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Isailă OM, Drima E, Hostiuc S. An Ethical Analysis Regarding the COVID-19 Pandemic Impact on Oral Healthcare in Patients with Mental Disorders. Healthcare (Basel) 2023; 11:2585. [PMID: 37761783 PMCID: PMC10530757 DOI: 10.3390/healthcare11182585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
During the COVID-19 pandemic, restrictive measures were imposed that significantly impacted the healthcare system in general, and the dental healthcare system in particular. The literature cites a possible association between mental and oral health, as psychiatric patients have decreased awareness of their oral health and, therefore, poor dental status. Moreover, several studies have found a positive association between SARS-CoV-2 infection and oral health conditions, as well as between SARS-CoV-2 infection and mental health status. This context generated multiple ethical dilemmas in the case of persons with mental health disorders who require dental treatment because they are more vulnerable in this respect. This article aims to analyze the ethical issues in dental care for patients with mental disorders concerning the COVID-19 restrictive measures. The ethical aspects involved here are the basic principles of bioethics and the related elements of accessibility, equity, consent, and confidentiality.
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Affiliation(s)
- Oana-Maria Isailă
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Eduard Drima
- Medical Clinical Department, Dunărea de Jos University, 800201 Galați, Romania
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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Yeoh M, Lai JB, Ng CH. Learning from Covid 19 in a level 1 oral and maxillofacial trauma centre - Insights for the future. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023; 35:195-200. [PMID: 36168323 PMCID: PMC9502433 DOI: 10.1016/j.ajoms.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/21/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022]
Abstract
The coronavirus disease 2019 caused by the Severe Acute Respiratory Syndrome Coronavirus-2 has resulted in many confirmed cases around the world. Sars-CoV-2 remains viable and infectious in aerosols dispersed in air and is viable on surfaces up to several days. Symptomatic patients are the main reservoir for transmission. Evidence suggests that asymptomatic patients and patients during their incubation period can shed and transmit Sars-CoV-2. The infective potential can be reduced through the use of personal protective equipment. Healthcare professionals especially the oral maxillofacial surgeons are at increased risk of being infected by the virus. Oral maxillofacial injuries typically involve vital structures in the upper aerodigestive tract and are emergent. Facial trauma surgery cannot be delayed or deferred in a pandemic. This review focuses on precautions surgeons should adopt while managing facial trauma patients in the emergency department and whilst performing emergency surgeries on these patients during the current COVID-19 pandemic. Strict and effective infection control protocols for facial trauma management are needed to minimise this risk of transmission. This review was part of the lecture given by Professor Melvyn Yeoh at the 14th Asian congress on Oral and Maxillofacial Surgery recently held virtually in Singapore due to the pandemic.
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Affiliation(s)
- Melvyn Yeoh
- Division Chief of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, USA
| | - Juen Bin Lai
- Department of Oral and Maxillofacial Surgery, The National Dental Centre, Singapore
| | - Chee-Hon Ng
- Department of Oral and Maxillofacial Surgery, Novena Medical Centre, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Kaurani P, Batra K, Rathore Hooja H, Chander NG, Bhowmick A, Arora S, Baba SM, Khateeb SU, Abdulla AM, Grover V, Saluja P. Assessing the Compliance of Dental Clinicians towards Regulatory Infection Control Guidelines Using a Newly Developed Survey Tool: A Pilot Cross-Sectional Study in India. Healthcare (Basel) 2022; 10:healthcare10101877. [PMID: 36292324 PMCID: PMC9601445 DOI: 10.3390/healthcare10101877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/27/2022] Open
Abstract
Adherence to the dental practice regulatory guidelines instituted during the COVID-19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase I- developing survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis (EFA) on the responses collected in Spring 2021. The EFA was achieved using a traditional unweighted least squares extraction method through a varimax rotation with Kaiser normalization. A six-factor solution with 18 items (with the global reliability of 86%) related to screening, regular infection prevention measures, infection control inside the dental operatory, disinfection of the dental unit, disposal, and other COVID-19-specific preventive measures were extracted. Our sample had higher compliance with regard to providing alcohol-based hand scrubs, providing protective gear to attendees, collecting travel/medical history, and screening patients for COVID-19 symptoms. In contrast, less compliance was observed regarding the use of paperless forms of practice and rubber dams in the operatory. The use of a validated survey tool ensures the collection of reliable and valid data, which can serve as baseline data to measure the uptake and effectiveness of dental practice regulatory guidelines in a clinical setting and community dental health clinics.
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Affiliation(s)
- Pragati Kaurani
- Department of Prosthodontics, Mahatma Gandhi Dental College and Hospital, Sitapura Industrial Area, Jaipur 302004, India
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
- Correspondence:
| | - Himangini Rathore Hooja
- Department of Psychology, IIS (deemed to be University), Gurukul Marg, Mansarovar, Jaipur 302020, Rajasthan, India
| | - N. Gopi Chander
- Department of Prosthodontics, SRM Dental College, Ramapuram Chennai 600089, India
| | - Anamitra Bhowmick
- Indegene Lifesystems Private Limited, Bengaluru, Karnataka 560045, India
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Suheel Manzoor Baba
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Shafait Ullah Khateeb
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Anshad M. Abdulla
- Department of Pediatric Dentistry & Orthodontics, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Vishakha Grover
- Department of Periodontology & Oral Implantology, Dr. H. S. J. Institute of Dental Sciences & Hospital, Panjab University, Chandigarh 160015, India
| | - Priyanka Saluja
- Department of Conservative Dentistry and Endodontics, JCD Dental College, Vidyapeeth Sirsa 125055, Haryana, India
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Huraib W, Al-Ghalib T, Tash Niyazi A, Bamigdad M. Assessment of nutritional and psychosocial status of elderly patients wearing removable dental prosthetics. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S429-S432. [PMID: 36110758 PMCID: PMC9469388 DOI: 10.4103/jpbs.jpbs_840_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/27/2021] [Accepted: 01/03/2022] [Indexed: 11/04/2022] Open
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Attardi SM, Harmon DJ, Barremkala M, Bentley D, Brown KM, Dennis JF, Goldman H, Harrell KM, Klein BA, Ramnanan C, Farkas GJ. An analysis of anatomy education before and during Covid-19: August-December 2020. ANATOMICAL SCIENCES EDUCATION 2022; 15:5-26. [PMID: 34758206 PMCID: PMC8653345 DOI: 10.1002/ase.2152] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/26/2021] [Accepted: 11/06/2021] [Indexed: 05/21/2023]
Abstract
Coronavirus disease-2019 (Covid-19) disrupted the in-person teaching format of anatomy. To study changes in gross anatomy education that occurred during August-December, 2020 compared to before the pandemic, an online survey was distributed to anatomy educators. The 191 responses received were analyzed in total and by academic program, geographic region, and institution type. Cadaver use decreased overall (before: 74.1 ± 34.1%, during: 50.3 ± 43.0%, P < 0.0001), as well as across allopathic and osteopathic medicine, therapy, undergraduate, and veterinary programs (P < 0.05), but remained unchanged for other programs (P > 0.05). Cadaver use decreased internationally and in the US (P < 0.0001), at public and private (P < 0.0001) institutions, and among allopathic medical programs in Northeastern, Central, and Southern (P < 0.05), but not Western, US geographical regions. Laboratories during Covid-19 were delivered through synchronous (59%), asynchronous (4%), or mixed (37%) formats (P < 0.0001) and utilized digital resources (47%), dissection (32%), and/or prosection (21%) (P < 0.0001). The practical laboratory examination persisted during Covid-19 (P = 0.419); however, the setting and materials shifted to computer-based (P < 0.0001) and image-based (P < 0.0001), respectively. In-person lecture decreased during Covid-19 (before: 88%, during: 24%, P = 0.003). When anatomy digital resources were categorized, dissection media, interactive software, and open-access content increased (P ≤ 0.008), with specific increases in BlueLink, Acland's Videos, and Complete Anatomy (P < 0.05). This study provided evidence of how gross anatomy educators continued to adapt their courses past the early stages of the pandemic.
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Affiliation(s)
- Stefanie M. Attardi
- Department of Foundational Medical StudiesOakland University William Beaumont School of MedicineRochesterMichiganUSA
| | - Derek J. Harmon
- Department of AnatomyUniversity of California, San Francisco, School of MedicineSan FranciscoCaliforniaUSA
| | - Malli Barremkala
- Department of Foundational Medical StudiesOakland University William Beaumont School of MedicineRochesterMichiganUSA
| | - Danielle C. Bentley
- Division of Anatomy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Kirsten M. Brown
- Department of Anatomy and Cell BiologyGeorge Washington University School of Medicine and Health SciencesWashingtonDCUSA
| | - Jennifer F. Dennis
- Department of AnatomyKansas City University College of MedicineJoplinMissouriUSA
| | - Haviva M. Goldman
- Department of Neurobiology and AnatomyDrexel University College of MedicinePhiladelphiaPennsylvaniaUSA
| | - Kelly M. Harrell
- Department of Anatomy and NeurobiologyVirginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | - Barbie A. Klein
- Department of AnatomyUniversity of California, San Francisco, School of MedicineSan FranciscoCaliforniaUSA
| | | | - Gary J. Farkas
- Department of Physical Medicine and RehabilitationUniversity of Miami Miller School of MedicineMiamiFloridaUSA
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Samaranayake L, Fakhruddin KS. Pandemics past, present, and future: Their impact on oral health care. J Am Dent Assoc 2021; 152:972-980. [PMID: 34749921 PMCID: PMC8570943 DOI: 10.1016/j.adaj.2021.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Pandemics have significantly modified our societal behaviour over the millennia, and the COVID-19 pandemic is no exception. TYPES OF ARTICLES REVIEWED In this article, the authors review the history of pandemics, the probable reasons for their emergence, and the COVID-19 pandemic due to the severe acute respiratory syndrome virus 2 (SARS-CoV-2) and its variants, as well as its possible impact on dentistry during the postpandemic period. RESULTS There are multiple reasons why catastrophic pandemics occur due to new infectious organisms that cross the species barrier from animals to humans. These include, population explosion, mass migration, and prolonged survival of debilitated and susceptible cohorts on various immunosuppressants. Coupled with global warming and the resultant loss of habitats, such vicissitudes of humans and nature lead to microbes evolving and mutating at an exponential pace, paving the way for pandemics. The contemporary epidemics and pandemics beginning with the HIV pandemic have modulated dentistry beyond recognition, now with assiduous and robust infection control measures in place. CONCLUSIONS AND PRACTICAL IMPLICATIONS Because COVID-19 may become an endemic disease, particularly due to emerging SARS-CoV-2 variants the dental community should adopt modified infection control measures, teledentistry, and point-of-care diagnostics, among other measures. It is likely, that clinical ecosystems in future would be rendered even safer by predicting how pathogens evolve and priming the human immune system for the next wave of microbial combatants through vaccines produced using deep mutational scanning in which artificial intelligence and machine learning can predict the next variants even before their arrival.
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Impact and Perspectives of Pediatric Dental Care during the COVID-19 Pandemic Regarding Unvaccinated Children: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212117. [PMID: 34831874 PMCID: PMC8618805 DOI: 10.3390/ijerph182212117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 12/17/2022]
Abstract
The pandemic caused by the COVID-19 virus has led to enormous challenges in pediatric dental care. In contrast to adults, many children are without any symptoms of disease if infected with COVID-19 and are not vaccinated. The aim of this study was to conduct an inquiry into the perspective of pediatric dentists in Germany towards the impact of COVID-19 on daily patient care during the lockdowns caused by the pandemic. All members of the Germany Society of Pediatric Dentistry were invited to participate in an online survey. The questionnaire focused on five topics: safety measures, well-being/knowledge, patient care, prospects, and demographic data. A total of 549 pediatric dentists participated (58.11% females, 8.2% males, 0.18% inter/diverse, and 33.51% no answer). In total, 75.2% of the dental clinics were open during the first lockdown (LD1) and 78.1% during the second lockdown (LD2). In LD1, only 22.2% were operating at full capacity, while 40.1% were open with restrictions, and 11.8% only offered emergency treatment. In LD2, 71.2% of practices were operating again and resumed offering all treatment methods. A significant decrease in pediatric patients was reported due to the fact of COVID-19. Furthermore, measures, such as oral hygiene and recall appointments, were reduced. Measures that were performed after the lockdown were mainly aerosol-generating procedures and extractions as well as general anesthesia or sedation. The increased willingness to treat in the second lockdown has shown that pediatric dentists have adapted to the pandemic conditions, which seems to be of great importance, especially in view of the problem of unvaccinated children.
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Banava S, Gansky SA, Reddy MS. Coronavirus Disease Update on Epidemiology, Virology, and Prevention. COMPENDIUM OF CONTINUING EDUCATION IN DENTISTRY (JAMESBURG, N.J. : 1995) 2021; 42:280-289. [PMID: 34077666 PMCID: PMC8440952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In March 2020, the World Health Organization declared COVID-19 as the first coronavirus-initiated pandemic. COVID-19's fast-paced global spread with a broad range of clinical manifestations compelled health regulatory organizations, public health professionals, and researchers to update their information about the disease and provide individual- and community-based guidelines, solutions, and regulations to break the disease cycle, mitigate person-to-person transmission, and reduce cross-contamination in healthcare settings. In this review, the authors provide known facts and updated information about SARS-CoV-2 virology and its new variants, transmission routes, reported clinical symptoms, epidemiology, and infection control and prevention guidelines with a focus on a hierarchy of controls in dental settings.
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Affiliation(s)
- Sepideh Banava
- Postdoctoral Fellow, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | - Stuart A Gansky
- Associate Dean for Research, Professor, and Lee Hysan Chair of Oral Epidemiology, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California; Affiliate Member, Philip R. Lee Institute for Health Policy Studies, UCSF
| | - Michael S Reddy
- Dean and Associate Vice Chancellor, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
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Implementation of COVID-19 Infection Control Measures by German Dentists: A Qualitative Study to Identify Enablers and Barriers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115710. [PMID: 34073452 PMCID: PMC8198934 DOI: 10.3390/ijerph18115710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES COVID-19 infection control measures have been recommended for dental practices worldwide. This qualitative study explored barriers and enablers for the implementation of these measures in German dental practices. METHODS Semi-structured phone interviews were conducted in November/December 2020 (purposive/snowball sampling). The Theoretical Domains Framework (TDF) and the Capabilities, Opportunities and Motivations influencing Behaviors model (COM-B) were used to guide interviews. Mayring's content analysis was employed to analyze interviews. RESULTS All dentists (28-71 years, 4/8 female/male) had implemented infection control measures. Measures most frequently not adopted were FFP2 masks, face shields (impractical), the rotation of teams (insufficient staffing) and the avoidance of aerosol-generating treatments. Dentists with personal COVID-19 experience or those seeing themselves as a role model were more eager to adopt measures. We identified 34 enablers and 20 barriers. Major barriers were the lack of knowledge, guidelines and recommendations as well as limited availability and high costs of equipment. Pressure by staff and patients to ensure infection control was an enabler. CONCLUSIONS Dentists are motivated to implement infection control measures, but lacking opportunities limited the adoption of certain measures. Policy makers and equipment manufacturers should address these points to increase the implementation of infection control measures against COVID-19 and potential future pandemics.
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