline holography (DIH) METHODS: Particles at two locations, near-field and far-field, which represent the field closer to the procedure location and within 0.5 m from the procedure location respectively, are studied using two different DIH systems. The effect of three parameters namely rotational speed, coolant flow rate, and bur angle on particle generation and dispersion are evaluated by using 10 different operating conditions. The particle characteristics at different operating conditions are estimated from the holograms using machine learning-based analysis.

RESULTS

The particle concentration decreased by at least two orders of magnitude between the near-field and far-field locations across the 10 different operating conditions, indicating significant dispersion of the particles. High rotational speed is found to produce a larger number of smaller particles, while lower rotational speeds generate larger particles. Coolant flow rate is found to have a greater impact on particle transport to the far-field location. Irregular shape dental particles account for 29% of total particles at far-field location, with the majority of these irregular shape particles having diameters ranging from 12 to 18 μm.

CONCLUSIONS

All three parameters have significant effects on particle generation and dispersion, with rotational speed having a more significant influence on particle generation at near-field and coolant flow rate playing a more important role on particle transport to the far-field.

CLINICAL RELEVANCE

This study provides valuable insights on particle characteristics during high-speed drilling. It can help dental professionals minimize exposure risks for themselves and patients by optimizing clinical operating conditions.

Novel Coronavirus (COVID-19) Knowledge, Attitude, and Practice among Dental Sciences and Internship Students in Ajman University, United Arab Emirates: A Cross-Sectional Study

Background

The aim of this study was to assess the COVID-19-related knowledge, attitudes, and practice among dental students (DS) and internship students at Ajman University (AU).

Methods

A cross-sectional, web-based study was conducted among Ajman dental college students registered in the academic year 2019/2020, about COVID-19 during the first week of April 2020. A questionnaire was developed and distributed to all DS to examine their knowledge and attitudes toward the COVID-19 pandemic. Chi-square (χ²) test was used to investigate the level of association among categorical variables at the significance level of p < 0.05.

Results

Out of 769 students in the dental college, majority (75%) had adequate knowledge of COVID-19, but only 40.6% of the participants projected a positive attitude. A positive behavior was reported by an overwhelming 94.5% of the participants. Participants above 25 years of age had significantly higher (p < 0.001) adequate knowledge (88.2%), positive attitude (56.9%), and positive behavior (100%) compared to those below 25 years of age. Study participants reported social media (71.1%), government websites (63.7%), and family and friends (41.0%) as top three sources of information regarding COVID-19 related information.

Conclusion

The results of this study show that AU dental and internship students have adequate knowledge and positive attitude of the COVID-19 pandemic but the majority are not eager to adopt effective strategies to avoid the spread of COVID-19 (practice). Further education should be offered to encourage efficient infection management practices to protect students, faculty, and other university staff.

Management Protocols of the Hot Tooth-A KAP Survey among General Dentists and Endodontists

Aim

Pain management is a cornerstone in the practice of endodontics. However, optimum pain control has been a challenge in cases of symptomatic irreversible pulpitis resulting in a "hot tooth." Thus, the objective of the study is to assess the knowledge and attitude and to determine the clinical protocols of "hot tooth" management followed among general practitioners and specialists.

Materials and Methods

The KAP questionnaire contained 05 knowledge, 04 attitudes, and 06 practice-related items. The questionnaire was pretested among 10 randomly selected general dentists and endodontists. Testing-retesting was also performed. The questionnaire was self-administered and the acceptance to answer the questionnaire was considered consent to participate in the study. The sample size was calculated to be 200 with a 95% level of confidence. Descriptive statistics were used. For significance level, P < 0.05 was considered statistically significant. The Chi-square test was used for comparison between the endodontists and the general dentists.

Results

The anesthetic techniques that clinicians are most skilled in are infiltration and inferior alveolar nerve block (IANB) - 96.6% and 98.5% respectively. The intraosseous technique (IO) was the least preferred technique (6.8%). The most common supplementary injection used among both the BDS and MDS graduates was intrapulpal anesthesia. In cases of acute pulpitis, 54% of the respondents prescribed NSAIDs as a pre-anesthetic medication.

Conclusion

The current study shows that supplemental injections like intraosseous and intraligamental techniques are underutilized. Also, the benefits of preanesthetic medication for hot tooth management are not harnessed among clinicians despite the sufficient body of evidence.

Knowledge, Attitude and Practice towards COVID-19 Pandemic among Patients Attending Dental Outpatient Department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India

Background

The 2019 coronavirus disease (COVID-19) is an extremely contagious illness that spreads mostly via the dentistry practice. Patients in need of dental care are at a higher risk of becoming infected with and becoming carriers of the illness.

Aim

To assess the COVID-19-related knowledge, attitude, and practice (KAP) of patients visiting dental outpatient department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India.

Materials and Methods

In this cross-sectional study, patients visiting dental outpatient department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India were included. The questionnaire had four sections including demographic information, knowledge, attitudes, and practice in relation to COVID-19. Along with computation of descriptive statistics, data analysis was performed using unpaired t-test.

Results

A total of 332 people took part in the research. The female respondents were higher in number (53.01%) and the highest percentage of the respondents belongs to the age group 18-40 years (55.72%). Nearly, 98% of respondents were vaccinated. The highest percentage of KAP level was recorded for knowledge (74.95%) followed by that of attitude (50.84%) and practices (37.05%).

Conclusion

While respondents' overall knowledge was high but their enthusiasm for taking preventative measures was low, and their efforts to stem the pandemic were lagging at best. Future campaigns should focus more on reaching out to marginalized populations, such as those with less education or higher poverty rates.