Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

ABSTRACT Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Countryand sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies (AU).

Getting to Know SARS-CoV-2: Towards a Better Understanding of the Factors Influencing Transmission

Abstract In November 2002, a virus known as SARS-CoV was identified in Guangdong, China, and it was implicated as the etiology of severe acute respiratory syndrome. Seventeen years later, in the same month of November, a similar disease with more dramatic outcomes was identified in neighboring Wuhan. It has been six months since the identification of first cases of COVID-19 pandemic; however, unveiling clinical characteristics and modes of transmission of the disease are taking longer than expected. This overview aims to highlight some important points regarding the mode of transmission for which continuously surprising facts are being revealed every day. We also raise some vital questions to alert the scientific community to find the right answers and minimize the drastic fatal outcomes of this disease. It can be stated that SARS-CoV-2 could be transmitted as aerosol infection as well as through contacting infected surfaces. The possible role of abdominal gases as a route of spread of the virus should be considered and a fecal sample might be a useful diagnostic tool. Moreover, medical face masks are not protective from virus transmission during treating COVID-19 patients in settings where aerosol-generating procedures are performed. Doffing of PPE for healthcare workers needs more attention as this might be a source of infection unless additional measures of PPE disinfection are employed before doffing.

Knowledge and Attitudes Towards Antibiotic Prescribing Among Dentists in Sudan

Objective: To evaluate antibiotic prescribing practices of dentists working in a major teaching hospital in Sudan, and to assess the need for establishing education programmes to enhance dentists' awareness of antibiotic use. Material and Methods: A cross-sectional study was carried out by distributing an anonymous self-administered questionnaire to a convenience sample of dental practitioners at major teaching hospital in Khartoum/Sudan. The questionnaire investigated knowledge and attitudes of participants in relation to antibiotic prescribing in dental practice. Results: One hundred out of 135 dental practitioners working at the hospital participated in the survey with 48 males and 52 females. Most of the participants (N=44) did not specify their preferable drug reference, while 32 participants specified British National Formulary, and the practice was significantly associated with a higher professional rank (p<0.001). Metronidazole was the most frequently cited antibiotic for dentofacial infections (N=73) and Acute Necrotizing Ulcerative Gingivitis (N=56), while amoxicillin was the most frequently cited antibiotic for dento-alveolar infections and infective endocarditis prophylaxis (N=88 and N=47, respectively). Conclusion: Undergraduate, as well as postgraduate courses,, are required in Sudan to provide up-to-date orientation on antibiotic use, and to increase awareness of dentists about antibiotic prescribing.

Arabic Coffee as a Potential Alternative to Black Coffee in the Post- Bleaching Period: An in-vitro Study

Objective: To investigate the effect of Arabic coffee on bleached teeth in comparison to black coffee. Material and Methods: Forty teeth (sound maxillary or mandibular premolars with no carious lesions) were randomly selected into 4 groups (A, B, C and D). One group (A) did not receive bleaching and was incubated in saline. The second group (B) was bleached and then incubated in saline. The last two groups were bleached and were immersed in either Arabic coffee (C) or black coffee (D). Color recording of the samples was always carried out as near to their mid-buccal surfaces as possible using VITA Easyshade Advance System. Color measurements were carried out using a digital spectrophotometer at baseline and after short-term and long-term immersion. Data were subjected to two way ANOVA and T-test. The level of significance was set at was set at 0.05. Results: Results show that immersion in Arabic coffee resulted only in significant reduction in the b* color value upon long-term immersion (i.e. a reduction in the yellow hue). Black coffee on the other hand resulted in significant: reduction in lightness, increased red tint and increased yellow hue altogether. Conclusion: The use of Arabic coffee did not deteriorate color, with the only significant change being the reduction of yellowish hue. Arabic coffee could be an alternative to black coffee after bleaching.

Antibiotic Self-Medication for Oral Conditions: Characteristics and Associated Factors

Objective: To investigate the prevalence and contributing factors of antibiotic selfmedication for oral conditions in dental patients. Material and Methods: A questionnaire was distributed to 501 patients attending Taibah University Dental College and Hospital, Al Madinah, Saudi Arabia during late 2016. Questions were on socio-demographic characteristics, and pattern of antibiotic self-medication for oral disease. Statistical analysis was performed using IBM SPSS software version 21. Statistical significance level was set at p ≤.05. Results: Age range was 15-64 years (29.08±9.32 years) with 297 females (59.3%) and 204 males (40.7%). 135 patients (27%) self-medicated with antibiotics for oral disease. This practice was statistically significantly associated with the older adults (p=0.001), lack of medical or dental insurance (p=0.014 and 0.007, respectively), and poor dental attendance (p=0.021). A number of 26 (25.7%) perceived analgesics as antibiotics. Amoxicillin-clavulanic acid was the most commonly cited antibiotic by 18 patients (17.8%). Dental pain was the most frequently reported oral condition. Pharmacists were the most common source for antibiotic prescription cited by 58 (57.4%). Conclusion: Antibiotic self-medication for oral disease is associated with the use of broad-spectrum antibiotics for non-indicated clinical oral conditions. The practice was encouraged by lenient behavior of pharmacists, lack of health insurance, and poor dental attendance.

The Use of Unconventional Substances and Tools in Narghile Smoking; a Pilot Study in Jordan.

Aims: Narghile smoking may be associated with a number of unconventional practices that need to be thoroughly investigated for their potential health problems. We investigated the prevalence and pattern of unconventional practices related to narghile smoking including the use of medications, fruits, and alcohol, among a sample of café patrons. Place and Duration of Study: A few cafés at Amman, Jordan during July 2011. Methodology: This was a cross-sectional survey whereby a pre-prepared questionnaire was distributed to a sample of café patrons. Questionnaire included demographic information, history of tobacco use, pattern of narghile smoking including unconventional practices and lastly health awareness and attitudes towards cessation. Results: Out of 96 café patrons, 61 (63.5%) agreed to participate with 42 males and 19 females. Age range was 16-64 years (mean=27.5±9.2). About 47.5% used fruits as the narghile head and 16.4% used fruits as water tank. Equal proportions (9.5%) of the sample added either milk/soft drinks to tank or added drugs to tobacco mix or the liquid contents of the tank. Conclusion: Narghile smoking may be associated with unconventional practices like the use of psychoactive drugs and alcohol. Further research is needed to explore the reasons behind this trend, and the associated potential health hazards.