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.

Perspectives on Light-Based Disinfection to Reduce the Risk of COVID-19 Transmission during Dental Care

Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) is a positive-sense single-stranded RNA coronavirus capable of causing potentially lethal pneumonia-like infectious diseases in mammals and birds. The main mechanisms by which SARS-CoV-2 spreads include airborne transmission (aerosols and droplets) and the direct exposure of tissues (conjunctival, nasal, and oral mucosa) to contaminated fluids. The aerosol formation is universal in dentistry due to the use of rotary instruments (handpieces), ultrasonic scalers, and air–water syringes. Several layers of infection control should protect key stakeholders such as dentists, dental staff, and patients. These include the utilization of personal protective equipment, high-volume evacuation systems, pre-procedural mouthwashes, rubber dam, and more recently, antimicrobial photodynamic therapy and intra-oral visible light irradiation. These non-specific light-based approaches are relatively simple, inexpensive, and effective against viruses, bacteria, and fungi. Therefore, the present perspective review discusses the current efforts and limitations on utilizing biophotonic approaches as adjunct infection control methods to prevent the transmission of SARS-CoV-2 in dental settings. In addition, the present perspective review may positively impact subsequent developments in the field, as it offers relevant information regarding the intricacies and complexities of infection control in dental settings.

Provision of Endodontic Treatment in Dentistry amid COVID-19: A Systematic Review and Clinical Recommendations

Background. The risk of acquiring COVID-19 during a pandemic is a major concern among health care workers. Dental professionals being in close proximity to the patients had been exposed more than other health care workers. Hence, all the standard operating procedures (SOPs) are strictly advised to be followed. Methods. A detailed relevant literature search was conducted in international databases such as PubMed, Web of Science, and Science Direct, from January 2020 to November 2020. All the studies that provided recommendations regarding endodontic procedures during the COVID-19 pandemic were included, and those that were not in the English language, case reports, book chapters, and short communications were excluded in this review. In the end, only 6 articles were selected for the systematic review considering that complete information regarding the provision of dental care in the time of COVID-19 with diagnostic accuracy (STARD) was provided. Results. Endodontic treatments were restricted to only emergency dental procedures, and all other patients have advised medications and catered through teledentistry. Endodontic emergencies were advised to be carried out with minimal aerosol production procedures. Conclusion. Provision of endodontic care during COVID-19 restricted to only emergency dental procedures by strictly following standard operating procedures. A protocol for COVID-19 prevention was followed by all the dentists and the dental staff in the dental clinics.

Prediction of emotional exhaustion over the course of the COVID-19 pandemic in primary care dental staff: an intensive longitudinal study

ObjectiveTo investigate the fatigue trajectory during a 6-month duration of the COVID-19 pandemic for dental health professionals in primary dental care and for those in training.DesignA longitudinal intensive panel diary was conducted (July–December 2020) assessing weekly self-ratings of emotional fatigue.SettingDental care services in Scotland.ParticipantsDental trainees and primary dental care staff (N=53). These data were merged with respondents’ replies to a cross-sectional baseline survey (Humphris et al). Recruitment was through ‘Portal’, an online tool administered by National Health Service Education for Scotland. Questback software was employed for data collection.Primary and secondary outcome measuresThe diary questionnaire, consisted of a three-item fatigue scale and, from the baseline survey, three multi-item scales including: preparedness (14 items of the Dental Professional Preparedness for Practice Scale), the 22-item Impact of Event Scale-Revised and depressive symptomatology using the Patient Health Questionnaire-2. Statistical analysis included estimating the variability of fatigue over the study duration using a multilevel linear growth model. In addition, a path analysis was performed to determine the ability of preparedness and COVID-19 pandemic trauma to predict fatigue trajectories directly, or mediated through depressive symptomatology.ResultsA large variation of fatigue trajectories (p<0.001) was found from staff who completed a mean of 11 weekly uploads of their diary (diary uploads: minimum 4–maximum 24). The average slope was positive (standardised estimate=0.13, 95% CI: 0.07 to 0.19, p<0.001). Slope variation was modelled successfully from baseline data showing direct and indirect effects from preparedness, trauma and depressive symptoms.ConclusionStaff who volunteered to participate over a significant period of the COVID-19 pandemic in Scotland displayed a highly significant variety of individual trajectories. The results show some consistency with a job demands-resources model of burnout development. Suitable resource structures are indicated for staff over periods of extensive public service change.

Trueness of full-arch IO scans estimated based on 3D translational and rotational deviations of single teeth—an in vitro study

Objectives To three-dimensionally evaluate deviations of full-arch intraoral (IO) scans from reference desktop scans in terms of translations and rotations of individual teeth and different types of (mal)occlusion. Materials and methods Three resin model pairs reflecting different tooth (mal)positions were mounted in the phantom head of a dental simulation unit and scanned by three dentists and three non-graduate investigators using a confocal laser IO scanner (Trios 3®). The tooth-crown surfaces of the IO scans and reference scans were superimposed by means of best-fit alignment. A novel method comprising the measurement of individual tooth positions was used to determine the deviations of each tooth in the six degrees of freedom, i.e., in terms of 3D translation and rotation. Deviations between IO and reference scans, among tooth-(mal)position models, and between dentists and non-graduate investigators were analyzed using linear mixed-effects models. Results The overall translational deviations of individual teeth on the IO scans were 76, 32, and 58 µm in the lingual, mesial, and intrusive directions, respectively, resulting in a total displacement of 114 µm. Corresponding rotational deviations were 0.58° buccal tipping, 0.04° mesial tipping, and 0.14° distorotation leading to a combined rotation of 0.78°. These deviations were the smallest for the dental arches with anterior crowding, followed by those with spacing and those with good alignment (p < 0.05). Results were independent of the operator’s level of education. Conclusions Compared to reference desktop scans, individual teeth on full-arch IO scans showed high trueness with total translational and rotational deviations < 115 µm and < 0.80°, respectively. Clinical relevance Available confocal laser IO scanners appear sufficiently accurate for diagnostic and therapeutic orthodontic applications. Results indicate that full-arch IO scanning can be delegated to non-graduate dental staff members.

What can data mining tell us about patient safety? Using linear discriminant analysis to identify characteristics associated with positive safety rating in London NHS organisations.

Objective: To identify key characteristics associated with a CQC positive and negative safety rating across London NHS organisations. Design: Advanced data analytics and linear discriminant analysis. Data sources: Linked CQC data with patient safety variables sources from 10 publicly available datasets. Methods: Iterative cycles of data extraction, insight generation, and analysis refinement were done and involved regular meetings between the NHS London Patient Safety Leadership Forum and analytic team to optimise academic robustness alongside with translational impact. Ten datasets were selected based on data availability, usability, and relevance and included data from April 2018 to December 2019. Data pre-processing was conducted in R. Missing values were imputed using the median value while empty variables were removed. London NHS organisations were categorised based on their safety rating into two groups: those rated as "inadequate" or "requires improvement" (RI) and those rated as "Good" or "outstanding" (Good). Variable filtering reduced the number of variables from 1104 to 207. The top ten variables with the largest effect sizes associated with Good and RI organisations were selected for inspection. A Linear Discriminant Analysis (LDA) was trained using the 207 variables. Effect sizes and confidence intervals for each variable were calculated. Dunn′s and Kruskal-Wallis tests were used to identify significant differences between RI and Good organisations. Results: Ten variables for Good and RI NHS organisations were identified. Key variables for Good organisations included: Organisation response to address own concerns (answered by nurse/midwife) (Good organisation = 0.691, RI organisation = 0.618, P<.001); fair career progression (answered by medical/dental staff) (Good organisation = 0.905, RI organisation = 0.843, P<.001); existence of annual work appraisal (answered by medical/dental staff)) (Good organisation = 0.922, RI organisation = 0.873, P<.001); organisation's response to patients' concerns (Good organisation = 0.791, RI organisation = 0.717, P<.001); harassment, bullying or abuse from staff (answered by AHPHSSP) (Good organisation = 0.527, RI organisation = 0.454, P<.001); adequate materials supplies and equipment (answered by "Other" staff) (Good organisation = 0.663, RI organisation = 0.544, P<.001); organisation response to address own concerns (answered by medical/dental staff) (Good organisation = 0.634, RI organisation = 0.537, P<.001); staff engagement (answered by medical/dental staff) (Good organisation = 0.468, RI organisation = 0.376, P<.001); provision of clear feedback (answered by "other" staff) (Good organisation = 0.719, RI organisation = 0.650, P<.001); and collection of patient feedback (answered by wider healthcare team) (Good organisation = 0.888, RI organisation = 0.804, P<.001). Conclusions: Our study shows that healthcare providers that received positive safety inspections from regulators have significantly different characteristics in terms of staff perceptions of safety than those providers rated as inadequate or requiring improvement. Particularly, organisations rated as good or outstanding are associated with higher levels of organisational safety, staff engagement and capacities to collect and listen to patient experience feedback. This work exemplifies how a partnership between applied healthcare and academic research organisations can be used to address practical considerations in patient safety, resulting in a translational piece of work.

Antimicrobial Resistance and Molecular Epidemiological Characteristics of Methicillin-Resistant and Susceptible Staphylococcal Isolates from Oral Cavity of Dental Patients and Staff in Northern Japan

The acquisition of drug resistance and virulence by staphylococcal species colonizing humans is a growing public health concern. The present study was conducted to investigate the prevalence, antimicrobial resistance and genetic characteristics of Staphylococcus isolates from the oral cavity and skin (hand) of systemically healthy subjects with dental disease and dental staff in northern Japan. Among a total of 133 subjects (91 patients and 42 staff), 87 coagulase-positive Staphylococcus (83 S. aureus/4 S. argenteus) and 162 coagulase-negative Staphylococcus (CoNS) isolates were recovered from 59 (44.4%) and 95 (71.4%) subjects, respectively. Three oral isolates were methicillin-resistant S. aureus (MRSA) (3.6%, 3/83) that were genotyped as ST8-SCCmec-IVl, ST4775(CC1)-SCCmec-IVa and ST6562(CC8)-SCCmec-IVa. Remarkably, the ST6562 isolate harbored PVL genes on ΦSa2usa and type I ACME (arginine catabolic mobile element). Four methicillin-susceptible isolates were identified as S. argenteus belonging to ST1223 and ST2250, which harbored enterotoxin genes egc-2 and sey, respectively. Among the fourteen CoNS species identified, methicillin-resistant (MR) isolates were detected in five species (11 isolates, 13.3% of CoNS), with S. saprophyticus and S. haemolyticus being the most common. ACME was prevalent in only S. epidermidis and S. capitis. These findings indicated the potential distribution of USA300 clone-like MRSA, toxigenic S. argenteus and MR-CoNS in the oral cavity of dental patients.

An overview of COVID-19 infection in dental practices - a questionnaire survey

Dental nurses and practitioners are at high risk of exposure to COVID-19 due to physical proximity and exposure to body fluids during treatment. Dental practices have implemented multiple protective protocols to decrease COVID-19 transmission; however, it is difficult to evaluate how effective these measures are, as there is limited data on COVID-19 in dental practices. To evaluate COVID-19 infection rates among dentists, dental staff, and patients in different countries through an online survey, with a primary focus on South Africa (SA). Cross-sectional online survey. One hundred fifty-four participants from 52 countries answered the survey, 48.6% (n=561) from SA. COVID-19 infections were reported in 18.2% (n=210) of dental practices. Only 1.1% regarded the practice as the source of infection for dentists and staff who got infected. In total, 13.9% (n=160) treated COVID-19 patients. SA presented a higher infection rate (19% vs 13%, p=0.04) and more frequent treatment of COVID-19 patients than the other countries combined (17% vs 11%, p=0.006). These findings support the need to maintain strict infection control measures to decrease transmission of SARSCoV-2 during the delivery of oral care.

Awareness regarding COVID-19 among auxiliary dental staff in a tertiary dental care centre in Kerala- A cross-sectional study

Corona virus disease officially called as COVID-19, declared a “pandemic” by the World Health Organization; became a major public health problem causing worldwide morbidity and mortality, despite various control measures. Extraordinary measures are taken universally to fight the spread of the ongoing outbreak. In such a scenario, people’s adherence to preventive measures is largely influenced by their knowledge and perception of the disease. Since dental care professionals are having high chances of infectivity, which in turn has serious implications, it is essential that the auxiliary dental staff must be educated, empowered and provided appropriate and relevant knowledge of the disease.To assess the level of awareness regarding COVID-19 among auxiliary dental staff in a Tertiary Dental Care Centre in Kerala. A cross sectional survey was conducted among all the auxillary staff in a tertiary dental care centre by an online questionnaire through google forms. Details regarding demographic data, knowledge about the spread, symptoms, diagnosis, prevention and safety practices related to COVID-19 were obtained after getting an online informed consent. Descriptive statistics and Chi square test were done. Associations and differences were considered significant when the p value was less than 0.05.The initial sample size was 50. Forty two participants completed the study. Out of the participants 36% (n=15) were below 40 years and were males. About 40.5% (n=17) had experience less than 5 years. Around 69% (n=23) of the participants had good knowledge regarding COVID 19. Statistically significant results were seen with mode of transmission of Covid 19 and age of the respondents (p value=.006);current treatment of Covid 19 and years of experience of the respondents (p value=.011).The study concluded that there is overall good awareness level among the participants of the study.