Restorative dental treatment in times of COVID-19

2020 ◽  
Vol 68 ◽  
Author(s):  
Robson de Lima GOMES ◽  
Marlus da Silva PEDROSA ◽  
Claudio Heliomar Vicente da SILVA
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Dental Treatment ◽  
Close Contact ◽  
Cross Contamination ◽  
Clinical Protocols ◽  
Know How ◽  
Dental Procedures ◽  
Dental Staff ◽  
Dental Professional ◽  
Restrictive Measures

ABSTRACT Since the outbreak of the Coronavirus Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), numerous restrictive measures have been adopted by governments of different countries. The return to elective dental care in Brazil is a reality even during the COVID-19 pandemic. During restorative dental procedures, the dental professional requires close contact with the patient, being exposed to contaminated saliva and fluids. In addition, transmission of COVID-19 by the generation of aerosol produced by dental handipieces may be possible. Thus, the dental staff must know how to act during restorative dental procedures, putting into practice the correct clinical protocols to avoid cross-contamination and COVID-19 spread. The purpose of this article is to review the literature on the biosafety practices especially in the context of restorative dental procedures in times of COVID-19.

scholarly journals Compare the Efficacy of Two Commercially Available Mouthrinses in reducing Viable Bacterial Count in Dental Aerosol produced during Ultrasonic Scaling when used as a Preprocedural Rinse

2013 ◽  
Vol 14 (5) ◽  
pp. 848-851 ◽  
Author(s):  
Shamila K Shetty ◽  
Karanth Sharath ◽  
Santhosh Shenoy ◽  
Chandini Sreekumar ◽  
Rashmi N Shetty ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Bacterial Count ◽  
Cross Contamination ◽  
Chlorhexidine Digluconate ◽  
Infectious Agents ◽  
Tea Tree Oil ◽  
Bacterial Colony ◽  
Tea Tree ◽  
Dental Procedures ◽  
Oral Microbes

ABSTRACT Aim To evaluate and compare the efficacy of preprocedural mouthrinses (chlorhexidine digluconate and tea tree oil) in reducing microbial content of aerosol product during ultrasonic scaling procedures by viable bacterial count. Settings and design It was a randomized single blind, placebocontrolled parallel group study. Materials and methods Sixty subjects were randomly assigned to rinse 10 ml of any one of the mouthrinses (chlorhexidine digluconate or tea tree oil or distilled water). Ultrasonic scaling was done for a period of 10 minutes in presence of trypticase soy agar plates placed at standardized distance. Plates were then sent for microbiological evaluation for the aerosol produced. Results This study showed that all the antiseptic mouthwashes significantly reduced the bacterial colony forming units (CFUs) in aerosol samples. Chlorhexidine rinses were found to be superior to tea tree when used preprocedurally in reducing aerolized bacteria. Conclusion This study advocates preprocedural dural rinsing with an effective antimicrobial mouthrinse during any dental treatment which generates aerosols, reduces the risk of crosscontamination with infectious agents in the dental operatory. Clinical significance The aerolization of oral microbes occurring during dental procedures can potentially result in cross-contamination in the dental operatory and transmission of infectious agents to both dental professionals and patient. It is reasonable to assume therefore, that any stratagem for reducing the viable bacterial content of these aerosols could lower the risk of cross-contamination. How to cite this article Shetty SK, Sharath K, Shenoy S, Sreekumar C, Shetty RN, Biju T. Compare the Efficacy of Two Commercially Available Mouthrinses in reducing Viable Bacterial Count in Dental Aerosol produced during Ultrasonic Scaling when used as a Preprocedural Rinse. J Contemp Dent Pract 2013;14(5):848-851.

Intra Operative Use of Anti Emetic Drugs for Children Undergoing Full Dental Rehabilitation under General Anesthesia. A Double Blind Randomized Clinical Trial

2016 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hisham Y El Batawi ◽  
Ahmed A Shorrab
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Double Blind ◽  
Dental Procedures ◽  
Dental Staff ◽  
Significant Difference ◽  
Dental Rehabilitation

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.

scholarly journals Aerosol-generating Procedures and Decision Drivers for COVID Pre-procedure Testing

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Sam Wakim ◽  
Dovid Friedman ◽  
Eva Turbiner ◽  
Shmuel Halpert ◽  
Jeffrey Kaminetzky ◽  
...  
Keyword(s):  
Close Contact ◽  
Healthcare Providers ◽  
Dental Services ◽  
Process Improvements ◽  
Dental Patients ◽  
Asymptomatic Patients ◽  
Dental Procedures ◽  
Dental Staff ◽  
Effective Delivery ◽  
Asymptomatic Individuals

Introduction: SARS-CoV-2 is thought to spread between individuals in close contact, primarily through respiratory droplets, including asymptomatic individuals [1,2]. The virus has been shown to persist in aerosols for hours [3]. Aerosol-generating procedures may increase the risk of transmission to healthcare providers, potentially putting dentists and patients at greater risk of exposure [3]. Current CDC guidelines for dental professionals include: N95 or higher-level respirator use during aerosol-generating procedures; COVID screening and triaging of patients; hand and respiratory hygiene best practices; facility updates; and physical distancing. The CDC also recommends considering pre-procedure testing to identify pre- and asymptomatic patients [2]. Methods: In June 2020, New Jersey health centers Zufall Health and CHEMED implemented COVID-19 testing prior to aerosol-generating dental procedures, along with other protocols, as part of the safe reopening of their facilities. They utilized screening and testing to safeguard dental staff and patients, to calm anxious front-line employees, and to facilitate patient follow-through on dental care. In September 2020, the centers undertook additional process improvements to determine the continued viability of pre-procedure COVID testing in their dental facilities. Results: From September 2020 to March 2021, the centers found parity between their COVID testing methods. Testing results were similar, indicating very few asymptomatic dental patients tested positive. Staff treating patients later determined positive for COVID were not infected. Conclusions: In an area of low, moderate, and high transmission, providers can feel confident that stringent adherence to recommended COVID precautions can safeguard staff and patients, including during aerosol-generating dental procedures. While testing is an important public health tool and helpful in reassuring staff and patients, one center determined it was no longer necessary to the safe and effective delivery of dental services. By the completion of the project, the other center was evaluating halting pre-procedure testing, and has since stopped testing.

scholarly journals Dental Treatment for the Pregnant Patient

2014 ◽  
Vol 17 (3) ◽  
pp. 3 ◽  
Author(s):  
Thalita Guarda Fagoni ◽  
Rafaela Andrade de Vasconcelos ◽  
Paula Elaine Cardoso ◽  
Ana Paula Martins Gomes ◽  
Carlos Henrique Ribeiro Camargo ◽  
...  
Keyword(s):  
Literature Review ◽  
Pregnant Women ◽  
Dental Treatment ◽  
Pregnant Patient ◽  
Therapeutic Agents ◽  
Dental Procedures ◽  
Dental Professional

<p>Dental treatment of pregnant women should be accomplished with safety. Consequently, the dental professional should evaluate its real need and risks for the mother and the baby. This paper reports, through a literature review, the caution with the clinical dental procedures commonly performed and possible risks of the therapeutic agents used, allowing the dentist to evaluate the treatment and the drug to be administered to the pregnant women.</p><p> </p>

scholarly journals Compliance of Dental Staff and Students to Dental Guideline amidst the COVID-19 Pandemic: An Institutional Analysis

2021 ◽  
pp. 12-27
Author(s):  
Nor Azura Ahmad Tarmidzi ◽  
Nor Haliza Mat-Baharin ◽  
Diana Md Zahid ◽  
Muhammad Syafiq Alauddin
Keyword(s):  
Dental Treatment ◽  
Standard Operating Procedure ◽  
Dental Students ◽  
Faculty Members ◽  
Clinical Staff ◽  
Treatment Quality ◽  
Blurred Vision ◽  
Dental Procedures ◽  
Dental Practitioners ◽  
Dental Staff

COVID-19 can be transferred via aerosols. Amidst the COVID-19 pandemic, dental practitioners, supporting clinical staff and clinical-year dental students are directly exposed to aerosols produced during dental treatment. Thus, the Faculty of Dentistry of Universiti Sains Islam Malaysia (USIM) developed dental guidelines that included a standard operating procedure for clinical settings. This study aimed to assess the adherence of clinical staff and students to dental guidelines during the COVID-19 pandemic and investigate the nature and extent of difficulties encountered by the faculty members in complying with the guidelines. The dental guidelines were explained to all faculty members, and then an audit form was developed on the basis of the guidelines. A series of clinical audits was conducted on a weekly basis. Afterwards, a survey was conducted to investigate any problems faced by dental clinical staff and students in terms of complying with the guidelines. The percentage of noncompliance to wearing goggles and face shields during dental procedures was 7.1% and 2.1%, respectively. Amongst 128 respondents, 84.1% reported unclear vision due to the fogging of the goggles, whereas 45.2% reported blurred vision when goggles and face shields were worn together. Moreover, approximately 30.2% of the respondents claimed that KN95 masks contribute to difficulty in breathing. Nevertheless, most of the dental clinical staff and students were compliant to the dental guidelines. Noncompliance was mainly caused by the fogging issue when wearing goggles. Thus, this issue should be tackled to prevent the impairment of treatment quality.

scholarly journals Availability of ‘Do-It-Yourself’ orthodontics in the United Kingdom

2021 ◽  
pp. 146531252110216
Author(s):  
Annabelle Carter ◽  
Susan Stokes
Keyword(s):  
Web Search ◽  
Dental Treatment ◽  
Limited Information ◽  
Treatment Length ◽  
Do It Yourself ◽  
Dental Professional ◽  
The Uk ◽  
Product Costs ◽  
Age Range

Objective: To identify the number of companies providing Do-It-Yourself (DIY) orthodontics and explore information available on websites for DIY brace providers operating in the UK. Design: Web search and review of websites providing DIY braces. Setting: Leeds, UK. Methods: A Web search was completed in November 2020 and April 2021 of all companies providing DIY braces for UK consumers. Each website was evaluated, and the following data collected: name; year started operating; costs; process; involvement of a dental professional; average ‘treatment’ length; retention; consent process; information on risks and benefits; aligner material; social media presence; age suitability; and consumer ratings on Trustpilot. Quality of website information was assessed via the DISCERN tool. Results: Seven DIY orthodontic companies were operating in the UK. Websites reviewed revealed the following: product costs were in the range of £799–£1599, ‘treatment’ length quotes were in the range of 4–12 months; Trustpilot reviews were in the range of 1.6–4.8 stars; and websites claimed their aligners were suitable for individuals with an age range of 12–18 years. Quality of content regarding risks described on websites varied, and there was limited information regarding involvement of a dental professional. Quality of websites information scored ‘poor’ or ‘very poor’ on the DISCERN scoring. Conclusions: There has been an increase in the number of DIY orthodontic companies operating in the UK over the last three years. There is a need to determine whether these products constitute dental treatment in their own right. If so, it is crucial to ensure these are regulated appropriately with adequate information available to satisfy informed consent and have greater transparency over dental professional involvement to safeguard the public.

scholarly journals Disinfection of SARS-CoV-2 Contaminated Surfaces of Personal Items with UVC-LED Disinfection Boxes

Viruses ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Maren Bormann ◽  
Mira Alt ◽  
Leonie Schipper ◽  
Lukas van de Sand ◽  
Mona Otte ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Close Contact ◽  
Credit Cards ◽  
Organic Matrix ◽  
Viral Loads ◽  
Small Aerosol ◽  
Time Periods ◽  
Respiratory Droplets ◽  
Glass Metal

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted from person to person by close contact, small aerosol respiratory droplets, and potentially via contact with contaminated surfaces. Herein, we investigated the effectiveness of commercial UVC-LED disinfection boxes in inactivating SARS-CoV-2-contaminated surfaces of personal items. We contaminated glass, metal, and plastic samples representing the surfaces of personal items such as smartphones, coins, or credit cards with SARS-CoV-2 formulated in an organic matrix mimicking human respiratory secretions. For disinfection, the samples were placed at different distances from UVC emitting LEDs inside commercial UVC-LED disinfection boxes and irradiated for different time periods (up to 10 min). High viral loads of SARS-CoV-2 were effectively inactivated on all surfaces after 3 min of irradiation. Even 10 s of UVC-exposure strongly reduced viral loads. Thus, UVC-LED boxes proved to be an effective method for disinfecting SARS-CoV-2-contaminated surfaces that are typically found on personal items.

scholarly journals Questioning COVID-19 Surface Stability and Fomite Spreading in Three Aeromedical Cases: A Case Series

2020 ◽  
Author(s):  
Sean Horoho ◽  
Stephen Musik ◽  
David Bryant ◽  
William Brooks ◽  
Ian M Porter
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Close Contact ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Posture Analysis ◽  
Surface Stability ◽  
Single Positive ◽  
Means Of Transmission ◽  
Respiratory Droplets

ABSTRACT It is well established that coronavirus disease 2019 is primarily transmitted through respiratory droplets, and there is mounting research speculation that it may also be transmitted via fomites. Several studies have shown that the virus can persist on both porous and nonporous surfaces for hours to days, depending upon the material. This article examines three cases of polymerase chain reaction–proven severe acute respiratory syndrome coronavirus 2 infection with several additional individuals meeting CDC close contact criteria. In 1 case, 195 downstream contacts were all tested to prevent a mass outbreak in a deployment posture. Analysis of these contacts yielded only a single positive test, which could be reasonably ascribed to respiratory droplet transmission. While these cases and their contacts ultimately represent a small sample size, we suggest fomite spread may not be a significant means of transmission for severe acute respiratory syndrome coronavirus 2 in real-world operational scenarios.

scholarly journals Evaluation of the Most Stressful Dental Treatment Procedures of Conservative Dentistry among Polish Dental Students

2021 ◽  
Vol 18 (9) ◽  
pp. 4448
Author(s):  
Katarzyna Mocny-Pachońska ◽  
Rafał J. Doniec ◽  
Sylwia Wójcik ◽  
Szymon Sieciński ◽  
Natalia J. Piaseczna ◽  
...  
Keyword(s):  
Dental Treatment ◽  
High Stress ◽  
Dental Students ◽  
Endodontic Treatment ◽  
Stressful Environment ◽  
Caries Treatment ◽  
Dental Procedures ◽  
Conservative Dentistry ◽  
High Level ◽  
Treatment Procedures

Background: Dental schools are considered to be a very stressful environment; the stress levels of dental students are higher than those of the general population. The aim of this study was to assess the level of stress among dental students while performing specific dental procedures. Methods: A survey was conducted among 257 participants. We used an original questionnaire, which consisted of 14 questions assigned to three categories: I—Diagnosis, II—Caries Treatment, and III—Endodontic Treatment. Each participant marked their perceived level of stress during the performed dental treatment procedures. The scale included values of 0–6, where 0 indicates no stress, while 6 indicates high stress. Results: Third- (p=0.006) and fourth-year (p=0.009) women were characterized by a higher level of perceived stress during dental procedures related to caries treatment. Caries treatment procedures were the most stressful for 18.3% of third-year students, 4.3% of fourth-year students, and 3.2% of fifth-year students. Furthermore, 63.4% of third-year students, 47.3% of fourth-year students, and 17.2% of fifth-year students indicated that they felt a high level of stress when performing endodontic procedures. Conclusion: Third- and fourth-year female students are characterized by a higher level of stress during caries and endodontic treatment procedures. The most stressful treatments for participants were endodontic treatment procedures.

scholarly journals 967. Concordance of Antibiotic Prescribing with the Proposed American Dental Association Acute Oral Infection Guidelines within Veterans Affairs (VA) Dentistry

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S31-S32
Author(s):  
Daniel Carlsen ◽  
Katie J Suda ◽  
Ursula C Patel ◽  
Gretchen Gibson ◽  
Marianne M Jurasic ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Apical Periodontitis ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Oral Infections ◽  
American Dental Association ◽  
Dental Procedures ◽  
Icd 10 ◽  
Future Work ◽  
Irreversible Pulpitis

Abstract Background US dentists prescribe 10% of outpatient antibiotics. However, assessing the appropriateness of dental antibiotic prescribing has been challenging due to a lack of guidelines for common infections. In 2019, the American Dental Association proposed clinical practice guidelines (CPG) on the management of common acute oral infections for the first time. Our objective was to describe national baseline antibiotic prescribing for the treatment of irreversible pulpitis, apical periodontitis, and acute apical abscess prior to the release of the proposed CPG. Methods We performed a cross-sectional analysis of national VA data from January 1, 2017 to December 31, 2017. We identified cases of irreversible pulpitis, apical periodontitis, and acute apical abscess using ICD-10-CM codes. Patient demographics, facility location, medical conditions, dental procedure codes (“CDTs”), and diagnostic (ICD-10-CM) codes were extracted from the VA Corporate Data Warehouse. Antibiotics prescribed by a dentist within 7 days of a visit were included. Multivariable logistic regression identified variables associated with antibiotic prescribing for each infection. Results Of the 470,039 VA dental visits with oral infections coded, 25% of irreversible pulpitis, 41% of apical periodontitis, and 61% of acute apical abscess visits received antibiotics. Amoxicillin was prescribed most frequently. Although the median days’ supply was 7 days, prolonged use of antibiotics was frequent (9.2% of irreversible pulpitis, 17.8% of apical periodontitis, 28.7% of acute apical abscess received antibiotics for ≥8 days). Of the irreversible pulpitis visits with antibiotics prescribed, 20.0% received ≥2 antibiotics. Patients with high-risk cardiac conditions, prosthetic joints, and certain dental procedures were associated with receipt of antibiotics (table). Conclusion Prior to the release of the ADA guidelines, 75.8% and 59.4% of irreversible pulpitis and apical periodontitis were concordant with proposed recommendations. These data identify opportunities to improve prescribing and serve as a benchmark for future outpatient antimicrobial stewardship efforts. Future work should assess definitive dental treatment and populations without access to oral health care. Disclosures All Authors: No reported Disclosures.

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