Clinical Response to COVID-19 and Utilization of an Emergency Dental Clinic in an Academic Institution

IntroductionThe spread of coronavirus disease 2019 (COVID-19) in the spring of 2020 resulted in the temporary suspension of elective dental procedures and clinical dental education in academic institutions. This study describes the use of the Tufts University School of Dental Medicine emergency dental clinic during the peak surge in COVID-19 cases in Massachusetts, highlighting the number of endodontic emergencies.MethodsAggregate data from clinical encounters and call records to an emergency triage phone line from March 30 through May 8, 2020, were used to describe the characteristics of dental emergencies, clinical encounters, and procedures performed.ResultsA total of 466 patient interactions occurred during this period, resulting in 199 patients advised by phone and 267 clinical encounters. The most common dental emergencies were severe dental pain from pulpal inflammation (27.7% of clinical encounters) followed by a surgical postoperative visit (13.1%). The most frequent procedures were extractions (13.9% of clinical encounters) and surgical follow-up (13.5%); 50.2% of the clinical encounters were categorized as aerosol generating, and 86.1% of encounters would have required treatment in a hospital emergency department if dental care was not available. There were no known transmissions of severe acute respiratory syndrome coronavirus-2 among clinic providers, patients, or staff during this period.ConclusionsThese results highlight the importance of endodontic diagnosis and treatment in the provision of emergency dental care during a pandemic and demonstrate that dental treatment can be provided in a manner that minimizes the risk of viral transmission, maintaining continuity of care for a large patient population.     

Dental students’ academic performance before and after the Covid-19 pandemic: A retrospective analysis

Delivering quality education to students with fair assessment strategies is a key indicator of an excellent educational institution. The present study explored the impact of the COVID-19 pandemic on the academic performance of dental students in terms of the evaluations/grades awarded to them before and during the pandemic. The targeted groups were dental students, studying in the third year of 2018–2019 and 2020–2021 academic years. The sample size included all male and female students who enrolled and completed the following courses: pre-clinical fixed prosthodontics (SDS333), pre-clinical removal prosthodontics (SDS323), clinical operative dentistry-1 (RDS313), and pre-clinical endodontics (RDS323). Evaluations for students who did not complete the requirements were not included in the statistical analysis. Paired sample statistics were used for comparisons between the different groups at p < 0.05. Results revealed statistically significant differences (p ≤ 0.05) for all the course pairs. It was found that students’ grades for all the courses during the pandemic year were higher compared to the grades before the pandemic. While female students demonstrated the highest mean difference (6.13) before and during the pandemic year for RDS323, males demonstrated the highest mean difference (8.14) for SDS323. However, both male and female students demonstrated the lowest mean difference (0.25 and 2.03, respectively) for SDS333. The grades were higher during the COVID-19 pandemic. Overall, female students achieved higher grades than male students.     

Attitude towards Oral Health at Various Colleges of the University of Zagreb: A Pilot Study

Purpose

The aim of this study was to compare the oral status of three various groups of students: students of the School of Dental Medicine, students of technical sciences and students of humanities.

Material and methods

Research included 58 students of the University of Zagreb. They answered 3 questions: how often they brush their teeth, how often they visit their dentist and how important dental health is to them. After a standard dental check-up we calculated the DMFT index. They were given an indicator for plaque Mira-2-Ton® (Hager Werken, Duisburg, Germany) and we calculated the plaque index. For statistical analysis the ANOVA test was used.

Results

Students of the School of Dental Medicine had a lower plaque index than other students and this was statistically significant (p=0.0018; f=7.14). They also had a lower DMFT index, but it was not statistically significant (p=0.1004; f=2.4). 83% of students said that they brushed their teeth 2-3 times a day. Only 17% of all students brush their teeth more than 3 times a day and they are all students of the School of Dental Medicine (21% of them). Perception of oral health is on a high level, but perception of oral disease is not. The social approval of the answer was also an important factor.

Conclusion

Students of the School of Dental Medicine are an illustrative example of improving our habits due to education.Key Words: Oral Health, University of Zagreb, Cavities     

Frequency and pattern of outpatient dental visits during the COVID-19 pandemic at hospital and community clinics

BackgroundThe authors aimed to measure the frequency of dental visits before and during the COVID-19 pandemic and to evaluate whether dental visits can be predicted from demographic characteristics, socioeconomic status, oral problem diagnoses, and dental service providers.MethodsParticipants for this retrospective study were patients visiting dental care providers at hospital- and community-based outpatient clinics in Alberta, Canada. Data were retrieved from electronic databases from March 12, 2020, through September 30, 2020, and from the same period for 2018 and 2019. The COVID-19 lockdown was declared for March 12 through May 14, 2020. Data were analyzed using analysis of variance test and multiple logistic regression at α = 0.05.ResultsFrom a total of 14,319 dental visits, 5,671, 5,036, and 3,612 visits occurred in 2018, 2019, and 2020, respectively. The mean (standard deviation) frequency of daily visits was 36.69 (15.64), 32.09 (15.51), and 24.24 (14.78), respectively. Despite the overall decrease, the frequency of visits for infections, salivary problems, and temporomandibular disorders increased during the COVID-19 pandemic in 2020. Dental visits during the pandemic were associated with more complicated oral diagnoses and dental services as well as higher economic status.ConclusionsDuring the COVID-19 pandemic, the frequency of dental visits decreased specifically during lockdown. Patients with complicated problems requiring urgent treatments mainly visited dental clinics. Reduced access to care was observed primarily among socially disadvantaged groups.Practical ImplicationsAlthough guidelines and related recommendations have been effective in restoring the compromised dental system during the COVID-19 pandemic, additional modifications are needed to promote in-person visits to improve the oral health status of patients.     

Dental trainees’ mental health and intention to leave their programs during the COVID-19 pandemic

BackgroundDental trainees (dental students, graduate students, and postdoctoral residents) are at increased risk of experiencing poor mental health, which can lead to intentions to leave their program, especially during the COVID-19 pandemic.MethodsThe authors invited 355 dental trainees at the University of Washington School of Dentistry to complete an 83-item questionnaire in August and September 2020. The outcome analyzed was intention to leave their programs. There were 4 self-reported predictors: anxiety, burnout, depression, and COVID-19 impact on overall mental health. The authors ran multiple variable logistic regression models to evaluate relationships between each predictor and outcome (α = .05) and reported odds ratios (ORs) and 95% CIs.ResultsThe survey response rate was 35.5%. Overall, 12.7% of participants reported any intention to leave. In total, 22.2% and 16.7% of participants endorsed clinically significant anxiety or depression symptomatology, respectively; 28.6% reported 1 or more burnout symptoms; and 69.0% reported that COVID-19 affected their overall mental health. Participants reporting anxiety (OR, 8.87; 95% CI, 1.80 to 43.57; P = .007), depression (OR, 11.18; 95% CI, 1.84 to 67.74; P = .009), or burnout (OR, 8.14; 95% CI, 1.73 to 38.23; P = .008) were significantly more likely to report intention to leave than those not reporting mental health problems. All participants reporting that the COVID-19 pandemic impacted their mental health expressed intention to leave.ConclusionsPoor mental health is common among dental trainees and is associated with intention to leave their program.Practical ImplicationsCOVID-19 has exacerbated the prevalence and consequences of poor mental health among dental students, highlighting the importance of providing wellness resources.     

Did the March 2020 lockdown cause an increase in patients presenting to the emergency department with odontogenic pain and infection? A single centre,retrospective analysis

On the 25 March 2020 the Chief Dental Officer (CDO) published guidance to restrict the provision of routine dental care in England due to the rapid spread of the severe acute respiratory syndrome Coronavirus 2 (COVID-19). We analysed the impact of the pandemic on the number of patients presenting with odontogenic pain and infection to the emergency department (ED) of an urban-based teaching hospital, the Bristol Royal Infirmary (BRI). Furthermore, we investigated the severity of infection at first presentation to the ED. The study period encompassed three phases that represented the stages of pandemic restrictions: phase 1 prior to lockdown measures, with no restrictions to dental practice; phase 2 during the government lockdown, with the severest restrictions on dental practices; and phase 3 following the ease of lockdown measures, with return to limited dental services. Data were collected retrospectively from electronic patient records (EPR) regarding adult patients presenting to the ED with dental pain. The rate of presentations (per week) was calculated for each timepoint and compared. A severity score was assigned to each patient using a grading system based on signs of clinical infection and treatment modality. Patients' presentations were analysed at each phase of the pandemic. There was a 42.8% increase in attendance with oral facial pain and infection to ED from phases 1 to 3. The COVID-19 pandemic resulted in restrictions to routine primary dental care services, which were deemed necessary to reduce the spread of the virus. However, this increased demand on secondary care services, as patients increasingly struggled to access primary dental care to manage dental pain.     

FORENSIC SCIENCE:: 20 YEARS OF FORENSIC DENTISTRY AT THE UNIVERSITY OF ZAGREB, 1994 - 2014

Data from available literature point to an early beginning of Forensic Dentistry in Croatia relating to a post-mortem examination of a female patient after a dental procedure in the 1930s. Later on, there were several mass casualties due to collisions and airplane crashes and a railway accident at the Zagreb Main Railway Station wherein the identity of the victims was established based on dental features. Foreign experts in forensics helped identify those victims, particularly forensic dentists because this specialty was almost unknown in our region at the time. During the twenty-year period of the development of Forensic Dentistry at the University of Zagreb, the School of Dental Medicine, the city of Zagreb and Croatia have become internationally recognised on the forensic map of the world.Key words: Forensic Dentistry, Dental Identification, University of Zagreb, School of Dental Medicine     

Prevalence of Dental Anomalies in Orthodontic Patients

AimThe aim of this retrospective study was to determine the frequency of hypodontia, hyperdontia, invagination, impaction, dilacerations, peg-shaped lateral incisors, taurodontism and short or blunt and narrow or pipette-shaped roots in Croatian orthodontic patients.Material and methods506 orthopantomographs and study casts from 12-16 year-old orthodontic patients treated at the Department of Orthodontics, School of Dental Medicine University of Zagreb were analyzed.ResultsAt least one dental anomaly was present in 24.1% of patients, and more than anomaly in 1.2% of them. The frequency was not significantly different between genders. Hypodontia was the most frequent anomaly with the incidence of 7.5%, followed by teeth impaction with the incidence of 6.3%.ConclusionThe distribution and the prevalence of anomalies were similar to those described in the general Croatian population.     

Impact of Gingival Margin Asymmetries on the Smile Esthetic Perception of Dental Specialists,Doctors of Dental Medicine,Students, and Laypeople: a Comparative Pilot Study

ObjectiveTo evaluate the perceptions of altered incisor gingival position among dental specialists, dentists, dental students, and laypeople.Materials and methodsFour digital smile photographs with altered gingival margin position of the right maxillary incisor (0, 1, 2, and 3 mm) were presented to a sample of 232 respondents (71.1% female; 28.9% male): 42 dental specialists, 63 dentists, 33 dental students (1^st to 3^rd year), 38 dental students (4^th to 6^th year) and 56 laypeople. The questionnaire consisted of four randomly displayed photographs, administered via Google Form, and respondents were asked to rate the images on a scale from 1 to 5, from the least attractive to the most attractive. A statistical analysis was performed using the TIBCO Statistica program (v. 13.3. 0, TIBCO Software Inc., Palo Alto, CA, USA; 2017). According to the Shapiro- Wilk''s test, the data were not distributed normally. The Kruskal-Wallis test with post hoc multiple comparisons with the Bonferroni adjustment were used to compare group esthetic scores and to determine the threshold levels of deviation at which each group was discriminated between esthetic and non-esthetic situations.ResultsMedian values of esthetic scores decreased in all groups as the gingival asymmetries increased. Dental professionals were significantly more critical of esthetics than laypeople in all levels of asymmetry. The greatest difference was found for 2 mm of gingival asymmetry (p=0.002).ConclusionFrom the results of our study, we can conclude that the perception of gingival asymmetries in the esthetic zone of smile differs among dental specialists, doctors, students, and laypeople. Dental specialists, doctors, and clinical students were more critical of these asymmetries, while preclinical students and laypeople noticed only 2 mm or more of gingival asymmetry of central incisors.     

Multifaceted impact of COVID-19 on dental practice: American dental care professionals prepared and ready during unprecedented challenges

BackgroundThe purpose of this study was to evaluate the multifaceted impact of the COVID-19 pandemic on dental practices and their readiness to resume dental practice during arduous circumstances.MethodsThe authors distributed an observational survey study approved by The University of Texas Health Science Center at San Antonio Institutional Review Board to dental care practitioners and their office staff members using Qualtrics XM software. The survey was completed anonymously. The authors analyzed the data using R statistical computing software, χ² test, and Wilcoxon rank sum test.ResultsNearly all participants (98%) felt prepared to resume dental practice and were confident of the safety precautions (96%). Only 21% of dentists felt the COVID-19 pandemic changed their dental treatment protocols, with at least two-thirds agreeing that precautions would influence their efficiency adversely. Although most participants were satisfied with the resources their dental practice provided for support during the pandemic (95%), most were concerned about the impact on their general health and safety (77%) and to their dental practice (90%), found working during the pandemic difficult (≈ 60%), and agreed there are challenges and long-term impacts on the dental profession (> 75%).ConclusionsDental care professionals, although affected by the COVID-19 pandemic and at high risk of developing COVID-19, were prepared to resume dental practice during most challenging circumstances.Practical ImplicationsThe pandemic has affected dental care practitioners substantially; thus, there is need to formulate psychological interventions and safety precautions to mitigate its impact. Further research should evaluate the long-term effects on dentistry and oral health and interceptive measures for better communication and programming around future challenges.     

Methods Helping Dentists to Detect Dental Fear

ObjectivesDental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients’ self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed.MethodsA cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new “traffic light” colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants.ResultsOf the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF “traffic light” system. The association between dentists’ and participants’ estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = −0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS.ConclusionsColour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.     

Self-reported differences between oral health attitudes of pre-clinical and clinical students at a dental teaching institute in Saudi Arabia

ObjectiveTo compare the attitudes of preclinical and clinical dental students toward their own oral health using the Hiroshima University-Dental Behavioral Inventory (HU-DBI).MethodsThe English-language version of the 20-item HU-DBI was distributed to all preclinical and clinical students at the College of Dentistry, University of Dammam, Kingdom of Saudi Arabia. Dichotomized (agree/disagree) responses to 12 HU-DBI items were used in this study, with a maximum possible score of 12. Responses to the remaining eight statements reflected general oral health attitudes and were excluded from the analysis. Data were analyzed statistically.ResultsThe overall response rate was 72.2% (preclinical, 72.5%; clinical, 72%). The mean HU-DBI score was significantly higher among clinical than among preclinical dental students (7 vs. 5.8; P < 0.05). Higher proportions of preclinical than clinical students did not worry about visiting the dentist but postponed dental visits until they experienced toothache. Furthermore, more preclinical than clinical students reported that their gums bled upon brushing, used a child-sized toothbrush, had observed white, sticky deposits on their teeth, and used strong strokes for toothbrushing. More clinical than preclinical students reported that they did not feel that the condition of their teeth was worsening despite brushing, worried about the color of their teeth, brushed each of their teeth carefully, and checked their teeth in the mirror after brushing.ConclusionsDental health awareness programs should be implemented and information about positive oral health attitudes should be provided to the students at an initial stage of dental training.     

Dental Anxiety Amongst Pregnant Women: Relationship With Dental Attendance and Sociodemographic Factors

Introduction: Access to oral care during pregnancy is important for the maintenance of optimal oral health.Objective: The aim of this study was to estimate dental anxiety (DA) and its association with previous dental visits and sociodemographic factors amongst pregnant women.Methods: A cross-sectional study was conducted (June through August 2019) amongst pregnant women (N = 825) attending hospitals and health centres in Dhahran, Khobar, and Dammam cities in the Eastern province of Saudi Arabia. The Modified Dental Anxiety Scale (MDAS) was used to assess DA and the World Health Organization Oral Health Survey for Adults was administered to evaluate patterns of dental attendance.Results: DA was found in 90.9% of the pregnant women. The mean DA score of the sample was 12.53 ± 5.33 (range, 5 to 25) and it was significantly higher amongst non-Saudi (13.21 ± 5.24) vs Saudi women (12.15 ± 5.34) (P = .006), those who had negative dental experience (13.99 ± 5.62) vs those without such experience (12.2 ± 5.21) (P < .001), and those with dental pain or discomfort (13.18 ± 5.46) vs without pain or discomfort (11.94 ± 5.14) (P = .001). The study found a significant relationship between DA and reasons for dental attendance before pregnancy (P = .002) and time since the last dental visit (P = .009). Multiple logistic regression analysis showed significantly increased odds (OR, 1.69; 95% CI, 1.25 to 2.27) of experiencing moderate to extreme DA amongst pregnant women who visited the dentist after a year/never visited compared to those who visited in less than a year. Similarly, participants with negative dental experience were significantly more likely to have moderate to extreme DA (OR, 1.49; 95% CI, 1.02 to 2.20) than those without negative experience after adjusting for sociodemographic factors.Conclusions: DA was highly prevalent amongst pregnant women, which was significantly associated with negative dental experience, dental pain or discomfort, and reasons for and time since the last dental visit.     

Dental esthetics and quality of life in adults with severe malocclusion before and after treatment

Objective:To investigate the association between satisfaction with dental esthetics and quality of life, and esthetics satisfaction in relation to esthetic evaluations of three panel groups.Materials and Methods:Fifty-two patients (36 women, 16 men; age 18–61 years) with severe malocclusion were treated in Oulu University Hospital. Of these, 38 and 14 patients underwent orthodontic/surgical treatment and orthodontic treatment, respectively. A questionnaire and dental photographs were collected before and after treatment. The 14-item Oral Health Impact Profile (OHIP-14) was used to measure oral health-related quality of life. Satisfaction with dental esthetics was evaluated using the Visual Analogue Scale. Dental photographs were presented to three panel groups: 30 laypersons, 30 dental students, and 10 orthodontists, who rated the photographs using the Aesthetic Component of the Index of Orthodontic Treatment Need.Results:Oral health–related quality of life (OHIP-14 severity score) and esthetic satisfaction (according to the Visual Analogue Scale) improved after the treatment (P < .001). The most unsatisfied patients reported oral effects more often both before and after treatment. Changes in oral health–related quality of life components of severity, psychological discomfort, and psychological disability correlated positively with the changes in esthetic satisfaction. Orthodontists graded the situation before treatment as worse and the outcome as better than the laypersons; the level of grading by dental students fell between these two groups.Conclusion:Improvement in esthetic satisfaction due to the treatment of severe malocclusion improves oral health–related quality of life, particularly by decreasing psychological discomfort and psychological disability.     

Dental fear among a young adult Saudian population

AIMS: To assess the prevalence of dental fear and reasons for irregular dental attendance among young adult university students; to describe the gender distribution of the dentally anxious population according to the perceived origins or sources of fear; to identify the time of fear development and preference for anaesthesia or sedation before dental treatment. METHOD: A questionnaire incorporating the Dental Fear Scale (DFS) with items related to sources of dental fear stimuli, together with the preference of anaesthesia or sedation before dental treatment and other characteristics. Approximately 500 questionnaires were distributed among Saudian undergraduate students. RESULTS: 368 questionnaires were completed and presented for statistical analysis. The sight and sensation of anaesthetic needles and the sight, sound and sensation of the drill were rated the most fear-eliciting stimuli. Also, females tended to be more anxious than males. Increased heart rate was the most common reported physiological response to fear resulting from dental treatment. The overall level of fear of dental work among the studied population was found to be about 39%.'Lack of time' and 'no need for treatment' were found to be the main reasons for irregular dental visits. Fear of pain and trauma were the major perceived sources of reported fear reactions and were developed mainly during childhood. About 63% of the subjects preferred to have local anaesthesia before dental treatment to prevent or ameliorate dental fear.     

Psychometric properties of the Revised Dental Beliefs Survey

OBJECTIVES: The objectives of this pair of studies were to examine the internal reliability, test-retest reliability, and construct validity of the Revised Dental Beliefs Survey. METHODS: A total of 108 college students completed two questionnaires containing the Revised Dental Beliefs Survey, as well as the Revised Iowa Dental Control Index, and Desirability of Control scales. As part of another experiment, 141 study participants with dental injection phobia completed the Revised Dental Beliefs Survey and the Dental Anxiety Scale. RESULTS: Both the internal and test-retest reliabilities of the Revised Dental Beliefs Survey were high. The measure demonstrated good convergent and discriminant validities. CONCLUSION: The Revised Dental Beliefs Survey is well-suited for use with clinical and nonclinical populations, in which a stable and valid measure of perceptions of the dental situation is desired.     

COVID-19–Related Factors Delaying Dental Visits of Workers in Japan

BackgroundThe aim of this research was to investigate the factors associated with postponing dental attendance amongst Japanese workers during the coronavirus disease 2019 (COVID-19) pandemic.MethodsWe conducted an internet-based survey in Japan from November 24 to 29, 2021. The participants were selected from people registered with an online research company. The inclusion criteria for this study were full-time or part-time workers aged 20 to 69 years. Participants filled out a questionnaire about their oral health, behaviour, and working conditions.ResultsA total of 1840 participants were included in the analysis. Three hundred ninety-eight participants (21.5%) answered that they postponed dental attendance due to COVID-19. Multiple logistic regression showed that women were more likely to postpone dental attendance (odds ratio [OR], 1.74; 95% confidence interval, 1.33–2.26). Moreover, employment status, household income, changes in income, working at home, interdental cleaning device use, regular dental attendance, awareness of untreated teeth, and dental pain were also associated with postponing dental attendance. The results of decision tree analysis showed that regular dental attenders with dental pain were the most likely to postpone dental attendance.ConclusionsThe characteristics of postponed dental visits for Japanese workers differ depending on whether one is a regular dental attender or not. Amongst regular dental attenders, worsening oral health due to interruptions in dental attendance is concerning. Meanwhile, untreated teeth might be neglected amongst nonregular dental attenders. Preventing patients from refraining from dental attendance, regardless of whether or not they are regular dental attenders, is important during the COVID-19 pandemic.Key words: COVID-19, Postponed dental attendance, Dental visits, Regular checkups     

The impact of COVID-19 on access to dental care for people with disabilities: a global survey during the COVID-19 first wave lockdown

Background It is unclear what immediate impact the COVID-19 pandemic has had on delivery of oral healthcare to people with disabilities worldwide. Aim: To report the international impact of COVID-19 lockdown on oral healthcare provision for people with disabilities before, during and after the first lockdown (March to July 2020).Material and Methods Cross-sectional online self-administered survey of dentists who treat people with disabilities completed 10th to 31st of July 2020. Responses allowed comparison from before, during and immediately after the first wave lockdowns of the COVID-19 pandemic. Data were analysed using McNemar’s test to compare reported practice before to during lockdown, and before to after lockdown.Results Four-hundred-thirty-six respondents from across global regions reported a significant reduction from before to during and from before to after lockdown regarding: the proportion of dentists treating people with all types of disability (p <0.001) and the number of patients with disabilities seen per week (p<0.0001). The proportion reporting no availability of any pharmacological supports rose from 22% pre-lockdown to 61% during lockdown (p < 0.001) and a persistent 44% after lockdown (p < 0.001). An increase in teledentistry was observed.Conclusions During the first COVID-19 lockdown, there was a significant negative impact on the delivery of dental care to people with disabilities. Oral healthcare access was significantly restricted for people with disabilities with access to sedation and general anaesthesia particularly affected. There is now an increased need to ensure that no-one is left behind in new and existing services as they emerge post-pandemic. Key words:COVID-19, disability, dental care, access.     

Impact of the Coronavirus on Providing Oral Health Care in the Netherlands

ObjectiveTransmission of SARS-CoV-2 during oral health care is potentially increased compared to regular social activities. Specific amendments to the Dutch national infection control guidelines were promulgated. This study aimed to map the impact of the coronavirus pandemic on providing oral health care during the first wave of the coronavirus pandemic in 2020 in the Netherlands.MethodsA cross-sectional web-based survey was sent via email to a representative sample of dental hygienists and dentists in the Netherlands.ResultsOf the 1700 oral health care practitioners approached, 440 (25.9%) responded to the survey. Patient access to oral health care was severely restricted during the lockdown in the spring of 2020. A total of 1.6% of the oral health care practitioners had laboratory-confirmed COVID-19 during the study period, although this is likely to be an underrepresentation due to limited access to testing at that time. Over half of the participants perceived an increased risk of virus transmission during aerosol-generating treatments in their practices. A large majority (65.0%–87.1%) of the oral health care practitioners followed the COVID-19-specific amendments to the national infection control guidelines. Compared to the pre-pandemic period, additional personal protective equipment and protocols were applied. Factors related with compliance with the additional recommendations were age, employment status, and occupation.ConclusionsThe pandemic had a profound impact on both the accessibility and practice of oral health care. This survey study found that most Dutch oral health care practitioners paid extra attention to hygiene and infection control. Also, a low number of COVID-19 infections detected amongst Dutch oral health care practitioners was reported in the Netherlands. These overall outcomes suggest that safe oral health care can be provided when following the current infection control recommendations.Key words: SARS-CoV-2, COVID-19, Dental infection control, Dental care, Dental practice management, Dentists     

Dental archforms in dentoalveolar Class I,II and III

Objective:To test the hypothesis that no differences exist in dental arch dimensions between dentoalveolar Classes I, II, and III, and between male and female subjects, as measured on virtual three-dimensional (3D) models.Materials and Methods:Samples included randomly selected plaster dental casts of 137 white patients (43 Class I, 50 Class II, and 44 Class III) from the Department of Orthodontics, School of Dental Medicine, University of Zagreb, Croatia. Dental models were scanned and digitized using ATOS II SO (“Small Objects”) scanning technology (GOM mbH, Braunschweig, Germany). Eight linear and two proportional measurements were calculated for both upper and lower dental arches.Results:In men, a significant difference in the upper dental arch was present in the incisor region, and in the lower dental arch, differences were found in intercanine and intermolar widths (P < .05). Significant differences were noted between male groups in the upper molar depth dimension (P  =  .022) and in the lower molar and canine depth dimensions (P < .05). Class III males had the greatest lower molar and canine width/depth ratios and the smallest lower canine depth/molar depth ratio. Class III women had wider and shorter mandibular arches when compared with Class I and Class II females.Conclusion:The hypothesis was rejected. The dimensions of the dental arches are related to gender and to dentoalveolar class. Class I and II subjects have similar dimensions of maxillary dental arch, but Class II subjects have a transverse deficit in the mandible. In Class III subjects, the maxillary dental arch is insufficient in transverse and sagittal dimensions, and the mandibular arch dominates in the transverse but not in the sagittal dimension.