The Epidemiology of Dental Pathologies in Elderly Patients Admitted to a Tertiary Level Hospital in Oradea, NW Romania: A 5-Year Retrospective Study.

Oral diseases can affect the quality of life of all individuals, including elderly people. In elderly people, the associated general diseases can increase the risk of dental pathologies or can impact their treatment. The main aim of this study was to identify elderly patients with dental pathology out of the total number of patients admitted to the Department of Oral and Maxillofacial Surgery at a tertiary-level hospital in North-Western Romania. Another aim was to describe the characteristics of the patients included in this study, as well as to analyze data from patients with dental pathologies. In this retrospective study, the medical records of patients admitted to the Department of Oral and Maxillofacial Surgery at the Bihor County Emergency Hospital between 2016 and 2020 were analyzed, with a focus on patients aged 65 years or more. After applying the exclusion criteria, 721 patients were kept in the study, of which 316 (43.8%) had at least one dental pathology. Most elderly patients with dental pathologies were admitted in 2018 (n = 89). The most common associated systemic diseases were arterial hypertension (n = 268) and ischemic heart disease (n = 233), while the most common dental pathologies were pulpitis (n = 185), chronic apical periodontitis (n = 61) and abscesses (n = 35). Most patients were either healed or had an improved condition at the time of discharge. The great number of dental pathologies, as well as the diversity in dental pathologies, underline the necessity for better preventive programs aimed not only at children, adolescents or young people but at the elderly population as well.

Pediatric Dental Emergencies during the COVID-19 Pandemic in Romania: A Retrospective Study.

Pediatric dental emergencies can occur as a result of untreated dental caries, or can be caused by trauma or periodontal issues. The lockdown imposed during the COVID-19 pandemic reduced the number of centers authorized to deliver dental services in Romania, with only a small number of dentists delivering dental emergency treatments. The aim of this study was to investigate the demographic characteristics of children and adolescent patients who were treated in the dental emergency department of Oradea, Romania and to compare the patients who were treated in the dental emergency department in the pre-lockdown (2019), lockdown (2020) and post-lockdown year (2021). All patients who were treated in the dental emergency department were included in the study except for adults and medical files that did not contain all relevant information. Several variables were investigated (age, gender, living environment, location of affected teeth, type of emergency). In 2019, 257 children and adolescents were treated, in 2020, 198, and in 2021, 136. Most patients were aged 7-12 years in all investigated years (2019-47.9%; 2020-50.5%; 2021-43.4%), and the most affected teeth were located in the lower posterior arch (2019-53.3%; 2020-53%; 2021-48.5%). The most frequent emergencies were pulpitis (2019-40.5%; 2020-43.9%) and acute apical periodontitis (2021-42.6%). It was observed that in 2019, patients aged between 0 and 6 years were more frequently associated with trauma (p < 0.001), and in 2019 and 2020, patients aged between 7 and 12 years were more frequently associated with periodontal emergencies (p < 0.001). In 2020, patients from rural areas were more frequently associated with pulpitis (p = 0.025), and in 2021, patients from rural areas were more frequently associated with pulpitis or acute apical periodontitis, and patients from urban areas were associated more frequently with periodontal emergencies (p = 0.042). Pediatric patients with ages between 7 and 12 years old, who lived in an urban environment were most affected. Teeth located in the lower and upper posterior dental arches were most affected, and pulpitis or acute apical periodontitis were the most common pathologies.

The Impact of the COVID-19 Pandemic on the Dental Emergency Service from Oradea, Romania: A Retrospective Study.

The COVID-19 pandemic affected the daily lives of the global population, not only in terms of social interaction but also in terms of access to medical and dental care. Non-urgent dental treatments could not be continued during the lockdown and only a small number of dental centres addressed patients with dental emergencies. The aim of this study was to evaluate the socio-demographic characteristics (age, gender, and living environment) of the individuals that accessed the dental emergency centre in Oradea (North-West Romania) and the main causes for accessing the dental emergency service among the population of Oradea (North-West Romania), during the COVID-19 lockdown, between March and May 2020 and, furthermore, to compare the results obtained in the lockdown timeframe (March-May 2020), with the results obtained in the corresponding timeframe in the pre-lockdown year (March-May 2019) and post-lockdown year (March-May 2021). The retrospective study was carried out by analysing the medical records of the patients who were treated in the dental emergency service of the Oradea County Emergency Clinical Hospital in the following periods: March-May 2019, March-May 2020, and March-May 2021. Most patients were treated in 2020, during the lockdown (n = 784), predominantly in April (n = 308). Most patients treated in April 2020 were male patients (43.7%, n = 205) and were aged between 30 and 39 years (19.4%, n = 74). The most frequent types of dental emergencies were acute apical periodontitis and acute pulpitis in all the months and years investigated. During the lockdown months of 2020, acute pulpitis was the most frequent type of emergency in March (42.2%, n = 100) and May (45.6%, n = 109), while in April, acute apical periodontitis was the most frequent type of emergency (43.5%, n = 166). The COVID-19 lockdown led to an increase in the number of patients that required emergency treatments and impacted all groups of people investigated.

Mini-Implant Rejection Rate in Teenage Patients Depending on Insertion Site: A Retrospective Study.

Mini-implants have undeniable advantages in Orthodontics. However, the use of mini-implants shows some limitations and disadvantages related to patient age, the quality of the bone tissue, the characteristics of the oral mucosa, implant site, the state of health of the organism and the quality of oral hygiene. The aim of this paper was to analyze the rejection rate of mini-implants in teenage patients, depending on their insertion site, and examine their stability up to three months after insertion. This retrospective study was conducted on dental charts belonging to patients aged between 12 and 17 years, from Oradea, Romania. The mini-implants were placed for various therapeutic reasons and were inserted in the following sites: buccal maxillary area, the infrazygomatic region, palatal area, buccal mandibular area and lingual area; they had a diameter of 1.6 mm (inter-radicular spaces) and of 2 mm (nonbearing tooth areas), and a length of 6-8 mm (mandible) or 8-10 mm (maxilla). The rejection rate was checked in the first month, second month, third month and after the third month from insertion. A total of 432 patients were included in the study, and they had a total of 573 mini-implants. Most implants were placed in the buccal region of the maxilla (27.7%), and most patients had one mini-implant placed (65.7%). The highest rejection rate was obtained in the first month (15.2%). The rejection rate between genders was similar. The mini-implants from the buccal mandibular region had a significantly higher rate of rejection in the first month (M1) in comparison to the mini-implants from the palatal region (24.4% vs. 8.3%). The mini-implants from the lingual region of the mandible had a significantly higher rate of rejection in the second month (M2) in comparison to the mini-implants from the infrazygomatic or the palatal region (10.5% vs. 0%/0%). Mini-implants are very useful for carrying out various orthodontic treatments, but their stability should be enhanced.

The Attitudes of Children Undergoing Orthodontic Treatment toward Face Mask Wearing during the COVID-19 Pandemic: A Cross Sectional Study.

During the COVID-19 pandemic, the protective face mask has proven to be essential. The protective face masks cover the lower part of the face, including teeth and, for orthodontic patients, the orthodontic appliances. The aim of this study was to assess the impact that the restrictive measures that were imposed during the COVID-19 pandemic and, especially, wearing a protective face mask had on a sample of Romanian children, and to compare the results previously obtained on a sample of Romanian teenagers with the results obtained after investigating children under the age of 12 years. The cross-sectional survey was conducted in two orthodontic offices from the city of Oradea, Romania. The study sample included children with ages between 8 and 11.9 years that were undergoing an orthodontic treatment with removable or fixed orthodontic appliances. After obtaining the results, comparisons were made with the answers provided by a group of adolescents previously investigated. The questionnaires consisted of 9 items that investigated children' attitudes toward protective face mask wearing and other aspects related to the COVID-19 pandemic. Two hundred fifty-six children were included in the study (53.1% female patients, 46.9% male patients). Most of the children were not worried that face masks would hide their orthodontic appliances (Item 1-Never, 40.2%; Rarely, 28.9%) and did not consider that the necessity of face mask wearing negatively impacted their desire to undergo an orthodontic treatment, despite the fact that it covered the appliances (Item 2-Never, 37.1%; Rarely, 31.6%). However, 44.5% of children were not happy because they had to wear a face mask during the orthodontic treatment, considering the fact that it covered the orthodontic appliance (Item 6), and most patients (49.2%) did not want the face mask to continue to be mandatory (Item 7). Although children were not happy that they had to wear a face mask that covered the orthodontic appliances, protective face masks were generally well tolerated by Romanian children.

Symptoms of Burnout Syndrome among Physicians during the Outbreak of COVID-19 Pandemic-A Systematic Literature Review.

Background: Studies in the recent decades show that the medical profession has a high risk to develop burnout due to constant exposure to mental and physical suffering or death. The pandemic period induced additional stress for healthcare professionals due to the likelihood of a high rate of infection, long working shifts, using protective equipment, staying away from family, implementing new medical procedures. The present study is focusing on assessing the prevalence of burnout among physicians working in the healthcare system during the COVID-19 pandemic, and discovering the main factors associated with burnout syndrome among the population of physicians. Material and methods: A systematic review was conducted by searching PubMed, Wiley, and Google Scholar in November 2021. A total of 35 studies were eligible for the evaluation. Results: The samples ranged from 39 to 3071 physicians, and the overall burnout ranged from 14.7% to 90.4%. Sociodemographic characteristics associated with a high prevalence of burnout were the female gender, less experienced, not having children, and single marital status, associated with high levels of anxiety, depression, and stress in the female gender. The highest level of burnout among all the studies was 90.4% on a sample of physicians from the Republic of Korea, 80.2% among psychiatrists in Saudi Arabia, followed by a study in Ireland with a 77% level of burnout among senior and specialist physicians, and 74.7% prevalence of burnout for emergency physicians in USA. Conclusions: During the pandemic, the factors that contribute to burnout are the lack of personal protective equipment and the violence of issues related to organizational health; the high prevalence of burnout symptoms is associated with anxiety, depression, and stress.

Body-Esteem, Self-Esteem and Loneliness among Social Media Young Users.

The use of social networking sites for socializing, having fun, solving academic tasks or even getting counselling for health-related problems is now inevitable. METHODS: A total of 427 medical students, who are users of social media sites, were included in the research. Data about socio-demographic, anthropometric, and self-rated items regarding satisfaction with physical and mental health were collected. Three psychological tools were also used to measure self-esteem (Rosenberg Self-Esteem Scale), body-esteem (Body Esteem Scale for Adolescents and Adults) and loneliness (UCLA Loneliness Scale). Collected data were analyzed using SPSS version 23. RESULTS: Students use these networks for socialization (49.0%), entertainment (31.1%) and academic tasks (19.9%), spending 3.38 ± 0.80 h per day on SNSs. Less than half of them (47.5%) compared themselves to other SNS profiles. The use of Snapchat was found to be strongly positively correlated with self-esteem, and weight status was negatively correlated with the use of TikTok. More than three-quarters declared that they exercised to lose weight or to prevent weight gain. Participants were found to have a high level of body esteem. Almost half of the students proved to have a moderate to a high level of loneliness. Age and gender were found to be important: the younger the user, the higher the scores for loneliness and feeling depressed, and the greater the number of hours on SNSs. The total score for self-esteem was significantly higher in men than in women, and male students appreciated themselves as being in a better state of mental health than women. CONCLUSIONS: The results prove a relationship between the use of SNSs and the presence of loneliness, self-esteem and body-esteem, with gender differences. However, the use of SNSs should not be neglected in clinical settings, and are a good means of reaching patients and providing medical and psychological intervention.

Oral Health among Elderly, Impact on Life Quality, Access of Elderly Patients to Oral Health Services and Methods to Improve Oral Health: A Narrative Review.

Dental health is often neglected among the elderly because of the numerous comorbidities in this population, such as cardiovascular diseases. However, dental health influences general health and quality of life by impacting both the general health and the psychological state of the individual. The present review highlights the main dental comorbidities in the elderly population, their impact on the quality of life, the barriers towards access to dental care in the elderly and methods to improve their dental health. Information related to dental care and its importance must be provided both to older individuals and their caregivers in order to detect dental pathology and treat it adequately. Ensuring dental health involves the whole society of elders, caregivers, dental care providers, the public sector, health policymakers, and the private sector.

Gender Differences in Healthy Lifestyle, Body Consciousness, and the Use of Social Networks among Medical Students.

Background and Objectives: The goal of this survey was to identify the relationship between the level of satisfaction with body image, perceived health, and the usage of social media among freshmen medical university students. The influence of social media and peers was also related to body image. Materials and Methods: An online survey was distributed among freshmen healthcare students. The questionnaire collected sociodemographic, anthropometric data, and information about students' perception about healthy lifestyle using open-ended questions, as well as their opinion about the importance of perfect body image and the level of satisfaction with their physical appearance. Questions focusing on the use of social media and the relationship with body image collected data on the use of social networks and how they affect students' opinion about their own body image. Psychometric data were also gathered using the Body Consciousness Scale. For the statistical analysis, QSR NUD*IST (Non-numerical Unstructured Data Indexing Searching and Theorizing) Vivo 12 was used for qualitative data and IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 23 (SPSS Inc., Chicago, IL, USA) was used for descriptive and comparative results. Results: In total, 77 students aged 20.09 ± 2.47 years, of which the majority were women (75.30%), were included in the survey. The use of social network was about 4.81 ± 3.60 h/day. Facebook was the most used social networking site (94.80%), followed by Instagram (92.20%), Snapchat (16.90%), WhatsApp (15.60%), and TikTok (10.40%). The most common reason for using these sites was socialization. We found that 64.90% of healthcare students were normal weight. The main barriers for having a healthy lifestyle, as they were perceived by students, were the busy schedule and the lack of time needed to prepare healthy meals, lack of motivation, and lack of money. Women scored higher for the Private Body Consciousness and Public Body Consciousness scales. The main aspects related to a healthy lifestyle referred to physical activity, consumption of fruit and vegetables, water consumption, and a good quality of sleep. Gender differences were discussed as well. Conclusions: The results illustrated the complexity of the relationship between social media and body image and the need to prevent body image concerns, especially in young women.

Impact of COVID-19 Pandemic on Academic Activity and Health Status among Romanian Medical Dentistry Students; A Cross-Sectional Study.

During the first year of the COVID-19 pandemic, dental faculties had to rethink their way of teaching and interacting with students and of delivering solid theoretical knowledge and practical skills to students. BACKGROUND: The purpose of the study was to assess dentistry students' opinions about the online activity, together with a self-evaluation of their mental and physical health, during the first wave of the pandemic. METHODS: A cross-sectional study was conducted using an online survey. Three hundred and three students, enrolled across all six years of study, were included in the research. Socio-demographic and academic data were collected, along with a self-evaluation of physical and mental status. Some items investigated students' opinions about distance learning and the impact of that online activity on their achievement. The answers were rated using a five-item Likert-like scale. Data were analyzed using SPSS (v.24). RESULTS: statistical analyses showed that more than 20% of the students strongly agreed with the statement that they felt more anxious and depressed during the first months of the pandemic, and more than 30% were totally satisfied with their relationships with their family members. One-fifth of the respondents declared that they were totally dissatisfied with the relationships with their colleagues and friends. Overall, 50.60% of the students attended the courses/labs in their entirety when they were connected online. Two-thirds of the respondents considered that their practical training was affected due to the online activity, and that not all of the subjects could be taught online. More than half of the respondents agreed that the most objective evaluation method is that of the multiple-choice exams administered at school, and considered that exclusively utilizing online assessments of students encourages unethical behaviors. Age, involvement in online activity, and active participation using video cameras were strongly correlated with satisfaction with academic results. CONCLUSIONS: The results of the present study showed that online activity was a good alternative for dentistry students during the pandemic restrictions. The positive aspects, together with the negative consequences, of distance learning should also be taken into consideration by university teachers and academic institutions to improve teaching experiences and to ensure a solid professional formation for dentistry students.

The Relationship between Fear of Infection and Insomnia among Dentists from Oradea Metropolitan Area during the Outbreak of Sars-CoV-2 Pandemic.

Various studies have shown the impact of COVID-19 pandemic on mental health, identifying that people with a strong fear of getting infected are more prone to become stressed, depressed, anxious and to experience sleeping disturbance. The present study focuses on the impact of fear of COVID-19 and its relationship with insomnia among dentists. 83 dentists from public and private clinics were included in the research. A questionnaire was especially constructed for this study, consisting of three parts: the first part gathered socio-demographic and medical data, and a succession of self-rated items collected opinions about lockdown and preventive behaviors; the second part evaluated the level of fear of infection with Coronavirus-19 using the Fear of Covid 19 Scale; the third part investigated the presence of insomnia using the Athens Insomnia Scale. Collected data were processed using SPSS (v. 25). The total scores for fear of COVID 19 and insomnia were assessed. A strong positive correlation was identified between the total score of AIS and the total score of FCV-19S. The fear of COVID-19 had a significant positive correlation with the practice of several preventive behaviors. Dentists with chronic diseases were found to be more prone to suffer from insomnia than healthy dentists. Significant differences between women and men in terms of night symptoms were discussed. The findings are useful for dentists and policy makers to evaluate the impact of fear of infection on mental health status.

Evaluating the Practice of Preventive Behaviors and the Fear of COVID-19 among Dentists in Oradea Metropolitan Area after the First Wave of Pandemic; a Cross-Sectional Study.

Dental clinics were suspected to be a hotspot for nosocomial transmission of COVID-19 due to the easy spread of the virus. The study investigated the preventive behaviors applied in dentistry settings and the level of fear of COVID-19 infection among dentists. A total of 83 respondents (34.94% male and 63.86% female) were included in the research. Sociodemographic data were collected, together with new institutional and personal rules regarding preventive behaviors. Fear of COVID-19 Scale was used to measure the fear of infection. Data was analyzed using SPSS (v.25, SPSS Inc., Chicago, IL, USA). During the first seven months of confinement, 3.9% of dentists were confirmed with COVID-19 and one fourth treated confirmed positive patients. A quarter of the doctors declared that they had periods when they lived away from home being afraid of transmitting the disease to their family members, and significant data were found in doctors being parents. The closure of dental offices had a negative impact on the financial situation of dentists, especially on those working in rural area offices. Many doctors encountered difficulties in purchasing protective suits and medical supplies, and more than half of the respondents (65.1%, N = 54) focused on the quality of protective suits when purchasing them. More than half of the dentists were trained how to use them. The score for fear of COVID 19 was similar to dentists from other countries. Respondents with chronic diseases were more prone to show higher level of anxiety when following the news and stories related to COVID-19 on TV, media, or social networks. One third of dentists mentioned that they had treated exclusively specific urgent dental problems since the onset of the pandemic and more than 13.3% declared that they refused to provide medical assistance to some specific pathologies because of the fear of infection. The results reflect new challenges and rules adopted by dentists in order to diminish the risk of infection and the impact of pandemic considering their psychological, familial, and financial context. Policymakers and professional associations around may benefit from these findings while formulating guidelines to support dentists during COVID-19 or any future pandemics.