Optimizing Safe Dental Practice During the COVID-19 Pandemic: Recommendations Based on a Guide Developed for Dental Practices in China.
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ABSTRACT:
SUBMITTER: Li L
PROVIDER: S-EPMC8187590 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:In the context of a pandemic, the rapid development of clinical practice guidelines (CPGs) is critical to guide dental staff towards the safe provision of dental care; detailed knowledge of the recommendations will help to achieve the intended results. We carried out a systematic review of the recommendations in clinical practice guidelines (CPGs) on the provision of dental care issued during the first year of the COVID-19 pandemic. A systematic database search was performed in MEDLINE, EMBASE, LILACS, Epistemonikos, and Trip databases to identify documents with recommendations intended to minimize the risk of COVID-19 transmission during dental care. The selection process and data extraction were carried out by two researchers independently. The majority of CPGs recommended the use of rubber dam, high-volume evacuator, mouthwash prior to dental care, four-handed work, and mechanical barriers. The use of aerosol-generating equipment should be avoided whenever possible. In aerosol-generating procedures, the use of a N95 respirator (or similar) is recommended, in addition to a face protector, an impermeable disposable apron/gown, a cap, and gloves. The CPGs developed during the first year of the pandemic offer recommendations which guide dental staff in providing safe dental care, minimizing exposure to SARS-CoV-2 and reducing the risk of COVID-19 infection in the clinical environment. Such recommendations must, however, be updated as new evidence arises.
| S-EPMC8508467 | biostudies-literature
Project description:The physician and patient come into close contact during botulinum toxin treatments, increasing the chances of COVID-19 infection. Therefore, it is essential to use an effective injection method that can prevent infection with SARS-CoV-2 virus. In order to minimize the risk of SARS-CoV-2 transmission during botulinum toxin treatment in the COVID-19 era, the Italian Botulinum Toxin Network study group of the Italian Society of Neurology has prepared a video of best practice recommendations on how to organize the work of a clinic performing botulinum toxin treatments.
| S-EPMC8287114 | biostudies-literature
Project description:Dental clinics were suspected to be a hotspot for nosocomial transmission of coronavirus disease 19 (COVID-19), yet there has been no clear recommendation about emergency dental care and appropriate personal protective equipment during pandemics. In this paper, we aim to summarize recommendations for (i) patient risk assessment, (ii) patient triage, and (iii) measures to prevent infection of health professionals and nosocomial transmission in dental clinics. The available evidence was collected by performing searches on PubMed, Embase, and Cochrane databases. We reviewed papers on COVID-19, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, and related respiratory viral diseases. Legal and ethical frameworks, as well as international (e.g., World Health Organization (WHO)) and national (e.g., public health institutes, dental associations) guidelines were screened to summarize recommendations related to dental emergency care. To assess the patient risk, a questionnaire was developed to classify patients at unknown, high, and very high risk. Patient triage recommendations were summarized in a flow chart that graded the emergency level of treatments (i.e., urgent, as soon as possible, and postpone). Measures to prevent disease transmission based on current evidence were grouped for dental health professionals, dental clinics, and patients. The present recommendations may support health professionals implement preventative measures during the pandemic.
| S-EPMC7357003 | biostudies-literature
Project description:AimPromote safe breastfeeding during the pandemic.MethodsAll participants were encouraged to request safe breastfeeding education from their prenatal provider. Pregnant mothers received appropriate breastfeeding and COVID-19 safe breastfeeding education in line with the CDC's COVID-19 breastfeeding guidelines. Data were obtained from 39 mothers attending Nashville General Hospital pediatric well-baby clinics (Group I: from December 2019 to June 2020) and 97 pregnant women attending prenatal clinics (Group II: from July 2020 to August 2021).ResultsThe participants' ages ranged from 15 to 45 years, with a mean of 27.5 ± 6.2. The women in both groups were similar in age, education, employment, and breastfeeding experience. They were equally unlikely to use face masks at home even while receiving guests or holding their babies. Although 121 (89.0%) women claimed face mask use while shopping, the rate for never doing so was 7 (18.0%) vs. 8 (8.3%) (p < 0.006) for Groups I and II, respectively. Safe practices included limited outing (66 (48.5%)), sanitized hands (62 (45.6%)), restricted visitors (44 (32.4%)), and limited baby outing (27 (19.9%)), and 8 (8.3%) in Group II received COVID-19 vaccinations. About half described fair and accurate COVID-19 safe breastfeeding knowledge, but 22 (30.1%) of them claimed they received no information. Breastfeeding contraindication awareness for Groups I and II were as follows: cocaine = 53.8% vs. 37.1%, p < 0.06; HIV = 35.9% vs. 12.4%, p < 0.002; breast cancer = 17.9% vs. 16.5%; and COVID-19 with symptoms = 28.2% vs. 5.2%, p < 0.001. The information source was similar, with family, friends, and media accounting for 77 (56.6%) of women while doctors, nurses, and the CLC was the source for 21 (15.4%) women. Exclusive breastfeeding one month postpartum for Groups I and II was 41.9% and 12.8% (p < 0.006), respectively.ConclusionThe mothers were not more knowledgeable regarding breastfeeding safely one year into the COVID-19 pandemic. Conflicting lay information can create healthy behavior ambivalence, which can be prevented by health professionals confidently advising mothers to wear face masks when breastfeeding, restricting visitors and outings, and accepting COVID-19 vaccination. This pandemic remains an open opportunity to promote and encourage breastfeeding to every mother as the default newborn feeding method.
| S-EPMC9914864 | biostudies-literature
Project description:Sexual activity offers numerous advantages for physical and mental health but maintains inherent risks in a pandemic situation, such as the current one caused by SARS-CoV-2. A group of experts from the Spanish Association of Sexuality and Mental Health (AESexSAME) has reached a consensus on recommendations to maintain lower-risk sexual activity, depending on one's clinical and partner situations, based on the current knowledge of SARS-CoV-2. Different situations are included in the recommendations: a sexual partner passing quarantine without any symptoms, a sexual partner that has not passed quarantine, a sexual partner with some suspicious symptoms of COVID-19, a positive sexual partner with COVID-19, a pregnant sexual partner, a health professional partner in contact with COVID-19 patients, and people without a sexual partner. The main recommendations include returning to engaging in safe sex after quarantine is over (28 days based on the duration one can carry SARS-CoV-2, or 33 days for those who are >60 years old) and all parties are asymptomatic. In all other cases (for those under quarantine, those with some clinical symptoms, health professionals in contact with COVID-19 patients, and during pregnancy), abstaining from coital/oral/anal sex, substituting it with masturbatory or virtual sexual activity to provide maximum protection from the contagion, and increasing the benefits inherent to sexual activity are recommended. For persons without a partner, not initiating sexual activity with a sporadic partner is strongly recommended.
| S-EPMC7408907 | biostudies-literature
Project description:COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency from China has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim of this paper is to provide practical advice for dentists based on the recent literature, which may be useful in reducing the risk of spreading COVID-19 during clinical practice.
| S-EPMC7369766 | biostudies-literature
Project description:Given the widespread lack of access to dental care for many vulnerable Americans, there is a growing realization that integrating dental and primary care may provide comprehensive care. We sought to model the financial impact of integrating dental care provision into a primary care practice. A microsimulation model was used to estimate changes in net revenue per practice by simulating patient visits to a primary dental practice within primary care practices, utilizing national survey and un-identified claims data from a nationwide health insurance plan. The impact of potential changes in utilization rates and payer distributions and hiring additional staff was also evaluated. When dental care services were provided in the primary care setting, annual net revenue changes per practice were -$92,053 (95% CI: -93,054, -91,052) in the first year and $104,626 (95% CI: 103,315, 105,316) in subsequent years. Net revenue per annum after the first year of integration remained positive as long as the overall utilization rates decreased by less than 25%. In settings with a high proportion of publicly insured patients, the net revenue change decreased but was still positive. Integrating primary dental and primary care providers would be financially viable, but this viability depends on demands of dental utilization and payer distributions.
| S-EPMC7175120 | biostudies-literature
Project description:BackgroundThe authors conducted a qualitative study of private-practice dentists in their offices by using vignette-based interviews to assess barriers to the use of evidence-based clinical recommendations in the treatment of noncavitated carious lesions.MethodsThe authors recruited 22 dentists as a convenience sample and presented them with two patient vignettes involving noncavitated carious lesions. Interviewers asked participants to articulate their thought processes as they described treatment recommendations. Participants compared their treatment plans with the American Dental Association's recommendations for sealing noncavitated carious lesions, and they described barriers to implementing these recommendations in their practices. The authors recorded and transcribed the sessions for accuracy and themes.ResultsPersonal clinical experience emerged as the determining factor in dentists' treatment decisions regarding noncavitated carious lesions. Additional factors were lack of reimbursement and mistrust of the recommendations. The authors found that knowledge of the recommendations did not lead to their adoption when the recommendation was incongruent with the dentist's personal experience.ConclusionsThe authors found that ingrained practice behavior based on personal clinical experience that differed substantially from evidence-based recommendations resulted in a rejection of these recommendations.Practical implicationsAttempts to improve the adoption of evidence-based practice must involve more than simple dissemination of information to achieve a balance between personal clinical experience and scientific evidence.
| S-EPMC3676186 | biostudies-literature
Project description:Synthetic pesticides are widely applied for pest and disease control in Indonesia. However, a lack of knowledge and use of Good Agricultural Practices (GAP) for safe pesticide usage among Indonesian farmers remains a problem. This study aims to investigate the gap between farmers' knowledge of GAP for safe pesticide usage and their application of it. This research was conducted in 2020 in five Indonesian provinces. Primary data collection was by means of a survey, in which 298 respondents answered structured questionnaires. The survey also identified the sources of the information recorded and the respondents' experience of pesticide exposure. The analysis tools used were the Wilcoxon Signed Ranked Test and Importance-Performance Analysis (IPA). There were significant differences in the results of the first analysis. These results appear to confirm the results of further analysis using IPA, which show that a high level of knowledge does not mean that farmers will apply this knowledge in practice: this is particularly relevant to wearing gloves and masks, using tools to remove blockages, never clearing blocked nozzles by blowing into them, and disposing of empty containers properly. Nevertheless, in some cases high levels of knowledge do result in high levels of application. Cases of pesticide exposure affecting human health by causing symptoms such as dizziness, nausea, and vomiting confirm that GAP for pesticide usage are not being implemented properly by some farmers. It is therefore recommended that their knowledge should be enhanced through the series of technical training programs using participatory approaches, so that farmers accumulate knowledge which will drive them to adopt GAP for safe pesticide usage.
| S-EPMC8753126 | biostudies-literature
Project description: Not available
| S-EPMC7768215 | biostudies-literature