COVID-19 collaborative screening: An action-research project for large scale contact tracing in Northern Portugal.

In late November 2020, when Europe reached the highest 14-day incidence of COVID-19 cases, the resource-intensive and time-consuming traditional contact tracing performed by Public Health was challenged. In this context, innovative approaches were necessary to guarantee a timely interruption of disease transmission. "COVID-19 Collaborative Screening" Project was developed as a faster solution, not only because the contact tracing process is simpler for the operator, but mainly because it is possible to quickly scale up the number of operators involved. It was designed to interrupt family and social transmission chains, in a partnership with the Local Public Health Services - allowing these services to dedicate to scenarios of more complex risk assessment, using the traditional contact tracing. To perform contact tracing, this method involves Public Servants, Armed Forces and Medical Dentists. The Project also promotes participatory citizenship, by delegating to the citizen the responsibility of registering his/hers contacts with high-risk exposure in an online form, in contrast to the traditional contact tracing method which is more health professional-dependent. Until the end of January 2021, the Project has trained eight teams, enrolling a total of 213 professionals, and was implemented in eight Health Regions (with an estimated population of 1,346,150 inhabitants). The Project was successful at facing the delays in case interview and contact tracing. The strategy implemented by ColabCOVID is assembled as a sustainable, reproducible and scalable platform and is ready to be re-implemented to face the emergence of more contagious variants, as well as an eventual forthcoming health threat.

Remote diagnosis of children dental problems based on non-invasive photographs - a valid proceeding?

Telemedicine models using commercially available technology have enabled high-quality illness care in paediatric primary care settings and markedly improved access. This fact should be explored in Pediatric Dentistry, considering that dental problems are very common in children at pre-school age and it becomes important to screen them as early as possible in order to promote the appropriate treatment. In this sense, we aim to know how telemedicine, or more specifically, teledentistry, could help on this process, evaluating the validity of children dental problems remote diagnosis based on non-invasive photographs, using accessible and low-cost technologies. Three photographs were taken for each of 66 children to be remotely analyzed by four dentists. Each dentist filled a web-based questionnaire for each child. The same children had a traditional in-person dental consultation that is used as a gold standard in this study. The results show sensitivity between 94% and 100% and specificity between 52% and 100%. The positive predictive value was between 67% and 100% and the negative predictive value between 94% and 100%. These results suggest that remote diagnosis of children dental problems based on non-invasive photographs constitute a valid resource when we pretend to exclude referred children to a dentist for treatment of dental problems, but further studies should be carried out to increase the validity of this proceeding to referring children for the same treatment.

Dental erosion in alcoholic patients under addiction rehabilitation therapy.

OBJECTIVE: To determine the occurrence and severity of dental erosion in alcoholic patients undergoing detoxification at the North Alcoholic Regional Centre (CRAN), Porto, Portugal, and to assess socioeconomic and behavioural covariates of dental erosion occurrence. DESIGN: A cross-sectional descriptive study was carried out in one centre (CRAN) for addiction rehabilitation therapy in the north of Portugal. A sample of 1064 teeth was examined. The condition of the dental erosion was classified by means of severity and anatomic location, according to the Eccles and Jenkins dental erosion index, and a dichotomous outcome assessing the occurrence of dental erosion (severity dental erosion levels > 0 ). Dental erosion results were linked to data supplied by a questionnaire assessing socio-demographic characteristics, behaviour related to alcohol and drug use, including a history of drug and alcohol abuse, and oral health promotion using logistic multivariate regression analysis. RESULTS: Enamel and/or dentine erosion lesions were present on 49.4% of the teeth. Among these, 36.9% of occlusal surfaces presented dental erosion with a severity level of 1, 11.4% with a severity level 2 and 1.1% with a severity level 3. The highest occurrence of severity level 3 was found to exist in palatal dental surfaces (1.9%). Dental erosion on teeth surfaces was found to be independently associated with intra oral location (by arch, tooth type), patients' socio-demographic characteristics, behaviour associated with a history of alcohol and drug abuse, and oral health promotion. Maxillary teeth, more so than mandibular teeth, presented moderate to higher severity erosion injuries (Wilcoxon test; p< 0.001); and significant differences in the severity of dental erosion were found between anterior and posterior teeth, in both the maxillary and the mandibular arches (Friedman test, p< 0.001). CONCLUSIONS: Alcohol-dependent patients undergoing a detoxification programme presented a high occurrence and a low severity of dental erosion lesions.The palatal surfaces of the anterior teeth, followed by incisive/occlusal surfaces in both anterior and posterior teeth, respectively, were most affected by erosion injuries.