Delaying Intraoral Radiographs during the COVID-19 Pandemic: A Conundrum

Background. The COVID-19 pandemic has made dentists very assiduous about cross-infection during dental treatment, thereby delaying dental radiographs for treatment. However, patients needing dental emergency treatment in the ongoing pandemic require relevant intra/extraoral dental radiography for adequate diagnosis and treatment planning. Methods. This article is aimed at adding to the hot debate: Is delay for intraoral radiographs justified or a possible proxy? As a narrative review, it provides an insight into the reasons for delaying intra-oral dental radiographs during in the pandemic and options of the nontraditional radiographic techniques available until the pandemic subsides. Discussion and Conclusion. Cross-contamination concerns through respiratory droplets grow while using intraoral film holders that stimulate gag reflex, coughing, saliva secretion, and if proper disinfection protocols are not applied. Since the patients’ acquiring emergency dental treatment cannot be neglected, the return-to-work guidelines by the health regulatory bodies urge to prioritize extraoral radiographic imaging techniques to curb the infection, offering the best diagnostic efficacy. The dental professionals can consider cone-beam computed tomography (CBCT) scans and sectional dental panoramic radiographs (SDPRs), followed by a risk assessment for COVID-19, a safer modality in reducing cross-contamination and assuring an innocuous environment for both patient and coworkers.

Pediatric Dental Emergency Pattern and Dental Care Provided during COVID-19 Pandemic Lockdown at a Tertiary Care Center in Kathmandu, Nepal

Introduction: Pediatric dental management is difficult in its own way which was even more challenging during COVID-19 outbreak and lockdown period. Constrained dental providing clinics and hospitals severely compromised the pediatric dental needs and services. Objective: The aim of this study was to describe pattern of dental emergencies encountered and services provided to the pediatric patients visiting a dental hospital during the first lockdown period in Kathmandu, Nepal. Methods: A cross sectional study was done from 24 March 2020 to 21 July 2020 among the pediatric patients who visited dental hospital during lockdown. Data was collected from questionnaire and dental case history sheet, and statistically analyzed in Statistical Package of Social Sciences (SPSS) version 20. Results: Of the total 172 pediatric patients of mean age 8.3± 2.60 years, majority were males (59.3%) and of 6-12 age group (76.2%). Major complain was mobile/retained teeth (38.4%) and most common diagnosis was exfoliating mobility (23.3%). According to American Dental Association (ADA, 2020) guidelines, urgent dental care (46.5%) followed by non-emergency dental care (43.6%) were mostly found. The predominant procedures were emergency (68.6%) and least was elective (9.3%) and treatment given to majority was extraction (51.8%).There was a statistically significant association between age group and pediatric dental care (ADA). Conclusions: The findings of this study regarding dental emergency encountered and definitive treatment received even during pandemic lockdown can be helpful in finding out how dental care was provided and can be applicable in similar future pandemics.

Impact of COVID-19 on the Utilization of Dental Services: A Systematic Review

Emergency Department (ED) visits result from urgent conditions and instances caused by disease, disaster, accidents, or injury and require immediate medical attention. Today, emergency dental services are becoming an integral and crucial facet of properly functioning healthcare systems. Dental emergency visits are a risky undertaking when the COVID-19 epidemic is decimating global health systems. Emergencies in dental care are possibly life-threatening occurrences and demand instant attention to curb infection, severe pain, and tissue bleeding. Examples of these conditions include trauma affecting different facial bones, bacterial infection on soft tissues or cellulitis, and uncontrolled bleeding. Today, given the implications of the COVID-19 pandemic, all providers need to use their professional judgment to determine the need for emergency or urgent care for a patient. Consequently, this systematic review of literature reviews the implications of the COVID-19 epidemic on the use of dental services in different care facilities across the nation.

SARS-CoV-2 pandemic: potential relationship between psychiatric disorders and pulpits

The coronavirus outbreak is a global public health emergency with high transmission among the population. Over 18 million people were affected globally (06th August 2020). In most of the cases, patients present flu-like symptoms, such as fever, cough, headaches and myalgias are commonly reported. Lockdown measures have been implemented to control the spread of the virus. In contrast, these measures have been reported to increase the probability of psychological and physical disorders. As the pandemic intensifies, the number of patients seeking dental emergency services due to acute symptoms (i.e. pulpitis, acute apical abscesses) has increased. There is an increasing need to investigate the association between psychological disorders and dental emergencies. There is critical need for the development of public policies for mental and dental health worldwide, leading to the improvement in the quality of life of the population.

Peran Serta Rumah Sakit Khusus Gigi dan Mulut Selama Masa Pandemi Covid-19

The COVID-19 pandemic, which has occurred for almost 2 years, has infected more than 200 countries in the world, has made hospital conditions change the service strategy provided. Services that are usually provided during normal times, must change conditions starting from screening patients on arrival until the service ends. When referral hospitals are trying to save patients infected with COVID-19, other hospitals, especially dental and oral hospitals, also participate in removing this nation from the grip of the COVID-19 pandemic, although they do not directly treat COVID-19 patients. By using descriptive qualitative research methods, researchers can obtain deeper information from a case study at a special dental and oral hospital, which usually only provides dental services. The purpose of this study was to get an overview of the efforts made by dental and oral hospitals in providing services to the community in an effort to break the chain of transmission of COVID-19. The results obtained are an evaluation of the increase in the number of patients and dental emergency room services, the implementation of tracing and testing for all hospitalians, as well as providing vaccination services, which are things that special dental and oral hospitals can do in participating in taking part and breaking the chain of transmission of COVID-19.

Management of the Oral Health of Children During the COVID-19 Pandemic in Poland

Managing the oral health of children during the time of a health emergency linked to the current COVID-19 pandemic presents specific problems. A high number of non-specific effective infection control protocols are available in dental settings. It is of fundamental importance to implement specific protocols relating to those clinical situations that normally do not represent an emergency but which now fall into that category. The aim of this study was the comparison of data obtained from the Regional National Health Fund (NFZ) relating to the number and the type of procedures in the oral health management of children aged 0–18 years from the Wielkopolska region, with the months of March and April of 2019 being compared with those of the, respective, pandemic period of 2020. The results showed statistical differences in the number of performed procedures when comparing 2019 and 2020; especially in April (n = 53,077 in 2019 but only n = 2,287 in 2020), when lockdown restrictions reached their highest level and when only 30% of the dental clinics for children were open for patients in the Wielkopolska region of Poland. Regarding surgical cases, there were no differences in percentage frequency between April 2019 and 2020 in terms of extractions. However, an increase was observed in abscess incisions (3.5–17.8%) and surgical dressings (1.5–10.07%). There was a decrease in the total number of performed conservative dentistry procedures in April 2020, but temporary fillings in primary and permanent teeth showed a prominent increase: from 6.4% in 2019 to 19.3% in 2020; and 5.8–11.4%, respectively. Pulp treatment and mucosal lesions therapy fall into the dental emergency category during this COVID-19 pandemic. These cases have shown an increase from 3.2% in 2019 to 12.8% in 2020 for pulp treatment, and from 2.3 to 4.3% for the treatment of oral mucosal lesions. As suspected, after the lockdown was implemented, the number of pediatric dental cases were low. Moreover, the analysis revealed differences in the profile of clinical situations that represented the emergency cases and the pandemic treatment protocols. Future implications suggest that dental prophylactic procedures be included in pandemic protocols with even dental services being limited to a form of urgent treatment. New approaches and treatment models should be implemented in the control of the infectious spread of the disease in the management of the oral health of children in this pandemic period.

Traumatic Dental Injuries: Clinical Case Presentation and a 10-Year Epidemiological Investigation in an Italian Dental Emergency Service

Traumatic dental injuries (TDIs) are very common in the world population, and international literature reports several studies which helped in the definition of international guidelines. The aim of this study is to present two clinical cases of TDI and to investigate epidemiological and etiological aspects of TDIs in patients treated in Modena, Italy, between January 2010 and December 2020. The presented case reports are two explicative clinical cases of successful TDI management with a long-term follow-up. The epidemiological analysis was performed on patients who visited the Dental Emergency Service of the Dentistry and Oral-Maxillo-Facial Surgery Unit of Modena (Italy) over a period of 10 years. Data relating to age, gender, type of trauma, and place of accident were collected. Five-hundred-sixty-five TDIs that occurred to patients from 1 to 68 years old were reported, with a total of 860 injured teeth. The peak age at which TDIs are most represented varies between 2 and 3 years old, and they occurred frequently from 1 up to 7 years old. 57.5% were male, while 42.5% were female. The most common trauma resulted to be the uncomplicated crown fracture (20%), immediately followed by lateral luxation (19%), intrusive luxation (18%), avulsion (17%), and complicated crown fracture (15%). TDIs occurred at home in 44% of cases. The need for more prevention training must be highlighted, due to the fact that many TDIs occur at home and in a preschool age.

Applications of teledentistry in a French inmate population: A one-year observational study

Teledentistry oral examination protocol was evaluated for one year at the Villeneuve-lès-Maguelone Correctional Facility. The aim of the study was to simplify the obligatory dental consultation protocol at the entrance visit for new detainees. 1051 detainees were enrolled and 651 of them (58.9%) accepted an oral examination by teledentistry throughout the entire year of 2018. Only 1 inmate did not need treatment and 88.06% of those who have been examined had at least one untreated cavitated carious lesion. Forty-four percent of people who received a teledentistry check-up were referred to a dentist with a dental emergency. The use of teledentistry at the entry visit in a detention facility may facilitate the oral health screening without wasting the dentist’s time, and may allow an optimization of the inmate’s oral healthcare.