Oral findings in SARS-CoV-2 infection- A comprehensive review

The COVID-19 has presented as a worldwide threat to global health. It is highly necessary to study signs and symptoms associated with this infection. This review highlights the role of dental practitioners to diagnose the early signs of oral lesions in COVID-19 infection. They can play an important role in managing pain, giving support to patient and improving the quality of life, by becoming a part of multi-disciplinary team to fight against this global pandemic.

Awareness, Knowledge, Attitude, and Practice of Teledentistry among Dental Practitioners during COVID-19: A Systematic Review and Meta-Analysis

Background and Objectives: This systemic review aims to appraise and analyse the awareness, knowledge, attitude, and practice of teledentistry among dental practitioners during COVID-19. Materials and Methods: This review was registered in the PROSPERO database (CRD42021283404). Cross-sectional articles on dental practitioners’ perceptions towards teledentistry published between March 2020 and September 2021 were searched in ten online databases (PubMed, Google Scholar, Web of Science, ScienceDirect, Cochrane, EMBASE, SIGLE, EBSCO, LILACS, and Open Grey). The Joanna Briggs Institute critical appraisal tool was employed to analyse the risk of bias (RoB) of each article, whereas the Oxford Centre for Evidence-Based Medicine recommendation tool was used to evaluate the level of evidence. Data were analysed using the DerSimonian–Laird random effect model based on a single-arm approach. Results: Six studies were included and demonstrated Level 3 evidence. A single-arm meta-analysis revealed that dental practitioners had a high level of awareness (70.4%) and attitude (72.5%) towards teledentistry during the COVID-19 pandemic, but their knowledge level (57.9%) was moderate with a poor practice level (35.8%). A substantial heterogeneity was observed with the overall I2 ranging from 90.78% to 98.21%. Furthermore, meta-regression indicated that the sample size of each study had a significant (p < 0.05) impact on the degree of data heterogeneity. Conclusions: Despite their high degree of awareness and attitude, dental practitioners demonstrated moderate knowledge and relatively poor practice of teledentistry during the COVID-19 pandemic. More well-designed studies are warranted to investigate the alternatives for enhancing dental practitioners’ knowledge and practice of teledentistry interventions.

Vaccine-associated complications: a comparative multicenter evaluation among dental practitioners and dental students—which candidate vaccine is more safe in SARS COV II, Gam-COVID-Vac (Sputnik V), ChAdOx1 nCoV-19 (AstraZeneca), BBV152 (Covaxin), or BBIBP-CorV(Sinopharm)?

Background The rapidly developed vaccines against the severe acute respiratory syndrome coronavirus 2 carry a risk of provoking side effects. This study aimed to evaluate current vaccination non-serious/serious side effects. Methods A multicenter electronic questionnaire via an online platform was conducted over a 1-week period among vaccinated dental staff and dental students inquiring whether they experienced vaccine-related side-effects after vaccine administration. Results A total of 1205 respondents with a mean age of 39 (SD: 12) were retained for the analyses. The following vaccines were reported; Gam-COVID-Vac (Sputnik V), ChAdOx1 nCoV-19 (AstraZeneca), BBV152 (Covaxin), or BBIBP-CorV (Sinopharm). The majority of respondents received ChAdOx1 nCoV-19 (51.1%) and Gam-COVID-Vac (37.6%). The symptoms most frequently reported after vaccination were fatigue (79%), local pain in the injection site (77.4%), malaise (73%), and body pain (71.1%). Enrollees reported more onset of reactions on 0–12 h (44.1%) and 12–24 h (29.0%) after vaccine administration (p value <0.001). In 75.7%, the side effects last for up to 3 days. Merely 5.5% of cases reported the presence of side effects after the first week. Individuals with a history of SARSCoV-2 and other infections (MERS, influenza, and EBV) were more likely to report a number of unserious systemic side effects. Conclusion The commonly reported adverse events were in line with similar studies. We have concerns with the frequency of serious adverse effects. This work necessitates the need for further clinical assessments with larger sample sizes.

Administration of Systemic Antibiotics for Dental Treatment in Kosovo Major Dental Clinics: A National Survey

Objective Antibiotics misuse and a high level of antibiotics resistance is observed worldwide, but particularly in developing countries. Kosovo in the last decade is facing challenges regarding antimicrobial resistance. The purpose of the present study was to investigate patterns of antibiotics prescriptions of dentists in Kosovo's major dental clinics. Materials and Methods For Kosovo's prescribing pattern, data collection was obtained from 10 Regional Dental Clinics and a Tertiary Health Center regarding patients who were prescribed antibiotics in the years 2015 to 2019. Data analysis was performed by using descriptive statistics and was processed by using MS Excel. Results Most prescribed antibiotic during the observed period from 2015 to 2019 in Kosovo was amoxicillin, although a drastic increase of amoxicillin with clavulanic acid—as a broad-spectrum antibiotic—is observed. The trend of antibiotics use in tertiary health institutions is in an overall decrease in Kosovo with an exception in the year 2017. Despite this overall decrease, inconsistency in prescribing is observed when the pattern is analyzed for each region separately. The highest number of patients in health care dental clinics received antibiotics for maxilla-related health conditions and the lowest number of them for oncologic ones. Conclusion The patterns of antibiotics prescriptions by dental practitioners in Kosovo during the years 2015 to 2019 are fluctuating. Compared with the global health care standards, the irrational use of antibiotics in dental health care clinics in Kosovo still exist and this issue should be further addressed by respective actors.

Improving baseline serological investigations for dental workers at specialized dental center

Objective: Serological tests for dental workers have been suggested by different international agencies to ensure the safety of dental practitioners and, subsequently, their patients. In our organization, the percentage of dental workers who underwent serological tests was low (26%). Material and Methods: An intervention was designed using three sequential PDSA cycles to test changes proposed by team members. The percentage of dental workers who underwent these tests was used as the measure. Results: During the project period, the percentage of dental workers who underwent serological tests within nine months increased from 24% to 87%. Amongst the three interventions, the final one exhibited the most prominent change leading to major improvement. Conclusion: Serological tests are essential investigational data used to ensure the safety of dental workers, which subsequently also enhances patient safety. Further interventions are highly recommended to maximize the number of dental workers who undergo serological investigation.

Is There a Link between COVID-19 and Periodontal Disease? A Narrative Review

The coronavirus disease-2019 (COVID-19) pandemic greatly affected human well-being, social behavior, global economy, and healthcare systems. Everyday clinical practice in dentistry has been adjusted to the increased hazards of aerosol production by routine dental procedures. The objective of this study was to assess the existing literature to determine possible mechanisms of a relationship between COVID-19 and periodontitis, as well as describe findings from relevant epidemiological studies.Scarce data exist in the literature that directly addresses the relationship between the two diseases. However, several data describe the role of the oral cavity and periodontal tissues as portals of entry of severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2), and the contribution of cytokines known to be produced in periodontal disease to severe forms of COVID-19. It is also suggested from the current literature that periodontal disease, shown to be associated with systemic diseases such as diabetes mellitus, cardiovascular and respiratory diseases, shares common risk factors with—especially—severe forms of COVID-19.Further clinical studies are required to establish the relationship between these diseases. Oral hygiene performance and intact periodontal tissues can assist in mitigating the pandemic, and it is suggested that dental practitioners can contribute to identifying at-risk patients.

General and Paediatric Dentists’ Knowledge, Attitude and Practices Regarding the use of Silver Diammine Fluoride for the Management of Dental Caries: A National Survey in the Netherlands

Background: Silver Diammine Fluoride (SDF) is a topical medication used to arrest cavitated carious lesions non-invasively. The primary aim of this research was to investigate, and analyse the relationships between; knowledge, attitudes and practices (including barriers and facilitators) as they relate to SDF use for the management of dental caries by general dental practitioners (GDPs) and paediatric dentists (PDs) in the Netherlands. A secondary aim was to explore any differences between these groups.Methods: A sample of 600 Dutch GDPs (random selection from 9,777 registered) and all 57 registered PDs were invited to participate in this cross-sectional survey, consisting of four sections: 1) participant characteristics, 2) knowledge (through responses to summative questions), 3) attitudes (through agreements using 5-point Likert scale), and 4) practices, use, barriers and facilitators (through multiple choice questions). Results: Response rates were: GDPs 23% (n=140) and PDs 47% (n=27). Knowledge: out of 15 questions testing understanding of SDF, the mean correct answers were GDPs 6.7; SD 2.6 and PDs 7.4, SD 2.2 (no statistically significant differences). Mean overall attitude score showed positivity towards SDF use in both groups. Compared to GDPs, PDs were more likely to use SDF (p<0.001) and expected this to increase (p=0.03). The main barrier for users was parental acceptance (47%) and for non-users it was lack of knowledge (60%). The main facilitator for both users and non-users was gaining knowledge through courses and workshops, followed by written information leaflets about SDF for parents.Conclusions: Less than half knowledge questions about SDF were answered correctly. Despite low knowledge, attitude towards its use was positive. Practitioners believed that its use would be facilitated by professionals having more accessible information and training and by the availability of parent information leaflets. SDF was used more frequently by PDs than GDPs.

General dental practitioners’ perceptions on Team-based learning pedagogy for continuing dental education

Introduction: Team-based learning (TBL) pedagogy is a structured, flipped classroom approach to promote active learning. In April 2019, we designed a TBL workshop to introduce the New Classification of Periodontal Diseases 2017 to a group of general dental practitioners (GDPs). We aimed to investigate GDPs feedback on learning this new classification using TBL pedagogy. Methods: Two articles related to the 2017 classification were sent to 22 GDPs 2 weeks prior to a 3-hour workshop. During the face-to-face session, they were randomly assigned to five groups. They participated in individual and group readiness assurance tests. Subsequently, the GDPs had inter- and intragroup facilitated discussions on three simulated clinical cases. They then provided feedback using a pen-to-paper survey. Based on a 5-point Likert scale (1-strongly disagree to 5-strongly agree), they indicated their level of agreement on items related to the workshop and their learning experience. Results: Majority (94.7%, 18 out of 19 GDPs) agreed the session improved their understanding of the new classification and they preferred this TBL pedagogy compared to a conventional lecture. All learners agreed they can apply the knowledge to their work and there was a high degree of participation and involvement during the session. They found the group discussion and the simulated clinical cases useful. Conclusion: A TBL workshop is suitable for clinical teaching of the New Classification of Periodontal Diseases 2017 for GDPs. Its structure promotes interaction among learners with the opportunity to provide feedback and reflection during the group discussions. This model might be a good pedagogy for continuing dental education.

Perspectives of Dental Practitioners Regarding Their Readiness for Medical Emergencies: A Study in Saudi Arabia

Background: Training dental practitioners on emergency preparedness and response is essential for the successful management of medical emergencies. Objectives: To assess the perceptions of dental practitioners in Saudi Arabia about their readiness to manage medical emergencies in the dental practices. Methods: This cross-sectional survey was conducted among dental practitioners working in 52 dental centers in Saudi Arabia. Questionnaires mainly gathered data on the measures taken by dental practitioners to prevent medical emergencies, BLS certification, availability of essential drugs and equipment, and perceptions of dental practitioners regarding the adequacy of their training for medical emergencies. Results: Of the total 270 participants, the majority reported that they take medical history (94%), perform visual inspection (90%), consult with patients’ physician when needed (89%), and modify treatment plan as necessary (94%). However, only 19% of them routinely take baseline vital signs for their patients and 52.6% have valid BLS certification. Only 29.6% and 16.3% of dental practitioners have reported that they have all essential drugs and equipment, respectively. Conclusion: The preventive measures for medical emergency appears to be deficient because most dental practitioners are not routinely taking baseline vital signs for their patients. This important issue is combined with shortage of BLS certification among dental practitioners and inadequate availability of all medical emergency drugs and equipment in dental practices.

The Knowledge of General Dentists Regarding Trigeminal Neuralgia in Lahore- a Questionnaire Based Study

Objective: To assess and document the knowledge general dentists possess in relation to incidence, diagnosis and management of trigeminal neuralgia and its application in their practice. Methods: This was a cross-sectional survey. The data collection tool was a piloted, self- designed, 14 item structured questionnaire that had questions regarding demographics, factual knowledge and practices of the participants. Hundred general dental practitioners were selected through purposive sampling in Lahore. Only general dentists were included in this survey and all other dental specialties were part of the exclusion criteria. Data was entered and analyzed using IBM SPSS Statistics® (Version 23). Results: Most practitioners responded that they were able to identify a patient with trigeminal neuralgia on the basis of diagnosis of exclusion. Carbamezapine was the drug of choice of pharmacological management or in case pharmacological management did not provide relief the patient was referred to an oral and maxillofacial surgeon. Conclusion: It was concluded that general dentists had adequate knowledge and sound practices on management of Trigeminal Neuralgia. A need for multi-disciplinary approach and continued medical education (CME) was identified. Keywords: Dentists, Disease Management, Facial Pain, Neuralgia, Knowledge, Trigeminal Neuralgia (TN).