1
|
Keir G, Chengazi H, Tan D, Keir V, Kirsch CFE, Zohrabian VM. The early effect of COVID-19 on dental infections by neuroimaging in the emergency department setting. Clin Imaging 2023; 102:31-36. [PMID: 37481988 DOI: 10.1016/j.clinimag.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/28/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES In early 2020, at COVID-19's onset in the United States, the American Dental Association recommended postponing elective dental procedures to minimize viral spread. Subsequently, concerns arose that this could result in increased dental infections and resultant emergency department visits. This study quantifies the number and severity of dental infections at the onset of the early COVID-19 outbreak in early 2020 in the Northeast United States resulting in emergency room visits and radiographic imaging compared to 2017-2019 with an analysis of geographic population characteristics. METHODS Cross-sectional head and neck imaging performed at an East Coast hospital system was retrospectively reviewed for dental infections from March 2020 through December 2020, and compared to prior years 2017-2019. Inclusion criteria included radiology reporting of a dental infection, ranging in severity. Electronic medical records (EMR) and imaging reports were queried for patient characteristics and dental findings. RESULTS There were 735 confirmed imaging reports of odontogenic infections. There was a significant increase in imaging reporting of odontogenic infections in the post-shutdown period. These were more frequently early-type infections, involved a higher proportion of male and non-white patients, and the patients were more often from disadvantaged zip codes when compared with prior years. CONCLUSIONS These findings highlight the varying impact of outpatient dental office closures on different socioeconomic groups in the setting of a pandemic. Potential implications include increased morbidity and mortality for patients, as well as increased cost and resource allocations for the healthcare system.
Collapse
Affiliation(s)
- Graham Keir
- Northwell Health, Division of Radiology at North Shore University Hospital, Long Island Jewish Medical Center, United States of America.
| | - Hamza Chengazi
- Northwell Health, Division of Radiology at North Shore University Hospital, Long Island Jewish Medical Center, United States of America
| | - Dylan Tan
- Zucker School of Medicine at Hofstra/Northwell, United States of America
| | - Victoria Keir
- Northwell Health, Division of Oral and Maxillofacial Surgery, United States of America
| | - Claudia F E Kirsch
- Yale Department of Radiology and Biomedical Imaging, United States of America
| | - Vahe M Zohrabian
- Northwell Health, Division of Radiology at North Shore University Hospital, Long Island Jewish Medical Center, United States of America
| |
Collapse
|
2
|
Whyte F, Chan WY, Silverstein DK, Conrad H, Lee B. Dental Utilization in a Pediatric Emergency Department and Urgent Care Centers Before, During, and After Shutdown of a Pediatric Dental Clinic During the COVID-19 Pandemic, 2019-2021. Public Health Rep 2023:333549221148176. [PMID: 36734190 PMCID: PMC9899675 DOI: 10.1177/00333549221148176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Limited data are available on how the closure of pediatric dental clinics because of the COVID-19 pandemic affected hospital pediatric emergency department (ED) visits in the United States. We evaluated changes in dental-related visits at a pediatric ED and associated urgent care centers (UCCs) after the shutdown of a large pediatric dental clinic because of the COVID-19 pandemic. METHODS We conducted a single-center retrospective medical record review of 811 patients aged 0 to 17 years who presented to a pediatric ED or associated UCC at Rady Children's Hospital-San Diego for dental-related concerns from March 19, 2019, through January 17, 2021. Patients were classified into 3 periods: before shutdown, during shutdown, and after shutdown. We collected data on demographic characteristics; International Classification of Diseases, Tenth Revision codes; dental diagnosis; treatment; and COVID-19 test results. We compared the frequency and proportion of patients seen for dental-related concerns, dental diagnosis, and treatment during the 3 periods. RESULTS The proportion of dental-related concerns in the ED doubled during the shutdown (0.7%) and was 1.5 times higher after the shutdown (0.6%) compared with before the shutdown (0.4%; P < .001). Significantly more patients were seen in EDs than in UCCs during and after the shutdown than before the shutdown (P = .005). During and after the shutdown, admission to the hospital for antibiotic treatment increased significantly to 6.5% and 7.9%, respectively, compared with before the shutdown (2.8%; P = .022), and nonaerosolized procedures and ED/UCC discharge increased to 13.4% and 9.3%, respectively, compared with before the shutdown (6.2%; P = .015). CONCLUSIONS Mitigating future closures of dental offices is important given the shifted burden of dental care to the ED.
Collapse
Affiliation(s)
- Fadra Whyte
- Rady Children’s Hospital–San Diego, San
Diego, CA, USA,Fadra Whyte, DMD, MPH, Rady Children’s
Hospital–San Diego, 3020 Children’s Way, San Diego, CA 92123, USA.
| | - Wai-Yin Chan
- Rady Children’s Hospital–San Diego, San
Diego, CA, USA
| | - Donna-Kritz Silverstein
- Herbert Wertheim School of Public
Health and Longevity Science, University of California San Diego, La Jolla, CA,
USA,Department of Family Medicine, School
of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Heather Conrad
- Rady Children’s Hospital–San Diego, San
Diego, CA, USA,Department of Pediatrics, University of
California San Diego, La Jolla, CA, USA
| | - Begem Lee
- Rady Children’s Hospital–San Diego, San
Diego, CA, USA,Department of Pediatrics, University of
California San Diego, La Jolla, CA, USA
| |
Collapse
|
3
|
The impact of COVID-19 on individual oral health: a scoping review. BMC Oral Health 2022; 22:422. [PMID: 36138456 PMCID: PMC9502893 DOI: 10.1186/s12903-022-02463-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor oral health due to dental caries is one of the most prevalent non-communicable diseases worldwide. It has a significant impact on individuals across the lifespan and is a leading cause of preventable hospitalizations. The impacts of COVID-19 on oral health at the practice level are well documented, but gaps in understanding the impact on individual oral health remain. This review addresses this gap. METHODS Using a JBI scoping review process we mapped and summarized the evidence to identify the impact of COVID-19 on individual oral health. Key search terms were developed, and searches were undertaken by an experienced research librarian. RESULTS The 85 included studies were conducted in 23 countries from 5 regions across the world classified using the United Nations Geoscheme system. The majority (82/85) were quantitative, 2 were reviews and there was one qualitative interview study. Cross-sectional surveys were the most common data collection approach followed by an analysis of clinical data, analysis of internet trends and other online methods. Five key areas were identified including changes to the provision of emergency dental services, provision of routine oral health services, oral hygiene maintenance at home, changes in dietary preferences, alternative models of dental provision and help-seeking and attitudes towards dental care in the future. CONCLUSIONS This scoping review has demonstrated that the pandemic has impacted on oral health at the individual level. It is important that we are aware of these impacts and ensure that support systems are in place to overcome future periods where access to dental care might be compromised. The provision of preventive care remains a vital first step in ensuring good overall oral health as is paramount during periods where access to dental treatment might be limited.
Collapse
|
4
|
Pediatric Dental Emergency Visits and Treatment during Lockdown in the COVID-19 Pandemic: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073774. [PMID: 35409461 PMCID: PMC8998070 DOI: 10.3390/ijerph19073774] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has affected all the professions of life, particularly the healthcare sector. In dentistry, prevention of viral spread among healthcare professionals and patients was a substantial challenge. The virus can directly or indirectly infect dentists during dental procedures. This study focuses on the purpose of pediatric patients’ emergency visits to dental clinics and the treatments practiced during the lockdown. It compares the purpose of emergency pediatric patient visits in dental clinics and their treatments before, during, and after the lockdown periods. Computerized data for two consecutive years (2019 and 2020), between 19 March and 30 April and after the lockdown period from 1 May to 12 June 2020, were collected from five random dental clinics in Israel. The emergency visits of patients under 18 years before, during, and after the lockdown was organized into demographic characteristics, the purpose of the visits, and the treatments with medication or dental procedures. Categorical variables were compared and correlated with the chi-squared test and Pearson’s test, respectively, by using SPSS version 21. During the lockdown, emergency cases got appointments for a physical checkup. Herein, we found higher cases of emergency visits of pediatric patients with pain (n = 281, 32.6%) than trauma (n = 18, 24.7%), followed by infection (n = 31, 28.4%) and treatment continuation (n = 7, 20.6%) during the lockdown period, compared to before and after the lockdown periods. The patients treated with medication and dental procedures during lockdown were significantly different (p < 0.001) than before and after the lockdown. Extraction (n = 81, 41.5%), filling (n = 84, 50.6%), fluoride (n = 13, 92.9%), and pulp treatment (n = 92, 42.6%) were substantially practiced in pediatric patients during the lockdown. Further, this study confirmed the rapid adaptation of professional dentists to deal with non-vaccinated pediatric patients and reinforced the better preparation and requirements for such challenges in the future.
Collapse
|
5
|
Carmagnola D, Toma M, Henin D, Perrotta M, Gianolio L, Colombo A, Dellavia C. Dental Emergencies in an Italian Pediatric Hospital during the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10030537. [PMID: 35327015 PMCID: PMC8949433 DOI: 10.3390/healthcare10030537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/21/2022] Open
Abstract
Emergency rooms (ER) are largely used by patients with oral complaints, who choose the ER over private or public dental offices for oral prevention and treatment. During the COVID-19 pandemic, the activity of most dental facilities was limited, and most hospitals and ERs were dedicated to the treatment of COVID-19 patients. The present study analyzed the number of and reason for visits at the emergency room (ER) of Ospedale dei Bambini “Vittore Buzzi”, the main pediatric hospital in Milano, Italy, between 2019 and 2020, with a particular focus on oral emergencies. In 2019, 25,435 children turned to the ER, compared to 16,750 in 2020. About 10% of the children were eventually admitted to the hospital in both years. The number of admissions for infectious diseases, other than COVID-19, signed an important decrease in 2020, while trauma/injuries decreased slightly in number but increased in proportion. The number and proportion of ER visits for oral complaints decreased in 2020 compared to 2019. Stomatitis was the most frequent condition, followed by traumatic injuries, which decreased in number and percentage between 2019 and 2020. Oral infections and painful caries accounted for about 15% of the cases in both 2019 and 2020. These data highlight the need to promote territorial services for the prevention and treatment of oral health complaints, including dental emergencies.
Collapse
Affiliation(s)
- Daniela Carmagnola
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy; (D.C.); (D.H.); (M.P.); (C.D.)
| | - Marilisa Toma
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy; (D.C.); (D.H.); (M.P.); (C.D.)
- Correspondence: ; Tel.: +39-02-5031-5407
| | - Dolaji Henin
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy; (D.C.); (D.H.); (M.P.); (C.D.)
| | - Mariachiara Perrotta
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy; (D.C.); (D.H.); (M.P.); (C.D.)
| | - Laura Gianolio
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, Università degli Studi di Milano, Via Lodovico Castelvetro 32, 20154 Milano, Italy; (L.G.); (A.C.)
| | - Alessandra Colombo
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, Università degli Studi di Milano, Via Lodovico Castelvetro 32, 20154 Milano, Italy; (L.G.); (A.C.)
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy; (D.C.); (D.H.); (M.P.); (C.D.)
| |
Collapse
|
6
|
Self-reported periodontal health and incident hypertension: longitudinal evidence from the NutriNet-Santé e-cohort. J Hypertens 2021; 39:2422-2430. [PMID: 34261955 DOI: 10.1097/hjh.0000000000002941] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE An association between periodontitis and arterial hypertension has been suggested recently. This study aimed at investigating the hypothesis that periodontal health is linked to incident arterial hypertension. METHODS We analyzed data from the French population-based e-cohort NutriNet-Santé, selecting participants who had completed two oral health questionnaires in 2011-2012. Pregnant women, participants with diabetes, cancer, arterial hypertension and cardiovascular diseases at inclusion were excluded. Incident cases of arterial hypertension were self-reported and/or based on the use of antihypertensive therapy. Periodontal health was evaluated by estimating the modified and validated PEriodontal Screening Score (mPESS), with mPESS at least 5 corresponding to a high probability of severe periodontitis. Descriptive statistics and Cox proportional hazards regression models, taking into account sociodemographic and lifestyle confounders, were used. RESULTS The study population consisted of 32 285 participants (mean age: 45.79 ± 13.87 years); 78.5% were women. Two thousand one hundred and sixteen incident cases of arterial hypertension were identified during a median follow-up of 8 years (April 2012--December 2019). In the fully adjusted model, an mPESS at least 5 [hazard ratio: 1.84; 95% confidence interval (CI): 1.66-2.03] and the presence of nonreplaced missing teeth (hazard ratio: 1.13; 95% CI: 1.03-1.23) were significantly associated with a greater risk of incident arterial hypertension, whereas a regular annual visit to the dentist was associated with a lower risk (hazard ratio: 0.88; 95% CI: 0.80-0.97). CONCLUSION Self-reported assessed periodontitis was associated with incident arterial hypertension over an 8-year period. The present results highlight the importance of considering periodontal health when assessing an individual's risk of arterial hypertension. TRIAL REGISTRATION # NCT03335644.
Collapse
|