Can Coronavirus Disease-19 Lead to Temporomandibular Joint Disease?

An Ethical Analysis Regarding the COVID-19 Pandemic Impact on Oral Healthcare in Patients with Mental Disorders

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.

The Prevalence and Predicting Factors of Temporomandibular Disorders in COVID-19 Infection: A Cross-Sectional Study

Introduction

During the pandemic of coronavirus disease 2019 (COVID-19), an increase in temporomandibular disorders (TMDs) was noticed in infected patients. In the present study, we aimed to assess the prevalence of TMDs during COVID-19 infection and to evaluate associated factors.

Methods

An observational cross-sectional online survey was conducted in April and May 2021 in order to estimate the prevalence of TMDs in participants who were previously infected with COVID-19. A multivariable logistic regression model was carried out to explore predicting factors of TMDs during COVID-19 infection.

Results

In total, the prevalence of TMDs during the COVID-19 infection period among participants was 41.9%. High fever episodes (adjusted odds ratio {aOR}: 3.25), gastro-esophageal reflux (aOR: 2.56), and toothache (aOR: 3.83) during COVID-19 illness were found to be positive predictors of TMDs, while vitamin D deficiency was found to be a negative predictor (aOR: 0.28).

Conclusion

Our study has highlighted a relatively high prevalence of TMDs in COVID-19-infected patients that may conclude TMDs as a possible COVID-19 symptom. Further studies are warranted to confirm the association between TMDs and COVID-19 infection and thereupon include TMDs among the known symptoms of COVID-19.

Quantitative Fit Test of a 3D Printed Frame Fitted Over a Surgical Mask: An Alternative Option to N95 Respirator

Background

COVID-19 has spread worldwide and caused severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to numerous dead cases. However, with the new COVID-19 outbreaks, there is a shortage of personal protective equipment (PPE) especially N95 masks worldwide including Thailand. This issue had placed the health professional in great need of an alternative mask.

Aim

This study aimed to measure the fit factor of 3D printed frames by quantitative fit testing (QNFT) to find an alternative facemask by using a mask fitter together with 2 different kinds of the American Society for Testing and Materials (ASTM) level 1 surgical mask.

Materials and Methods

Two commonly used surgical masks (Sultan Com-Fit Super Sensitive Ear Loop Mask or “White Mask Group,” not water-resistant, and Sultan Blue Com-Fit Super High Filtration Ear Loop Mask or “Blue Mask Group,” water-resistant) with and without 3D printed frame covering. The fit performance was measured by a quantitative fit test (QNFT) device (PortaCount, model 8048, TSI Incorporated, Minnesota, USA) accepted by the Occupational Safety and Health Administration (OSHA). The PortaCount device, which is based on a miniature continuous flow condensation nucleus counter (CNC), assesses the respiratory fit by comparing the concentration of ambient dust particles outside the surgical mask to the concentration that has leaked into the surgical mask. The ratio of these two concentrations (C_out/C_in) is called the fit factor. A fit factor of a 3D printed frame of at least 100 is required and considered as a pass level.

Results

We found that the mask fitter improves the overall performance of surgical masks significantly. The improved performance is comparable to that of N95.

Conclusion

The mask fitter improves the performance of surgical masks. The authors suggested that further study on frame material, shape, and expanded sample size would be beneficial to society.

COVID-19 Pandemic Impact on Dental Practice

Introduction: The COVID-19 pandemic has had a huge impact on the dentistry industry from the initial lockdown in March 2020 to the present day, nearly one year later with dentists unable to practice during the initial lockdown, that is when revenue took the biggest hit. The study aims to examine the impact of COVID-19 on dental practices during the pandemic in Bulgaria. Material and methods: A specially developed questionnaire was distributed electronically among 138 dentists from all regions of Bulgaria. The collected primary statistical information was entered and processed with the statistical package SPSS Statistics 19.0 Results: Statistical analyzes of the questionnaire show that (62,32%±4,12) of dentists say COVID-19 made no impact on their decision to retire or continue practicing; 43% of respondents predict revenue or costs will be the biggest challenge facing their practice in 2021. Part of dentists (34.78 % ± 4,05) believe that COVID-19 allowed them to learn more about infection control. Most of the respondents (87.68% ± 2.79) agree their income was lower in April to September of 2020 compared to 2019. More than half of dentists (61.59 % ± 4.14) believe Covid 19 has not impacted the products or services they offer. The majority of the participants (84.78 % ± 3.05) did not perform non-emergency procedures during the pandemic. Conclusion: Despite the numerous disadvantages caused by the COVID-19 pandemic, our survey shows dentists have found ways to adapt and succeed. Introduction: The COVID-19 pandemic has had a huge impact on the dentistry industry from the initial lockdown in March 2020 to the present day, nearly one year later with dentists unable to practice during the initial lockdown, that is when revenue took the biggest hit. The study aims to examine the impact of COVID-19 on dental practices during the pandemic in Bulgaria. Material and methods: A specially developed questionnaire was distributed electronically among 138 dentists from all regions of Bulgaria. The collected primary statistical information was entered and processed with the statistical package SPSS Statistics 19.0 Results: Statistical analyzes of the questionnaire show that (62,32%±4,12) of dentists say COVID-19 made no impact on their decision to retire or continue practicing; 43% of respondents predict revenue or costs will be the biggest challenge facing their practice in 2021. Part of dentists (34.78 % ± 4,05) believe that COVID-19 allowed them to learn more about infection control. Most of the respondents (87.68% ± 2.79) agree their income was lower in April to September of 2020 compared to 2019. More than half of dentists (61.59 % ± 4.14) believe Covid 19 has not impacted the products or services they offer. The majority of the participants (84.78 % ± 3.05) did not perform non-emergency procedures during the pandemic. Conclusion: Despite the numerous disadvantages caused by the COVID-19 pandemic, our survey shows dentists have found ways to adapt and succeed.

Oral Habits during the Lockdown from the SARS-CoV-2 Pandemic in the Romanian Population

Background and Objectives: The SARS-CoV-2 pandemic led to changes in population daily patterns. In order to adapt oral health promotion measures for future similar conditions, the main objective of the study was to assess changes in dental hygiene and eating and smoking habits during the government lockdown in Romania. Materials and Methods: The cross-sectional study was conducted immediately after the end of the lockdown and consisted of 800 adult subjects. Data collection was done via an online survey. Participants were divided into two groups: non-medical/dental practitioners (N-M/D group) and medical/dental practitioners (M/D group). Results: An increased use of dental floss from 27% (pre-lockdown) to 30.5% (during lockdown) was identified in the M/D group, while the manual toothbrush usage increased to 64.8% (during lockdown) from 61.7% (pre-lockdown) in the N-MD/group. No significant differences regarding toothbrushing frequency were observed in either group. A change in the number of daily snacks was identified in both groups (3–4 snacks per day: from 11% to 20.2% in the N-M/D group, from 13.1% to 22.2% in the M/D group). The consumption of sweets as a preferred snack was also noticed. A decrease of tobacco consumers was assessed in the lockdown period (from 66.6% to 60.4% in the M/D group, from 68.5% to 61.9% in the N-/M/D group). Conclusions: Oral habits were changed during the pandemic lockdown through the increase in the frequency of the consumption of snacks and sweets and the decrease in frequency of smokers. Only minor changes were observed in oral hygiene.

COVID-19 and Its Repercussions on Oral Health: A Review

In 2019, a new type of coronavirus, SARS-CoV-2, the causing agent of COVID-19, was first detected in Wuhan, China. On 11 March 2020, the World Health Organization declared a pandemic. The manifestations of COVID-19 are mostly age-dependent and potentially more severe in cases with involved co-morbidities. The gravity of the symptoms depends on the clinical stage of the infection. The most common symptoms include runny nose and nasal congestion, anosmia, dysgeusia or hypogeusia, diarrhea, nausea/vomiting, respiratory distress, fatigue, ocular symptoms, diarrhea, vomiting, and abdominal pain. These systemic conditions are often accompanied by skin and mucosal lesions. Oral lesions reported in patients with COVID-19 include: herpex simplex, candidiasis, geographic tongue, aphthous-like ulcers, hemorrhagic ulcerations, necrotic ulcerations, white hairy tongue, reddish macules, erythematous surfaces, petechiae, and pustular enanthema. It is still unclear if these manifestations are a direct result of the viral infection, a consequence of systemic deterioration, or adverse reactions to treatments. Poor oral hygiene in hospitalized or quarantined COVID-19 patients should also be considered as an aggravating condition. This narrative review is focused on presenting the most relevant data from the literature regarding oral manifestations related to SARS-CoV-2, as well as the challenges faced by the dental system during this pandemic. A routine intraoral examination is recommended in COVID-19 patients, either suspected or confirmed, as, in certain cases, oral manifestations represent a sign of severe infection or even of a life-threatening condition. It is our belief that extensive knowledge of all possible manifestations, including oral lesions, in cases of COVID-19 is of great importance in the present uncertain context, including new, currently emerging viral variants with unknown future impact.