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Kwak GH, Baek SH, Kwak EJ. Effects of the COVID-19 pandemic on senior dental students in Korea: Examining stress, burnout, and depression. J Dent Sci 2024; 19:909-918. [PMID: 38618054 PMCID: PMC11011050 DOI: 10.1016/j.jds.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/27/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose The COVID-19 pandemic has had a profound and enduring impact on various aspects of society, including medical education and the training of dental students. The field of dentistry, given its nature, is particularly susceptible to the challenges posed by a pandemic. Prolonged exposure to the pandemic is believed to have increased stress and burnout among medical and dental students. This study aimed to investigate and analyze the relationship between COVID-19 and stress, burnout, and depression in Korean dental students. Materials and methods A cross-sectional survey was conducted among 162 third and fourth-grade students from the School of Dentistry at Seoul National University. The survey comprised four main sections: general information, the Maslach Burnout Inventory (MBI), the Patient Health Questionnaire-9 (PHQ-9), and the Impact of Event Scale-Revised (IES-R). Results The results indicated significant differences in age, study time, career satisfaction, and counseling needs between third and fourth-grade students. The fourth-grade students exhibited higher scores in the IES-R survey, PHQ-9 total score, emotional exhaustion, and depersonalization subscale items of the MBI. Furthermore, the group with abnormal responses to COVID-19 demonstrated lower levels of career satisfaction. Conclusion Fourth-grade dental students experienced higher levels of depression, vulnerability to the effects of COVID-19, and burnout. These findings highlight the need for addressing the mental health challenges faced by dental students during the COVID-19 pandemic.
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Affiliation(s)
- Gloria Hyunjung Kwak
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Seung-Ho Baek
- Department of Conservative Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Eun-Jung Kwak
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
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2
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Yang X, Liu R, Zhu J, Luo T, Zhan Y, Li C, Li Y, Yu H. Evaluating the microbial aerosol generated by dental instruments: addressing new challenges for oral healthcare in the hospital infection. BMC Oral Health 2023; 23:409. [PMID: 37344797 DOI: 10.1186/s12903-023-03109-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Using a rotary instrument or ultrasonic instrument for tooth preparation is a basic operation in the dental clinic that can produce a significant number of droplets and aerosols. The dental droplet and aerosol can lead to the transfer of harmful germs. The goal of this study was to analyze the properties of microbiological aerosol created by droplets and aerosol generated by three common tooth-preparation instruments. METHODS Streptococcus mutans UA159 was used as the biological tracer to visualize the droplets and aerosols. The passive sampling method was used to map the three-dimensional spatial distribution and the six-stage Andersen microbial sampler (AMS) was used as the active sampling method to catch aerosol particles at a specific time. RESULTS The aerosol concentration is related to instruments, three-dimensional spatial distribution, and dissipation time. Most aerosols were generated by air turbines. More microorganisms are concentrated at the 1.5 m plane. The majority of the post dental procedure contamination was detected within the 0-10-min period and it decreased rapidly within 30 min. CONCLUSION This study is conducive to the proposal and improvement of relevant infection control measures in dental procedures and provides a basis for the assessment of measures, reducing the risk of nosocomial infection.
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Affiliation(s)
- Xin Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd, Chengdu, 610041, Sichuan Province, China
| | - Ruolan Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd, Chengdu, 610041, Sichuan Province, China
| | - Jiakang Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd, Chengdu, 610041, Sichuan Province, China
| | - Tian Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd, Chengdu, 610041, Sichuan Province, China
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, 610065, Sichuan, China
| | - Chunyuan Li
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, 610065, Sichuan, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd, Chengdu, 610041, Sichuan Province, China.
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Coker MO, Subramanian G, Davidow A, Fredericks-Younger J, Gennaro ML, Fine DH, Feldman CA. Impact of DHCWs' Safety Perception on Vaccine Acceptance and Adoption of Risk Mitigation Strategies. JDR Clin Trans Res 2023; 8:188-197. [PMID: 35191352 PMCID: PMC10029133 DOI: 10.1177/23800844211071111] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To estimate the association between safety perception on vaccine acceptance and adoptions of risk mitigation strategies among dental health care workers (DHCWs). METHODS A survey was emailed to DHCWs in the New Jersey area from December 2020 to January 2021. Perceived safety from regular SARS-CoV-2 testing of self, coworkers, and patients and its association with vaccine hesitancy and risk mitigation were ascertained. Risk Mitigation Strategy (RiMS) scores were computed from groupings of office measures: 1) physical distancing (reduced occupancy, traffic flow, donning of masks, minimal room crowding), 2) personal protective equipment (fitted for N95; donning N95 masks; use of face shields; coverings for head, body, and feet), and 3) environmental disinfection (suction, air filtration, ultraviolet, surface wiping). RESULTS SARS-CoV-2 testing of dental professionals, coworkers, and patients were perceived to provide safety at 49%, 55%, and 68%, respectively. While dentists were least likely to feel safe with regular self-testing for SARS-CoV-2 (P < 0.001) as compared with hygienists and assistants, they were more willing than hygienists (P = 0.004; odds ratio, 1.79 [95% CI, 1.21 to 2.66]) and assistants (P < 0.001; odds ratio, 3.32 [95% CI, 1.93 to 5.71]) to receive the vaccine. RiMS scores ranged from 0 to 19 for 467 participants (mean [SD], 10.9 [2.9]). RiMS scores did not significantly differ among groups of DHCWs; however, mean RiMS scores were higher among those who received or planned to receive the COVID-19 vaccine than those with who did not (P = 0.004). DHCWs who felt safer with regular testing had greater RiMS scores than those who did not (11.0 vs. 10.3, P = 0.01). CONCLUSIONS Understanding DHCWs' perception of risk and safety is crucial, as it likely influences attitudes toward testing and implementation of office risk mitigation policies. Clinical studies that correlate risk perception and RiMS with SARS-CoV-2 testing are needed to demonstrate the effectiveness of RiMS in dental care settings. KNOWLEDGE TRANSFER STATEMENT Educators, clinicians, and policy makers can use the results of this study when improving attitudes toward testing and implementation of risk mitigation policies within dental offices, for current and future pandemics.
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Affiliation(s)
- M O Coker
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - G Subramanian
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - A Davidow
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - J Fredericks-Younger
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - M L Gennaro
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Public Health Research Institute and New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - D H Fine
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - C A Feldman
- Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
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Warmling CM, Spin-Neto R, Palma LZ, Silva-Junior MF, Castro RG, Finkler M, Baldani MH, Bitencourt FV. Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil. Int J Environ Res Public Health 2023; 20:1301. [PMID: 36674057 PMCID: PMC9859153 DOI: 10.3390/ijerph20021301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
The aim of this study was two-fold: (1) to describe the surveillance and biosafety measures adopted by dentists, dental hygienists, and dental assistants who worked in the Southern Region of Brazil and (2) to evaluate access to information in the context of the COVID-19 pandemic. This was a multicenter and cross-sectional design, using a self-applied and validated online questionnaire. The availability of health-care-related supplies and the adoption of biosafety measures recommended by the Technical Note of the National Health Surveillance Agency No. 04/2020 were analyzed. A total of 2560 Brazilian workers participated (75.8% dentists, 15.7% dental assistants and 8.5% dental hygienists), 52.7% from the public and 37.7% from the private sector. Approximately 70% of the individuals reported being away from work during the pandemic. The surveillance measures adopted with higher mean scores were the investigation of respiratory infection symptoms when scheduling appointments and the adoption of distancing in the waiting room. Of the biosafety measures to avoid aerosols, the procedures with lower compliance were those related to the use of intraoral radiographs and rubber dams. Moreover, the correct use of personal protective equipment at work seems to be related to self-perceived stress and anxiety. Worryingly, high access to information through non-governmental documents was observed. Permanent health education policies should reinforce safe practices and encourage workers to implement biosafety and surveillance measures in health services.
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Affiliation(s)
- Cristine Maria Warmling
- Graduate Program Teaching in Health, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, RS, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, 8000 Aarhus, Denmark
| | - Luciana Zambillo Palma
- Graduate Program Teaching in Health, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, RS, Brazil
| | | | - Renata Goulart Castro
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
| | - Mirelle Finkler
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
| | - Márcia Helena Baldani
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa 84010-330, PR, Brazil
| | - Fernando Valentim Bitencourt
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- Steno Diabetes Center Aarhus, 8200 Aarhus, Denmark
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5
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Durbin PM, Viana G, Allareddy V, Kusnoto B, Ravindran S, Kadkol S, Atsawasuwan P. COVID-19 infection rates and mitigation strategies in orthodontic practices. BMC Oral Health 2023; 23:8. [PMID: 36611143 PMCID: PMC9825002 DOI: 10.1186/s12903-022-02705-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND COVID-19 has impacted and increased risks for all populations, including orthodontic patients and providers. It also changes the practice management and infection control landscape in the practices. This study aimed to investigate the COVID-19 infection and vaccination status of orthodontic providers and mitigation approaches in orthodontic practices in the United States during 2021. METHODS A validated 50-question research electronic data capture (REDCap) browser-based questionnaire was distributed to 12,393 orthodontists and pediatric dentists who reported actively providing orthodontic treatment. Questions were designed to collect demographic data of respondents, evaluate the COVID-19 mitigation approaches, and evaluate the history of COVID-19 infection and vaccination status of the orthodontic providers. Associations of demographic and the COVID-19 mitigation approaches were assessed using chi-square tests at the significance level of 0.05. RESULTS Four hundred fifty-seven returned the survey (response rate 3.69%) for analysis. Most respondents were vaccinated, and increased infection control measures in response to the pandemic. Half of the respondents practiced teledentistry and switched to digital impression systems. Two-thirds reported difficulties in attaining PPEs due to the increased cost and scarcity of PPEs. About 6% of respondents reported a history of COVID-19 infection, and 68.9% of their staff had COVID-19 infection. Statistically significant associations were found between increased practice experience with difficulties in acquiring PPE (p = .010). There were no significant associations between races of respondents, geographic location, and years of practicing when cross-tabulated with vaccination status or COVID-19 infection rate (p > .05). CONCLUSION Increased infection control strategies were employed in almost all orthodontic practices in addition to existing universal precaution. Most of the orthodontic providers and their staff members were vaccinated. While staff's infection rates were an issue, doctors' infection rates remained low.
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Affiliation(s)
- Peter M Durbin
- grid.185648.60000 0001 2175 0319Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL United States of America
| | - Grace Viana
- grid.185648.60000 0001 2175 0319Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL United States of America
| | - Veerasathpurush Allareddy
- grid.185648.60000 0001 2175 0319Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL United States of America
| | - Budi Kusnoto
- grid.185648.60000 0001 2175 0319Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL United States of America
| | - Sriram Ravindran
- grid.185648.60000 0001 2175 0319Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL United States of America
| | - Shrihari Kadkol
- grid.185648.60000 0001 2175 0319Department of Pathology, College of Medicine, University of Illinois Chicago, Chicago, IL United States of America
| | - Phimon Atsawasuwan
- grid.185648.60000 0001 2175 0319Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL United States of America
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6
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Piela K, Watson P, Donnelly R, Goulding M, Henriquez FL, MacKay W, Culshaw S. Aerosol reduction efficacy of different intra-oral suction devices during ultrasonic scaling and high-speed handpiece use. BMC Oral Health 2022; 22:388. [PMID: 36068515 PMCID: PMC9447970 DOI: 10.1186/s12903-022-02386-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/28/2022] [Indexed: 12/01/2022] Open
Abstract
Background The COVID-19 pandemic led to significant changes in the provision of dental services, aimed at reducing the spread of respiratory pathogens through restrictions on aerosol generating procedures (AGPs). Evaluating the risk that AGPs pose in terms of SARS-CoV-2 transmission is complex, and measuring dental aerosols is challenging. To date, few studies focus on intra-oral suction. This study sought to assess the effectiveness of commonly used intra-oral suction devices on aerosol mitigation. Methods Ultrasonic scaling and high-speed handpiece procedures were undertaken to generate aerosol particles. Multiple particle sensors were positioned near the oral cavity. Sensor data were extracted using single board computers with custom in-house Bash code. Different high-volume and low-volume suction devices, both static and dynamic, were evaluated for their efficacy in preventing particle escape during procedures. Results In all AGPs the use of any suction device tested resulted in a significant reduction in particle counts compared with no suction. Low-volume and static suction devices showed spikes in particle count demonstrating moments where particles were able to escape from the oral cavity. High-volume dynamic suction devices, however, consistently reduced the particle count to background levels, appearing to eliminate particle escape. Conclusions Dynamic high-volume suction devices that follow the path of the aerosol generating device effectively eliminate aerosol particles escaping from the oral cavity, in contrast to static devices which allow periodic escape of aerosol particles. Measuring the risk of SARS-CoV-2 transmission in a dental setting is multi-factorial; however, these data suggest that the appropriate choice of suction equipment may further reduce the risk from AGPs. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02386-w.
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Affiliation(s)
- Krystyna Piela
- Oral Sciences, Glasgow Dental Hospital and School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G2 3JZ, UK
| | - Paddy Watson
- Oral Sciences, Glasgow Dental Hospital and School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G2 3JZ, UK
| | - Reuben Donnelly
- Oral Sciences, Glasgow Dental Hospital and School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G2 3JZ, UK
| | | | - Fiona L Henriquez
- School of Health and Life Sciences, University of the West of Scotland, Lanarkshire Campus, Blantyre, G72 0HL, UK
| | - William MacKay
- School of Health and Life Sciences, University of the West of Scotland, Lanarkshire Campus, Blantyre, G72 0HL, UK
| | - Shauna Culshaw
- Oral Sciences, Glasgow Dental Hospital and School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G2 3JZ, UK.
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7
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Atsawasuwan P, Del Campo DM, Del Campo LM, Viana G, Ravindran S, Allareddy V, Kadkol S. Positivity rates of SAR-CoV-2 infection in orthodontic patients at the orthodontic clinic, University of Illinois Chicago. PLoS One 2022; 17:e0270311. [PMID: 35737693 PMCID: PMC9223323 DOI: 10.1371/journal.pone.0270311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
COVID-19 has impacted and increased risks for healthcare providers, including orthodontists. There is no information regarding the potential transmission risks in the orthodontic community. This study aims to compare the positivity rate of SARS-CoV-2 infection in orthodontic patients at the University of Illinois Chicago (UIC) orthodontic clinic to the positivity rate of the local population in Chicago. All orthodontic patients who sought treatment at the UIC orthodontic clinic from June 16 to October 31, 2021, were invited to participate in the study. Three milliliters of saliva from the participants were collected in the sample collection tubes and subjected to a polymerase chain reaction (PCR) based assay to detect SAR-CoV-2. All participants’ age, sex, history of COVID-19 infection, and vaccination status were recorded. The COVID-19 positivity rates of Chicago, Cook County of Illinois, and the orthodontic clinic at UIC were compared. One thousand four hundred and thirty-seven orthodontic patients aged 6 to 70 years old (41.8% males and 58.2% females) participated in the study. Among all participants, nine participants tested positive for SARS-CoV-2 (5 males and 4 females). During the study, the average COVID-19 positivity rate at the UIC orthodontic clinic was 0.626%. All of the positive participants were asymptomatic, and two of the participants had a history of COVID-19 infection. Among all positive participants, three participants had received complete COVID-19 vaccination. An increased frequency of positive cases at the orthodontic clinic was observed during the time of high positivity rate in Chicago and Cook County. A potential risk of COVID-19 transmission from patients to orthodontic providers remains, even with asymptomatic and vaccinated patients.
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Affiliation(s)
- Phimon Atsawasuwan
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, United States of America
- * E-mail:
| | - Dhammacari Martin Del Campo
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Laura Martin Del Campo
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Grace Viana
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Sriram Ravindran
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Veerasathpurush Allareddy
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Shrihari Kadkol
- Department of Pathology, College of Medicine, University of Illinois Chicago, Chicago, Illinois, United States of America
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8
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Ahmadieh A, Dincer S, Navazesh M. Is saliva collected passively without forceful coughing sensitive to detect SARS-CoV-2 in ambulatory cases? A systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:530-538. [PMID: 35227640 PMCID: PMC8743389 DOI: 10.1016/j.oooo.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This systematic review was conducted to assess the sensitivity rate of SARS-CoV-2 detection in the saliva of ambulatory asymptomatic and mildly symptomatic patients, with saliva being collected passively without any forceful coughing. STUDY DESIGN A literature search was performed from January 2020 to July 2021. Prospective studies excluding letters to editors were included in our review only if saliva and nasopharyngeal samples were collected simultaneously and sensitivity was reported using reverse transcription polymerase chain reaction (RT-PCR) in asymptomatic or mildly symptomatic ambulatory cases. RESULTS A total of 436 studies were assessed; 10 (4 cohorts and 6 cross-sectional) studies met our inclusion criteria. The sensitivity rate of saliva to detect SARS-CoV-2 varied from 85.7% to 98.6% in all except for 3 studies. Lower sensitivity levels were attributed to low viral load (51.9% and 63.8%) or lack of supervision while collecting saliva (66.7%). CONCLUSIONS Passively collected saliva in the absence of coughing has a high sensitivity rate to detect SARS-CoV-2 in asymptomatic and mildly symptomatic patients compared with nasopharyngeal swabs. Limitations of previous studies, such as lack of attention to the method of saliva collection, stages, and severity of the disease at the time of sample collection, can be researched in future investigations.
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Affiliation(s)
- Azadeh Ahmadieh
- Clinical Assistant Professor of Dentistry, Division of Biomedical Sciences, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA.,Corresponding author
| | - Sibel Dincer
- Clinical Assistant Professor of Dentistry, Division of Biomedical Sciences, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA
| | - Mahvash Navazesh
- Executive Associate Dean for Academic, Faculty & Student Affairs, Division of Periodontology, Diagnostic Sciences & Dental Hygiene, Professor of Diagnostic Sciences, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA
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9
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Kakkar M, Barmak AB, Gajendra S. Evaluation of fear, anxiety, and knowledge among dental providers during the COVID 19 pandemic. J Dent Sci 2022; 17:1648-1655. [PMID: 35382432 PMCID: PMC8970412 DOI: 10.1016/j.jds.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/15/2022] [Indexed: 01/08/2023] Open
Abstract
Background/purpose COVID-19 has caused a global public health crisis with a major impact on the dental community. The unknown nature of the disease, close and prolonged contact between the patient and provider, aerosol-generating dental procedures in dental settings, guidelines that kept evolving are some of the factors that have alarmed the dental community. The purpose of this study was to evaluate the fear/anxiety among dental providers and assess the knowledge and related practice modification in a post-doctoral dental institution in Upstate New York. Materials and methods An online, anonymous, validated survey was sent to all dental faculty and trainees (n = 358) including general dentists and specialists from various departments between August and October 2020. Descriptive statistics and Chi-square goodness-of-fit test were performed. Results A total of 144 responded to the survey. It was reported that the majority of the dental providers (faculty (80%) and trainees (90%)) were afraid of getting infected with COVID-19 from the patient. Approximately 90% in both groups reported fear of carrying the infection home to their family and about reports of people dying. The majority of dental providers were well-versed with the Centers for Disease Control and Prevention guidelines. There was difference in knowledge about using N-95 and level 3 masks with face shields for various dental procedures. Conclusion The study concluded that COVID-19 related fear/anxiety among dental providers was immediate and needed to be addressed.
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Affiliation(s)
- Mayank Kakkar
- Department of General Dentistry, Eastman Institute for Oral Health, Rochester, NY, USA
| | - Abdul Basir Barmak
- Department of Dentistry Eastman Institute for Oral Health, Rochester, NY, USA
| | - Sangeeta Gajendra
- Department of Community Dentistry, Eastman Institute for Oral Health, Rochester, NY, USA
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10
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Wemyss C, Hobson S, Sweeney J, Chua PR, Binti Mohd Khairi SA, Edwards M, Burns J, McGoldrick N, Braid R, Gorman M, Redmond S, Clark C, Brown C, Watling C, Conway DI, Culshaw S. Improving participation and engagement with a COVID-19 surveillance programme in an outpatient setting. BMJ Open Qual 2022; 11:bmjoq-2021-001700. [PMID: 35347067 PMCID: PMC8960458 DOI: 10.1136/bmjoq-2021-001700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background On 3 August 2020, Public Health Scotland commenced a prospective surveillance study to monitor the prevalence of COVID-19 among asymptomatic outpatients attending dental clinics across 14 health boards in Scotland. Objectives The primary aim of this quality improvement project was to increase the number of COVID-19 tests carried out in one of the participating sites, Glasgow Dental Hospital and School. The secondary aim was to identify barriers to patient participation and staff engagement when implementing a public health initiative in an outpatient setting. Method A quality improvement working group met weekly to discuss hospital findings, identify drivers and change ideas. Details on reasons for patient non-participation were recorded and questionnaires on project barriers were distributed to staff. In response to findings, rapid interventions were implemented to fast-track increases in the numbers of tests being carried out. Results Over 16 weeks, 972 tests were carried out by Glasgow Dental Hospital and School Secondary Care Services. The number of tests per week increased from 19 (week 1) to 129 (week 16). This compares to a similar ‘control’ site, where the number of tests carried out remained unchanged; 38 (week 1) to 36 (week 16). The most frequent reason given for non-participation was fear that the swab would hurt. For staff, lack of time and forgetting to ask patients were identified as the most significant barriers. Conclusion Public health surveillance programmes can be integrated rapidly into outpatient settings. This project has shown that a quality improvement approach can be successful in integrating such programmes. The key interventions used were staff engagement initiatives and front-line data collection. Implementation barriers were also identified using staff questionnaires.
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Affiliation(s)
- Callum Wemyss
- Department of Oral Surgery, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Simon Hobson
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jill Sweeney
- Department of Paediatric Dentistry, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Pei Rong Chua
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Siti Aishah Binti Mohd Khairi
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Maura Edwards
- Department of Public Health, NHS Ayrshire and Arran, Ayr, South Ayrshire, UK
| | | | | | | | | | | | | | - Clare Brown
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - David I Conway
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Public Health Scotland, Glasgow, UK
| | - Shauna Culshaw
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Public Health Scotland, Glasgow, UK
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11
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Dudding T, Sheikh S, Gregson F, Haworth J, Haworth S, Main BG, Shrimpton AJ, Hamilton FW, Ireland AJ, Maskell NA, Reid JP, Bzdek BR, Gormley M. A clinical observational analysis of aerosol emissions from dental procedures. PLoS One 2022; 17:e0265076. [PMID: 35271682 PMCID: PMC8912243 DOI: 10.1371/journal.pone.0265076] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/22/2022] [Indexed: 12/27/2022] Open
Abstract
Aerosol generating procedures (AGPs) are defined as any procedure releasing airborne particles <5 μm in size from the respiratory tract. There remains uncertainty about which dental procedures constitute AGPs. We quantified the aerosol number concentration generated during a range of periodontal, oral surgery and orthodontic procedures using an aerodynamic particle sizer, which measures aerosol number concentrations and size distribution across the 0.5-20 μm diameter size range. Measurements were conducted in an environment with a sufficiently low background to detect a patient's cough, enabling confident identification of aerosol. Phantom head control experiments for each procedure were performed under the same conditions as a comparison. Where aerosol was detected during a patient procedure, we assessed whether the size distribution could be explained by the non-salivary contaminated instrument source in the respective phantom head control procedure using a two-sided unpaired t-test (comparing the mode widths (log(σ)) and peak positions (DP,C)). The aerosol size distribution provided a robust fingerprint of aerosol emission from a source. 41 patients underwent fifteen different dental procedures. For nine procedures, no aerosol was detected above background. Where aerosol was detected, the percentage of procedure time that aerosol was observed above background ranged from 12.7% for ultrasonic scaling, to 42.9% for 3-in-1 air + water syringe. For ultrasonic scaling, 3-in-1 syringe use and surgical drilling, the aerosol size distribution matched the non-salivary contaminated instrument source, with no unexplained aerosol. High and slow speed drilling produced aerosol from patient procedures with different size distributions to those measured from the phantom head controls (mode widths log(σ)) and peaks (DP,C, p< 0.002) and, therefore, may pose a greater risk of salivary contamination. This study provides evidence for sources of aerosol generation during common dental procedures, enabling more informed evaluation of risk and appropriate mitigation strategies.
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Affiliation(s)
- Tom Dudding
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Bristol Dental Hospital and School, University of Bristol, Bristol, United Kingdom
| | - Sadiyah Sheikh
- Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Florence Gregson
- Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Jennifer Haworth
- Bristol Dental Hospital and School, University of Bristol, Bristol, United Kingdom
- Royal United Hospital Bath, Combe Park, Bath, United Kingdom
| | - Simon Haworth
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Bristol Dental Hospital and School, University of Bristol, Bristol, United Kingdom
| | - Barry G. Main
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Bristol Dental Hospital and School, University of Bristol, Bristol, United Kingdom
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - Andrew J. Shrimpton
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Fergus W. Hamilton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Infection Sciences, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | | | - Anthony J. Ireland
- Bristol Dental Hospital and School, University of Bristol, Bristol, United Kingdom
- Royal United Hospital Bath, Combe Park, Bath, United Kingdom
| | - Nick A. Maskell
- Academic Respiratory Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - Jonathan P. Reid
- Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Bryan R. Bzdek
- Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Mark Gormley
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Bristol Dental Hospital and School, University of Bristol, Bristol, United Kingdom
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12
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Mikkola MK, Gästgifvars JJ, Helenius-Hietala JS, Uittamo JT, Furuholm JO, Välimaa H, Ruokonen HMA, Nylund KM. Triage and urgent dental care for COVID-19 patients in the Hospital District of Helsinki and Uusimaa. Acta Odontol Scand 2022; 80:433-440. [PMID: 35100516 DOI: 10.1080/00016357.2022.2032328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This paper describes and reports the patient-specific characteristics of an urgent dental care clinic for COVID-19 infected, suspected, exposed or quarantined patients from March to December 2020 in the Hospital District of Helsinki and Uusimaa, Finland. MATERIAL AND METHODS The triage and the treatment protocol were established based on the scientific data. Patient files were evaluated from the hospital district's electronic medical record system. IBM SPSS software was used for statistical analysis. RESULTS There were 1114 consultations and 257 visits at the clinic. Most of the patients were generally healthy with mean age of 35, had toothache and were suspected to be SARS-CoV-2 positive. Seventeen of the patients received positive tests for COVID-19 infection. The main treatment was tooth extraction, mostly due to caries. Statistically significant differences between COVID-19 infected and other patients occurred in age (45 vs 34 years-of-age, p = .009) and number of teeth (25 vs 28, p = .031). No SARS-CoV-2 infection transmission chains were traced to the clinic. CONCLUSION During the challenging pandemic time, patients were carefully screened by specialists in clinical dentistry and treated safely and effectively. Patient-specific characteristics revealed no differences between COVID-19 infected and other patients in terms of symptoms or treatment needs.
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Affiliation(s)
- Maria Kaarina Mikkola
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jenny Johanna Gästgifvars
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Sisko Helenius-Hietala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johanna Tuulikki Uittamo
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jussi Oskari Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannamari Välimaa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Virology, University of Helsinki, Helsinki, Finland
| | - Hellevi Merja A. Ruokonen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Karita Maaria Nylund
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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13
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Ortega KL, Braz-Silva PH. Letter to the Editor: "Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols". J Dent Res 2021; 101:235. [PMID: 34928741 DOI: 10.1177/00220345211039484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- K L Ortega
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - P H Braz-Silva
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Laboratory of Virology, Institute of Tropical Medicine of São Paulo, School of Medicine, University of São Paulo, São Paulo, Brazil
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14
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Natapov L, Schwartz D, Herman HD, Markovich DD, Yellon D, Jarallah M, Liphshiz I, Carmeli Y, Karakis I. Risk of SARS-CoV-2 transmission following exposure during dental treatment - A national cohort study. J Dent 2021; 113:103791. [PMID: 34455018 PMCID: PMC8388145 DOI: 10.1016/j.jdent.2021.103791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/28/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Health care workers are at an increased risk of SARS - CoV-2 transmission. The risk of infection for dental teams is assumed to be high, due to work settings, proximity to mouth, exposure to saliva and aerosols. There is a lack of evidence that quantifies the risk of SARS-CoV-2 transmission for dental patients and staff. Our objective was to assess SARS-CoV-2 transmission risk for dental staff members (DSMs) and patients following exposure in dental clinics during the second wave of the pandemic in Israel. METHODS The study analyzed new positive SARS-CoV-2 cases following exposures in dental clinics from May to September 2020. Two data sources were used: case report forms (CRFs) and epidemiological investigations. CRFs were developed by the MoH and distributed to dental clinics to identify DSMs exposed to SARS-CoV-2 positive patients, and patients exposed to positive DSMs. SARS-CoV-2 status was diagnosed using MoH approved tests in certified laboratories and verified against the national COVID-19 database. Statistical analysis on a non-identified basis was performed. The population incidence and dental setting transmission rates were calculated for the study period with 95% Confidence Intervals. RESULTS Following 962 reported exposures of DSMs to 508 SARS-CoV-2 positive patients, 7 DSMs were SARS - CoV-2 positive with a 0.7% cumulative transmission rate. Following 507 reported exposures by 43 SARS-CoV-2 positive DSMs, 3 patients were SARS - CoV-2 positive, with a 0.6% cumulative transmission rate. During the study period, the SARS-CoV-2 incidence rate in dental clinics was significantly lower when compared to the population. CONCLUSIONS The transmission rate of SARS-CoV-2 in dental settings was very low for both patients and DSMs. CLINICAL SIGNIFICANCE Our results suggest that routine dental care could be safely provided during the pandemic. Continuous monitoring should be performed due to the emergence of new variants and the vaccination programs.
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Affiliation(s)
- Lena Natapov
- Dental Health Division, Ministry of Health, Israel
| | | | | | | | - David Yellon
- Dental Health Division, Ministry of Health, Israel
| | | | | | - Yehuda Carmeli
- Division of Epidemiology and the National Institute for Infection Control and Antibiotic Resistance, Tel Aviv Sourasky Medical Center, Israel
| | - Isabella Karakis
- Faculty of Health Science, Ben-Gurion University, Beer Sheva, Israel; Department of Environmental Epidemiology, Ministry of Health, Israel
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15
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Shields A, Faustini S, Kristunas C, Cook A, Backhouse C, Dunbar L, Ebanks D, Emmanuel B, Crouch E, Kröger A, Hirschfeld J, Sharma P, Jaffery R, Nowak S, Gee S, Drayson M, Richter A, Dietrich T, Chapple I. COVID-19: Seroprevalence and Vaccine Responses in UK Dental Care Professionals. J Dent Res 2021; 100:1220-1227. [PMID: 34077690 PMCID: PMC8461044 DOI: 10.1177/00220345211020270] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Dental care professionals (DCPs) are thought to be at enhanced risk of occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, robust data to support this from large-scale seroepidemiological studies are lacking. We report a longitudinal seroprevalence analysis of antibodies to SARS-CoV-2 spike glycoprotein, with baseline sampling prior to large-scale practice reopening in July 2020 and follow-up postimplementation of new public health guidance on infection prevention control (IPC) and enhanced personal protective equipment (PPE). In total, 1,507 West Midlands DCPs were recruited into this study in June 2020. Baseline seroprevalence was determined using a combined IgGAM enzyme-linked immunosorbent assay and the cohort followed longitudinally for 6 mo until January/February 2021 through the second wave of the coronavirus disease 2019 pandemic in the United Kingdom and vaccination commencement. Baseline seroprevalence was 16.3%, compared to estimates in the regional population of 6% to 7%. Seropositivity was retained in over 70% of participants at 3- and 6-mo follow-up and conferred a 75% reduced risk of infection. Nonwhite ethnicity and living in areas of greater deprivation were associated with increased baseline seroprevalence. During follow-up, no polymerase chain reaction-proven infections occurred in individuals with a baseline anti-SARS-CoV-2 IgG level greater than 147.6 IU/ml with respect to the World Health Organization international standard 20-136. After vaccination, antibody responses were more rapid and of higher magnitude in those individuals who were seropositive at baseline. Natural infection with SARS-CoV-2 prior to enhanced PPE was significantly higher in DCPs than the regional population. Natural infection leads to a serological response that remains detectable in over 70% of individuals 6 mo after initial sampling and 9 mo from the peak of the first wave of the pandemic. This response is associated with protection from future infection. Even if serological responses wane, a single dose of the Pfizer-BioNTech 162b vaccine is associated with an antibody response indicative of immunological memory.
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Affiliation(s)
- A.M. Shields
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - S.E. Faustini
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - C.A. Kristunas
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - A.M. Cook
- The Binding Site Group Ltd, Birmingham, UK
| | - C. Backhouse
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - L. Dunbar
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - D. Ebanks
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - B. Emmanuel
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - E. Crouch
- Birmingham Local Dental Committee, Birmingham, UK
| | - A. Kröger
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
- Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK
| | - J. Hirschfeld
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
- Periodontal Research Group, University of Birmingham, Birmingham, UK
| | - P. Sharma
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
- Periodontal Research Group, University of Birmingham, Birmingham, UK
| | - R. Jaffery
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - S. Nowak
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - S. Gee
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - M.T. Drayson
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - A.G. Richter
- Clinical Immunology Service, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - T. Dietrich
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
- Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK
| | - I.L.C. Chapple
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
- Periodontal Research Group, University of Birmingham, Birmingham, UK
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16
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Persoon IF, Volgenant CMC, van der Veen MH, Opdam NJM, Manton DJ, Bruers JJM. Impact of the Coronavirus on Providing Oral Health Care in the Netherlands. Int Dent J 2021; 72:545-551. [PMID: 34706826 PMCID: PMC8452527 DOI: 10.1016/j.identj.2021.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Transmission of SARS-CoV-2 during oral health care is potentially increased compared to regular social activities. Specific amendments to the Dutch national infection control guidelines were promulgated. This study aimed to map the impact of the coronavirus pandemic on providing oral health care during the first wave of the coronavirus pandemic in 2020 in the Netherlands. METHODS A cross-sectional web-based survey was sent via email to a representative sample of dental hygienists and dentists in the Netherlands. RESULTS Of the 1700 oral health care practitioners approached, 440 (25.9%) responded to the survey. Patient access to oral health care was severely restricted during the lockdown in the spring of 2020. A total of 1.6% of the oral health care practitioners had laboratory-confirmed COVID-19 during the study period, although this is likely to be an underrepresentation due to limited access to testing at that time. Over half of the participants perceived an increased risk of virus transmission during aerosol-generating treatments in their practices. A large majority (65.0%-87.1%) of the oral health care practitioners followed the COVID-19-specific amendments to the national infection control guidelines. Compared to the pre-pandemic period, additional personal protective equipment and protocols were applied. Factors related with compliance with the additional recommendations were age, employment status, and occupation. CONCLUSIONS The pandemic had a profound impact on both the accessibility and practice of oral health care. This survey study found that most Dutch oral health care practitioners paid extra attention to hygiene and infection control. Also, a low number of COVID-19 infections detected amongst Dutch oral health care practitioners was reported in the Netherlands. These overall outcomes suggest that safe oral health care can be provided when following the current infection control recommendations.
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Affiliation(s)
- Ilona F Persoon
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Catherine M C Volgenant
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Monique H van der Veen
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Oral Hygiene, InHolland University of Applied Sciences, Amsterdam, the Netherlands
| | - Niek J M Opdam
- Department of Dentistry, Radboud UMC, Nijmegen, The Netherlands
| | - David J Manton
- Cariology and Paediatric Dentistry, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
| | - Josef J M Bruers
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Royal Dutch Dental Association (KNMT), Utrecht, The Netherlands
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17
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Carvalho JC, Declerck D, Jacquet W, Bottenberg P. Dentist Related Factors Associated with Implementation of COVID-19 Protective Measures: A National Survey. Int J Environ Res Public Health 2021; 18:ijerph18168381. [PMID: 34444131 PMCID: PMC8391182 DOI: 10.3390/ijerph18168381] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022]
Abstract
Little is known about the extent to which dentists have implemented COVID-19 infection control guidelines and the factors influencing this process in daily practice. This national online survey assessed the implementation of enhanced infection control guidelines in daily practice, and explored dentist related factors influencing their application, more specifically dentist infection status and their perceived risk of cross-infection in the dental setting. The survey was validated, pretested and carried out in 2020. A total of 1436 dentists participated, of whom 9.1% presumably had COVID-19 infection experience. At least 75% of dentists complied with the core part of the recommended protective measures protocol. For each patient treated during the pandemic, an additional cost of 10–30 EUR (86.7%) and an extra time of 10–30 min (70.7%) was estimated. A stepwise binary logistic regression analysis revealed that dentists assumed to have experienced COVID-19 reported a higher self-perceived risk of virus acquisition (β = 2.090; p = 0.011), lower concern of getting infected (β = 0.576; p = 0.027), and lower confidence in being able to prevent disease transmission in the dental setting (β = 0.535; p = 0.022). Some parts of the protective measures were more difficult to apply than others; however, there was no indication of increased disease acquisition in the dental setting.
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Affiliation(s)
- Joana Christina Carvalho
- Faculty of Medicine and Dentistry, UCLouvain, 1200 Brussels, Belgium
- Correspondence: ; Tel.: +32-475-626-927
| | - Dominique Declerck
- Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, 3000 Leuven, Belgium;
| | - Wolfgang Jacquet
- Oral Health Research Cluster, Faculty of Medicine and Pharmacy, VUB, 1090 Brussels, Belgium; (W.J.); (P.B.)
| | - Peter Bottenberg
- Oral Health Research Cluster, Faculty of Medicine and Pharmacy, VUB, 1090 Brussels, Belgium; (W.J.); (P.B.)
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18
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Farshidfar N, Jafarpour D, Hamedani S, Dziedzic A, Tanasiewicz M. Proposal for Tier-Based Resumption of Dental Practice Determined by COVID-19 Rate, Testing and COVID-19 Vaccination: A Narrative Perspective. J Clin Med 2021; 10:2116. [PMID: 34068858 PMCID: PMC8153624 DOI: 10.3390/jcm10102116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 12/23/2022] Open
Abstract
Since the emergence of the new coronavirus disease (COVID-19), profound alterations in general and specialist dental practice have been imposed to provide safe dental care. The guidelines introduced in response to the COVID-19 pandemic to mitigate healthcare disruption are inconsistent regarding the dental practice re-installation, particularly during a transitional time. Despite the successful mass vaccination campaigns rolled out in 2021, the presence of more than 80 genotypes of COVID-19, rapid neutralisation of antibodies within a short period of seropositivity, and the likelihood of recurrent infection raise some doubts on whether vaccination alone will provide long-term immunity against COVID-19 and its variants. Here, from this perspective, we aim to provide an initial proposal for dental services reinstallation, easily applicable in various care settings. We discuss the potential options for the transition of dental services, as well as challenges and opportunities to adapt to new circumstances after mass COVID-19 vaccination. The proposal of the universal three-tier system of dental services resumption, determined by regional COVID-19 rates, testing accessibility, and vaccination rollout has been presented. Following herd COVID-19 immunity enhancement, it would be prudent to confer various preventative measures until virus spread naturally diminishes or becomes less virulent. Based on modelling data, dental practices may not return to normal, routine operation even after global vaccination as there would still be a significant risk of outbreaks of infection. Variable, multi-level measures will still be required, depending on the local COVID-19 cases rate, to secure safe dental care provision, despite predicted success of vaccination agendas. This approach can be implemented by achievable, practical means as a part of risk assessment, altered work pattern, and re-arrange of dental surgery facilities. The adequate standard operating procedure, with the support of rapid point-of-care testing at workplace, would vastly intensify the uninterrupted recovery of the dental care sector.
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Affiliation(s)
- Nima Farshidfar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Dana Jafarpour
- Faculty of Dentistry, McGill University, Montreal, QC H3A 1G1, Canada;
| | - Shahram Hamedani
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz 71956-15878, Iran;
| | - Arkadiusz Dziedzic
- Department of Restorative Dentistry with Endodontics, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Marta Tanasiewicz
- Department of Restorative Dentistry with Endodontics, Medical University of Silesia, 40-055 Katowice, Poland;
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19
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Shirazi S, Stanford CM, Cooper LF. Testing for COVID-19 in dental offices: Mechanism of action, application, and interpretation of laboratory and point-of-care screening tests. J Am Dent Assoc 2021; 152:514-525.e8. [PMID: 34176567 PMCID: PMC8096195 DOI: 10.1016/j.adaj.2021.04.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/07/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The dental office potentially possesses all transmission risk factors for severe acute respiratory syndrome coronavirus 2. Anticipating the future widespread use of COVID-19 testing in dental offices, the authors wrote this article as a proactive effort to provide dental health care providers with current and necessary information surrounding the topic. METHODS The authors consulted all relevant and current guidelines from the Centers for Disease Control and Prevention and the US Food and Drug Administration, as well as online resources and review articles. RESULTS Routine COVID-19 screening and triage protocols are unable to detect all infected people. With the advancements in diagnostic tools and techniques, COVID-19 testing at home or in the dental office may provide dentists with the ability to evaluate the disease status of their patients. At-home or point-of-care (POC) tests, providing results within minutes of being administered, would allow for appropriate measures and rapid decisions about dental patients' care process. In this review, the authors provide information about available laboratory and POC COVID-19 screening methods and identify and elaborate on the options available for use by dentists as well as the regulatory requirements of test administration. CONCLUSIONS Dentists need to be familiar with COVID-19 POC testing options. In addition to contributing to public health, such tests may deliver rapid, accurate, and actionable results to clinical and infection control teams to enhance the safe patient flow in dental practices. PRACTICAL IMPLICATIONS Oral health care must continue to offer safety in this or any future pandemics. Testing for severe acute respiratory syndrome coronavirus 2 at the POC offers a control mechanism contributing to and enhancing the real and perceived safety of care in the dental office setting.
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