Effect of coronavirus pandemic on oral and maxillofacial surgical education and training: Developing standards for effective online training

Oral and maxillofacial surgery deals with the diagnosis and treatment of dentofacial problems and usually requires a four year specialized training after a bachelor's degree in dental surgery. The COVID 19 pandemic in early 2020 led to disruptions in the training programs worldwide and urged the supervisors and faculty to devise ways and means to continue the residents' learning experience utilizing different online teaching modalities. An account of some strategies for developing standards for effective online training to equip oral and maxillofacial training programs for similar future emergencies.Copyright © 2022 The Authors

Compliance to donning and doffing of personal protective equipment among dental healthcare practitioners during the coronavirus pandemic: a quality improvement plan, do, study and act (PDSA) Initiative.

INTRODUCTION: With the emergence of SARS-Cov-2, the Centers for Disease Control and Prevention (CDC) defined mandatory guidelines for donning and doffing personal protective equipment (PPE) among dental healthcare professionals. The study's objective was to improve the compliance of the donning and doffing protocols for PPE among dental practitioners by the Plan, Do, Study, and Act (PDSA) cycle. MATERIALS AND METHODS: A quasi-experimental study was conducted on a sample of dental healthcare professionals using the non-probability purposive technique. In the first planning stage, compliance with CDC-approved donning and doffing was assessed on the clinical premises. In the second stage, an educational session was arranged with all the healthcare professionals to explain stepwise guidelines of donning and doffing to improve the quality of donning and doffing compliance. In the third stage, improvement in the quality outcome was then assessed after the session. Data were normally distributed. Qualitative variables for all the steps of donning and doffing are reported as frequency and percentages. Pareto charts were made to assess the non-compliance rate for donning and doffing protocols among dental healthcare professionals. RESULTS: There was an improvement of 44.55% in the hand hygiene practices before wearing the PPE after the second step of the PDSA cycle. A percentage improvement of 7.4% was recorded for removing jewellery, wearing the gown and wearing a surgical cap. No improvement was seen in securing the mask/ respirator ties, washing hands after wearing the respirator, placing the goggles or face shield practices. CONCLUSIONS: PDSA cycle improved the overall compliance to PPE donning and doffing practices. Most of the protocols were followed by the dental healthcare professionals; however, some of them remained the same or worsened due to ease in SARS-CoV 2 restrictions.

Examination Stress During COVID-19 and Its Coping Interventions Used by Medical Students of Pakistan

Objective: To determine the examination stress and anxiety score during COVID-19 pandemic and to identify coping mechanisms adapted by medical students. Study Design: Cross-sectional study. Place and Duration of Study: Sir Syed College of Medical Sciences for Girls, Karachi, from Apr-May 2021. Methodology: A total of 250 students were recruited in the study and validated questionnaire was used for data collection. Test anxiety scores were calculated from a previous study scale by Nist and Diehl (1990). Data was analyzed by using SPSS-23. Results: The mean age of students was 20.1 ± 0.6 years. 74 (29.6%) students felt stress sometimes, 40 (16.0%) students felt always and 30 (12.0%) students never felt stressed before examination. Students who reported improved performance during the examination due to stress were 121 (48.4%). 76 (30.4%) students reported decrease in performance and 53 (21.2%) reported that their stress did not affect their performance. Students were inquired regarding the methods to cope the stress. 78 (31.2%) students reported that they took study break, 66 (26.4%) students spent time with family and friends, 49 (19.6%) found solace in sleep, 30 (12.0%) students listened to music, 13 (5.2%) used beverages (tea, coffee), 11 (4.4%) used numerous combinations of methods, and only 3 (1.2%) students exercised. It was found that 158 (77%) students experienced healthy anxiety, 68 (27.2%) unhealthy anxiety, and 22 (8.8%) students were anxiety-free. Conclusion: Examination stress among medical students has increased during COVID-19 and various coping methods are used by the students to prevent anxiety. College administration must address stressors to improve the learning and mental health of the students. © 2022, Army Medical College. All rights reserved.

Comparison of bracket bond failure with the aerosol-generating and novel non-aerosol-generating bonding techniques during the SARS-CoV-2 pandemic among orthodontic patients: A retrospective cohort study.

BACKGROUND: As per the Centers for Disease Control and Prevention (CDC) guidelines, dentists must avoid the aerosol-generating procedures during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. OBJECTIVES: This study aimed to compare the rate of bracket bond failure with the aerosol-generating and non-aerosol generating bonding techniques. MATERIAL AND METHODS: A retrospective cohort study was conducted during the SARS-CoV-2 pandemic on a sample of 44 patients (880 teeth), equally divided into 2 groups: the conventional aerosol-generating bonding technique (ABT); and the novel non-aerosol-generating bonding technique (NABT). The rate of bracket survival and total number of bracket breakages in the 2 groups were assessed by means of the survival regression analysis. The influence of pre-treatment factors, such as the sagittal jaw relationship (ANB), the Frankfort-mandibular plane angle (FMA), overjet, overbite, and upper and lower crowding, on the rate of bracket survival was also evaluated. RESULTS: There was a statistically significant difference between ABT and NABT in terms of bracket survival. The mean bracket survival with ABT was 176.21 ±77.89 days and with NABT it was 162.53 ±83.34 days. The novel technique showed a hazard ratio of bracket survival of 2.99 as compared to the conventional method. There was a statistically significant influence of overjet on the rate of bracket survival (p = 0.010). The posterior segment had a higher rate of bracket failure as compared to the anterior segment in NABT, which was statistically significant (p < 0.001). However, this difference was statistically non-significant in the case of ABT. CONCLUSIONS: There was an increased rate of bracket failure with NABT as compared to ABT. The rate of bracket breakages in the anterior quadrants was comparable for both bonding techniques.

Impact of COVID-19 on the Mental Health of Medical Students of Karachi, Pakistan

Background: The biggest dilemma of today's world is COVID-19. This pandemic situation has completely engulfed the globe with a rapidly increasing number of cases and has affected a great number of lives along with their lifestyle including the educational sector. Objective: This study explores the impact of COVID-19, how frequent lockdown, and online learning have affected the mental health of the students of medical college. Methods: A cross-sectional study was conducted among the medical students of Karachi, in September 2021, in Jinnah Medical and Dental College. A total of 312 medical students were enrolled in the study. Out of which 208 were females and 104 were males. Depression Anxiety Stress Scale-21 (DASS-21) was used to assess the mental health of students of medical college. Results: The results of the study revealed that a total of 312 medical students were enrolled in the study;belonging to the age group of (18-25) years. Approximately 104 (66 %) of female students experienced depression, 44 (21%) anxiety, and 60 (28%) stress. Hence gender and year of study of the participants were found to be significant (p-value<0.05). The odds of first-year students showed high levels of anxiety as compared to final-year students (OR = 1.679, 95% CI [1.202-2.634], P = 0.002). Conclusion: This study will help in making relevant policies, mental health strategies and providing a better framework for the medical colleges and universities which is essential for the mental health of students.

Acceptance of SARS-CoV-2 vaccination and the associated factors among dental health care professionals: A cross-sectional survey.

BACKGROUND: One of the greatest inventions of the 21st century is the development of vaccines against the life-threatening pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whenever a new medication or treatment modality is introduced globally, it is accompanied by anxiety in the general public and among health care professionals. OBJECTIVES: The aim of the study was to explore factors that may influence the acceptance of COVID-19 vaccination among dental health care professionals, as they are the first subgroup in the population to receive the vaccine. MATERIAL AND METHODS: A survey-based cross-sectional study was conducted on 164 health care professionals (general dentists, dental specialists with 2 years of experience after graduation and dental assistants). Data was collected by sending a URL link to the hardand soft-copy questionnaire on Google Forms through all social media platforms. The questionnaire had 2 sections - the 1st part concerned the demographic details and the 2nd part was designed to assess the acceptance of SARS-CoV-2 vaccination among dental health care professionals and the related factors. The normality of the data was assessed with the Shapiro-Wilk test. The Cox regression algorithm was applied to evaluate the factors associated with the acceptance of SARS-CoV-2 vaccination. RESULTS: Out of 164 participants, 85.37% showed a positive attitude toward vaccination and only 7.32% of dental health care professionals were not willing to get vaccinated; out of them, 5 were males and 7 were females. Those who refused to get vaccinated included 3.6% of general dentists, 21.1% of dental specialists and 11.7% of dental assistants. The complications of major concern were fever, myalgia and the lethargic condition immediately after vaccination. CONCLUSIONS: A small percentage of health care professionals declined to get vaccinated against COVID-19 and the main reason was uncertainty about the associated side effects. The respondents were mostly concerned about such side effects as fever, myalgia and the lethargic condition immediately after vaccination.

Effect of coronavirus pandemic on oral and maxillofacial surgical education and training: Developing standards for effective online training

Oral and maxillofacial surgery deals with the diagnosis and treatment of dentofacial problems and usually requires a four year specialized training after a bachelor's degree in dental surgery. The COVID 19 pandemic in early 2020 led to disruptions in the training programs worldwide and urged the supervisors and faculty to devise ways and means to continue the residents' learning experience utilizing different online teaching modalities. An account of some strategies for developing standards for effective online training to equip oral and maxillofacial training programs for similar future emergencies.

Knowledge and awareness of dental specialists, general dentists and dental assistants regarding SARS­CoV­2.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) has had drastic effects among healthcare professionals. OBJECTIVES: This study aimed to assess knowledge and awareness among dental specialists, general dentists and dental assistants regarding standard patient care guidelines for minimizing the spread of the infection. MATERIAL AND METHODS: A survey-based cross-sectional study was conducted on a sample of 84 participants. The participants were divided into groups of dental specialists, general dentists and dental assistants. A modified version of a validated questionnaire was used to evaluate knowledge and awareness regarding SARS­CoV­2 as per the Centers for Disease Control and Prevention (CDC) guidelines. Data was analyzed using the one-way analysis of variance (ANOVA) and post-hoc Tukey's tests to assess differences in knowledge regarding the SARS­CoV­2 guidelines across the 3 groups. The simple linear regression analysis was used to examine factors influencing the knowledge scores. RESULTS: Among all dental specialists, 13 orthodontists, 9 operative dentists, 8 maxillofacial surgeons, 4 prosthodontists, and 1 periodontist responded to the survey. The mean knowledge scores of dental specialists, general dentists and dental assistants were 10.05 ±2.10, 9.95 ±2.30 and 8.53 ±2.10, respectively. Overall, we found a significant difference (p = 0.02) in the knowledge scores between the groups, and pairwise comparisons showed that there was a significant difference (p = 0.03) in the knowledge scores between dental specialists and dental assistants. CONCLUSIONS: These findings suggest that hospitals should conduct mandatory workshops, training sessions and seminars to raise the awareness of the novel coronavirus pandemic and disinfection protocols, not only for specialists, but for all staff members.

Stress and anxiety among dental practitioners during the COVID-19 pandemic: A cross-sectional survey

BACKGROUND: Dental professionals are at great risk of contracting coronavirus disease 2019 (COVID-19). OBJECTIVES: The objectives of this study were to determine the levels of stress and anxiety among dental professionals, and to determine which dental procedures cause the greatest amount of stress and anxiety during the COVID-19 pandemic. MATERIAL AND METHODS: This cross-sectional survey was conducted by requesting voluntary participation of dental healthcare workers through the authors' own e-form, which consisted of our self-developed questionnaire, the Perceived Stress Scale (PSS) and the Generalized Anxiety Disorder-7 scale (GAD-7). The simple and multiple linear regression analyses were used to assess the effect of dental procedures and other factors associated with stress and anxiety among the participants. A p-value <=0.05 was considered statistically significant. RESULTS: This survey included 85 participants (32 males, 53 females) with a mean age of 31.6 +/-6.0 years. Significant associations were found between severe stress for scaling (p < 0.001;p < 0.001), complex fillings (p < 0.001;p < 0.001), root canal treatment (RCT) (p = 0.001;p = 0.007), crown and bridge work (p < 0.001;p < 0.001), denture work (p = 0.034;p = 0.001), third molar extractions (p < 0.001;p < 0.001), surgical procedures (p < 0.001;p = 0.001), and implant placement (p = 0.001;p = 0.022) and the PSS and GAD-7 scores, respectively. CONCLUSIONS: Dental healthcare workers exhibit severe stress and anxiety associated with elective dental procedures. Dental emergencies should take precedence and elective dental treatment should be carried out with utmost caution, ensuring all protective measures. Psychological support for dental healthcare professionals should be made accessible.