Dental Care Workers Research Articles

Reduction of aerosol and droplet dispersions using intraoral and extraoral vacuums for dental treatments with face-up, diagonal and upright positions

PurposeThe COVID-19 pandemic has affected lives and dental treatment. Aerosols and droplets generated during dental treatment present a risk of infection for dental care workers. However, detailed elucidation of the conditions under which those are generated has yet to be presented, and no clear countermeasures for protection have been established. The present study aimed to clarify the process of generation of aerosol and droplets in dental treatment, as well as their dynamics for establishment of effective countermeasures and protection strategies.MethodsImages were obtained using a high-speed camera of aerosol and droplets generated during dental treatments performed on a mannequin. The effects of intraoral vacuum and extraoral vacuum to reduce those, as well as splash range with different body position were examined. Quantitative evaluations of aerosol and droplets were also performed using water-sensitive paper.ResultsAerosol and droplets quantities were significantly reduced by use of both intraoral and extraoral vacuums as compared to no vacuum in both image analysis and findings obtained with water-sensitive paper (p < 0.05). Additionally, the intensity of aerosol and droplets when using the intraoral and extraoral vacuum devices with a body position of 45 degrees was a significantly less as compared to the other settings (p < 0.001).ConclusionsThe present study demonstrated the effectiveness of visualization of the aerosol and droplets generated by dental tools using a high-speed camera. Use of an extraoral vacuum resulted in a reduction of those generated during simulated dental treatment, and also contributed to diffusion prevention to protect the operator and assistant. Nevertheless, it is necessary to be careful because the use of extraoral vacuums may reverse the spread of aerosol and droplets depending on the position of patient.

Attitudes and practices of dentists treating HIV+ patients in the era of new antiretroviral therapy: A 12-year update

During the first years of the HIV pandemic, the virus diffusion was responsible for discriminatory behavior from medical and dental care workers towards HIV-infected patients, as described by our research group in 2009. The aim of the current study was to provide an update on the previous data, investigating the presence of discriminatory behaviors, evaluating the level of dentists’ knowledge about the virus and proposing strategies to be implemented to avoid professional exposure and cross-infections. This study was a cross-sectional, online, national survey on dentists, members of the main national dental associations (ANDI and AIO). The questionnaire was divided into four major sections, with the same structure as the questionnaire administered in 2009. The differences between groups were analyzed using the software program IBM SPSS Statistic, version 21.0. A total of 1054 dentists filled out the questionnaire completely. Among them 0.04% revealed a discriminatory attitude towards HIV-infected patients. The univariate analysis showed that discrimination towards HIV + patients was statistically associated with personal experiences and the level of fear associated with treating them (p = 0.001) and with the type of dental treatments performed (p = 0.01). This cross-sectional study revealed the persistence of dentists who still discriminate against HIV + patients, and the percentage of these dentists was only slightly lower than that in the previous survey (4.3% in the present survey vs. 4.5%). The survey also depicted other information worthy of consideration, such as a perceived ability to detect HIV + patients based on their appearance, complaints about not having received adequate training for treating HIV + individuals, and a lack of scientific knowledge about the virus. From the evidence reported by the present survey, it can be argued that universities, professional boards, and training institutions must increase their efforts in spreading correct knowledge about HIV among all dental care workers.

Assessment of Knowledge Towards Clinical Audit on Infection Control Among Dental, Medical Practitioners and Health Care Workers in Tamil Nadu: A Cross Sectional Survey

Assessment of Knowledge Towards Clinical Audit on Infection Control Among Dental, Medical Practitioners and Health Care Workers in Tamil Nadu: A Cross Sectional Survey

COVID-19 outbreak… journey of dental care workers: A systematic review.

The conditions of health-care professionals including dental fraternity have been extremely affected during the COVID-19 pandemic. Dental care workers have suspended all routine dental activities with the fear of transmission of the virus from aerosol-generating dental procedures. They have also stood with medical care professionals as frontline warriors because of the exponentially overburdened of the COVID-19-positive patients worldwide. With the available literature, the aim of this article is to address the trajectories of the life of oral health workers during the outbreak of COVID-19 as well as to analyze what measures shall be taken to improve their overall physical, mental, social, and economic health and precautions while working in dental environment.

Factors affecting infection control measures performed by dental workers

Background/purposeAn understanding of self-protection related factors is important for dental infection control. This study aimed to investigate factors associated with personal self-protection in infection control among dental care workers. Materials and methodsA cross-sectional survey with self-report questionnaire was conducted between Jan and Dec, 2018.275 dentists and 298 dental assistants were enrolled from randomly selected dental care settings. ResultsCompliance with wearing hair caps, facial masks, and hand washing is not as high as oral masks and gloves (over 90%). For dentists, the level of clinical setting (aOR = 3.1, P < 0.001) and the correct use of disinfectants for impression materials (aOR = 2.0, P < 0.05) were associated with hair cap wearing. Gender (aOR = 0.15, P < 0.05) and correct use of indicator during sterilization (aOR = 2.9, P < 0.05) were associated with facial mask wearing. The correct use of indicator during sterilization (aOR = 2.4, P < 0.05) and disinfection for impression materials (aOR = 2.2, P < 0.05) were associated with hand washing. For dental assistants, longer work experience (aOR = 1.05, P < 0.05), working days (aOR = 1.82, P < 0.05), the correct use of disinfectants for impression materials (aOR = 2.4, P < 0.001), and the frequent use of gloves (aOR = 8.0, P < 0.05) were associated with facial mask wearing. The surface disinfection of working tables (aOR = 2.8, P < 0.001) and the frequent changing of gloves (aOR = 5.96, P < 0.05) were associated with hand washing. ConclusionGender, the length of work practice, and correct techniques for sterilization use were identified as major factors associated with compliance with self-protection in infection control among dental care workers.

Awareness and Practice Regarding Cross Infection Control Among Dental House Officers in a Tertiary Care Setting

Background: Dental care workers including dental assistant &amp; doctors are at joint risk of receiving infection. Cross infection can be defined as “the spread of infection between staff members &amp; patients in clinical setting.” Precautions should be adopted while treating or checking the patients. Methods: This cross-sectional study of 3 months duration was carried on dental house officers of Multan Medical and dental college Multan. 60 dental house officers willingly participated in our study. Universal sampling technique was utilized in order to collect the data. Informed consent was sign up from the partakers. Results: Out of sixty dental house officers, males were twenty seven while females were thirty three . 85% participants consider that dental clinics/hospitals are more predisposed to the infection/contamination than other medical fields. 73.3% partakers wash the hands regularly after providing the treatment to every patient. All the partakers reported that usage of PPE has a foremost part in the prevention of cross contamination. Majority of the partakers use gloves as well as facemask but goggles or protective eyewear, head caps &amp; aprons were not in use by most of participants. Conclusion: Adequate awareness/knowledge but less satisfactory practice about infection control was reported. Knowledge acquired must also be transferred into everyday practice. Continuous infection control education through lectures/ tutorials or seminars must be organized. Cross-contamination control guidelines should also be established by dental colleges.

COVID-19 Vaccines: Vagaries and Vacillations

All healthcare workers, including dental professionals are foot soldiers in the battle against the COVID-19 pandemic. Indeed, in the USA, dental practitioners and dental students are now recruited to deliver COVID-19 vaccines to the general population to expedite vaccine uptake, and rapidly suppress the pandemic. There are many unknowns in the evolving COVID-19 vaccine story, although we now see the true situation in a better light, with the rapid emergence of data from numerous countries, including UK, where the vaccine has currently been administered to millions. The situation is further compounded by the reported vagaries of the increasing number of brand-name vaccines, manufactured on both the new and old vaccine platforms, the purported or real, vaccine adverse effects, the emergence of possible vaccine-resistant viral variants, and the resultant low vaccine uptake due to vacillating public opinion. In this COVID-19 Commentary, we provide an update on the efficacy of the vaccines and the prevalence of adverse effects, as well as a summary of useful information for dental care workers on vaccine protocols appertaining to special situations, as promulgated both by the UK Committee on Vaccination and Immunisation, and the US Advisory Committee on Immunization Practices (ACIP).

Knowledge, Awareness &amp; Practice about Cross Contamination Control among the Students of Dentistry

Background: Cross contamination is stated as “Spread of infection between staff members &amp; patients in clinical setting”. Cross infection throughout clinical training might occur with transfer of infectious agents between health workers &amp; patients in a clinical location. Dental care workers including dental assistant &amp; doctors are at giant risk of receiving infection. Aim: To assess the awareness/knowledge &amp; practice about cross contamination control among students of dentistry Study design: Cross-sectional study Place and duration of study: This study of 3 months duration was carried on students of Multan dental college Multan. Methodology: 60 students willingly participated in our study. Simple random sampling technique was utilized in order to collect the data. Well-structured Performa was consumed. Informed consent was sign up from the partakers. Results: 85% participants consider that dental clinics/hospitals are more predisposed to the infection/contamination than other medical fields. 90% of the partakers were totally aware about universal precautions to avert the cross contamination. All the subjects usually maintained the additional precautions while treating AIDS &amp; hepatitis B, C patients. Majority of the partakers use gloves as well as facemask but googles or Protective eyewear, head caps &amp; aprons were not in use by most of participants. Conclusion: Participants of our study showed adequate &amp; sufficient awareness/knowledge but less satisfactory practice about contamination control. Knowledge gained should also be transferred into daily routine practice Keywords: Cross contamination control, Dentistry, Students, and Precautionary measures

Adherence to COVID-19 Preventive Measures among Dental Care Workers in Vietnam: An Online Cross-Sectional Survey.

An online cross-sectional survey using a “snowball” sampling method was carried out to assess the adherence to COVID-19 preventive measures among dental care workers (DCWs) during the pandemic. Six questions concerning the COVID-19 preventive guidelines issued by the Vietnam Ministry of Health were used to evaluate DCWs’ adherence to preventive measures at dental care clinics. The quality of life of DCWs was assessed using the WHO-5 questionnaire and was defined as low if the total score was less than 13 points. Factors relating to adherence to COVID-19 prevention measures of DCWs were determined by multivariate linear regression analysis. In total, 514 DCWs completed the questionnaire. A total of 37% DCWs rated their quality of life as low. Regression analysis suggested that older age, a better quality of life, living in an urban area, and training on COVID-19 prevention were associated with better adherence to COVID-19 preventive measures, while being a dentist and lack of personal protective equipment was associated with less adherence to COVID-19 preventive measures. The pandemic had a significant negative impact on the physical and mental health of DCWs. Therefore, specific national guidelines for the prevention and control of the spread of COVID-19 in dental facilities should be issued.

How Often Are Dental Care Workers Exposed to Occupational Characteristics That Put Them at Higher Risk of Exposure and Transmission of COVID-19 ?

How Often Are Dental Care Workers Exposed to Occupational Characteristics That Put Them at Higher Risk of Exposure and Transmission of COVID-19 ?

The impact of COVID-19 on knowledge, attitude, and infection control behaviors among dentists

BackgroundThis study seeks to elucidate the impact of COVID-19 on knowledge, attitude, and infection control behaviors among dentists.MethodsChanges in knowledge, attitude, and infection control behaviors reported in 2020 (COVID-19 period) were compared to the historical control of the non-COVID-19 period in 2018. A proportional random sampling method was used to select the study samples from 400 dental institutions. The response rate was 69% in 2018 and 62.8% in 2020. A total of 276 dentists in 2018 and 251 dentists in 2020 responded to this questionnaire. Multiple logistic regression was used to assess the associations between factors and recommended infection control practices.ResultsHigh rates of correct COVID-19 knowledge (94.76%), fears of being infected with the virus (94%) and use of personal protective equipment (mask, glove and protection gown; 95%) were reported. We found that knowledge regarding environmental infection control, HIV transmission, and the window of HIV transmission were significantly higher in the post-COVID-19 period compared with the pre-COVID-19 period. High compliance rates of wearing mask, gloves and protection were reported. The number of dentists wearing a hair cap and a protective eye mask/face shield during the pandemic significantly increased compared with that noted before the COVID-19 pandemic. Factors associated with the use of a hair cap and an eye mask/face shield differed between the pre- and post-COVID-19 periods. The factors associated with compliance regarding environment infection control also differed between the pre- and post-COVID-19 periods.ConclusionThe significant impact of COVID-19 on the knowledge, attitude, and infection control behaviors among dental care workers was observed in the current study. In particular, the use of hair caps and protective eye mask or face shields as well as environmental disinfection protocols has significantly improved.Trial registration TMU-JIRB: N201804006.

Oral health related quality of life and reasons for non-dental attendance among patients with substance use disorders in withdrawal rehabilitation.

No study has assessed the socio‐behavioral distribution of oral health related quality of life (OHRQoL) among patients with substance use disorders receiving medically assisted rehabilitation therapy (MAR) in Norway.ObjectivesTo examine the prevalence of oral impacts on daily performances (OIDP) and its distribution among MAR patients in western Norway. We also examined whether oral impacts discriminate with different reasons for non‐dental attendance.Material and MethodsA cross‐sectional study focusing OHRQoL was nested to the INTRO‐HCV study and implemented in six rehabilitation clinics for people with substance use disorders. A total of 167 MAR patients completed personal interviews and oral clinical examination upon entering the clinic for their MAR medication.ResultsThe prevalence of oral impacts (OIDP > 0) was 61%. Logistic regression, adjusted for sex and age presented with odds ratios (OR) with 95% confidence intervals (CI) revealed that less than 20 remaining teeth (OR = 5.3 95% CI: 1.6–23.3) and dissatisfaction with dental care (OR = 5.1 95% CI: 1.3–19.0) increased the odds of having OIDP > 0. OIDP > 0 was also associated with insufficient dental follow‐up due to dental anxiety and poor experiences with perceived attitudes of dental workers. Means OIDP among people with negative experiences with attitudes of dental care workers were 3.1 (SD 0.8) compared to 1.4 (SD 0.7) among those without negative experiences, and 2.8 (SD) for those with dental anxiety compared to 1.8 (SD) among those without.ConclusionOHRQoL among MAR patients was generally poor. To reach those with a need for dental care, modification of the existing rehabilitation approach toward closer collaboration between dental health care workers and others in contact with drug users might be necessary.

Effects of Natural Ventilation and Saliva Standard Ejectors during the COVID-19 Pandemic: A Quantitative Analysis of Aerosol Produced during Dental Procedures.

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.

COVID-19 in Dental Settings: Novel Risk Assessment Approach.

The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and this emergency led to postponing elective dental care procedures. The postponing aimed to protect the public from an unknown risk caused by COVID-19. At the beginning of the outbreak, for public health authorities, the aerosol-generating procedures and the close proximity between dental care workers and patients in dentistry represented sufficient justification for the delay of dental visits. Dental care is a priority, and for many years, studies have proven that the lack and delay of dental care can cause severe consequences for the oral health of the general population, which can cause a high global burden of oral diseases. Safety is necessary while resuming dental activities, and risk assessment is an efficient method for understanding and preventing the COVID-19 infectious threats facing the dental industry and affecting dental care workers and patients. In this study, for safe dental care delivery, we adapted risk assessment criteria and an approach and an occupational classification system. Based on those tools, we also recommend measures that can help to minimize infectious risk in dental settings.

COVID-19 Vaccines: Vagaries and Vacillations

All healthcare workers, including dental professionals are foot soldiers in the battle against the COVID-19 pandemic. Indeed, in the USA, dental practitioners and dental students are now recruited to deliver COVID-19 vaccines to the general population to expedite vaccine uptake, and rapidly suppress the pandemic. There are many unknowns in the evolving COVID-19 vaccine story, although we now see the true situation in a better light, with the rapid emergence of data from numerous countries, including UK, where the vaccine has currently been administered to millions. The situation is further compounded by the reported vagaries of the increasing number of brand-name vaccines, manufactured on both the new and old vaccine platforms, the purported or real, vaccine adverse effects, the emergence of possible vaccine-resistant viral variants, and the resultant low vaccine uptake due to vacillating public opinion. In this COVID-19 Commentary, we provide an update on the efficacy of the vaccines and the prevalence of adverse effects, as well as a summary of useful information for dental care workers on vaccine protocols appertaining to special situations, as promulgated both by the UK Committee on Vaccination and Immunisation, and the US Advisory Committee on Immunization Practices (ACIP).

Knowledge, attitude and practices towards COVID-19 among dental professionals: A cross-sectional survey

Background: Coronavirus disease (COVID-19) is an extremely alarming situation across the world. Researchers have identified it to be transmitted by direct/indirect contact through droplets from body fluids like saliva. Dental professionals are considered to be at high risk.Aim: The aim of the current study was to evaluate the knowledge, attitude, and practice regarding COVID-19 pandemic among dental professionals.Materials and Methodology: A self-administered, structured, pilot-tested close-ended 21 questionnaire was distributed among the dental professionals (Bachelor of Dental Surgery (BDS) students, internship, postgraduates, and practitioners. Data obtained was analyzed using SPSS 17.0 (SPSS Inc., Chicago, IL, USA) for descriptive analysis of the data.Results: A total of 513 participants completed the survey, of which 217 (42.2%) were BDS students, 64 (12.5%) were interns, 88 (17.2%) were postgraduates, and 144 (28.1%) were practitioners. Out of 513 respondents, 144 (71.9%) were males and 369 (28.1%) were females.Conclusion: All the respondents seem to have sufficient knowledge regarding COVID-19 and the adoption of World Health Organization and dental association guidelines. However, a difference in viewpoint was observed and the possible explanation could be the level of education and understanding. We believe that this survey may have reemphasized the importance of vigilance and practice by the dental care workers, in preventing the transmission of novel viral disease.

Knowledge and attitudes towards Covid-19 vaccine among Indian dentists

Background Dental care workers are considered a susceptible group for Severe Acute Respiratory Coronavirus 2 infection (SARS-CoV-2). Although efficacious vaccines are now available for the prevention of the Coronavirus Disease 2019 (COVID-19), their knowledge and attitude towards these vaccines are not clear. Aim To assess the knowledge, perception, and attitudes of Indian dental professionals towards COVID-19 vaccines. Methods An anonymous web-based survey of Indian dental practitioners and clinical dental students was conducted using a pre-tested self-administered questionnaire, to elicit data on the COVID-19 vaccine uptake, attitudes to the vaccine, and the general knowledge related to vaccination. Results A total of 350 dental practitioners and clinical dental students/undergraduates participated in the study. The vast majority (90%) of the respondents’ perceived that they have adequate knowledge of the vaccine. There is a statistically significant association in the probability of uptake of the COVID-19 vaccine related to the level of knowledge on COVID-19 vaccine perceived by the dental practitioners in India. Conclusions In general, the knowledge, perception and attitudes of Indian dental professionals on COVID-19 vaccines appear satisfactory, but there dental students appear to be hesitant in taking the vaccine. Data on the efficacy and the effectiveness of the COVID-19 vaccines should be continuously promoted by the dental professional bodies to protect their fraternity.

Mobile phones of dental care workers: A mute source of contamination

Mobile phones of dental care workers: A mute source of contamination

Considerations for Pregnant Dental and Health Care Workers amid COVID-19.

Coronavirus disease 2019 (COVID-19) is a highly contagious disease that quickly reached pandemic levels. Over 5 million COVID-19 cases and approximately 330,000 deaths have been recorded worldwide. Transmission is primarily spread through direct, indirect (through contaminated objects or surfaces), or close contact with infected people via respiratory droplets, the mouth, and/or nose secretions. Health care professionals (HCPs), including dental HCPs, are recognized to be at considerably high risk for infection due to the close proximity to patients and aerosol-generating procedures. During pregnancy, HCPs may be at even higher risk since pregnancy substantially increases the susceptibility to infectious diseases. Here, we present the posed risks and potential effects of COVID-19 on maternal and fetal health. Current prevention and management strategies for COVID-19 on pregnant dental and HCPs are also discussed. Significant progress is being made in understanding the pathogenesis and clinical consequences of COVID-19. Pregnant women are affected more adversely with viral illnesses, although evidence of vertical transmission of COVID-19 is controversial. Based on the presence of atypical symptoms, the significant numbers of asymptomatic individuals who are COVID-19 positive, and the high susceptibility to viral diseases observed in pregnant women, recommendations have been put forth to limit the exposure of COVID-19-positive or even suspected cases to pregnant HCPs, and these are likely to evolve as new information becomes available. Pregnant HCPs require extra caution: not only are they considered a high-risk population, but their work at the frontline in a pandemic may expose them to additional risks. Complete awareness of the effects of COVID-19 on maternal and fetal/infant health, as well as prevention and management guidelines for pregnant HCPs, will allow for a safer work environment. Health care institutional policies aimed at protecting pregnant HCPs should consider avoiding their assignment as first responders, especially if equally trained staff are available. Dental and health care professionals can use the information in this review to improve their awareness of COVID-19 risks, signs, and symptoms and the associated effects on the health of pregnant health care professionals and their unborn/newborn children.

Being a dentist in the pandemic.

Data sources The authors provide no detail as to how the review was undertaken. Therefore the paper does not provide any methodological processes for data extraction. The paper describes the assimilation of available information regarding 2019-nCoV at the time of writing. The authors provide information on the COVID-19 pandemic in order to inform front-line dentists.The paper is as essay on the available information relating to:Background to the pandemic• Coronaviruses in general• Pathogenesis• COVID-19• Clinical manifestations• Patient characteristics• Diagnosis• Protocol for managing the disease in the clinical setting• Transmission dynamics• Transmission dynamics in dentistry practice• Infection control• Mouth rinses• Rubber dam isolation• Anti-retraction handpiece• Appropriate disinfectants• Management of medical waste.Conclusions Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers to risk of infection and there is high risk of cross-infection. The authors apply available international guidelines to provide a protocol for managing possible exposure to patients or those suspected of having a 2019-nCoV infection. Dentists play a significant role in disrupting the transmission trail of the virus by simply postponing non-emergency care for all patients.