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Ruff RR, Barry Godín TJ, Whittemore R, Murray Small T, Santiago-Galvin N, Sharma P. Unmet Dental Needs in Children Following Suspension of School-Based Oral Health Services Due to COVID-19. THE JOURNAL OF SCHOOL HEALTH 2024; 94:427-432. [PMID: 38234044 DOI: 10.1111/josh.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Dental caries (tooth decay) is the world's most prevalent noncommunicable disease and can lead to pain, infection, and edentulism. Many children with caries lack access to traditional dental services. School-based caries prevention can increase access to care and reduce health inequities. Disruptions in school-based care due to pandemic control policies may result in children losing access to their primary dental care option. METHODS The CariedAway project was a school-based caries prevention program in operation from 2019 to 2023 in urban schools with a high proportion of low-income, minority students. Program operations were suspended for 2 years due to the COVID-19 pandemic. We estimated the prevalence of untreated decay, swelling, fistula, and pulpal involvement in participants at baseline and again after restrictions were lifted. RESULTS A total of 2998 children between the ages of 5 and 13 years were enrolled and received preventive care prior to pandemic shutdowns, and 1398 (47%) completed a follow-up observation after 2 years. At baseline, approximately 30% had untreated caries on any dentition, 11% of children presented with evidence of dental sealants, and no participants had swelling, fistula, or pulpal involvement. After 24 months, 12% of participants had swelling fistula, or pulpal involvement that was not treated during the pandemic period. CONCLUSION There are considerable unmet dental needs in high-risk children that may be further exacerbated by a lack of access to care during disease outbreaks.
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Affiliation(s)
- Ryan R Ruff
- New York University College of Dentistry, New York, NY, USA
- New York University School of Global Public Health, New York, NY
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Zaeneldin A, Chu CH, Yu OY. Dental Pulp Response to Silver-Containing Solutions: A Scoping Review. Dent J (Basel) 2023; 11:dj11050114. [PMID: 37232765 DOI: 10.3390/dj11050114] [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: 03/06/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Dentists used silver-containing solutions for deep cavity disinfection before restoration. This review aims to identify the silver-containing solutions reported in the literature for deep cavity disinfection and summarize their effects on dental pulp. An extensive search was performed using the search words "(silver) AND (dental pulp OR pulp)" in ProQuest, PubMed, SCOPUS, and Web of Science to identify English publications on silver-containing solutions for cavity conditioning. The pulpal response to the included silver-containing solutions was summarized. The initial search identified 4112 publications and 14 publications met the inclusion criteria. Silver fluoride, silver nitrate, silver diamine nitrate, silver diamine fluoride, and nano-silver fluoride were used in deep cavities for antimicrobial purposes. Indirect silver fluoride application induced pulp inflammation and reparative dentine in most cases, and pulp necrosis in some cases. Direct silver nitrate application caused blood clots and a wide inflammatory band in the pulp, whilst indirect silver nitrate application caused hypoplasia in shallow cavities and partial pulp necrosis in deep cavities. Direct silver diamine fluoride application induced pulp necrosis, while indirect silver diamine fluoride application induced a mild inflammatory response and reparative dentine formation. No evidence of the dental pulpal response to silver diamine nitrate or nano-silver fluoride was available in the literature.
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Affiliation(s)
- Ahmed Zaeneldin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Five reasons why essential dental medicines deliver more equity in oral health care. J Am Dent Assoc 2023; 154:107-109. [PMID: 36411137 DOI: 10.1016/j.adaj.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/31/2022] [Accepted: 09/13/2022] [Indexed: 11/19/2022]
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Singh H, Sachdeva S, Srivastava D, Kapoor P, Sharma P, Kumar Maurya R, Roy P. Sailing through the COVID-19 Pandemic and Beyond: An Evidence-Based Analysis for Dental Healthcare and Practice. Front Dent 2022; 19:14. [PMID: 35937150 PMCID: PMC9293723 DOI: 10.18502/fid.v19i14.9217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 12/23/2021] [Indexed: 11/24/2022] Open
Abstract
This integrative review aims to provide a consolidated evidence-based appraisal of the most up-to-date guidelines and recommendations of international public and professional health regulatory bodies in relation to preparedness framework for restructuring safe delivery of dental services amid and beyond the coronavirus disease-2019 (COVID-19) pandemic. Most recent updated guidelines for dental professionals from major international health regulatory bodies were reviewed. PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, WHO COVID-19 and LILACS databases, along with relevant preprints were searched, and citations were checked up to January 23, 2021. The search was performed by one author. Shortlisted articles were read and brought to consensus to be included in the study by at least two co-authors. In case of any disagreement between the judgements, an independent co-author's decision was taken as final. Of 849 records searched, 61 articles were included in the study. Following content analysis of the global guidelines and the collected prevailing evidence, the common themes and recommendations of different guidance documents were collated and summarized into seven domains. Most guidelines have a consensus regarding implementation of rigorous administrative, engineering and environmental infection control strategies. However, variations do exist with regard to the use of respirators in non-aerosol-generating procedure (non-AGP) settings, employment of airborne precautions during non-AGPs, use of supplemental air-handling systems, and preoperative use of mouthwashes. This evidence-based analysis can serve as a useful reopening resource tool and facilitate effective restructuring for delivery of optimal, equitable and safe dental practices globally, during and while emerging from the pandemic.
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Affiliation(s)
- Harpreet Singh
- Department of Orthodontics and Dentofacial Orthopedics ESIC Dental College and Hospital, Sector 15, Rohini, Delhi, India
| | - Shabina Sachdeva
- Department of Prosthodontics, Faculty of Dentistry, Jamia Milia Islamia, Delhi, India
| | - Dhirendra Srivastava
- Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Sector 15, Rohini, Delhi, India
| | - Pranav Kapoor
- Department of Orthodontics and Dentofacial Orthopedics, ESIC Dental College and Hospital, Sector 15, Rohini, Delhi, India
| | - Poonam Sharma
- Department of Orthodontics and Dentofacial Orthopedics, ESIC Dental College and Hospital, Sector 15, Rohini, Delhi, India
| | - Raj Kumar Maurya
- Dental Officer & Specialist (Orthodontics), Central Government Dental Unit, Nagaland, India
| | - Pinaki Roy
- Department of Orthodontics and Dentofacial Orthopedics, Dr. R. Ahmed Dental College and Hospital, Kolkata, India
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Effect of silver diamine fluoride on vital dental pulp: A systematic review. J Dent 2022; 119:104066. [DOI: 10.1016/j.jdent.2022.104066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/21/2022] [Accepted: 02/05/2022] [Indexed: 12/14/2022] Open
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Aladelusi TO, Atiba FA, Gbadebo SO, Adeyemo YI, Olusanya AA, Akadiri OA. COVID-19 outbreak and dental health care provision in Nigeria: a national survey. BMC Oral Health 2021; 21:493. [PMID: 34607593 PMCID: PMC8489369 DOI: 10.1186/s12903-021-01860-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background The impact of the COVID-19 pandemic on the world is unprecedented, posing greater threats to vulnerable healthcare systems, especially in developing countries. This study aimed to assess the knowledge of dental healthcare providers in Nigeria about the disease and evaluate their responses to the preventive measures necessitated by COVID-19. Methods This was an online self-administered questionnaire-based study conducted among dentists practicing in Nigeria. A message containing the link to the survey was sent widely via social medial platforms and electronic mails to dentists practicing in Nigeria. The data collection was done between the 2nd of June and 3rd of July 2020. Results A total of 314 responses was recorded. Fever was the most specified generalized symptom (97.5%), while the use of masks (100%), hand hygiene (99.7%), social distancing (97.7%) and surface cleaning (99.4%) were the most commonly employed general preventive methods. The main identified risk of transmission in the clinic was aerosol generating procedures (98.7%). Conclusion The general knowledge of dental personnel in our study population appears to be adequate on the common clinical features of COVID-19 but less adequate regarding the less common features. The COVID-19 pandemic has also modified some aspects of dental service delivery but more needs to be done in this regard. Preventive measures against the transmission of COVID-19 in dental practice settings include proper utilization of teledentistry, clinical triage, preprocedural 1% hydrogen peroxide oral rinses, and the use of appropriate Personal Protective Equipment (PPE) which should always be encouraged.
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Affiliation(s)
- Timothy Olukunle Aladelusi
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Foluso Ayobami Atiba
- Department of Anatomy, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Shakeerah Olaide Gbadebo
- Department of Restorative Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Yewande Isabella Adeyemo
- Department of Child Dental Health, Faculty of Dentistry, College of Health Sciences, Bayero University, Kano, Kano State, Nigeria.
| | - Adeola Adenike Olusanya
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Oladimeji Adeniyi Akadiri
- Department of Oral and Maxillofacial Surgery, College of Health Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
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Spray mist reduction by means of a high-volume evacuation system-Results of an experimental study. PLoS One 2021; 16:e0257137. [PMID: 34478480 PMCID: PMC8415595 DOI: 10.1371/journal.pone.0257137] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES High-speed tooth preparation requires effective cooling to avoid thermal damage, which generates spray mist, which is a mixture of an aerosol, droplets and particles of different sizes. The aim of this experimental study was to analyze the efficacy of spray mist reduction with an intraoral high-volume evacuation system (HVE) during simulated high-speed tooth preparation for suboptimal versus optimal suction positions of 16 mm sized cannulas and different flow rates of the HVE. MATERIAL AND METHODS In a manikin head, the upper first premolar was prepared with a dental turbine, and generated particles of 5-50 microns were analyzed fifty millimeters above the mouth opening with the shadow imaging technique (frame: 6.6×5.3×1.1 mm). This setup was chosen to generate a reproducible spray mist in a vertical direction towards an imaginary operator head (worst case scenario). The flow rate (FR) of the HVE was categorized into five levels (≤120 l/min up to 330 l/min). The number of particles per second (NP; p/s) was counted, and the mass volume flow of particles per second (MVF; μg/s*cm3) was calculated for 10 sec. Statistical tests were nonparametric and two-sided (p≤0.05). RESULTS With increasing flow rate, the NP/MVF values decreased significantly (eta: 0.671/0.678; p≤0.001). Using a suboptimally positioned cannula with an FR≤160 l/min, significantly higher NP values (mean±SD) of 731.67±54.24 p/s (p≤0.019) and an MVF of 3.72±0.42 μg/s*cm3 (p≤0.010) were measured compared to those of the optimal cannula position and FR≥300 l/min (NP/MVF: 0/0). No significant difference in NP and MVF was measurable between FR≥250 l/min and FR>300 l/min (p = 0.652, p = 0.664). CONCLUSION Within the limitations of the current experimental study, intraoral high-flow rate suction with ≥300 l/min with an HVE effectively reduced 5-50 μm sized particles of the spray mist induced by high-speed tooth preparation with a dental turbine.
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Alassaf A, Almulhim B, Alghamdi SA, Mallineni SK. Perceptions and Preventive Practices Regarding COVID-19 Pandemic Outbreak and Oral Health Care Perceptions during the Lockdown: A Cross-Sectional Survey from Saudi Arabia. Healthcare (Basel) 2021; 9:healthcare9080959. [PMID: 34442094 PMCID: PMC8391299 DOI: 10.3390/healthcare9080959] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
Aims: The study aimed to evaluate perceptions and preventive practices regarding the COVID-19 pandemic and oral health care perceptions during the lockdown in the Saudi Arabian population. Materials and Method: This cross-sectional study was performed by collecting the data from individuals belonging to various parts of the Saudi Arabian Population through an online self-reported questionnaire. The questionnaire had two main parts: first comprised of demographic data include the region of residence, gender, nationality, age, the number of family members, monthly income of the family, and the second was further divided into three sections of perception (P), practice (PRA) and oral health care practice (D) questions. All these (P, PRA, and D) were analyzed by comparing all of the demographic characteristics. Statistical analysis was performed using SPSS IBM (version 21.0), and statistical significance was set at a 5% level. Results: Overall, 2013 participants (54% males and 46% females) contributed to the Saudi Arabia study. Only 5% of non-Saudis live in Saudi Arabia were participated in the study, while the majority of participants were of 21–40 years age group (45%), 59% of having more than five family members, and 60% of them had ≤10 K Suadi riyal monthly income respectively. The majority of the participants were from Riyadh (33.7%) and Asir (25.1%) in the study. Overall, 89.5% of the participants were aware of the COVID-19 global pandemic. The majority of the participants (55%) from Saudi Arabia utilized the Ministry of Health website, a source of information regarding COVID-19. However, 56.5% of the participants had COVID-19 related perception, and 74.3% followed an appropriate preventive practice. Approximately 60% had good oral health practice. The study participants showed mixed opinions on perceptions regarding COVID-19, preventive practice, and oral health practices. Conclusion: The present study suggested that the Saudi Arabian population has good attention to COVID-19, but preventive practice and oral health perception need better awareness to control this novel virus spread. The Ministry of Health website utilized as a significant source of information among the Saudi Arabian population regarding COVID-19.
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Martignon S, Cortes A, Douglas GVA, Newton JT, Pitts NB, Avila V, Usuga-Vacca M, Gamboa LF, Deery C, Abreu-Placeres N, Bonifacio C, Braga MM, Carletto-Körber F, Castro P, P Cerezo M, Chavarría N, Cifuentes OL, Echeverri B, Jácome-Liévano S, Kuzmina I, Lara JS, Manton D, Martínez-Mier EA, Melo P, Muller-Bolla M, Ochoa E, Osorio JR, Ramos K, Sanabria AF, Sanjuán J, San-Martín M, Squassi A, Velasco AK, Villena R, Zandona AF, Beltrán EO. CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol. BMC Oral Health 2021; 21:329. [PMID: 34210281 PMCID: PMC8248759 DOI: 10.1186/s12903-021-01674-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time.
Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h. Protocol-version 2: 27/01/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01674-1.
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Affiliation(s)
- Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia.
| | - Andrea Cortes
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Gail V A Douglas
- Dental Public Health, Leeds Dental Institute, University of Leeds, Leeds, UK
| | - J Timothy Newton
- Dental Innovation and Impact, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Nigel B Pitts
- Dental Innovation and Impact, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Viviana Avila
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Margarita Usuga-Vacca
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Luis F Gamboa
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Christopher Deery
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Ninoska Abreu-Placeres
- Biomaterials and Dentistry Research Center (CIBO-UNIBE), Academic Research Department, Universidad Iberoamericana UNIBE, Santo Domingo, Dominican Republic
| | - Clarisa Bonifacio
- Department of Pediatric Dentistry, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Mariana M Braga
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fabiana Carletto-Körber
- Comprehensive Children and Adolescents Clinic, Paediatric Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Patricia Castro
- School of Dentistry, Corporación Universitaria Rafael Núñez, Cartagena, Colombia
| | - María P Cerezo
- School of Dentistry, Universidad Autónoma de Manizales, Manizales, Colombia
| | - Nathaly Chavarría
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Olga L Cifuentes
- School of Dentistry, Universidad Autónoma de Manizales, Manizales, Colombia
| | - Beatriz Echeverri
- School of Dentistry, Universidad Cooperativa de Colombia, Envigado, Colombia
| | - Sofía Jácome-Liévano
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Irina Kuzmina
- Department of Preventive Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - J Sebastián Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - David Manton
- Centrum Voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, Groningen, The Netherlands
| | - E Angeles Martínez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Paulo Melo
- EpiUnit, Faculty of Dental Medicine, Institute of Public Health, University of Porto, Porto, Portugal
| | | | - Emilia Ochoa
- School of Dentistry, Universidad Cooperativa de Colombia, Envigado, Colombia
| | | | - Ketty Ramos
- School of Dentistry, Universidad de Cartagena, Cartagena, Colombia
| | - Angie F Sanabria
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Johanna Sanjuán
- Paedriatric Dentistry Department, Fundación Universitaria de Colegios de Colombia (UNICOC), Bogotá, Colombia
| | - Magdalena San-Martín
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia.,School of Dentistry, Universidad Católica de Uruguay, Montevideo, Uruguay
| | - Aldo Squassi
- School of Dentistry, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - A Karina Velasco
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Rita Villena
- Paediatric Dentistry Department, Universidad San Martín de Porres, Lima, Peru
| | - Andrea Ferreira Zandona
- Department of Comprehensive Care, School of Dental Medicine, Tufts University, Boston, MA, USA
| | - Edgar O Beltrán
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
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Farshidfar N, Jafarpour D, Hamedani S, Dziedzic A, Tanasiewicz M. Proposal for Tier-Based Resumption of Dental Practice Determined by COVID-19 Rate, Testing and COVID-19 Vaccination: A Narrative Perspective. J Clin Med 2021; 10:2116. [PMID: 34068858 PMCID: PMC8153624 DOI: 10.3390/jcm10102116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 12/23/2022] Open
Abstract
Since the emergence of the new coronavirus disease (COVID-19), profound alterations in general and specialist dental practice have been imposed to provide safe dental care. The guidelines introduced in response to the COVID-19 pandemic to mitigate healthcare disruption are inconsistent regarding the dental practice re-installation, particularly during a transitional time. Despite the successful mass vaccination campaigns rolled out in 2021, the presence of more than 80 genotypes of COVID-19, rapid neutralisation of antibodies within a short period of seropositivity, and the likelihood of recurrent infection raise some doubts on whether vaccination alone will provide long-term immunity against COVID-19 and its variants. Here, from this perspective, we aim to provide an initial proposal for dental services reinstallation, easily applicable in various care settings. We discuss the potential options for the transition of dental services, as well as challenges and opportunities to adapt to new circumstances after mass COVID-19 vaccination. The proposal of the universal three-tier system of dental services resumption, determined by regional COVID-19 rates, testing accessibility, and vaccination rollout has been presented. Following herd COVID-19 immunity enhancement, it would be prudent to confer various preventative measures until virus spread naturally diminishes or becomes less virulent. Based on modelling data, dental practices may not return to normal, routine operation even after global vaccination as there would still be a significant risk of outbreaks of infection. Variable, multi-level measures will still be required, depending on the local COVID-19 cases rate, to secure safe dental care provision, despite predicted success of vaccination agendas. This approach can be implemented by achievable, practical means as a part of risk assessment, altered work pattern, and re-arrange of dental surgery facilities. The adequate standard operating procedure, with the support of rapid point-of-care testing at workplace, would vastly intensify the uninterrupted recovery of the dental care sector.
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Affiliation(s)
- Nima Farshidfar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Dana Jafarpour
- Faculty of Dentistry, McGill University, Montreal, QC H3A 1G1, Canada;
| | - Shahram Hamedani
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz 71956-15878, Iran;
| | - Arkadiusz Dziedzic
- Department of Restorative Dentistry with Endodontics, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Marta Tanasiewicz
- Department of Restorative Dentistry with Endodontics, Medical University of Silesia, 40-055 Katowice, Poland;
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Starr JR, Ruff RR, Palmisano J, Goodson JM, Bukhari OM, Niederman R. Longitudinal caries prevalence in a comprehensive, multicomponent, school-based prevention program. J Am Dent Assoc 2021; 152:224-233.e11. [PMID: 33632412 DOI: 10.1016/j.adaj.2020.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/19/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Globally, children's caries prevalence exceeds 30% and has not markedly changed in 30 years. School-based caries prevention programs can be an effective method to reduce caries prevalence, obviate traditional barriers to care, and use aerosol-free interventions. The objective of this study was to explore the clinical effectiveness of a comprehensive school-based, aerosol-free, caries prevention program. METHODS The authors conducted a 6-year prospective open cohort study in 33 US public elementary schools, providing care to 6,927 children in communities with and without water fluoridation. After dental examinations, dental hygienists provided twice-yearly prophylaxis, glass ionomer sealants, glass ionomer interim therapeutic restorations, fluoride varnish, toothbrushes, fluoride toothpaste, oral hygiene instruction, and referral to community dentists as needed. The authors used generalized estimating equations to estimate the change in the prevalence of untreated caries over time. RESULTS The prevalence of untreated caries decreased by more than 50%: from 39% through 18% in phase 1, and from 28% through 10% in phase 2. The per-visit adjusted odds ratio of untreated caries was 0.79 (95% confidence interval, 0.73 to 0.85). CONCLUSIONS AND PRACTICAL IMPLICATIONS This school-based comprehensive caries prevention program was associated with substantial reductions in children's untreated caries, supporting the concept of expanding traditional practices to include office- and community-based aerosol-free care.
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic revealed a lack of consensus on the concept of essential oral health care. We propose a definition of essential oral health care that includes urgent and basic oral health care to initiate a broader debate and stakeholder alignment. We argue that oral health care must be part of essential health care provided by any health system. Essential oral health care covers the most prevalent oral health problems through an agreed-on set of safe, quality, and cost-effective interventions at the individual and community level to promote and protect oral health, as well as prevent and treat common oral diseases, including appropriate rehabilitative services, thereby maintaining health, productivity, and quality of life. By default, essential oral health care does not include the full spectrum of possible interventions that contemporary dentistry can provide. On the basis of this definition, we conceptualize a layered model of essential oral health care that integrates urgent and basic oral health care, as well as advanced/specialist oral health care. Finally, we present 3 key reflections on the essentiality of oral health care. First, oral health care must be an integral component of a health care system's essential services, and by implication, oral health care personnel are part of the essential health care workforce. Second, not all dental care is essential oral health care, and not all essential care is also urgent, particularly under the specific risk conditions of the pandemic. Third, there is a need for criteria, evidence, and consensus-building processes to define which dental interventions are to be included in which category of essential oral health care. All stakeholders, including the research, academic, and clinical communities, as well as professional organizations and civil society, need to tackle this aspect in a concerted effort. Such consensus will be crucial for dentistry in view of the Sustainable Development Goal's push for universal health coverage, which must cover essential oral health care.
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Affiliation(s)
- H. Benzian
- Department Epidemiology and Health Promotion,
WHO Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of
Dentistry, New York University, New York, NY, USA
- Global Health Center, Geneva Graduate
Institute for Policy Studies, Geneva, Switzerland
| | - E. Beltrán-Aguilar
- Department Epidemiology and Health Promotion,
WHO Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of
Dentistry, New York University, New York, NY, USA
| | - M.R. Mathur
- Public Health Foundation of India, Gurugram,
India
- Department of Public Health, Policy and
Systems, University of Liverpool, Liverpool, UK
| | - R. Niederman
- Department Epidemiology and Health Promotion,
WHO Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of
Dentistry, New York University, New York, NY, USA
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13
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Benzian H, Beltrán-Aguilar E, Niederman R. Systemic Management of Pandemic Risks in Dental Practice: A Consolidated Framework for COVID-19 Control in Dentistry. Front Med (Lausanne) 2021; 8:644515. [PMID: 33718412 PMCID: PMC7943457 DOI: 10.3389/fmed.2021.644515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Dental teams and their workplaces are among the most exposed to airborne and bloodborne infectious agents, and therefore at the forefront of pandemic-related changes to how dental care is organized and provided to patients. The increasing complexity of guidelines makes is challenging for clinicians to navigate the multitude of COVID-19 guidelines issued by different agencies. A comparative analysis of guidance issued for managing COVID-19 in dental settings leading U.S. agencies was conducted, including documents of the Occupational Safety and Health Administration (OSHA), an agency of the U.S. Secretary of Labor, and of the U.S. Centers for Disease Prevention and Control (CDC), an agency of the U.S. Secretary of Health and Human Services. Details of infection control and other risk mitigation measures were reviewed for consistency, overlaps and similarities, then clustered according to thematic areas covering all domains of managing a dental healthcare setting. The analysis revealed five distinct areas of pandemic control, comprising (1) planning and protocols, (2) patient screening, (3) preparation of facilities, (4) PPE and infection control, and (5) procedures and aerosol control; thereby covering systematically all aspects requiring adaptation in a pandemic context. The "Pandemic-5 Framework for COVID-19 Control in Dentistry" provides an opportunity to simplify comprehensive decision-making from a clinical practitioner perspective. The framework supports a comprehensive systems-driven approach by using dental clinics as a setting to integrate pandemic clinical responses with the implementation of appropriate infection control protocols. Traditionally these two aspects are addressed independently from each other in separate concepts.
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Affiliation(s)
- Habib Benzian
- Department Epidemiology and Health Promotion, World Health Organization Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of Dentistry, New York University, New York, NY, United States
- Global Health Center, Geneva Graduate Institute for Policy Studies, Geneva, Switzerland
| | - Eugenio Beltrán-Aguilar
- Department Epidemiology and Health Promotion, World Health Organization Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of Dentistry, New York University, New York, NY, United States
| | - Richard Niederman
- Department Epidemiology and Health Promotion, College of Dentistry, New York University, New York, NY, United States
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14
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Soltani P, Baghaei K, Tavakoli Tafti K, Spagnuolo G. Science Mapping Analysis of COVID-19 Articles Published in Dental Journals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2110. [PMID: 33671518 PMCID: PMC7926941 DOI: 10.3390/ijerph18042110] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic is an ongoing global health crisis with unmatched outcomes and effects. This pandemic has caused an infodemic of article publication in scientific journals. Dental journals have been active in the publication of COVID-19 related articles from the beginning of the pandemic. In this cross-sectional survey, we present an analysis of the scientific output of dental journals on COVID-19. The PubMed COVID-19 database was searched with the "Dental Journals" filter. Data including journal name, country, month of publication and number of citations were recorded. Science mapping analysis of the most used keywords was also performed. The search retrieved a total of 659 articles, of which 28 were excluded. Oral Diseases has published the most COVID-19 articles (15.1%), followed by the British Journal of Oral and Maxillofacial Surgery (8.6%) and the Journal of Dental Education (7.9%). Most of the articles were from researchers from the United States (168), United Kingdom (120) and Brazil (83). The number of citations of the published articles ranged from 0 to 406, with most articles (64.2%) having no citations. Science Mapping analysis revealed that the most used keywords were coronavirus infections, pandemics and humans. The dental community has been active in the publication of COVID-19 articles from the beginning of the pandemic. The papers published by dental journals explore issues such as the management of clinical practices during the outbreak, infection control in the dental setting, signs and symptoms of COVID-19 affecting the oral cavity, and the impact of the COVID-19 pandemic on educational and clinical programs.
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Affiliation(s)
- Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81746, Iran;
| | - Kimia Baghaei
- Dental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81746, Iran
| | - Kioumars Tavakoli Tafti
- Dental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81746, Iran
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy;
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15
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Ionescu AC, Brambilla E, Manzoli L, Orsini G, Gentili V, Rizzo R. Aerosols modification with H 2O 2 reduces airborne contamination by dental handpieces. J Oral Microbiol 2021; 13:1881361. [PMID: 33552403 PMCID: PMC7850367 DOI: 10.1080/20002297.2021.1881361] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective: We designed an in vitro study to evaluate the efficiency of an 0.5 vol% hydrogen peroxide-based spray in reducing Coronavirus 229E spread during a conventional dental procedure. Methods: A class III cabinet-like chamber was custom-built, using phantoms for both patient and operator. A suspension of HCoV-229E in artificial saliva having a similar viral load to SARS-CoV-2 asymptomatic patients was inoculated inside the patient’s phantom mouth. A 10 s-lasting dental procedure was performed using an aerosol-generating air-turbine, with or without high-volume evacuation (HVE). The effect of 0.5 vol% H2O2 cooling spray in reducing viral loads was tested. Viral presence on the operator phantom was assessed by Real-Time quantitative PCR on the mask’s outer surface, on the phantom’s forehead, and inside its mouth. Results: When the H2O2 cooling spray was used, as compared to the conventional spray, viral loads were significantly lower on all tested sites, falling below the detection limit. Viral loads did not significantly change in any tested site when HVE was used. Conclusion: The use of 0.5 vol% H2O2 cooling spray by dental handpieces drastically reduced the possibility of coronaviruses spread during aerosol-generating dental procedures. This strategy deserves further consideration among the preventive measures to be adopted during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Andrei Cristian Ionescu
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Eugenio Brambilla
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Lamberto Manzoli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Valentina Gentili
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Roberta Rizzo
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
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16
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Beltrán-Aguilar E, Benzian H, Niederman R. Rational perspectives on risk and certainty for dentistry during the COVID-19 pandemic. Am J Infect Control 2021; 49:131-133. [PMID: 32534866 PMCID: PMC7290219 DOI: 10.1016/j.ajic.2020.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 11/26/2022]
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