COVID-19 Pandemic Impact on US Childhood Caries and Potential Mitigation

Impact of Interrupting Oral Prevention on Dental Health of 7- to 8-Year-Old Children Due to COVID-19

Background/Objectives: In Marburg (Hesse, Germany), the selective intensive preventive program (SIP) with fluoride varnish applications had to be interrupted due to the COVID-19 pandemic. The aim of this retrospective anonymized evaluation was to investigate possible effects of SIP interruption on oral health in socially vulnerable 7- and 8-year-olds. Methods: The caries increment in 7- and 8-year-olds for the test group (N = 180) between last dental check-up before the interruption of SIP (02/2019-02/2020) and the first check-up after restart (01/2022-07/2022) were calculated from dental public health service data. The test group was compared to a control group of children (N = 215; same age and schools, with SIP, data collected between the school year 2017/18 and 2019/20). One dentist conducted the dental examinations. The University of Marburg ethics committee approved the study. The Mann-Whitney U test and Pearson's chi-square test were used for statistical analysis. Results: There was no significant difference in the caries increment in the first dentition between the test and the control group for both age groups. In the different groups, a maximum of 61% of the children with caries experience were completely treated. There was no significant difference between the test and control groups in either the percentage of sealed first permanent molars or the degree of restoration. Conclusions: The interruption of SIP had no negative impact on caries increment. It is possible that the children examined went through the pandemic without a significant increase in tooth decay because the children were well-trained in tooth brushing since kindergarten.

The Disproportionate Impact of the COVID-19 Pandemic on Preventive Dental Care and Treatment for Children Who Are American Indian: Public Health Surveillance Utilizing School-Based Sealant Program Data

OBJECTIVES

School-based dental sealant programs are important in expanding the reach of oral health care to underserved populations. However, data collection during these visits is also valuable for public health surveillance and program planning. This study aimed to utilize these data to identify groups disproportionately impacted by pandemic closures.

METHODS

SEAL!ND is a program in North Dakota that serves schools, where 45% or more of students are enrolled in the free and reduced-fee school lunch program. SEAL!ND provides dental screening, application of fluoride varnish and dental sealants, and oral health surveillance. Data are collected for evaluation and to track pediatric oral health. In the spring of 2020, the COVID-19 pandemic and subsequent public health emergency stalled the program and left these children without access to preventive dental services. We examined previous dental visits, untreated decay, treated decay, and early and urgent care need during the 2019-2020, 2020-2021, and 2021-2022 school years. Binomial and multinomial logistic regressions were conducted to examine the odds ratios of the oral health outcomes by race.

RESULTS

The proportion of poor outcomes had noticeably increased for American Indian students compared to White students. There was also increased odds of untreated decay, treated decay, and early and urgent care need for American Indian students compared to White students.

CONCLUSIONS

These findings aid in identifying groups of students whose oral health was disproportionately impacted by the disruption in community-based, preventive dental care services during the pandemic for the purpose of future intervention.

A step towards quantifying, modelling and exploring uncertainty in biomedical knowledge graphs

OBJECTIVE

This study aims at automatically quantifying and modelling the uncertainty of facts in biomedical knowledge graphs (BKGs) based on their textual supporting evidence using deep learning techniques.

MATERIALS AND METHODS

A sentence transformer is employed to extract deep features of sentences used to classify sentence factuality using a naive Bayes classifier. For each fact and its supporting evidence in a source KG, the deep feature extractor and the classifier are used to quantify the factuality of each sentence which are then transformed to numerical values in [0,1] before being averaged to get the confidence score of the fact.

RESULTS

The fact classification feature extractor enhances the separability of classes in the embedding space. This helped the fact classification model to achieve a better performance than existing factuality classification with hand-crafted features. Uncertainty quantification and modelling were demonstrated on SemMedDB by creating USemMedDB, showing KGB2U's ability to process large BKGs. A subset of USemMedDB facts is modelled to demonstrate the correlation between the structure of the uncertain BKG and the confidence scores. The best-trained model is used to predict confidence scores of existing and unseen facts. The top-ranked unseen facts were grounded using scientific evidence showing KGB2U's ability to discover new knowledge.

CONCLUSION

Supporting literature of BKG facts can be used to automatically quantify their uncertainty. Additionally, the resulting uncertain biomedical KGs can be used for knowledge discovery. BKG2U interface and source code are available at http://biofunk.datanets.org/ and https://github.com/BahajAdil/KBG2U respectively.

Second molar sealants among US adolescents and their association with select sociodemographic factors and first molar sealants: A cross-sectional study using National Health and Nutrition Examination Survey data

BACKGROUND

Caries is an important public health concern. Dental sealants are effective in preventing caries; however, their uptake is suboptimal and little is known about second molar (2M) sealants. The authors examined the prevalence of 2M sealants among US adolescents and investigated the factors associated with their presence.

METHODS

The authors conducted a cross-sectional analysis of 2011-2016 National Health and Nutrition Examination Survey data on adolescents aged 12 through 19 years with complete sealant data (n = 3,636). Race and ethnicity, income, and first molar (1M) sealant were primary variables of interest. The logistic regression models were used to estimate the factors associated with 2M sealants. All analyses used survey weights and accounted for complex survey design.

RESULTS

Only 34.6% of adolescents (95% CI, 31.2% to 38.0%) had 2M sealants. Approximately 89.0% of adolescents (95% CI, 86.1% to 92.0%) with 2M sealants and 19.6% (95% CI, 17.1% to 22.2%) without 2M sealants had 1M sealants. In the adjusted models, race and ethnicity were strongly associated with 2M sealant presence, but the association did not hold when 1M sealant was included in the model. 1M sealants were the most significant factor explaining the presence of 2M sealants (odds ratio, 0.03; 95% CI, 0.02 to 0.04).

CONCLUSIONS

Two of 3 adolescents lacked 2M sealants, with considerable disparities in their presence. To improve adolescent oral health, clinical and community programs should increase delivery of 2M sealants.

PRACTICAL IMPLICATIONS

Study findings highlight the need to evaluate adolescent sealant delivery programs to improve the uptake of 2M sealants.

Dental service utilization and the COVID-19 pandemic, a micro-data analysis

BACKGROUND

Global crises and disease pandemics, such as COVID-19, negatively affect dental care utilization by several factors, such as infection anxiety, disrupted supply chains, economic contraction, and household income reduction. Exploring the pattern of this effect can help policy makers to be prepared for future crises. The present study aimed to investigate the financial impact of COVID-19 disruptions on dental service utilization.

METHODS

Data on the number of dental services offered in Dental School Clinics of Tehran University of Medical Sciences was collected over a period of two years, before and after the initial COVID-19 outbreak in Iran. School of Dentistry operates two clinics; one with competitive service fees and one with subsidies. Regression analyses were performed to determine the effect of the pandemic on the number of dental services divided by dental treatment groups and these clinics. The analyses were adjusted for seasonal patterns and the capacity of the clinics.

RESULTS

There was a significant drop in dental services offered in both clinics across all dental groups in the post-COVID period (on average, 77 (39.44%) fewer services per day). The majority of the procedure loss happened in the Private clinic. Adjusting for seasonal patterns and the service capacity, regression results documented 54% and 12% service loss in Private and Subsidized clinics following the pandemic, respectively. Difference-in-difference analysis documented that the Subsidized clinic performed 40% more treatments than the Private clinic in the post-COVID period.

CONCLUSIONS

Pandemic -reduction in dental care utilization could have long-term ramifications for the oral health of the population, and policymakers need to provide supportive packages to the affected segments of the economy to reverse this trend.

Impact of the COVID-19 pandemic on oral health care use in the United States through December 2021

BACKGROUND

The purpose of this study was to assess the effects of the COVID-19 pandemic on oral health care provided from July 2020 through December 2021 using national claims data.

METHODS

Deidentified quarterly claims from 2017 through 2021 were analyzed (2017-2019 provided prepandemic data). Data were sorted into multiple treatment categories. Analyses compared prepandemic with postpandemic procedure volumes and were stratified according to age groups (0-5 years, 6-18 years, 19-64 years, ≥ 65 years).

RESULTS

For children aged 0 through 5 years, use of sealants and topical fluorides other than varnish were considerably lower in 2021, as were direct operative and palliative procedures from 2020 through 2021. Only use of silver diamine fluoride, prefabricated crowns, and oral surgery increased significantly (P < .05) in some quarters. For children aged 6 through 18 years, diagnostic, direct operative, periodontic, oral surgery, and palliative procedures were significantly lower in most of 2020 through 2021, and only prefabricated crowns and indirect operative procedures increased significantly in more than 3 quarters. For adults aged 19 through 64 years, diagnostic and preventive procedures were significantly lower in 3 quarters, and direct operative, gingival surgery, endodontic, and palliative procedures were significantly lower in most of 2020 through 2021. Only occlusal guards and scaling and root planing increased significantly in more than 3 quarters. For adults 65 years and older, direct operative, gingival and osseous surgery, and palliative procedures were significantly lower in more than 3 quarters; all other procedures increased significantly in more than 3 quarters.

CONCLUSIONS

The pandemic was associated with changes in the provision of oral health care that persisted for more than 1 year.

PRACTICAL IMPLICATIONS

Reductions in preventive procedure volumes across age groups younger than 65 years may have implications for longer-term effects of the pandemic.

COVID-19 Related Information on Pediatric Dental Care including the Use of Teledentistry: A Narrative Review

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people's health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned.