ArticlePDF Available

Oral healthcare during the COVID-19 pandemic

Authors:
Ondine Lucaciu at Iuliu Haţieganu University of Medicine and Pharmacy
Ondine Lucaciu
Dorottya Tarczali
Dorottya Tarczali
Dorottya Tarczali
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Nausica Petrescu at Iuliu Haţieganu University of Medicine and Pharmacy
Nausica Petrescu
Download full-text PDF
Read full-text
Download citation

Figures

Figures - available via license: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Content may be subject to copyright.
Available via license: CC BY-NC-ND 4.0
Content may be subject to copyright.
Perspective
Oral healthcare during the COVID-19
pandemic
Q2 Ondine Lucaciu
ay
, Dorottya Tarczali
by
, Nausica Petrescu
a
*
y
a
Department of Oral Health, Faculty of Dentistry, “Iuliu Hat
‚ieganu” University of Medicine and
Pharmacy, Cluj-Napoca, Romania
b
Regional Hospital, Cluj-Napoca, Romania
Received 20 April 2020; Final revision received 26 April 2020
Introduction
Q1
The Coronavirus Disease 2019 (COVID-19) epidemic began in
Wuhan, China, in December 2019.
1
On January 1st, 2020,
WHO announced that this outbreak represents an interna-
tional public health emergency, affecting 2,725,920 people
by April 24, 2020, causing, 191,061 deaths.
2
On February 11,
The International Committee on Taxonomy of Viruses has
made public the name of the virus causing COVID-19: severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
3
Transmission paths
The two modes of transmission are via aerosols, through
drops of fluid spread by coughing, sneezing, and fecal-oral
(digestive).
1
Characteristics of COVID-19
The incubation period is 1e14 days, most commonly 3e7
days. Patients are contagious in the latency period. On
average, a patient can infect another 2e2.5 people.
4
The main symptoms are represented by:
Fever
Cough (especially dry)
Fatigue
Sputum
Shortness of breath
Dry throat
Headache
Digestive manifestations in a small percentage of
patients
1
The fraction of severe, critical cases and mortality rate
is higher, compared to influenza. The number of deaths per
day relative to the total number of cases gives us a per-
centage of 3e4%.
4
Control of infection in oral healthcare settings
In light of the thread of COVID-19 pandemic, the conception
of strict and efficient protocols for oral healthcare settings
is of paramount importance. This specialty is prone to cross
infection among patients and healthcare workers. This
article provides recommendation on patient evaluation,
treatment approach for dental emergencies and infection
control protocols.
Screening for COVID-19 status and triaging for
dental treatments
During the pandemic, it is recommended to perform
exclusively emergency dental procedures to protect the
medical personnel, the patients and to reduce as much as
possible the consumption of personal protective equip-
ment. Patients’ general health assessment before dental
* Corresponding author. Department of Oral Health, Faculty of
Dentistry, “Iuliu Hat
‚ieganu” University of Medicine and Pharmacy, No.
15, Victor Babes street, 1st floor, Cluj-Napoca, 400012, Romania.
E-mail address: nausica_petrescu@yahoo.com (N. Petrescu).
y
All authors contributed equally to the work.
+MODEL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
JDS721_proof ■30 April 2020 ■1/4
Please cite this article as: Lucaciu O et al., Oral healthcare during the COVID-19 pandemic, Journal of Dental Sciences, https://doi.org/
10.1016/j.jds.2020.04.012
https://doi.org/10.1016/j.jds.2020.04.012
1991-7902/ª2020 Association for Dental Sciences of theRepublic of China.Publishing services by Elsevier B.V. Thisis an open access article under
the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Available online at www.sciencedirect.com
ScienceDirect
journal homepage: www.e-jds.com
Journal of Dental Sciences xxx (xxxx) xxx
treatment is very important (Fig. 1), as dental health
workers can identify undiagnosed COVID-19 patients.
Emergency dental patients that test positive for SARS-CoV-2
should be referred for emergency care where appropriate
Transmission-Based Precautions are available. The indica-
tion for SARS convalescing patients was to postpone dental
treatments for 1 month.
7
Same recommendation could be
adopted for COVID-19 patients.
Figure 1 Screening for COVID-19 status and triaging patients for dental treatments and guidelines of dental problem
assessment.
5,6
2 O. Lucaciu et al
+MODEL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
JDS721_proof ■30 April 2020 ■2/4
Please cite this article as: Lucaciu O et al., Oral healthcare during the COVID-19 pandemic, Journal of Dental Sciences, https://doi.org/
10.1016/j.jds.2020.04.012
What is considered an emergency in dentistry, according
to ADA?
Dental emergencies are those that put the patient’s life
at risk and require immediate treatment to stop bleeding,
reduce pain and stop infection. The emergency dental
cases are represented by:
Severe pain of pulp origin
Pericoronaritis, pain in the third molar region
Postoperative osteitis, dry alveolitis
Dental fractures causing pain or soft-tissue injuries
caused by trauma
Luxations, dental avulsions
Dental treatments required before general medical
procedures
Final cementation of crowns, decks if provisional resto-
ration is lost, deteriorated or causes gum irritation
Biopsies
Other emergencies shall be considered as follows:
Extended cavities or damaged restorations causing pain
(Temporary restorations are performed)
Suppression of suture threads
Dental treatments of oncology patients
Dental adjustments when function is impaired
Change of temporary fillings in endodontic access cav-
ities, if they have caused pain
Adjustment of the orthodontic apparatus if it has caused
pain or ulceration on the oral mucosa.
8
Assessment of the gravity of the dental emergency is
very important. The evaluation of the dental and general
health status of the patient is based on the workflow in
Fig. 1. Dental practitioners should aim to ease patients
suffering and alleviate the burden that dental emergencies
would place on hospital emergency departments.
Effective control of infection in the dental office
Social distancing protocol for patients should be adopted in
the dental office. Appointments should be scheduled apart
to minimize contact between patients. If this standard is
not applicable, patients can wait in their personal vehicle,
until it is their turn.
Since the main route of transmission of the virus is the
aerial one, it is necessary to use personal protective
equipment, gloves, face masks (N-95 or FFP2), goggles or
facial shield to protect the skin and mucous membranes of
the medical personnel as well as waterproof robes, jump-
suits. If the mask is damaged, or the doctor has difficulties
breathing, the mask should be changed. Dental health
worker should have a seasonal flu vaccine this year, ill-
health status of medical personnel has to be assessed daily.
Rigorous hand hygiene and surfaces in the dental office is
the most important measure of reducing the transmission of
microorganisms to patients. Depending on surface type,
temperature, humidity, SARS-CoV-2 may persist on surfaces
from a few hours to a few days. All reading materials, mag-
azines and toys should be removed from the dental office.
To minimize the formation of drops and aerosols, it is
recommended to perform minimally invasive procedures,
to use the surgical vacuum cleaner, 4-hand work, and rub-
ber dam isolation of the operator field. Before dental pro-
cedures it is recommended that the patient rinses with
antimicrobial oral solutions.
9
Resorbable sutures after sur-
gical procedures are recommended. Aerosol generating
procedures should be scheduled at the end of the program.
Figure 1 (continued).
Oral healthcare during the COVID-19 pandemic 3
+MODEL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
JDS721_proof ■30 April 2020 ■3/4
Please cite this article as: Lucaciu O et al., Oral healthcare during the COVID-19 pandemic, Journal of Dental Sciences, https://doi.org/
10.1016/j.jds.2020.04.012
If procedures were performed without N95 masks, both the
healthcare provider and the patient are at moderate risk
for SARS-CoV-2 infection/transmission. Fourteen days of
quarantine are recommended after this exposure. As
intraoral x-ray can induce saliva secretion and coughing,
10
extraoral radiographies (panoramic, Cone Beam Computer
Tomography) are alternatives.
After providing dental care, facial protective equipment
should be cleaned and disinfected. The X-ray equipment,
the light and the dental chair should be disinfected ac-
cording to the instructions of the manufacturer. The floors
should also be disinfected. Handpieces must be sterilized
after each patient. Frequently used surfaces such as: door
handles, bathrooms, desks must be disinfected often.
In the areas severely affected by COVID-19, the patients
arriving in the waiting room should receive protective
masks.
1
Conclusion
The COVID-19 pandemic represents a global challenge,
given the increased contagiousness of SARS-CoV-2,
dental healthcare providers have to adopt new pro-
tocols for a better infection prevention in the dental
office and new working protocols aimed to prevent
spreading the virus.
Declaration of Competing Interest
The authors have no conflicts of interest relevant to this
article.
Acknowledgements
The authors received no funding for this work.
References
1. Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19):
emerging and future challenges for dental and oral medicine. J
Dent Res 2020;99:481e7.
2. Wordometer. Reported cases and deaths by country, territory,
or conveyance. Available at: https://www.worldometers.info/
coronavirus/#countries. [Accessed 24 April 2020].
3. World Health Organization. Naming the coronavirus disease
(COVID-19) and the virus that causes it. Available at: https://
www.who.int/emergencies/diseases/novel-coronavirus-2019/
technical-guidance/naming-the-coronavirus-disease-(covid-
2019)-and-the-virus-that-causes-it. [Accessed 23 April 2020].
4. World Health Organization. Coronavirus disease 2019 (COVID-
19) situation report 46. 2020. Available at: https://www.who.
int/emergencies/diseases/novel-coronavirus-2019/situation-
reports. [Accessed 19 April 2020].
5. Scottish Cental Clinical Effectiveness Programme. Management
of acute dental problems during COVID-19 pandemic. Available
at: http://www.sdcep.org.uk/published-guidance/acute-
dental-problems-covid-19/. [Accessed 19 April 2020].
6. American Dental Association. ADA interim guidance for man-
agement of emergency and urgent dental care. Available at:
https://www.ada.org/w/media/CPS/Files/COVID/ADA_Int_
Guidance_Mgmt_Emerg-Urg_Dental_COVID19.pdf. [Accessed
19 April 2020].
7. Samaranayake L, Reid J, Evans D. The efficacy of rubber dam
isolation in reducing atmospheric bacterial contamination.
ASDC J Dent Child 1989;56:442e4.
8. American Dental Association. What constitutes a dental
emergency?. Available at: https://success.ada.org/w/media/
CPS/Files/Open%20Files/ADA_COVID19_Dental_Emergency_
DDS.pdf?_gaZ2.253879752.110187285.1584496315-
1622146531.1565271894. [Accessed 19 March 2020].
9. Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ,
Malvitz DM. Guidelines for infection control in dental health-
care settingsd2003. MMWR Recomm Rep 2003;52:1e61.
10. Vandenberghe B, Jacobs R, Bosmans H. Modern dental imaging:
a review of the current technology and clinical applications in
dental practice. Eur Radiol 2010;20:2637e55.
4 O. Lucaciu et al
+MODEL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
JDS721_proof ■30 April 2020 ■4/4
Please cite this article as: Lucaciu O et al., Oral healthcare during the COVID-19 pandemic, Journal of Dental Sciences, https://doi.org/
10.1016/j.jds.2020.04.012
... Identifying the outcomes for strategy planning, implementation, or research: Data presentation by tabulation or text sonal protective measures, optimal environmental safety measures, and use of equipment to control contaminants and aerosols. Fourteen articles suggested mouthwash rinse prior to dental procedures to decrease the viral load [4,8,12,13,16,[18][19][20][22][23][24][25][26][27]. Final recommendations are presented in Table 2. ...
... Also, the patients should disinfect their hands with hand sanitizers available in the office. If the patient leaves the office for a while and then comes back, all the aforementioned steps should be repeated [24,25]. A separate safe room should be preferably considered for active screening of patients to minimize contact between patients, the staff, and dental clinician. ...
... Mouthwashes have low substantivity on the oral mucosa, and the viruses present in the saliva can easily re-colonize the mucosa; 1% hydrogen peroxide is most commonly recommended for this purpose due to its optimal virucidal effect. To prepare 15 mL of 1% hydrogen peroxide, 5 mL of 3% hydrogen peroxide should be added to 10 mL of distilled water [13,16,18,19,24,26]. ...
The significance of coronavirus disease 2019 in dentistry: A scoping review
Article
Full-text available
  • Jul 2022
Background: The emergence of coronavirus disease 2019 (COVID-19) pandemic had a significant impact on dental profession, and COVID-19 prevention and control have been the topic of numerous investigations. Objectives: This study aimed to review and present the most effective strategies for prevention and control of COVID-19 before, during, and after dental procedures in the pandemic and post-pandemic era. Materials and methods: This scoping review was conducted according to the five stages of conduct proposed by Arksey and O’Malley. The latest findings available in most accredited databases and scientific websites including Science Direct, Scopus, PubMed, and Google Scholar, and the guidelines recommended by the World Health Organization and Center for Disease Control and Prevention were searched using the following MeSH terms: “COVID-19”, “Dentistry”, “Infection Control”, and “SARS-CoV-2”. Irrelevant articles, duplicates, and those not meeting the eligibility criteria were excluded. The remaining 24 eligible articles were reviewed. Results: After data analysis, an efficient protocol for dental procedures during the COVID-19 pandemic was tabulated, which included emergency treatments only, preoperative rinsing of an effective mouthwash, patient triage, principles of personal protection for patients and the staff, aerosol elimination from the office, efficient disinfection of the environment, and specific measures for different dental procedures. Conclusion: Dental clinicians can play a pivotal role in prevention of COVID-19 transmission by precise adherence to the protocols, updating their knowledge, and educating patients prior to their visit. Accordingly, they can fulfill their professional responsibility in treatment of emergency cases and other patients. Despite the ongoing global vaccinations against the COVID-19, genetic mutations that occur in the viral genome over time can still challenge the future of dental profession.
View
... It is reported that, each infected person can infect another 2-2.5 people averagely. 1,10 Unfortunately, asymptomatic patients are also carriers of SARS-CoV-2 and patients can infect others in their incubation period which makes the control of the disease's transmission extremely challenging. 8,9 The presence of SARS-CoV-2 in saliva has been proved and as it is known that dental procedures produce aerosols and droplets which in turn can strongly increase the risk of the virus spread in the environment. ...
... Recently many studies have discussed dental practice during the outbreak of the COVID-19 and some of them addressed the knowledge, attitudes and practice of dental practitioners regarding the COVID-19 pandemic and its infection control. 10,12,14,15 However, these studies represent some limited communities and enough data of most countries are not available yet. ...
Dental students’ knowledge about protective guidelines for clinical practice during the COVID‐19 pandemic
Article
Full-text available
  • Mar 2023
Objective: The coronavirus disease 2019 (COVID-19) originated in China, in December 2019, spread worldwide promptly and turned into an outbreak which caused an international public health concern. The novel coronavirus which is also called SARS-CoV-2 transmits predominantly by respiratory droplets and the spread pattern of this infection throughout the community became a big challenge encountering the dental profession. Recently several guidelines have been developed for dental clinicians to protect both patients and practitioners, agents this infection. The aim of this study was to estimate the knowledge of dental students about the content of protective guidelines for clinical practice during the COVID-19 pandemic. Methods: An online questionnaire was developed by a team of specialists which were the faculty member of Tehran University of Medical sciences according to the content of the protective guidelines of ADA for dental practice during the COVID-19 pandemic. The questionnaire was validated and its reliability was confirmed by retesting 10 samples after 2 weeks with a cronbach alpha of 0.9. The online questionnaire was sent to 4 dental schools in the city of Tehran and was fill out by 170 dental students. Results: The mean knowledge score for all 170 participants was 16.23 out of 32 (50.72%) with the maximum score of 24 (75.0%) and the minimum score of 1 (3.1%). There was a significant relationship between the gender of participants and their knowledge score (p = 0.032) in the way that male students had significantly higher score than females. Students with more advanced educational level achieved higher knowledge scores. (p = 0.038) However, there were no significant correlation between other variables and the students' knowledge score. (p > 0.05). Conclusion: Dental students had acceptable knowledge about the general protocols against corona virus in terms of hand hygiene, wearing face masks, surface sanitization and diagnostic symptoms of a patient susceptible to be infected by corona virus. However, mostly they were not aware of the details of the guideline's items which makes it crucial to add related content in the dental students' educational curriculum.
View
... Other Coronaviridae in this family include severe acute respiratory syndrome coronavirus (SARS-CoV), first detected in 2002, and the Middle East respiratory syndrome coronavirus (MERS-CoV), 6,7 first identified in 2012 . As the published genome sequence for this novel coronavirus has a close semblance with other beta-coronaviruses such as SARS-CoV and MERS-CoV, the Coronavirus Study Group of the International Committee on Taxonomy of Viruses gave it the scientific name SARS-CoV-2, but Nig Dent J Vol 29 No. 1 Jan. -June 2021 6,8 popularly called the COVID-19 virus . On January 30, 2020, the World Health Organization (WHO) declared the rampant spread of SARS-CoV-2 and its associated disease (COVID-19) a public health emergency with a currently known overall mortality 6 rate to be as high as 3.4% . ...
The Fear of COVID-19 Infection and Its Correlates with Clinical Practice among Nigerian Dentists
Article
Full-text available
  • Jun 2021
  • Niger Dent J
Background: The COVID-19 pandemic was not without its consequences like fear and effect on the economy and health care systems, with dentists being at a high risk of contracting the infection. Objectives: The study aimed to assess the fear and risk of contracting the disease among Nigerian dentists. It also assessed a self-reported economic impact of the outbreak of COVID-19 disease on dental practices in Nigeria. Methods: An online cross-sectional survey was conducted among Nigerian dentists. The survey link was forwarded on social media platforms of Nigerian dentists. The questionnaire inquired about fear/anxiety, self-reported effect on clinic income, adequacy of knowledge on COVID-19, and use of N95 facemask, among others. The statistical level was set at 5%. Results: A total of 314 dentists (184 males and 130 females) within the age range of 22 to 63 years responded. The majority (214; 68.2%), were confident about their knowledge of the COVID-19 disease. Almost all the participants (298; 94.9%) entertained fears of contracting the disease through practice and transmission to family members, while 54.1% strongly agreed that theN95 mask should be worn routinely. However, all (100.0%) reported an economic impact of the pandemic on dental practice. Conclusion: The fear of contracting COVID-19 infection was high among dentists. Therefore, adequate and regular use of protective and preventive measures such as N95 face mask should be a priority among dentists. Attention should be paid to constant medical evaluation to those at risk.
View
... While much of the initial dental research in relation to the COVID-19 pandemic pertains to infection control and guidance on dental precautions, the specific dental care provided in the USA during the COVID-19 pandemic has more recently undergone investigation. 1 Dentistry includes many aerosol generating procedures that are associated with increased transmission of respiratory infection. 2 Thus, it has been hypothesised that dentists are at increased risk of occupational exposure to the novel coronavirus, as COVID-19 is spread via respiratory droplets and is detectable in saliva. ...
The impact of COVID-19 on dental care in New York State and Georgia
Article
Full-text available
  • Jan 2023
Introduction During the COVID-19 pandemic, there was an unprecedented and forced closure of dental offices worldwide. As American state recommendations differed considerably during this period, this research strives to better define the effects of this pause on dental care. Materials and methods A 16-question Qualtrics survey was sent to the membership of the New York State Dental Association (NYSDA) and Georgia Dental Association (GDA). Licenced, actively practising dental members of the NYSDA and GDA (n = 680) answered questions about their practice demographics, appointment cancellations, reopening times and the volume of individual dental procedures performed from 1 March through to 1 August 2020, compared to the same five-month period in 2019. Results Demographic characteristics of respondent NYSDA and GDA members were statistically similar. Nonetheless, NYSDA members reported significantly larger decreases in provision of all types of dental procedures, except for antibiotic prescription, including prophylaxis, elective care, emergency dental care and speciality procedures. Discussion and conclusions All dental procedures declined significantly during the COVID-19 pandemic, with greater decrease in New York than in Georgia. This study raises concerns about the negative impact of the pandemic on oral public health and mandates both further research and clinical strategies to mitigate against this future risk.
View
... Among the measures taken in the context of the state of emergency was the closure of dental offices throughout the country. Exceptions were the regional dental offices from Emergency Care Units (Urgent Dental Care (UDC) hub) and private offices that showed their availability and approval of the College of Dentists to provide emergency dental care (which refers exclusively to the treatment of severe pain, infection or bleeding, dental fractures causing pain or soft-tissue injuries caused by trauma, luxation, dental avulsions [3]) at the same time fulfilling the additional conditions for the control of COVID-19 infection (having the required Infection Control Protocols and Personal Protective Equipment requirements in place). Apart from these private offices and UDC centers, all private offices have been closed since March 16. ...
Oral health, the patient's perspective during the COVID 19 pandemic
Article
Full-text available
  • Oct 2022
Background and aims: On March 16, 2020, the state of emergency was established with drastic measures of isolation and quarantine. Among the measures taken in the context of the state of emergency was the closure of dental offices throughout the country. The aim of our questionnaire-based cross-sectional study was to identify the psycho-affective implications of the Romanian citizens induced by the COVID-19 pandemic period as well as their opinion related to the self-perceived oral health status during this period. Methods: An original questionnaire was designed consisting of 41 questions, which were distributed to the general population via the Internet. The first part of the questionnaire investigated the respondents' opinion regarding the impact of this COVID-19 pandemic period of isolation on their oral health and the attention paid by the subjects to oral hygiene during restrictions. The second part refers to their addressability to the dental services during this pandemic and the third part interrogates different characteristics, namely the presence of comorbidities, possible anxiety, and stress. Results: A total of 769 participants answered the questionnaire online. Conclusion: According to their responses most of the respondents were not afraid of the possibility of contracting Sars-Cov-2 during dental treatments, but were in certain periods deprived of accessing dental services due to lockdown restrictions. They are aware of their oral health problems and pay more attention to oral hygiene so that they do not get worse during restrictions.
View
... The coronavirus disease-2019 (COVID- 19) outbreak raised a worldwide concern, and due to its rapid person-to-person transmission, it 2 / 11 promptly turned into a pandemic [1,2]. Several countries implemented mandatory lockdowns which included closure of all universities and suspension of all non-essential activities of institutions [3]. ...
Concerns and Problems of Orthodontic Patients During the COVID-19 Pandemic
Article
Full-text available
  • Jul 2022
Objectives: We aimed to find the main concerns of patients undergoing active orthodontic treatments and their orthodontic treatment-related (OTR) problems during the coronavirus disease-2019 (COVID-19) pandemic. Materials and methods: A researcher-made questionnaire addressing several aspects of the effects of COVID-19 pandemic on treatment was distributed among 181 orthodontic patients receiving active treatment. Anxiety, concern, problems, and willingness to attend orthodontic appointments and to undergo other dental procedures was questioned. The correlation of gender, age, COVID-19-related anxiety and OTR anxiety was statistically analyzed. Patient satisfaction level with different aspects of dental-clinic performance was also evaluated. Results: The participants included 117 females and 64 males, of which 94% adhered to the pandemic restrictions. The mean COVID-19-related- and OTR-anxiety were 51.7% and 52.7%, respectively. Higher COVID-19-related anxiety was significantly correlated with higher OTR anxiety (P<0.001). There was an inverse correlation between general COVID-19-related anxiety and OTR anxiety and willingness to attend orthodontic appointments (P<0.05). A positive insignificant (P=0.07) correlation existed between age and willingness to attend appointments. The main concern was prolongation of treatment and the most common problem was irritation of oral soft tissues by appliances. The majority (65.3%) were willing to attend their orthodontic appointments. Orthognathic surgery (62%) had the highest while, dental restorations and radiography had the lowest refusal rates (9.9%). Conclusion: COVID-19 pandemic significantly affected orthodontic treatment. The level of COVID-19-related anxiety was moderately high and patients were concerned about the impact of lockdown on their orthodontic treatment outcome. Young adults demonstrated higher levels of stress than other age-groups.
View
... During the onset of the 2020 SARS-CoV-2 (COVID-19) pandemic, there was an unprecedented, forced closure of dental o ces in the United States (US) mandated by state governors in all states except North Dakota and Wyoming (1). While much of the current dental research in relation to the COVID-19 pandemic pertains to infection control and guidance on dental precautions, the speci c dental care provided in the United States during the COVID-19 pandemic has yet to be quanti ed (2). ...
Impact of COVID-19 on Dental Care in New York State and Georgia
Preprint
Full-text available
  • Jul 2022
Introduction: During the COVID-19 pandemic, there was an unprecedented, forced closure of dental offices worldwide. As American state recommendations differed considerably during this period, this research strives to better define the effects of this pause on dental care. Materials & Methods: A 16-question Qualtrics survey was sent to the membership of the New York State Dental Association (NYSDA) and Georgia Dental Association (GDA). Licensed, actively practicing dental members of the NYSDA and GDA (n = 680) answered questions about their practice demographics, appointment cancellations, reopening times, and the volume of individual dental procedures performed from March 1 through August 1, 2020, compared to the same 5-month period in 2019. Results: Demographic characteristics of respondent NYSDA and GDA members were statistically similar. Nonetheless, NYSDA members reported significantly larger decreases in provision of all types of dental procedures except for antibiotic prescription, including prophylaxis, elective care, emergent care, and specialty procedures. Discussion & Conclusions: All dental procedures declined significantly during the COVID-19 pandemic, with greater decrease in New York than in Georgia. This study raises concern about the negative impact of the pandemic on oral public health, and mandates both further research and clinical strategies to mitigate against this future risk.
View
Practice of Modified Safety Measures for Covid-19 Adopted by Dental Health Care Providers and Barriers Faced by Them: Practice of Modified Safety Measures for COVID-19
Article
Full-text available
  • Apr 2023
The COVID-19 infection has influenced almost everyone belonging to every walk of life especially dental practitioners are introduced to a higher bet of getting infected because of close contact with such patients. The COVID-19 has put an enormous hassle on clinical benefits system across the globe. The dental practice is to highly needed change in accordance with the new scourge circumstance in order to reduce the risks of SARS-CoV-2 infection transmission. Objective: To investigate practice of modified safety measures by the dentists regarding COVID-19 outbreak. Methods: Descriptive cross-sectional study was conducted among dentists working at Institute of dentistry Liaquat University of Medical and Health Sciences Jamshoro, Dental outpatient department of Hyderabad, and private dental practitioners of Hyderabad city, Pakistan by convenience sampling technique. The analysis of data were conducted using SPSS version 23.0 after adjusting the potential confounders and to analyze association between dentist response and age, gender, and other characteristics by applying Chi-Square test. Results: Most of the dental professionals are scared of developing COVID-19 from a patient or co-worker (83.17%) and are well known about its transmission (93.36%) and use PPE (74.17%). Conclusions: Although having a high valuable level of knowledge and practice, dental practitioners around the world are in a state of anxiety and dread while working in their respective fields due to the COVID-19 pandemic impact on mankind.
View
Safety Precaution and Infection Control Practices among Dental Practitioners in Nigeria during the COVID-19 Pandemic
Article
Full-text available
  • Apr 2023
Background: COVID-19 remains a major public health threat globally and dental practitioners are particularly at risk due to the proximity of care givers to the patient and the generation of aerosols during many dental treatment procedures. Dental practitioners are therefore required to strictly observe standard universal precautions in their clinical practice. Objectives: To determine the safety precaution and infection control practices among dental practitioners in Nigeria during the COVID-19 Pandemic. Methods: A cross-sectional self-administered pre-tested questionnaire based survey of consenting dental practitioners from different geopolitical zones in Nigeria was employed for the study. Study participants were recruited by non-random convenience sampling. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 105 out of 142 respondents completed and returned the survey questionnaire giving a response rate of 74%. About 24-55% of study respondents performed aerosol/splatter/droplet generating procedures. Hand hygiene and donning of face mask were the most common safety practices while the use of face shield and N95 facemask were common infection control practices. Over 60% of respondents practiced triaging of patients, pre-procedural mouth rinse and donning of disposable surgical gowns. Almost half of the respondents practiced decontamination of the clinic work environment and over 70% of respondents used N95 masks. Conclusion: Aerosol generating procedures were not uncommon dental practices in Nigeria during COVID-19 pandemic. However, use of N95 mask was relatively high and there was a reasonable level of practice of basic standard COVID-19 safety measures and infection prevention and control guidelines.
View
Proceedings From the California Dental Association Symposium on Geriatrics and Oral Health
Article
  • Mar 2023
The California Dental Association and the University of the Pacific, Arthur A. Dugoni School of Dentistry convened a gathering of experts and stakeholders to conduct a strengths, weaknesses, opportunities and threats (SWOT) analysis with regard to oral health needs, dental education and workforce, financial and reimbursement structures and legislative opportunities as they relate to improving oral health for older Californians. The consensus was that change must begin in dental education, with relevant and innovative clinical experiences in geriatric care, including interprofessional education (IPE) and interprofessional practice (IPP) with appropriately trained faculty. Incentives for faculty and professional development are needed to develop role models who can appropriately manage the diverse and unique oral health care needs of older adults as part of an interprofessional team. Value-based care and novel dental benefit and reimbursement mechanisms are needed to support many older Californians who are lacking financial resources for care. Innovation in care delivery models to meet the needs of those who are most vulnerable and removed from opportunities for care are also needed to improve access to care and health outcomes across California. The entire health care team must be engaged. Oral health care must be perceived and practiced as an integral component of primary health care to achieve optimal health outcomes.
View
Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine
Article
Full-text available
  • Mar 2020
The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.
View
Guideline for infection control in dental healthcare settings
Article
Full-text available
  • Jan 2004
This report consolidates previous recommendations and adds new ones for infection control in dental settings. Recommendations are provided regarding 1) educating and protecting dental health-care personnel; 2) preventing transmission of bloodborne pathogens; 3) hand hygiene; 4) personal protective equipment; 5) contact dermatitis and latex hypersensitivity; 6) sterilization and disinfection of patient-care items; 7) environmental infection control; 8) dental unit waterlines, biofilm, and water quality; and 9) special considerations (e.g., dental handpieces and other devices, radiology, parenteral medications, oral surgical procedures, and dental laboratories). These recommendations were developed in collaboration with and after review by authorities on infection control from CDC and other public agencies, academia, and private and professional organizations.
View
MMWR Guidelines for Infection Control in Dental Health-Care Settings—2003
Article
  • Dec 2003
This report consolidates previous recommendations and adds new ones for infection control in dental settings. Recommendations are provided regarding 1) educating and protecting dental health-care personnel; 2) preventing transmission of bloodborne pathogens; 3) hand hygiene; 4) personal protective equipment; 5) contact dermatitis and latex hypersensitivity; 6) sterilization and disinfection of patient-care items; 7) environmental infection control; 8) dental unit waterlines, biofilm, and water quality; and 9) special considerations (e.g., dental handpieces and other devices, radiology, parenteral medications, oral surgical procedures, and dental laboratories). These recommendations were developed in collaboration with and after review by authorities on infection control from CDC and other public agencies, academia, and private and professional organizations
View
Modern dental imaging: A review of the current technology and clinical applications in dental practice
Article
  • Nov 2010
  • EUR RADIOL
A review of modern imaging techniques commonly used in dental practice and their clinical applications is presented. The current dental examinations consist of intraoral imaging with digital indirect and direct receptors, while extraoral imaging is divided into traditional tomographic/panoramic imaging and the more recently introduced cone beam computed tomography. Applications, limitations and current trends of these dental "in-office" radiographic techniques are discussed.
View
The efficacy of rubber dam isolation in reducing atmospheric bacterial contamination
Article
  • Nov 1989
A study was made to ascertain the efficacy of rubber dam isolation in controlling atmospheric bacterial contamination, when conservative pedodontic procedures are performed. There was a highly significant (p less than 0.001) reduction in bacterial contamination of the atmosphere, perioperatively, when rubber dam isolation was used. As the reduction in bacterial aerosols was greatest at 1 m from the headrest, the use of rubber dam would minimize significantly the inhalation of infective aerosols by dental personnel.
View
Reported cases and deaths by country, territory, or conveyance
  • Apr 2020
  • 24
  • Wordometer
Wordometer. Reported cases and deaths by country, territory, or conveyance. Available at: https://www.worldometers.info/ coronavirus/#countries. [Accessed 24 April 2020].