Special Issue "Dentistry and COVID-19: Challenges and Opportunities for Providing Safe Care"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Oral Health".

Deadline for manuscript submissions: 31 January 2023.

Special Issue Editors

Prof. Dr. Guglielmo Campus
E-Mail Website
Guest Editor
Prof. Dr. Maria Grazia Cagetti
E-Mail Website
Guest Editor
Director Post-graduated School in Pediatric Dentistry, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20142 Milan, Italy
Interests: pediatric dentistry; community dentistry; caries prevention; oral health promotion; caries epidemiology; oral health of special needs children
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The scientific and medical world are still involved in intensive research to face the SARS-CoV-2 outbreak. In dentistry, the risk of cross-infection is recognized to be high since the proximity with the patient's head and production of splatters and aerosols during dental treatments may represent potential hazards for virus diffusion.

Several strategies to control SARS-CoV-2 transmission in the dental environment during the pandemic were recommended, including the use of appropriate personal protection devices and the reduction, if possible, of treatments that can produce droplets or aerosols.

Nevertheless, these strategies are not reasonable in the long term, as it is mandatory for several dental treatments to be performed using rotary handpieces. The pandemic calls for a reorganization of the dental profession, both for public and private providers. The formulation and test of protocols that ensure the provision of safe care both for patients and dental personnel is essential.

Papers addressing these topics are invited to this Special Issue, including protocol papers on the health professional risk of COVID-19, the epidemiology of SARS-CoV-2 diffusion in health professionals and dental personnel, risk assessment for patients and health workers, and risk management and intervention studies aiming to control the virus diffusion in the dental setting, ensuring safe dental care.


Prof. Dr. Guglielmo Campus

Assoc. Prof. Dr. Maria Grazia Cagetti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oral health
  • COVID-19
  • treatment decision-making
  • dental profession
  • infection control
  • aerosol
  • dentistry
  • dental hygienist
  • dentists
  • dental personnel

Published Papers (7 papers)

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Research

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Article
The Impact of Coronavirus Information-Seeking Behavior on Dental Care Access: A Cross-Sectional Questionnaire-Based Study
Int. J. Environ. Res. Public Health 2021, 18(22), 12050; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212050 - 17 Nov 2021
Viewed by 323
Abstract
Health information-seeking behavior provides a variety of benefits, such as reducing knowledge gaps and educating individuals outside the medical office. This study aimed at evaluating if different sources used to gather information on COVID-19 could affect the willingness to undergo dental appointments. An [...] Read more.
Health information-seeking behavior provides a variety of benefits, such as reducing knowledge gaps and educating individuals outside the medical office. This study aimed at evaluating if different sources used to gather information on COVID-19 could affect the willingness to undergo dental appointments. An anonymous survey was posted on social media. The 1003 respondents used several channels of communication, clearly distinguishing reliable from unreliable ones. Multiple logistic regression estimated the effect of different information channels on the probability of being strongly influenced by COVID-19 in accessing upcoming dental appointments. Newspapers were the most-used channel of information (61.2%), blogs and forums the least used (11.2%). Overall, the more an individual was informed, the higher was the risk of missing upcoming dental care appointments (OR 2.05, CI 1.45–2.90, p < 0.001). The two most reliable channels of communication were identified in journals/websites of medicine and healthcare professionals. Women proved to be more active in gathering information and relying on less secure but more personal channels, such as social media and friends and family, thus having an increased risk of being influenced by COVID-19 information regarding upcoming dental care appointments (OR 3.62, CI 0.85–15.52, p < 0.1 and OR 1.60, CI 1.00–2.58, p < 0.1, respectively). Social media should have a greater presence on the side of medical service providers to avoid distortions of information and fake news that ultimately cause fear among citizens and compromise their health. Healthcare professionals and institutions should adapt their communication channels based on the audience they want to address to optimize the education and information of the final users. Full article
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Article
Impact of COVID-19 on Dental Care during a National Lockdown: A Retrospective Observational Study
Int. J. Environ. Res. Public Health 2021, 18(15), 7963; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18157963 - 28 Jul 2021
Cited by 1 | Viewed by 724
Abstract
The coronavirus disease 19 (COVID-19) has challenged dental health professions. This study analyzes its impact on urgent dental care in the Department of Conservative Dentistry and Periodontology, University Hospital Munich and Bavaria, Germany. Patient numbers without and with positive/suspected COVID-19 infection, their reasons [...] Read more.
The coronavirus disease 19 (COVID-19) has challenged dental health professions. This study analyzes its impact on urgent dental care in the Department of Conservative Dentistry and Periodontology, University Hospital Munich and Bavaria, Germany. Patient numbers without and with positive/suspected COVID-19 infection, their reasons for attendance, and treatments were retrospectively recorded (February–July 2020) and linked to local COVID-19 infection numbers, control measures, and numbers/reasons for closures of private dental practices in Bavaria, Germany. Patient numbers decreased within the urgent care unit and the private dental practices followed by a complete recovery by the end of July. While non-emergency visits dropped to almost zero during the first lockdown, pain-related treatments were administered invariably also in patients with positive/suspected COVID-19 infections. Reasons for practice closures were lack of personal protective equipment (PPE), lack of employees, staff’s increased health risks, and infected staff, which accounted for 0.72% (3.6% closures in total). Pain-driven urgent dental care remains a constant necessity even in times of high infection risk, and measures established at the beginning of the pandemic seem to have provided a safe environment for patients as well as oral health care providers. PPE storage is important to ensure patients’ treatment under high-risk conditions, and its storage and provision by regulatory units might guarantee a stable and safe oral health care system in the future. Full article
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Article
Effects of Natural Ventilation and Saliva Standard Ejectors during the COVID-19 Pandemic: A Quantitative Analysis of Aerosol Produced during Dental Procedures
Int. J. Environ. Res. Public Health 2021, 18(14), 7472; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147472 - 13 Jul 2021
Cited by 6 | Viewed by 943
Abstract
The novel Coronavirus Disease 2019 (COVID-19) pandemic has renewed attention to aerosol-generating procedures (AGPs). Dental-care workers are at high risk of contamination by SARS-CoV-2. The aim of this study was to evaluate the efficacy of standard saliva ejectors and natural ventilation in reducing [...] Read more.
The novel Coronavirus Disease 2019 (COVID-19) pandemic has renewed attention to aerosol-generating procedures (AGPs). Dental-care workers are at high risk of contamination by SARS-CoV-2. The aim of this study was to evaluate the efficacy of standard saliva ejectors and natural ventilation in reducing particulate matter (PM) concentration during different routine dental procedures in the pandemic period. The DustTrak monitor was used to measure PM1, PM2.5, PM10, and breathable (<4 microns) total dust during 14 procedures performed with and without the presence of natural ventilation in a dental unit. Moreover, measurements were performed near the practitioners or near the standard saliva ejectors during the different procedures. In the latter condition, reduced levels of PM10 were recorded (82.40 ± 9.65 μg/m3 vs. 50.52 ± 0.23 μg/m3). Moreover, higher levels of PM (53.95 ± 2.29 μg/m3 vs. 27.85 ± 0.14 μg/m3) were produced when the dental unit’s windows were open. At the same time, the total level of PM were higher during scaling than during other procedures (data suggest not to adopt natural ventilation—both window and door opened—during dental procedures). It was also demonstrated that the use of standard saliva ejectors can considerably reduce the total released amount of PM10. Full article
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Article
Risk Perception of SARS-CoV-2 Infection and Implementation of Various Protective Measures by Dentists Across Various Countries
Int. J. Environ. Res. Public Health 2021, 18(11), 5848; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115848 - 29 May 2021
Cited by 1 | Viewed by 1412
Abstract
Objective: Healthcare workers in general are at a high risk of potential infections with COVID-19, especially those who work with aerosol generating procedures. Dentists fall in this category, as not only do they operate with aerosol generating procedures but also operate within a [...] Read more.
Objective: Healthcare workers in general are at a high risk of potential infections with COVID-19, especially those who work with aerosol generating procedures. Dentists fall in this category, as not only do they operate with aerosol generating procedures but also operate within a face-to-face contact area. Methods: A structured self-administered questionnaire was developed at Najran University and provided to the participants for data collection. The data collected included information on risk perception and incorporation of measures for protection against COVID-19 to gauge the attitude of dentists during this period. Also, clinical implementation of various protective measures was reviewed. Results: Of the n = 322 dentists that answered the questions, 50% were general dentists and 28.9% were dentists working at specialist clinics, while the remaining 21.1% of dentists were employed in academic institutions. Among the newer additions to the clinic, 36.3% of dentists answered that they had added atomizers to their practices, followed by 26.4% of dentists that had incorporated the use of UV lamps for sterilization. We found that 18.9% dentists were using HEPA filters in their clinics, while 9.9% of dentists were making use of fumigation devices to control the risk of infection. One-way ANOVA was also carried out to demonstrate that there was a statistically significant difference (p = 0.049) between groups of dentists utilizing HEPA filters, UV lamps, atomizers, and fumigation devices to prevent the spread of SARS-CoV2 across their workplaces. Conclusion: Dentists are aware of recently updated knowledge about the modes of transmission of COVID-19 and the recommended infection control measures in dental settings. A better understanding of the situation and methods to prevent it will ensure that the dental community is able to provide healthcare services to patients during the pandemic. Full article
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Article
Facial and Oral Manifestations Following COVID-19 Vaccination: A Survey-Based Study and a First Perspective
Int. J. Environ. Res. Public Health 2021, 18(9), 4965; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094965 - 07 May 2021
Cited by 3 | Viewed by 1691
Abstract
(1) Background: Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) emerged in Wuhan, China, in late 2019. The development of effective and safe vaccines against SARS-CoV-2 has been extremely fast. The list of orofacial adverse effects of BNT162b2 and mRNA-1273 vaccines based on the clinical [...] Read more.
(1) Background: Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) emerged in Wuhan, China, in late 2019. The development of effective and safe vaccines against SARS-CoV-2 has been extremely fast. The list of orofacial adverse effects of BNT162b2 and mRNA-1273 vaccines based on the clinical trials are reported to be rare. The aim of this study was to investigate the facial and oral manifestations of COVID-19 vaccination using a survey-based study. (2) Methods: The questionnaire was developed using Google Forms and sent anonymously to a total of 700 subjects (medical personnel) in Poland, Italy, and other EU countries. (3) Results: 223 people answered the questionnaire, mainly vaccinated with BNT162b2. Only 3.1% and 5.4% experienced oral and facial symptoms, respectively. General diseases presence and age have significant influence on the probability of oral symptoms occurrence after the second dose. Facial symptoms are correlated with general disease; autoimmune pathologies and age, at first and second dose, respectively. Gender, smoking and regular medication intake have significant influence on the probability of taking an absence day. Gender, age, and smoking have a significant influence on the duration of symptoms after second dose. (4) Conclusions: Based on the results of this preliminary survey, there is no observed significant correlation between vaccine administration for COVID-19 and facial and oral manifestations. Full article
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Article
Dissemination of Aerosol and Splatter in Clinical Environment during Cavity Preparation: An In Vitro Study
Int. J. Environ. Res. Public Health 2021, 18(7), 3773; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073773 - 04 Apr 2021
Cited by 3 | Viewed by 1031
Abstract
Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a [...] Read more.
Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a great risk of transmitting contagious infections to health care workers and patients, especially in an era of social distancing due to COVID-19. The current study was conducted to evaluate contamination amount, duration, the distance of aerosol, and splatter produced after cavity preparation using a two-hole and four-hole handpiece. The study was performed on a dental manikin in a dental simulation laboratory at the College of Dentistry, King Faisal University Al Ahsa. The dental manikin was set to a reclined position to simulate the clinical operatory position of the patient for dental restorative procedures. Aerosol and splatter were collected on Grade 1 qualitative cotton cellulose filter paper. These were placed on adhesive tape extending from the headrest of the dental manikin in six different directions (2, 4, 6, 8, 10, and 12 o’clock) for up to 60 inches and on certain positions of the operator and assistant such as the chest, head, forearms, upper leg, and inside facemask. Class V cavity preparation was done by the principal investigator at a specific time of 3 min on tooth #11 using a two-hole high-speed handpiece, then on the next day, Class V cavity preparation was performed on tooth #21 by a four-hole handpiece. High volume suction was used throughout the cavity preparation. Immediately after cavity preparation, the first filter paper disc was replaced with new ones in all positions. The second set of filter papers was removed after 30 min. Transparent grids were used to count the contamination area on the filter paper disc. No statistically significant difference was found in the mean amount of aerosol and splatter produced by both handpieces, however, a statistically significant difference was found in an amount of aerosol and splatter produced at a 12, 24, and 36 inches distance immediately after cavity preparation and 30 min after cavity preparation, regardless of the type of handpiece used. It is advisable to refrain from removing the personal protective barriers immediately after the procedure within the vicinity of the dental practice. The use of other adjuncts such as high volume suction to reduce the spread of aerosol and splatter is also recommended. Full article
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Review

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Review
Recommendations for Safe Dental Care: A Systematic Review of Clinical Practice Guidelines in the First Year of the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(19), 10059; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910059 - 24 Sep 2021
Viewed by 858
Abstract
In the context of a pandemic, the rapid development of clinical practice guidelines (CPGs) is critical to guide dental staff towards the safe provision of dental care; detailed knowledge of the recommendations will help to achieve the intended results. We carried out a [...] Read more.
In the context of a pandemic, the rapid development of clinical practice guidelines (CPGs) is critical to guide dental staff towards the safe provision of dental care; detailed knowledge of the recommendations will help to achieve the intended results. We carried out a systematic review of the recommendations in clinical practice guidelines (CPGs) on the provision of dental care issued during the first year of the COVID-19 pandemic. A systematic database search was performed in MEDLINE, EMBASE, LILACS, Epistemonikos, and Trip databases to identify documents with recommendations intended to minimize the risk of COVID-19 transmission during dental care. The selection process and data extraction were carried out by two researchers independently. The majority of CPGs recommended the use of rubber dam, high-volume evacuator, mouthwash prior to dental care, four-handed work, and mechanical barriers. The use of aerosol-generating equipment should be avoided whenever possible. In aerosol-generating procedures, the use of a N95 respirator (or similar) is recommended, in addition to a face protector, an impermeable disposable apron/gown, a cap, and gloves. The CPGs developed during the first year of the pandemic offer recommendations which guide dental staff in providing safe dental care, minimizing exposure to SARS-CoV-2 and reducing the risk of COVID-19 infection in the clinical environment. Such recommendations must, however, be updated as new evidence arises. Full article
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