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 reduction of dental care in Primary Health Care in Brazil after the emergence of COVID-19: a cross-sectional study, 2020. / Fatores associados à redução de atendimentos odontológicos na Atenção Primária à Saúde no Brasil, com o surgimento da COVID-19: estudo transversal, 2020.

OBJECTIVE: To analyze factors associated with the reduction of dental care in Primary Health Care, during the COVID-19 pandemic in Brazil. METHODS: This was a cross-sectional study conducted with dentists in primary healthcare centers (PHCCs). The reduction of dental care was the outcome, and the exposure variables were sociodemographic data, availability of personal protective equipment (PPE) and measures adopted by PHCCs during the pandemic. Poisson regression was performed to determine the prevalence ratio and 95% confidence interval (95%CI). RESULTS: Of the total of 958 participants, 62.6% reported a reduction of over 50% in dental visits after the beginning of the pandemic. Adoption of biosafety protocols (PR = 1.04; 95%CI 1.01;1.07), availability of PPE recommended by new protocols (PR = 0.94; 95%CI 0.89;0.99) and adoption of tele-screening (PR = 0.90; 95%CI 0.85;0.96) were associated with the reduction. CONCLUSION: The availability of new types of PPE and implementation of tele-screening in PHCCs seem to have minimized the reduction of dental care after the beginning of the pandemic.

Virucidal efficacy of chlorhexidine: a systematic review.

This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine®), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.

Knowledge about biosafety measures in clinical setting during the COVID-19 pandemic: a cross-sectional study with Brazilian dental students.

OBJECTIVE: To evaluate the knowledge of Brazilian dental students about biosafety measures that should be adopted in the clinical setting during the coronavirus disease-2019 (COVID-19) pandemic. METHODS: A cross-sectional study with 1,050 dental students was conducted. A semi-structured questionnaire was shared with students. Mean knowledge score on biosafety guidelines during the COVID-19 pandemic was the outcome, with a maximum of 8 scores. Explanatory variables included sociodemographic and educational characteristics, aspects related to biosafety education, actions adopted by the dental schools during the pandemic, and sources of biosafety information. Multivariate linear regression analyses were performed. RESULTS: Mean knowledge score was 5.19 (1.28). Female students (ß=0.346; 95%CI:0.154-0.539), those enrolled in the intermediate (ß=0.525; 95%CI:0.167-0.883) or final (ß=0.569; 95%CI:0.200-0.937) stage of course, and those who had already received theoretical-practical training in biosafety (ß=0.464; 95%CI:0.063-0.866) presented higher mean knowledge scores. Students who did not receive guidance on aerosol control measures before the pandemic (ß=-0.324; 95%CI:-0.519--0.130) had the lowest score. CONCLUSION: Students presented a medium level of knowledge about dental biosafety measures in the COVID-19 pandemic. Sociodemographic characteristics and those related to the institutional profile of the participants, and access to orientation and training in biosafety may influence their knowledge.

Anxiety symptoms and alcohol abuse during the COVID-19 pandemic: A cross-sectional study with Brazilian dental undergraduate students.

AIM: The aim of this study is to assess whether anxiety symptoms are associated with alcohol abuse in Brazilian undergraduate dental students during the COVID-19 pandemic. METHOD: A cross-sectional study was conducted. A semi-structured questionnaire addressing the variables of interest was hosted on Google Forms and shared with dental undergraduate students from all Brazilian regions between July 8 and 27, 2020. Alcohol abuse was measured using the Cut down, Annoyed, Guilty, Eye opener (CAGE) questionnaire score of ≥2. All participants responded to the seven-item Generalized Anxiety Disorder Scale (GAD-7). Hierarchical logistic regression was also conducted. RESULTS: Among the 1050 students evaluated, 18.7% (n = 196) had a positive screening for alcohol abuse during the pandemic. The prevalence of mild (GAD-7 = 5-9), moderate (GAD-7 = 10-14), and severe (GAD-7 ≥15) anxiety among students were 31.3%, 29.6%, and 24.2%, respectively. The final hierarchical logistic regression model showed that during the COVID-19 pandemic, anxiety levels predict the likelihood of alcohol abuse among students with moderate (OR 10.05 [95% IC: 4.12-24.52]) or severe (OR 15.82 [95% IC: 6.46-38.73]) anxiety, especially for male students (moderate anxiety: OR 17.06 [95% CI: 8.36-34.78]; severe anxiety: OR 28.38 [95% CI: 8.62-38.24]). CONCLUSION: The prevalence of alcohol abuse and moderate or severe anxiety in Brazilian undergraduate dental students during the COVID-19 pandemic was high. Male students may be more sensitive to the presence of anxiety symptoms in this period, thus contributing to higher levels of alcohol consumption, in comparison to female students. Intervention strategies that promote the adoption of healthier lifestyles can enable the effective management of anxiety symptoms during the pandemic and thus, hold the potential to reduce exacerbated alcohol intake in this population.

Changes in dental practice in times of COVID-19: review and recommendations for dental health care

ABSTRACT The aim of this article was to discuss biosafety measures described in the main protocols for minimizing the risk of COVID-19 transmission during dental care. COVID-19 appeared in China in late 2019 and quickly spread to other countries. Factors inherent to dental practice, such as proximity to the patient, transmission through saliva and breath, and the generation of aerosols during procedures, place the dental team at the top of the list among the most vulnerable healthcare providers. Health authorities initially recommended only maintaining urgent and emergency care and suspending elective dental procedures. Currently, elective care is gradually being resumed and requires numerous adjustments to the environment and professional routine in terms of biosafety. Several methods had been recommended to prevent the spread of other infectious diseases prior to the outbreak of COVID-19. However, further modifications are needed for the waiting room, patient screening and flow, procedures, garments, and even in dental office itself. Thus, dental professionals need to be prepared to adopt the new recommendations in order to reduce the chance of disease transmission.