COVID-19 Pandemic and Periodontal Practice: The Immunological, Clinical, and Economic Points of View

The recent global health problem, COVID-19, has had far-reaching impacts on lifestyles. Although many effective WHO-approved vaccines have been produced that have reduced the spread and severity of the disease, it appears to persist in humans for a long time and possibly forever as everyday it turns out to have new mutations. COVID-19 involves the lungs and other organs primarily through cytokine storms, which have been implicated in many other inflammatory disorders, including periodontal diseases. COVID-19 is in a close association with dental and periodontal practice from two respects: first, repeated mandatory lockdowns have reduced patient referrals to dentists and limited the dental and periodontal procedures to emergency treatments, whereas it is important to recognize the oral manifestations of COVID-19 as well as the influence of oral and periodontal disease on the severity of COVID-19. Second, dentistry is one of the high-risk professions in terms of close contact with unmasked individuals, necessitating redefining the principles of infection control. The pressures of the economic recession on patients as well as dentists add to the difficulty of resuming elective dental services. Therefore, this study is divided into two parts corresponding to what mentioned above: the first part examines the clinical and immunological associations between COVID-19 and periodontal and oral diseases, and the second part delineates the measures needed to control the disease transmission in dental clinics as well as the economic impact of the pandemic era on dental services.

Patients’ Perspective on Their Experience of Dental Treatments Covered by Public Health Insurance in Romania—A Pilot Study

Although the aims of any public health coverage are prevention, diagnosis, treatment, rehabilitation, and maintenance, dental services are hardly ever included in services. The goal of our pilot study is to assess the perspective of a group of adult patients on their covered dental treatments. The present cross-sectional study was conducted on 140 patients who reported their perception by filling in a questionnaire. All the collected data were statistically analyzed using IBM SPSS Statistics 25. Most of the subjects (40.7%, n = 57) were treatment oriented, visiting the dentist only in an emergency situation. A total of 40.7% (n = 57) of the participants stated that all the dental treatments had coverage and 22.8% (n = 13) had to split their treatment plan because of the insurance budget limit. The subjects who had chosen covered dental services because they considered it was a right they should benefit from (53.7%, n = 22) and those who had chosen covered dental services because of financial reasons (29.3%, n = 12) were more frequently unsatisfied with the types of covered dental services. The reduced level of satisfaction was associated mainly with the list of dental procedures accepted for coverage and also with younger and highly educated patients. For a more accurate description, the present study should be completed by future studies not only on a representative population at national level, but also by assessing the perspective of dental professionals.

UTILIZATION RATE OF DENTAL SERVICES IN THE ERA OF NATIONAL HEALTH INSURANCE IN PRATAMA CLINIC, CITY OF JEPARA

ABSTRACTBackground: The utilization rate is the use of dental and oral health which can be calculated using the number of National Healthcare Security (BPJS) patients per month compared to the number of BPJS participants multiplied by 100%Method: This study was an observational study used cross sectiona design and nominal data scale that produced quantitative data which was carried out by analysing the Pcare data started from March-August 2019 in eight primary clinics of Jepara City and District. Before conducted the study, Ethics Review No.098 / b.1-KEPK / SA-FKG / VII / 2019 was done.Result: The results of the utilization rate study based on the visit rates, Armina Pratama Clinic was 1.585%, Multisari II Pratama Clinic was 0.665%, Sentra Husada Pratama Clinic was 0.68%, Jepara General Pratama Clinic was 2.329%, Yasmin Medika Pratama Clinic was 2.173%, Hanis Pratama Clinic was 0.752%, Az-Zahra pratama clinic 2.945%, and Armina Denta pratama clinic was 1.885%.Conclusion: In conclusion, the utilization rate based on pratama clinic visits in the city and the regency of Jepara was still in the low to the ideal category. Meanwhile, the utilization rate based on the referral numbers of pratama clinic in the city and the regency of Jepara was far from the standard value

A document analysis for improving Oral Health Services in Niue

ABSTRACT Background There is very little research that focuses on oral health in the Pacific region. This paper outlines a document analysis of dental reports from the dental clinic in Niue and to examine their oral health and dental services. Furthermore this paper is intended to highlight how oral services in Niue can be improved for better oral health care for the Niue community. Methods: A document analysis of seven Niue dental reports between July 2011 to July 2018. The information found in the documents were organised under the sections clinical data reporting. The analysis also focused on a strength based approached for discussing the key challenges; the main achievements; and future recommendations for improving dental services for Niue. Results: Dental caries are the most common reason for tooth extractions followed by periodontal diseases. Primary school students are affected the most with 60 percent of students experiencing untreated dental caries. Among high school students, the rate of dental caries experienced is relatively low. Women appear to attend the dental clinic more than men however the number of visits for both men and women has declined. The key challenges faced by the dental team were a lack of resources specifically shortage of computers and functioning dental chairs, unfamiliarity with MEDTECH and limited staff development opportunities. Despite these challenges, the team were still able to establish the ‘Atuhau Mamali’ programme and upskill one staff member through professional development. Other achievements included reducing noise pollution, allocating a budget for safety equipment and establishing clinical guidelines for practice. Conclusions: Recommendations to improve oral health and dental services in Niue are to deliver targeted dental caries interventions in schools, introduce stronger food policies and to implement collaborative networks across the Pacific region. It is recommended that the Niue dental team develop more rigorous methods of data documentation to gain a more accurate picture of oral health in the country.

Associations of Medical Visits with Dentist Visits: A Register-Linkage Study of a Working-Age Population in Finland

Studies have usually addressed the utilization of either medical or dental services, and less is known about how medical and dentist visits are associated. As oral health is linked to systemic health, knowledge on care coordination between dental and medical services is important to gain understanding of the overall functioning of health care. Register data on 25–64-year-old residents of the city of Oulu, Finland, were used for the years 2017–2018 (N = 91,060). Logit models were estimated to analyze the probability of dentist visits, according to the number of medical visits in total and by three separate health care sectors. The majority, 61%, had visited both a medical professional and a dentist. All sectors combined, as few as one to two visits increased the odds of dentist visits (OR: 1.43, CI: 1.33, 1.53). When separated by medical professionals’ health care sectors, for one to two visits, the strongest association was found with public (OR: 1.17, CI: 1.12, 1.22) and private sector (OR: 1.35, CI: 1.30, 1.41). For occupational health service visits, the odds increased only after six or more visits. The results support the idea of integrated medical and dental care. However, the result may also arise from individual health behavior where health-conscious persons seek both medical and dental care independently.

Dentistry & COVID-19: Spreading facts not myths

Dental professionals are trying to adapt to the new norms, while the medium to long-term impact of COVID-19 on dentistry needs further investigation. The COVID-19 risk mitigation strategies include strict adherence to infection control practices (use of hand sanitizers, facemask and maintaining social distancing), reducing the amount of aerosol production in the dental setting, and managing the quality of air in the dental treatment rooms by reducing the use of air conditioners and improving air exchange. Among several potential transmission sources in the spreading of the COVID-19, dental services have received a high volume of attention. The aim of this article was to review the available literature on the relevant aspects of dentistry in relation to COVID-19 and to discuss potential impacts of COVID-19 outbreak on clinical dentistry, dental education and research. Although the coronavirus pandemic has caused many difficulties for provision of clinical dentistry, there would be an opportunity for the dental educators to modernize their teaching approaches using novel digital concepts in teaching of clinical skills and by enhancement of online communication and learning platforms. This pandemic has also highlighted some of the major gaps in dental research and the need for new relevant knowledge to manage the current crisis and minimize the impact of such outbreaks on dentistry in the future.

A Proposed Model for Dental Services Management in Iran

Background: Oral health is an integral part of general health and one of the necessities of a good life. Having a healthy mouth and teeth requires individual care, the development and implementation of community-based intervention programs, and professional care. The purpose of this study was to design a model for the management of dental services in Iran. Methods: This was an applied research in terms of purpose, descriptive in terms of implementation method, and a survey research in terms of descriptive typology. The statistical population included dental experts. To conduct the study among policy makers, planners, managers, university professors and the staff of the dental services, dental experts were chosen using purposive non-probability sampling for in-depth interviews based on grounded theory method to collect indicators of dental services management for providing a suitable selection model. To reach theoretical saturation, the text of the interviews was analyzed, phrase by phrase and sentence by sentence, through constant comparative analysis. For analysis, the grounded theory method was used, and the collected data were coded in 3 steps. In order to assess the validity of the research regarding interviews, the participants' feedback and the opinions of colleagues were used. To ensure the reliability of the interviews, 2 methods of test-retest and double coding were used. In this study, Delphi method was used in designing the model. Results: According to the obtained model, 29 factors were effective in managing dental services. The obtained indicators were included in the Delphi survey. During the Delphi stages, consensus was reached on 29 indicators which were classified into 5 dimensions (components) including planning, organizing, mobilizing of resources and facilities, guiding, monitoring and controlling. Conclusion: The results of the study showed that a 5-component model is suitable for the management of dental services in Iran, and health planners and policy makers can use it to improve the delivery of dental services.

STUDY OF APPROACHES TO IMPROVING DENTAL HEALTH OF DONETSK REGION RESIDENTS ON THE BASIS OF SELECTIVE ANALYSIS OF ORAL CAVITY DISEASES

The need to improve the dental health of the population does not lose its relevance and remains an unresolved medical, economic and social problem, with the need to find new approaches to the provision of dental care.The aim of the study was to determine the effectiveness of preventive measures and public awareness of the course and consequences of dental pathology in order to improve dental health.To achieve this goal, the data of the annual reports of municipal dental services of Donetsk region were analyzed and a survey with additional functional (electromyography and digital analysis of occlusion) examination of the dental status of 200 people was conducted.Thus, in 2018, the number of primary visitors to therapeutic departments within the region included 718097 people. Patients who underwent primary preventive measures included: hygienic training and education, individual choice of prevention only 21.09% of the total number of people.Within the survey, 82.5 % did not understand the dependence of hygiene and carious processes, 75.5% had no information about the need for quality restoration of the anatomy of the dentition, and 21.5 % did not understand the need to replace the final defects of the dentition. It has been found some reflection of these facts in the analysis of annual reports. Thus, the percentage of filled teeth due to caries or its complications to removed teeth, for the same reasons, was 46.46 %. A similar result in 46.58 % was the number of patients who applied after the removal of teeth to the orthopedic department in order to restore the integrity of the dentition (removable, conditionally removable, non-removable structures). But in addition to the lack of full restoration of the dentition, it was found that the ratio of total filled teeth to cement fillings was 44.5 percent of all filled teeth due to both caries and its complications. 44.5 % was the restoration of lost tooth tissues using cements (zinc phosphate and SIC). Due to the impossibility of restoring quality anatomy, and as a result of the function of the tooth, such a percentage does not meet the needs of today in understanding quality dental services.Based on the results of the analysis of the study data, we concluded that patients are poorly informed about their condition, variations in their treatment and the consequences of lack of comprehensive treatment, the causes and consequences of certain dental conditions and prevention. The results of our surveys and diagnostic tests revealed the need for modern and objectively motivated approach to diagnosis and informing patients about their condition, which leads to a better understanding of the cause-and-effect relationships and the desire for full rehabilitation.In turn, this not only improves dental health at the end of treatment, but also helps to maintain it for a long time, which in turn improves the social and economic life of the patient.