Looking at the Mental Health of Children and Adolescents with Cleft Lip and/or Palate through Neuroticism and Emotional Regulation Strategies: A Case-Controlled Observational Study.

Background: Children and adolescents with cleft lip and/or palate (CL/P) are at an increased risk of developing emotional disorders. This study aims to explore this question in greater depth by addressing three objectives: (1) the presence of neuroticism as an indicator of emotional symptomatology, (2) the use of adaptive and non-adaptive emotional regulation strategies, and (3) the relationship between these strategies and neuroticism. Methods: A case-control correlational methodology was employed, with 60 children and adolescents with CL/P (mean age = 12.80 years; 33 females) and 60 non-clinical equivalent children and adolescents. Results: The CL/P group has higher scores on neuroticism (t = -7.74; p ≤ 0.001, d Cohen = 1.43) and lower scores in almost all emotional regulation strategies. The presence of CL/P moderated the relationship between neuroticism and self-blame (Beta = -0.46, t = -2.81, p = 0.005), rumination (Beta = -0.49, t = -3.73, p < 0.001), catastrophizing (Beta = -0.61, t = -4.26, p < 0.001), and blaming others (Beta = -0.45, t = -2.84, p = 0.005). This model predicted a significant variance of neuroticism (all p < 0.005), which ranged from 39% to 41%. Conclusions: The CL/P group has worse mental health indicators. Particularly novel results about the CL/P group are the lower scores on regulation strategies (both adaptive and non-adaptive) and the fact that non-adaptive strategies contribute, contrary to their effect in the general population, to a decrease in neuroticism. It supports the need to incorporate mental health indicators in the diagnosis and treatment of children and adolescents with CL/P.

Tooth-Bone-Borne vs Bone-Borne Rapid Maxillary Expanders on Dentoskeletal Changes.

Purpose: This study compared the insertion and thickness of the cortical bone, the parallelism of the midpalatal suture, and the skeletal transverse dimension using a microimplant-assisted rapid palatal expansion (MARPE) with those produced by bone-anchored maxillary expander (BAME) in adults. Patients and Methods: The sample comprised 18 patients (mean age, 29.9±9.4 years) selected for the MARPE group and 18 (mean age 24.8±6.8 years) selected for the BAME group. Cone-Beam computed tomography scans taken just before and after the expansion. Results: After treatment, there was a significant palatal depth decrease. In addition, maxillary and mandibular width were increased in both groups. Regarding the cortical bone insertion and cortical bone width, it is shown an increase in both groups but those changes are not significant. However, the anterior suture opening effect occurs more frequently in the BAME than in the MARPE device. There are no differences in the frequency of opening of the midpalatal suture in the cases treated with MARPE and BAME, in both cases the most frequent opening morphology is parallel, independently of midpalatal suture maturation. Conclusion: There are no differences in the use of MARPE or BAME in the parallelism of the middle palatal suture, the cortical bone insertion, and thickness according to the maturation stages of the midpalatal suture but significantly increases the transverse dimensions of the maxillary skeleton.

Short-term outcomes in the upper airway with tooth-bone-borne vs bone-borne rapid maxillary expanders.

BACKGROUND: This study compared the area and minimal section of the nasal cavity, nasopharynx, oropharynx, and hypopharynx in cases treated with different methods of microimplant-assisted expansion. METHODS: Based on a pilot study to calculate the sample size, 30 patients with transverse maxillary deficiency over 14 years of age were retrospectively selected. These patients had received two different types of microimplant-assisted maxillary expansion treatment (MARPE and BAME). The patient underwent Cone-Beam computed tomography (CBCT) before and after treatment (mean time 1.5 months) with MARPE or BAME and upper airway measurements (volume and minimum cross-sectional area) were taken to assess upper airways changes and compare changes between the groups. A paired sample t-test was performed to evaluate the T0-T1 change of airway measurements obtained with MARPE and BAME, and a student t-test to compare changes in airway measurements between MARPE and BAME. RESULTS: This investigation shows a statistically significant increase in total nasopharyngeal airway volume (0.59 ± 1.42 cm3; p < 0.01), total oropharyngeal airway volume (3.83 ± 7.53 cm3; p < 0.01) and minimum oropharyngeal cross-section (53.23 ± 126.46 mm2; p < 0.05) in all cases treated with micro-screw assisted expansion. The minimal cross-sectional area of the oropharynx ((79.12 ± 142.28 mm2; p < 0.05) and hypopharynx (59.87 ± 89.79 mm2; p < 0.05) showed significant changes for cases treated with BAME. As for the comparison between cases treated with MARPE and BAME, no differences in upper airway changes have been observed, except for the minimum cross-sectional area of the nasal cavity, which increases for MARPE (52.05 ± 132.91 mm2) and decreases for BAME (-34.10 ± 90.85 mm2). CONCLUSIONS: A significant increase in total area and minimal section at the level of nasopharynx and oropharynx was observed in cases treated with BAME. Regarding the comparison of MARPE and BAME treatments, no differences were found in the total airway volume and minimal section in upper airway except for the minimum cross section of the nasal cavity that increases for MARPE and decreases for BAME.

Changes in Molar Tipping and Surrounding Alveolar Bone with Different Designs of Skeletal Maxillary Expanders.

This study compared the buccolingual angulation (BLA) of the upper and lower first permanent molars before and after using the different methods of microimplant-assisted expansion in adults and its influence on bone insertion loss. METHODS: Cone-beam computed tomography scans taken before and after the expansion in 36 patients (29.9 ± 9.4 years) were used to assess dental and periodontal changes and compare changes between the groups. RESULTS: This research shows a statistically significant increase in the BLA of the upper first molars. An increase of the BLA of the lower molars is also observed in MARPE. Regarding the comparison between cases treated with MARPE (4.42° ± 10.25°; 3.67° ± 9.56°) and BAME (-0.51° ± 4.61°; 2.34° ± 4.51°), it was observed that upper molar torque increased significantly less in cases treated with BAME. In cases with CWRU < 96° at T0, a slight bone insertion gain was observed at T1, whereas if CWRU ≥ 96°, a slight bone insertion loss was observed. Regarding the labial cortical bone loss, a slight gain of CBW was observed in all cases. This labial cortical enlargement (T0-T1) is greater in cases where the CWRU < 96° at T0. CONCLUSIONS: Patients treated with MARPE show torque increase in the teeth selected to support the expansion appliance compared to cases treated with BAME. In cases where the BLA at T0 < 96°, an increase in thickness and cortical insertion is observed in the upper molars after treatment with disjunction appliances assisted with microscrews.

The impact of vaccination upon dental clinic avoidance and the cessation of individual protection measures.

The aim of this study was to analyze the evolution of germ aversion, to perceived infectability and to the fear of COVID-19 from the beginning of the pandemic until the arrival of the vaccines. A repeated measures design was used with three time points during the pandemic. The survey consisted of: Scale of perceived vulnerability to disease; Scale of fear of COVID-19; They were asked if they were vaccinated and if that vaccination is complete. They were asked if they would avoid the dental clinic through fear of COVID-19; and if they have reduced preventive practice in response to COVID-19. A T0-T1 increase in perceived infectability and germ aversion was reported. However, fear of COVID-19 decreased at T1-T2. The vaccinated experienced a greater reduction than the unvaccinated and a greater relaxation of their preventive practice. The frequency of dental avoidance decreased in the vaccinated group from T1 to T2 by 68.3% while in the non-vaccinated this reduction was only 4.9%; X 2 = 18.58 (p < 0.01). In summary, vaccination has had an impact in the reduction of perceived infectability and in reducing fear of COVID-19. Nevertheless, germ aversion has remained stable and independent of vaccination. Empirical support is found for the affirmation that vaccination can reduce certain preventive behavior and dental avoidance.

The Influence of Parenting Styles on Eating Behavior and Caries in Their Children: A Cross-Sectional Study.

The type of parenting style influences the way children cope with problems and can create states of anxiety that can even alter their eating habits, which can cause problems in their oral health. The present study aimed to find out which parenting style is more favorable for the oral health of their children. In this cross-sectional study, 186 children (aged 8-15 years) were examined to assess the mean Decayed/Missing/Filled teeth (DMFT + dmft) index, and they were asked to complete the State-Trait Anxiety Inventory, the Parenting Style Scale, and questions about their oral hygiene habits. On the other hand, their parents answered the Parental Feeding Style Questionnaire and the Children's Eating Behavior Questionnaire. Results showed that a worse oral health status was associated with a higher state of anxiety, more overeating, more emotional eating, and higher psychological control. A higher rate of missing teeth was associated with increased undereating and overeating. Emotional eating was positively related to psychological control. State of anxiety, overeating, and parental psychological control predicted 24.6% of DMFT + dmft. In addition, emotional eating had a moderating effect in DMFT + dfmt only in those with low levels of affection and communication. In conclusion, high psychological control and low levels of parental affection and communication will increase the state of anxiety in children, influencing their caries rate.

Co-Sleeping as a Protector against Malocclusion in the Primary Dentition: A Cross-Sectional Study.

Mothers practice co-sleeping and breastfeeding simultaneously, for convenience and to strengthen bonding. Due to the scarcity of studies analyzing the impact of co-sleeping on primary dentition, this study aimed to analyze the possible effects of co-sleeping on children's occlusion. In this cross-sectional study, mothers of 221 children aged 2−5 years who had been breastfed for less than 6 months completed a questionnaire about non-nutritive sucking habits. The WHO (World Health Organization) and IOTN-AC indices (the Aesthetic Component of the Index of Orthodontic Treatment Need) were used to assess malocclusion. The type of sagittal (dental and skeletal), transverse and vertical malocclusion was recorded. The non-co-sleeping group showed significantly higher pacifier use (p < 0.05), digital sucking (p < 0.05) and atypical swallowing (p < 0.05) habits. The non-co-sleeping group showed significantly higher mean scores on the IOTN-AC (p < 0.05) and WHO (p < 0.01), a significantly higher presence of canine class II (p < 0.05), anterior open bite (p < 0.05), posterior crossbite (p < 0.05), overbite (p < 0.05), skeletal class II (p < 0.01) and protrusion (p < 0.05). In conclusion, children who practice co-sleeping appear to have a lower frequency and duration of non-nutritive sucking habits. Co-sleeping may contribute to a lower development of malocclusions in children who are weaned early (before six months of age).

Evaluation of Dietary Habits, Type A Behavior Pattern and Its Relationship with Oral Health Status in Dental Undergraduate Students: A Cross-Sectional Study.

Oral health status among dental students has been widely studied, and while the repercussions of certain factors, such as personality type, adherence to healthy lifestyle habits and certain eating patterns, have been considered in the past, this study aims to study the combination of such factors and to carry out, in addition, clinical examinations that could provide deeper knowledge of real oral health status. A sample of 195 dental students was gathered and basic sociodemographic data (gender, age, nationality, hygiene habits, body mass index (BMI)) were collected, and type A personality scale (ERCTA), emotional eating (EE) and healthy lifestyle scale (EVS) values were registered. Descriptive analysis, Pearson correlations, a hierarchical linear regression model and moderation analysis were performed. Results showed that higher EE values were associated with a higher BMI, an increase in the decayed, missing, and filled teeth (DMFT) index, a higher number of carious and filled teeth, a higher ERCTA and a lower adherence to the EVS. Likewise, a higher DMFT was associated with a higher BMI, higher bleeding on probing index (BOP) values, higher ERCTA values and lower adherence to EVS. Dental floss disuse, BMI, EE and EVS predicted 25.3% of DMFT. In addition, a type A personality has a moderating effect only in those with medium and high EE levels.

Scale of self-efficacy in oral hygiene (OHSE): analysis of psychometric properties in Spain.

AIM: Oral self-efficacy has been shown to be an important variable in predicting successful treatment, preventing health risks and encouraging health-promoting behaviour. In the context of oral health, it is of paramount importance to facilitate the use of the Oral Hygiene Self-Efficacy Scale (OHSE) in clinical practice. The aim of this study was to analyze the psychometric properties of the OHSE scale in a sample of Spanish adults and offer standards for interpreting the scale. METHOD: A sample of 360 people aged from 18 to 75 years was assessed using the OHSE scale. The scale was culturally adapted and translated, reliability tests, construct validity, comparison of means by sex and age group were carried out, and scales for evaluating the responses were prepared. RESULTS: After eliminating six items, the reliability and validity analyses showed adequate psychometric properties. There were no differences between sex or age group. CONCLUSION: The OHSE scale for a Spanish adult population has sufficient empirical support to be considered a valid and useful instrument with solid psychometric properties and it offers an opportunity for oral health education intervention programs aimed at the adult population.

Fear of COVID-19 in Madrid. Will patients avoid dental care?

INTRODUCTION: The objective of this research is to describe how perceived infectability, germ aversion, and fear of COVID-19 in adults in Madrid have changed from the beginning of the pandemic until the lockdown exit phase and their influence on dental care behaviour. MATERIALS AND METHODS: Some 961 participants were monitored in a study in Madrid at 2 time points: before lockdown (T0) and after completion of the total lockdown (T1). A questionnaire that included basic sociodemographic variables, the perceived vulnerability to disease scale (including perceived infectability and germ aversion), the fear of COVID-19 scale, and dental visiting behaviour after confinement for fear of COVID was administered. RESULTS: The participants had higher scores for infectability and germ aversion at T1 than at T0 (P < 0.01). Of those studied, 24.5% (235) of the participants would not go to the dentist for fear of COVID-19. Those who had a high perceived infectability scale score were at least 5 times more likely to not visit the dentist. Those with high COVID-19 fear were at least 6 times more likely to not visit the dentist, and those older than 60 years were 8 times more likely to not visit. CONCLUSIONS: The population's high levels of vulnerability to infectability and perceived germ aversion associated with fear of COVID-19 and the resultant avoidance behaviour to dental care will remain until an effective drug or vaccine for SARS-CoV2 is found.

The impact of co-sleeping less than 6 months on children's anxiety, oral habits, and malocclusion in a Spanish sample between 2 and 5 years old: a cross-sectional study.

OBJECTIVES: Families often use co-sleeping to mitigate potential physiological and emotional effects on infants. The purpose of this study was to investigate whether the early termination of co-sleeping is associated with high levels of anxiety, non-nutritive sucking habits for self-comfort, and increased malocclusion. METHODS: A cross-sectional study was performed on the parents of 215 children [aged 2-5 years (3.94 ± 0.89)], who were divided according to the duration of co-sleeping (≤6 months or >6 months). The parents completed a questionnaire about co-sleeping, sucking, breastfeeding habits, and anxiety. Finally, a clinical examination was carried out to diagnose malocclusion according to the World Health Organization (WHO) index, and the aesthetic component of the Index of Orthodontic Treatment Need (IOTN-AC) was recorded. RESULTS: Children that co-slept for 6 months or less had an increased incidence of pacifier use (P < 0.05), finger sucking (P < 0.01), and atypical swallowing (P < 0.05). Lower anxiety levels were found in the group with a longer duration of co-sleeping (P < 0.01). In the assessment of malocclusions, the group that co-slept for ≤6 months had higher IOTN scores (P < 0.01) and WHO indices (P < 0.05); in addition, there were differences in anterior open bite (P < 0.05), posterior crossbite (P < 0.01), skeletal Class II (P < 0.01), canine Class II (P < 0.05), and overjet (P < 0.05). CONCLUSION: A co-sleeping duration of >6 months appears to be a protective factor associated with less anxiety, fewer negative sucking habits, and a decreased incidence of malocclusions in co-sleeping children.

Lockdown impact on lifestyle and its association with oral parafunctional habits and bruxism in a Spanish adolescent population.

AIM: To analyse the possible association between decreased physical and social activity and an increase in the use of mobile devices, internet, and social networks with increased anxiety and the appearance of oral parafunctions and bruxism for adolescents before and during COVID-19. DESIGN: A total of 213 adolescents attended private clinics at two different times: before lockdown (T0) and after completion of total lockdown (T1). In T0 and T1, a clinical examination was carried out to assess dental wear (IA) and only in T1 were they given the self-report questionnaire which focuses on the periods before and during lockdown (self-reported bruxism, state anxiety, mobile phone and internet, social network use, physical and social activity, and questions on parafunctions). RESULTS: There were a decrease in physical activity at T0-T1 and an increase in social media use, internet, state anxiety, and clinical and self-reported bruxism at T0-T1. There was a positive correlation between increased self-reported bruxism, increased social media use, mobile device use, and state anxiety. CONCLUSIONS: There has been a change in adolescent lifestyle during lockdown with an increase in the prevalence of oral parafunctions and bruxism. In particular, the increase in the use of social networks at night and also in anxiety levels during lockdown were associated with of the increase in self-reported bruxism.

How Can We Reduce Dental Fear in Children? The Importance of the First Dental Visit.

Dental fear is a common problem amongst children. It can affect children's psychological well-being, quality of life, and oral and systemic health. The aim of this study was to identify whether the patients' age at which visits to the paediatric dentist begin as well as the periodicity of these visits are factors that can prevent dental fear. This observational transversal study was conducted on 575 school children (average age 6.85 ± 0.78) and their mother/father/guardian. Parents completed a survey on the characteristics of dental visits and the child completed the index of dental anxiety and fear (IDAF-4C) to assess dental fear. The correlation between dental fear and age at first visit (r = -0.36 p < 0.01) and dental fear and frequency of visit (r = -0.65 p < 0.01) were statistically significant. The regression analysis performed showed that both variables predicted 44.4% of the dental fear in the child. In conclusion, the age of initiation to the paediatric dentist (before 2 years) and the periodic revisions (every 6 months or every year) could protect the child from dental fear.

Oral-Health-Related Quality of Life and Cosleeping: The Role of Nocturnal Breastfeeding.

The purpose of this paper is to analyse the association between cosleeping and the number of breastfeeding sessions in infants, OHRQoL of the child and the family, and the DMFT Child's index. The sample comprised 273 children (2-4 years old). In addition to the clinical examination of the child to assess the DMFT Index, the mother was requested to complete a questionnaire to collect data about the breastfeeding practice, diet, dental hygiene, dental check-ups, quality of the child's oral life, and family impact (ECOHIS Scale). The children's OHRQoL is positively correlated with number of night-time breastfeeding sessions at 12 months (r2 = 0.40 **), DMFT index (r2 = 0.60 **), impact family (r2 = 0.65 **), and duration of cosleeping (r2 = 0.36 **). The moderating effect explained 41% of OHRQoL; the interaction between the number of breastfeeding sessions at 18 months and the DMFT index significantly increased the coefficient of determination. A longer practice time for cosleeping was associated with an increase in breastfeeding sessions, a higher impact on OHRQoL, a higher family impact, and a higher DMFT index. More than three night-time breastfeeding sessions moderate the relationship between the DMFT index and the child's OHRQoL.

Facial Self-Touching and the Propagation of COVID-19: The Role of Gloves in the Dental Practice.

BACKGROUND: Despite facial self-touching being a possible source of transmission of SARS-Co-V-2 its role in dental practice has not been studied. Factors such as anxiety symptoms or threat perception of COVID-19 may increase the possibility of contagion. The objective was to compare the impact of control measures, such as gloves or signs in the reduction in facial self-touching. METHODS: An intra-subject design was undertaken with 150 adults. The patients' movements in the waiting room were monitored with Microsoft Kinect software on three occasions: without any control measures, using plastic gloves or using advisory signs against self-touching. Additionally, the participants completed the sub-scale of STAI (State-Anxiety) and the BIP-Q5 (Brief Illness Perception Questionnaire); their blood pressure and heart rate were recorded. RESULTS: The lowest incidence of facial self-touching occurred in the experimental situation in which gloves were introduced. The subjects with elevated anxiety symptoms realized more facial self-touching regardless of the control measures. However, the threat perception of COVID-19 is associated negatively with facial self-touching. CONCLUSIONS: The use of gloves is a useful control measure in the reduction in facial touching. However, people with anxiety symptoms regardless of whether they have greater threat perception for COVID-19 exhibit more facial touching.

Anxiety and facial self-contacts: possible impact on COVID-19 transmission in dental practice.

BACKGROUND: The purpose was to analyse the associations between dental and trait anxiety, fear of COVID-19 and the duration and frequency of spontaneous hand-to-face contact (self-contact). METHODS: A cross-sectional design was carried out with 128 adult patients from four dental clinics in Madrid, during the confinement, from March 15 to May 15. The patients' movements in the waiting room were monitored with Microsoft Kinect Software, also completed the Trait anxiety subscale of the STAI, the COVID-19 Fear and the S-DAI questionnaire. RESULTS: Associations were observed between the duration and frequency of facial, mask and eye contact with trait anxiety and dental fear was determined only by the frequency of this self-contact. Trait anxiety is associated with dental anxiety and with fear of COVID-19. Although facial self-contact is higher in women, it also rises in men as dental fear increases. Moreover, dental anxiety is a good predictor of trait anxiety and the incidence of facial self-contact. CONCLUSIONS: Understanding the possible associations between biopsychosocial factors, such as trait anxiety, dental anxiety and self-contact is important. It may help to prevent the spread of COVID-19 in the population as well as enabling the formulation of effective interventions to improve oral health care through the implementation of dental care programmes.

Impact of Breastfeeding and Cosleeping on Early Childhood Caries: A Cross-Sectional Study.

The type and duration of breastfeeding can be key factors in the development of early childhood caries (ECC). The association between nighttime feeding and ECC was investigated. Specifically, whether cosleeping is a potential mediator of children's oral health was investigated, considering many of the etiological factors of caries. In this cross-sectional study, 212 children (aged 2-4 years) from Madrid (Spain) who breastfed at night were examined to assess the mean decayed/filled primary teeth (dft) index, and a questionnaire was administered to the mothers to collect data on the practice of breastfeeding and cosleeping and its duration, the number of nighttime feeding sessions, sugar content in the diet, dental hygiene habits, and age at first dental visit. The dft index was lower in the group that breastfed for less than 18 months (p = 0.02). In addition, there were significant differences in the dft index in the group breastfeeding for more than 18 months between those who coslept for 18 months or more and those who coslept for less than 18 months (p < 0.05), as well as between those who coslept for 18 months or more and those who did not cosleep (p < 0.01). In conclusion, breastfeeding at night from 18 months onwards is considered a risk factor for ECC.

Oral hygiene habits and possible transmission of COVID-19 among cohabitants.

BACKGROUND: To find out whether misuse of dental hygiene, in terms of certain dental habits, may facilitate the spread of COVID-19 among cohabiting individuals. METHODS: 302 COVID-19 infected (PCR +) subjects cohabiting with someone else at home were selected for an observational cross-sectional study. An anonymous online questionnaire was developed using Google forms to avoid person-to-person contact. The structured questionnaire consisted of questions covering several areas: sociodemographic data, cross transmission to another person living together, oral hygiene habits during confinement, care and disinfection control behaviours in the dental environment like sharing toothbrush, sharing toothbrush container, sharing toothpaste, placing brush vertically, placing cap with hole for brush, disinfecting brush with bleach, closing toilet lid before flushing. RESULTS: Tongue brushing was more used in the group where there was no transmission of the disease to other members (p < 0.05). Significant differences were found for shared toothbrush use (p < 0.05), although shared use was a minority in this group (4. 7%), significant differences were also found for the use of the same container (p < 0.01), shared use of toothpaste (p < 0.01), toothbrush disinfection with bleach (p < 0.01), brush change after PCR + (p < 0.05). The women performed significantly more disinfection with toothbrush bleach (p < 0.01), closing the toilet lid (p < 0.05) and changing the brush after PCR + (p < 0.05). CONCLUSIONS: The use of inappropriate measures in the dental environment could contribute to the indirect transmission of COVID-19 between cohabitants.

Perceived vulnerability to Coronavirus infection: impact on dental practice.

SARS-CoV-2 is a new virus responsible for the outbreak of the respiratory disease COVID-19, which has spread to several countries around the world, causing considerable consternation and a fear of contagions in global healthcare settings. The objective of this study is to identify, among Madrid's adult population, the impact of COVID-19 on self-perceived vulnerability, infectiousness, aversion to germs, and other behaviors in the current situation regarding dental practice. This cross-sectional observational study involves 1,008 persons randomly surveyed on the streets of Madrid, Spain between March 1 and March 8, 2020. Their perceived vulnerability to disease was measured using the perceived vulnerability to disease scale. An additional questionnaire evaluated basic sociodemographic aspects, medical history, personal hygiene behavior, willingness to go to certain places and the perception of the risk of contagion when going to a dental practice. There are significant differences by sex on the germ aversion subscale (p < 0.05) and in the risk of waiting in the waiting room (p < 0.01), tooth extraction ((p < 0.05), endodontics (p < 0.05) and fillings ((p < 0.05). Women consider the risk to be higher than men do. The risk group (over 60 and with systemic disease) has significant differences on the subscales of infectivity (p < 0.01) and germ aversion (p < 0.01). Our study shows high levels of vulnerability regarding contracting COVID-19 and avoiding dental care as perceived by the population over 60 years old and with a systemic disease.

Perceived vulnerability to Coronavirus infection: impact on dental practice

SARS-CoV-2 is a new virus responsible for the outbreak of the respiratory disease COVID-19, which has spread to several countries around the world, causing considerable consternation and a fear of contagions in global healthcare settings. The objective of this study is to identify, among Madrid's adult population, the impact of COVID-19 on self-perceived vulnerability, infectiousness, aversion to germs, and other behaviors in the current situation regarding dental practice. This cross-sectional observational study involves 1,008 persons randomly surveyed on the streets of Madrid, Spain between March 1 and March 8, 2020. Their perceived vulnerability to disease was measured using the perceived vulnerability to disease scale. An additional questionnaire evaluated basic sociodemographic aspects, medical history, personal hygiene behavior, willingness to go to certain places and the perception of the risk of contagion when going to a dental practice. There are significant differences by sex on the germ aversion subscale (p < 0.05) and in the risk of waiting in the waiting room (p < 0.01), tooth extraction ((p < 0.05), endodontics (p < 0.05) and fillings ((p < 0.05). Women consider the risk to be higher than men do. The risk group (over 60 and with systemic disease) has significant differences on the subscales of infectivity (p < 0.01) and germ aversion (p < 0.01). Our study shows high levels of vulnerability regarding contracting COVID-19 and avoiding dental care as perceived by the population over 60 years old and with a systemic disease.