新型冠状病毒肺炎疫情期口腔专科感染防控的应急管理

本文根据国家有关新型冠状病毒感染防控要求和突发公共卫生事件应急条例,以及口腔专科的临床诊疗特点,参考国内外口腔诊疗中感染防控相关指南和文献,结合医院疫情期口腔诊疗中感染防控的应急管理工作举措,提出应对此次新型冠状病毒肺炎疫情期医院感染防控的建议,重点聚焦疫情期医务人员防护培训及医院感染防控落实等方面,旨在为口腔专科在疫情发生期快速应对新型冠状病毒感染防控的应急管理提供参考。     

新冠肺炎疫情复工复产期间口腔外科门诊手术室的院感防控策略

当前新型冠状病毒肺炎疫情防控形势持续向好,但随着复工复产和境外人员输入,疫情仍存在较大风险。正确落实各项防控措施,降低感染发生和传播的风险,同时有序开放口腔外科门诊手术,保障广大患者的就诊需求,是目前口腔外科门诊手术室面临的重要问题。本文梳理了当前复工复产和境外人员输入时期新型冠状病毒肺炎控制的难点和问题,根据突发公共卫生事件应急响应级别,制订并适时调整对应的院感防控策略,提出了当前新型冠状病毒肺炎疫情复工复产期间口腔外科门诊手术室的院感防控策略,以供临床参考。     

从新型冠状病毒肺炎疫情防控看传染病流行期口腔门诊管理策略

新型冠状病毒肺炎爆发对口腔医疗机构管理和临床诊疗中的传染病防护提出了新课题。本文结合我国传染病防治法、国家卫生健康委员会颁发的相关规范标准,参考部分省份口腔医疗质量控制中心制定的口腔门、急诊医院感染控制规范和本次新型冠状病毒肺炎疫情情况,对口腔门、急诊在疫情控制期控制交叉感染和医务人员防护等方面进行了探讨,希望为疫情发生时口腔医疗机构的应对和相关的临床研究提供参考。     

口腔医疗机构应对国家突发公共卫生事件的问题与思考

突发公共卫生事件应急管理是一个全球性的课题。本文就2019年12月以来发生在中国的新型冠状病毒肺炎这一突发公共卫生事件,口腔医疗机构及其从业人员面临的相关问题进行法律层面的分析与思考,以期对口腔医疗行业应对突发公共卫生事件提供帮助和指导。     

新型冠状病毒肺炎疫情下提高口腔种植门诊诊疗工作的安全性

新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)的爆发和传播,成为被世界卫生组织认定的“国际关注的突发公共卫生事件”[1],对口腔种植门诊的诊疗和护理带来巨大的挑战。口腔种植门诊诊疗操作的特殊性,新型冠状病毒肺炎的流行病学特点,使口腔医务人员成为新型冠状病毒肺炎感染的高危群体,疫情存在口腔操作中爆发的危险。本文根据对新型冠状病毒防控的总体要求,结合口腔种植门诊的专业特点,制定相关护理防控措施,保证护理工作有序进行,提高诊疗工作的安全性。本文内容涉及预检分诊、不同工作场景下的防护及提高口腔种植门诊诊疗环境安全性等,提出了疫情下的口腔护理防护策略,达到保护医护人员和患者健康的目的,以期为口腔种植门诊在疫情期的护理防控工作提供参考。     

疫情下口腔医学研究生教学管理的探讨

目的：探讨新型冠状病毒疫情影响下不同阶段研究生教学的应急管理措施,为研究生教学管理工作提供参考与探讨。方法：从加强疫情防控工作、调整研究生培养方案、保证“停课不停学”、做好心理疏导工作、准备全面返校复学、制定后疫情时代培养方案等方面探讨新型冠状病毒疫情影响下,不同阶段重庆医科大学口腔医学院研究生教学的管理工作。结果：疫情期间,重庆医科大学口腔医学院研究生无新冠肺炎确诊病例发生,研究生培养工作进展顺利,并以本次疫情为契机加强院感培训,提高口腔医学研究生对突发公共卫生事件的应对能力。结论：应对突发公共卫生事件,我院采取对研究生精准分类,及时调整培养方案;重视线上教学,弥补不能线下教学的不足;做好学生思想工作,为全面复学做准备;后疫情时代,提高对口腔医学研究生应对突发公共卫生事件能力培养的重视。     

新型冠状病毒防控阶段口腔颌面创伤管理策略

新型冠状病毒肺炎（COVID-19）疫情在短期内已扩散至全球30个国家和地区,被世界卫生组织认定为“突发公共卫生事件”。正确的防控措施可以阻断新型冠状病毒在医院内的传播,降低感染发生风险,有效防止疫情的进一步扩散。口腔颅颌面科承担着颌面部创伤急诊的工作,因诊疗操作的特殊性,交叉感染的风险较高,严格的防控措施尤其重要。本文从新型冠状病毒的流行病学特点、患者评估以及门急诊诊疗操作规范、围术期全方位防护管理等方面进行讨论,并提出相应建议。     

新型冠状病毒肺炎防疫期口腔患者的心理干预

突发公共卫生事件可对公众心理产生影响。新型冠状病毒疫情暴发影响了全国口腔医疗机构正常开展诊疗服务,口腔门诊延期等应对措施可对口腔疾病患者的体验、认知、治疗和康复等方面产生潜在影响。本文通过文献复习,对口腔黏膜病、颞下颌关节病、磨牙症、牙周病等与患者心理状态密切相关的口腔心身疾病进行回顾,认为这些患者可能更容易受到应激事件的影响,需要口腔专科医师提高关注度。同时分析了不同口腔疾病患者可能出现的心理应激症状,为口腔医师远程咨询和急诊接诊提出建议。疫情期间口腔医师不仅承担了口腔专业指导的专家角色,还承担了帮助患者进行心理疏导的角色。     

口腔诊疗中新型冠状病毒感染的防控

新型冠状病毒肺炎(COVID-19)疫情在短期内扩散至全球多个国家和地区,确诊和死亡病例数持续上升,成为被世界卫生组织认定的"国际关注的突发公共卫生事件"。正确的防控措施可以阻断新型冠状病毒在医院内的传播,降低感染风险,有效防止疫情进一步扩散。口腔专业因诊疗操作的特殊性,交叉感染的风险较高,严格的防控措施尤其重要。本文从新型冠状病毒的流行病学特点、口腔诊疗医院感染特点、患者评估以及诊疗操作和环境的防控等方面进行阐述,并提出相应的建议。     

新型冠状病毒肺炎疫情期间口腔医务人员口罩的选择和使用建议

在新型冠状病毒肺炎疫情爆发环境中,口腔专业医务人员因其专业特殊性,面临着更加严峻的感染风险。本文分析新型冠状病毒在口腔诊疗过程中的传播途径,并结合国家卫生健康委员会发布的相关规范和指南,总结国内外医用口罩和防颗粒防护口罩的种类、评价指标以及使用标准,希望为疫情期间口腔医务人员口罩的选择和使用提供参考。     

新型冠状病毒肺炎疫情期间对急性牙痛临床诊疗工作的防控建议

当前新型冠状病毒肺炎（COVID-19,简称新冠肺炎）疫情防控形势严峻,口腔诊疗由于其专业特殊性,受到了业界和卫生行政主管部门的关注。那么在疫情防控期间,作为最常见的口腔急症（急性牙痛）应该如何处理？本文结合国家卫生健康委员会颁发的相关规范标准和广东省、广州市卫生健康委员会颁发的口腔门、急诊诊疗工作文件,对疫情期间急性牙痛的处理拟定若干防控建议,以期为临床诊疗提供参考和指引。     

Improving the oral health of older people: the approach of the WHO Global Oral Health Programme

The proportion of older people continues to grow worldwide, especially in developing countries. Non-communicable diseases are fast becoming the leading causes of disability and mortality, and in coming decades health and social policy-makers will face tremendous challenges posed by the rapidly changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia and oral precancer/cancer. The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers. The means for strengthening oral health programme implementation are available; the major challenge is therefore to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health. National public health programmes should incorporate oral health promotion and disease prevention based on the common risk factors approach. Control of oral disease and illness in older adults should be strengthened through organization of affordable oral health services, which meet their needs. The needs for care are highest among disadvantaged, vulnerable groups in both developed and developing countries. In developing countries the challenges to provision of primary oral health care are particularly high because of a shortage of dental manpower. In developed countries reorientation of oral health services towards prevention should consider oral care needs of older people. Education and continuous training must ensure that oral health care providers have skills in and a profound understanding of the biomedical and psychosocial aspects of care for older people. Research for better oral health should not just focus on the biomedical and clinical aspects of oral health care; public health research needs to be strengthened particularly in developing countries. Operational research and efforts to translate science into practice are to be encouraged. WHO supports national capacity building in the oral health of older people through intercountry and interregional exchange of experiences.     

Patient- and population-reported outcomes in public health dentistry: oral health-related quality of life

At present no process is in place in the United States to comprehensively monitor the national burden of oral diseases from the perspective of oral health-related quality of life (OHRQoL), yet available evidence shows that a substantial percentage of the adult population rates their oral health poorly. This article reviews applications of OHRQoL in dental public health. The authors specifically review its use, contributions, and needed advances in: (1) monitoring the impacts of oral diseases on OHRQoL at the national level, and in public health surveillance at the state and local levels; (2) treatment outcomes research and program evaluation; and (3) clinical practice.     

Global oral health inequalities: dental caries task group--research agenda

The IADR Global Oral Health Inequalities Task Group on Dental Caries has synthesized current evidence and opinion to identify a five-year implementation and research agenda which should lead to improvements in global oral health, with particular reference to the implementation of current best evidence as well as integrated action to reduce caries and health inequalities between and within countries. The Group determined that research should: integrate health and oral health wherever possible, using common risk factors; be able to respond to and influence international developments in health, healthcare, and health payment systems as well as dental prevention and materials; and exploit the potential for novel funding partnerships with industry and foundations. More effective communication between and among the basic science, clinical science, and health promotion/public health research communities is needed. Translation of research into policy and practice should be a priority for all. Both community and individual interventions need tailoring to achieve a more equal and person-centered preventive focus and reduce any social gradient in health. Recommendations are made for both clinical and public health implementation of existing research and for caries-related research agendas in clinical science, health promotion/public health, and basic science.     

上海市新型冠状病毒肺炎防疫阶段口腔放射防控规范化专家共识

国家卫生健康委员会公告（2020年第1号）将新型冠状病毒肺炎纳入《中华人民共和国传染病防治法》规定的乙类传染病,按甲类传染病管理。各级人民政府及卫生健康行政部门高度重视。随着全国范围内新型冠状病毒病（corona virus disease 2019,COVID-19）疫情防控向好,口腔科门诊逐步恢复诊疗活动。因新型冠状病毒传播途径主要为呼吸道飞沫和接触传播,部分口腔放射检查为高危操作,规范的口腔放射学检查流程对降低病毒传播风险具有重要意义。按照国家卫生健康委员会发布的《新型冠状病毒感染的肺炎诊疗方案(试行第7版)》及上海市卫生健康委员会发布的《上海市新型冠状病毒肺炎防控方案（第5版）》要求,结合上海市各医疗机构的实际情况,上海口腔医学会口腔颌面放射专业委员会拟定了防控流程规范化专家共识,供临床参照执行,并将根据疫情防控形势及新的诊疗方案及时更新。     

Nurses’ Perceptions of Oral Health Care Provision After the COVID-19 Lockdown

ObjectiveThis study aimed to investigate nurses’ perceptions of oral health care provision to inpatients in Japanese hospitals and the infection control measures taken by them after the coronavirus disease 2019 (COVID-19) lockdown to promote collaborative oral health care.MethodThe participants were 1037 nurses working in inpatient wards at 4 hospitals in Fukuoka Prefecture, Japan. Data were collected through a questionnaire survey approximately 6 months after the first COVID-19 lockdown.ResultsMore than 90% of the 734 nurses participating in this study positively perceived the preventive effect of oral health care on aspiration pneumonia, ventilator-associated pneumonia, and viral infection. However, approximately half of them had negative perceptions about their knowledge and confidence regarding the control of COVID-19 with oral health care provision, and 84.7% expected to be provided with the necessary information by oral health professionals. Further, 537 nurses (73.2%) provided oral health care to their patients; 9 nurses (1.7%) responded that those patients who received oral health care decreased after the lockdown; and 12 (2.4%) responded that they could no longer collaborate with oral health professionals because of the lockdown. Additionally, 41.7% of them used neither protective glasses nor face shields even after the lockdown began.ConclusionsThis study showed that almost all the nurses perceived the benefcial effect of oral health care for the prevention of viral infection and pneumonia. However, some nurses perceived that their oral health care provision and collaborative oral health care were negatively affected. It also showed that most nurses’ knowledge, confidence, and use of infection control measures were insufficient. The results indicate that oral health professionals should support nurses in providing oral health care by providing them with information on COVID-19 infection control measures to prevent infection transmission.Key words: COVID-19, Lockdown, Nurse, Oral health care, Infection control, Personal protective equipment