Self-reported periodontitis association with impaired smell and taste: A multicenter survey.

OBJECTIVES: To investigate the association between self-reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities. MATERIALS AND METHODS: Data were collected through a digital survey. A total of 1239 individuals from Aarhus University - Denmark, the University of Iowa, and the University of Florida - USA were included. Self-reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self-perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID-19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach. RESULTS: The total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self-reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]). CONCLUSION: Our findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.

The Impact of COVID-19 on the Oral Health of Patients with Special Needs.

In March 2020, the World Health Organization declared a global public health emergency due to the spread of COVID-19, and medical and dental elective care was suspended, disproportionally affecting persons with special needs. As many of the special needs population live in a communal environment, they were at higher risk of being infected with and dying of COVID-19. Consequently, their access to medical and dental services was limited to emergency care. A method of reaching these populations evolved by the expansion of telehealth, including dentistry, to provide diagnosis, management, prevention, and provision of psychosocial support for patients.

COVID-19 pandemic and its impact on dental students: A multi-institutional survey.

PURPOSE/OBJECTIVES: To investigate dental students' perceptions and concerns regarding the COVID-19 pandemic, their coping strategies and support resources, and their perceived stress levels. METHODS: A customized 19-item survey and the perceived stress scale (PSS) were applied to undergraduate dental students from the US, Spain, Ireland, Chile, India, and Brazil between April 10 and July 5, 2020. Linear modeling and mediation analysis were used to explore the relationships among demographics, stressors, coping mechanisms, social support, and stress RESULTS: A total of 4475 students responded to the survey. The majority (72.4%) were women, and 52.3% had no COVID-19 training at the time of the survey. The students reported that they had to accommodate to changes in patient care (96.6%) and didactic learning (95.2%) activities, while 88.5% of the respondents indicated at least one of their courses moved online. Transition to online courses went "smoothly with some troubles" for 51.8% of the respondents, and 48.3% perceived the faculty as prepared for the online transition; however, 45.9% reported feeling extremely concerned about the impact of COVID-19 on their education. The average PSS score was 21.9 of 40 (moderate stress). Multivariate models were built for participants with full data (n = 3899). Being male, having completed more dental coursework, and perceiving a smoother transition were associated with lower PSS scores; more concern about academic progress was associated with higher PSS. Faculty support mediated the relationship between a smoothness of transition and concern about academic progress and PSS scores CONCLUSION: Stress caused by the pandemic may be alleviated by smoother transition and good faculty support.

Impact of COVID-19 pandemic on oral health procedures provided by the Brazilian public health system: COVID-19 and oral health in Brazil.

OBJECTIVE: The objective of this study was to assess the number of dental procedures performed in the Brazilian Public Health System (SUS) during the first wave of COVID-19 in Brazil (1st semester of 2020) and compare it with the same period of 2019. METHODS: A retrospective study was conducted based on the SUS Dataset (DATASUS). Descriptive analysis of the number of dental procedures and socio-demographic regions was presented and the number of dental procedures during the first semester of 2020 was compared to 2019, using Wilcoxon Signed Rank Test (α = 0.05). The number of COVID-19 confirmed cases and deaths were also retrieved from DATASUS. RESULTS: Dental procedures decreased from 47 million in the first semester of 2019 to 15 million in 2020, representing an overall decrease of about 66%. Statistically significant differences were observed for the numbers of procedures regarding preventive actions related to oral health (-84.53%; p < 0.001), primary care (-60.69%; p < 0.001), endodontic specialized care (-52.50%; p < 0.001), and periodontal and oral surgery specialized care (-54.57%; p < 0.001). CONCLUSION: The COVID-19 pandemic also reduced by half the number of oral health procedures provided by the SUS in almost all Brazilian states regardless of whether these states had a large number of confirmed cases or deaths. Future policies are recommended in order to reduce the negative impact of the suspension of dental services on the oral health of the population.

COVID-19 and Geriatric Dentistry: What will be the new-normal?

Older adults may face many barriers when accessing oral health care. The most vulnerable groups are people living in long term care institutions and the homebound. These barriers are related but not limited to socio-economic issues, medical and oral health problems. Some socio-economic problems are lack of finances, absence of dental insurance, lack of social support networks, and being institutionalized. Some general health problems are multiple co-morbidities, polypharmacy, dementia, and reduced autonomy. Some oral health problems are having heavily restored dentitions, dry mouth, root caries, and inability to maintain adequate oral hygiene independently. In addition to these existing barriers, many new barriers have arisen which are expected to further reduce access to oral health care for older adults due to the emergence of the COVID-19 pandemic. Older adults are at greater risk of fatal outcomes from COVID-19 infection and many dental procedures have an increased risk of creating aerosols, thereby spreading COVID-19 infection. Consequently, older adults due to fear are less likely to seek or receive oral health care until a treatment or vaccine is developed for COVID-19 infections. In this article, the authors discuss the implications of the COVID-19 pandemic to the practice of geriatric dentistry, and what is expected to be the new normal in this field of dentistry (AU) Os idosos geralmente enfrentam muitas barreiras para acessar os serviços de saúde bucal. Os grupos mais vulneráveis são formados por pessoas que vivem em instituições de longa permanência ou estão restritos às suas casas. Essas barreiras estão relacionadas, entre outras, a questões socioeconômicas e problemas de saúde geral e oral. Alguns problemas socioeconômicos são: problemas financeiros, falta de convênio odontológico, falta de redes de apoio social e institucionalização. Alguns problemas gerais de saúde são: múltiplas comorbidades, polifarmácia, demência e autonomia reduzida. Alguns problemas de saúde bucal são: dentição muito restaurada, boca seca, cárie radicular e incapacidade de manter uma higiene bucal adequada de forma independente. Além das barreiras já existentes, devido ao surgimento da pandemia de COVID-19 surgiram novas barreiras que deverão reduzir ainda mais o acesso aos cuidados de saúde bucal para idosos. Idosos correm maior risco de complicações fatais da COVID-19 e muitos procedimentos odontológicos têm um risco aumentado de gerar aerossóis, espalhando assim a COVID-19. Consequentemente, os idosos têm menor probabilidade de procurar ou receber cuidados de saúde bucal devido ao medo, até que um tratamento ou vacina seja desenvolvido para a COVID-19. Neste artigo, os autores discutem as implicações da pandemia de COVID-19 na prática da odontologia geriátrica e o que se espera ser o novo normal nesse campo da Odontologia.(AU)

Implementation of an online treatment planning exercise focused on vulnerable patient groups.

The coronavirus disease 2019 (COVID-19) pandemic presented formidable challenges in our ability to impart in-person extra-mural clinical training, including the Geriatric and Special Needs Program, to a group of 20 fourth-year dental students. A new course delivery format was developed wherein students used a validated Rapid Oral Health Deterioration (ROHD) risk assessment tool to critically appraise clinical case information relating to a young adult with special needs. In the alternative virtual educational approach that was created, students applied an interprofessional practice concept leading to patient treatment planning outcomes. Providing adequate information, additional reading resources, a response template, clear instructions and a process-oriented assessment policy all ensured a good level of participation from students in the alternative learning format. An association was noted between students' staging of risk for ROHD and their subsequent recommendations for treatment.

Disruptions during a pandemic: Gaps identified and lessons learned.

Global disruptions caused by coronavirus disease 2019 (COVID-19) affects all walks of life, and dentistry and dental education are no exceptions. Dental education uniquely blends didactic courses and hands-on clinical training seamlessly to prepare oral healthcare providers of the future. Apart from economical and access to care implications, closure of all the dental institutions in the United States affects their educational mission greatly, equally disturbing pre-doctoral and graduate training. Efforts are ongoing to continue the educational mission in dental institutions by delivering scheduled course content remotely using multiple online tools. In spite of those efforts, since clinical experiences cannot be completely replaced by any available alternative method of instruction that is delivered remotely, students are missing out on valuable patient-based clinical experiences. In this perspective article, we briefly discuss the several implications of COVID-19, in the context of dental education. We then highlight some of the lessons we can learn from this pandemic which we hope will have several positive implications, including curricular changes, increased public health awareness and preparedness for future public health emergencies.