Infection Control in Dental Practice during the COVID-19 Pandemic: What Is Changed?

The COVID-19 pandemic has profoundly changed our lives. Since the SARS-CoV-2 was discovered, many studies have been done on the transmission mode, its replication within humans, and its survival even in the outside environment and on inanimate surfaces. Undoubtedly, health care workers have faced the greatest risks because of their close contact with potentially infected patients. Of these, dental health care professionals are certainly among the most vulnerable categories, precisely because infection occurs with the airborne virus. The treatment of patients within the dental office has changed profoundly, respecting all preventive measures towards the patient and the practitioners themselves. The aim of this paper is to understand whether the protocols changed for the prevention of SARS-CoV-2 infection among dentists remained even after the most acute phase of the pandemic. In particular, this study analyzed habits, protocols, preventive measures, and any costs incurred in the COVID-19 era for the prevention of SARS-CoV-2 infection among dental workers and patients.

Oral Lesions in Pediatric Subjects: SARS-CoV-2 Infection and COVID-19 Vaccination

A plethora of systemic manifestations of COVID-19 and adverse reactions to COVID-19 vaccines have been described in pediatric subjects. Therefore, the present systematic review primarily aimed to assess the prevalence and macro-microscopic features of oral lesions following SARS-CoV-2 infection, grading primary oral lesions based on COVID-19 forms, in pediatric subjects. The secondary aim was to evaluate the epidemiology, clinical appearance, and histopathology of oral lesions following the WHO Emergency Use Listing approved and EMA authorized vaccines, in relation to cases and vaccine characteristics. The study protocol was compliant with the PRISMA statement and registered on PROSPERO (CRD42022351821). Case reports, case series, and observational studies were electronically searched till 27 July 2022, on MEDLINE/PubMed, Scopus, and Cochrane library databases, and the PROSPERO register. Data from nine studies describing oral lesions following viral infection and two records reporting oral lesions following vaccine administration, evaluated through the ROBINS-I tool for quality, were independently extracted and qualitatively synthesized, resulting in scarce, jeopardized, and incomplete findings. Since most of the rare lesions recorded were a part of broad-spectrum systemic disorders and syndromes and, thus. undetailed or nonspecific, further studies should assess oral lesions following SARS-CoV-2 infection and vaccination in pediatric subjects, considering novel viral variants and newly developing vaccines.

Prevalence, Features and Degree of Association of Oral Lesions in COVID-19: A Systematic Review of Systematic Reviews.

Regardless of rapidly emerging findings on oral lesions described in adult SARS-CoV-2-positive subjects, the evidence level remains quite low and rather contrasting; therefore, the present systematic review of systematic reviews primarily aims to point out the overall prevalence of diagnosed cases. Secondary aims are to estimate the degree of association between oral lesions and SARS-CoV-2 infection and to grade, based on the reported frequency, the primary oral lesions, with related clinical presentations and microscopic features, in relation to COVID-19 forms. A study protocol compliant with the PRISMA statement was developed. Twelve studies were included, reporting highly heterogeneous and incomplete findings, thus precluding a meta-analysis. Further studies should be conducted to assess the overall prevalence of cases diagnosed with oral lesions among adult SARS-CoV-2-positive subjects, especially considering novel viral variants, and to determine their degree of association with SARS-CoV-2 infection and COVID-19 forms. Moreover, the reported findings noticed the need to evaluate the putative role both of SARS-CoV-2 in oral lesions genesis and of periodontitis and periodontal microbiome in COVID-19 worsening and re-activations. Deeper insights into oral lesions in adult SARS-CoV-2-positive subjects could enhance the comprehension of illness pathogenesis, natural history and clinical presentation, thus improving the preparedness of health professionals in the inter-disciplinary management of COVID-19.

Prevalence, Features and Degree of Association of Oral Lesions in COVID-19: A Systematic Review of Systematic Reviews

Regardless of rapidly emerging findings on oral lesions described in adult SARS-CoV-2-positive subjects, the evidence level remains quite low and rather contrasting;therefore, the present systematic review of systematic reviews primarily aims to point out the overall prevalence of diagnosed cases. Secondary aims are to estimate the degree of association between oral lesions and SARS-CoV-2 infection and to grade, based on the reported frequency, the primary oral lesions, with related clinical presentations and microscopic features, in relation to COVID-19 forms. A study protocol compliant with the PRISMA statement was developed. Twelve studies were included, reporting highly heterogeneous and incomplete findings, thus precluding a meta-analysis. Further studies should be conducted to assess the overall prevalence of cases diagnosed with oral lesions among adult SARS-CoV-2-positive subjects, especially considering novel viral variants, and to determine their degree of association with SARS-CoV-2 infection and COVID-19 forms. Moreover, the reported findings noticed the need to evaluate the putative role both of SARS-CoV-2 in oral lesions genesis and of periodontitis and periodontal microbiome in COVID-19 worsening and re-activations. Deeper insights into oral lesions in adult SARS-CoV-2-positive subjects could enhance the comprehension of illness pathogenesis, natural history and clinical presentation, thus improving the preparedness of health professionals in the inter-disciplinary management of COVID-19.

COVID-19: The Dentists' Perceived Impact on the Dental Practice.

OBJECTIVES: The present study aimed to investigate the dentists' knowledge of the risks from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and how it will impact their practice. MATERIALS AND METHODS: An ad hoc self-administered anonymous questionnaire was submitted to Italian dentists. STATISTICAL ANALYSIS: Differences in rates were calculated using the chi-square test. The level of significance was set at p < 0.05. RESULTS: A total of 849 dentists fully completed the survey. Eighty-eight per cent of Italian dentists are worried about the health of their families, with no difference in high-risk (red zone) and low-risk (orange zone) regions. About 86% of professionals report some income loss and 94% fear a drop in patients after the quarantine phase, with the dentists working the red zone claiming a greater economic loss and fearing a reduced practice after the end of the lockdown. DISCUSSION: A large majority of the Italian dentists appears to be aware of the need for changes in their dental practices by planning specific sterilization processes between appointments, testing patients for SARS-CoV-2 serology, asking patients not to be accompanied, and reducing the number of visits per day. CONCLUSION: The survey expresses the serious concern of the dentists for the pandemic's effects on their profession.

Infection Control in Dental Practice During the COVID-19 Pandemic.

COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency from China has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim of this paper is to provide practical advice for dentists based on the recent literature, which may be useful in reducing the risk of spreading COVID-19 during clinical practice.

The Perception of COVID-19 among Italian Dentists: An Orthodontic Point of View.

COVID-19 has severely impacted dentists, who are at a great risk of infection. This study aimed to investigate if dentists are anxious about returning to their daily activities, and what the perception of the risk is for dentists and orthodontists regarding orthodontic procedures. An online questionnaire, including the Patient Health Questionnaire-4 (PHQ-4), was sent to Italian dentists during the final days of the lockdown with items about anxiety, fear, distress, perceived risk for operators, and concerns about orthodontic patients caused by working during the COVID-19 outbreak. Data were analyzed with a chi-square test and logistic regression analysis. The level of significance was set as p < 0.05. A total of 349 dentists completed the survey, including 183 orthodontists. Returning to their daily work activity was a source of anxiety for 192 participants and this was associated with the level of distress (odds ratio (OR) = 3.7; p < 0.001). Most of the orthodontists (67.6%) thought that they would increase the number of working hours during the week (OR = 1.8; p = 0.007). Italian dentists were mostly scared to return to their daily activities because they considered their jobs a high risk to them and their families. Dentists with an exclusive/prevailing orthodontic activity were forced to increase their working day during the week.