La COVID-19 y sus repercusiones en la práctica odontológica / COVID-19 and their repercussions on dental practice

La llegada del COVID-19 generó diversos cambios significativos en el área de la salud y particularmente en el área odontológica, donde se priorizaron los tratamientos de urgencia relegando los procedimientos menores y atención de citas a la vía virtual. Otras modificaciones se concentraron en el uso de equipos de protección personal y logística de atención tanto para el paciente como para el profesional, siguiendo las indicaciones de las normas diseñadas para esta función; adicionalmente se hicieron adecuaciones en las áreas de recepción y práctica odontológica, y se capacitó a los profesionales en temas relativos a la enfermedad. El objetivo del presente artículo es analizar las implicaciones generadas en la práctica odontológica durante la pandemia por COVID-19 en los ámbitos de triaje, infraestructura, normativa y capacitación (AU)

The arrival of COVID-19 produced a series of significant changes in the health area and particularly in the dental area where emergency treatments were prioritized, relegating minor procedures and appointment care to the virtual route, other modifications focused on the use of personal protective equipment and care logistics for both the patient and the professional following the indications of the standards designed for this function, additionally adjustments were made in the reception and dental practice areas, and professionals were trained on issues related to the disease. The objective of this article is to analyze the implications generated in dental practice during the COVID-19 pandemic in the areas of triage, infrastructure, regulations and training (AU)

Assessing the reliability of automatic sentiment analysis tools on rating the sentiment of reviews of NHS dental practices in England.

BACKGROUND: Online reviews may act as a rich source of data to assess the quality of dental practices. Assessing the content and sentiment of reviews on a large scale is time consuming and expensive. Automation of the process of assigning sentiment to big data samples of reviews may allow for reviews to be used as Patient Reported Experience Measures for primary care dentistry. AIM: To assess the reliability of three different online sentiment analysis tools (Amazon Comprehend DetectSentiment API (ACDAPI), Google and Monkeylearn) at assessing the sentiment of reviews of dental practices working on National Health Service contracts in the United Kingdom. METHODS: A Python 3 script was used to mine 15800 reviews from 4803 unique dental practices on the NHS.uk websites between April 2018 -March 2019. A random sample of 270 reviews were rated by the three sentiment analysis tools. These reviews were rated by 3 blinded independent human reviewers and a pooled sentiment score was assigned. Kappa statistics and polychoric evalutaiton were used to assess the level of agreement. Disagreements between the automated and human reviewers were qualitatively assessed. RESULTS: There was good agreement between the sentiment assigned to reviews by the human reviews and ACDAPI (k = 0.660). The Google (k = 0.706) and Monkeylearn (k = 0.728) showed slightly better agreement at the expense of usability on a massive dataset. There were 33 disagreements in rating between ACDAPI and human reviewers, of which n = 16 were due to syntax errors, n = 10 were due to misappropriation of the strength of conflicting emotions and n = 7 were due to a lack of overtly emotive language in the text. CONCLUSIONS: There is good agreement between the sentiment of an online review assigned by a group of humans and by cloud-based sentiment analysis. This may allow the use of automated sentiment analysis for quality assessment of dental service provision in the NHS.

Evaluation of YouTube videos for patients' education on periradicular surgery.

The aim of this study was to evaluate the content of periradicular surgery-related YouTube videos available for patients' education. YouTube search was made for videos related to periradicular surgery using specific terms. After exclusions, 42 videos were selected, viewed and assessed by two independent observers. The videos were assessed in terms of duration, days since upload, country of upload, number of views, likes and dislikes, authorship source, viewing rate and interaction index. To grade the content of videos about periradicular surgery, a usefulness score was created with 10 elements based mainly on the American Association of Endodontists guidelines. Each element was given a score of 0 or 1. SPSS software (SPSS Inc, Chicago, IL, USA) was used to analyze data at a 95% confidence level. An inter-evaluator reliability analysis for the scoring system was performed using the Kappa statistic. The videos received an average of 35103.9 views (range: 9-652378) with an average duration of 338.71 seconds (range: 42-2081), respectively. Most videos were provided by individuals (57%). Half of the videos were posted by authors from the United States. The inter-evaluator reliability for usefulness scoring was 94.5%. No video covered the 10 scoring elements completely, presenting very low usefulness scores (mean: 3.2; range: 1-7). The most discussed elements were supporting media (100%) and steps of the procedure (90.5%) followed by indications and contraindications (45.2%) and symptoms (31%). None of the included videos discussed the procedure's cost or prognosis. In terms of usefulness score, no significant difference was detected between different sources of upload (chi-square test, P > 0.05). Information on periradicular surgery in YouTube videos is not comprehensive and patients should not rely on YouTube as the only source of information. Dental professionals should enrich the content of YouTube with good quality videos by providing full and evidence-based information that will positively affect patients' attitudes and satisfaction.

COVID-19: ¿una oportunidad para la toma de conciencia sobre el cuidado integral del odontólogo? / COVID-19: An opportunity to raise awareness about dentists' holistic wellbeing?

La pandemia de COVID-19 generó en la comunidad odon- tológica argentina un profundo desconcierto e incertidumbre frente a su práctica profesional, su economía y su cuidado. Mediante un cuestionario difundido a través de redes so- ciales en octubre de 2020, se formularon preguntas vinculadas al ejercicio profesional en ese contexto y otras en las que se incluyeron variables referidas a signos de ansiedad, depresión y resiliencia. Los odontólogos presentaron signos de estrés, ansiedad, tensión emocional, dificultad para conciliar el sueño, senti- mientos de culpa y sensación de soledad. Manifestaron casi en su totalidad que su esfuerzo y el cuidado de su persona frente a este nuevo paradigma no son valorados por el sistema de salud y que se evidencia en la escasa retribución que perciben por sus prestaciones. Las conclusiones tienen el mandato del cambio pues los datos arrojados por la encuesta y el sentir manifestado con vehemencia y desolación ponen sobre la mesa la necesidad de iniciar una nueva etapa (AU)

The COVID-19 pandemic created a profound state of be- wilderment and uncertainty among dentists regarding their professional practice, economy and personal care. An online survey posted on social media in October 2020 asked ques- tions about professional practice in this context and other variables such as signs of anxiety, depression and resilience. Dentists reported signs of stress, anxiety, emotional tension, difficulty to get to sleep, and feelings of guilt and loneliness. Most of them felt that the efforts they made to do their job and ensure their personal care in this new paradigm were not valued by the healthcare system, as reflected by the low compensation for their services. From the data obtained through the survey and the feelings of vehemence and grief expressed by respondents, it is concluded there is a need for action and change (AU)

Para minimizar el riesgo de transmisión del SARS-COV-2 durante la atención odontológica generadora de bioareosoles: Guía de práctica clínica - No GES / To minimize the risk of SARS-COV-2 transmission during bioaerosol generating dental care: clinical practice guideline - non GES

Proveer al equipo de salud odontológico recomendaciones basadas en la mejor evidencia científica disponible, orientada a minimizar el riesgo de transmisión de SARS-CoV-2 durante la atención odontológica generadora de bioaerosoles ambulatoria y de urgencia a nivel primario y secundario de salud: a) Usuarios que reciban atención odontológica generadora de bioaerosoles en toda la Red pública y privada de salud.b) Personal de salud que otorga atención odontológica con procedimientos generadores de bioaerosoles en sistema público o privado de salud. Profesionales de la salud responsables de la atención odontológica generadora de bioaerosoles en centros de salud públicos y privados en todos los niveles de atención y de establecimientos de educación superior. La elaboración de esta Guía de práctica clínica con metodología GRADE, se enmarca en un convenio de colaboración entre la Universidad de La Frontera y el Ministerio de Salud, en el contexto de la pandemia del COVID-19 y los múltiples desafíos en orientar a los equipos clínicos con la evidencia científica disponible al respecto.

Impacto de la pandemia en la práctica de los profesionistas de la salud oral en México / Impact of the COVID-19 pandemic in the oral health professionals' practice in Mexico

partir de la pandemia, los odontólogos han presentado una serie de complicaciones en su práctica diaria, la naturaleza misma de la profesión representa un alto riesgo de contagio y la posibilidad de generar una infección cruzada por el virus SARS-CoV-2, por lo que han tenido que limitar su labor a la atención de urgencias, adquiriendo insumos relacionados a incrementar los cuidados de su grupo de trabajo y del paciente. Objetivo: Conocer el impacto de esta plaga en la práctica de los profesionistas de la salud oral en México. Material y métodos: Se realizó un estudio descriptivo y transversal mediante la aplicación de una encuesta a través de redes sociales a odontólogos, los resultados se expresaron con tablas de frecuencias y porcentajes. Resultados: Se recibieron respuestas de 200 cirujanos dentistas con clínica privada, 71% comentó haber cerrado su consultorio al inicio de esta calamidad, en contraste, el 53.5% de profesionales afirmaron tener actualmente una consulta no restringida, refiriendo que se ha visto reducida entre 50 y 75%, la mayoría reconoce que han tenido que reforzar el uso de EPP y algunos protocolos de protección, 16.5% ha padecido COVID-19. Conclusiones: La pandemia ha generado un impacto económico importante en la práctica de los odontólogos, al combinarse la disminución del número de pacientes con el aumento de gastos. Se debe considerar a la odontología como una profesión de alto riesgo, por lo que este gremio debe ser tomado en cuenta para el plan de vacunación como parte importante del sector salud (AU)

Given the nature of their profession, the COVID-19 pandemic has brought complications in their daily practice to odontologists, who are at a high risk of contracting the disease, and the possibility of creating a cross infection by the SARS-CoV-2 virus. That is why odontologists have had to restrain their practice to attend to emergencies only and acquire consumables and equipment related to improve their patients' care and the safety of their work team. Objective: To know the COVID-19 pandemic impact in the oral health professionals' practice in Mexico. Material and methods: A transversal, descriptive study was conducted by using a survey through social networks to gather information from odontologists practicing in Mexico. Results were presented in frequency and percentage tables. Result: Responses of 200 dental surgeons in private practice were received. 71% said that they closed their office at the beginning of the pandemic. On the other hand, 53.5% of them currently have a non-restricted practice but it is reduced between 50 and 75%. Most of them recognized that they had to improve the use of PPE and add some protection protocols, 16.5% have suffered from COVID-19. Conclusions: This pandemic has generated an important economic impact in the odontological practice, combining the decrease in the number of patients with the increase in their office expenses. Odontology must be considered a high-risk profession and an important part of the health sector, consequently, these professionals must be included in the vaccination plan on a priority basis (AU)

Periodontitis y mayor riesgo de complicaciones en la enfermedad COVID-19 / Periodontitis and increased risk of complications in COVID-19 disease

En esta ocasión, se convocó al Prof. Mariano Sanz, coau- tor del artículo recientemente publicado acerca de la relación entre periodontitis y el mayor riesgo de padecer complicacio- nes de COVID-19, a fin de que comparta su mirada sobre este relevante hallazgo (AU)

On this occasion, Prof. Mariano Sanz, co-author of the recently published article on the relationship between peri- odontitis and the increased risk of suffering complications from COVID-19, was invited to share his views on this rel- evant finding (AU)

Legislación y Normas Atingentes a la Atención Odontológica y el COVID-19. Una Perspectiva Desde las Clínicas Universitarias / Lesgislation and Norms Related to Dental Care and the COVID-19. A Perspective from University Clinics

RESUMEN: La enfermedad por coronavirus 2019 (COVID-19) es una enfermedad infecciosa causada por el Coronavirus 2 del Síndrome Respiratorio Agudo Grave (SARS-CoV-2). La mayoría de los pacientes infectados con SARS-CoV-2 tiene una evolución asintomática o leve. Sin embargo, una parte de los infectados presentará un deterioro en su condición de salud, desarrollando una neumonía aguda grave, que puede producir la muerte. Las personas vinculadas a las clínicas odontológicas están en riesgo de infección por SARS-CoV-2, pues la saliva es un importante método de transmisión del virus. Por su naturaleza, la atención odontológica se realiza a corta distancia del paciente, con constante exposición a saliva, sangre y otros fluidos corporales, y es frecuente el manejo de instrumentos cortopunzantes. Por consiguiente, los elementos de protección personal cobran gran importancia y las reglamentaciones de la autoridad sanitaria en el contexto de la pandemia que actualmente se vive deben cumplirse a cabalidad, debido a obligaciones éticas y legales. En esta revisión narrativa se revisa y discute la reglamentación de la autoridad sanitaria que involucra las prestaciones odontológicas en el contexto del COVID-19, cómo se aplicará en las clínicas universitarias y cómo complementar la normativa con la evidencia científica disponible.

ABSTRACT: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by Coronavirus 2 of Severe Acute Respiratory Syndrome (SARS-CoV-2). The majority of patients infected with SARS-CoV-2 have an asymptomatic or mild evolution. However, a part of those infected will present a deterioration in their health condition, developing severe acute pneumonia, which can lead to death. People linked to dental clinics are at risk of SARS-CoV-2 infection, since saliva is an important method of transmission of the virus. Due to its nature, dental care is performed at a short distance from the patient, with constant exposure to saliva, blood and other body fluids, and the use of sharp instruments is frequent. Consequently, the elements of personal protection are very important and the regulations of the health authority in the context of the current pandemic must be fully complied with, due to ethical and legalobligations. This narrative review reviews and discusses the regulation of the health authority that involves dental services in the context of COVID-19, how it will be applied in university clinics and how to complement the regulations with the available scientific evidence.

Professional oral care in end-of-life patients with advanced cancers in a hospice ward: improvement of oral conditions.

BACKGROUND: In end-of-life patients with advanced cancers, oral examination, oral care, and oral re-examination are crucial. Although oral symptoms are among the major complaints of end-of-life patients, few studies have focused on oral care in these patients. In this study, the association between oral symptoms and oral dryness among end-of-life patients was examined, and improvement of oral conditions after oral care interventions by a professional dentist was quantified. METHODS: This prospective intervention study included 27 terminally ill patients with advanced cancers in a hospice ward. Professional oral care was administered every morning, and the improvement of oral conditions was assessed by comparing oral conditions before and after the intervention. Oral assessment was performed using the Oral Health Assessment Tool (OHAT) and Oral Assessment Guide. Oral dryness was evaluated through Clinical Diagnosis Classification of oral dryness and an oral moisture device. Oral cleanliness was evaluated using a bacterial counter, and tongue smears were collected for Candida examination; furthermore, oral function was recorded. RESULTS: The presence of oral mucositis was closely associated with severe oral dryness (odds ratio [OR] = 14.93; 95% confidence interval [CI]: 1.95-114.38). The level of oral debris retention was significantly related to the degree of oral dryness (OR = 15.97; 95% CI: 2.06-123.72). The group with higher scores (OHAT > 8), which represent poor oral conditions, showed severe oral dryness (OR = 17.97; 95% CI: 1.45-223.46). Total OHAT scores (median: 7 vs 2) and those of other subgroups (lip, tongue, gums and tissues, saliva, and oral cleanliness showed a significant decrease after the intervention. Furthermore, the occurrence of mucositis (47.1% vs 0%), candidiasis rate (68.8% vs 43.8%), oral dryness self-sensation (63.6% vs 9.1%), and severe oral debris (52.9% vs 11.8%) decreased significantly. CONCLUSIONS: Proper oral care can improve oral health and hygiene, reduce the rate of mucositis, reduce the sensation of oral dryness, increase oral moisture, and reduce the chances of oral infections among end-of-life patients. Daily oral care is necessary and can alleviate oral discomfort, increase food intake, and increase the chances of communication between end-of-life patients and their families.

Infection Control in Dental Practice During the COVID-19 Pandemic.

COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency from China has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim of this paper is to provide practical advice for dentists based on the recent literature, which may be useful in reducing the risk of spreading COVID-19 during clinical practice.

Nota técnica nº 01, de 26 de março de 2020: orienta a atenção primária à saúde dos municípios para o enfrentamento do novo Coronavírus (COVID-19) / Technical note No. 01, of March 26, 2020: guides primary health care in municipalities to face the new Coronavirus (COVID-19)

Orienta os serviços de Atenção Primária à Saúde (APS) ou Atenção Básica (AB), por meio da Estratégia Saúde da Família (ESF), no manejo e controle da infecção COVID-19. Indica os instrumentos de orientação clínica para os profissionais do Sistema Único de Saúde (SUS) a partir da transmissão do novo Coronavírus (COVID-19) no Tocantins.

It guides the Primary Health Care (PHC) or Basic Care (AB) services, through the Family Health Strategy (FHS), in the management and control of the COVID-19 infection. Indicates the instruments of clinical guidance for professionals of the Unified Health System (SUS) from the transmission of the new Coronavirus (COVID-19) in Tocantins.

Orienta a los servicios de Atención Primaria de Salud (APS) o Atención Básica (AB), a través de la Estrategia de Salud de la Familia (ESF), en el manejo y control de la infección por COVID-19. Indica los instrumentos de orientación clínica para profesionales del Sistema Único de Salud (SUS) a partir de la transmisión del nuevo Coronavirus (COVID-19) en Tocantins.

Benefits of Oral Health Education at Women, Infant, and Children (WIC) Clinic Visits: Assessments of Parent's Oral Health Beliefs, Behaviors and Dental Access in O'ahu, Hawai'i.

Improving oral health outcomes in Hawai'i for children and families remains a high priority. Children in the state are leading the nation with the highest caries rates, while women before, during, and after pregnancy are failing to receive regular and necessary dental care resulting in poor health outcomes. To answer for this need, an educational intervention was conducted among families enrolled in the Kapi'olani Medical Center for Women and Children's Women, Infant, and Children program (WIC) in O'ahu. The project included the following activities: (1) identification the oral health beliefs and behaviors of families, (2) providing oral health education to families, and (3) reassessing beliefs and behaviors in 3-6 months to document the impact of theeducation session. Participants consisted of 81 families resulting in the data on 176 children and 4 pregnant women. Of the 81 families, 40 representing84 children completed the follow-up oral health questionnaire. Results of the assessment and education demonstrated a positive impact on the family's oral health behaviors. Parents were 6.61 times as likely to report using fluoride toothpaste in the follow-up visit compared to their initial visit (95% confidence interval [CI] = 3.12-14.00). Additionally, statistically significant changes were noted in the frequency of children's daily tooth brushing (odds ratio [OR] = 2.15, 95% CI = 1.33-3.46), as well as in the incidence of children receiving fluoride varnish application over time (OR = 2.66, 95% CI = 1.50-4.73). These results provide further evidence that initiating a simple educational intervention can have a positive impact on oral health behaviors in groups that are at highest risk for developing dental disease in Hawai'i.

El miedo es contagioso: menoscabos por una pandemia / Fear is contagious: impairment of a pandemic

En los últimos meses la población del mundo ha estado sometida por la pandemia de COVID-19 a un reto emocional causado por el riesgo de pérdida de la salud (incluida la muerte) y del riesgo real o potencial de la alteración de la estabilidad socioeconómica personal y global. Por otro lado, los individuos reciben diariamente información de diversa valía en relación a veracidad y oportunismo, lo que los expone a incertidumbre respecto a la toma de decisiones relacionadas con el bienestar o asociadas con aspectos laborales y productivos. Debe observarse que esto está sucediendo con: pacientes, empleados, proveedores y profesionistas en el modelo odontológico. El miedo es la respuesta prevalente que induce este conjunto de estímulos amenazantes, en el que de manera secundaria se manifiestan otros estados emocionales, sentimentales y de conducta. Contrarrestar el miedo en todos los actores del concepto práctica dental debería ser la estrategia en la recuperación de la actividad odontológica en esta nueva realidad, siendo la palabra clave, seguridad; misma que no debe estar representada exclusivamente por la implantación de medidas sanitarias, también de manera muy principal por la comunicación y la estimulación positiva de emociones y sentimientos que alcancen la mente afectiva no sólo de los pacientes, sino también de los miembros del grupo de trabajo ­mente inconsciente­(AU)

In recent months the world's population has been exposed by the pandemic advent of COVID-19 to an emotional challenge caused by the risk of health disturbance, death encompassed, and the real or latent risk of disruption of personal and global socioeconomic steadiness. Individuals on the other hand, receive day-to-day information of varying connotation in relation to truthfulness and opportunism, exposing them to decision-making uncertainty regarding welfare, as well employment and productive subjects. At the dental scheme, this is happening with: patients, employees, providers and professionals themselves. The widespread reaction that brings this myriad of threatening stimuli is fear, where other emotional, sentimental and behavioral expressions, secondarily occur. In this new reality, disparate the fear in all and any participant of the dental practice concept should be the strategy applied for dental activity recovering; being the key word, safety. Concept that should not be represented exclusively by the implementation of sanitary actions and warnings, but in a conspicuous manner by communication of this safety concept and the induction of positive stimuli by means of emotions and feelings that could reach the affective mind of patients, and the working group ­unconscious mind­ (AU)

Propuesta del modelo para control de infecciones en la consulta odontológica ante la pandemia de COVID-19 / Proposal for an infection control protocol in the dental consultation against the COVID-19 pandemic

Catalogada su labor como Servicios de Salud Indispensables, el profesional de la odontología se ha mantenido al pendiente de sus pacientes durante la pandemia de COVID-19, brindando atención de urgencia a quien lo solicita. A su regreso a la práctica típica, el odontólogo encontrará un entorno distinto o NUEVA NORMALIDAD, viéndose obligado a hacer modificaciones clínicas pertinentes y preparar a su equipo de trabajo para continuar brindando atención de calidad con un margen de seguridad amplificado, que de igual manera proteja a pacientes y al equipo de trabajo. Ante la falta de una vacuna que brinde protección y de tratamiento específico contra el SARS-CoV-2 (COVID-19), elevar el nivel de control de infecciones en el consultorio se vuelve ineludible y posiblemente irreversible en el quehacer odontológico cotidiano. En este artículo se propone un Protocolo de Control de Infecciones en la consulta odontológica que permita brindar seguridad en la atención bucal, considerando COVID-19, útil también para control infeccioso de otros patógenos virales o bacterianos (AU)

Considered dentistry as an Indispensable Health Services, during the COVID-19 pandemic the dental professional has been providing mostly emergency care. Upon return to typical dental practice, the dentist will find a different environment or NEW NORMALLY, being forced to make relevant clinical modifications and prepare his team to continue providing quality care with an amplified safety margin, which equally protects patients and dental team. In the absence of an available vaccine that provides protection or a specific treatment against SARSCoV- 2 (COVID-19), raising the level of infection control at the dental office will become unavoidable and possibly irreversible in the future quotidian dental work. This article proposes an Infection Control Protocol for the dental consultation that allows provide safety oral care, considering COVID-19, also useful for other viral or bacterial pathogens control (AU)

COVID-19: un nuevo desafío / COVID-19: a new challenge

Los primeros casos del nuevo coronavirus fueron descriptos en Wuhan, China, desde diciembre de 2019, con una rápida propagación a nivel mundial. En la actualidad, no existe una vacuna para prevenir la enfermedad ni un tratamiento específico aprobado para tratarla, por lo que los esfuerzos mundiales se centran en disminuir la propagación y el impacto de este virus. La odontología es considerada una de las profesiones con mayor riesgo de exposición a esta enfermedad, teniendo en cuenta que el virus se propaga, fundamentalmente, por vía aérea y por el contacto directo con las secreciones infectadas. En el presente artículo se destacan las características epidemiológicas y clínicas de esta enfermedad, así como las medidas de prevención que se deben adoptar, para proteger, tanto al personal sanitario, como a los pacientes (AU)

The first cases of the new coronavirus were described in Wuhan, China, since December 2019, with a rapid spread worldwide. Currently, there is no vaccine to prevent the disease or a specific approved treatment to treat it, so global efforts are focused on reducing the spread and impact of this virus. Dentistry is considered one of the professions with the highest risk of exposure to this disease, taking into account that the virus is mainly spread by means of direct contact with infected secretions. This article details the epidemiological and clinical characteristics of this disease, as well as preventive measures to be adopted, to protect both health care workers and patients (AU)