Delivery of health care by spanish dental hygienists in private and public dental services during the COVID-19 de-escalation phase (June 2020): a cross-sectional study

© 2021 by the authors. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by/4.0/. This document is the Published version of a Published Work that appeared in final form in International Journal of Environmental Research and Public Health. To access the final edited and published work see https://doi.org/10.3390/ijerph18168298Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). Conclusions: Dental hygienists’ return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors

Delivery of Health Care by Spanish Dental Hygienists in Private and Public Dental Services during the COVID-19 De-Escalation Phase (June 2020): A Cross-Sectional Study

Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). Conclusions: Dental hygienists’ return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors

Impact of the Coronavirus on Providing Oral Health Care in the Netherlands

OBJECTIVE: Transmission of SARS-CoV-2 during oral health care is potentially increased compared to regular social activities. Specific amendments to the Dutch national infection control guidelines were promulgated. This study aimed to map the impact of the coronavirus pandemic on providing oral health care during the first wave of the coronavirus pandemic in 2020 in the Netherlands. METHODS: A cross-sectional web-based survey was sent via email to a representative sample of dental hygienists and dentists in the Netherlands. RESULTS: Of the 1,700 oral health care practitioners approached, 440 (25.9%) responded to the survey. Patient access to oral health care was severely restricted during the lockdown in the Spring of 2020. A total of 1.6% of the oral health care practitioners had laboratory-confirmed COVID-19 during the study period, although this is likely to be an underrepresentation due to limited access to testing. Over half of the participants perceived an increased risk of virus transmission during aerosol-generating treatments in their practices. A large majority (65.0 – 87.1%) of the oral health care practitioners followed the COVID-19-specific amendments to the national infection control guidelines. Compared to the pre-pandemic period, additional personal protective equipment and protocols were applied. Factors related with compliance with the additional recommendations were age, employment status and occupation. CONCLUSIONS: The pandemic had a profound impact on both the accessibility and practice of oral health care. This survey study found that most Dutch oral health care practitioners paid extra attention to hygiene and infection control. Also, a low number of COVID-19 infections detected amongst Dutch oral health care practitioners was reported in the Netherlands. These overall outcomes suggest that safe oral health care can be provided when following the current infection control recommendations

Occupational Health Practices Among Dental Care Professionals Before and During the COVID-19 Pandemic

BACKGROUND: The COVID-19 pandemic has posed a substantial burden on dental care professionals. While dentistry is known as one of the most exposed and high-risk professions, dental care professionals are indeed at even greater risk. OBJECTIVE: The aim of this study was to assess knowledge, attitudes, occupational health practices, personal protective equipment usage, and mental stressors during COVID-19 pandemic among dental care professionals. METHODS: A cross-sectional study was conducted among dental care professionals who were subscribers to a dental hygiene journal using a self-administered online survey (n = 1047 respondents). Cross-tabulations were performed to determine differences in the responses to the statements related to different domains. RESULTS: COVID-19 impacted the healthy work-life balance (p \u3c  0.001) and caused sleeping difficulty among the respondents (p \u3c  0.001). Moreover, a lower response on changing respirators and gloves for each patient compared with before viral pandemic was observed (p \u3c  0.01). CONCLUSIONS: Ongoing training on infection control, occupational health practices, and PPE usage can prevent the transmission of COVID-19 among dental care professionals and the public. Lack of adequate personal protective equipment (PPE) is a burden for applying occupational health practices in dental clinics and present a risk to the public. COVID-19 may contribute to developing psychological stress and disrupt healthy work-life balance among dental professionals

Factors affecting well-being and work activity in Italian dental hygienists during COVID-19 emergency

Objectives. The goal of this study was to assess the effect of the COVID 19 pandemic in terms of work-related stress on a sample of 424 Italian dental hygienists (rate response 98%). It was tested which factors may influence most the perception of stress among Italian dental hygienists, which coping strategies hygienists adopted, and which protective factors may help them to cope with stress. Methods. Data were collected during a phase of moderate improvement of epidemiological conditions in Italy (Summer 2021 - from June to September) through an online questionnaire, 424 questionnaires were considered for analysis. Results. Results show a perception of good satisfaction among participants about their job, although the level of stress perception seems to be significant. They have also a perception of effective risk management in the workplace. The elements that seem to influence mostly work-related stress levels are associated to 1) repetitive movements and postural changes due to the use of mechanical tools; 2) the use of personal protective equipment (e.g., surgery masks, gloves, etc.); 3) Relations with patients. Results show that participants tend to implement coping strategies such as physical activity and/or spending time with family and/or friends, but it seems that at an organizational level no systematic measures have been taken. Conclusion. This study shows some protective factors that may help in coping with work-related stress, such as support from the dentist, a good work-life balance, role clarity with respect to the operational and professional role, the perception of self-efficacy at work, good integration into the teamwork and perceived support from colleagues

Am J Ind Med

Background:Early studies during the COVID-19 pandemic suggested dental occupations were among the highest risk for exposure to SARs-CoV-2 because of multiple factors increasing exposure, including close proximity to unmasked patients and performance of aerosol-generating procedures. However, to date, few studies have investigated COVID-19 deaths in United States dental occupations, and compared COVID-19 deaths among healthcare occupations.Methods:We analyzed 2020 mortality data collected by the National Center for Health Statistics\u2019 National Vital Statistics System. Multivariable logistic regression was used to generate odds ratios (ORs) and 95% confidence intervals for COVID-19 as the underlying cause of death in relation to occupation in working-age decedents ( 6465 years), after adjusting for age, sex, race/ethnicity, education, and medical conditions associated with severe COVID-19.Results:Dental occupations did not have significantly higher risk for COVID-19 death when compared to all other occupations combined. Among healthcare occupations with frequent, direct patient- or client interactions, LPNs and LVNs, and speech and language pathologists had significantly elevated adjusted ORs for COVID-19 death when compared to dentists, dental hygienists, or dental assistants. Similarly, nurse practitioners had significantly higher ORs for COVID-19 mortality than dentists or dental hygienists, and approached significance when compared to dental assistants. Conversely, massage therapists and other health diagnosing and treating practitioners had significantly lower adjusted ORs for COVID-19 death compared with dental occupations.Conclusion:Our study highlights potential differences in work-related transmission of SARs-CoV-2 and subsequent COVID-19 deaths in healthcare occupations, and furthers a previously limited understanding of COVID-19 deaths in healthcare occupations in 2020, before COVID-19 vaccine availability. Our results indicate that dental occupations were not among the highest, nor lowest risk, healthcare occupations for COVID-19 deaths in 2020, despite their known risks of direct exposure.CC999999/ImCDC/Intramural CDC HHSUnited States

Mental Health and Well-being: An Occupational Hazard in Oral Health Care

The purpose of this research is to bring awareness to risk factors leading to the increased prevalence and magnitude of mental health issues and well-being in oral health care professionals. Mental health is an essential component of overall health and is dependent upon the complex interplay of emotional, physical, and psychological stress. Health care workers experience high levels of occupational stressors, which has been shown to negatively impact mental health. To make matters worse, the COVID-19 pandemic has exacerbated these conditions into potential hazardous working environments for oral health care professionals. The CDC recommends that N95 respirators and eyewear be worn during procedures. As a result, many health care professionals are experiencing severe headaches and ear lobe pain from wearing an N95 respirator as well as protective eyewear. Headaches are another added stressor to health care professionals that may cause a decline in mental health and the quality of care provided. It is important to understand how stressors can affect one's emotional, physical, and psychological well-being, so when stress related ailments begin to surface, practical self-care strategies can be implemented to cope with the stress. Research has demonstrated that stress management techniques such as meditation, journaling, exercise, and therapy are very effective ways to cope with stress. By having these practical self-care strategies in place beforehand, one will be better equipped to cope with those stressors. Above all, it is important to not remain silent when dealing with mental illness. It takes great courage and bravery to recognize one's limitations and ask for help

Evaluation of Exposures and Health Concerns in a Dental Clinic [2024]

Request: We received a management request for a health hazard evaluation at a dental clinic. The request stated concerns about idiopathic pulmonary fibrosis (IPF). IPF is a serious long term lung disease that can cause permanent scarring in the lungs. IPF was first identified in a cluster of dentists reported in 2018. In response to the request, we performed an air sampling survey in August 2022 to evaluate potential exposures to respirable dust, respirable crystalline silica, respirable metals, and volatile organic compounds (VOCs). We also assessed the existing ventilation systems in the dental clinic. Workplace: The dental clinic provides dental care services to patients. General dentistry services and procedures are performed at the clinic and clinic laboratory. The dental clinic is housed on the second floor of a two-story medical clinic on an academic campus. At the time of our survey, eight staff were onsite, including two dentists, two dental hygienists, three dental assistants, and one administrative staff. Our Approach We conducted a site visit in August 2022 to assess possible exposures during routine dental care, assess the ventilation systems in use, and informally interview clinic staff. We conducted opening and closing meetings with employees and management to share background information about NIOSH and this health hazard evaluation. We also described the purpose of our survey, activities that would be performed while onsite, and actions that would be taken after we concluded our survey. During our onsite survey, we: a) Collected full-shift personal air samples on dental clinic employees for respirable dust and respirable crystalline silica. b) Collected full-shift area air samples in multiple locations in the dental clinic for respirable dust, respirable crystalline silica, respirable metals, and volatile organic compounds (VOCs). c) Collected instantaneous air samples for VOCs during various tasks and procedures. d) Collected real-time measurements of respirable aerosols in and just outside of the laboratory. e) Assessed the heating, ventilation, and air-conditioning (HVAC) systems in use. f) Informally interviewed clinic staff to learn about any health concerns potentially related to exposures at work. Our Key Findings: All personal air samples were below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) and the American Conference of Governmental Industrial Hygienists (ACGIH\uae) threshold limit value (TLV\uae) for respirable dust. All personal air samples for respirable crystalline silica were below the NIOSH recommended exposure limit (REL) and OSHA PEL. All area air samples for respirable dust, respirable crystalline silica, and respirable metals were low; some metals were measured in all or most areas of the clinic. Some VOCs were higher in some locations or during specific tasks and procedures. Ethanol and isopropyl alcohol were the highest measurements collected during full-shift area sampling and during task or source sampling and were likely due to cleaning and disinfecting tasks. Treatment rooms (dental operatories) and staff offices did not receive adequate outdoor air from existing mechanical ventilation systems, and the clinic was unable to maintain temperatures in the clinic recommended by ASHRAE. LEV controls in the laboratory were not consistently used. When no LEV was used, higher levels of air contaminants were measured in the laboratory and adjacent hallway. Respirable aerosol generated in the laboratory migrated to adjacent areas. Employees reported no work-related symptoms. Our Recommendations: 1: Reduce risk of entrainment of air from the laboratory into adjacent spaces. 2: Encourage employees to utilize local exhaust ventilation (LEV) controls in the laboratory area during grinding, trimming, or soldering tasks. 3: Consider using LEV controls such as high-volume evacuation (HVE) and voluntarily using N95\uae filtering facepiece respirators (or other air-purifying particulate respirators) when performing dental procedures with nickel or silica (e.g., restorative procedures). 4: Improve ventilation so that all areas receive adequate outdoor air and maintain appropriate temperatures and comfortable humidity levels. 5: Make NIOSH-approved N95 filtering facepiece respirators (or other air-purifying particulate respirators) available for voluntary use and train employees on proper use of respiratory protection. 6: Ensure employees understand the hazards associated with working in a dental clinic and how to protect themselves. 7: Encourage employees to report any new, persistent, or worsening respiratory symptoms, particularly those with a work-related pattern, to their healthcare providers and, as instructed by their employer, to a designated individual at their workplace

Awareness of droplet and airborne isolation precautions among dental health professionals during the outbreak of corona virus infection in Riyadh city, Saudi Arabia

Background: This study aimed to determine knowledge, attitude and practice of airborne and droplet isolation precautions among Dental Health Professionals (DHPs) (dental students, interns, practitioners and auxiliaries) during the outbreak of MERS (Middle East Respiratory Syndrome), corona virus infection in Riyadh city, Saudi Arabia. Material and Methods: A cross-sectional survey was conducted among 406 dental health professionals (DHPs) working in selected dental facilities in Riyadh city, Saudi Arabia during the outbreak of MERS (April-June 2013). A structured, close-ended, self-administered questionnaire explored the knowledge, attitude, and practice towards droplet and isolation precautions. Collected data was subjected to descriptive statistics to express demographic information, mean knowledge score, mean attitude score and practice score of DHPs. Inferential statistics (MannWhitney U test and Kruskal Wallis tests, p < 0.05) were used to examine differences between study variables. Spearmanâ s rho correlation was used to identify the association between the knowledge-attitude, knowledge-practice, and attitude-practice. Results: A response rate of rate of 90.22% (406 out of 452) was obtained. The mean scores of knowledge, attitude and practice were 10.61 ± 1.19, 50.54 ± 7.53 and 8.50 ± 2.14 respectively. Spearmanâ s correlation test revealed a significant linear positive correlation between knowledge and attitude (r-0.501, P- 0.01), knowledge and practice (r-0.185, P-0.01) and attitude and practice (r-0.351, P- 0.01) of DHPs about airborne isolation precautions. Conclusions: Dental health professionals considered in the present study showed good knowledge, positive attitude and good practice towards droplet and airborne isolation precautions during outbreak of MERS

The Management of Aerosols with Airpolishing Delivery Systems

In summary. aerosol production is inherent with airpolishers. as well as other dental equipment such as handpieces, ultrasonic scalers, and air/water syringes. By practicing prudent infection control techniques and utilizing proper operating techniques, the clinician can continue to enjoy the time-efficient and efficacious benefits of airpolishers, while ensuring a maximum protection from aerosols for the patient and the operator