COVID-19 Severity in Patients With Apical Periodontitis: A Case Control Study.

OBJECTIVES: Apical periodontitis (AP) has been associated with systemic inflammatory biomarkers that have also been associated with COVID-19 severity. This study was designed to test the hypothesis that the presence of apical periodontitis could be associated with increased risk of COVID-19 complications. METHODS: A case control study (N = 949) was performed using the medical and dental records of patients diagnosed with COVID-19 in the State of Qatar between March 2020 and February 2021. Cases comprised COVID-19 patients (n = 63) who experienced complications (death, intensive care unit admissions, mechanical ventilation), and controls were COVID-19 patients (n = 886) who recovered without such complications. The presence of periapical apical periodontitis was assessed on the radiographic records taken prior to COVID-19 infection. Associations between apical periodontitis and COVID 19 complications were analysed using logistic regression models adjusted for demographic and medical factors. Blood biomarkers were assessed in both groups and compared using the Kruskal-Wallis test. RESULTS: COVID-19 complications were found to be associated with the presence of apical periodontitis (adjusted odds ratio = 2.72; 95% CI, 1.30-5.68; P = .008). Blood analyses revealed that COVID-19 patients with apical periodontitis had higher levels of white blood cells and haemoglobin A1c than the patients without apical periodontitis. CONCLUSIONS: The presence of apical periodontitis could be associated with increased risk of COVID-19 complications.

Correlates of childhood caries: A study in Qatar.

BACKGROUND: The prevalance of dental caries in children in Qatar is high, which necessitates preventive efforts. AIM: To identify the sociodemographic and behavioural correlates of dental caries in the primary dentition of children 4- to 8-year-olds in Qatar. DESIGN: Weighted data from the Qatar Child Oral Health Survey 2017 were analysed for caries prevalence (dmft>0) and experience (dmft). Sociodemographic and behavioural variables were also drawn from the survey. RESULTS AND CONCLUSION: Among the 1154 children, caries prevalence was 69.3% (95%CI [63.4, 74.5]) and experience at 3.8 dmft (95%CI [3.3, 4.2]). The prevalence ratio (PR) 0.82 (0.72, 0.94) was lower among younger than in older children; those for non-Qatari nationality Arabic PR 0.91 (0.82, 1.00) and Other PR 0.75 (0.57, 0.99) than for Qatari nationality; those attending international kindergartens/schools PR 0.89 (0.80, 0.99) than independent schools; and whose parents had university-level education PR 0.85 (0.75,0.95) than did not. Caries prevalence was lower among those toothbrushing by age 3 years PR 0.88 (0.80,0.99) than later; children with low/intermediate sugar exposures PR 0.85 (0.74,0.97) and 0.89 (0.79,1.00) than those with high exposures; children with a dental check-up PR 0.68 (0.53,0.87) than those without; and children who drank bottled water with some fluoride PR 0.89 (0.80,0.99) than those who did not. Findings were similar for dmft. In conclusion caries prevalence varied but was high across sociodemographic correlates indicating vulnerablity. Interventions focusing on behaviours - such as toothbrushing, reducing sugar intake, check-up and encouraging intake of water with fluoride - are needed.

Nicolau Syndrome after Endodontic Treatment: A Case Report.

Calcium hydroxide has been used successfully in root canal therapy for many years. However, it can cause serious damage if it is inadvertently displaced into surrounding vital structures, resulting in thrombosis if displaced into blood vessels, damaging connective tissue, and causing skin necrosis. These adverse reactions are known as Nicolau syndrome (NS) or embolia cutis medicamentosa. Very few case reports have been published about these adverse effects of injecting calcium hydroxide beyond the apex during root canal therapy. A 16-year-old female patient was referred to the endodontic department of Hamad Dental Center for assessment after treatment by the maxillofacial surgery department for swelling and tissue necrosis that occurred after endodontic treatment in another clinic. When the patient initially attended the maxillofacial surgery department, she presented with swelling on the left side in the region of the maxillary left first permanent molar. On examination, there was a change in the color of the skin of the left cheek in that area along with some reported paralysis of the left side of her lips. Analgesics and antibiotics had already been prescribed at the referring clinic. Two weeks later, the patient developed a necrotic patch of skin on the same area. Subsequent evaluation at the endodontic department of Hamad Dental Center led to a diagnosis of NS. NS is a very rare iatrogenic condition. Displacing calcium hydroxide beyond the apex might increase the chance of NS. Clinicians should avoid overinstrumentation and forced injection of calcium hydroxide to prevent NS.

Oral health behavior and factors associated with poor oral status in Qatar: results from a national health survey.

OBJECTIVES: Oral health is a crucial determinant of quality of life. We aimed to determine oral health condition and factors associated with poor oral status in the adult national population of Qatar. METHODS: We used data from the World Health Organization supported STEPS (STEPwise approach to Surveillance) Survey conducted by the Supreme Council of Health, Qatar in 2012. A total of 2,496 Qataris (1,053 men, 1,443 women) answered the national survey. The Rao-Scott Chi-Square test was used to analyze oral health characteristics and multinomial logistic regression to assess risk factors. RESULTS: The self-perceived oral status of approximately 40 percent of respondents was either "average" or "poor" rather than "good." Poor oral status was more often reported by women (OR = 1.93; 95%CI = 1.30-2.80), by older (OR = 3.38; 95%CI = 1.59-7.19) and less educated respondents (OR = 3.58; 95%CI = 2.15-5.96). Other risk groups included people with diabetes (OR = 1.87; 95%CI = 1.24-2.81), smokeless tobacco users (OR = 3.90; 95%CI = 1.75-8.68), or ever tobacco users (OR = 1.66; 95%CI = 1.03-2.67). Oral health status appeared to be independent of diet, BMI status, and history of hypertension. Difficulties and behaviors related to oral health were more frequently reported by women than by men. These included pain (P < 0.001), difficulty chewing (P < 0.001), and discomfort over appearance of teeth (P < 0.001). Participants used toothbrushes, toothpicks, dental floss, and miswak to maintain oral hygiene. CONCLUSION: Our results provide evidence that oral health remains a public health concern in Qatar.