Environmental Disinfection of a Dental Clinic during the Covid-19 Pandemic: A Narrative Insight.

BACKGROUND: The control of biological hazard risk in health care and dental clinic environments represents a critical point in relation to the Covid-19 infection outbreak and international public health emergency. The purpose of the present review was to evaluate the scientific literature on the no-touch disinfection procedures in dental clinics aiming to limit transmission via airborne particles or fomites using no-touch procedures for environmental decontamination of dental clinics. METHODS: An electronic database literature search was performed to retrieve research papers about Covid-19 and no-touch disinfection topics including full-length articles, editorials, commentaries, and outbreak studies. A total of 86 papers were retrieved by the electronic research. RESULTS: No clinical article about the decontamination of a dental clinic during the Covid-19 pandemic was detected. About the topic of hospital decontamination, we found different no-touch disinfection procedures used in hospital against highly resistant organisms, but no data were found in the search for such procedures with respect to SARS-CoV-2: (1) aerosolized hydrogen peroxide, (2) H2O2 vapor, (3) ultraviolet C light, (4) pulsed xenon, and (5) gaseous ozone. One paper was retrieved concerning SARS-CoV-2; 32 documents focused on SARS and MERS. The cleaning and disinfection protocol of health care and dental clinic environment surfaces are essential elements of infection prevention programs, especially during the SARS-CoV-2 pandemic. CONCLUSION: The decontamination technique that best suits the needs of the dental clinic is peroxide and hypochlorous which can be sprayed via a device at high turbine speed with the ability of producing small aerosol particles, recommendable also for their low cost.

Impact of COVID-19 pandemic on otolaryngology, ophthalmology and dental clinical activity and future perspectives.

OBJECTIVE: Since the COVID-19 outbreak, otolaryngologists, ophthalmologists and dentists have been severely affected, both for the transmission routes and for the diagnostical and therapeutic procedures typical of these disciplines. MATERIALS AND METHODS: In this article, we discuss the transmission routes, the potential risk of contagion for patients and healthcare providers during procedures, and comment on the changes that will affect head and neck clinical practice in the future of outpatient and surgical activities. RESULTS: Otolaryngologists, ophthalmologists and dentists are at high risk for infection contagion and spread because they perform diagnostic and therapeutic procedures that generate aerosol and droplets thus facilitating virus transmission. Furthermore, examination involves close doctor-patient contact and otolaryngologists and dentists have to remove patient's protective devices during the visit. CONCLUSIONS: Special attention to prevention protocols for diagnostic and therapeutic procedures and the use of protective equipment is of utmost importance to limit contagion and prevent a new virus spread in the near future.

Mobile Dental Delivery System: An Effective Protocol for Hygiene and Disinfection.

Mobile dental delivery systems (MDDSs) are receiving growing interest for reaching isolated patients, as well as in dental care for fragile and hospitalized patients, with the advantage of being able to be used from room to room or during general anesthesia (GA) in an operating room. Therefore, ensuring the care safety is crucial. The aim of this study was to elaborate and assess an MDDS maintenance protocol, containing the management of dental unit waterlines and adapted to specific conditions such as dental care under GA. A step-by-step protocol was established and implemented for an MDDS used during dental care under GA in children. Samples of the output water were collected at J0, J+1, 3, 6, 12, and 24 months, and cultured to observe the microbiological quality of the water. All the results (heterotrophic plate count at 22 °C, at 37 °C, and specific pathogenic germs sought) showed an absence of contamination. The protocol presented was effective over time and allowed ensuring the safety of care to be ensured when using MDDS, even during dental procedures under GA. As a result, it could be implemented by any dental care delivery structure wanting to reinforce the safety of its practice.

Improving Dental School Clinic Operations Using Business Intelligence Data.

In dental school clinics, students spend a great deal of time waiting for faculty members to check and approve their work. Traditionally at the University of Michigan School of Dentistry, students have left their cubicles to form lines behind supervising faculty members, and this line of students would follow the faculty member around from patient to patient. To address this problem and improve the patient experience, the school computerized the approval-seeking process by building the Faculty Request System (FRS) to enable students to stay with their patients while seeking the necessary approvals. The FRS produced a large volume of time-stamped, business intelligence data that enabled further evaluation. The aim of this study was to assess the effects of this change, including the quality/process improvement interventions that were possible due to information revealed by the FRS. The results showed no change in the number of students or faculty members per clinic session across the three years of this evaluation. With the FRS, the amount of time students spent away from their patients was reduced from 40.6 minutes to 12.1 minutes. After the FRS was implemented, there was an eradication of appointments that ended 30 minutes late (from 0.03% to zero) and a reduction of appointments that ended 15 minutes late (from 0.25% to 0.01%). There were also increases in students' starting appointments on time (9.8% of start checks to 25.8%), 15 minutes late (16.6% to 35.2%), and 30 minutes late (13.2% to 22.2%). By critically analyzing data from the new system, the school's leadership can analyze trends and make data-driven decisions to alter operations. The results of this study suggest that this process can improve the patient and student experience and faculty utilization.

A comparison of patient safety culture at two campuses of Riyadh based dental College.

OBJECTIVE: To identify potential shortcoming(s) in relevance to patient safety culture at dental clinics. METHODS: The cross-sectional study was conducted from March to June 2016 at two clinics of a dental teaching college in Riyadh, Saudi Arabia, and comprised subjects who had either direct or indirect contact with patients in the dental clinics. The subjects were handed over a questionnaire based on the Patient Safety Culture Hospital Questionnaire. SPSS 21 was used for data analysis. RESULTS: Of the 149 subjects, 96(64.4%) were male, and 130(87%) were in direct contact with patients, while 19(13%) were in indirect contact. Overall, 52(35%) subjects stated that their unit did not have enough staff to handle the workload, and 71(47.7%) said that not encountering serious errors in their unit was pure luck. An encouraging finding was that 104(69.8%) subjects said their managers appreciated them when they followed the established patient safety protocol. Conclusion: There was a variation in the perception of patient safety culture among professionals.

Introducing and Evaluating Intraprofessional Team-Based Care Delivery in a Dental School Clinic: A Pilot Study.

There is growing interest in developing more efficient, patient-centered, and cost-effective models of dental care delivery using teams of professionals. The aims of this small pilot study were to assess the number of patient visits, type and number of procedures performed, and clinic revenues generated by an intraprofessional team of dental, dental hygiene, and dental therapy students and to determine the students' and patients' perceptions of this model of care. Sixteen senior students from three student cohorts (dental, dental hygiene, and dental therapy) at the University of Minnesota piloted a team-based dental delivery model from January to April 2015. The group was named the Team Care Clinic (TCC), and the team for each clinical session consisted of one dental student, three dental hygiene students, and one dental therapy student. Data were collected from the school's database to determine the number of patient visits, type and number of procedures performed, and clinic revenue generated by the TCC. Focus groups were used to assess student perceptions of the experience, and patient satisfaction surveys were administered to assess the patients' experience. The TCC students were given twice as many patients as non-TCC students, and they managed them effectively. Working as a team, the TCC student providers completed twice as many procedures per patient encounter as non-TCC students. Patients and students said their experiences in the TCC were positive, and students expressed a preference for team-based care delivery. The results of the study suggest the team-based dental care delivery model is promising. Team-based care delivery may allow providers to accomplish more during a patient appointment and increase provider satisfaction.

Assessing the Effectiveness of a School-Based Dental Clinic on the Oral Health of Children Who Lack Access to Dental Care.

This program evaluation examines the effectiveness of a school-based dental clinic. A repeated-measures design was used to longitudinally examine secondary data from participants ( N = 293). Encounter intensity was developed to normalize data. Multivariate analysis of variance and Kruskal-Wallis test were used to investigate the effect of encounter intensity on the change in decay, restorations, and treatment urgency. A Pearson's correlation was used to measure the strengths of association. Encounter intensity had a statistically significant effect on change in decay ( p = .005), restorations ( p = .000), and treatment urgency ( p = .001). As encounter intensity increased, there was a significant association with the decrease in decay (-.167), increase in restorations (.221), and reduction in referral urgency (-.188). Incorporating dental care into a school-based health center resulted in improved oral health in underserved children while overcoming barriers that typically restrict access. The collaboration of school nurses with the school-based dental clinic was an important element for maximizing student access to dental care.

The Frequency of Dietary Advice Provision in a Dental Hygiene Clinic: A Retrospective Cross-Sectional Study.

PURPOSE: The aim of this retrospective, cross-sectional study was to assess the frequency of dietary advice provision by dental hygiene students. METHODS: Data was obtained from clinical records of third-year Bachelor of Oral Health students at the University of Newcastle. Frequency of dietary advice was recorded by students over a 12-month period. The study investigated associations between demographics, treatment provided and frequency of dietary advice. RESULTS: The results indicated dietary advice was provided infrequently by dental hygiene students, with only 6.48% of all patients seen during the 12-month period receiving dietary advice. A statistically significant correlation was observed between dietary advice and age, with children under the age of 18 being 2.5 times more likely than adults to receive dietary advice. Additionally, patients who received oral hygiene instruction were 2.5 times as likely to receive dietary advice. Strong correlations were also observed between topical and concentrated fluoride application and dietary advice. CONCLUSION: The findings indicate dietary advice is provided infrequently by dental hygiene students. Further research is required to strengthen the findings and to investigate barriers to dietary advice provision, as well as perceptions of dental practitioners regarding dietary advice.

The importance of, and the benefits derived from, forward dental peripatetic clinics in Afghanistan.

The majority of dental care for military personnel is carried out in clinics that would be familiar to all dental professionals. In times of conflict, however, dental care is often required to travel to those in need. Dental morbidity has a detrimental effect on a fighting force, both at the personal level and for maintaining combat efficiency. In Afghanistan, two main dental centres provided the majority of emergency care to coalition forces, but from March to September 2012, 23 peripatetic clinics also took place with 472 dental casualties treated. Assessment of these peripatetic clinics demonstrates both quantitative and qualitative benefits. Return travel to main base clinics takes between three to five days. If all personnel during this period had attended a main base and returned to their duty station in only three days, over 1,000 duty days would have been lost. This compares to the 32 days actually lost by attending peripatetic clinics instead and illustrates the considerable time that was saved. Additionally, time spent travelling in a hostile environment is also time at risk of attack. Forty-one anonymous comments about the clinics were left by personnel. All were positive and enthusiastic. The results of this review demonstrate that these clinics save considerable mission time, reduce risk to military personnel, and were greatly valued by those suffering dental problems.

Health literacy environmental scans of community-based dental clinics in Maryland.

OBJECTIVES: We conducted health literacy environmental scans in 26 Maryland community-based dental clinics to identify institutional characteristics and provider practices that affect dental services access and dental caries education. METHODS: In 2011-2012 we assessed user friendliness of the clinics including accessibility, signage, facility navigation, educational materials, and patient forms. We interviewed patients and surveyed dental providers about their knowledge and use of communication techniques. RESULTS: Of 32 clinics, 26 participated. Implementation of the health literacy environmental scan tools was acceptable to the dental directors and provided clinic directors with information to enhance care and outreach. We found considerable variation among clinic facilities, operations, and content of educational materials. There was less variation in types of insurance accepted, no-show rates, methods of communicating with patients, and electronic health records use. Providers who had taken a communication skills course were more likely than those who had not to use recommended communication techniques. CONCLUSIONS: Our findings provide insight into the use of health literacy environmental scan tools to identify clinic and provider characteristics and practices that can be used to make dental environments more user friendly and health literate.

Papel de los antioxidantes en la promoción de la salud oral / Role of antioxidants in the promotion of oral health

Actualmente, existen suficientes investigaciones que sostienen que incorporar a la dieta ciertos alimentos ricos en antioxidantes, tiene un efecto beneficioso en la salud en general. Una dieta equilibrada disminuye el riesgo de patologías tales como las enfermedades cardiovasculares, cáncer y diabetes, entre otras. También el papel de los antioxidantes en la salud oral, es objeto de estudio en este momento. Se buscan beneficios y aplicaciones en la prevención y tratamiento de patologías orales, que de ser demostrados podrían suponer en el futuro un cambio en el manejo de estas patologías. Se ha realizado una revisión de la literatura para determinar si existe suficiente evidencia científica que avale la presencia de propiedades preventivas y terapéuticas de los antioxidantes en la salud oral. Para ello, se han consultado las bases de datos PubMed/Medline y Cochrane con las palabras clave: antioxidants, oral health, oral cancer, nutrition, quimioprevention, leukoplakia, lycopene (AU)

Nowadays, it is proved that incorporating food which is rich in antioxidants has beneficial effects to health. A balanced diet decreases the risk of suffering pathologies as heart disease, cancer and diabetes among others. In addition, the role of antioxidants in oral health is currently understudy. The aim of this paper is to find benefits and applications in the prevention and treatment of oral pathologies. If this was proved it could mean a future change in these pathologies management. A review of the scientific evidence todeterminate whether antioxidants have preventive and therapeutic properties in oral health hasbeen done, using the data bases PubMed/Medline, Cochrane with the following key words:antioxidants, oral health, oral cancer, nutrition, quimioprevention, leukoplakia, lycopene (AU)

Consideraciones dentales en el síndrome de maullido de gato: a propósito de tres casos / Dental considerations in cat’s cry syndrome: report of three cases

El síndrome de maullido de gato es una cromosomopatía rara. Se caracteriza por retrasomental, facies característica, malformaciones congénitas y llanto semejante al maullido de un gato. Se presentan tres pacientes con dicho diagnóstico, que tenían policaries y mal oclusiones. Se llevó a cabo el tratamiento dental con anestesia general. Uno de los tres niños presentó una cúspide en garra en 1.2. Se realiza una revisión bibliográfica al respecto, siendo escasas las publicaciones sobre el tema (AU)

The cat’s cry syndrome results from a rare chromosomal anomaly. It includes mental retardation, characteristic features, congenital malformations and a peculiar cat-like cry. We present three patients with cat’s cry syndrome who had much tooth decay and dental malocclusion. The dental treatment was performed under general anaesthesia. One of the three children reported talon cusps. A bibliographic review in this respect is done, publications about this subject being few (AU)

The development of a primary dental care outreach course.

The aim of this work was to develop the first north-east based primary dental care outreach (PDCO) course for clinical dental undergraduate students at Newcastle University. The process of course design will be described and involved review of the existing Bachelor of Dental Surgery (BDS) degree course in relation to previously published learning outcomes. Areas were identified where the existing BDS course did not meet fully these outcomes. This was followed by setting the PDCO course aims and objectives, intended learning outcomes, curriculum and structure. The educational strategy and methods of teaching and learning were subsequently developed together with a strategy for overall quality control of the teaching and learning experience. The newly developed curriculum was aligned with appropriate student assessment methods, including summative, formative and ipsative elements.

[The effect of fluoride application in adolescents of lower socio-economic status]. / Het effect van de fluorideapplicatie bij jongeren met een lagere sociaal-economische status.

Purpose was to study the effect of professionally applied topical fluoride on oral health status on the population level in adolescents with lower socio-economic status. Adolescents attending dental clinics where professional fluoride application is a routine procedure (high-fluoride group) were compared to adolescents from other clinics (low-fluoride group). The study consisted of a questionnaire, a clinical examination with two bitewing radiographs. X-rays showed no statistically significant differences in the number of DS, FS or DFS. Clinically, there were no statistically significant differences in the number of FS or in the number of DFS. The low-fluoride group had a statistically significant higher number of DS than the high-fluoride group. The results suggest that professionally applied fluoride has a limited effect on caries and treatment experience in a population. These results justify a randomised clinical trial to study the effectiveness of professionally applied topical fluorides.

Clínica para bebés: Facultad de Odontología de la Universidad Federal do Rio Grande do Sul, Brasil / Clinic for babies: School of Dentistry, Federal University of Rio Grande do Sul, Brazil

La atención odontológica al niño debe iniciarse en los primeros 6 meses de vida, conociendo el déficit en la capacidad de los odontólogos para atender este grupo de edad y con base en los patrones de la clínica de bebé de Londrina - UEL (Estado de Paraná, Brasil), se organizó a partir de 1990 una clínica para la atención de bebés en la Facultad de Odontología de la UFRGS. En la actualidad se encuentra funcionanado y prestando servicios de capacitación para odontólogos a través de un curso de extensión universitaria y con carga horaria total de 336 horas. El objetivo de este curso es ofrecer un conocimiento básico en odontopediatría con énfasis en la primera infancia, permitiendo la atención integral del pequeño paciente. De esta forma, el alumno estará capacitado para promover la salud bucal en la primera infancia por medio de la prevención, procedimientos quirúrgico-restauradores y principalmente la educación continua a los padres y/o responsables del niño. Nuestra prioridad es la atención de niños de 0-1 años de edad, sin tener en cuenta el aspecto físico, psicológico o neurológico. Al final de cada curso, se hace una evaluación del tratamiento ofrecido por la clínica, relacionando la distribución de los niños por grupo de edad, motivo de la consulta, evaluación inicial y final de la actividad cariosa y la relación entre la edad y el motivo de la consulta. Los datos del año 1999, donde fueron registrados 366 bebés, evidencian que el grupo más atendido fue el de 0-1 año de edad (43,17 por ciento), siendo la prevención el motivo principal de la primera consulta (94.32 por ciento). Se logró invertir el cuadro de actividad de la enfermedad de 50 por ciento de los niños en la edad más susceptible (2-3 años). Podemos afirmar que la atención odontológica para niños de tierna edad es oportuna y que si los profesionales fueran capacitados para realizar este tipo de tratamiento, lograríamos invertir la alta prevalencia de caries dental, tan importante en los niños del Brasil

Clínica para bebés: Facultad de Odontología de la Universidad Federal do Rio Grande do Sul, Brasil / Clinic for babies: School of Dentistry, Federal University of Rio Grande do Sul, Brazil

La atención odontológica al niño debe iniciarse en los primeros 6 meses de vida, conociendo el déficit en la capacidad de los odontólogos para atender este grupo de edad y con base en los patrones de la clínica de bebé de Londrina - UEL (Estado de Paraná, Brasil), se organizó a partir de 1990 una clínica para la atención de bebés en la Facultad de Odontología de la UFRGS. En la actualidad se encuentra funcionanado y prestando servicios de capacitación para odontólogos a través de un curso de extensión universitaria y con carga horaria total de 336 horas. El objetivo de este curso es ofrecer un conocimiento básico en odontopediatría con énfasis en la primera infancia, permitiendo la atención integral del pequeño paciente. De esta forma, el alumno estará capacitado para promover la salud bucal en la primera infancia por medio de la prevención, procedimientos quirúrgico-restauradores y principalmente la educación continua a los padres y/o responsables del niño. Nuestra prioridad es la atención de niños de 0-1 años de edad, sin tener en cuenta el aspecto físico, psicológico o neurológico. Al final de cada curso, se hace una evaluación del tratamiento ofrecido por la clínica, relacionando la distribución de los niños por grupo de edad, motivo de la consulta, evaluación inicial y final de la actividad cariosa y la relación entre la edad y el motivo de la consulta. Los datos del año 1999, donde fueron registrados 366 bebés, evidencian que el grupo más atendido fue el de 0-1 año de edad (43,17 por ciento), siendo la prevención el motivo principal de la primera consulta (94.32 por ciento). Se logró invertir el cuadro de actividad de la enfermedad de 50 por ciento de los niños en la edad más susceptible (2-3 años). Podemos afirmar que la atención odontológica para niños de tierna edad es oportuna y que si los profesionales fueran capacitados para realizar este tipo de tratamiento, lograríamos invertir la alta prevalencia de caries dental, tan importante en los niños del Brasil (AU)

Microscópio odontológico para o clínico geral: a qualidade total chega aos consultórios odontológicos / The operating microscope for the general clinician: the excellence era arrives to the dental office

Desde o princípio do século, tanto a medicina como a odontologia, tem se beneficiado enormemente do uso da magnificaçäo, tendo consequentemente seus horizontes ampliados. A melhora da acuidade visual dos profissionais, conseguida principalmente através do uso intenso de magnificaçäo óptica, tem tornado parte integral dos consultórios odontológicos modernos. Através da grande tendência mundial da Micro-Odontologia, os autores usaram princípios de microcirurgia para melhorar a acuidade visual, bem como a precisäo das técnicas operatórias já existentes, para modificar e ampliar definitivamente o espectro da açäo da Odontologia moderna. Este artigo tem por objetivo fornecer um breve histórico da utilizaçäo da magnificaçäo (Microscópio Odontológico) na odontologia, uma suscinta descriçäo do Microscópio Odontológico, bem como o quanto os Cirurgiöes Dentistas podem se beneficiar desta nova tecnologia. Certamente estamos diante de uma nova era na Odontologia: a era da excelência clínica