Impact of delayed orthodontic care during COVID-19 pandemic: Emergency, disability, and pain

Reliability of YouTube videos on the management of orthodontic emergencies during COVID-19 pandemic: A quantitative and qualitative analysis

OBJECTIVES

To assess the content of YouTube videos on the management of orthodontic emergencies during the COVID-19 pandemic.

MATERIALS AND METHODS

YouTube was systematically searched using the keywords "orthodontic emergency," "orthodontic homecare," "braces emergency," and "braces homecare." The first 100 videos for each keyword were assessed. The upload source, number of views, likes and dislikes, duration, and global quality score were extracted. Home and clinical advice reliability was evaluated using the reliability score (DISCERN) according to the COVID-19 orthodontic emergencies protocol published by the British Orthodontic Society.

RESULTS

The majority of the videos were found to be poor quality. Home care advice showed higher reliability than clinical advice. Orthodontic emergency videos uploaded by healthcare professionals had higher reliability.

CONCLUSION

Many types of orthodontic emergencies have received little attention on YouTube, and more useful and reliable educational videos should be uploaded in the event of future pandemics.

Effects of delayed appointments in fixed orthodontic patients due to lockdown during the COVID-19 pandemic

Objectives

To determine the frequency of orthodontic emergencies and their impact on the treatment progress caused by delayed appointments due to the lockdown during the COVID-19 pandemic.

Materials and methods

Two hundred thirty-eight patients undergoing fixed orthodontic treatment participated in this cross-sectional study. A pre-structured questionnaire was divided into six parts (Part A-C comprised of orthodontic emergencies and Part D-F comprised of various adverse effects and impacts on treatment progress). Two specialist orthodontists performed clinical examinations to complete the questionnaire. The final data were expressed as frequency and percentage.

Results

Maximum number of patients reported four months after lockdown. Nearly half of the patients reported debonding of at least one of the brackets. Loosening of molar bands and debonding of second molar tubes were observed in 12.6% and 18.9% of patients, respectively. Ligation method failures were reported in 41.2% of the patients. Patients fitted with transpalatal arch/lingual arch skeletal anchorage showed a failure rate of 26.1% and 10%, respectively. Almost 29% of the patient complained of discomfort due to distal wire impingement. Undesired tooth movements were seen in almost 25% of patients. Alignment, space closure, and settling of occlusion were affected in 47.6%, 17.4%, and 35.7% of patients, respectively.

Conclusions

This study helps to determine various types of adverse effects that can occur due to delayed appointments. The study's outcomes suggest that clinicians should be prepared to deal with future pandemics or other causes that might lead to delayed appointments.

Cross-cultural adaptation and psychometric properties of the Mainland Chinese version of the manchester orofacial pain disability scale (MOPDS) among college students

BACKGROUND

Orofacial pain (OFP) is a highly prevalent disorder in mainland China that predisposes to an associated physical and psychological disability. There is lack of a good properties mainland Chinese version of instrument to examine OFP. This study aims to cross-cultural adaptation and evaluate psychometrics properties of the Manchester Orofacial Pain Disability Scale (MOPDS) in mainland Chinese Mandarin context.

METHODS

Translation and cross-cultural adaption of the mainland Chinese version MOPDS were conducted following accepted guidelines of self-report measures. Chinese college students (N = 1039) completed the mainland Chinese version of the MOPDS for item analysis, reliability and validity tests, and measurement invariance analysis, and after a one-month interval, around 10% of the sample (n = 110) were invited to retest. To conduct the CFA and measurement invariance analysis, Mplus 8.4 was used. IBM SPSS Statistics 26 software were used for all additional studies.

RESULTS

We found that the mainland Chinese version of MOPDS contains 25 items, divided into two categories: physical disability and psychological disability. The scale demonstrated excellent internal reliability, test-retest reliability, and validity. The measurement invariance results proved that the scale could be applied to people of different gender, age, and health consultation status.

CONCLUSIONS

The results demonstrated the mainland Chinese version of MOPDS has good psychometric properties and can be used to measure the level of physical and psychological disability of Chinese OFP peoples.

Orthodontic care in orthodontic patients during the COVID-2019 pandemic: emergency, emergency response and orthodontic treatment preference

BACKGROUND

The objective of this study was to investigate the characteristics of emergencies and the requirement for emergency treatment after the suspension of orthodontic appointments. The attitude towards orthodontic treatment preference was evaluated as well, including receiving orthodontic treatment and the preference for orthodontic appliances.

SUBJECTS AND METHODS

An electronic questionnaire was distributed to the patients, including 4 sections: Section 1 - demographic and basic information; Section 2 - the characteristics of emergencies and emergency treatment requirements; Section 3 - the NRS-11 for pain and Manchester Orofacial Pain Disability Scale used to evaluate the intensity of orofacial pain and disability; and Section 4 - attitudes towards receiving orthodontic treatment and appliance preference. Descriptive statistics, Pearson's chi-square test, Wilcoxon's rank-sum test and stepwise generalized linear model (GLM) were performed with significance set at P < 0.05.

RESULT

Most participants' (91.61%) follow-up appointments were suspended. The emergency rate and emergency treatment requirements were not different between the fixed appliance (FA) and clear aligner (CA) groups. Patients who reported emergencies (P < 0.01) in the FA group (P < 0.05) and some emergencies in the FA (P < 0.05) suffered worse pain and disability. More FA participants preferred alternative appliances (P < 0.05) due to pain and disability (P < 0.05).

CONCLUSION

FA patients' emergencies caused worse pain and disability when orthodontic appointments were suspended. Pain and disability were not the causes of emergency treatment requirements. The CA group seemed to show a tendency towards orthodontic appliance preference, which was an ideal modality to weather the epidemic, combined with telemedicine.

Assessment of the willingness of Nigerian Orthodontists to offer face-to-face orthodontic services to patients infected with Covid-19

Introduction

Efforts to contain the spread of the COVID-19 disease led to suspension of many services which caused orthodontists to resort to providing only emergency services. The aims of this study were to assess the willingness of Nigerian Orthodontists and Orthodontic resident doctors to treat patients infected with Covid-19 as well as to ascertain advice given regarding traumatic arch wires and aligners during the pandemic.

Participants and study design

This was a descriptive cross-sectional study. We included dentists who were Orthodontists and orthodontic resident doctors practicing in Nigeria. Data was collected via an online questionnaire (Google form) which was sent three times weekly throughout May/June, 2020 and analysed using SPSS version 23. Descriptive statistics were used to analyse the data.

Results

Forty-eight out of the 90 members of the WhatsApp group responded within the allotted time, giving a response rate of 53.3%. Out of a total of 48 respondents, 39 (81.3%) were unwilling to treat patients infected with COVID-19 during the pandemic. The major reason was fear of infection with the virus (12, 25.0%). Most of the respondents (41, 55.4%) suggested the use of wax for relief of trauma from arch wires.

Conclusion

Majority of Orthodontists and orthodontic residents practicing in Nigeria expressed unwillingness to treat patients infected with COVID-19. Aligner therapy was proffered as an alternative to bracket therapy.

Orthodontic emergencies and mental health of patients undergoing orthodontic treatment during COVID-19 pandemic: A questionnaire study

Objectives

To evaluate the impact of COVID-19 pandemic on orthodontic treatment and mental health of patients undergoing orthodontic treatment and to compare their mental health with the age-matched control group.

Materials and methods

484 orthodontic patients (245 males and 239 females) and 200 age-matched control subjects were divided into two age groups. Group 1 had 14-18 years of adolescents (N = 274) and 100 control participants (Group 2) and Group 3 comprised of 19 years above adults (N = 210) and 100 control participants (Group 4). Group 1 and 3 patients filled the 4 sections of the questionnaire related to orthodontic emergencies (Sections 1-3) and mental distress (Kessler Psychological Distress Scale-Section 4), while groups 2 and 4 were asked to fill only Section-4. The comparison of mental distress on high/low Kessler scores was made using the Chi-Square test/Fisher's exact test. The factors which came out to be significant were put to bivariate logistic regression analysis.

Results

The percentage of patients with high Kessler scores among Group 1 and Group 3 were 9.9% and 17.2% respectively, and their differences with age-matched control groups were non-significant. The mean differences of Kessler score were significantly higher for Group 3 compared to group 1. The higher Kessler score was associated with age, higher education, a feeling of concern for non-availability of appointments, increased treatment duration, its effect on the quality of treatment, and sabotaging of definitive future plans.

Conclusions

The orthodontic treatment and emergencies may not be a significant factor contributing to increased stress among patients during the lockdown.

The Impact of the COVID-19 Pandemic on Israeli Orthodontic Practice: A Clinic's Activity and Patients' Attitudes

The current study aimed to characterize the activity in orthodontic clinics during the COVID-19-induced lockdown and the inter-lockdown periods, as well as to evaluate patients’ perspectives with respect to their fears, their extent of cooperation with treatment, and their emergency needs during the lockdown. The data were gathered from 11 private orthodontic clinics from 1 January 2020 to 8 March 2021, which included three lockdowns and inter-lockdowns. Information specifying the number of admissions, missed appointments, and emergency visits was gathered. Four hundred and twenty-nine orthodontic patients treated in those clinics agreed to complete a questionnaire that evaluated their concerns and expectations, the treatment emergency issues, implementation of the orthodontist’s instructions, and contact with the clinical staff during lockdowns. There was a significant increase in the number of scheduled appointments during the inter-lockdown periods, compared with the pre-pandemic period (p = 0.001). No difference in the number of missed/canceled or emergency appointments was found between the different periods (p > 0.420). The majority (89.6%) of the emergency visits involved issues with appliances; 68.7% of the subjects were advised to present themselves at clinics. During the peaks of the waves of the COVID-19 pandemic, a sharp rise in the number of missed and urgent appointments was not found. Reducing the number of orthodontic emergencies may assist in reducing patient fears.

Patient-Reported Outcome Measurements in Temporomandibular Disorders and Headaches: Summary of Measurement Properties and Applicability

INTRODUCTION

Several patient-reported outcome measurements (PROMs) are available in the literature to support the evaluation and diagnosis of temporomandibular disorders and headaches. However, clinicians and researchers usually complain that they had no education on PROMs and low overall knowledge about PROMs.

OBJECTIVE

This study aimed to summarize, describing the measurement properties and clinical applicability of the main condition-specific PROMs available in the literature to the assessment of patients with Temporomandibular Disorders and Headaches.

METHODS

The current manuscript reviewed 10 PROMs commonly used in the field. Four instruments about functioning and disability: 1. Mandibular Function Impairment Questionnaire (MFIQ), 2. Craniofacial Pain and Disability Inventory (CF-PDI), 3. 8-item and 20-item Jaw Functional Limitation Scale (JFLS), and 4. Manchester Orofacial Pain Disability Scale (MOPDS). Two instruments about headache-related disability: 5. Headache-Related Disability Index (HDI) and 6. Headache Impact Test-6 (HIT-6). Three instruments focused on TMD and headache screening: 7. 3Q/TMD, 8. Short-Form Anamnestic Fonseca Index (SFAI), 9. Headache Screening Questionnaire. In addition, one instrument about maladaptive beliefs regarding pain and injury: 10. Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD).

CONCLUSIONS

The knowledge about the limitations and applicability of the PROMs commonly used to assess TMDs and Headaches can help clinicians and researchers to obtain reliable and valid outcomes to support the decision-making process. The current review recognizes the importance of using patient-reported outcome measures in research and clinical practice. However, our findings call the attention that further studies on the measurement properties of such instruments are imperative.

Factors Associated with Pain Intensity in Patients Undergoing Orthodontic Treatment Based on Mini-Implants

Introduction: Pain is currently reported as the most common side effect associated with orthodontic treatment. The aim of this study was to evaluate the factors associated with the intensity of pain perception during orthodontic procedures consisting in anesthesia, orthodontic mini-implant placement and removal, as well as during the postoperative period following these procedures. Material and Methods: The study included 50 young adults with a permanent dentition in need of orthodontic treatment. The pain assessment was based on visual analogue scale (VAS), using self-report questions from approved questionnaires. Pain severity was analyzed in relation to: anesthesia, implant placement, implant removal, implant movement, elastic traction and gingiva/bone pain around the implant. The study lot was divided into Group 1 – patients experiencing a pain degree of 1 or 2, and Group 2 – patients experiencing a pain degree of 3 or 4 during implant placement. Results: The maximum pain intensity (PI) was recorded during implant placement, which has been associated with a PI of 2.4 ± 0.8 (95% CI: 2.17–2.63), followed by implant removal (PI = 2.36 ± 0.66, 95% CI: 2.17–2.54), gingiva/bone pain around the implant (PI = 2.32 ± 2.58, 95% CI: 2.15–2.48), and elastic traction (PI = 2.26 ± 0.63, 95% CI: 2.08–2.44). Male gender was present in a significantly higher extent in the group of patients presenting a high intensity pain during implant placement (86.3% in Group 2 vs. 3.5% in Group 1, p <0.0001). The age group most sensitive to pain was 18 to 21 years. Conclusions: In our study, pain perception was significantly higher in males and in the 18–21 years age group. The most painful procedure during surgery was the initial moment of implant placement, followed by the moment of implant removal, gingival/bone pain around the implant, and the elastic tractions placed on the implant during anchorage.

The Implications of the COVID-19 Pandemic on the Interest in Orthodontic Treatment and Perspectives for the Future. Real-Time Surveillance Using Google Trends

Background: The COVID-19 pandemic outbreak may have a large impact on orthodontic treatment. Regular orthodontic visits were strongly and widely interrupted by the unprecedented epidemiological threat. Methods: The data regarding orthodontic queries were investigated in a real-time surveillance using Google Trends. Search terms “braces”, “invisalign”, “get braces”, “get braces off”, “braces pain” and the phrase “social distancing” were analyzed regarding the year preceding the pandemic outbreak and the time of the pandemic. Moreover, the five-year trend for queries “braces” vs. “invisalign”, as an example of different types of orthodontic appliances, was compared. Results: There was a significant decrease in orthodontics phrase queries in the spring of 2020, connected with the worldwide restrictions and lockdowns announced all over the world. There was a lower interest in the “braces pain” query during the first lockdown in 2020. The number of searches for “invisalign” increased steadily over time, while the number of searches for “braces” was relatively stable across the investigated time period. Conclusions: The course of the COVID-19 pandemic has had a large impact on the orthodontic-related search queries. Orthodontists must be better-prepared for any sudden changes in the possible future in the epidemiological situation that may change accessibility to dental offices.

The impact of COVID-19 pandemic on patients receiving orthodontic treatment: An online questionnaire cross-sectional study

Background

The spread of Coronavirus Disease 2019 (COVID-19) has led to a major public health issue; most dental clinics were closed and millions of orthodontic patients were unable to complete their treatment. This study aimed to assess the challenges faced by patients receiving orthodontic treatment and their preferred solutions to overcoming these challenges during this pandemic.

Methods

An online questionnaire was developed and sent to patients receiving orthodontic treatment at a public or private clinic.

Results

A total of 388 responses were analyzed: mean age 20.4 ± 4 years, 75% (291) female, and 58% (226) received their treatment at a public clinic. Of all participants, 27.3% (106) were still unable to attend their appointments and 69% (244) stated that closing of the clinic was the main reason for missing their appointments. Depending on their type of appliance, the patients faced different problems and chose multiple ways to deal with them. Most participants had fixed appliances, 84% (327), and only 21% (64) of them stated that they had no problem compared with 39% (11) and 36% (8) for removable appliance and clear aligner groups, respectively.

Conclusion

The COVID-19 pandemic has had a significant impact on orthodontic treatments. Almost every orthodontic patient had to stop attending their appointments, which put them in complicated situations and in fear of delayed treatment. Patients from a public clinic and patients with fixed appliances reported more problems than others. More attention should be giving to teleorthodontics; also orthodontists should prepare their patients to deal with some of the problems related to their appliances when possible.

Appropriate orthodontic appliances during the COVID-19 pandemic: A scoping review

INTRODUCTION

The esoteric Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection or COVID-19 has been an unusual plummet in dental/orthodontic practice. Based on current recommendations for various amendments in an orthodontic practice, this scoping review aims to identify orthodontic appliances that are most appropriate to us during this on-going pandemic.

METHODS

Electronic databases (PubMed, Scopus, Web of Science, Science Direct, and Google Scholar) were searched up until August 11, 2020. Full-text articles in English with keywords "COVID-19 and Orthodontics" and related search terms were included.

RESULTS

Out of 17 retracted articles, only 4 articles were found to be brief the choice for orthodontic appliances in pandemic times speculating clear aligner therapy (CAT) to be a pragmatic solution. The remaining articles were also thoroughly studied and the new norms set by the pandemic were determined. Criteria for orthodontic appliance selection included careful patient screening and collection of records, minimal physical visits, efficient use of technology, virtual consultations but the use of PPE for physical appointments; and lesser AGPs with a lesser risk of airborne transmission.

CONCLUSIONS

Subject to regional demands, CAT can be considered as the relatively safer modality-predictable and effective apposite to fixed orthodontic appliances in these unprecedented times.