Impact of the COVID-19 pandemic on patients with osteogenesis imperfecta

OBJECTIVES: On March 11, 2020, the WHO classified COVID-19 as a global pandemic. Measures to quell the pandemic included limiting non-essential activities including clinic visits and procedures. It is unclear if individuals with OI had disruptions in their access to healthcare or medications, and if such disruptions affected patients' symptoms. METHOD(S): A REDCap survey was distributed through the OI Foundation on August 31. Surveys completed through September 11 by individuals with OI or their caregiver are included in this analysis. Participants were asked to compare their symptoms and access to healthcare during the first 4 months of the pandemic to the 4 months before the pandemic. RESULT(S): 85 surveys were completed, and 6 were partially completed. The median age of participants was 40 years;35% were children. 32% of participants self-identified as having severe OI. Although most reported no changes in bone pain or fractures, 46% reported they were less likely to seek emergency medical care to treat a fracture, while 33% reported they were more likely to treat fractures at home (Fig 1A). There were delays in accessing all services, with greatest delays accessing dentistry (74%) and aquatic therapy (84%) (Fig 1B). 36% of participants receiving bisphosphonate infusions had delayed infusions because of the pandemic (Fig 1C). Of note, 50% of planned surgeries were delayed. CONCLUSION(S): Although many individuals with OI and their caregivers reported delays in accessing bone-related services/clinics during this 4-month period, there was not a concomitant increase in reported symptoms. This may have related to shelter-in-place restrictions and decreased activity. Limitations of this study include small sample size and potential selection bias because responses were obtained only from OIF members. To address these limitations, we are distributing the survey through healthcare providers of individuals with OI across major regions of the US from a variety of practice types including endocrine, orthopedics and multidisciplinary clinics. Furthermore, as the COVID-19 pandemic continues, we hope that this survey will provide information to address what aspects of healthcare may be in greatest need, as well as the modality through which services may be met. (Figure Presented).

Epidemics, pandemics and dentistry: a commentary

There is no doubt that epidemics and pandemics have transformed dentistry beyond recognition. In this commentary we recapitulate the possible reasons for the emergence of major global epidemics and pandemics, how and why they emerge, and the successful attempts of the dental profession to mitigate infectious transmission in the clinic, which in turn has metamorphosed our profession today. We also peer into the future of dentistry through the prism of the new conceptual approach of 'one world, one health' recently declared by the Centers for Disease Control (CDC). Finally, we discuss five realms of dentistry that have been irretrievably impacted by the recent COVID-19 pandemic, viz vaccines, point of care diagnostics, teledentistry, reinforced infection control, and dental pedagogy. CPD/Clinical Relevance: Vaccines and vaccinations have become integral to societal wellbeing and the prevention of global pandemics.

Attitudes of Medical Practitioners towards Collaboration with Dental Professionals during a Pandemic: A Past Experience and a Future alert

Aim: To determine the attitude of medical practitioners towards collaborating with dental professionals during a pandemic. Material(s) and Method(s): The present study is a cross sectional survey conducted among the medical practitioners of India. 2100 medical practitioners were randomly selected as study subjects. The data pertaining to their attitude toward collaboration with dental professionals were gathered using a self-administered questionnaire. Data was analyzed using descriptive studies. Result(s): Among the study subjects, 93% of the medical doctors said in the future if the pandemic occurs then they would feel contended if they were to be given the provision to be aided by a well-trained dental support team, 80% of them said they experienced high stress during the pandemic. When asked to specify the reason in case they have not approached the dentist during the pandemic, 89% said they did not ponder over the thought of taking help from the dentist. Conclusion(s): If a pandemic occurs in the future, the contribution of the dentist can be beyond dentistry provided we adopt and execute proper measures and plan them beforehand.Copyright © 2021 Muslim OT et al.

Medical Dental Integration in Wisconsin: Integrating dental hygienists into pediatric well child visits and prenatal care

Disparities exist in access to early oral health care, disproportionately impacting minority ethnic groups and populations with low socioeconomic status. Medical dental integration provides an opportunity to create a new dental access point for early prevention and intervention as well as care coordination. The Wisconsin Medical Dental Integration (WI-MDI) model expanded early access to preventive oral health services by integrating dental hygienists (DHs) into pediatric primary care and prenatal care teams to address oral health inequities with the goal of reducing dental disease. This case study will describe how DHs were incorporated into the medical care teams in Wisconsin and how legislation expanding scope of practice made this possible. Since 2019, five federally qualified health systems, one non-profit clinic, and two large health systems have enrolled in the WI-MDI project. Thirteen DHs have worked across nine clinics in the WI-MDI project and over 15,000 patient visits to a medical provider included oral health services provided by DHs from 2019 to 2023. Dental hygienists working in alternative practice models such as those demonstrated in the innovative WI-MDI approach are positioned to reduce oral health disparities through the provision of early and frequent dental prevention, intervention, and care coordination.

Maxillofacial infections in post covid-19 era: A series of 2 cases

Everybody in the world including the health care sector has witnessed the devastating effects of COVID- 19 infection. It is an enigma to say whether COVID -19 has gone for good or not, but has definitely presented as a challenge in itself for dental professionals. Complications have escalated especially at the end of the 2nd wave, probably due to various immunosuppressant drugs that have been used for it's aggressive treatment. These cases highlights osteomyelitis of maxilla and surrounding structures in patients due raised levels of blood sugar and also due to steroidal therapy. Recent reports that have been published, show a rate of approximately 80.76% of such cases in maxilla, out of which 61.53% patients were found to be diabetic before diagnosis. These cases presents post COVID-19 osteomyelitis which is believed to be triggered by highly raised blood sugar levels in a patient who was not a known case of diabetes mellitus.

Dental Students' Perceptions Regarding Bioterrorism, a Cross-Sectional Study

Introduction: During the COVID-19 outbreak, dental professionals have demonstrated their importance in combating mass casualty incidents. This study aimed to understand dental students' perceptions of their potential roles in a bioterrorism attack. Methods: This cross-sectional study used a self-administered anonymous questionnaire, which was sent to all dental students and interns at King Abdulaziz University, Saudi Arabia. Bivariate and multiple linear regression analyses were conducted to assess dental students' willingness to provide care during a bioterrorism attack, knowledge regarding bioterrorism and total number of roles a dentist should play during an attack. Results: This study included 472 dental students and interns. The mean knowledge score regarding bioterrorism was 3.3 +/- 1.9 out of 5. A large majority of the respondents (83.8%) were willing to provide care during a bioterrorism attack. Students with a cumulative grade point average (GPA) of 4.5-5 were more likely to indicate that a dental professional should take on more roles during a bioterrorism attack than those with a GPA of 2.5-2.99. Fourth- and fifth-year dental students had lower knowledge scores regarding bioterrorism than dental interns (B: -0.71;SE: 0.30;95% CI: -1.3-0.1 and B: -0.68;SE: 0.30;95% CI: -1.3- -0.1, respectively). Conclusion: Despite the fact that dental curricula do not cover topics related to bioterrorism, most students would be willing to provide care under bioterrorism conditions. There is wide agreement among the students regarding the need to add bioterrorism-related educations to dental curricula.

Evaluation of Distance and Face-to-Face Anatomy Education From the Perspective of Students During the COVID-19 Pandemic Period

During the COVID-19 pandemic, a questionnaire was administered to the students who took anatomy courses through distance education in the Faculties of Medicine and Dentistry. Through the questionnaire, the aim was to figure out whether the infrastructure of Firat University was ready and adequate for distance education, how efficient the distance theoretical and practical anatomy classes were, and in what proportions the students would prefer to take face-to-face and distance anatomy classes when the pandemic is over. A questionnaire of 35 questions was applied to 555 students studying at the Medicine and Dentistry Faculties of Firat University. The students widely accepted the opinion that Firat University successfully implemented the distance education system, and distance education offered the opportunity to receive the lessons repeatedly regardless of time and place. In addition, it has been determined as a common opinion that anatomy classes given via distance education were equally beneficial as face-to-face education in terms of duration, content, and efficiency. Despite these advantages, the lack of face-to-face interaction and weak information permanence were reported as the negative aspects of distance education. The students emphasized that applied anatomy classes and especially cadaver studies should be conducted face to face. Anatomy education is quite substantial in the acquisition and development of professional skills. It is considered that distance anatomy education will be inadequate to provide this gain. The high demand for face-to-face practical classes by students also backs this up.Copyright © 2023, Universidad de la Frontera. All rights reserved.

COVID-19 pandemic and impact on dental education: perception of Brazilian dental students

Aim: The aim of the present study is to assess the perception of undergraduate students on the impact of the COVID-19 pandemic on Brazilian dental education. Methods: This crosssectional study was conducted using an online questionnaire hosted in Google Forms platform and publicized on Instagram® and Facebook®. The questionnaire was available between July 8-27, 2020. Absolute and relative frequencies were obtained for variables of interest using Pearson's chi-squared and considering 95% confidence intervals. Prevalence of learning resource variables according to self-reported skin color, educational institution, and Brazilian region were presented using equiplots. Results: A total of 1,050 undergraduate dental students answered the questionnaire. Most students reported being in full-distance learning mode. Among the undergraduate students, 65.4% reported perceiving a very high impact in dental education, and 16.6% of students reported not being able to follow distance learning. In addition, 14% reported not having a personal laptop or desktop to study with, with this condition being more prevalent among non-white than white individuals. Conclusion: We conclude that Brazilian dental students perceived a high impact of COVID-19 on dental education, as well as one-sixth of the students reported not having adequate resources to continue with distance learning. It is important that different policies are developed at the institutional and governmental levels to reduce the impact of the pandemic on dental education

Generalized anxiety disorder in Brazilian undergraduate dental students during the COVID-19 pandemic: A cross-sectional study.

OBJECTIVE: Explore the prevalence of generalized anxiety disorder (GAD) and associated factors in undergraduate dental students during the first wave of the COVID-19 pandemic in Brazil. MATERIALS AND METHODS: Cross-sectional study. A semi-structured questionnaire addressing the variables of interest was shared with dental students between July 8 and 27 2020. The outcome was determined using the seven-item generalized anxiety disorder (GAD-7) scale. A 'positive' diagnosis was defined as a total of ≥10 points on the scale. Statistical analysis involved descriptive, bivariate and multivariate analyses, with the significance level set at 5%. RESULTS: Among the 1050 students evaluated, 53.8% had a positive diagnosis for GAD. The multivariate analysis revealed that the prevalence of symptoms was higher among individuals who resided with more than three people, those enrolled at teaching institutions that suspended all clinical and laboratory activities, those who did not have an adequate home situation to maintain distance learning, those who had been diagnosed with COVID-19, those who felt anxious about having to see patients with a suspicion or diagnosis of COVID-19 and those who preferred to interrupt in-person academic activities until the population is vaccinated for the COVID-19 virus. CONCLUSION: The prevalence of GAD was high. Aspects related to the composition and organization of the home, the suspension of academic activities, a history of COVID-19 contamination, feelings of anxiety in providing dental care to patients with symptoms/suspected of COVID-19 infection and the preference to interrupt in-person academic activities until the population is vaccinated for COVID-19 were factors predisposing the students to anxiety during the first wave of the pandemic.

Factors Associated with the Level of Knowledge about Biosafety against COVID-19 in Peruvian Dental Students: A Cross-Sectional Study under a Multivariable Regression Model.

AIM: Biosafety is a set of preventive measures aimed at controlling risk factors arising from biological, physical, and/or chemical agents. This topic is particularly important in the dental field since saliva is the main biological agent of the transmission of coronavirus. The present study aimed to determine the factors associated with the level of knowledge about biosafety against COVID-19 in Peruvian dentistry students. MATERIALS AND METHODS: The present observational, cross-sectional, and analytical study evaluated 312 Peruvian dentistry students. A validated 20-question questionnaire was used to measure the level of knowledge. The nonparametric Mann-Whitney U and Kruskal-Wallis tests were used to compare levels of knowledge between categories of each variable. A logit model was used to evaluate associated factors such as sex, age, marital status, place of origin, academic year of study, being in the academic upper third, history of COVID-19, and living with vulnerable family members. A significance level of p < 0.05 was considered. RESULTS: 36.2%, 31.4%, and 32.4% presented poor, fair, and good knowledge levels, respectively. Students under 25 years of age were 64% less likely to pass the biosafety against COVID-19 questionnaire than students 25 years of age and older (OR = 0.36; CI: 0.20-0.66). Students in the academic upper third were nine times more likely to pass the test than other students (OR = 9.38; CI: 4.61-19.07). Finally, third-year students were 52% less likely to pass the exam than fifth-year students (OR = 0.48; CI: 0.28-0.83). CONCLUSION: Only a minority of dentistry students had a good level of knowledge about biosafety against COVID-19. Younger and less educated students were more likely to fail the questionnaire. On the other hand, those students with outstanding academic performance were more likely to pass the questionnaire.

PROFESSIONAL TRAINING OF MASTERS OF DENTISTRY WITHIN QUARANTINE RESTRICTIONS AND MARTIAL LAW: A COMPARATIVE ANALYSIS OF EDUCATIONAL PROCESS.

OBJECTIVE: The aim: To present a comparative analysis of the educational technologies effectiveness that were used in the process of professional training of masters of dentistry during quarantine restrictions and martial law. PATIENTS AND METHODS: Materials and methods: To perform the set tasks, the following the empirical methods of scientific research were used: quantitative data were collected based on analyzing the results of students' educational achievements, as well as implementing special questionnaire that was sent to the students of the Faculty of Dentistry of NMU; qualitative data were collected with the help of several focus groups formed from students and teachers of the faculty. Analysis was undertaken using statistical methods (Pearson's test), and qualitative data were analyzed descriptively. RESULTS: Results: This paper analyzes the effectiveness of educational technologies used during quarantine restrictions and martial law, the role of phantom classes in providing professional training of dentistry specialists, summarizes the results of a comprehensive analysis of scientific literature, teaching experience at the dental faculty and the results of sociological research (student surveys, discussion in focus groups). CONCLUSION: Conclusions: The outbreak of the COVID-19 pandemic and the full-scale war unleashed by the russian federation in Ukraine forced to quickly find and implement mixed forms of teaching future masters of dentistry, which, in combination with digital technologies, enables implementing high-quality and effective training.

The psychological toll of the COVID-19 pandemic on dental care providers in Iran: A multicenter cross-sectional study.

Background/Purpose: The COVID-19 pandemic affects social and psychological resources. Healthcare workers, especially dental personnel, are more at risk for mental issues due to anxiety, pressure, and frustration. This study assessed mental health outcomes during the COVID-19 epidemic among Iranian dental care providers, focusing on insomnia, anxiety, depression, and posttraumatic stress disorder (PTSD). Methods: In this multicenter cross-sectional survey, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, and the Global Psychotrauma Screening were masured. Six hundred thirty-eight dental care providers (dental specialists, general dentists, dental hygienists, dental assistants, and dental students) from different parts of Iran (Tehran, Shiraz, Tabriz, and Mashhad) were investigated by the stratified sampling method. The univariate analysis was incorporated as independent in binary logistic regression models to analyze the data. In this study, the significance level was set at 0.05. Results: Among all the participants, 42.8% were dental students or residents, 21.9% were general or specialist dentists, 18.7% were dental assistants, and 16.6% were nonclinicians. The prevalence of insomnia, anxiety, and depression was 31.3%, 40.8%, and 54.9%, respectively. The frequency of participants in the low, moderate, and high levels of PTSD resulting from LCA 56.6%, 33.7%, and 9.7%, respectively. Conclusions: This study found a significant frequency of mental health issues among Iranian dentists. Females, participants whose relatives have COVID-19, and those with a higher workload were more likely to develop mental health symptoms. As mental problems among dental professionals might affect the quality of patient care, diagnostic, supportive, and therapeutic interventions should be taken.

Effect of the Ongoing Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Dental Service Utilization in Patients With Comorbidities.

BACKGROUND: The keystone of safe and effective patient management is to approach a patient with up-to-date medical information. Assessment of patients for their medical conditions has changed during the coronavirus disease 2019 (COVID-19) pandemic and the need for appropriate research infrastructure has increased. Considering an updated list of high-risk underlying conditions in the post-COVID-19 era, this study aimed to evaluate the utilization of dental services by patients with comorbidities during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS:  Data of patients with comorbidities seeking dental care at a dental school during the COVID-19 pandemic were retrospectively evaluated. Demographic variables (age, gender) and medical history of the participants were recorded. The patients were classified according to their diagnosis. Data were analyzed using descriptive statistics and Chi-square analysis. The significance level was determined at α=0.05. RESULTS:  The study included data from 1067 patient visits between September 1, 2020 and November 1, 2021. Among these patients, 406 (38.1%) were males and 661 (61.9%) were females, with a mean age of 38.28 ± 14.36 years. Comorbidities were identified in 38.3% of the patients with predominance in females (74.1% n=303). Single comorbidity was observed in 28.1% while multi-morbidity was detected in 10.2% of the cohort. The most prevalent comorbidity was hypertension (9.7%), followed by diabetes (6.5%), thyroid disorders (5%), various psychological diseases (4.5%), COVID-19 infection (4.5%), and different allergies (4%). The presence of one or more co-morbidities was observed mostly in the 50-59 years age group. CONCLUSIONS:  The seeking of dental care among the adult population with comorbidities was high during the SARS-CoV-2 pandemic. It would be beneficial to develop a template for obtaining a medical history from patients by taking full account of the consequences of the pandemic. The dental profession needs to respond accordingly.

Numerical investigation of the impacts of environmental conditions and breathing rate on droplet transmission during dental service

Dental services are yet to return to a semblance of normality owing to the fear and uncertainty associated with the possible airborne transmission of diseases. The present study aims to investigate the impacts of environmental conditions [changes in ventilation location, ventilation rate, and relative humidity (RH)] and variations in dental patient's breathing rate on droplet transmission during dental service. Computational fluid dynamics simulation was performed based on our previous experimental study during ultrasonic scaling. The impacts of different factors were numerically analyzed by the final fate and proportion of emitted droplets in the dental surgery environment. The results revealed that about 85% of droplets deposited near the dental treatment region, where the patient's torso, face, and floor (dental chair) accounted for around 63%, 11%, and 8.5%, respectively. The change in the ventilation location had a small impact on the deposition of larger droplets (> 60 mu m), and a spatial region with high droplet mass concentration would be presented near the dental professional. The change in the ventilation rate from 5 to 8 ACH led to a 1.5% increment in the fraction of escaped droplets. 50% RH in dental environments was recommended to prevent droplets' fast evaporation and potential mold. Variations in the patient's breathing rate had little effect on the final fate and proportion of emitted droplets. Overall, environmental factors are suggested to maintain 50% RH and larger ACH in dental surgery environments. The findings can give policymakers insights into the role of environmental factors on infection control.

Laser: A boon during the COVID pandemic in aerosol mitigation - A systematic review

The scientific community was always intrigued by the indoor air quality in dental offices. The unexpected emergence of the COVID pandemic has put greater challenges on dental professionals. Shortly after the declaration of coronavirus as a pandemic by the World Health Organization in March 2020, the American Dental Association abstained the dental society from providing routine dental procedures. An evidence-based review of the literature was conducted electronically using three databases, PubMed, Science Direct, and Google Scholar between January 2005 to December 2021. Three articles were selected for the qualitative analysis out of 41 screened articles from the databases. The evidence suggests that there is a significant reduction in aerosol generation with laser when compared to conventional treatment modalities. Laser-assisted treatment procedures bring the dentist and patients a step closer to providing safe dental treatments and reducing the risk of transmission of disease.

Fear of COVID-19 in dentistry students: an evaluation of their knowledge and practices

Background: This study's objective was to analyse the fear of COVID-19 among the dentistry student and the knowledge, attitude, and practices during the COVID-19 pandemic. Methods: It was a cross-sectional questionnaire-based study. An online survey form was designed and distributed to undergraduate dental students via google forms. A previously validated fear of coronavirus scale (FCV-19S) was used to analyse the fear. SPSS 21 was used for data entry and data analysis. Descriptive statistics were applied to calculate the frequencies of different variables. Independent t-test was executed to determine the difference of FCV-19S among gender and between public and private dental colleges. ANOVA was carried out to evaluate the difference in fear among different levels of BDS. Results: Data of 983 individuals from different dental colleges in Karachi, Pakistan, have been analysed. The majority of the students were females in 1st year and private sector dental colleges (P<0.001). The mean FCV-19S was 20.99 +or- 6.48, which is higher than the cut-off value 15. A highly significant difference in mean FCV-19S among the different variables has been observed (P<0.001). A significant difference has been observed among the gender (t (932) = -5.40, p<0.001) in all 4-years of BDS. Conclusion: Despite good knowledge and following the COVID-19 guidelines, fear is prevalent among the students.

Clinical Guidelines for Dentistry in China During the Coronavirus Disease 2019 Pandemic

Preventing the spread of Coronavirus Disease 2019 (COVID-19) has become the focus of epidemiologists as the highly infectious respiratory disease spreads primarily by close, person-to-person contact via droplets or the skin. Aerosol dissemination may occur in a closed, high-aerosol environment. The aerosols generated in dental procedures can pollute surrounding air and device surfaces. In this paper, we summarize prevention and control measures relating to dentistry. We focus on the relationship between COVID-19 and dental disease prevention and control in dental treatment procedures and imaging examinations, oral health education and perspectives, and guidance for the practice of dentistry during the COVID-19 pandemic to provide a consistent and broadly endorsed standard for dental hospital and clinics. Copyright © 2021 Luo, Wang, Tang, Peng, Ma and Wu.