Dental Practice Infection Control Measurements: Coronavirus Disease (COVID-19) Outbreaks

Effect of COVID-19 on dental service delivery in Fiji: Perspective of Dental Officers (Dos) and Dental Managers (DMs)

BACKGROUND

Corona Virus Disease 2019 (COVID-19) was declared a global pandemic by the World Health Organization (WHO) has had significant impact on dentistry in Fiji. Due to lack of previous study, this study aims to explore the perspective of Dental Officers (DOs) and Dental Managers (DMs) on the effects of COVID-19 on dental service delivery in Fiji Islands.

METHODS

This qualitative study was conducted amongst 30 DOs and 17 DMs between 9th August to 12th September, 2021. It was conducted in the government dental clinics, private dental clinics and the School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji. The study settings were randomly selected. Purposive sampling method was used for the selection of participants who met the study criteria. Semi-structure open ended questionnaires were used for data collection through in-depth interviews via zoom. Manual thematic analysis of the data was conducted to derive themes and codes.

RESULTS

The participants interviewed for the study included more female DOs (66.7%) and male DMs (58.8%). Seven themes emerged from data analysis: range of services delivered, appointment versus walk-in patients for aerosol generating procedures (AGPs), impact of pandemic on clinic opening hours, impact of COVID-19 on patient numbers, quality of services delivered, resources and infrastructure, perceptions about the burden of disease.

CONCLUSION

COVID-19 has significantly affected dental service delivery. Mostly emergency dental services were delivered. AGPs were delivered on appointment basis. Most participants stated the quality of services had improved. Participants stated that they were not given adequate resources and the infrastructure was not up to standard to provide dental services during the pandemic. The dental disease burden had increased during the pandemic as per the participants. Future research can be conducted amongst other dental professionals in other divisions of the country.

Clinical management and infection control protocols during the COVID-19 pandemic: An online survey

BACKGROUND

SARS-CoV-2 (COVID-19) is considered a highly infectious and life threatening disease.

OBJECTIVE

The present paper aims to evaluate various aspects of preventive measures and clinical management of the scheduled visits for orthodontic patients to the dental clinics during the outbreak of COVID-19, and to assess how orthodontists dealt with this challenge.

METHODS

Orthodontists in private and public clinics were invited to fill a questionnaire that addressed infection control protocols and concerns about clinical management of patients in the clinics during the pandemic. Frequncies and percentages of the responses were obtained and compared using Chi-square tests.

RESULTS

About 77% of those working in private clinics, and 63% of those working in private and governmental clinics performed room disinfection following each patient. In case of patients needing urgent management and have active infection, 56% of the participants provided care under high infection control measures; on the contrary, 64% provided symptomatic intervention including orthodontic wax, analgesics and sometimes mouthwash.

CONCLUSION

The COVID-19 pandemic has had a negative impact on the orthodontic treatments. All pre-cautionary measures have to be made available in the clinic in order to minimize the spread of viral infection with continuous dental health care training.

The Investigation of Clinical Guidelines and Standards on Infection Control in Specialized Dental Departments

Background: It is important to adhere to infection control measures in dental procedures due to direct contact with blood and saliva. During the Coronavirus disease 2019 pandemic, regular surveillance is imperative to ensure adherence to the standards. This study aimed to assess the level of adherence to infection control guidelines in specialized dental clinics in different working shifts. Materials and Methods: This study was assessed the level of adherence of 45 selected dental departments to three main guidelines released by (I) the Center for Disease Control (CDC), (II) Ministry of Health (MOH), and (III) armed forces organization (AFO) in three different working shift. The CDC checklist had eight domains. Thus, the items of each domain were individually scored, and considering the weighting coefficient of each item, the total score was calculated. The same procedure was carried out for the two remaining guidelines. Possible effect of working shifts and different specialties on infection control practice was also calculated. Results: The mean rate of adherence was 70.7% to the CDC, 93.8% to the MOH and 84.4% to the AFO guidelines indicating that adherence to the CDC guidelines was lower than the other two domestic guidelines. Individual assessment of each item revealed that hand hygiene (39%) and safe handling and disposal of sharp instruments (46%) acquired the lowest, and sterilization (79%) and safe injection (97%) acquired the highest score according to the CDC checklist. There was no relationship between working shifts and dental specialties regarding the adherence to infection control standards. Conclusion: Dental clinics had different performances regarding infection control guidelines. Further emphasis should be placed on hand hygiene and disposal of sharp instruments.

Behavioral Preventative Strategies Undertaken by Dental Clinics in Fiji during COVID-19 Pandemic

Introduction:

COVID-19 has created a significant impact on dentists and oral health professionals. This research aimed to explore the perspective of dental officers (DOs) and dental managers (DMs) on behavioral preventative strategies and recommendations for preventing the virus transmission in the dental clinics in Fiji.

Materials and Methods:

This qualitative study was conducted among DOs and DMs who worked in nine private dental clinics, eight government dental clinics, and one School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji between August 9 and September 12, 2021. The participants were selected using purposive sampling method using the inclusion and exclusion criteria. Self-developed semi-structured open-ended questionnaires were used for data collection through in-depth interviews via zoom. Manual thematic analysis of the data was conducted.

Results:

Thirty DOs and 17 DMs participated in this study. Seven themes emerged from data analysis: Risk perception-COVID-19 versus dentistry; Staff safety, satisfaction, and motivation; Breaking the chain of infection transmission; Adaptability, and acceptance; Shared responsibility; Roles and knowledge; and Importance of good planning. Majority of participants felt that dental professionals are at high risk, and hence, need to take extra precautionary measures. Participants also stated that more care should be provided to patients by accepting the situation and moving forward.

Conclusion:

This study highlighted the importance of dentists in preventing disease transmission in a dental setting. Continuation with the protocols and strategies gave the participants more sense of protection. The importance of good planning, accepting the situation, and moving forward was highlighted. Future research is recommended in other divisions and other health-care professionals can be included.

Clinical Experience, Knowledge, Attitudes and Practice of Turkish Pediatric Dentists during the COVID-19 Pandemic

Background and Objectives: “Coronavirus Disease 2019” (COVID-19) is a critical public health problem that has affected all fields, including dentistry. The dental management of children has become even more difficult during the COVID-19 pandemic. The purpose of this study was to evaluate the current knowledge, attitudes and practices of Turkish pediatric dentists who have been providing dental treatments to children during the COVID-19 pandemic. Materials and Methods: After receiving ethical approval, this cross-sectional study was conducted using the Google Forms online survey instrument. An online questionnaire link was sent to all the members of the Turkish Society of Paediatric Dentistry by e-mail and through social media. Statistical analyses were performed using descriptive statistics and Chi-square test; a p-value less than 0.05 was considered statistically significant. Results: A total of 200 pediatric dentists participated in this study and most of them (82%) only performed emergency dental treatments, whereas 18.5% performed both emergency and routine dental practices during the COVID-19 pandemic. The vast majority (72.5%) of pediatric dentists prescribed antibiotics and analgesics to their patients who were not cooperative with non-pharmacological behavior management techniques. The findings of the current study showed that the Turkish pediatric dentists had a good level of knowledge about COVID-19, satisfactorily conducted most of the infection control measures before and after the dental treatments, and attached importance to the use of PPEs; however, infection control measures during the dental treatments could be implemented better. Conclusions: Along with all precautions, the vaccination of healthcare workers and requesting a recent test result from patients showing a lack of COVID-19 disease before dental appointments could be used as effective infection control measures. Additionally, pediatric dentists should continue to follow local and universal guidelines, and education programmes should be frequently implemented in order to keep their COVID-19 management strategies up to date.

Dentists' Working Conditions during the First COVID-19 Pandemic Lockdown: An Online Survey

The aim of this study was to investigate the operating conditions of dentists in Central Europe during the first coronavirus disease 2019 (COVID-19) lockdown. A survey including 24 questions was emailed to dentists in Austria, Germany, Switzerland and South Tyrol (Italy). Questions regarding dentists’ field of work, working hours, treatments performed, personal protective equipment and protocols, and economic consequences were asked. 1731 participants were included. 30.4% of participants worked mainly in Austria, 60.8% in Germany, 6% in Switzerland and 2.1% in South Tyrol. A country-specific analysis for the situation of South Tyrol was not possible due to the low participation; 53.7% of German, 45.5% of Austrian, and 11.7% of Swiss respondents reduced their working hours; 42.8% of Austrian, 41.5% of Swiss, and 17.3% of German participants closed their offices temporarily; 52.2% of respondents provided emergency service including pain management, restorations/temporaries, and denture repairs. A lack of access to FFP2/FFP3 (filtering facepiece) respirators was indicated by 59.4% Austrian, 38.0% German, and 11.7% Swiss dentists (p < 0.001). FFP2/FFP3 respirators were, when available, most frequently used in Austria (86.9%), followed by Switzerland (61.2%) and Germany (56.7%) (p < 0.001). Financial consequences could not be conclusively quantified by 58.6% of the participants. Most respondents in all partaking countries made use of governmental support. A lack of blueprints/guidelines resulted in heterogeneous working conditions. In consideration of a potentially high risk of infection in the dental setting, non-emergency dental treatments were largely suspended in all participating countries.