Preparedness among dental professionals towards COVID-19 in India

Assessing the Compliance of Dental Clinicians towards Regulatory Infection Control Guidelines Using a Newly Developed Survey Tool: A Pilot Cross-Sectional Study in India

Adherence to the dental practice regulatory guidelines instituted during the COVID-19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase I- developing survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis (EFA) on the responses collected in Spring 2021. The EFA was achieved using a traditional unweighted least squares extraction method through a varimax rotation with Kaiser normalization. A six-factor solution with 18 items (with the global reliability of 86%) related to screening, regular infection prevention measures, infection control inside the dental operatory, disinfection of the dental unit, disposal, and other COVID-19-specific preventive measures were extracted. Our sample had higher compliance with regard to providing alcohol-based hand scrubs, providing protective gear to attendees, collecting travel/medical history, and screening patients for COVID-19 symptoms. In contrast, less compliance was observed regarding the use of paperless forms of practice and rubber dams in the operatory. The use of a validated survey tool ensures the collection of reliable and valid data, which can serve as baseline data to measure the uptake and effectiveness of dental practice regulatory guidelines in a clinical setting and community dental health clinics.

COVID-19 Contraction Among Dental Healthcare Workers in the Department of Conservative Dentistry and Endodontics - A Retrospective Analysis During the Pandemic

Introduction

The COVID-19 pandemic has led to major challenges for the healthcare sector across the globe including dental healthcare workers (DHCWs) due to the increased risk of transmission of virus during aerosol-generating procedures. We conducted the present retrospective analysis determining the risk of contraction of COVID-19 infection among DHCWs since the outbreak of the pandemic for a year (March 2020 through March 2021) in Mumbai.

Methods

In total, 18,058 patients visited the Nair Hospital Dental College for dental treatment related to the Department of Conservative Dentistry and Endodontics during the assessed year. All the patients were subjected to intensive triage, which included recording their body temperature, oxygen saturation level, travel, and COVID-19 exposure history.

Results

A total of 26 DHCWs were responsible for attending and treating the patients with all the standard infection control measures. Seventy-four (0.40%) patients out of 18058 were referred for a nasal rapid antigen test (RAT) on giving a positive affirmation about COVID-19 like symptoms when screened at the triage. Of those 74 patients referred, 20 reported a positive nasal rapid antigen test and the infection was confirmed by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Among 26, 9 (34,7%) DCHWs were found to have contracted the infection during the assessed year.

Conclusion

The analysis found that the risk of COVID-19 infection contraction amongst the DHCWs is considerably less. This could be attributed to the intensive triage and the preventive measures taken while rendering treatment.

How the COVID-19 Pandemic Affects Risk Awareness in Dentists: A Scoping Review

Dentists are on the frontline of infection, especially when it comes to respiratory viruses like the new coronavirus. The purpose of this paper is to conduct a scoping review to better understand dentists’ risk awareness, awareness of COVID-19 symptoms, preventive measures, and effective methods of COVID-19 infection prevention and management. This paper systematically assesses the published literature on dentistry and COVID-19. Various electronic databases including Ovid MEDLINE, Scopus, Embase, and MEDLINE via PubMed were searched up to 9 September 2021. Overall, 39 papers were included. Almost the entirety of dentists (94.5%) reported awareness of the three most common COVID-19 symptoms, and a risk awareness score of about 90% was shown, while 88.2% of dentists reported adopting preventive measures. More than 50% did not want to treat infected people. While 70.3% of dentists recommended usage of N95 masks, the rate of dentists using them was below 40%. Sufficient awareness of risks during the pandemic was found in dentists. Although they were using preventive measures, there remains upside potential for adopting all recommended measures. Further, the usage of N95 masks is improvable, even though the benefit of wearing them could not be confirmed.

Assessment of knowledge, attitude and practices among dental practitioners on methods of infection control while carrying out dental procedures during novel coronavirus (COVID-19) pandemic

Introduction

dental procedures produce bio-aerosols that can carry the highly contagious COVID-19 virus. Hence, the entire dental care team has to follow the current COVID-19 related infection control protocols. The study aims to assess the knowledge, attitude, and practices associated with infection control methods during dental procedures among dental practitioners during the COVID-19 pandemic in India.

Methods

the online questionnaire consisted of four sections namely, demographic details, eight questions on knowledge, four questions on attitude and eight questions on the practice of dentists during COVID-19 pandemic. One point was attributed for a correct response and zero point for an incorrect response. The study used descriptive statistics and binary logistic regression models in Jamovi 1.8.1 to establish relationships between knowledge, attitude, and practices among dental professionals and their demographic characteristics.

Results

among 384 dentists, 294 (76.6%) were aware of the hand hygiene methods, 372 dentists (96.9%) were aware of the Personal Protective Equipment (PPE), 343 dentists (89.3%) recorded the body temperature of the patients. One hundred and thirty eight (138) dentists (35.9%) did not use rubber dam and 158 dentists (41.1%) were not aware of the four-handed dentistry. Among the study participants, 57.8% displayed adequate knowledge, 63.8% possessed good attitude and 93.5% followed good practices on COVID-19 appropriate infection control measures during dental procedures. The mean knowledge, attitude, and practice scores were found to be 6.61, 2.04, and 3.38 respectively. Based on multivariable binary logistic regression analysis, it is observed that males (aOR: 0.55, 95% CI 0.35-0.87; p=0.011) have a lower likelihood of having a good knowledge when compared with females after adjusting for the other independent variables in the model. Also, individuals with higher qualifications (aOR: 0.57, 95% CI 0.36-0.92; p=0.022) appear to have lower likelihood of having good knowledge on COVID-19 infection control methods during dental procedure.

Conclusion

the study concludes that participants possess sound knowledge, attitude and practice on hand hygiene, PPE, patient triage and waiting area modifications at the workplace. However, poor response was noted on the use of rubber dam, remote telephonic screening and four-handed dentistry practice.

Impact on Utilization and Shift in Treatment Needs Post-COVID Lockdown of Pediatric Dentistry in a Tertiary Care Hospital

Background: The COVID-19 pandemic has brought all treatments other than emergencies to a halt. Dental disease, being a multifactorial microbial disease, is capable of progressing to pulpits and its sequelae. The purpose of this study is to predict the impact of utilization of dental services and the progression of treatment needs in children during the lockdown and partial lockdown.

Methods: Outpatient department data from the year 2017–2019 from the Department of Pediatric and Preventive Dentistry, JSS Dental College was collected. A table of treatments provided was prepared. Utilization of services as care-seeking rates at 10, 25, and 50% were assumed and modeled corresponding to each stage of the lockdown using linear regression analysis. Dental caries progression was calculated as shifts in treatment needs from permanent restorations to temporary restorations, pulpectomies, or extraction, assuming a 10% progress to each sequela.

Results: The p-values for 10, 25, and 50% care-seeking rates were 0.021, <0.001, and <0.001, respectively.

Conclusion: The number and severity of cases were predicted to have increased. However, after removal of lockdown, it was noted that the number of patients seeking care was significantly less. The advancement in progression of dental disease further adds to the burden of society and caregivers.

Implementation of COVID-19 Infection Control Measures by German Dentists: A Qualitative Study to Identify Enablers and Barriers

OBJECTIVES

COVID-19 infection control measures have been recommended for dental practices worldwide. This qualitative study explored barriers and enablers for the implementation of these measures in German dental practices.

METHODS

Semi-structured phone interviews were conducted in November/December 2020 (purposive/snowball sampling). The Theoretical Domains Framework (TDF) and the Capabilities, Opportunities and Motivations influencing Behaviors model (COM-B) were used to guide interviews. Mayring's content analysis was employed to analyze interviews.

RESULTS

All dentists (28-71 years, 4/8 female/male) had implemented infection control measures. Measures most frequently not adopted were FFP2 masks, face shields (impractical), the rotation of teams (insufficient staffing) and the avoidance of aerosol-generating treatments. Dentists with personal COVID-19 experience or those seeing themselves as a role model were more eager to adopt measures. We identified 34 enablers and 20 barriers. Major barriers were the lack of knowledge, guidelines and recommendations as well as limited availability and high costs of equipment. Pressure by staff and patients to ensure infection control was an enabler.

CONCLUSIONS

Dentists are motivated to implement infection control measures, but lacking opportunities limited the adoption of certain measures. Policy makers and equipment manufacturers should address these points to increase the implementation of infection control measures against COVID-19 and potential future pandemics.

Switching to a Coronavirus Disease 2019 (COVID-19) Center: Lessons From Ariana Hospital Experience

After the translating of the worldwide pandemic coronavirus disease 2019 (COVID-19) disease from South East Asia to Europe, North African countries accelerate their steps to follow WHO guidelines to prepare the outbreak response. In March 2020, the Tunisian Ministry of Health switched Abderrahmen Mami Hospital to a COVID-19 center. The main objectives were management of patients but also setting-up new rules to permit enough safety for the staff members and harmony between medical, nonmedical, and administrative departments within the facility. Organization and communication during the fast-paced preparation process were crucial to get enough qualified human resources, material resources, and clear procedural texts in place before cases arrived in huge numbers. A group of medical and administrative experts within a central crisis unit brought this challenge into reality.