Guidelines and Standard Operating Protocol for Pediatric Dental Practice during COVID-19: A Systematic Review

The aim of this systematic review and network meta-analysis was to identify and rank the effectiveness of different interventions used in dental practice to reduce microbial load in aerosolized compounds. Seven electronic databases were searched to April 6, 2020, for randomized controlled trials (RCTs) or nonrandomized prospective studies in the field. Study selection, data extraction, and risk-of-bias assessment were performed for all included studies, while the outcome of interest pertained to differences in bacterial load quantification through the use of different interventions prior to aerosol-generating procedures in dental practices. Random effects frequentist network meta-analysis was performed, with mean difference (MD) and 95% CI as the effect measure. Confidence in the documented evidence was assessed through the newly fueled CINeMA framework (Confidence in Network Meta-analysis) based on the GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation). Twenty-nine clinical trials were deemed eligible, 21 RCTs and 8 nonrandomized studies, while 11 RCTs contributed to the network meta-analysis, comprising 10 competing interventions. Tempered chlorhexidine (CHX) 0.2% as compared with nonactive control mouth rinse, prior to routine ultrasonic scaling, was most effective toward reduced postprocedural bacterial load with an MD of −0.92 (95% CI, −1.54 to −0.29) in log10 bacterial CFUs (colony-forming units). For CHX 0.2%, an MD of −0.74 (95% CI, −1.07 to −0.40) was observed as compared with control. Tempered CHX 0.2% presented the highest probabilities of being ranked the most effective treatment (31.2%). Level of confidence varied from very low to moderate across all formulated comparisons. These findings summarize the current state of research evidence in the field of aerosolized bacteria in dentistry. Instigated by the era of SARS-CoV-2 pandemic, the stipulation of a broader evaluation of the aerosolized microbes, including viruses, potentially coupled with disinfectant-based prevention schemes should be prioritized.

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Use of distraction techniques for the management of anxiety and fear in paediatric dental practice: A systematic review of randomized controlled trials

International Journal of Paediatric Dentistry ◽

10.1111/ipd.12499 ◽

2019 ◽

Vol 29 (5) ◽

pp. 650-668 ◽

Cited By ~ 6

Author(s):

Ivana Meyer Prado ◽

Larissa Carcavalli ◽

Lucas Guimarães Abreu ◽

Júnia Maria Serra‐Negra ◽

Saul Martins Paiva ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Controlled Trials ◽

Dental Practice ◽

Randomized Controlled ◽

Anxiety And Fear

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The effectiveness of guideline implementation strategies in the dental setting: a systematic review

Implementation Science ◽

10.1186/s13012-019-0954-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

Amy R. Villarosa ◽

Della Maneze ◽

Lucie M. Ramjan ◽

Ravi Srinivas ◽

Michelle Camilleri ◽

...

Keyword(s):

Systematic Review ◽

Guideline Adherence ◽

Pay For Performance ◽

Guideline Implementation ◽

Implementation Strategies ◽

Audit And Feedback ◽

Dental Practice ◽

Practice Setting ◽

Dental Setting ◽

Multifaceted Interventions

Abstract Background Guideline implementation has been an ongoing challenge in the dental practice setting. Despite this, there are no reviews summarising the existing evidence regarding effective guideline implementation strategies in this setting. In order to address this, this systematic review examines the effectiveness of guideline implementation strategies in the dental practice setting. Methods A systematic search was undertaken according to the PRISMA statement across nine electronic databases, targeting randomised controlled trials and quasi-experimental studies which evaluated the effectiveness of guideline implementation strategies in improving guideline adherence in the dental setting. All records were independently examined for relevance and appraised for study quality by two authors, with consensus achieved by a third author. Data were extracted from included studies using a standardised data extraction pro forma. Results A total of 15 records were eligible for inclusion in this review, which focused on the effects of audit and feedback, reminders, education, patient-mediated interventions, pay for performance and multifaceted interventions. Although there were some conflicting evidence, studies within each category of implementation strategy indicated a positive effect on guideline adherence. Conclusions This study has identified education, reminders and multifaceted interventions as effective implementation strategies for the dental practice setting. Although this is similar to research findings from other health sectors, there is some evidence to suggest patient-mediated interventions may be less effective and pay for performance may be more effective in the dental setting. These findings can inform policy makers, professional associations, colleges and organisations in the future adoption of clinical guidelines in the dental practice setting. Trial registration This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration ID CRD42018093023.

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Particulate Production and Composite Dust during Routine Dental Procedures. A Systematic Review with Meta-Analyses

Materials ◽

10.3390/ma13112513 ◽

2020 ◽

Vol 13 (11) ◽

pp. 2513 ◽

Cited By ~ 3

Author(s):

Anna Iliadi ◽

Despina Koletsi ◽

Theodore Eliades ◽

George Eliades

Keyword(s):

Systematic Review ◽

Risk Of Bias ◽

P Value ◽

Dental Practice ◽

Qualitative Synthesis ◽

Eligibility Criteria ◽

Manual Search ◽

Dust Generation ◽

Dental Procedures ◽

Meta Analyses

Composite dust generation is most likely a continuous and daily procedure in dental practice settings. The aim of this systematic review was to identify, compile and evaluate existing evidence on interventions and composite material properties related to the production of aerosolized dust during routine dental procedures. Seven electronic databases were searched, with no limits, supplemented by a manual search, on 27 April 2020 for published and unpublished research. Eligibility criteria comprised of studies of any design, describing composite dust production related to the implementation of any procedure in dental practice. Study selection, data extraction and risk of bias (RoB) assessment was undertaken independently either in duplicate, or confirmed by a second reviewer. Random effects meta-analyses of standardized mean differences (SMD) with associated 95% confidence intervals (CIs) were employed where applicable. A total of 375 articles were initially identified, resulting in 13 articles being included in the qualitative synthesis, of which 5 contributed to meta-analyses overall. Risk of bias recordings ranged between low and high, pertaining to unclear/raising some concerns, in most cases. All types of composites, irrespective of the filler particles, released significant amounts of nano-sized particles after being ground, with potentially disruptive respiratory effects. Evidence supported increased % distribution of particles < 100 nm for nanocomposite Filtek Supreme XTE compared to both conventional hybrid Z100MP (SMD: 1.96, 95% CI: 0.85, 3.07; p-value; 0.001) and nano- hybrid Tetric EvoCeram (SMD: 1.62, 95% CI: 0.56, 2.68; p-value: 0.003). For cytotoxicity considerations of generated aerosolized particles, both nanocomposites Filtek Supreme XTE and nanohybrid GradiO revealed negative effects on bronchial epithelial cell viability, as represented by % formazan reduction at 330–400 μg/mL for 24 hours, with no recorded differences between them (SMD: 0.19; 95% CI: −0.17, 0.55; p-value: 0.30). Effective and more rigorous management of dental procedures potentially liable to the generation of considerable amounts of aerosolized composite dust should be prioritized in contemporary dental practice. In essence, protective measures for the clinician and the practices’ personnel should also be systematically promoted and additional interventions may be considered in view of the existing evidence.

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Evaluation of Green Dental Practice Implementation among Dental Practitioners Worldwide - A Systematic Review

10.17303/jdoh.2020.7.104 ◽

2020 ◽

Keyword(s):

Systematic Review ◽

Dental Practice ◽

Dental Practitioners ◽

Practice Implementation

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Optimizing Caries Prevention Program in Dental Practice Based on Human Development Index (HDI): A Systematic Review

International Journal of Clinical Preventive Dentistry ◽

10.15236/ijcpd.2021.17.3.188 ◽

2021 ◽

Vol 17 (3) ◽

pp. 188-188

Author(s):

Regina Widjaja ◽

Putri Durotun Nafisa ◽

Clarabella Shakeena Aribowo ◽

Ivana Abigayl

Keyword(s):

Systematic Review ◽

Human Development ◽

Prevention Program ◽

Human Development Index ◽

Caries Prevention ◽

Dental Practice ◽

Development Index

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Pivoting Dental Practice Management during the COVID-19 Pandemic—A Systematic Review

Medicina ◽

10.3390/medicina56120644 ◽

2020 ◽

Vol 56 (12) ◽

pp. 644

Author(s):

Syed Sarosh Mahdi ◽

Zohaib Ahmed ◽

Raheel Allana ◽

Alessandro Peretti ◽

Francesco Amenta ◽

...

Keyword(s):

Systematic Review ◽

Infection Control ◽

Practice Management ◽

Main Theme ◽

Dental Practice ◽

Substantial Impact ◽

Corona Virus ◽

Number Of Patients ◽

Novel Coronavirus ◽

Dental Professionals

Background and Objectives: The aims of this systematic review were to identify additional infection control measures implemented in dental practice globally to prevent cross-infection and evaluate the psychological impacts of the pandemic among dental professionals. Materials and Methods: A sequential systematic literature search was conducted from December 2019 to 30 April 2020 through PubMed, CINAHL, Scopus, Google Scholar, Embase, and Web of Science databases. The search yielded the following results: “COVID-19” (n = 12,137), “Novel corona virus” (n = 63), “COVID-19 and dentistry” (n = 46), “COVID-19 and oral health” (n = 41), “Novel Corona virus and Dentistry” (n = 0), “dental health and Novel Coronavirus” (n = 26), and “dental practice and Novel Coronavirus” (n = 6). Results: After a careful review and eliminating articles based on inclusion and exclusion criteria, the final review included 13 articles. Management of infection control is discussed extensively in the literature and remains the main theme of many Coronavirus Disease 2019 (COVID-19) articles on dentistry. Telephone triage using a questionnaire, hand hygiene, personal protective equipment (PPE) for clinical and nonclinical staff, a preprocedural mouth rinse, and aerosol management have been discussed and implemented in few countries. Three studies recommended that elective treatments for patients with a temperature of >100.4 F or 38 °C should be postponed or performed in an airborne infection isolation room (AIIR) or negative-pressure room. Limiting the number of patients in the waiting area, the removal of shared objects, proper ventilation, and physical distancing were highly recommended. Psychological distress among dental professionals in relation to existing medical conditions and self-efficacy has been discussed. Conclusions: Although the COVID-19 pandemic has had a substantial impact on the dental profession worldwide, our review highlights many practice management approaches to adopt the new norm. More research highlighting evidence-based safety practices and multisectoral collaboration is required to help dental professionals make informed decisions and make the profession safe, both for the patient and dental professionals.

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