Special Issue "Dental Public Health: Issues, Challenges and Opportunities"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Oral Health".

Deadline for manuscript submissions: 31 July 2021.

Special Issue Editors

Dr. Marco Mascitti
E-Mail Website
Guest Editor
Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, 60121 Ancona, Italy
Interests: oral squamous cell carcinoma; head and neck cancer; prognostic markers in tissues; odontogenic neoformations
Special Issues and Collections in MDPI journals
Prof. Dr. Giuseppina Campisi
E-Mail Website
Guest Editor
Department of Surgical, Oncological and Oral Sciences, Sector of Clinical Research “Valerio Margiotta”, University of Palermo, 90127 Palermo, Italy
Interests: oral medicine; Medication-related Osteonecrosis of the Jaw; head and neck oncology; viral oral infections; dental public health; teledentistry
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

The aging of the global population is one of the challenges that dentistry must face in the 21st century, with important implications for health and society. The presence of several medical and dental conditions simultaneously impacts the oral health status of older adults. Furthermore, other factors like psychological, cognitive, and social conditions can further worsen the quality of life of these patients. The scientific community has questioned the traditional medical approach centered on the disease and is paying increasing attention to the patient's involvement in the diagnosis and treatment process, starting from the narrative interview, understood as different from the traditional anamnesis and able to detect the patient's universe.

In addition to oral health management in older adults, Public Dentistry must also face other issues, such as oral cancer, potentially malignant disorders, and adverse drug reactions such as mucositis and medication-related osteonecrosis of the jaw (MRONJ), an emerging adverse drug reaction characterized by the progressive destruction and death of maxillary and mandibular bones.

In recent years, technological advances have led to the development of “Telehealth”, defined as the distribution of health-related services via electronic information and telecommunication technologies. The application of this new approach in the field of Public Dentistry, also called “Teledentistry”, can be used to assist general dentists and improve services to underserved populations.

Nevertheless, technological and therapeutic advances are insufficient on their own. Indeed, the increasingly obvious limits found in the approach of the current health care systems "focused on illness" require a radical rethinking by health professionals, in approach and methodology. For this reason,  a new paradigm “focuses on patients” with the aim of reducing inadequate medical practices to ensure more accurate diagnoses and avoid the waste of limited resources.

For this Special Issue we invite submissions in every field of research on Public Dentistry. The topics may include (but are not limited to):

• Applied epidemiology of oral diseases;
• Dental health practice and impact (clinical, social);
• Oral health promotion and disease prevention;
• Public health programs/interventions;
• Narrative dentistry and team management;
• New approaches and technologies in Public Dentistry;
• Dental Public Health: Issues, Challenges and Opportunities;
• COVID-19/SARS-CoV-2 Dental emergency and issues around.

Dr. Marco Mascitti
Prof. Dr. Giuseppina Campisi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oral cancer
  • osteonecrosis of the jaw
  • Teledentistry
  • geriatric dentistry
  • oral epidemiology
  • oral health
  • public dentistry
  • oral prevention
  • slow dentistry
  • COVID-19/SARS-CoV-2

Published Papers (30 papers)

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Editorial

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Editorial
Dental Public Health Landscape: Challenges, Technological Innovation and Opportunities in the 21st Century and COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2020, 17(10), 3636; https://doi.org/10.3390/ijerph17103636 - 21 May 2020
Cited by 9 | Viewed by 1347
Abstract
In response to the 2008 economic and financial crisis and to its effects on healthcare systems, dental care has become unaffordable for many people, and a huge number of patients worldwide are avoiding or skipping necessary dental treatments [...] Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

Research

Jump to: Editorial, Review, Other

Article
Does Head Orientation Influence 3D Facial Imaging? A Study on Accuracy and Precision of Stereophotogrammetric Acquisition
Int. J. Environ. Res. Public Health 2021, 18(8), 4276; https://doi.org/10.3390/ijerph18084276 - 17 Apr 2021
Viewed by 573
Abstract
This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures [...] Read more.
This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures of a mannequin head were obtained with a stereophotogrammetric system (Face Shape 3D MaxiLine). Image acquisition was performed with no rotations and with various pitch, roll, and yaw angulations. On 3D images, 14 linear distances were measured. Various indices were used to quantify error magnitude, among them the acquisition error, the mean and the maximum intra- and inter-operator measurement error, repeatability and reproducibility error, the standard deviation, and the standard error of errors. Two one-sided tests (TOST) were performed to assess the equivalence between measurements recorded in different head angulations. The maximum intra-operator error was very low (0.336 mm), closely followed by the acquisition error (0.496 mm). The maximum inter-operator error was 0.532 mm, and the highest degree of error was found in reproducibility (0.890 mm). Anthropometric measurements from alternative acquisition conditions resulted in significantly equivalent TOST, with the exception of Zygion (l)–Tragion (l) and Cheek (l)–Tragion (l) distances measured with pitch angulation compared to no rotation position. Face Shape 3D Maxiline has sufficient accuracy for orthodontic and surgical use. Precision was not altered by head orientation, making the acquisition simpler and not constrained to a critical precision as in 2D photographs. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial
Int. J. Environ. Res. Public Health 2021, 18(6), 3018; https://doi.org/10.3390/ijerph18063018 - 15 Mar 2021
Cited by 2 | Viewed by 744
Abstract
Background: Based on the holistic approach to prevention diabetic disease, the role of periodontal inflammation in type 2 diabetes mellitus (T2DM) is under intensive scrutiny. Data from clinical trials have shown benefit from a periodontal therapy in providing patients with type 2 diabetes [...] Read more.
Background: Based on the holistic approach to prevention diabetic disease, the role of periodontal inflammation in type 2 diabetes mellitus (T2DM) is under intensive scrutiny. Data from clinical trials have shown benefit from a periodontal therapy in providing patients with type 2 diabetes improvement despite relatively disappointing long-terms response rates. The aim of this study was to investigate the short-term glycemic control level and systemic inflammatory status after periodontal therapy. Methods: This was a randomized trial with a 6-months follow-up. Participants aged 56.4 ± 7.9 years with diagnosed type 2 diabetes and periodontitis were enrolled. Among the 187 type 2 diabetic patients, 93 were randomly assigned to receive non-surgical periodontal treatment immediately and 94 to receive the delayed treatment. Within and between groups comparison was done during the study period, and the differences between groups were assessed. Results: The difference between HbA1c values at baseline (Mdn = 7.7) and 6 months after non-surgical periodontal treatment (Mdn = 7.2) was statistically significant, U = 3174.5, p = 0.012, r = 0.187. However, although technically a positive correlation, the relationship between the glycated hemoglobin value and periodontal variables was weak. The differences between both the groups over 6 months were not statistically considerable, failing to reach statistical significance. At 6 months the difference between groups about the C-reactive protein (CRP) levels was statistically significant, U=1839.5, p = 0, r = 0.472, with a lower concentration for the intervention group. Furthermore, the intervention group showed a statistically significant difference between baseline and 6 months evaluation (U = 2606.5, p = 0, r = 0.308). Conclusions: The periodontal intervention potentially may allow individuals with type 2 diabetes to improve glycemic control and CRP concentrations, and diabetes alters the periodontal status. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Musculoskeletal Disorders among Italian Dentists and Dental Hygienists
Int. J. Environ. Res. Public Health 2021, 18(5), 2705; https://doi.org/10.3390/ijerph18052705 - 08 Mar 2021
Cited by 1 | Viewed by 621
Abstract
Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian [...] Read more.
Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian dental professionals and the most affected body regions. A cross-sectional observational study was conducted between March 2019 and February 2020. The Nordic Musculoskeletal questionnaire (NMQ) was implemented with questions related to working habits (dental occupation, working hours per week and per days, years of work) and lifestyle (practiced physical activity, including frequency and duration, mobilization activities, and knowledge of ergonomic guidelines) was used. The-chi square test was carried out to detect any statistically significant difference (p < 0.05). Logistic regression was carried out to detect the most significant factors associated to WMSD occurrence. A total of 284 questionnaires have been used for the analysis. A high proportion of dental professionals (84.6%) were affected by WMSD in the last 12 months. A higher prevalence was found in females (87%) when compared to males (80%). The prevalence of WMSD was correlated to the working hours/day and hour/week, with a higher risk for operators working >5 h/day and >30 h/week. In addition, a high prevalence was found in operators working for 2–5 years after graduation. Most of the surveyed dental professionals practiced physical activity (70.1%) but only a few had satisfactorily knowledge of ergonomic guidelines (12.7%). Interestingly, participants who practiced yoga or stretching as physical activities demonstrated lower WMSD (77%) when compared to other physical activities (84%). We can highlight that generic physical activities have no functional effect on WMSD for dental professionals. The most affected body areas were neck (59.9%), shoulders (43.3%), lumbar region (52.1%), dorsal region (37.7%) and wrists (30.6%). Considering the magnitude of the problem, there is an urgent need to implement the education in ergonomics among dental professionals, that may be achieved by teaching biomechanics, posturology and integrative functional therapies (such as yoga) during the university education and by promoting holistic health of dental operators. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health
Int. J. Environ. Res. Public Health 2021, 18(5), 2372; https://doi.org/10.3390/ijerph18052372 - 01 Mar 2021
Viewed by 734
Abstract
Community water fluoridation (CWF), a long-established public health intervention, has been studied for scientific evidence from both of yea and nay standpoints. To justify CWF with scientific evidence inevitably leads to ethical justification, which raises the question of whether oral health is of [...] Read more.
Community water fluoridation (CWF), a long-established public health intervention, has been studied for scientific evidence from both of yea and nay standpoints. To justify CWF with scientific evidence inevitably leads to ethical justification, which raises the question of whether oral health is of individual concern or social responsibility. As dental caries is a public health problem, public health ethics should be applied to the topic instead of generic clinical ethics. From both pro- and anti-fluoridationists’ perspectives, CWF is a public health policy requiring a significant level of intervention. Thus, there needs to take further considerations for justifying CWF beyond the simple aspect of utility. For further ethical considerations on CWF, three caveats were suggested: procedural justice, social contexts, and maintenance of trust. The process to justify CWF should also be justified, not simply by majority rule but participatory decision-making with transparency and pluralistic democracy. Social contexts are to be part of the process of resolving conflicting values in public health interventions. Public trust in the dental profession and the oral healthcare system should be maintained over the considerations. This article suggests accountability for reasonableness as a framework to consider infringement by CWF for public justification of its implementation. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Protective Face Masks: Effect on the Oxygenation and Heart Rate Status of Oral Surgeons during Surgery
Int. J. Environ. Res. Public Health 2021, 18(5), 2363; https://doi.org/10.3390/ijerph18052363 - 28 Feb 2021
Cited by 5 | Viewed by 1597
Abstract
Background: Safety in medical work requires eye protection, such as glasses, and protective facial masks (PFM) during clinical practice to prevent viral respiratory infections. The use of facial masks and other full personal protective equipment increases air flow resistance, facial skin temperature and [...] Read more.
Background: Safety in medical work requires eye protection, such as glasses, and protective facial masks (PFM) during clinical practice to prevent viral respiratory infections. The use of facial masks and other full personal protective equipment increases air flow resistance, facial skin temperature and physical discomfort. The aim of the present study was to measure surgeons’ oxygenation status and discomfort before and after their daily routine activities of oral interventions. Methods: 10 male voluntary dentists, specializing in oral surgery, and 10 male voluntary doctors in dentistry, participating in master’s courses in oral surgery in the Department of Oral Surgery of the University of Chieti, with mean age 29 ± 6 (27–35), were enrolled. This study was undertaken to investigate the effects of wearing a PFM on oxygenation status while the oral surgeons were actively working. Disposable sterile one-way surgical paper masks (Surgical Face Mask, Euronda, Italy) and FFP2 (Surgical Face Mask, Euronda, Italy) were used and the mask position covering the nose did not vary during the procedures. The FFP2 was covered by a surgical mask during surgical treatment. A pulse oximeter was used to measure the blood oximetry saturation during the study. Results: In all 20 surgeons wearing FFP2 covered by surgical masks, a reduction in arterial O2 saturation from around 97.5% before surgery to 94% after surgery was recorded with increase of heart rates. A shortness of breath and light-headedness/headaches were also noted. Conclusions: In conclusion, wearing an FFP2 covered by a surgical mask induces a reduction in circulating O2 concentrations without clinical relevance, while an increase of heart frequency and a sensation of shortness of breath, light-headedness/headaches were recorded. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
The Effect of Proximal Cleaning Devices on Periodontal Status in Korean Adults between 2016 and 2018
Int. J. Environ. Res. Public Health 2021, 18(4), 2116; https://doi.org/10.3390/ijerph18042116 - 22 Feb 2021
Viewed by 841
Abstract
Removal of the biofilm from the proximal space is essential for preventing periodontal disease. This study aimed to prove the association between the use of proximal cleaning devices, such as dental floss and interdental brushes, and periodontal health among nationally representative Korean adults. [...] Read more.
Removal of the biofilm from the proximal space is essential for preventing periodontal disease. This study aimed to prove the association between the use of proximal cleaning devices, such as dental floss and interdental brushes, and periodontal health among nationally representative Korean adults. Data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016–2018) were used for this purpose. A total of 11,359 participants aged 19 years or older who participated in KNHANES were reviewed. The response variable was the prevalence of high CPI (CPI of 3–4), and the explanatory variables were dental floss and interdental brush. A multivariable logistic regression analysis was performed to adjust for potential confounding factors and to analyze the association between periodontal disease and proximal cleaning devices. It was found that 63.1% of the participants did not use proximal cleaning devices at all, 17.5% used dental floss alone, 11.9% used an interdental brush, and 7.5% used both. Subjects who used both dental floss and interdental brush had a high CPI rate nearly half that of all the models for those who did not. In particular, for those using dental floss, the aOR of high CPI was 0.681 in Model 1, 0.714 in Model 2, and 0.737 in Model 3. Dental hygiene products for cleaning the proximal space, such as dental floss, are essential for removing the dental biofilm as a basic tool along with toothbrushes. Teaching and explaining the need to use these devices well are important for oral health care and maintenance. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
Article
More Teeth and Posterior Balanced Occlusion Are a Key Determinant for Cognitive Function in the Elderly
Int. J. Environ. Res. Public Health 2021, 18(4), 1996; https://doi.org/10.3390/ijerph18041996 - 19 Feb 2021
Viewed by 850
Abstract
Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability [...] Read more.
Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability and cognitive function in the elderly. A total of 563 participants aged 65 years or over residing in urban and rural areas of South Korea were surveyed. The chewing ability was measured by objectively measurable indications such as the number of remaining teeth, denture status, color-changeable gum, and occlusal balance using T-Scan III®. The cognitive function was measured by the Korean version of Mini-Mental State Examination-Dementia Screening (MMSE-DS) and a score of 24 or more (out of 30) indicates a normal cognition, below 23 indicates cognitive impairment. The association between socio-demographic factors, chewing ability factors, and cognitive function demonstrated statistically significant results. When comparing the denture status and chewing ability, the proportion of need denture group had fewer remaining teeth and anterior balanced occlusion. The average number of remaining teeth in anterior balanced occlusion with cognitive impairment was 11.2 compared to posterior balanced occlusion with the normal cognition 19.2. A multiple linear regression analysis declared a significant correlation between number of remaining teeth, denture status, occlusal balance, and cognitive function. Results of the present study revealed objectively measurable indications are suitable for chewing ability assessment and correlated with cognitive function. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
Article
Analysis of the Efficacy of Two Treatment Protocols for Patients with Symptomatic Oral Lichen Planus: A Randomized Clinical Trial
Int. J. Environ. Res. Public Health 2021, 18(1), 56; https://doi.org/10.3390/ijerph18010056 - 23 Dec 2020
Cited by 1 | Viewed by 1062
Abstract
Oral lichen planus (OLP) is a chronic, inflammatory, immune-mediated disease, which can alter the quality of life of patients. The aim of this randomized clinical trial was to compare the therapeutic efficacy of clobetasol oral gel 0.05% versus an anti-inflammatory in oral solution [...] Read more.
Oral lichen planus (OLP) is a chronic, inflammatory, immune-mediated disease, which can alter the quality of life of patients. The aim of this randomized clinical trial was to compare the therapeutic efficacy of clobetasol oral gel 0.05% versus an anti-inflammatory in oral solution (mouthwash) in the management of patients suffering from symptomatic OLP. The secondary objective was to analyze which one of the two treatments induced a greater risk of developing side effects. Forty patients were assigned (20 patients for group), through a randomized design, to receive clobetasol gel 0.05% or an anti-inflammatory mouthwash, which contains calcium hydroxide, hyaluronic acid, umbelliferone and oligomeric pro-anthocyanidins) for three months. At baseline (T0) and after 3 months (T1), patients underwent dental and dermatological examinations to assess their symptoms (Numerical Pain Scale (NRS) score) and signs (Thongprasom score). Data were calculated using T-test for the dependent variable, Wilcoxon test and Mann-Whitney u test. Both clobetasol and anti-inflammatory resulted in a statistically significant reduction of signs, (p < 0.001 and p = 0.02, respectively) and symptoms (p < 0.001 for clobetasol and p = 0.02 for anti-inflammatory). In conclusion, the results evidenced that, compared to clobetasol, the anti-inflammatory was less effective in determining the reduction of signs and symptom in OLP patients. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Medication-Related Osteonecrosis of the Jaws and CDK4/6 Inhibitors: A Recent Association
Int. J. Environ. Res. Public Health 2020, 17(24), 9509; https://doi.org/10.3390/ijerph17249509 - 18 Dec 2020
Cited by 1 | Viewed by 665
Abstract
The purpose of the present study was to estimate the prevalence of cyclin-dependent kinase (CDK) 4/6 inhibitors use among cancer patients from the medication-related osteonecrosis of the jaw (MRONJ) cohort of the University of Messina. We retrospectively reviewed the records of all patients [...] Read more.
The purpose of the present study was to estimate the prevalence of cyclin-dependent kinase (CDK) 4/6 inhibitors use among cancer patients from the medication-related osteonecrosis of the jaw (MRONJ) cohort of the University of Messina. We retrospectively reviewed the records of all patients with either intravenous bisphosphonates or denosumab-related MRONJ reported in the electronic health records of the Unit of Oral Surgery, School of Dentistry, University of Messina between the first quarter of 2018 and the first quarter 2020 to identify eligible patients. We observed six cases of MRONJ associated with CDK4/6 inhibitors concomitantly with intravenous bisphosphonates and/or denosumab in breast cancer patients. The CDK4/6 inhibitors registered were palbociclib (n = 5) and abemaciclib (n = 1). Data of cancer patients diagnosed with MRONJ in the same period (n = 10) were extracted for comparison. The comparative assessment with this group of patients showed a similar distribution of MRONJ stage ranged and clinical course after treatment. The degree of risk for osteonecrosis in patients taking these new classes of drugs is uncertain but warrants awareness and close monitoring. The role of premedication dental evaluation as a prevention strategy has been acknowledged for cancer patients about to initiate intravenous bisphosphonates and/or denosumab for treatment of bone metastasis, but additional attention should be paid to whom are assuming CDK4/6 inhibitors because of their oral adverse events. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Dental Challenges and the Needs of the Population during the Covid-19 Pandemic Period. Real-Time Surveillance Using Google Trends
Int. J. Environ. Res. Public Health 2020, 17(23), 8999; https://doi.org/10.3390/ijerph17238999 - 03 Dec 2020
Cited by 3 | Viewed by 1402
Abstract
Background: The outbreak of the COVID-19 pandemic may lead to changes in the dental needs of the population and new challenges concerning oral health care. Methods: The Google Trends tool was used to collect data on the Internet search interest. The investigated material [...] Read more.
Background: The outbreak of the COVID-19 pandemic may lead to changes in the dental needs of the population and new challenges concerning oral health care. Methods: The Google Trends tool was used to collect data on the Internet search interest. The investigated material was collected from 1 January 2020 to 23 August 2020. Search terms “toothache”, “dentist” and “stay at home” were retrieved for the whole world as well as for the US, the UK, Poland, Italy and Sweden. Results: During the lockdown, correlation analysis indicates the lowest public interest in the word “dentist” one week preceding the peak for “toothache”, followed by an increase in the word search for “dentist”. On 12 April, worldwide, the maximum of Google Trends Relative Search Volume (RSV) for “toothache” was observed. Conclusion: Decrease in “dentist” queries during lockdown followed by an increase in “toothache” search predicts greater dental needs in the post-pandemic period. The surveillance shows significant changes in queries for dental-related terms during the course of the COVID-19 pandemic. In order to prepare for future pandemic outbreaks teledentistry programs should be taken into consideration. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Risks of Aerosol Contamination in Dental Procedures during the Second Wave of COVID-19—Experience and Proposals of Innovative IPC in Dental Practice
Int. J. Environ. Res. Public Health 2020, 17(23), 8954; https://doi.org/10.3390/ijerph17238954 - 01 Dec 2020
Cited by 6 | Viewed by 1127
Abstract
Dental-care workers operate very close to the patient’s mouth and are at high risk of contamination by SARS-CoV-2. Droplets may be contaminated by patient’s saliva and exhaled breath particles. All asymptomatic patients should be considered as Coronavirus positive. All dental procedures must be [...] Read more.
Dental-care workers operate very close to the patient’s mouth and are at high risk of contamination by SARS-CoV-2. Droplets may be contaminated by patient’s saliva and exhaled breath particles. All asymptomatic patients should be considered as Coronavirus positive. All dental procedures must be revised after positive identification of SARS-Cov-2. Novel recommendations as the use of novel suction cannula designed for fast spray/saliva aspiration, use of Tyvek suits and innovative sprayhoods designed for dental-care worker protections are proposed to prevent virus transmission. New tailored operative and clinical procedures are being currently developed by university dental clinics and hospitals in attempt to reduce risk for dental workers and patients. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
The Management of Dental Practices in the Post-COVID 19 Era: An Economic and Operational Perspective
Int. J. Environ. Res. Public Health 2020, 17(23), 8905; https://doi.org/10.3390/ijerph17238905 - 30 Nov 2020
Viewed by 884
Abstract
Background: In order to protect dental teams and their patients during the COVID-19 pandemic, dentists have had to adopt several measures (operating and post-operating procedures) which may increase the total treatment time and costs relating to individual protective measures. This paper will propose [...] Read more.
Background: In order to protect dental teams and their patients during the COVID-19 pandemic, dentists have had to adopt several measures (operating and post-operating procedures) which may increase the total treatment time and costs relating to individual protective measures. This paper will propose a thorough analysis of operating dentistry procedures, comparing the economic performance of the activity in a dental surgery before and after the adoption of these protective measures, which are required to contain the risk of SARS-COV-2 infections. Methods: The economic analysis is articulated in three approaches. Firstly, it assesses a reduction in markup by maintaining current charges (A); alternatively, it suggests revised charges to adopt in order to maintain unvaried levels of markup (B). And the third Approach (C) examines available dental treatments, highlighting how to profitably combine treatment volumes to reduce markup loss or a restricted increase in dental charges. Results: Maintaining dental charges could cause a loss in markup, even rising to 200% (A); attempting to maintain unvaried levels of markup will result in an increase in dental charges, even at 100% (B); and varying the volumes of the single dental treatments on offer (increasing those which current research indicates as the most profitable) could mitigate the economic impact of the measures to prevent the transmission of SARS-COV-2 (C). Conclusions: The authors of this paper provide managerial insights which can assist the dentist-entrepreneur to become aware of the boundaries of the economic consequences of governmental measures in containing the virus infection. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Italian Response to Coronavirus Pandemic in Dental Care Access: The DeCADE Study
Int. J. Environ. Res. Public Health 2020, 17(19), 6977; https://doi.org/10.3390/ijerph17196977 - 24 Sep 2020
Cited by 5 | Viewed by 977
Abstract
The aim of the study was to evaluate the impact of the coronavirus pandemic on the willingness, anxiety and concerns of Italian people on undergoing dental appointments. An anonymous survey was posted online on social media on 11 May 2020 and was completed [...] Read more.
The aim of the study was to evaluate the impact of the coronavirus pandemic on the willingness, anxiety and concerns of Italian people on undergoing dental appointments. An anonymous survey was posted online on social media on 11 May 2020 and was completed by 1003 respondents in one week. Multiple correspondence analysis and multiple logistic regression were used to evaluate the association between socio-demographic characteristics, dental care access, contagion fear of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), trust in dentists regarding sanitization procedures and perception of the impact of the risk of contagion on dental care. Subjects with a high level of education, attending public dental offices and that are used to go to dental offices for urgent care would not feel comfortable in undergoing a dental appointment and would prefer to postpone or cancel dental visits, waiting for a decrease in the number of the contagions. Moreover, the risk of canceling or postponing the appointment at the dentist was 1.59 times greater in those who claimed to be strongly influenced by SARS-CoV-2. Fear of coronavirus disease (COVID-19), new cases decrease and the not urgent nature of dental visits influenced more than the lowered income household on upcoming or resuming dental appointments. In the next months, despite the forecasted economic crisis caused by coronavirus pandemic, fear and anxiety generated by the spread of the virus will impact more than the lowered familiar income with regards to access to dental care. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Perceived Job Insecurity and Depressive Symptoms among Italian Dentists: The Moderating Role of Fear of COVID-19
Int. J. Environ. Res. Public Health 2020, 17(15), 5338; https://doi.org/10.3390/ijerph17155338 - 24 Jul 2020
Cited by 23 | Viewed by 2495
Abstract
Containment measures adopted to reduce the spread of coronavirus disease 2019 (COVID-19) have produced a general perception of job insecurity. Dentists have been highly affected by such measures, as they represent an easy source of contagion. As perceived job insecurity is associated with [...] Read more.
Containment measures adopted to reduce the spread of coronavirus disease 2019 (COVID-19) have produced a general perception of job insecurity. Dentists have been highly affected by such measures, as they represent an easy source of contagion. As perceived job insecurity is associated with psychological distress and Italian dentists have been highly affected by the COVID-19 outbreak in terms of potential financial loss and the risk of being infected, this study aimed at assessing whether the fear of COVID-19 moderated the effect of perceived job insecurity on depressive symptoms. This cross-sectional online study has included 735 Italian dentists recruited during the lockdown and ranging in age from 27 to 70 years old (495 men and 240 women). A quantile regression model with an inference based on the median and with an interaction term between the fear of COVID-19 and perceived job insecurity has been used to estimate the hypothesized associations. The results indicated that both perceived job insecurity and fear of COVID-19 were positively associated with depressive symptoms, and that the effect of perceived job insecurity on depressive symptoms was weaker among those with a low fear of COVID-19. The findings may inform public health policies for dentists in relation to reducing the risk of developing negative mental health outcomes. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Cross-Sectional Association between Behaviors Related to Sugar-Containing Foods and Dental Outcomes among Hispanic Immigrants
Int. J. Environ. Res. Public Health 2020, 17(14), 5095; https://doi.org/10.3390/ijerph17145095 - 15 Jul 2020
Viewed by 568
Abstract
A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to [...] Read more.
A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to examine the associations of behaviors related to added sugar-containing foods/beverages (overall intake and consumption before bed) with dental outcomes. Outcome measures involved dental outcomes, dental self-care practices, and added sugar intake. Estimated daily added sugar intake among all participants was 98 (SD = 99) g, with no difference in consumption among participants from different countries. The majority of added sugar (63 (SD = 74) g) was provided by sugar-sweetened beverages. Participants who reported consuming sugar-containing foods or beverages within an hour before bed were more likely to report having a fair/poor/very poor condition of teeth and gums and having felt dental pain (p < 0.05 for all). The amount of sugar intake was associated with being prescribed medication for oral or dental problems (p = 0.008) and dental pain (p = 0.003). Findings support the association between sugar containing food–related behaviors and dental problems among Hispanic immigrants to the U.S. Health promotion and preventive interventions for this population should consider these behaviors as modifiable contributors to adverse dental outcomes. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
Article
Geriatric Dentistry Curriculum in Six Continents
Int. J. Environ. Res. Public Health 2020, 17(13), 4682; https://doi.org/10.3390/ijerph17134682 - 29 Jun 2020
Cited by 1 | Viewed by 814
Abstract
The purpose of this study was to examine the presence of geriatric dentistry (GD) in the curricula of worldwide dental schools, and to identify and compare their curriculum content. Eighty-three dental schools (16.4% response rate), from 24 countries, in six continents, completed a [...] Read more.
The purpose of this study was to examine the presence of geriatric dentistry (GD) in the curricula of worldwide dental schools, and to identify and compare their curriculum content. Eighty-three dental schools (16.4% response rate), from 24 countries, in six continents, completed a 25-item online questionnaire, to assess their GD curriculum, and were included in the study. GD was a mandatory course in 56 dental schools (67.5%), an independent subject in 14 schools (16.9%), and was taught as a series of lectures in 31 schools (37.4%). Clinically, 56 dental schools (67.5%) had some form of mandatory education in GD. The type of school, location and method of presentation were not associated with greater interest in expanding their curriculum in GD (p = 0.256, p = 0.276, and p = 0.919, respectively, using the Chi-square test). We found GD is a curriculum requirement in most of the surveyed dental schools and is becoming more common among dental school curricula. This survey is the first study to present data from dental schools from all continents, using a web-based survey which is a resourceful, less-expensive tool to gather data. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
Article
Efficacy of a U-Shaped Automatic Electric Toothbrush in Dental Plaque Removal: A Cross-Over Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2020, 17(13), 4649; https://doi.org/10.3390/ijerph17134649 - 28 Jun 2020
Cited by 2 | Viewed by 4152
Abstract
Background: The aim of this single-use, four-treatment, four-period (visit), cross-over, mono-centered, examiner-blind, cross-over randomized controlled trial (RCT) was to evaluate the efficacy in dental plaque removal of a U-shaped automatic electric toothbrush (U) compared to a conventional powered toothbrush (P), a habitual [...] Read more.
Background: The aim of this single-use, four-treatment, four-period (visit), cross-over, mono-centered, examiner-blind, cross-over randomized controlled trial (RCT) was to evaluate the efficacy in dental plaque removal of a U-shaped automatic electric toothbrush (U) compared to a conventional powered toothbrush (P), a habitual toothbrushing procedure (H), and no brushing (N). Methods: Eligible participants were volunteer students. Primary outcome measure was the reduction in full-mouth plaque score (FMPS) after brushing. The secondary outcome variable was a visual analogic scale (VAS) on subjective clean mouth sensation. Mixed models were performed for difference in FMPS and VAS. Results: Twenty-two participants were randomized to the treatments in the four periods of the study. The differences between treatments in FMPS reduction after brushing were statistically significant (p < 0.0001). The differences were statistically significant between the U and P groups (difference −48; 95% CI from −54 to −41) favoring the P group, and between the U and H groups (difference −45; 95% CI from −52 to −39) favoring the H group. On the contrary, the difference between the U and N groups was not significant (difference 5; 95% CI from −2 to 12) favoring the U group. The differences between treatments in clean mouth VAS was statistically significant (p < 0.0001) favoring the P and H groups. Conclusions: The U-shaped automatic electric toothbrush tested in this study proved to be not effective in removing dental plaque. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Facial Skin Temperature and Discomfort When Wearing Protective Face Masks: Thermal Infrared Imaging Evaluation and Hands Moving the Mask
Int. J. Environ. Res. Public Health 2020, 17(13), 4624; https://doi.org/10.3390/ijerph17134624 - 27 Jun 2020
Cited by 39 | Viewed by 4497
Abstract
Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present [...] Read more.
Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present study was to compare the facial skin temperature and the heat flow when wearing medical surgical masks to the same factors when wearing N95 respirators. A total of 20 subjects were recruited and during the evaluation, each subject was invited to wear a surgical mask or respirator for 1 h. The next day in the morning at the same hour, the same subject wore a N95 mask for 1 h with the same protocol. Infrared thermal evaluation was performed to measure the facial temperature of the perioral region and the perception ratings related to the humidity, heat, breathing difficulty, and discomfort were recorded. A significant difference in heat flow and perioral region temperature was recorded between the surgical mask and the N95 respirator (p < 0.05). A statistically significant difference in humidity, heat, breathing difficulty, and discomfort was present between the groups. The study results suggest that N95 respirators are able to induce an increased facial skin temperature, greater discomfort and lower wearing adherence when compared to the medical surgical masks. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Career Prospects of Young Dentists in Switzerland
Int. J. Environ. Res. Public Health 2020, 17(12), 4310; https://doi.org/10.3390/ijerph17124310 - 16 Jun 2020
Cited by 3 | Viewed by 753
Abstract
The observational cross-sectional study was aimed to obtain information on the promotion and development of young professionals in Switzerland. An online survey with 20 questions was sent out. Data was collected on participants’ demographic data, including age, gender, level of qualification, place of [...] Read more.
The observational cross-sectional study was aimed to obtain information on the promotion and development of young professionals in Switzerland. An online survey with 20 questions was sent out. Data was collected on participants’ demographic data, including age, gender, level of qualification, place of work, information on employment, future perspectives, and career prospects. The survey was sent out to 1920 practitioners, of which 440 (22.9%) responded (37.1% males and 62.9% females). Of them, 76.6% were members of the Swiss Dental Association (SSO) 15.9% students, and 7.5% non-SSO members. Most participants had parents with a dental education (80.9%), and 19.8% did not. Young dentists in Switzerland most often saw their career prospects as neutral (39.8%) or rather positive (39.3%). Whereas significantly fewer dentists had a negative view of their professional future (16.8%), including more women than men, the fewest dentists of both sexes (4.1%) saw their career prospects as positive by far. The majority of young dentists were satisfied with their career prospects. Within the limitations of the current study, the reasons for this need further investigation. Despite good career prospects, there is a desire among young colleagues for cantonal practice assistance and mentoring programs, as well as support in finding a job and in taking the plunge into self-employment. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
Article
Functional Dentition and 12-Month Changes in Body Measurements among Thai Older Adults
Int. J. Environ. Res. Public Health 2020, 17(12), 4200; https://doi.org/10.3390/ijerph17124200 - 12 Jun 2020
Cited by 1 | Viewed by 734
Abstract
This study evaluated the association of functional dentition with 12-month changes in body measurements and nutrient intake among older adults. Data from 651 community dwellers, aged 60 years and over, in Phetchaburi, Thailand, were analysed (retention rate: 83%). Data were collected via interviews [...] Read more.
This study evaluated the association of functional dentition with 12-month changes in body measurements and nutrient intake among older adults. Data from 651 community dwellers, aged 60 years and over, in Phetchaburi, Thailand, were analysed (retention rate: 83%). Data were collected via interviews (including a semi-structured food frequency questionnaire), anthropometric measurements and dental examinations. Associations were tested in linear regression models adjusted for baseline sociodemographic factors, behaviours, chronic conditions and medications. On average, participants experienced a significant increase in body mass index (BMI) and significant decreases in waist circumference (WC) and triceps skinfold thickness (TSF). A negative, albeit not significant, association between functional dentition and change in BMI was observed after adjusting for confounders. Whilst participants who had non-functional dentition without dentures experienced increases in BMI (predicted mean change: 0.25; 95% Confidence Interval: 0.09, 0.41), those who had non-functional dentition with dentures (0.21; 95%CI: −0.08, 0.50) and functional dentition (−0.07; 95%CI: −0.42, 0.28) remained stable. No similar trends were noted for WC or TSF. Functional dentition was not associated with changes in nutrient intake either. The findings provide little evidence on the association of functional dentition with short-term changes in nutrient intake or nutritional status. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
Article
Association of Work Patterns and Periodontitis Prevalence in Korean Adults Aged 50 Years or Older: A Nationwide Representative Study
Int. J. Environ. Res. Public Health 2020, 17(11), 4006; https://doi.org/10.3390/ijerph17114006 - 04 Jun 2020
Cited by 1 | Viewed by 899
Abstract
This study analyzed the relationship between the work pattern and the prevalence of periodontitis. We analyzed the data of 3320 adults (1779 men, 1543 women) aged 51–80 years from the Korean National Health and Nutrition Examination Survey (2013–2015). The work pattern was divided [...] Read more.
This study analyzed the relationship between the work pattern and the prevalence of periodontitis. We analyzed the data of 3320 adults (1779 men, 1543 women) aged 51–80 years from the Korean National Health and Nutrition Examination Survey (2013–2015). The work pattern was divided into two groups (regular and irregular). The periodontal status was assessed using the community periodontal index. We observed a statistically significant difference in the association between work patterns and prevalence of periodontitis in Korean women aged over 50 years. For female workers with irregular work patterns, the prevalence of periodontitis was lower than that in workers with regular work patterns by 10.3% (40.3% vs. 30.0%, p = 0.011). The annual health examination rate was significantly higher in the irregular group than in the regular group (for men 77.9% vs. 73.5%; p < 0.001, for women 76.4% vs. 75.9%; p < 0.001). In female workers with irregular work patterns, the annual dental examination rate was significantly higher than that in workers with a regular work pattern by 7.7% (34.3% vs. 26.6%, p = 0.043). In conclusion we found a statistically significant difference between the work patterns and prevalence of periodontitis in Korean women aged over 50 years. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia
Int. J. Environ. Res. Public Health 2020, 17(10), 3459; https://doi.org/10.3390/ijerph17103459 - 15 May 2020
Cited by 74 | Viewed by 3472
Abstract
The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and [...] Read more.
The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and the second highest in Europe. An anonymous online survey composed of 40 questions has been sent to dentists practicing in the area of Modena and Reggio Emilia, one of the areas in Italy most affected by COVID-19. The survey was aimed at highlighting the practical and emotional consequences of COVID-19 emergence on daily clinical practice. Specifically, it assessed dentists’ behavioral responses, emotions and concerns following the Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20), as well as the dentists’ perception of infection likelihood for themselves and patients. Furthermore, the psychological impact of COVID-19 was assessed by means of the Generalized Anxiety Disorder-7 test (GAD-7), that measures the presence and severity of anxiety symptoms. Using local dental associations (ANDI-Associazione Nazionale Dentisti Italiani, CAO-Commissione Albo Odontoiatri) lists, the survey was sent by email to all dentists in the district of Modena and Reggio Emilia (874 practitioners) and was completed by 356 of them (40%). All dental practitioners closed or reduced their activity to urgent procedures, 38.2% prior to and 61.8% after the DM-10M20. All reported a routinely use of the most common protective personal equipment (PPE), but also admitted that the use of PPE had to be modified during COVID-19 pandemic. A high percentage of patients canceled their previous appointments after the DM-10M20. Almost 85% of the dentists reported being worried of contracting the infection during clinical activity. The results of the GAD-7 (General Anxiety Disorder-7) evaluation showed that 9% of respondents reported a severe anxiety. To conclude, the COVID-19 emergency is having a highly negative impact on the activity of dentists practicing in the area of Modena and Reggio Emilia. All respondents reported practice closure or strong activity reduction. The perception of this negative impact was accompanied by feelings of concern (70.2%), anxiety (46.4%) and fear (42.4%). The majority of them (89.6%) reported concerns about their professional future and the hope for economic measures to help dental practitioners. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
Article
Can Teledentistry Improve the Monitoring of Patients during the Covid-19 Dissemination? A Descriptive Pilot Study
Int. J. Environ. Res. Public Health 2020, 17(10), 3399; https://doi.org/10.3390/ijerph17103399 - 13 May 2020
Cited by 39 | Viewed by 3130
Abstract
The aim of this pilot study was to describe the advantages of telemedicine (TM) in dental practice during the current national emergency condition due to the Covid-19 dissemination. At Department of Oral Surgery and Pathology—Magna Graecia University of Catanzaro, regional reference center for [...] Read more.
The aim of this pilot study was to describe the advantages of telemedicine (TM) in dental practice during the current national emergency condition due to the Covid-19 dissemination. At Department of Oral Surgery and Pathology—Magna Graecia University of Catanzaro, regional reference center for Covid-19—two groups of patients were determined: patients with urgent conditions (group U) and patients in follow-up (group F). Both groups were instructed to implement remote consultations using a messaging service (WhatsApp Messenger, WhatsApp Inc., Mountain View, California, USA) to send photos. A total of 418 photos were collected by 57 patients. Thirty-four photos were obtained by five patients in the U group after surgical procedures. All patients sent photos on the established evening, except for two patients who sent two photos outside the set days. In the F group, 384 photos were collected by 52 patients. None of them sent more photos than the number that was established by the protocol. Telemedicine allowed a monitoring of all patients, reducing costs and limiting human contact, decreasing the risk of Covid-19 dissemination. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Article
Dentistry during the COVID-19 Epidemic: An Italian Workflow for the Management of Dental Practice
Int. J. Environ. Res. Public Health 2020, 17(9), 3325; https://doi.org/10.3390/ijerph17093325 - 11 May 2020
Cited by 25 | Viewed by 4510
Abstract
The COVID-19 outbreak has raised concerns about infection control all over the world. Among health workers, dentists are particularly exposed to the COVID-19 infection risk. The aim of this paper is to present a workflow to manage dental procedures already in use at [...] Read more.
The COVID-19 outbreak has raised concerns about infection control all over the world. Among health workers, dentists are particularly exposed to the COVID-19 infection risk. The aim of this paper is to present a workflow to manage dental procedures already in use at the Dental Unit of the University Hospital of Messina. The proposed workflow accounts for the many aspects of dental practitioners’ risk in the COVID-19 era, and focuses on the assessment of patient risk level, a two-phase dental procedure management (remote and face-to-face), and the use of specific preventive measures. No cases of COVID-19 infection were detected among patients and staff of the dental unit in a two-month period of time while using this protocol. This workflow seems a promising and effective solution to manage dental procedures during the COVID-19 outbreak, and could be implemented in both public and private practices until the emergency is contained. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Review

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Review
Dental Care Access and the Elderly: What Is the Role of Teledentistry? A Systematic Review
Int. J. Environ. Res. Public Health 2020, 17(23), 9053; https://doi.org/10.3390/ijerph17239053 - 04 Dec 2020
Cited by 2 | Viewed by 1215
Abstract
A high level of unmet oral health needs is very common among elderly people. In a society that is getting older and that has been hit so hard by the coronavirus pandemic, the development of new strategies aimed at enhancing general and oral [...] Read more.
A high level of unmet oral health needs is very common among elderly people. In a society that is getting older and that has been hit so hard by the coronavirus pandemic, the development of new strategies aimed at enhancing general and oral health status should be crucial in order to promote healthy aging. The aim of this systematic review is to assess the feasibility of Teledentistry in communities or in a domiciliary setting where elderly people live. A structured and systematic research was performed on the major electronic databases for studies published in English until 30 June 2020: the PubMed, Cochrane Library, Web of Science, Scopus, and CINAHL databases. A total of 13 articles were identified through database searching using combinations of keywords. Out of 13 papers, eight abstracts were reviewed to assess if they were coherent with the aim of the study, and full texts were retrieved. After abstract reviews, seven articles were selected for closer inspection. Of these, six were assessed for eligibility. Four papers were aimed at assessing patients and health practitioners experiences about Teledentistry, three studies reported a cost analysis and cost description of Teledentistry in residential aged care facilities, and two studies investigated the feasibility and accuracy of Teledentistry for diagnosis dental pathology. The implementation of Teledentistry in residential aged care facilities and in home-assistance programs could be a viable tool for the management of oral care in people who cannot access dental care. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Review
The Role of Matrix Metalloproteinases in Periodontal Disease
Int. J. Environ. Res. Public Health 2020, 17(14), 4923; https://doi.org/10.3390/ijerph17144923 - 08 Jul 2020
Cited by 11 | Viewed by 1243
Abstract
This review provides a detailed description of matrix metalloproteinases (MMPs), focusing on those that are known to have critical roles in bone and periodontal disease. Periodontal disease is an inflammatory process initiated by anaerobic bacteria, which promote the host immune response in the [...] Read more.
This review provides a detailed description of matrix metalloproteinases (MMPs), focusing on those that are known to have critical roles in bone and periodontal disease. Periodontal disease is an inflammatory process initiated by anaerobic bacteria, which promote the host immune response in the form of a complex network of molecular pathways involving proinflammatory mediators such as cytokines, growth factors, and MMPs. MMPs are a family of 23 endopeptidases, collectively capable of degrading virtually all extracellular matrix (ECM) components. This study critically discusses the available research concerning the involvement of the MMPs in periodontal disease development and progression and presents possible therapeutic strategies. MMPs participate in morphogenesis, physiological tissue turnover, and pathological tissue destruction. Alterations in the regulation of MMP activity are implicated in the manifestation of oral diseases, and MMPs comprise the most important pathway in tissue destruction associated with periodontal disease. MMPs can be considered a risk factor for periodontal disease, and measurements of MMP levels may be useful markers for early detection of periodontitis and as a tool to assess prognostic follow-ups. Detection and inhibition of MMPs could, therefore, be useful in periodontal disease prevention or be an essential part of periodontal disease therapy, which, considering the huge incidence of the disease, may greatly improve oral health globally. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Review
Covid-19 Pandemic: What Changes for Dentists and Oral Medicine Experts? A Narrative Review and Novel Approaches to Infection Containment
Int. J. Environ. Res. Public Health 2020, 17(11), 3793; https://doi.org/10.3390/ijerph17113793 - 27 May 2020
Cited by 32 | Viewed by 4356
Abstract
The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of [...] Read more.
The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (pre- vs post-COVID19) for the most common dental procedures. The outcome is forecast to help dentists to individuate for a given procedure the differences in terms of safety protocols to avoid infectious contagion (by SARS-CoV-2 and others dangerous agents). An investigation was performed on the online databases Pubmed and Scopus using a combination of free words and Medical Subject Headings (MESH) terms: “dentist” OR “oral health” AND “COVID-19” OR “SARS-CoV-2” OR “coronavirus-19”. After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The authors have highlighted the importance of knowing exactly the risk of infections in the dental practice, and to modulate correctly the use of PPE, in order to invest adequate financial resources and to avoid exposing both the dental team and patients to preventable risks. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Review
COVID-19 Surface Persistence: A Recent Data Summary and Its Importance for Medical and Dental Settings
Int. J. Environ. Res. Public Health 2020, 17(9), 3132; https://doi.org/10.3390/ijerph17093132 - 30 Apr 2020
Cited by 70 | Viewed by 5943
Abstract
Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not [...] Read more.
Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not to be underestimated at this stage of the pandemic. The purpose of this article is to highlight all the sources currently present in the literature concerning the persistence of the different coronaviruses in the environment as well as in medical and dental settings. As this was a current study, there are still not many sources in the literature, and scientific strategies are moving towards therapy and diagnosis, rather than knowing the characteristics of the virus. Such an article could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Other

Conference Report
Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020
Int. J. Environ. Res. Public Health 2020, 17(16), 5998; https://doi.org/10.3390/ijerph17165998 - 18 Aug 2020
Cited by 18 | Viewed by 2411
Abstract
The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons [...] Read more.
The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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