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Schwarz KM, Nienhaus A, Diel R. Risk of SARS-CoV-2 infection in dental healthcare workers - a systematic review and meta-analysis. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc09. [PMID: 38655123 PMCID: PMC11035909 DOI: 10.3205/dgkh000464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Mounting evidence supports an association between the use of personal protective equipment (PPE) and the risk of infection from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in dental healthcare workers (DCW). However, the prevalence and incidence of SARS-CoV-2 infections in the setting of dental care remains poorly characterized. Methods A systematic review and meta-analysis of studies published prior to Mai 2023 providing epidemiological data for the occurrence of SARS-CoV-2 in DCW was performed. A random-effects model was used to calculate pooled estimates and odds ratios (ORs) with corresponding 95% confidence intervals (CIs). The associated factors were narratively evaluated. Risk of bias was assessed using the Joanna Briggs Institute tool for prevalence studies. Results Twenty-nine eligible studies were identified including a total of 85,274 DCW at risk; 27 studies met the criteria for the meta-analysis. Among the included DCW, the overall prevalence of SARS-CoV-2 was 11.8% (13,155/85,274; 95%CI, 7.5%-17%), whereby the degree of heterogeneity between the studies was considerable (I2=99.7%). The pooled prevalence rate for dentists and dental hygienists alone was 12.7% (1943/20,860; 95%CI, 8.0%-18.0%), showing significantly increased odds of contracting a SARS-CoV-2 infection compared to dental assistant personnel, the prevalence rate for which was less than half, at 5.2% (613/15,066; OR=2.42; 95% CI, 2.2-2.7). In the subgroup of 17 studies from countries with high income there was a significantly lower prevalence rate of 7.3% (95% CI, 5%-10%) in DCW compared to the prevalence rate in low- and middle-income countries, which came to 20.8% (95% CI, 14%-29%; p<0.001). In 19 out of the 29 studies (65.5%), specific information on the use of and adherence to PPE was absent while in the reports with concrete figures the wearing of N95 (or at least surgical masks) by DCW appeared to be associated with lower SARS-CoV-2 prevalence rates. Conclusions DCW were, depending in each case on their proximity to patients, at particular risk of SARS-CoV-2 infection during the COVID-19 pandemic. Until a significant level of vaccination protection against newer SARS-CoV-2 variants can be built up in the population, dental healthcare facilities should further maintain their focus on using PPE according to current guidelines.
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Affiliation(s)
- Kira Marie Schwarz
- Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Albert Nienhaus
- Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany
| | - Roland Diel
- Institute for Epidemiology, University Medical Hospital, Schleswig-Holstein, Kiel, Germany
- LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
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2
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Bonn EL, Rohrhofer A, Audebert FX, Lang H, Auer DL, Scholz KJ, Schuster P, Wenzel JJ, Hiller KA, Buchalla W, Gottsauner JM, Vielsmeier V, Schmidt B, Cieplik F. Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2-Positive Patients: A Randomized Controlled Clinical Trial. J Dent Res 2023; 102:608-615. [PMID: 36942423 PMCID: PMC10030878 DOI: 10.1177/00220345231156415] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Soon after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, preprocedural mouthwashes were recommended for temporarily reducing intraoral viral load and infectivity of individuals potentially infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to protect medical personnel. Particularly, the antiseptic cetylpyridinium chloride (CPC) has shown virucidal effects against SARS-CoV-2 in vitro. Therefore, the aim of this randomized controlled clinical trial was to investigate the efficacy of a commercially available mouthwash containing CPC and chlorhexidine digluconate (CHX) at 0.05% each in SARS-CoV-2-positive patients as compared to a placebo mouthwash. Sixty-one patients who tested positive for SARS-CoV-2 with onset of symptoms within the last 72 h were included in this study. Oropharyngeal specimens were taken at baseline, whereupon patients had to gargle mouth and throat with 20 mL test or placebo (0.9% NaCl) mouthwash for 60 s. After 30 min, further oropharyngeal specimens were collected. Viral load was analyzed by quantitative reverse transcriptase polymerase chain reaction, and infectivity of oropharyngeal specimens was analyzed by virus rescue in cell culture and quantified via determination of tissue culture infectious doses 50% (TCID50). Data were analyzed nonparametrically (α = 0.05). Viral load slightly but significantly decreased upon gargling in the test group (P = 0.0435) but not in the placebo group. Viral infectivity as measured by TCID50 also significantly decreased in the test group (P = 0.0313), whereas there was no significant effect but a trend in the placebo group. Furthermore, it was found that the specimens from patients with a vaccine booster exhibited significantly lower infectivity at baseline as compared to those without vaccine booster (P = 0.0231). This study indicates that a preprocedural mouthwash containing CPC and CHX could slightly but significantly reduce the viral load and infectivity in SARS-CoV-2-positive patients. Further studies are needed to corroborate these results and investigate whether the observed reductions in viral load and infectivity could translate into clinically useful effects in reducing COVID-19 transmission (German Clinical Trials Register DRKS00027812).
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Affiliation(s)
- E L Bonn
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - A Rohrhofer
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - F X Audebert
- Praxiszentrum Alte Mälzerei, Regensburg, Germany
| | - H Lang
- Praxiszentrum Alte Mälzerei, Regensburg, Germany
| | - D L Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - K J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - P Schuster
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - J J Wenzel
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - K-A Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - W Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - J M Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - V Vielsmeier
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - B Schmidt
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - F Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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3
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Fredriksson L, Cederlund A, Murray M, Jansson L, Skott P. Prevalence of ongoing or previous SARS-CoV-2 infection among dental personnel - the Swedish experience. Acta Odontol Scand 2023; 81:119-123. [PMID: 35771959 DOI: 10.1080/00016357.2022.2095023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
CONCLUSIONS The seroprevalence of SARS-CoV-2 infection was approximately similar to that in healthcare personnel, and approximately equal compared to that in the general population. MATERIALS AND METHODS We carried out an observational cohort study from March to June 2020, including 341 employees randomly selected from Public Dental Service in the County of Stockholm. The primary outcome variable was the prevalence of SARS-CoV-2 RNA and/or antibodies against SARS-CoV-2. Throat samples were analysed for SARS-CoV-2 RNA. Venous blood was collected to detect antibodies against SARS-CoV-2 using the Luminex analysis tool (immunoassay) and ELISA. Logistic regression analysis was used to compare the independent groups and calculate the unadjusted odds ratio. OBJECTIVE To investigate whether personnel in a public dental clinic had a higher frequency of ongoing or previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than hospital healthcare workers or the general public in Stockholm during weeks 23-25 in 2020. RESULTS The mean age of the participants was 50.1 years, and 11.7% were male. The prevalence of SARS-CoV-2 RNA and/or antibodies against SARS-CoV-2 was 12.0% (95% confidence interval 8.8-16.0). Among them, 82.5% reported symptoms and 85.4% were on sick-leave between March and June 2020.
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Affiliation(s)
- Lars Fredriksson
- Folktandvården Stockholm, Public Dental Services, Stockholm County Council, Stockholm, Sweden
| | - Andreas Cederlund
- Folktandvården Stockholm, Public Dental Services, Stockholm County Council, Stockholm, Sweden
| | - My Murray
- Folktandvården Stockholm, Public Dental Services, Stockholm County Council, Stockholm, Sweden
| | - Leif Jansson
- Folktandvården Stockholm, Public Dental Services, Stockholm County Council, Stockholm, Sweden
| | - Pia Skott
- Folktandvården Stockholm, Public Dental Services, Stockholm County Council, Stockholm, Sweden
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Sarapultseva M, Zolotareva A, Nasretdinova N, Sarapultsev A. The Healing Environment of Dental Clinics through the Eyes of Patients and Healthcare Professionals: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13516. [PMID: 36294114 PMCID: PMC9603286 DOI: 10.3390/ijerph192013516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
The physical environment of healthcare settings can promote both the healing process and patient feelings of well-being, as well as instill positive emotions in employees. The present study aimed to evaluate the dental work environment of a typical private and public dental clinic to identify key parameters that determine the perception of health facilities by patients and employees. The study was carried out from 1 to 20 December 2021, in two dental clinics in Ekaterinburg (Russian Federation) using 'ASPECT'. The participants were 58 staff and 94 patients. The results showed that, compared with patients, staff reported higher views scores, nature and outdoors scores, and comfort and control scores. The common criterion that distinguishes private clinics from public ones was comfort and control. Compared with patients in state clinics, patients in private clinics reported higher privacy, company and dignity scores, comfort and control scores, interior appearance scores, and facility scores. In general, while views scores and nature parameters can be singled out as a universal absolute value for everyone in a particular environment, staff pay more attention to factors that contribute to long-term comfortable stay and performance of their duties.
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Affiliation(s)
- Maria Sarapultseva
- Department of Pediatric Dentistry, Medical Firm Vital EBB, 620144 Ekaterinburg, Russia
| | | | - Natal’ya Nasretdinova
- Autonomous Non-Commercial Organization «Association Stomatology», 620102 Ekaterinburg, Russia
| | - Alexey Sarapultsev
- Russian-Chinese Education and Research Center of System Pathology, South Ural State University, 454080 Chelyabinsk, Russia
- Ural Division of Russian Academy of Sciences, Institute of Immunology and Physiology (IIP), 620002 Ekaterinburg, Russia
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5
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Rock LD, Madathil S, Khanna M, Macdonald LK, Quiñonez C, Glogauer M, Allison P. COVID-19 incidence and vaccination rates among Canadian dental hygienists. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2022; 56:123-130. [PMID: 36451991 PMCID: PMC9674005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Oral health care settings potentially carry a high risk of cross-infection due to close contact and aerosol-generating procedures. There is limited evidence of the impact of COVID-19 among dental hygienists. This longitudinal study aimed to 1) estimate COVID-19 incidence rates among Canadian dental hygienists over a 1-year period; and 2) estimate vaccination rates among Canadian dental hygienists. METHODS A prospective cohort study design was used to collect self-reported COVID-19 status from 876 registered dental hygienists across Canada via an online baseline survey and then 6 follow-up questionnaires delivered between December 2020 and January 2022. Bayesian Poisson and binomial models were used to estimate the incidence rate and cumulative incidence of self-reported COVID-19. RESULTS The estimated cumulative incidence of COVID-19 in dental hygienists in Canada from December 2020 to January 2022 was 2.39% (95% CrI, 1.49%-3.50%), while the estimated cumulative incidence of COVID-19 in corresponding Canadian provinces was 5.12% (95% CrI, 5.12%-5.13%) during the same period. At last follow-up, 89.4% of participants self-reported that they had received at least 1 dose of a COVID-19 vaccine. CONCLUSION The low infection rate observed among Canadian dental hygienists between December 2020 and January 2022 is reassuring to the dental hygiene and general community.
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Affiliation(s)
- Leigha D Rock
- Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sreenath Madathil
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Mehak Khanna
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | | | - Carlos Quiñonez
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Paul Allison
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
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Kui A, Popescu C, Labuneț A, Almășan O, Petruțiu A, Păcurar M, Buduru S. Is Teledentistry a Method for Optimizing Dental Practice, Even in the Post-Pandemic Period? An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137609. [PMID: 35805267 PMCID: PMC9265299 DOI: 10.3390/ijerph19137609] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 01/27/2023]
Abstract
Background: For the past two and half years, dentists all across the world, along with their patients, have faced numerous challenges. In this context, the aim of this integrative review was to assess if dentists’ and patients’ attitudes regarding teledentistry (TD) have changed since the COVID-19 outbreak, and if the use of TD will continue to rise, even in the post-pandemic period; (2) Methods: A literature search was performed between August 2021 and January 2022. The PubMed, Scopus, and Science Direct databases were searched for articles published between 2012 and 2022 using a combination of the following Mesh terms: “COVID-19”, “pandemic”, “oral telemedicine”, “teledentistry”; (3) Results: Among the 52 included papers, nine papers were published between 2011 and 2019, and 43 articles were published after 2020 (12 were published in 2020, 29 papers were published in 2021, and two in 2022). Among the articles published before 2020, seven out of nine included papers were reviews, and two were original research. Among the 43 papers published after 2020, 18 were reviews and 25 original research. (4) Conclusions: Based on the results of this integrative review, there is clear evidence that the interest in teledentistry and teleassistance in the dental field has increased rapidly, especially in the context of the COVID-19 pandemic. Therefore, while dental practitioners should be encouraged to keep themselves updated about new technologies, patients should also be constantly informed about their options for receiving special oral health care.
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Affiliation(s)
- Andreea Kui
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.L.); (O.A.); (S.B.)
| | - Codruța Popescu
- Department of Abilities Human Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence:
| | - Anca Labuneț
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.L.); (O.A.); (S.B.)
| | - Oana Almășan
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.L.); (O.A.); (S.B.)
| | - Adrian Petruțiu
- Department of Periodontology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Mariana Păcurar
- Orthodontic Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania;
| | - Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.L.); (O.A.); (S.B.)
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Grillo R, Lopes T, Teixeira RG. Top 50 covid and oral health articles: A 2021 altmetric analysis. J Oral Biol Craniofac Res 2022; 12:458-464. [PMID: 35664949 PMCID: PMC9142403 DOI: 10.1016/j.jobcr.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 04/18/2022] [Accepted: 05/21/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives There is a world of information at our disposal, and it is increasingly difficult to transform this dull amount of data into knowledge. How to be constantly actualized? This study aims to create an altmetric list of the top 50 articles related to COVID-19 and oral health. Methods Research of terms COVID-19 and oral health was done using Dimensions app. Results were ranked in altmetric citations and analyzed through Microsoft Excel. Some tables and graphics were created. Graphical illustration of keywords was created using VOSviewer. Results Some interesting facts can be seen, like growing interest in dental aerosols, perspectives, and virucidal activity of some mouthwashes. Conclusions Altmetric analysis is a helpful manner to scientific updates, supplementing bibliometric analysis. A terrific manner to see trends. The scientific community goes to great lengths to solve problems with dental aerosols, particularly to reduce contamination. Some adjustments to dental office and the use of barriers are recommended.
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Affiliation(s)
- Ricardo Grillo
- Corresponding author. School of Dentistry – Faculdade São Leopoldo Mandic, São Paulo/Brazil. Rua Dr. José Rocha Junqueira 13 Ponte Preta, Campinas/São Paulo, ZIP Code: 13045-755, Brazil.
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SARS-CoV-2 IgG Among Dental Workers During the COVID-19 Pandemic. Int Dent J 2022; 72:353-359. [PMID: 35249702 PMCID: PMC8828433 DOI: 10.1016/j.identj.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives Since the SARS-CoV-2 outbreak in 2019, special safety protocols have been introduced in dentistry. Dental professionals were determined to be mostly at risk for contracting the virus due to aerosol-generating procedures used. This preliminary study starts the cycle of the laboratory protocols describing the quality and efficacy of laboratory tests in the SARS-CoV-2 immunoglobulin G (IgG) detection in the serum of asymptomatic dental personnel during the last quarter of 2020. Methods IgG levels were measured with the use of a semi-quantitative enzyme-linked immunosorbent assay (ELISA) in vitro diagnostic kit in the serum of a study group that consisted of 127 employees of the dental clinic divided into 3 subgroups: SUB1: dentists (n = 67); SUB2: dental assistants, dental hygienists, nurses, laboratory workers (n = 40); SUB3: administrative workers (n = 20). Pearson analysis of results from the questionnaires attached to the study protocol were provided to assure that the results compare to the participants’ impressions about their general health. Results Positive ELISA IgG results were found in 6% (n = 4) of the SUB1 group, 7.50% (n =3) of the SUB2 group, and 5% of the SUB3 group. The percentage of participants without work interruption from the beginning of the pandemic was 54% of dentists and 60% of chairside assistants. Conclusions Serum IgG prevalence with the use of a semi-quantitative test was low, and further research on the biobanked samples should follow to determine the levels of IgG with quantitative methods and/or to evaluate the presence of neutralising antibodies in dental personnel. Because of the low representation of seropositivity studies in this group, it will be crucial to confirm the risk of COVID-19 transmission in dental offices.
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Zellmer S, Bachmann E, Muzalyova A, Ebigbo A, Kahn M, Traidl-Hoffmann C, Frankenberger R, Eckstein FM, Ziebart T, Meisgeier A, Messmann H, Römmele C, Schlittenbauer T. One Year of the COVID-19 Pandemic in Dental Medical Facilities in Germany: A Questionnaire-Based Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:175. [PMID: 35010434 PMCID: PMC8750787 DOI: 10.3390/ijerph19010175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
(1) Background: The COVID-19 pandemic forced healthcare workers to adapt to challenges in both patient care and self-protection. Dental practitioners were confronted with a potentially high possibility of infection transmission due to aerosol-generating procedures. This study aims to present data on healthcare worker (HCW) screening, infection status of HCWs, pre-interventional testing, the use of personal protective equipment (PPE) and the economic impact of the pandemic in dental facilities. (2) Methods: Dental facilities were surveyed nationwide using an online questionnaire. The acquisition of participants took place in cooperation with the German Society for Dentistry, Oral and Maxillofacial Medicine. (3) Results: A total of 1094 private practices participated. Of these, 39.1% treated fewer than 600 patients per quarter and 59.9% treated over 600 patients per quarter. Pre-interventional testing was rarely performed in either small (6.6%) or large practices (6.0%). Large practices had a significantly higher incidence of at least one SARS-CoV-2-positive HCW than small practices (26.2% vs.14.4%, p < 0.01). The main source of infection in small practices was the private environment, and this was even more significant in large practices (81.8% vs. 89.7%, p < 0.01). The procedure count either remained stable (34.0% of small practices vs. 46.2% of large practices) or decreased by up to 50% (52.6% of small practices vs. 44.4% of large practices). Revenue remained stable (24.8% of small practices vs. 34.2% of large practices) or decreased by up to 50% (64.5% of small practices vs. 55.3% of large practices, p = 0.03). Overall, employee numbers remained stable (75.5% of small practices vs. 76.8% of large practices). A vaccination readiness of 60-100% was shown in 60.5% (n = 405) of large practices and 59.9% (n = 251) of small practices. (4) Conclusion: Pre-interventional testing in dental practices should be increased further. Economic challenges affected small practices as well as large practices. Overall, a steady employee count could be maintained. Vaccination readiness is high in dental practices, although with some room for improvement.
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Affiliation(s)
- Stephan Zellmer
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Ella Bachmann
- Department of Oral and Maxillofacial Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179 Augsburg, Germany;
| | - Anna Muzalyova
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Alanna Ebigbo
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Maria Kahn
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Neusäßer Straße 47, 86156 Augsburg, Germany;
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany;
| | - Fabian M. Eckstein
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, 30625 Hannover, Germany;
| | - Thomas Ziebart
- Department of Oral and Maxillofacial Surgery, Campus Marburg, Philipps University Marburg and University Medical Center Giessen and Marburg, Baldingerstr, 35033 Marburg, Germany; (T.Z.); (A.M.)
| | - Axel Meisgeier
- Department of Oral and Maxillofacial Surgery, Campus Marburg, Philipps University Marburg and University Medical Center Giessen and Marburg, Baldingerstr, 35033 Marburg, Germany; (T.Z.); (A.M.)
| | - Helmut Messmann
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Christoph Römmele
- Department of Internal Medicine III—Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany; (A.M.); (A.E.); (M.K.); (H.M.); (C.R.)
| | - Tilo Schlittenbauer
- Department of Oral and Maxillofacial Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179 Augsburg, Germany;
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COVID-19 and Its Repercussions on Oral Health: A Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111189. [PMID: 34833407 PMCID: PMC8619825 DOI: 10.3390/medicina57111189] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 12/14/2022]
Abstract
In 2019, a new type of coronavirus, SARS-CoV-2, the causing agent of COVID-19, was first detected in Wuhan, China. On 11 March 2020, the World Health Organization declared a pandemic. The manifestations of COVID-19 are mostly age-dependent and potentially more severe in cases with involved co-morbidities. The gravity of the symptoms depends on the clinical stage of the infection. The most common symptoms include runny nose and nasal congestion, anosmia, dysgeusia or hypogeusia, diarrhea, nausea/vomiting, respiratory distress, fatigue, ocular symptoms, diarrhea, vomiting, and abdominal pain. These systemic conditions are often accompanied by skin and mucosal lesions. Oral lesions reported in patients with COVID-19 include: herpex simplex, candidiasis, geographic tongue, aphthous-like ulcers, hemorrhagic ulcerations, necrotic ulcerations, white hairy tongue, reddish macules, erythematous surfaces, petechiae, and pustular enanthema. It is still unclear if these manifestations are a direct result of the viral infection, a consequence of systemic deterioration, or adverse reactions to treatments. Poor oral hygiene in hospitalized or quarantined COVID-19 patients should also be considered as an aggravating condition. This narrative review is focused on presenting the most relevant data from the literature regarding oral manifestations related to SARS-CoV-2, as well as the challenges faced by the dental system during this pandemic. A routine intraoral examination is recommended in COVID-19 patients, either suspected or confirmed, as, in certain cases, oral manifestations represent a sign of severe infection or even of a life-threatening condition. It is our belief that extensive knowledge of all possible manifestations, including oral lesions, in cases of COVID-19 is of great importance in the present uncertain context, including new, currently emerging viral variants with unknown future impact.
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Expósito-Delgado AJ, Ausina-Márquez V, Mateos-Moreno MV, Martínez-Sanz E, del Carmen Trullols-Casas M, Llamas-Ortuño ME, Blanco-González JM, Almerich-Torres T, Bravo M, Martínez-Beneyto Y. Delivery of Health Care by Spanish Dental Hygienists in Private and Public Dental Services during the COVID-19 De-Escalation Phase (June 2020): A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168298. [PMID: 34444048 PMCID: PMC8394270 DOI: 10.3390/ijerph18168298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/23/2022]
Abstract
Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). Conclusions: Dental hygienists’ return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors.
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Affiliation(s)
| | - Verónica Ausina-Márquez
- Department of Paediatric and Preventive Dentistry, Faculty of Dentistry, European University of Valencia, 46001 Valencia, Spain;
| | - María Victoria Mateos-Moreno
- Department of Dental Clinical Specialties, Faculty of Dentistry, University Complutense of Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913941912
| | - Elena Martínez-Sanz
- Department of Anatomy and Embryology, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain;
| | | | | | - José María Blanco-González
- Dirección General de Salud Pública, Servicio de Salud del Principado de Asturias, National Health Service, 33005 Oviedo, Spain;
| | - Teresa Almerich-Torres
- Department of Preventive Dentistry, Faculty of Medicine-Dentistry, University of Valencia, 46001 Valencia, Spain;
| | - Manuel Bravo
- Department of Preventive & Community Dentistry, Faculty of Dentistry, University of Granada, 18001 Granada, Spain;
| | - Yolanda Martínez-Beneyto
- Department of Preventive & Community Dentistry, Faculty of Medicine-Dentistry, University of Murcia, 30001 Murcia, Spain;
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Ahmed MA, Jouhar R. Dissemination of Aerosol and Splatter in Clinical Environment during Cavity Preparation: An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073773. [PMID: 33916609 PMCID: PMC8038515 DOI: 10.3390/ijerph18073773] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 12/18/2022]
Abstract
Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a great risk of transmitting contagious infections to health care workers and patients, especially in an era of social distancing due to COVID-19. The current study was conducted to evaluate contamination amount, duration, the distance of aerosol, and splatter produced after cavity preparation using a two-hole and four-hole handpiece. The study was performed on a dental manikin in a dental simulation laboratory at the College of Dentistry, King Faisal University Al Ahsa. The dental manikin was set to a reclined position to simulate the clinical operatory position of the patient for dental restorative procedures. Aerosol and splatter were collected on Grade 1 qualitative cotton cellulose filter paper. These were placed on adhesive tape extending from the headrest of the dental manikin in six different directions (2, 4, 6, 8, 10, and 12 o’clock) for up to 60 inches and on certain positions of the operator and assistant such as the chest, head, forearms, upper leg, and inside facemask. Class V cavity preparation was done by the principal investigator at a specific time of 3 min on tooth #11 using a two-hole high-speed handpiece, then on the next day, Class V cavity preparation was performed on tooth #21 by a four-hole handpiece. High volume suction was used throughout the cavity preparation. Immediately after cavity preparation, the first filter paper disc was replaced with new ones in all positions. The second set of filter papers was removed after 30 min. Transparent grids were used to count the contamination area on the filter paper disc. No statistically significant difference was found in the mean amount of aerosol and splatter produced by both handpieces, however, a statistically significant difference was found in an amount of aerosol and splatter produced at a 12, 24, and 36 inches distance immediately after cavity preparation and 30 min after cavity preparation, regardless of the type of handpiece used. It is advisable to refrain from removing the personal protective barriers immediately after the procedure within the vicinity of the dental practice. The use of other adjuncts such as high volume suction to reduce the spread of aerosol and splatter is also recommended.
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Sarapultseva M, Zolotareva A, Kritsky I, Nasretdinova N, Sarapultsev A. Psychological Distress and Post-Traumatic Symptomatology Among Dental Healthcare Workers in Russia: Results of a Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E708. [PMID: 33467573 PMCID: PMC7830086 DOI: 10.3390/ijerph18020708] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 12/25/2022]
Abstract
The spread of SARS-CoV-2 infection has increased the risk of mental health problems, including post-traumatic stress disorders (PTSD), and healthcare workers (HCWs) are at greater risk than other occupational groups. This observational cross-sectional study aimed to explore the symptoms of depression, anxiety, and PTSD among dental HCWs in Russia during the coronavirus disease 2019 (COVID-19) pandemic. The survey was carried out among 128 dental HCWs from three dental clinics of Ekaterinburg, Russia. The mean age of the sample was 38.6 years. Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale-21 (DASS-21); PTSD was assessed using the PTSD Symptom Scale-Self-Report (PSS-SR); subjective distress was assessed using the Impact of Event Scale-Revised (IES-R). The results indicated that 20.3-24.2% HCWs had mild to extremely severe symptoms of psychological distress, and 7.1-29.7% had clinical symptoms of PTSD. No differences between females and males were revealed. HCWs working directly with patients had significantly higher levels of PTSD symptoms and the risk of PTSD development compared to those working indirectly, whereas older HCWs had significantly higher levels of both psychological distress and PTSD symptoms compared to younger HCWs. Thus, dental HCWs are at high risk for psychological distress and PTSD symptoms during the COVID-19 pandemic.
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Affiliation(s)
- Maria Sarapultseva
- Department of Pediatric Dentistry, Medical Firm Vital EBB, 620144 Ekaterinburg, Russia;
- Ural Division of Russian Academy of Sciences, Institute of Immunology and Physiology (IIP), 620002 Ekaterinburg, Russia;
| | - Alena Zolotareva
- International Laboratory of Positive Psychology of Personality and Motivation, Department of Psychology, National Research University Higher School of Economics, 101000 Moscow, Russia
| | - Igor Kritsky
- Ural Division of Russian Academy of Sciences, Institute of Immunology and Physiology (IIP), 620002 Ekaterinburg, Russia;
- Institute of Natural Sciences and Mathematics, Ural Federal University Named after the First President of Russia, 620026 Ekaterinburg, Russia
| | - Natal’ya Nasretdinova
- Autonomous Non-Commercial Organization «Association Stomatology», 620102 Ekaterinburg, Russia;
| | - Alexey Sarapultsev
- Ural Division of Russian Academy of Sciences, Institute of Immunology and Physiology (IIP), 620002 Ekaterinburg, Russia;
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia
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