COVID-19 Impact on Community-Based Participatory Randomized Controlled Trials-Lessons From the Oral Health Disparities in Children Consortium.

The COVID-19 pandemic has had a major impact on nearly every sector of science and industry worldwide, including a significant disruption to clinical trials and dentistry. From the beginning of the pandemic, dental care was considered high risk for viral transmission due to frequent aerosol-generating procedures. This resulted in special challenges for dental providers, oral health care workers, patients, and oral health researchers. By describing the effect that the COVID-19 pandemic had on four community-based randomized clinical trials in the Oral Health Disparities in Children (OHDC) Consortium, we highlight major challenges so researchers can anticipate impacts from any future disruptions.

Endodontic treatment in an American Indian population: a 10-year retrospective study.

An epidemiological study of a regional population of Native Americans receiving treatment from 1991 to 2000 (n = 5460) was conducted via electronic survey. The objectives were to identify factors affecting the retention of endodontically treated teeth and to determine frequencies of endodontic care. Multiple factors were assessed. Analyses utilized chi(2) and frequency tests. The results indicated that endodontists tend to complete most posterior teeth and retreatment cases, while generalists tended to complete anterior teeth, primary endodontic therapy, and to restore immediately. Patients with multiple systemic diseases (p = 0.0225) and diabetes (p < 0.0001) experienced decreased retention of endodontically treated teeth and increased retreatment (p = 0.0109) by endodontists. Patients treated by general dentists experienced increased retention for female patients (p = 0.0066), immediate restoration of the treated tooth (p = 0.0212), and decreased retention with a history of hypertension (p = 0.0036) and diabetes (p = 0.0033). This study suggests that diabetes and/or hypertension, delayed or no restoration, and increasing age, may all contribute to decreased retention of endodontically treated teeth, but that immediate postendodontic restoration may enhance retention. In the early era, very few cases of molar endodontics were completed, and one could infer that there were greater numbers of posterior teeth extracted because of this fact. This demonstrates how a combination of providers can provide a broader range of clinical endodontic services, supporting an Indian Health Service goal of providing the highest level of oral health care possible.