COVID-19 in dental practice ­ an overview of challenges and preventive measures / COVID-19 na prática odontológica ­ uma revisão sobre os desafios e medidas preventivas

COVID-19 was identified to be caused by a new coronavirus named as SARS-CoV-2. Since the outbreak of this disease, World Health Organization (WHO) declared a global public health emergency. SARS-CoV-2 has a high estimate rate of human-tohuman transmission mainly through inhalation/ingestion/direct mucous contact with respiratory droplets. Considering this high transmission capacity, several countries have already registered cases of infection by health professionals. Even though dentists are not directly involved in the diagnosis and therapy of COVID-19 they represent undoubtedly a risk group due to high exposure and their work environment is a contagion factor for patients and staff. In this manner, the objective of this article is to approach important aspects of COVID-19 concerning dental care and provides an overview of its challenges on dental practice. For this, we used these following keywords in our research: COVID-19; dental general practice; prevention and control; infectious disease transmission; infectious disease transmission, patient to professional. Taking into account the global concern with patient care in midst of this pandemic, we address valid concerns regarding the potential means of contamination in the dental office and highlight practices and guidelines adopted in different countries to minimize risks in dental care in this global public health crisis, thus, reinforcing the challenges of dentistry in this context, highlighting the importance of rigorous preventive measures. However, there is still a lack of standardization of dental care protocols and consequently, reduce the risk of contagion.

COVID-19 foi identificada como sendo causada por um novo coronavírus denominado SARS-CoV-2. Desde o surgimento da doença, a Organização Mundial da Saúde (OMS) declarou uma emergência global de saúde pública. O SARS-CoV-2 tem uma alta taxa estimada de transmissão de pessoa para pessoa, principalmente por inalação/ingestão/contato direto da mucosa com gotículas respiratórias. Considerando essa alta capacidade de transmissão, vários países já registraram casos de infecção por profissionais de saúde. Mesmo que os dentistas não estejam diretamente envolvidos no diagnóstico e terapia do COVID-19, eles representam, sem dúvida, um grupo de risco devido à alta exposição e seu ambiente de trabalho é um fator de contágio para pacientes e equipe. Dessa forma, o objetivo deste artigo é abordar aspectos importantes do COVID-19 no que diz respeito à assistência odontológica e apresentar um panorama de seus desafios na prática odontológica. Para isso, utilizamos as seguintes palavras-chave em nossa pesquisa: COVID-19; clínica odontológica geral; prevenção e controle; transmissão de doenças infecciosas; transmissão de doenças infecciosas do paciente para o profissional. Levando em consideração a preocupação global com o atendimento ao paciente em meio a esta pandemia, foram abordadas preocupações válidas sobre os meios potenciais de contaminação no consultório odontológico e destacadas as práticas e diretrizes adotadas em diferentes países para minimizar os riscos na assistência odontológica nesta crise global de saúde pública, reforçando assim os desafios da odontologia neste contexto, evidenciando a importância de medidas preventivas rigorosas. Porém, ainda falta padronização dos protocolos de atendimento odontológico e, consequentemente, redução do risco de contágio.

The Current Status of Dental Education and the Dental Profession in Chile

Objective: To describe the current situation of the dental profession in Chile, including training and workforce issues. Material and Methods: Data were collected from different national institutions, which included information regarding number of current registered dentists, university of graduation, geographical distribution, professional position, additional specialty certifications obtained, the number and characteristics of dental surgeons who work in the public and private sectors, the traditional character of the university, the accreditation status of the undergraduate dental programs and the general population number. Results: Currently there are 32 schools of Dentistry in Chile, of which 21 have their quality certified. There are 19,100 Chilean dentists and 1,727 foreign dentists registered. The number of graduates from private universities has increased significantly. Currently, 2,164 dentists work for MINSAL. Less than a third hold a specialty certification. Forty-five percent of the dental specialists obtained their certification from universities. The current professional ratio is 104 dentists per 100,000 habitants. Conclusion: The number of dentists in Chile has increased progressively during the last years, mainly associated with the opening of new dental schools. Only 28% of the Chilean dental schools have certified their quality for the total duration of the undergraduate program. Regarding the workforce, there is a public/private and geographical inequities in dentists' distribution.

Health Information Technology (HIT): A Hit or Miss in Private Dental Practice in Chennai, Tamil Nadu, India ­ A Cross Sectional Survey

Objective: To assess the knowledge, perception and use of Health Information Technology (HIT) among private dental practitioners in Chennai, Tamil Nadu, India. Material and Methods: The sample population consisted of private dental practitioners in Chennai District of Tamil Nadu who were individually approached to participate in the cross-sectional survey. A structured, self-reported, close-ended questionnaire, which contained queries on the knowledge, usage and concerns about HIT in their practice, was designed. Descriptive statistics such as frequency distribution and percentages were analyzed using SPSS version 24. Results: Of the 483 dental clinics that were approached, 352 dental practitioners completed the questionnaire survey. A significant proportion of dental practitioners (65 percent) reported positive attitude towards use of HIT systems and believed that HIT systems could help make their work easier and efficient. However, it is unfortunate to note that almost half (47 percent) the dental practitioners were not interested in implementing HIT systems in their practice due to various monetary concerns such as installation and maintenance costs. Conclusion: The widespread adoption of HIT provides system connectivity and information exchange among providers of the same organisation, providers at different organisations and, ultimately, providers practising regionally and nationally.

Brazilian young dental practitioners' use and acceptance of digital radiographic examinations

PURPOSE: The aim of this study was to investigate the use and acceptance of digital radiographic examinations by Brazilian dental practitioners in daily practice and to evaluate the advances that have occurred over the past 5 years. MATERIALS AND METHODS: Dental practitioners enrolled in extension courses at the Piracicaba Dental School, University of Campinas, Brazil, responded to a self-administered questionnaire in the years 2011 and 2015. They were asked about sociodemographic factors and their knowledge and use of digital radiographic examinations. Descriptive analysis was performed, as well as the chi-square and Fisher exact tests, with a significance level of 5% (α=0.05). RESULTS: A total of 181 participants responded to the questionnaire in the years 2011 and 2015. Most of the respondents worked in private practice, had graduated within the last 5 years, and were between 20 and 30 years old. In 2011, 55.6% of respondents reported having ever used digital radiographic examinations, while in 2015 this number increased significantly to 85.4% (p<.0001), out of which 71.4% preferred it to conventional images. Moreover, 21.4% of respondents reported having used digital radiographic examinations for more than 3 years. A significant increase in use of intraoral digital radiography (p=0.0316) was observed in 2015. In both years, image quality and high cost were indicated, respectively, as the main advantage and disadvantage of digital radiographic examinations. CONCLUSION: This study showed that digital radiology has become more common in Brazil over the past 5 years. Most of the Brazilian dental practitioners evaluated in 2015 used digital radiographic examinations.

Consentimiento informado: aspectos éticos y legislación en la odontología / Informed consent: ethical issues and legislation in dentistry

Los avances científicos y su aplicación técnica en el ámbito de la odontología, ha motivado la reflexión bioética de la práctica en esta disciplina planteando las siguientes interrogantes: ¿cómo entender el papel del odontólogo?, ¿cómo se configura el universo bioético del odontólogo?, ¿cómo se posibilita el consentimiento válidamente informado? Para explorar la respuesta a estos cuestionamientos, se tiene como punto de partida la relación odontólogo-paciente, y se transita por aspectos de la bioética del odontólogo y las características del consentimiento informado en la práctica odontológica. La conclusión destaca la importancia de hacer del consentimiento informado el medio por el cual se recupera la dignidad de la persona mediante una relación ética y dialógica en tanto proceso mediante el cual se reconoce la alteridad del paciente durante la relación odontólogo- paciente además de coadyuvar a la educación en salud del paciente promoviendo su responsabilidad frente a la autonomía y sus derechos.

Scientific advances and their technical application in the field of Dentistry, have led to a bioethical reflection about practice in this discipline by asking questions like: how to understand the dentist´s role, how to set the dentist´s bioethical universe?, how is the valid informed consent made possible? To answer these questions, the patient-dentist relationship is taken as a starting point, and goes through the dentist´s bioethical aspects and informed consent characteristics in dental practice. The conclusion highlights the importance of the informed consent as a way to recover a person´s dignity by which the otherness of the patient is recognized as well as to contribute to the patient´s health education promoting responsibility towards autonomy and rights.

Insights into the state of radiation protection among a subpopulation of Indian dental practitioners

PURPOSE: Radiographs is an integral part of patient management in dentistry, despite their detrimental effects. As the literature pertaining to radiation protection among Indian dental practitioners is sparse, exploring such protection is needed. MATERIALS AND METHODS: All private dental practitioners in Mangalore, India were included in the study. A structured, pre-tested, self-administered questionnaire was employed to assess the knowledge, attitudes, practices, previous training, perceptions towards the need to spread awareness, and willingness to gain and implement knowledge about radiation hazards and protection. Information regarding each respondent's age, gender, education, and type and duration of practice was collected. RESULTS: Overall, 87 out of 120 practitioners participated in the study. The mean knowledge, attitude, and practice scores were 9.54+/-2.54, 59.39+/-7.01, and 5.80+/-3.19, respectively. Overall, 25.3% of the respondents had undergone training in radiation protection, 98.9% perceived a need to spread awareness, and 94.3% were willing to improve their knowledge. Previous training showed a significant correlation with age, sex, and duration of practice; attitude was significantly correlated with education and type of practice; and knowledge scores showed a significant correlation with type of practice. CONCLUSION: Although the knowledge and practices of respondents were poor, they had a positive attitude and were willing to improve their knowledge. Age, sex, and duration of practice were associated with previous training; education and type of practice with attitude scores; and type of practice with knowledge scores. The findings of this study suggest a policy is needed to ensure the adherence of dental practitioners to radiation protection guidelines.

Clinical usefulness of teleradiology in general dental practice

PURPOSE: This study was performed to investigate the clinical usefulness of teleradiology in general dental practice. MATERIALS AND METHODS: Two hundred and seventy five cases were submitted for inquiry to the case presentation board of the website of The Korean Academy of Oral and Maxillofacial Radiology for a 5 year periods. The diagnosis results of those cases were analyzed according to the disease classification, the correlation with the patient's chief complaint, the necessity of additional examinations or treatments, the image modalities, and the number of dentists inquiring. RESULTS: Differential diagnoses of normal anatomic structures were the most frequently submitted cases, covering 15.6% of all cases. Among 275 cases, 164 cases required no additional treatments or examinations. Panoramic radiographs were the most frequently submitted images, accounting for 248 inquiries. The 275 cases were submitted by 96 dentists. Fifty-two dentists wrote one inquiry, and 44 inquired 2 or more times. The average inquiry number of the latter group was 5.0 cases. CONCLUSION: A teleradiology system in general dental practice could be helpful in the differential diagnosis of common lesions and reduce unnecessary costs.