Colliding Pandemics and CoViD-19

Cases of the respiratory syncytial virus (RSV), monkeypox virus (MPXV), and avian influenza A Virus (IAV) have increased during our current prolonged Corona Virus Disease 2019 (CoViD-19) pandemic. The rise of these viral infectious diseases may be associated or even inter-dependent with acute, latent or recurrent infection with Systemic Acute Respiratory Syndrome Corona virus-2 (SARS-CoV2). The nonsensical neologism 'tripledemic' was tentatively introduced to describe the confluent nature of these trends (epidemic comes from two Greek words: epi=on, about, demos=people;pandemic is also derived from Ancient Greek: pan=all, demos=people;but 'tripledemic' would derive from Latin triplus=three, Greek demos=people, and would at best signify 'three countries, three peoples', but certainly not the current threat of confluence of three, or perhaps more pandemics). Emerging evidence suggests that monkey pox and CoViD-19, among several other viral diseases, produce significant observable manifestations in the oral cavity. From a clinical standpoint, dentists and dental personnel may be among the first health professionals to encounter and diagnose clinical signs of converging infections. From the immune surveillance viewpoint, viral recombination and viral interference among these infectious diseases must be examined to determine the potential threat of these colliding pandemics.

Psychological Effects of COVID-19 Pandemic in Dental Healthcare Workers

Objective: This study aimed to evaluate the mental health status of Dental Health Care Workers (DHCWs) in a dental emergency university clinic treating urgent patients during the pandemic. Materials and Methods: A hundred fifteen participants were selected from DHCWs who actively worked during the pandemic in a Dental Emergency Clinic of a university. Depression, anxiety and stress levels of participants were measured with the Depression-Anxiety-Stress Scale and their insomnia levels were assessed with the Insomnia Severity Index. Correlations between independent continuous and dependent variables tested with Spearman test. Mann-Whitney U and Kruskal-Wallis tests were used used to evaluate possible effects of independent variables. The psychological data of the aerosol-generating treatment group were compared to the rest of the participants using Mann-Whitney U tests. In all tests α=0.05 significance level was set. Results: The rates of DHCWs scored above the cut-off points were 54% for depression, 40% for anxiety, 36% for stress and 40% for insomnia. Feeling negative emotions before the pandemic significantly interacted with all psychometric measurements. Younger age, feeling anxious about changing working conditions and/or obtaining personal protective equipment was correlated positively with stress points (p=0.035, p=0.008, p=0.007, respectively). A significant percentage of DHCWs presented high scores on depression, anxiety, stress and insomnia in this study. Conclusion: The authorities and healthcare executives must show programmed leadership and support for DHCWs during the COVID-19 outbreak. The integration of programs developed to mitigate stress among DHCWs recommended during the COVID-19 pandemic.

Willingness and ability of oral health care workers to work during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic continues to disrupt dental practice in the United States. Oral health care workers play an integral role in societal health, yet little is known about their willingness and ability to work during a pandemic. METHODS: Oral health care workers completed a survey distributed on dental-specific Facebook groups during an 8-week period (May 1-June 30, 2020) about their willingness and ability to work during the COVID-19 pandemic, barriers to working, and willingness to receive a COVID-19 vaccine. RESULTS: Four hundred and fifty-nine surveys were returned. Only 53% of dentists, 33% of dental hygienists, 29% of dental assistants, and 48% of nonclinical staff members would be able to work a normal shift during the pandemic, and even fewer (50%, 18%, 17%, and 38%, respectively) would be willing to work a normal shift. Barriers included caring for family, a second job, and personal obligations, and these were faced by dental assistants and hygienists. Dentists were more likely than hygienists (P < .001), assistants (P < .001), and nonclinical staff members (P = .014) to receive a COVID-19 vaccine. CONCLUSIONS: Oral health care workers have a decreased ability and willingness to report to work during a pandemic, and dentists are significantly more able and willing to work than hygienists and assistants. Dentists are more likely than staff to receive a COVID-19 vaccine. PRACTICAL IMPLICATIONS: The results of this study may help inform future initiatives of dental workforce readiness during a pandemic. Dentists should be prepared to discuss alterations to standard operating procedures to allay staff members' fears and improve retention rates during pandemics, allowing for improved access to oral health care.

Dissemination of Aerosol and Splatter in Clinical Environment during Cavity Preparation: An In Vitro Study.

Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a great risk of transmitting contagious infections to health care workers and patients, especially in an era of social distancing due to COVID-19. The current study was conducted to evaluate contamination amount, duration, the distance of aerosol, and splatter produced after cavity preparation using a two-hole and four-hole handpiece. The study was performed on a dental manikin in a dental simulation laboratory at the College of Dentistry, King Faisal University Al Ahsa. The dental manikin was set to a reclined position to simulate the clinical operatory position of the patient for dental restorative procedures. Aerosol and splatter were collected on Grade 1 qualitative cotton cellulose filter paper. These were placed on adhesive tape extending from the headrest of the dental manikin in six different directions (2, 4, 6, 8, 10, and 12 o'clock) for up to 60 inches and on certain positions of the operator and assistant such as the chest, head, forearms, upper leg, and inside facemask. Class V cavity preparation was done by the principal investigator at a specific time of 3 min on tooth #11 using a two-hole high-speed handpiece, then on the next day, Class V cavity preparation was performed on tooth #21 by a four-hole handpiece. High volume suction was used throughout the cavity preparation. Immediately after cavity preparation, the first filter paper disc was replaced with new ones in all positions. The second set of filter papers was removed after 30 min. Transparent grids were used to count the contamination area on the filter paper disc. No statistically significant difference was found in the mean amount of aerosol and splatter produced by both handpieces, however, a statistically significant difference was found in an amount of aerosol and splatter produced at a 12, 24, and 36 inches distance immediately after cavity preparation and 30 min after cavity preparation, regardless of the type of handpiece used. It is advisable to refrain from removing the personal protective barriers immediately after the procedure within the vicinity of the dental practice. The use of other adjuncts such as high volume suction to reduce the spread of aerosol and splatter is also recommended.

Changing Dental Profession-Modern Forms and Challenges in Dental Practice.

In the last two decades, an increasing trend towards new forms of dental practice was observed [...].