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  Citation statistics : Table of Contents
   2020| November  | Volume 12 | Issue 8  
    Online since November 30, 2020

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Management of special needs patients in dentistry during the SARS-CoV-2 pandemic
Romeo Patini
November 2020, 12(8):53-56
Special needs patients and their guardians commonly encounter several difficulties due to delayed provision of oral healthcare services in private and public sectors. They are a vulnerable group and are considered highly susceptible to the repercussions of the coronavirus disease-2019 (COVID-19) pandemic. The reduction in the availability of operating rooms and the inability to manage routine visits highlight the need to redesign the doctor–patient and dentist–patient relationship for this category of patients. Diagnostic accuracy and adjustments in drug therapies are crucial elements considering that patients with COVID-19 take drugs that can interfere with those usually prescribed for the control of oral pain and infections. This review aimed to provide some guidelines for the management of patients with special needs in dentistry during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.
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Masks and respirators, selection criteria for periodontal therapy: Challenges for a periodontist during COVID-19
Sudhir Rama Varma
November 2020, 12(8):64-68
Coronavirus disease-2019 (COVID-19) has created a pandemic, which has upgraded most medical services across the globe to the level of emergency preparedness and the highest infection control measures. Use of personal protective equipment and masks along with respirators is possibly the only way to combat the spread and its use in areas where the personnel is in high-risk category offers a lifeline. This review aimed to examine, summarize the available evidence related to use of masks and respirators, and possibly provide a recommendation for the periodontist and dental fraternity as a whole. A literature search was conducted on the PubMed, PubMed Central, MEDLINE, and Embase databases with the keyword “surgical masks,” “COVID-19,” “Respirators,” “N95,” “health care worker,” “oral,” and “dental treatment.” Masks and respirators offer prevention and control of the spread of the pandemic. Respirators are found to be more effective than masks in the ability to prevent aerosol transmission to health care workers. More studies are needed to be carried out to evaluate efficacy and vital characteristics of the respirators available to rule out any possibility of breach caused either by noncompliance or otherwise. Although the virus transmission is caused by varied clinical presentations, the use of masks and respirators offers hope in reducing the risk of cross transmission both to the dentists and patients.
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Relationship among perceived stress, oral health status, stomatitis, and xerostomia in the community during the COVID-19 pandemic: A cross-sectional survey
Agus Susanto, Indah Suasani Wahyuni, Felisha Febriane Balafif
November 2020, 12(8):106-112
Aim: The aim of the study was to analyze the relationship between self-reported stress, oral health status, xerostomia, and stomatitis in the community during the COVID-19 pandemic.Materials and Methods: This is a cross-sectional study of 380 community respondents from the city of Bandung, Indonesia, consisting of 82 men and 298 women. Data obtained from online questionnaires using consecutive sampling method showed that the respondents agreed to participate in the study by filling in the informed consent. Furthermore, demographic data including age, education level, occupation, and total income were recorded. The variables measured by a questionnaire are self-reported stress, oral health status, xerostomia inventory, and stomatitis. Data distribution was performed by a descriptive statistic, χ2 test, Phi, and Spearman rank test for correlation analysis.Results: There was a significant correlation between perceived stress scale with oral health status (r’s = 0.135; P = 0.003), with stomatitis (r’s = 0.176; P = 0.015), and with xerostomia (r’s = 0.296; P = 0.022). In addition, age, education level, and total income also showed a significant correlation with stress level.Conclusion: From the findings of this study, it can be concluded that oral health status, xerostomia, and stomatitis were associated with levels of stress. Higher stress indicates poor oral health status, as well as severe xerostomia and stomatitis.
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The psychological impact of the COVID-19 pandemic on dental healthcare professionals
Aditya Shetty, Raksha Bhat, Preethesh Shetty, Mithra N Hegde, US Krishna Nayak, Neevan D’souza
November 2020, 12(8):98-105
Aims and Objectives: The advent of the novel coronavirus disease-2019 (COVID-19) pandemic has sparked a global crisis. Cumulatively, the modifications in patient care and financial restraints are leading to heightened levels of anxiety amongst dentists, making it imperative to comprehend the psychological health implications of the dental professionals. This study aimed to evaluate the psychological impact of the COVID-19 pandemic among Indian Dentists through an online web-based survey.Materials and Methods: The present randomized survey was designed to evaluate the anxiety levels. A total sample size of 405 was calculated. The questionnaire included demographic information and all the variables linked to probable cause of stress during clinical practices and the future prospects of the profession. The questions had to be responded on a scale of 1–10. The responses were statistically analyzed by subjecting the responses to descriptive analysis, Student’s t test, and Pearson’s chi-square tests.Results: A total of 405 responses were received. The levels of anxiety reported were high. Majority of the dentists were troubled by the thought of being in a high-risk profession and of transmitting the disease to others. Almost all questions were responded with a score of >5 on a scale of 1–10 depicting heightened anxiety levels. The fear levels were noted to be elevated in patients aged more than 35 years.Conclusion: Long-term unrecognized anxiety can predispose to significant psychiatric morbidity and fatigue. Identifying and acknowledging adverse factors in a crisis situation will facilitate early intervention to reduce and mitigate the impact of stress.
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Dental practice in COVID times: A review
Sesha Manchala Reddy, Shishir Ram Shetty, Hesham Fathi Ahmed Marei, Hossam Abdelatty Eid Abdelmagyd, Shakeel S Khazi, Venkataramana Vannala
November 2020, 12(8):57-63
Coronavirus originated from Wuhan, China in December 2019 was designated initially as an epidemic but later in a short period it was declared as a pandemic. Currently, this pandemic has spread to 210 countries. There is a steady increase in the number of people getting infected with COVID and a surge in mortality as well. It is an alarming situation for health-care professionals. Dental professionals, by the very nature of treatment (direct contact with the patient’s mouth, saliva, aerosols, and droplets), carry a potential risk of getting infected or transmitting infection. Various associations have developed guidelines for an approach to the dental treatment in COVID crisis. With current knowledge, prevention and isolation seem to be the best method reiterating the old-age saying “Prevention is better than cure.” In this review, we will discuss with the help of flowcharts various preventive measures to decrease the spread of infection and precautions for the dental practice.
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Managing prosthodontic (geriatric) patients during the SARS-CoV-2 pandemic
Khurshid A Mattoo, Shailesh Jain
November 2020, 12(8):69-75
Since the beginning of this millennium, we are witnessing a surge in outbreaks across the globe. COVID-19 has been termed as the disease responsible for the current pandemic. The disease is caused by a beta coronavirus (SARS-CoV-2 (2019)) and within a span of 6 months has affected more than 200 countries. The death toll of more than half a million people has particularly been severe on the geriatric population (65 years and older), especially those whose systemic status is compromised (existing comorbidities). Presently, only predictions are being made regarding the duration of this pandemic. Most gerodontic treatments are performed by prosthodontists. This review besides presenting an overview of the COVID-19 is also aimed to guide clinicians to develop a robust long-term approach to this crisis by overcoming the anxiety associated with COVID-19, identifying general and COVID-19-related limitations of gerodontic care, reorganizing clinical and academic practices with a new approach (important and urgent), and minimizing aerosol production during prosthodontic procedures. Novel psychosocial and ethical issues associated with the COVID-19 pandemic have also been addressed in brief. Academic and private clinical geriatric practice commencement has been discussed based on scientific facts. Limitations of this study being the highest level of unpredictability about the pandemic, which could end abruptly or may be a vaccine will be produced in which case everything may become null and void.
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Managing dental public health challenges during the SARS-CoV-2 pandemic
Chandrasekhar Vallepalli
November 2020, 12(8):76-79
As of July 10, 2020, there have been more than 12.1 million confirmed cases of coronavirus disease-2019 (COVID-19), including 551,046 deaths reported globally from 213 countries/regions according to World Health Organization (WHO). A novel type of coronavirus appeared in Wuhan, China in late December of 2019. WHO announced COVID-19 earlier as public health emergency of international concern (PHEIC) and a few days later as pandemic. In dental practice, protecting patients and personnel during the SARS-CoV-2 pandemic is challenging and any possible cross-infection can be prevented by the successful use of the personal protective equipment (PPE) and ensuring strict infection prevention and control measures. To discover the impact of SARS-CoV-2 and other infectious diseases on oral health, this is an opportunity to initiate and engage in scientific research projects.
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Managing pediatric dental patients during the SARS-CoV-2 pandemic
Ahmad Faisal Ismail
November 2020, 12(8):80-84
The coronavirus disease 2019 (COVID-19) represents one of the major medical challenges that the World Health Organization (WHO) had to declare the situation as a pandemic and public health emergency. As the virus spreads very rapidly across the world through droplets and direct contact, dental professionals are at the highest risk of exposure to the infection. The emergence of COVID-19 has totally changed the way we practise dentistry. However, the true impact of COVID-19 towards pediatric dental practice is under-reported. Literature search was conducted through PubMed, CINAHL, and SCOPUS databases using the combination of terms such as “Covid19,” “coronavirus,” “pediatric dentistry,” and “paediatric dentistry” to identify relevant documents. This review was written around the impact of COVID-19 on scheduling appointments, infection control practices, and clinical settings and impact on dental care practices. With limited available sources, recommendations were summarized from included guidelines and clinical recommendations. Pediatric dentists are advised to remain vigilant to recent international and local institutional guidelines; appropriate professional clinical judgment should be considered when making decisions.
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Managing periodontics patients during the SARS-CoV-2 pandemic
Dler A Khursheed
November 2020, 12(8):85-89
Nonsurgical periodontal therapy is usually completed with scaling, polishing, and root planing. These are usually associated with aerosol and splatter formation which is composed of saliva, blood, bacteria, and viruses. Studies have shown aerosol-generating procedures can contaminate the dental clinic atmosphere and transmit serious infection. Contamination of saliva with SARS-CoV-2 is a great concern in dentistry, particularly for periodontal practice. COVID-19 is a highly contagious disease and can be easily contracted during aerosol-generating procedures. This will, undoubtedly, have future impacts for periodontal practice in ensuring safe and effective treatment. Careful review of current equipment and practice in controlling cross-contamination can facilitate preparation of proper guidelines for future practice.
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Impact of SARS-CoV-2 on periodontal tissue manifestation
Nanda Rachmad Putra Gofur
November 2020, 12(8):90-92
Coronavirus disease 19 (COVID-19) is a recent infectious disease that is rapidly spreading worldwide and targets human angiotensin-converting enzyme 2 receptors. A recent study found that COVID-19 induces immune responses resulting in periodontal manifestation. The purpose of this study was to investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on periodontal tissue. Periodontal bacteria are implicated in systemic inflammation, bacteremia, and pneumonia. Moreover, it has been shown that 80% of patients with severe COVID-19 had high bacterial load. It has also been reported that the severity of COVID-19 in patients associates with increased levels of inflammatory markers such as interleukin and bacterial invasion. Systemic increase in the inflammatory response reveals the similarity with cytokine storm in COVID-19 patients. These conditions revealed that elevated levels of cytokines detected in locally inflamed gingival tissue through saliva analysis could expand to the systemic circulation, resulting in systemic inflammation and vice versa. It is suggested that there is a possibility of periodontitis due to increased inflammatory responses in host as an impact of SARS-CoV-2 infection. Periodontal impact was seen in COVID-19 patients as localized erythema in margins of gingiva leading to desquamative gingivitis and oral pain. Although COVID-19 might manifest in periodontal tissues, presence of periodontal pathogen could pose a risk of superinfection, and periodontal pocket could be a favorable anatomical niche for the virus, the literature is still lacking to conclude that COVID-19 has an impact on periodontal tissues and more studies are needed.
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Managing the oral and maxillofacial surgical patient during the SARS-CoV-2 pandemic: A review of guidelines
Sunil S Nayak
November 2020, 12(8):93-97
Management of the oral and maxillofacial surgical patient during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is quite challenging. This paper assesses the impact of coronavirus disease-2019 (COVID-19) on oral and maxillofacial surgical practice and lays down various guidelines employed to counter the pandemic. Separate protocol and guidelines are formulated for examining the patients in the Outpatient Department (OPD), minor surgical procedures in the clinics, and for managing patients in the triage and operation theatres. Particular emphasis should be given to disinfection and infection control measures to minimize the risk of COVID-19. Infection control in the clinical, hospital, and operation theatre setup is the most essential factor in the prevention of spread of COVID-19 disease in the workplace. The use of Personal Protective Equipment (PPE), barrier techniques, proper hand wash practices, surface disinfection, and proper sterilization of instruments help in infection control. Providing effective treatment to patients with conditions that cannot be deferred or controlled by pharmacological management and taking care to minimize the risk of COVID-19 to the hospital personnel is the primary concern in the present scenario.
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