Clinical Approaches to Hospital Medicine: Advances, Updates and Controversies: Second Edition

This book provides an update on recent clinical practice and an in-depth view of selected topics relevant to hospital medicine. It is divided into four sections that explore clinical, administrative, systems and ethical issues. Each section places an emphasis on the opportunities, challenges and potential directions of this bourgeoning subspecialty. This new edition expands on topics covered in the previous edition, including the COVID-19 pandemic, racial disparities in healthcare delivery and providers, and pediatric hospital medicine. Other chapters explore worldwide practice patterns and practical application of philosophical tools in daily practice. This up-to-date resource provides hospitalists, advanced nurse practitioners, medical students and administrators with the latest research, trends and issues in hospital medicine. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Proceedings of the 10th Pediatric Dermatology Research Alliance (PeDRA) Annual Conference.

The 10th Pediatric Dermatology Research Alliance (PeDRA) Annual Conference occurred November 3-5, 2022 in Bethesda, Maryland. This conference was the first in-person PeDRA conference after 2 years of a virtual format due to COVID-19. Fittingly, given the effects of the pandemic, the conference theme was "Reimagining Community." The conference included presentations and panel sessions on finding individual and collective purpose, leveraging community in pursuit of a shared goal, and creating a community of resources in collaboration with NIH. The goal of this meeting was to connect clinicians, basic scientists, patients, patient advocates, and industry partners. The reimagined community of pediatric dermatology research is a synergistic space for all members to better understand, prevent, treat, and cure dermatologic diseases and conditions in children. This two-and-a-half-day conference with over 300 attendees featured educational seminars including a keynote address, didactic lecture and panel sessions, skill-building workshops, 13 topic-specific breakout sessions, and an interactive poster session where 108 active and finished research projects could be discussed.

Experiences and management strategies of Norwegian GPs during the COVID-19 pandemic: a longitudinal interview study.

OBJECTIVE: When the COVID-19 pandemic reached Norway, primary health care had to reorganize to ensure safe patient treatment and maintain infection control. General practitioners (GPs) are key health care providers in the municipalities. Our aim was to explore the experiences and management strategies of Norwegian GPs during the COVID-19 pandemic - over time, and in the context of a sudden organizational change. DESIGN: Longitudinal qualitative interview study with two interview rounds. The first round of interviews was conducted from September-December 2020, the second round from January-April 2021. In the first interview round, we performed eight semi-structured interviews with GPs from eight municipalities in Norway. In the second round, five of the GPs were re-interviewed. Consecutive interviews were performed 2-4 months apart. To analyze the data, we used thematic analysis. RESULTS: The COVID-19 pandemic required GPs to balance several concerns, such as continuity of care and their own professional efforts. Several GPs experienced challenges in the collaboration with the municipality and in relation to defining their own professional position. Guided by The Norwegian Association of General practitioners, The Norwegian College of General Practice and collegial support, they found viable solutions and ended up with a feeling of having adapted to a new normal. CONCLUSIONS: Although our study demonstrates that the GPs adapted to the changing conditions, the current municipal health care models are not ideal. There is a need for clarification of responsibilities between GPs and the municipality to facilitate a more coordinated future pandemic response.Key PointsFacing the COVID-19 pandemic, the primary health care service in Norway had to reorganize to ensure safe patient treatment and maintain infection control.Several GPs experienced challenges in collaboration with the municipalities.There is a need for clarification of responsibilities between GPs and the municipality.

"Carriers of hope." Creating organizational spaces of hope during COVID-19

In this empirical study, we aim to explore how organizations can be targets of hope during COVID-19. More specifically, we ask: how do managers create spaces of hope, and what are the underlying mechanisms facilitating these processes of hope in a crisis situation? Based on an investigation of essays written by managers prior to and during the COVID- 19 pandemic and drawing on analyses from a focus group interview with managers, this article shows how creating organizational spaces of hope is part of a dynamic, relational and spiritual process. The managers are working on recognizing and affirming the organizational members' situation, helping them envision hope through a process of noticing despair, searching for meaning, and creating actions of hope to establish a horizon of possibilities. This hope process is facilitated through group reflection in safe spaces as well as times of slow-thinking, enabling hope practices in organizations to be part of viewing future horizons. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The Impact of COVID-19 on US and International Retina Specialists, Their Practices, and Their Patients.

Purpose: This work analyzes data from a series of surveys developed by the American Society of Retina Specialists (ASRS) that assesses the impact of COVID-19 on physicians, their practices, and their patients. Methods: Five surveys were sent by the ASRS between March and July 2020 to more than 2600 US and international retina specialists. Data and trends from these surveys were analyzed. Results: Most responding retina specialists (87%-95% in the United States and internationally) reported having no known COVID-related symptoms despite reported limitations in personal protective equipment. Clinic volumes globally were drastically reduced in March 2020 with only partial recovery through July 2020, which was slower internationally than in the United States. Practices were compelled to reduce staff and physician employment levels. Most respondents estimated some degree of delay in patient treatment with corresponding declines in vision and/or anatomy that were attributed most frequently to patients' fears of the pandemic and least frequently to office unavailability. Conclusions: The reported impact of COVID-19 on retina specialists, their practices, and their patients has been substantial. Although retina specialists were quickly resilient in optimizing delivery of patient care in a manner safe for patients and providers, the reduction in clinic volume has been devastating in the United States and internationally, with negative impacts on patient outcomes, reductions in practices' volume and employment, and risk to practices' financial health. Future studies will be required to quantify losses associated with these unprecedented and ongoing circumstances caused by the pandemic.

Impact of educational intervention regarding COVID-19 on knowledge, attitude, and practice of students before dental school re-opening.

BACKGROUND AND AIM: Lack of knowledge on COVID-19 among people and healthcare staff significantly impacts late management and its rapid transmission. Dental students must be aware of the exact preventive instructions due to their close contact with patients and clinical work in the dental setting during the pandemic. This interventional study aimed to investigate the effectiveness of designed educational content regarding COVID-19 on Iranian dental students' knowledge, attitudes, and practices at Alborz University of medical sciences. MATERIALS AND METHODS: A total of 88 dental students were investigated in this study. Educational content was designed based on the clinical guidelines regarding COVID-19 in dentistry. The content was presented to dental students as a three-hour webinar. In addition, the online, validated questionnaire was obtained from the students as pre, post, and follow-up surveys. RESULTS: A statistically significant difference between students' knowledge, attitudes, and practices were obtained before and after the intervention and the follow-up survey. 48.58% improvement in knowledge score, 6.37% in attitudes, and 17% in practice scores were observed. CONCLUSION: Although this educational intervention significantly improved the knowledge, attitude, and practice of dental students, additional education and clinical training are mandatory for effective and safe dental practice management in future crises.

State of the Oral Implantology Practice in Spain during the COVID-19 Pandemic: A Cross-Sectional Survey.

At the beginning of the COVID-19 pandemic, strict measures of confinement and social distancing were taken. Dentists were considered essential personnel and their activity was restricted to emergency treatment. The present observational study aims to determine the situation of oral implantology practice in Spain during the initial period of the COVID-19 pandemic. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of three blocks of questions was sent to all members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 237 participants (14.3%) responded to the questionnaire. The majority of participants (60.8%) only attended emergencies during the first 9 months of the pandemic. Despite this, 77.2% reported having performed dental implant surgeries and 75.5% indicated that they performed non-essential treatments. The activity was fully recovered by 64.1% of the surveyed dentists. The majority of dentists (90.7%) considered that sufficient/adequate preventive measures were carried out at their workplace, which possibly contributed to the fact that 49.3% were not afraid of becoming infected. This concern was significantly and directly proportionally associated with the age of the surveyed dentists. The oral implant practice was affected to a greater extent during the first 9 months of the pandemic, especially in urban areas, with a greater impact on the workload of professionals with less specialised training in oral implantology.

Teleophthalmology research: Where do we stand?

PURPOSE: To identify global research trends in teleophthalmology, as well as productivity and its association with Human development index (HDI). METHODS: A cross-sectional study. The main outcome measures were publication count, citation count, and publications count per million populations. Bibliographic data were derived from the Web of Science website. HDI data were derived from Human Development Report [2020]. One-way ANOVA test was used to examine the association between HDI and the outcome measures. We studied the correlation between continuous variables using Spearman's. Bibliometric analysis software's VOSviewer and Citspace were used to analyse results and creating visualizing maps. RESULTS: The results retrieved 355 publications, one-third of them have been published in the year of the COVID-19 pandemic; (2020). The USA has contributed to one-half of all publications, and just five countries have contributed to about 90% of all records. Very high HDI countries had significantly more publications count per million populations, than high (p-value = 0.0047), medium (p-value = 0.0081) or low HDI countries (p-value = 0.002). The main themes are screening programmes, reliability, photography, COVID-19, access, artificial intelligence, and cost-effectiveness. The leading countries in terms of both publications and citation count are the USA and India. In terms of publications count per million populations, the leading countries are Singapore and Australia. CONCLUSION: Most of the contribution in teleophthalmology research was confined to a small number of countries. More effort is needed to expand the global contribution. The hotspots in this field are artificial intelligence applications and COVID-19 impact.

Dental health care during the Covid-19 pandemic in a Zaragoza urban Health Center of the Aragonese Health Service

The work carried out by all health professionals, including those who work in Primary Care, presents a transcendental role during the situation created by the Covid-19 pandemic. In Spain, after bending the con-tagion curve, the de-escalation process has begun, by which all productive work activities must be started again, after the forced cessation produced by the State of Alarm, while trying to preserve the security of all citizens in the face of the latent threat of Covid-19. In the Health Centers of the Autonomous Public Health Systems, the patient care services have been modified, in order to obtain a quality care service while trying to guarantee the health of both the clinical-care staff, as of patients. For this reason, the Oral Health Units of the Health Centers of the Autonomous Community of Aragon have had to adapt to the new situation, presenting in this study the characteristics of oral care in the Oral Health Unit of the Seminario Health Center Romareda de Zaragoza in the first month of the de-escalation. Copyright © 2022, Ediciones Avances S.L.. All rights reserved.

Telemedicine during a pandemic with osteopathic considerations

Health care continues to make strides in the industry by incorporating technological innovation to capture consumer demand and financial growth. Over the past 10 years, significant technology advances in health care include developing electronic health records, patient portals, self-service kiosks, remote monitoring devices, genome sequencing and telemedicine. The topics covered include visit how-to's, presenting yourself professionally, displaying empathy and treating the whole person in the virtual platform. Practice management topics include benefits of telemedicine, billing and coding, reimbursement, and legal consideration. Multiple tables display various topics, including different types of telemedicine, different virtual platforms, CPT codes to code the visit and billing modifiers associated with telemedicine. Copyright © 2020 by the American College of Osteopathic Family Physicians. All rights reserved.

A comparison of telemedicine and in-person neurology visits: what are the factors that patients consider when selecting future visit type?

OBJECTIVE: To identify factors that patients consider when choosing between future in-person, video, or telephone visits. BACKGROUND: Telemedicine has been rapidly integrated into ambulatory neurology in response to the COVID-19 pandemic. METHODS: Ambulatory neurology patients at a single center were contacted via telephone to complete: (1) a survey quantifying likelihood of scheduling a future telemedicine visit, and (2) a semi-structured qualitative interview following their visit in March 2021. Data were processed using the principles of thematic analysis. RESULTS: Of 2493 visits, 39% assented to post-visit feedback; 74% were in-person visits and 13% video and telephone. Patients with in-person visits were less likely than those with video and telephone visits to "definitely" consider a future telemedicine visit (36 vs. 59 and 62%, respectively; p < 0.001). Patients considered five key factors when scheduling future visits: "Pros of Visit Type," "Barriers to Telemedicine," "Situational Context," "Inherent Beliefs," and "Extrinsic Variables." Patients with telemedicine visits considered convenience as a pro, while those with in-person visits cited improved quality of care. Accessibility and user familiarity were considered barriers to telemedicine by patients with in-person and telephone visits, whereas system limitations were prevalent among patients with video visits. Patients agreed that stable conditions can be monitored via telemedicine, whereas physical examination warrants an in-person visit. Telemedicine was inherently considered equivalent to in-person care by patients with telephone visits. Awareness of telemedicine must be improved for patients with in-person visits. CONCLUSION: Across visit types, patients agree that telemedicine is convenient and effective in many circumstances. Future care delivery models should incorporate the patient perspective to implement hybrid models where telemedicine is an adjunct to in-person visits in ambulatory neurology.

The Experience of Managers of Private Optometry Practice during the COVID-19 Pandemic in Nigeria

AJOL : Purpose: To provide an in-depth understanding of the experience of managers of private optometry practice in Nigeria during the COVID-19 pandemic.Methods: The study adopted a qualitative research design with a phenomenological research strategy. Through semi-structured interviews, the experiences of six managers of private optometry practice in Nigeria during the COVID-19 pandemic were studied and thematically analysed.Results: Data collected through the interviews identified interesting themes and sub-themes. 'Impact of COVID-19' emerged as a central theme, while 'workplace safety', 'reduced income', 'digital integration', 'supply chain and staffing issues' emerged as sub-themes. The result shows that the participants faced challenges such as the cost of maintaining a safe working space, reduced income, supply chain and staffing issues. The need for digital integration in private optometry practice, versatile staff, and the diversification of supplier networks emerged as key strategies to overcoming the challenges.Conclusion: Managers of private optometry practice have been faced with some challenges due to the COVID-19 pandemic. This study has identified strategies that can help minimise the negative impact of the COVID-19 pandemic and other future crises

Telemedicine Implementation in Pain Medicine: A Survey Evaluation of Pain Medicine Practices in Spring 2020.

BACKGROUND: The COVID-19 pandemic resulted in a novel challenge for healthcare delivery and implementation in the United States (US) in 2020 and beyond. Telemedicine arose as a significant and effective medium for safe and efficacious physician-patient interactions. Prior to the COVID-19 pandemic, telemedicine while available, had infrequently been utilized in pain medicine practices due to difficulties with reimbursement, the learning curve associated with new technology usage, and the need for new logistical systems in place to implement telemedicine effectively. Given the unique constraints on the healthcare system during the COVID-19 pandemic, the ubiquitous utilization of telemedicine among pain medicine physicians increased, giving insight into potential future roles for the technology beyond the pandemic. OBJECTIVES: To survey and understand the state of implementation of telemedicine into pain medicine practices across practice settings and geographical areas; to identify potential barriers to the implementation of telemedicine in pain medicine practice; and to identify the likelihood of telemedicine continuing beyond the pandemic in pain medicine practice. STUDY DESIGN: Online questionnaire targeting Pain Medicine physicians in the US. Participants were asked questions related to the use of telemedicine during the first peak of the COVID-19 pandemic. SETTING: Online-based questionnaire distributed to academic and private practice pain medicine physicians nationally in the United States. METHODS: A 34 web-based questionnaires were distributed by the American Society of Regional Anesthesia and Pain Medicine and the Society of Interventional Spine to all active members. Data were analyzed using SAS v9.4. RESULTS: Between December 3, 2020, and February 18, 2021, 164 participants accessed the survey with a response rate of 14.3%. Overall, academic physicians were more likely to implement telemedicine than private practice physicians. Telemedicine was also more frequently utilized for follow-up appointments rather than initial visits. LIMITATIONS: Although our n = 164, the overall low response rate of 14.3% warrants further investigation into the utilization of telemedicine throughout the COVID-19 pandemic. CONCLUSIONS: Telemedicine as an emerging technology for efficient communication played a key role in mitigating the adverse effects of the COVID -19 pandemic on chronic pain patients. The utilization of telemedicine remarkably increased after the start of the pandemic within 1 to 2 weeks. Overall, private hospital-based centers were significantly less likely to implement telemedicine than academic centers, possibly due to limited access to secure telemedicine platforms and high start-up costs. Telemedicine was used more frequently for follow-up visits than initial visit encounters at most centers. In spite of the unforeseen consequences to the healthcare system and chronic pain practices in the US from COVID-19, telehealth has emerged as a unique model of care for patients with chronic pain. Although it has flaws, telehealth has the ability to increase access to care beyond the end of the pandemic. Further identification of barriers to the use of telemedicine platforms in private practices should be addressed from a policy perspective to facilitate increased care access.

[Prioritization of risk situations in neuro-urology: Guidelines based on the Delphi method from Association française d'urologie (AFU), Association francophone internationale des groupes d'animation de la paraplégie (AFIGAP), Groupe de neuro-urologie de langue française (GENULF), Société française de médecine physique et de réadaptation (SOFMER) and Société interdisciplinaire francophone d'urodynamique et de pelvi-périnéologie (SIFUD-PP)]. / Priorisation des situations à risque en neuro-urologie : recommandations par méthode Delphi de l'Association française d'urologie (AFU), l'Association francophone internationale des groupes d'animation de la paraplégie (AFIGAP), le Groupe de neuro-urologie de langue française (GENULF), la Société française de médecine physique et de réadaptation (SOFMER) et la Société interdisciplinaire francophone d'urodynamique et de pelvi-périnéologie (SIFUD-PP).

PURPOSE: During the COVID-19 pandemic, a care reorganization was mandatory, and affected patients in different areas, including management of neurogenic lower urinary tract dysfunction. This work aims to provide validated schedule concerning the assessment and management of patients in neuro-urology. METHODS: Based on a literature review and their own expertise, a steering committee composed of urologists and physical medicine and rehabilitation practitioners generated a comprehensive risk-situation list and built a risk scale. A panel of French-speaking experts in neuro-urology was asked to define the timing for each clinical situation and validated these new recommendations through a Delphi process approach. RESULTS: The 49 experts included in the rating group validated 163 propositions among the 206 initial items. The propositions were divided into four domains - diagnosis and assessment, treatment, follow-up, and complications - and two sub-domains - general (applicable for all neurological conditions) and condition-specific (varying according to the neurological condition (spinal cord injury, multiple sclerosis, brain injury, Parkinsonism, spinal dysraphism, lower motor neuron lesions)). CONCLUSIONS: This multidisciplinary collaborative work generates recommendations based on expert opinion, providing a validated timing for assessment and management of patients in neuro-urology which may help clinicians to reorganize their patients' list with a personalized medicine approach, in a context of health crisis or not.

Experiences to date with the logistical management of long-acting cabotegravir and rilpivirine.

The logistical management of an injectable therapy for the treatment of HIV can be expensive, time consuming, frustrating and riddled with barriers. In this Commentary, we describe our experiences to date with acquiring, storing, handling, administering and billing for long-acting cabotegravir and rilpivirine through four scenarios, each of which have presented their own unique obstacles and learning curves. At the time of writing, we have successfully transitioned four patients from the CUSTOMIZE trial to long-acting cabotegravir and rilpivirine. In doing so, we encountered a variety of barriers to acquiring, handling and administering the medication for both insured and uninsured patients; it is expensive, on a limited number of insurance formularies, and often requires a prior authorization from the provider. Cold-chain handling of the injectable therapy, along with individual patient characteristics, present barriers to management and administration of this therapy. Whilst a seemingly very attractive option for the treatment of HIV-1 infection in adults, long-acting cabotegravir and rilpivirine present a variety of challenges to pharmacists, providers and clinic staff on how to obtain it for and administer it to the patient. We plan to continue documenting our experiences, progress and successes, or lack thereof, in order to fine-tune our process and share with others.

Anxiety, fear, awareness and economic influence amongst Indian dentists during the COVID-19 outbreak

Dental practitioners are at risk due to direct contact with possibly infected patients as front-line health care professionals during the coronavirus (COVID-19) pandemic. Therefore, it is of interest to measure the anxiety, fear, awareness and economic effect of the epidemic on Indian dentists at work .This study was conducted utilizing an online survey questionnaire and Google forms from August 22nd to August 23rd, 2021. A total of 485 doctors took part in the survey. The questionnaire included open-ended, closed-ended, and Likert five-point scale items to measure anxiety, awareness, and the financial impact of COVID-19 on dentists. The Mann-Whitney test was used for two groups. The Kruskal–Wallis test was used as a post-hoc test for multigroup comparisons. The average age of the participants was 36.5 ± 9.2 years, with the majority (75.21%) being just graduate dentists. More than 80.1% of interviewees expressed concern about contracting COVID-19. Younger dentists and females have higher levels of anxiety than older dentists. The level of awareness and practice of COVID-19 precautions and infection-control measures among these dentists (94.1%) was found to be high. This is due to age, qualification, and designation (except GP vs. Specialist). Data shows that about 75 percent of practitioners said their income had decreased by roughly 50 percent, independent of demographic characteristics. Data also shows that Indian dentists had a high degree of knowledge and awareness during the COVID-19 epidemic despite fear and anxiety. © 2022 International Journal of Health Sciences.All rights reserved.

Lessons from the implementation of the Health Care Homes program.

Australia's primary health care system works well for most Australians, but 20% of people live with multimorbidity, often receiving fragmented care in a complex system. Australia's 10-year plan for primary health care recognises that person-centred care is essential to securing universal health coverage, improving health outcomes and achieving an integrated sustainable health system. The Health Care Homes trial tested a new model of person-centred care for people with chronic and complex health conditions. This model demonstrated that change can be achieved with dedicated transformational support and highlighted the importance of enablers and reform streams that are now established in the 10-year plan.

High LACE index scores are associated with disproportionate excess deaths in hospital amongst patients with COVID-19.

Risk factors for COVID-19-related outcomes have been variably reported. We used the standardised LACE index to examine admissions and in-hospital mortality associated with COVID-19. Data were collected in the pre-pandemic period (01-04-2019 to 29-02-2020) from 10,173 patients (47.7% men: mean age ± standard deviation = 68.3 years ± 20.0) and in the pandemic period (01-03-2019 to 31-03-2021) from 12,434 patients. With the latter, 10,982 were without COVID-19 (47.4% men: mean age = 68.3 years ± 19.6) and 1452 with COVID-19 (58.5% men: mean age = 67.0 years ± 18.4). Admissions and mortality were compared between pre-pandemic and pandemic patients, according to LACE index. Admission rates rose disproportionately with higher LACE indices amongst the COVID-19 group. Mortality rates amongst the pre-pandemic, pandemic non-COVID-19 and COVID-19 groups with LACE index scores < 4 were 0.7%, 0.5%, 0%; for scores 4-9 were 5.0%, 3.7%, 8.9%; and for scores ≥ 10 were: 24.2%, 20.4%, 43.4%, respectively. The area under the curve receiver operating characteristic for predicting mortality by LACE index was 76% for COVID-19 and 77% for all non-COVID-19 patients. The risk of age and sex-adjusted mortality did not differ from the pre-pandemic group for COVID-19 patients with LACE index scores < 4. However, risk increased drastically for scores from 4 to 9: odds ratio = 3.74 (95% confidence interval = 2.63-5.32), and for scores ≥ 10: odds ratio = 4.02 (95% confidence interval = 3.38-4.77). In conclusion, patients with LACE index scores ≥ 4 have disproportionally greater risk of COVID-19 hospital admissions and deaths, in support of previous studies in patients without COVID-19. However, of importance, our data also emphasise their increased risk in patients with COVID-19. Because the LACE index has a good predictive power of mortality, it should be considered for routine use to identify high-risk COVID-19 patients.

Endodontic Specialists' Practice During the Coronavirus Disease 2019 Pandemic: 1 Year after the Initial Outbreak.

INTRODUCTION: The aims of this observational study were to determine if endodontists' practices in early 2021 experienced changes in patient characteristics compared with a comparable prepandemic period and to determine whether the changes reported during the initial outbreak of coronavirus disease 2019 (COVID-19) in 2020 were reversed 1 year later. METHODS: Demographic, diagnostic, and procedural data of 2657 patient visits from 2 endodontist private offices from March 16 to May 31 in 2019, 2020, and 2021 were included. Bivariate analyses and multiple logistic regression models were used to examine the impact of ongoing COVID-19 pandemic on patient data. RESULTS: Bivariate analyses showed that patients' self-reported pain levels and the number of visits with irreversible pulpitis in 2021 were higher than 2019 (P < .05). Patients' self-reported pain, percussion pain, and palpation pain levels in 2021 were less than 2020 (P < .05). Multiple logistic regression analyses showed that endodontists' practices in 2021 had an increase in the number of nonsurgical root canal treatments (odds ratio [OR] = 1.482; 95% confidence interval [CI], 1.102-1.992), and apicoectomies (OR = 2.662; 95% CI, 1.416-5.004) compared with 2019. Compared with the initial outbreak in 2020, endodontists' practices in 2021 had visits with older patients (OR = 1.288; 95% CI, 1.045-1.588), less females (OR = 0.781; 95% CI, 0.635-.960), more molars (OR = 1.389; 95% CI, 1.065-1.811), and less pain on percussion (OR = 0.438; 95% CI, 0.339-0.566). CONCLUSIONS: The ongoing COVID-19 pandemic was associated with an increase in the number of nonsurgical root canal treatments. Some of the changes observed during the initial outbreak in 2020, including objective pain parameters, returned to normal levels 1 year later.