[Emergency management of prevention and control of the novel coronavirus infection in departments of stomatology]

Appointment impact and orthodontic emergency occurrence during the coronavirus disease 2019 pandemic: A retrospective study

Introduction

This retrospective study aimed to quantify the impact of coronavirus disease 2019 (COVID-19) on the orthodontic appointment and make an analysis of orthodontic emergencies (OEs) that occurred during the pandemic.

Methods

A total of 628 patients were randomly sampled from 3489 subjects who were undergoing active orthodontic treatment with fixed appliances, and the medical records were reviewed. OE occurrence was analyzed from 617 patients who had explicit return-visit records after the COVID-19 outbreak. Wilcoxon signed rank tests, chi-square tests, and a binary logistic regression were performed.

Results

The return-visit of 98.6% of the patients was delayed significantly with an increase over 8.98 ± 4.76 weeks (P <0.001). In general, 32.3% of the patients suffered from various OEs while waiting for their first return-visit, and bracket or band debonding was the most frequently reported category. Most OEs did not receive timely treatments because of the lockdown. The incidence was nearly 2 times higher than that of the normal appointment times. No correlation was found between OE occurrence and different demographic and clinical characteristics of patients. The therapeutic progress of patients, especially those in stage 3, was postponed because of the occurrence of OEs.

Conclusions

Regardless of the limitations, our study suggested that it is highly possible that the COVID-19 pandemic has delayed appointments of fixed orthodontic patients. OEs did bother a minority of patients and could not be settled in time during the lockdown, which had a negative impact on the near-term treatment progress and should have been prevented. Further studies are required to investigate the long-dated influence of COVID-19 on orthodontic practices.

Challenges, limitations, and solutions for orthodontists during the coronavirus pandemic: A review

INTRODUCTION

Orthodontic patients worldwide missed appointments during the early months of the coronavirus disease 2019 (COVID-19) pandemic. A significant problem with this virus is its high transmission power. Asymptomatic patients can transmit the virus. The aim of this review is to examine orthodontic emergencies and the necessary strategies and measures for emergency and nonemergency treatment during the coronavirus pandemic.

METHODS

The following databases were comprehensively searched: PubMed, MEDLINE, Scopus, and Google Scholar. Up-to-date data released by major health organizations such as the World Health Organization and major orthodontic associations involved in the pandemic were also evaluated.

RESULTS

Few studies were conducted on managing orthodontic offices or clinics during the pandemic, and most are not of high quality. Appropriate communication is the most important issue in managing orthodontic patients, particularly virtual counseling. Many orthodontic emergencies can be managed in this way by patients themselves. Most studies recommend using the filtering facepiece 2 masks, equivalent to N95 masks for non-COVID-19 patients undergoing aerosol-generating procedures and all suspected or confirmed COVID-19 patients in orthodontic visits.

CONCLUSIONS

At this time, there are no definitive clinical protocols supported by robust evidence for orthodontic practice during the COVID-19 pandemic. Orthodontists should not rush to return to routine orthodontic work and should follow state guidelines. Nonemergency orthodontic visits should be suspended during the severe acute respiratory syndrome coronavirus 2 pandemic in high-risk areas. Resuming orthodontic procedures during the pandemic requires paying special attention to screening, performing maximum efforts to reduce aerosol generation, using appropriate personal protective equipment, having proper ventilation, and fully adhering to sterilization and disinfection principles.

COVID-19 - Recent advancements in identifying novel vaccine candidates and current status of upcoming SARS-CoV-2 vaccines

The COVID-19 pandemic caused by SARS-CoV-2 has spread rapidly. To date, countries have relied on the prevention of the disease through isolation, quarantine, and clinical care of affected individuals. However, studies on the roles of asymptomatic and mildly infected subjects in disease transmission, use of antiviral drugs, and vaccination of the general population will be very important for mitigating the effects of the eventual return of this pandemic. Initial investigations are ongoing to evaluate antigenic structures of SARS-CoV-2 and the immunogenicity of vaccine candidates. There also is a need to comprehensively compile the details of previous studies on SARS-related vaccines that can be extrapolated to identify potent vaccine targets for developing COVID-19 vaccines. This review aims to analyze previous studies, current status, and future possibilities for producing SARS-CoV-2 vaccines.

Mental distress in orthodontic patients during the coronavirus disease 2019 pandemic

Introduction

The ongoing coronavirus disease 2019 (COVID-19) outbreak impacts the mental health of patients, health workers, and the public. The level of impact on the mental health of orthodontic patients in treatment is unknown. The objective of the study was to evaluate the mental health of orthodontic patients in China during the early stage of the pandemic.

Methods

An online survey was conducted on a convenience sample of anonymous participants. The questionnaire, in Chinese (Mandarin), comprised 5 sections. Sections 1-3 included demographic, epidemical, and orthodontic status of the patients. Section 4 assessed mental health-related to orthodontics. Section 5 was the Kessler-10 Mental Distress Scale. A total of 48 orthodontists were invited to distribute the questionnaires to their patients. Descriptive statistics, principal component analysis, K-means cluster analysis, and bivariate logistics regression analysis were performed with significance set at P <0.05.

Results

Questionnaires were collected from 558 patients (104 males, 354 females; mean age 24.78 ± 6.33 years). The prevalence of mental distress was 38% (174/458). Higher odds ratios were associated with female participants, missed appointments, and Hubei residence. The type of orthodontic appliance was associated with the anxiety of prolonged treatment duration. The manner of communication with patients regarding the postponement of appointments was associated with patients' concerns of prolonged treatment duration. The frequency of contact from dentists was associated with patients' independence.

Conclusions

Over one-third of orthodontic patients experienced mental distress during the pandemic. Multiple factors affected the level of anxiety of orthodontic patients, such as the type of orthodontic appliance, time since last dental visit, manner of communication with the orthodontist, and the localities of the pandemic progression.

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Thirty-eight percent of patients had orthodontic-related mental distress during the pandemic.

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Orthodontic patients in the epicenter revealed higher odds of mental distress.

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Orthodontists who contact patients personally might relieve their anxiety.

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Patients with invisible appliances felt less anxiety about the duration of treatment.

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The results could guide orthodontists from other countries with similar situations.

Precautions and recommendations for orthodontic settings during the COVID-19 outbreak: A review

Introduction

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). It emerged as a global pandemic in early 2020, affecting more than 200 countries and territories. The infection is highly contagious, with disease transmission reported from asymptomatic carriers, including children. It spreads through person-to-person contact via aerosol and droplets. The practice of social distancing—maintaining a distance of 1-2 m or 6 ft—between people has been recommended widely to slow or halt the spread. In orthodontics, this distance is difficult to maintain, which places orthodontists at a high risk of acquiring and transmitting the infection. The objective of this review is to report to orthodontists on the emergence, epidemiology, risks, and precautions during the disease crisis. This review should help increase awareness, reinforce infection control, and prevent cross-transmission within the orthodontic facility.

Methods

A comprehensive literature review of English and non-English articles was performed in March 2020 using COVID-19 Open Research Dataset (CORD-19 2020), PubMed, MEDLINE, Scopus, and Google Scholar to search for infection control and disease transmission in orthodontics.

Results

This review emphasizes minimizing aerosol production and reinforcing strict infection control measures. Compliance with the highest level of personal protection and restriction of treatment to emergency cases is recommended during the outbreak. Surface disinfection, adequate ventilation, and decontamination of instruments and supplies following the guidelines are required.

Conclusions

Reinforcing strict infection control measures and minimizing personal contact and aerosol production are keys to prevent contamination within orthodontic settings. Although no cases of COVID-19 cross-transmission within a dental facility have been reported, the risk exists, and the disease is still emerging. Further studies are required.

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Coronavirus disease 2019 is a highly contagious global pandemic.

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It could transmit by asymptomatic carriers via person-to-person contact, aerosol, and droplets.

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Strict infection control and aerosol containment are required in orthodontic settings.