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An average person carries 1 to 2 kg of microbes in the alimentary track, including the oral cavity. There are more bacteria in a person's mouth than the total human population in the entire world. Oral health is critical to the general systemic health of an individual. The harmonious co-existence between more than 1000 bacterial species and the host's immune system underpins sustained, long-term homeostasis, the sine qua non of oral health. In a similar manner, global oral health is essential for general population health of the world. Since our last review of this subject in 2019, while significant clinical advances continue, the disparity, lack of prevention, insufficient care, and political unrest have persisted or significantly deteriorated. This review focuses on the following important questions: 1.What is oral microbiome? How to detect, characterize, compare, report, and interpret the results?2.How does oral microbiome affect and respond to local and systemic innate immunity?3.What is the role of oral microbiome in the pathogenesis of diseases of the mouth?4.What are the impacts of oral health or the lack of it at the systemic level?5.Why is oral health important at the population level?6.How can the healthcare providers restore and sustain harmonious co-existence between host and oral microbiome?Copyright © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Case presentation: Supportive periodontal care (SPC) is defined as step IV by the 2020 and 2022 EFP Guidelines for the treatment of periodontitis stages I-IV. SPC aims to maintain periodontal stability after active periodontal treatment is finished and the endpoints of periodontal therapy are achieved. SPC presumes preventive and therapeutic procedures performed at individualised, patient-based intervals. This case report describes a patient, 43 y/o female, with diagnoses of generalised periodontitis stage IV, grade C and periodontal health on reduced periodontium who was enrolled in longterm SPC provided at 3 - 4-monthly intervals. During the COVID-19 pandemic, the patient did not report for regular SPC due to personal fears of the contagion. After 20 months of absence, the patient was admitted for SPC. The comprehensive periodontal exam showed excellent oral hygiene (FMPS=7%), the presence of five 4 and 5 mm pockets and relapse of periodontal inflammation (FMBS=42%). The affected areas were mostly in the lower jaw. As periodontitis is a chronic disease, patients need to be continuously monitored. SPC reduces the probability of disease progression and tooth loss, as timely re-treatment can be provided in cases of disease recurrence. Various factors can contribute to disease relapse. In terms of the described patient, despite good oral hygiene, factors such as psychological stress and unhealthy living habits experienced during the COVID-19 pandemic might have negatively impacted the innate host response and led to disease relapse.
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COVID-19, or SARS-CoV-2, is an extremely deadly virus that is responsible for over half a million deaths of people in the world. This virus originated in China in December 2019 and rapidly spread worldwide in 2-3 months, and affected every part of the world. Its life-threatening nature forced governments in all countries to take emergency steps of lockdown that affected the entire world's education, health, social and economic aspects. Due to the implementation of these emergencies, the population is facing psychological, social and financial problems. Additionally, this pandemic has significantly influenced the health care systems as all the resources from governments of all countries were directed to invest funds to discover new diagnostic tests and manage COVID-19 infection. The impact of the COVID-19 pandemic on the education and social life of the population is described in this article. Additionally, the diagnosis, management, and phytoremedia-tion to control the spread of COVID-19 and traditional medicinal plants' role in managing its mild symptoms have been discussed.Copyright © 2023 Bentham Science Publishers.
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Purpose: This study explores the association between alveolar bone loss, tooth loss and severity of COVID-19. Material(s) and Method(s): In this retrospective cohort study, we included patients with confirmed COVID-19 who have had a dental panoramic radiograph within a maximum period of 5 years, providing information about alveolar bone loss and tooth loss. The severity of COVID-19 was determined based on the WHO clinical progression scale: (1) Mild/Ambulatory;(2) Moderate/Hospitalized;(3) Severe/Intensive care unit (ICU) or death. Result(s): 1730 patients were identified with COVID-19 from until October 31, 2020 in the Isala Hospital. Of these patients, 389 ever visited the OMFS department. 133 patients have had an orthopantomograph within a maximum period of 5 years and were included for analysis. The results showed a significant association between alveolar bone loss and COVID-19 severity (p = 0.028). Patients with alveolar bone loss had 5.6 times higher odds to be admitted to ICU or died, compared to ambulatory patients (OR: 5.60;95%CI: 1.21;25.99;P = 0.028). More tooth loss was significantly associated with COVID-19 severity (p = 0.047). Per tooth lost, patients had 4.2% higher odds for severe than mild COVID-19 (OR: 1.04;95%CI: 1.00;1.09;P = 0.047) and 6.0% higher odds for severe than moderate COVID-19 (OR: 1.06;95%CI: 1.01;1.11;P = 0.017). When adjusting for confounders in multivariate analyses, the significant associations of COVID-19 with alveolar bone loss and tooth loss were no longer present. Conclusion(s): In this retrospective explorative pilot study, alveolar bone loss and tooth loss are associated with the severity of COVID-19, however they are not independent risk factors. The current study could contribute to the design of further studies on the relationship between oral health and COVID-19.Copyright © 2021 The Authors
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OBJECTIVES Teledentistry is a telematics approach validated in the literature that allows the remote diagnosis and management of various oral health problems, avoiding direct face-to-face contact with the patient. This study aims to present a review of the scientific literature to analyze in which fields of pediatric dentistry teledentistry has found application and with what results;in addition, a case of unconventional oral candidiasis in a child, diagnosed and managed through the use of teledentistry during the SARS-CoV-2 pandemic in April 2020, is presented. MATERIALS AND METHODS The literature search was performed through PubMed (using keyword and MeSH terms), Scopus and Embase databases, evaluating observational, interventional, case reports and case series studies, published in English between 1999 and 2021 and conducted in children. The clinical case presented was diagnosed and managed through photographs that the pediatric dentist received from the patient's mother via a multi-platform messaging application. Through the same application, the mother was able to provide informed consent to take care of the patient remotely, after acceptance of possible critical issues regarding teledentistry, and receive a prescription for home treatment of oral candidiasis. RESULTS After exclusion of duplicates and articles that did not meet the inclusion criteria, 14 studies were selected. Teledentistry was applied in four different areas: oral health promotion, with 2 studies examining smartphone applications to improve home oral hygiene, diagnosis/follow-up/treatment in orthodontics with 4 studies, caries and other hard and soft tissue diseases of the oral cavity with 7 studies, and finally dental traumatology with a single study. With regard to the promotion of oral health, two applications for the improvement of home oral hygiene were examined. They showed promise for motivation and education. In orthodontics, the studies evaluated in this review reported that teledentistry is useful and valuable for follow-up and orthodontic consultations that can be obtained quickly;doubts remain regarding expense, intervention time and operator compensation. In addition, remotely supervised interceptive treatment appears to reduce the severity of malocclusions. About caries and other hard and soft tissue diseases of the oral cavity, results indicate that teledentistry can reduce waiting lists and the need for face-to-face examinations. Teledentistry is considered valid, efficient and potentially cost-effective for screening and follow-up of caries, being comparable to traditional clinical examination. Teledentistry has proven to be comparable to clinical examination for the diagnosis of dental trauma. CONCLUSIONS The data collected allow us to conclude that teledentistry, thanks to advances in technology, can be a useful means for pediatric dentists to improve the oral health of young patients and to provide better access to oral health services by effectively replacing face-to-face dentistry in various situations. The presented clinical case confirms the conclusions obtained from the literature search. CLINICAL SIGNIFICANCE Teledentistry can replace face-to-face visits in several areas of pediatric dentistry and ensuring safe care during any future pandemics.Copyright © 2023 EDRA SpA. Tutti i diritti riservati.
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Dental implants are a standard of care in contemporary dental practice and are widely employed for the restoration of missing teeth. The long-term utility of an implant is largely dependent on the successful implant osseointegration and maintenance of the same over time. Bone metabolism and inflammatory mechanism are interrelated phenomena and are usually collectively termed osteoimmunology, which may affect the predictability and success of implant osseointegration. Many biochemical mediators of inflammation, especially Interleukin (IL)1, IL-6, and Tumour necrosis factor (TNF)alpha, have been documented to increase the activity of bone-resorbing cells through the Receptor Activator of Nuclear Factor Kappa-B (RANK) and Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL)systems. Some of the earlier studies with very limited data suggest that SARS-CoV2 infection may also directly affect bone resorption. Thus, it is imperative to understand the pathophysiology of osseointegration in COVID-19 patients, to enhance successful implant osseointegration and prevent peri-implant bone loss in these patients. Here, we present a summary of the connection between inflammatory pathways and bone metabolism on a molecular basis which may assume a significant bearing in situations of exaggerated host immune response as seen in COVID-19 infection.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: Oroantral communication can occur due to maxillectomy defects, jeopardizing the integrity and function of oral cavity. It is an interdisciplinary challenge to restore these by surgery and prosthetics since many facets need to be addressed, such as speech, deglutition, mastication, aesthetics and psychological distress. Rationale: Surgical repair of maxillectomy defects is not always achievable due to various reasons such as poor systemic health, advanced age etc. Thus prosthetic rehabilitation becomes the most suitable treatment option. Relevance for Patients: Post COVID-19 mucormycosis has seen a surge in the past two years. It is an opportunistic fungal infection in humans infecting intracranial structures by direct invasion in the blood stream. Fundamental goal of prosthetic rehabilitation is the closure of oronasal communication and restoring it functionally thereby improving quality of life for the patient. CAD/CAM (computer aided design/computer aided milling) technology was employed to fabricate a milled framework for maxillary obturator in the most innovative way using PEEK (Polyether ether ketone). Result(s): PEEK material due to its excellent biocompatibility ensured a light weight prosthesis for the large maxillectomy defect and closure of the patency was achieved by the obturator framework.Copyright © 2022 Authors. All rights reserved.
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Objective: Describe the sociodemographic, clinical and therapeutic aspects of the patients received for an emergency, during this period of pandemic, in a service of reference the service of odontostomatology General Hospital Grand Yoff of Dakar. Patients and Methods: This was a descriptive cross-sectional study over a threemonth period from March 3 to June 3, 2020. Referred and non-referred patients received for odontostomatological emergencies were included in the study. The data collected were entered in Excel and analyzed using SPSS20.0 software with Chi2 tests performed between certain variables with a significance level set at 0.05. Result(s): Non-referred patients represented 64.9% (n = 131) of the study population and referred patients 35.1% (n = 71). Emergencies were infectious in 74.7% (n = 151) of cases and traumatic in 14.3% (n = 29). Acute apical periodontitis was encountered in 44.6% (n = 90), cellulitis in 16.4% (n = 33) and pulpitis in 9.4% (n = 19) of cases. Therapeutic attitudes were dominated by dental avulsion in 56.4% (n = 114) of cases, pulp sedation in 9.4% (n = 19) of cases and mono-maxillary restraint in 8.4% (n = 17) of cases. Conclusion(s): Despite the risk of contamination and possible dissemination of the covid19 virus, the continuity of oral care must be ensured because of the emergencies that can jeopardize the functional or even vital prognosis of patients. Certain recautions must therefore be taken at the level of the structures of care of these affections.Copyright © 2021
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With COVID-19 declared as a worldwide pandemic, a nationwide lockdown was implemented overnight in India on March 24, 2020. With no prior warning or anticipation, patient appointments were temporarily ceased as institutions and clinics were indefinitely closed. Thus, with no prior warning or anticipation, orthodontic appointments were temporarily ceased. In the field of orthodontics, treatment is generally not considered an emergency. However, what is not understood is the importance of regular check-ups or monthly appointments, as well as the impact of restrictions put on patients concerning visiting their orthodontists in times of need. Understanding whether patients realize the importance of regular follow-ups, feel the need for orthodontic treatment to be regarded as emergencies, or assess the reasons for fear or inconveniences in the minds of patients undergoing orthodontic treatment in a time where they are entirely restricted to the confines of their homes are grey areas that are left unexplored. A set of 12 questions was formulated and distributed among the study. The participants were asked to fill the questionnaire. The survey was conducted in an online forum. A total of 100 validated entries were collected. Data was entered into Microsoft Excel and analyzed in SPSS V20. Associations between categorical variables were determined using Chi-square. P<0.05 was considered statistically significant.85% of the population are aware of orthodontic treatment, 93% of the population responded that they are concerned about their facial appearance. 84% of the population believes orthodontic treatment is must. 76% of the population responded that orthodontic treatment affects their hygiene system. 63% of the population felt safe to visit dental clinics post COVID, 52% of the population are not aware of permanent teeth extraction during orthodontic treatment. Orthodontic treatment is required mainly in smile correction or any other dental problems like elimination of malocclusion, trauma, periodontitis. Hence awareness on orthodontic treatment post COVID was improved.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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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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Lateral luxation injuries are common during childhood and in young adolescence. These injuries involve the surrounding tissues that could lead to extensive clinical treatment problems with a risk of pulpal complications such as pulp necrosis. A case of a healthy 4-year-old Malay boy visiting the paediatric dental clinic after seven months of laterally luxated injury on the lower right lateral incisor (tooth 82) was reported. The traumatic tooth was splinted by a private practitioner three days after the trauma, however, the splint dislodged less than 24-hour after placement. In view of the mother's fear of bringing her child to the dentist due to the COVID-19, no follow-up and further treatment were carried out. This has resulted in the development of discolouration and pulpal necrosis to the injured tooth. Lesion sterilization and tissue repair technique (LSTR) was performed. This report highlights the rare occurrence of lateral luxation injury on tooth 82 and the management of pulp necrosis as a complication via lesion sterilization and tissue repair technique due to the uncooperative behaviour of the child.Copyright © 2022, Faculty of Medicine, University of Malaya. All rights reserved.
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Till the beginning of 2020, face masks were primarily linked with medical health professionals, forensic, industry employs, chemistry and clinical lab staff or those dealing with hazardous materials. Nobody then imagined that face masks would become a part and parcel of everyday life for common man as well. Now face masks have become a part of our lifestyle, even attaining the coveted spot of an accessory, some with designer tags on them to safeguard people against corona virus. Nobody imagined a pandemic like Covid-19 could strike the world and stay on for as long. Now the situation learns that even wearing masks for prolonged period can have adverse impact on health, especially on oral health. To improve oral hygiene good dental practices can be inculcated into our daily lifestyle. This article puts a light on the adverse effects of wearing masks for a prolonged period and spread awareness on the remedies to combat this problem.
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Purpose of Study: Community health fairs have been developed to address the unmet needs for disease prevention and health education among underserved communities. Hispanic communities experience significant non-financial barriers (e.g., cultural and linguistic) that also contribute to lower rates of access and utilization of health care services, including important preventive screening services. Around 3% of Mobile County's population is Hispanic. The aim of this event was: (1) To perform basic health screening, provide health education, and administer COVID-19 and Influenza vaccines to children under the age of 18 years. (2) To act as a bridge between the Hispanic families in the community and the available resources to help them overcome barriers to accessing quality care. Methods Used: We started by identifying and finalizing the location and the date for the health fair with help from the Guadalupe Center (a faith-based organization). We planned to divide the health fair into three specialized zones: Health Screening, Health Education, and Vaccination. The Health Screening zone would include anthropometry, developmental screening, and vision screening. The Health Education zone would educate the families on asthma care, breastfeeding, drowning prevention, road safety, safe sleep practices, oral hygiene, adverse childhood experiences, and healthy lifestyle. The Vaccination Zone would administer COVID-19 and Influenza vaccines. We designed and printed brochures for all health education topics in English and in Spanish. Age and gender appropriate 'Health Passports' with growth charts and other key parameters to record the child's health status were also created. Resident and medical student volunteers were trained regarding documentation, health screening, health education, and referrals to early intervention or specialist services that accepted uninsured or Medicaid patients. Summary of Results: A total of 49 children underwent health screening and health education. Each child's health status was documented in age and gender appropriate 'Health Passport'. In addition to this, these children and their parents were educated at the various health education stations and provided with brochures. Around 40% of the children that were screened had an abnormal vision screen, the parents of these children were given a list of available resources for further follow-up. Six children with developmental delay were identified and early intervention forms were filled out for two and more information regarding the Individualized Education Program (IEP) was given to the other four families. Eight children were vaccinated for COVID-19 and five were vaccinated for Influenza. Conclusion(s): The Hispanic community has persistently faced barriers to access healthcare due to literacy and socioeconomic status. Academic institutions and community- based organizations must work to develop and sustain culturally relevant health education and outreach events to reduce these disparities. Copyright © 2023 Southern Society for Clinical Investigation.
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Introduction/Aims: The COVID-19 pandemic increased the demands on nursing staff and resulted in many calls to our OMFS service regarding complaints related to basic mouth care. The aim of this audit was to assess the knowledge of nursing staff in relation to oral hygiene and mouthcare in COVID-19 inpatients. Material(s) and Method(s): Questionnaires were distributed to COVID-19 ICUs and wards during a two-week period. Responses were measured against standards relating to Public Health England guidance on providing mouth care in COVID-19 patients. After the initial audit, teaching sessions were implemented, and materials delivered to support delivery of these standards. A re-audit was then conducted in using the previous questionnaire design. Results/Statistics: Awareness of the PHE guidance increased from 26% (13/50) in the initial audit to 87% (26/30) in the reaudit. In the initial audit, 46% of staff rated their confidence in managing the oral care of COVID-19 patients as 'good';in the reaudit this increased to 63%. Staff rating their confidence as poor decreased from 4% to 0%. Staff using fluoride toothpaste to brush patients' teeth twice a day increased from 24% to 90%. 90% of staff reported finding the teaching and dental supplies useful. Conclusions/Clinical Relevance: By increasing staff awareness of the importance of oral hygiene for medical reasons and not just for comfort, we hope it will be afforded increased priority, and the perceived unpleasantness of the task may reduce. Our audit study has demonstrated that a small amount of engagement can result in a great increase in staff confidence and improved patient care. Copyright © 2022
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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.
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SESSION TITLE: Critical Care in Chest Infections Case Report Posters 2 SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Enterobacter species are notorious for causing nosocomial infection. They were found to be the third most common pathogen in the respiratory tract amongst isolates in the ICU. What makes the situation grim is the growing antibiotic resistance with regards to treating these infections. Such is the extent of this problem that in certain parts of the world the antibiotic sensitivity of Pluralibacter gergoviae is used as an indicator for the spreading antibiotic resistance in the environment. CASE PRESENTATION: A 73 year old female with past medical history significant for hypertension, atrial fibrillation, and Coronary artery disease s/p stent placement in 2019 presented to our facility with a 4 day history of fever, cough and chest discomfort. She had tested positive for COVID-19 two days prior to presentation and was initiated on remdesivir, tocilizumab, and dexamethasone. She was initially managed on the floors but in view of her increasing oxygen requirement she was transferred to the critical care where she was intubated due to respiratory failure. She continued to spike fevers and was persistently hypoxic. Initially this was attributed to COVID pneumonia and a trial of convalescent plasma was also given. After 3 weeks, she tested negative for COVID-19 while still intubated and precautions were taken off. However, she continued to spike fevers. Repeat chest X-ray was done and it showed multifocal airspace disease with increasing opacification in the left upper lobe. Her endotracheal aspirate grew carbapenemase producing Pluralibacter gergoviae sensitive for ciprofloxacin. Subsequently, she was started on IV levofloxacin and received it for a total of 21 days. Her treatment course was complicated by prolonged intubation requiring tracheostomy and development of Pneumatocele. After stopping the antibiotics, she did not have fever and her white blood cell count was within normal limits. DISCUSSION: P. gergoviae is a known contaminant in intravenous fluids, invasive medical devices, eye cream, children's shampoo, skin cream, hand cleaning paste, and cleansing wipes. Over the decades due to selective pressure especially in the cosmetic industry from preservatives it has gained antibiotic resistance via overexpression of detoxifying enzymes, flagellin, modification of membrane structure/function. Improving patient's oral hygiene, implementing infection control protocols strictly in the ICU, minimizing invasive medical devices/catheters and educating the stakeholders shall help in curbing these incidents. Once identified, early Infectious disease specialist involvement can help choose an apt antibiotic regimen on the basis of existing antibiograms. CONCLUSIONS: This case highlighted the importance of close microbiological surveillance, minimizing occurrence of nosocomial infection and treating atypical organisms. Reference #1: Enterobacter gergoviae adaptation to preservatives commonly used in cosmetic industry M. Périamé,J.-M. Pagès,A. Davin-Regli 14 May 2014 DISCLOSURES: No relevant relationships by Abinesh Sekar
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Background: Systemic lupus erythematosus (SLE) prognosis is determined by a wide range of factors, such as the severity of the disease manifestations, the psychosocial aspects of patients, the proper management of comorbidities, adoption of a healthy lifestyle and adherence to treatment. Studies on chronic diseases highlight the value of patient education to foster treatment adherence and improve prognosis. Objectives: To promote health education to SLE patients and their families providing accessible and comprehensive Scientific information, in order to improve adherence to treatment and the patient's prognosis. Methods: The Waiting Room Project is linked to the Extension Health Care Program for SLE patients and their families of Universidade Federal de Minas Gerais, Brazil, since 2011. A total of 700 patients under SLE treatment at the Rheumatology Unit of the University Hospital are involved. Medical students and rheumatology fellows, altogether, developed high-quality informative texts, with clear content and layman language appropriate for the patient, under the supervision of the rheumatology professors. The texts are illustrated by the team of the Communication Department of the Medical School and medical students, and are printed in a leafet format. The material is handed out to the patients, while they wait for their medical appointment, by the students and the care team. The content of the leafets is discussed, making sure that all the concerns and doubts are properly addressed Results: The Waiting Room Project has produced 17 leafets, addressing different aspects of SLE, comorbidities, and treatment. The texts approach the traditional cardiovascular risk factors (Smoking, Arterial Hypertension, Diabetes, Obesity, Physical Activity), and some medical conditions related to general health and SLE treatment (Sun Protection, Healthy Food, Oral Care, Vaccination, Pregnancy, Osteoporosis). In 2020 and 2021, two leafets about Covid-19 were produced in order to clarify important aspects of this disease, its impact on lupus patients and to solve questions about SLE medications: one regarding the association between Lupus and Covid-19 and another about the treatment of lupus and Covid-19. Other four leafets were produced concerning SLE treatment, including Adherence to Treatment, the use of Antimalarials, Corticos-teroids, and Immunosuppressants. Information about the drugs, general importance on lupus treatment, recommendations and possible adverse events were described. Futhermore, additional content is currently in production with themes such as Intravenous Corticosteroid and Cyclophosphamide, Human Papilloma-virus Infection, Malignant Neoplasm, and specifc cancers frequently affecting women, such as Colorectal Cancer, Cervical Cancer, and Breast Cancer. The leafets are also available online on the Medical School website in Portuguese and in English (medicina.ufmg.br/alo/material-didatico/), on the Minas Gerais Rheumatology Society website (reumatologia.org.br/orientacoes-ao-paciente/), and on the Instagram page @lupusufmg Conclusion: The leafets have been an important source of information and health education for SLE patients and their families, improving student/physician-patient communication. Despite the adversities caused by the coronavirus pandemic, the Waiting Room Project has kept its purpose to make each patient with SLE an agent of their healthcare. Improving the patients' access to evidence-based information must be a goal of healthcare professionals that treat patients with SLE.
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This study investigated dental problems and radiological and cardiac evaluations in patients affected by Covid-19. Heart disease is related to the health of the teeth, and people who have damaged and decayed teeth are more prone to cardiovascular disease. Researchers have concluded that poor dental hygiene is a sign of acute heart disease risks. In the report presented by Tarje Imna service, a group of researchers examined almost 65 thousand people infected with the corona virus in order to evaluate the effects of the covid 19 virus on the oral and dental health of the affected people. According to the results of this research, one of the effects of the corona virus on the body is the reduction of oral moisture. Almost 43% of patients accepted this effect. In general, dry mouth is one of the causes of oral and dental diseases, especially bad breath. Corona virus also increases the risk of tooth decay by reducing the moisture in the mouth. Another effect of the corona virus on the mouth and teeth is to cause ulcers in the gums and tongue. Of course, in this case, researchers do not comment with certainty, because they believe that other factors are also effective in causing these wounds. Some experts say that considering that more than 47 percent of adults who are 30 years old or older have periodontal diseases, such as gum infection, inflammation of the gums and bone around the teeth. We should expect that the existing dental and oral problems will become more acute in case of infection with Covid-19.
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Background: Nifedipine is a calcium channel-blocking drug, common antihypertensive medication. Gingival tissue enlargement is a frequent periodontal side effect, associated to the presence of dental plaque. Description of the procedure: In January 2018, a male 62-year-old patient was evaluated at the Dentistry Department of Coimbra University Hospital. His main complaint was gingival “swelling” and masticatory difficulty. Anamnesis revealed hypertension medicated with Nifedipine for 8 years. Besides partial edentulism and tooth migration, oral observation highlighted severe bimaxillary gingival enlargement, not restricted to the papillae, pronounced inflammation and periodontal attachment loss. Periodontal screening revealed 10 mm probing depth (PD) at several interdental sites, maximum clinical attachment loss (CAL) of 5 mm, bleeding on probing (BOP) of 61% and plaque index (PI) of 100%. The patient was diagnosed Nifedipine Gingival Enlargement with a Generalized Stage IV, Grade B Periodontitis. Non-surgical periodontal treatment was initiated with oral hygiene instructions, supra and subgingival instrumentation. Simultaneously, his assistant physician replaced nifedipine with enalapril. The patient attended regular periodontal appointments for 12 months. A decrease in gingival enlargement was noted in the subsequent months. Due to COVID-19 restrictions, patient was only reevaluated in May 2021. Outcomes: Three years after replacement of nifedipine and nonsurgical periodontal treatment, gingival enlargement was resolved. Periodontitis was stabilized, as periodontogram revealed a mean reduction PD of 6 mm at the deepest sites, grade II furcation involvements, BOP of 10% and PI of 34%. Step 3 periodontal therapy could be initiated. Due to economic restrictions, oral rehabilitation could not be fulfilled. Conclusions: Severe gingival tissue enlargement related to nifedipine in a periodontitis IVB patient was resolved by non-surgical periodontal treatment. Meticulous plaque control is mandatory. Communication with the Physician is important to alter the medication and restore patient's quality of life.
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Background: Necrotizing periodontal diseases (NPD) are fuso-spirochetal infections causing ulceration and destruction of periodontal tissues and associate with impaired host response. Elevated bacterial levels of Prevotella intermedia, Veillonella and Streptococci present in NPD lesions were detected in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Description of the procedure: A 40-year-old female, non-smoker patient was referred to the clinic with complaints of fever, halitosis, bad taste, severe gingival pain and bleeding. The patient reported a history of COVID-19 a month prior to any symptoms. Extra and intraoral examinations revealed submandibular lymphadenopathy, plaque accumulation, necrotic areas covered with pseudo-membranes, spontaneous gingival bleeding and suppuration. Alveolar bone loss was detected in the radiographic examination. Since periodontal pocket formation was present, the clinical diagnosis of the case was necrotizing gingivitis as a result of previously occurred periodontitis. During the first visit, necrotic areas were gently swabbed with 3% H2O2 moistened cotton pellets and oral hygiene instructions were given. Systemic antibiotic (metronidazole 500 mg 2 × 1) was prescribed for 5 days and rinsing with 0.12% chlorhexidine and 3% H2O2 was recommended. Three days later, since the acute complaints were reduced, clinical periodontal parameters were recorded and nonsurgical periodontal treatment (NSPT) was performed in 4 sessions in 2 weeks. One month after NSPT, all clinical periodontal parameters were recorded again. Outcomes: Following NSPT with the combination of systemic antibiotic regimen, all symptoms were resolved leading to the dissolution of necrotic areas. All clinical parameters were improved after NSPT. Conclusions: This case may be an evidence that COVID-19 could be a contributing factor for the appearance of NPD. Since COVID-19 leads to an altered immune response of the patient, a suitable environment becomes present orally for bacteria causing infections that result in NPD. The importance of routine intra-oral examination for COVID-19 patients is highlighted.