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Aim: SARS-CoV-2 has caused a global pandemic that has negative consequences for many parts of life. To our knowledge, no study has assessed the effect of the SARS-CoV-2 pandemic on a possible delay in prosthodontic treatments because of a potential concern of contamination in individuals. Therefore, the purpose of this study was to assess this potential impact of fear, as well as oral health-related quality of life, in partially edentulous patients using questionnaires during the SARS-CoV-2 pandemic. Material(s) and Method(s): A total of 135 partially edentulous patients (74 females and 61 males aged 18-70 years) participated in this study. A complete questionnaire consisting of general knowledge questions on SARS-CoV-2 and the OIDP scale, which evaluates the effect of oral status on daily activities were used in participants. Result(s): Statistical analyzes showed that participants with a history of SARS-CoV-2 and/or who are aware of a member of their social circle with a history of the virus, and/or who is deceased, were unwilling to receive dental care during the pandemic. Most of the participants between the ages of 31 and 60 were more worried about the transmission of SARS-CoV-2 during dental treatment. Discussion(s): Concerns about SARS-CoV-2 contamination of patients over 30 years of age may have a negative impact on oral health due to delayed prosthodontic treatments.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Objective: The objective of this study is to evaluate the awareness of cross-infection control measures followed by DHCPs during the 5th wave of Covid-19 pandemic, Omicron variant in a government sector university of Karachi, Pakistan. Method(s): A Cross-sectional study was conducted from June till September 2022 at Sindh Institute of Oral Health Science during the 5th wave of Covid 19 pandemic, Omicron variant. Data was collected from 153 DHCPs from government sector university using a self-administered questionnaire, comprising of 20 closed ended question to assess the awareness and practice of cross infection protocols by DHCPs. Result(s): 98.7% of the participants were vaccinated against Covid 19. 96% of the participants used surgical gowns, face shields, and face masks as part of PPE during examining patients and while performing procedure. After treatment 99.3% of participants washed hands with hand wash, soap or used antiseptic solution. 77.1% of participants asked for Covid 19 test report and 68.6% of participants asked for proof of vaccination against covid 19 before treating patients. 96.1% of participants recommended disinfection of dental unit after every patient. 98% of participants changed glove after every patient. 88.2% of the participants said they would carry all elective and emergency procedures. Conclusion(s): The results of this study show that DHCPs practicing at government sector university have adequate knowledge regarding prevention of cross infection protocols and their importance to limit spread of infections. But their practice of prevention of cross infection during Covid 19 pandemic is not ideal as percentage of DHCPs requiring proof of vaccination or negative reports for Covid 19 were rather low and the percentage of DHCPs willing to carry elective procedures along with emergency ones was rather high.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Telemedicine is a modality which utilizes technology to provide and support health care across large distances. It has redefined the practices of medicine in many specialties and continues to be a boon for clinicians on many frontiers. Its role in the branch of anesthesia remains largely unexplored but has shown to be beneficial in all the three phases: pre-operative, intra-operative, and post-operative. Now time has come that anesthesiologists across the globe reassess their strategies and utilize the telemedicine facilities in the field of anesthesia.Copyright © 2021 EDP Sciences. All rights reserved.
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Various dental, maxillofacial, and orthopedic surgical procedures (DMOSP) have been known to produce bioaerosols, that can lead to the transmission of various infectious diseases. Hence, a systematic review (SR) aimed at generating evidence of aerosols generating DMOSP that can result in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), further investigating their infectivity and assessing the role of enhanced personal protective equipment (PPE) an essential to preventing the spreading of SARS-CoV-2 during aerosol-generating procedures (AGPs). This SR was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidelines based on a well-designed Population, Intervention, Comparison, Outcomes and Study (PICOS) framework, and various databases were searched to retrieve the studies which assessed potential aerosolization during DMOSP. This SR included 80 studies (59 dental and 21 orthopedic) with 7 SR, 47 humans, 5 cadaveric, 16 experimental, and 5 animal studies that confirmed the generation of small-sized < 5 µm particles in DMOSP. One study confirmed that HIV could be transmitted by aerosolized blood generated by an electric saw and bur. There is sufficient evidence that DMOSP generates an ample amount of bioaerosols, but the infectivity of these bioaerosols to transmit diseases like SARS-CoV-2 generates very weak evidence but still, this should be considered. Confirmation through isolation and culture of viable virus in the clinical environment should be pursued. An evidence provided by the current review was gathered by extrapolation from available experimental and empirical evidence not based on SARS-CoV-2. The results of the present review, therefore, should be interpreted with great caution.
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Introduction: Aim of the study was to analyse the structure of patients referred for dental treatment in general anaesthesia (GA) and to analyse the triage outcomes. Material(s) and Method(s): Retrospective chart analysis of patients referred between January 1st 2018 and July 7th 2022 was performed. Following data were registered: age, sex, diagnosis/ reason for referral for GA, indication for dental treatment in GA, trisage outcome and waiting time for the GA procedure. Result(s): Charts of 193 referred in the aforementioned period were analysed. Most common reason for the referral was autism (65/33.7%), cerebral paralysis (29/15%) and mental retardation (27/14%). Indication for dental treatment in GA was found in 156(80.8%) patients while in 37(19.2%) patients no indication for dental treatment in GA was found. Out of the 156 patients who were indicated for dental treatment in GA, 98(62.8%) patients were managed through day-care surgery and 8(5.2%) patients were admitted to hospital. Twenty patients (12.8%) were still waiting for their GA appointment in the time of analysis, 29(18.6%) were lost to follow up and in one (0.6%) patient the anaesthesiologist recommended ambulatory treatment due to increased risk. Out of the 37 patients in whom no indication for the treatment in GA was found, 13(35.2%) had no caries, 16/ (43.2%) were referred to paediatric dentist and 8(21.6%) were managed on the initial exam. Median time of waiting for the procedure was 120(10-365) days. Before the COVID- 19 pandemics median waiting time was 90(15-300) days, and after the COVID-19 pandemics median waiting time was 135(10-365) days. Conclusion(s): In the majority of the patients referred for dental treatment in GA, indication for the procedure was established. Majority of the referred patients can be managed through a day-care surgery. COVID-19 pandemics is probably one of the reasons for the increased GA procedure waiting time.
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Background: The risk of SARS-CoV-2 transmission cannot be eliminated during aerosol-generating dental procedures in most dental settings. The present study was conducted to assess impact of COVID- 19 on utilization of dental services. Material(s) and Method(s): 485 patients who obtained dental treatment before and during COVID- 19 period were enrolled. Type of complaints for which patients visited dental offices was recorded. Result(s): Out of 485, males were 310 and females were 175. During pre- COVID period, 170 patients <18 years and 210 above 18 years visited dental office while during COVID period, 40 below 18 years and 65 above 18 years reported to dental clinics. The common complaints were periapical seen in 120 and 45, cellulitis in 80 and 30, cellulitis in 70 and 10 and trauma in 110 and 20 in pre- COVID and during COVID period. The difference found to be significant (P< 0.05). Conclusion(s): COVID- 19 had strong impact on utilization of dental services among patients.Copyright © 2020 Ubiquity Press. All rights reserved.
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The corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARSCoV-2), first detected in Wuhan, Hubei province of China, has emerged rapidly as a health crisis that has challenged health systems and health professionals all over the world. Transmission occurs primarily through droplet spread or contact routes. Due to these characteristics dental staff and dental practitioners are considered to be at the highest risk of acquiring SARS-CoV-2 infection because of their prolonged face to face exposure to patients and exposure to respiratory secretions and aerosols produced during procedures like ultrasonic scaling and cavity/access preparation using a high-speed air rotor with water jet cooling systems. Antiseptic mouthwashes have been widely used as a standard measure before routine dental treatment, especially preoperatively. They have an essential role in reducing the number of microorganisms in the oral cavity. Hence, present review of literature provides details on role of mouthwash in prevention of Covid-19 transmission.Copyright © 2020 Ubiquity Press. All rights reserved.
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Introduction: An urgent dental care centre (UDCC) was set up at Queen Mary's Hospital in Sidcup, in response to the COVID-19 pandemic. Alongside the reporting of clinical outcomes, it is important to determine the success of a service from a patient's perspective. The aim of this study was to ascertain patient reported outcome measures (PROMs) and patient reported experienced measures (PREMs) of our service. Method(s): The Oral Health Impact Profile 14 (OHIP-14) tool was used to assess the Oral Health-Related Quality of Life (OHRQoL) of patients, and completed before and after attending our UDCC for treatment. Patients were also asked to complete a patient satisfaction questionnaire. Result(s): 146 patients were recruited for our study, with 95 patients completing the OHIP-14 questionnaires pre- and post intervention at our UDCC and 136 patients completing a patient satisfaction questionnaire. A statistically significant reduction in OHIP score when comparing pre- and post-intervention was found across all OHIP-14 domains. The mean positive response rate (strongly agree or agree) for the patient satisfaction questionnaire was 97.1%. Conclusion(s): A significant improvement in OHRQoL was found after treatment at our UDCC, with the majority of patients reporting a positive experience. We conclude that PROMs and PREMs are vital tools to assess service efficacy, help with the planning of service provision and should remain at the forefront even during a crisis such as the COVID-19 pandemic.Copyright © 2021
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Introduction: During the 'Circuit Breaker' period of the COVID-19 pandemic in Singapore from April to June 2020, governmental policies restricted the practice of dentistry nationwide to the provision of emergency treatment only, regardless of the patient's COVID status. As such, teledentistry was used as an alternative means to continue providing some form of dental care to COVID-19-positive patients who were admitted to a COVID-19 Community Care Facility. Description: The patients were physically triaged by physicians who would send clinical photos to the author via a messaging application, who would in turn triage the patients and assess if they required referral for emergency dental treatment. For patients who did not meet the criteria for referral, the author would advise the physicians on the subsequent management plan which included, but was not limited to, the provision of symptomatic relief. Conclusion(s): This article shows the feasibility of undertaking teledental consultations using clinical photos transmitted via a messaging application. The practical implication is a reduced barrier for patients and healthcare professionals to access teledentistry, without having to resort to sophisticated equipment. Hopefully, this will translate into the continued provision of some form of dental care to patients during the ongoing pandemic as opposed to no care at all.Copyright © The Author(s) 2022.
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Introduction: Patients with congenital bleeding disorders (CBD) have an increased bleeding tendency, which varies according to the factor deficiency and severity. In most cases, prolonged bleeding is observed after trauma, surgery and/or invasive procedures. Haemostatic treatment is needed to prevent bleeding complications and allow a good clinical outcome. Our aim is to evaluate the management of patients with CBD in minor procedures. Method(s): Retrospective study of patients with CBD who performed minor procedures over a 7-year period, through review of clinical files. Result(s): Between January 2015 and December 2021, 249 minor procedures were performed in 113 patients with CBD: 42 had diagnosis of Haemophilia A (HA) (15 severe without inhibitors;3 severe with inhibitors;4 moderate and 20 mild);12 had Haemophilia B (HB) (7 severe without inhibitors;2 moderate and 3 mild);5 were carriers of HA and 2 of HB. 35 had von Willebrand disease (VWD);15 had rare bleeding disorders (8 FVII deficiency;6 FXI deficiency;1 FX deficiency) and 2 had diagnosis of inherited platelet glycoprotein deficiencies (1 Glanzmann thrombasthenia and 1 Bernard Soulier syndrome). Most procedures were dental treatments (189);synoviorthesis/ infiltration/mesotherapy (17);endoscopies and colonoscopies (15);skin lesions excision (8);COVID-19 vaccination (5);sebaceous cyst excision (4);cardiac catheterization (3);ureteral stent removal (3);bone marrow biopsy (2);cystoscopy (2) and breast fibroadenoma excision (1). Prophylactic treatment was performed in 237 (95%) of the procedures, respectively FVIII concentrate factor (59);FIX concentrate factor (27);DDAVP (66);von Willebrand factor/factor VIII concentrates (44);bypassing agents (24);platelet (6);inactivated human plasma (9);tranexamic acid (47) and epsilon-aminocaproic acid (161). No side effects were reported. Discussion/Conclusion: Most patients that underwent minor procedures had Haemophilia and VDW(83%). The most common procedure was dental treatment (76%). Patients with CBD require attention and special care in dental practice. The haemostatic prophylactic treatment varies according to the specific haemostatic defect, severity and type of procedure. The treatment performed has been demonstrated safe and effective, with low incidences of haemorrhagic and treatment-related complications. These patients' treatment requires multidisciplinary teams and reference centres.
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This paper assesses the changing guidelines regarding Aerosol Generating Procedures and fallow time in Oral and Maxillofacial Surgery Departments in the UK. Many departments have variable local policies and protocols and this could be a contributing factor in increased waiting lists for patients during a time when patients have less access to primary and secondary care.Copyright © 2021
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A 46-year-old man with no known allergies or history of atopy was referred for the investigation of a severe anaphylactic reaction following root canal dental treatment. The procedure had been done under local anaesthetic and involved drilling the tooth, removal of dental pulp, cleaning and insertion of a temporary filling. Preliminary skin prick tests (SPTs) and intradermal tests were negative to natural rubber latex, articaine (the local anaesthetic used for his procedure), lidocaine and chlorhexidine. He had negative specific IgE to chlorhexidine and latex, and a negative lidocaine challenge, confirming that he was not allergic to lidocaine. He returned for further dental treatment, which was done without local anaesthetic. As the procedure was completed, he developed severe anaphylaxis again. He made a full recovery and his dentist was asked for detailed information and samples of all the materials used during the procedure. Subsequent SPT showed a positive weal of 12 x 6 mm to the dental lubricant, Glyde, which was used on both occasions. Its ingredients included polyethylene glycol (PEG) 4253. SPT to other high-weight macrogol-containing products showed positive reactions to a 5% lidocaine ointment, Movicol, EMLA cream and Depomedrone. On further questioning he recalled minor immediate irritation after using a brand of children's shampoo, but a SPT to the shampoo was negative. An open test, closed test and SPT to a lower-molecular-weight patch-test allergen (PEG400 in petrolatum) were negative. PEGs or 'Macrogols' are hydrophilic polymers used in food, cosmetics and pharmaceutical reagents. They have recently attracted attention as they are excipients in several COVID-19 vaccines and have been suggested as a possible cause of anaphylaxis. Anaphylaxis to higher-molecular-weight PEGs has been reported from the use of bowel preparations and parenteral steroids. There are a handful of reports of contact urticaria to PEG-containing medicaments. We report this case to raise awareness of severe immediate hypersensitivity to these apparently innocuous ingredients and a novel source of exposure. A low index of suspicion, lack of standardized nomenclature and commercial reagents for testing are current barriers to diagnosis.
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Background: The rampant spread of SARS-CoV-2 worldwide increases the likelihood that dental health care professionals will treat this subset of the patient population. Due to the characteristics of the profession and the virus, two situations deserve attention: the disinfection of surfaces that can be contaminated during dental treatment and the presence of the virus in the oral cavity and the countless possibilities of microbial interaction with microorganisms in the oral cavity. Objective(s): The objective of this review was to point out the current stage of the discussion on dental bio-safety involving professionals, the work team and patients. Method(s): The following databases were consulted: MEDLINE (National Library of Medicine, USA-NLM), Lilacs, Scielo, Embase, Web of Science and Google Academic with the keywords COVID-19 and dental practice, dentistry, oral conditions, mouthrinses. Result(s): Disinfection of surfaces has always been paramount and the protocol to prevent the spread of SARS-CoV-2 seems to be established. SARS-CoV-2 is vulnerable to oxidation, it is recommended to use a mouth rinse containing oxidizing agents. Conclusion(s): Dentists are among the professionals who are most at risk of COVID-19 infection, and they must have extra attention during this period, biosafety measures must be reinforced and patients must be motivated to maintain a strict oral hygiene routine so that there is no accumulation of biofilm and this may somehow interfere with their systemic condition.Copyright © 2021 Bentham Science Publishers.
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Background: The pandemic caused by the spread of COVID19 generated throughout the world great changes in all areas of life. Social distancing was carried out very drastically in some countries, and even in the field of dental care, some countries prohibited the practice of dentistry. Objective(s): To demonstrate that the dental office is safe regarding the possibility of contagion of Sars-Cov-2 as long as good biosecurity protocols are used. Method(s): A structured survey of 19 questions was applied to 103 patients who subsequently attended a periodontics and oral and maxillofacial surgery office in Mexico, to receive care from these specialties between April 2020 and July 2021. The questions posed in this survey were aimed at knowing the opinion of the patients regarding the measures that this establishment has for the prevention of the transmission of COVID19, as well as questions regarding the possible effects of attending this office in contagion of the disease from patients and their families. Result(s): A total of 18 (17.5%) patients reported having suffered COVID19, and none reported that they fell ill after the consultation. None of the clinic's specialists and assistants have fallen ill with COVID-19 during the pandemic. Conclusion(s): It is not necessary to suspend or condition dental care during times of pandemics such as what happened with COVID19, as long as strict safety protocols are observed within clinical facilities.Copyright © 2022 The Authors
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Introduction: The new coronavirus COVID-19 is a high-risk disease due to its high rate of infection, which makes us aware of its seriousness and the fact that we will have to live with it for a long time. To propose guidelines based on research and analysis of scientific publications and the requirements of professionals, against the risk of contagion by COVID-19. Method(s): We applied qualitative study the technique used was a survey with a 10-question question-naire, applied to 16 professionals graduated from dentistry. Result(s): To obtain the results, we evaluated aspects relat-ed to the cessation of activities during quarantine, the lack of dental biosafety supplies, knowledge about protocols and biosafety barriers against COVID-19, emergency care during quarantine and return to clinical activity, as well as the practice of testing both patients and professionals before dental care before returning to work. Conclusion(s): The lack of ac-curate and timely information reveals the clear deficiencies of the National Public Health System, which has led to a lack of knowledge about biosecurity measures that are currently crucial to halt the spread of the new coronavirus and increase knowledge about the risk of infection. Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.
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Objective: This study compared the aerosol-generating and non-aerosol-generating endodontic emergency procedures' success and assessed the outcome of endodontic treatments initiated before a pandemic but could not be completed in the targeted time. Material(s) and Method(s): Emergency treatments were performed according to symptoms of teeth. Treatment success or failure was determined according to patients whether not re-referral with untimely pain. Short-term outcome and complications arising from teeth, which endodontic treatments were prolonged were also recorded. A chi-square test was used in the statistical analysis, and p<0.05 was considered significant. Result(s): The aerosol-generating procedure group's success rate was 86.2%, while it was 70.0% in the non-aerosol generating procedure group (p=0.050). The short-term survival rate of teeth was 83.7% in patients whose endodontic treatment had been prolonged. Conclusion(s): Considering the pros and cons, each emergency patient should be evaluated case-by-case. Copyright ©Meandros Medical and Dental Journal, Published by Galenos Publishing House.
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The risk of microbial air contamination in a dental setting, especially during aerosol-generating dental procedures (AGDPs), has long been recognized, becoming even more relevant during the COVID-19 pandemic. However, individual pathogens were rarely studied, and microbial loads were measured heterogeneously, often using low-sensitivity methods. Therefore, the present study aimed to assess microbial air contamination in the dental environment, identify the microorganisms involved, and determine their count by active air sampling at the beginning (T0), during (T1), and at the end (T2) of ultrasonic scaling in systemically and periodontally healthy subjects. Air microbial contamination was detected at T0 in all samples, regardless of whether the sample was collected from patients treated first or later; predominantly Gram-positive bacteria, including Staphylococcus and Bacillus spp. and a minority of fungi, were identified. The number of bacterial colonies at T1 was higher, although the species found were similar to that found during the T0 sampling, whereby Gram-positive bacteria, mainly Streptococcus spp., were identified. Air samples collected at T2 showed a decrease in bacterial load compared to the previous sampling. Further research should investigate the levels and patterns of the microbial contamination of air, people, and the environment in dental settings via ultrasonic scaling and other AGDPs and identify the microorganisms involved to perform the procedure- and patient-related risk assessment and provide appropriate recommendations for aerosol infection control.
Subject(s)
COVID-19 , Ultrasonics , Humans , Healthy Volunteers , Pandemics , Respiratory Aerosols and Droplets , Air Microbiology , Colony Count, MicrobialABSTRACT
The quality of dental services is an important component in the process of oral health care and requires constant evaluation for a possible increase in it. With the SARS-COV II pandemic, dental services have suffered. The restrictions applied successively led to the closure of the dental offices, offering services to urgent cases only. Thus, throurh the questionnaire method, we formed a representative sample of the population covering a variety of professions and ages, generating a general opinion about the evaluation of the dental patients satisfaction of the services received between January 2022 and February 2022. The study group involved 151 patients. Copyright © 2021 Rosu Elena Mirela, published by Sciendo.
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COVID-19 evidenced the need for preventive protocols to control its spread worldwide. Therefore, the purpose of this review was to compare the current indications and regulations for the use of personal protective equipment (PPE) in dental care. For the bibliographic search, keywords such as "Containment of Biohazards", "Personal Protective Equipment", "dental office", "COVID-19" were used during the advanced search in Pubmed and academic Google. Forty regulations were obtained that met all the selection criteria for preventive measures through the use of PPE by the operator and the patient;being more detailed the Sanitary Directive 100-MINSA published in 2020 without evidence of updating in this year 2021. Likewise, in studies carried out on the reuse of masks, it was determined that the most effective method was decontamination with UV-C, which maintains their integrity and filtering capacity. Copyright © 2022 Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado