The COVID-19 pandemic and its global effects on dental practice : An International survey

Objectives: A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and Personal Protective Equipment (PPE). Methods: A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) Personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) Working conditions and PPE adopted after the outbreak. Countries' data were grouped by the Country Positive Rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items. Results: A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n = 27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR = 1.80 95% =5.20 95% 95% CI = 1.60/2.82 and OR CI = 1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR = 1.09 CI = 0.97/1.60). The same significant associations were observed in the multivariate analysis. Conclusions: Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events

Urban-rural differences in dental caries of 5-year old children in Scotland

Previous research suggests there are significant differences between urban and rural areas in Scotland for health outcomes including heart disease, cancer and self reported health. The aim of this study was to describe the contemporary urban/rural variation in obvious decay experience amongst 5-year-olds in Scotland. Scotland was split into 6 geographies, ranging from 'The 4 Cities' (Glasgow, Edinburgh, Dundee and Aberdeen) to 'Remote Rural' areas. Data derived from the 2007/08 National Dental Inspection Programme, representative of the whole of Scotland, were modelled using Bayesian multilevel zero-inflated Negative Binomial and multilevel Poisson modelling, adjusting for age, sex and deprivation. The outcome variables modelled were d3mft (carious, extracted or filled deciduous teeth), d3t (carious teeth), mt (missing teeth, extracted due to caries) and ft (filled teeth). The proportion of 5-year old children in Scotland with d3mft = 0 was 58% in 2008. Adjusting for age and sex, the odds of a child in a Remote Rural area having d3mft>0 was 0.52 that of a city dweller. However, when deprivation was included in the model, the odds of having d3mft >0 rose to 0.74. The odds of d3mft>0 in 'Accessible Rural' areas also remained significantly lower than in the 4 Cities after adjustment for deprivation. For those with d3mft>0, the relative risk of additional d3mft was also significantly lower in Remote Rural areas, however this was explained by deprivation, while in Accessible Rural areas this remained significant even after adjustment for deprivation. The odds of having any extractions was lower in Rural areas, even after adjustment for deprivation, while the Care Index (ft/d3mft) was higher in Remote Towns. Deprivation, therefore, accounted for much but not all of the geographical difference in d3mft which exist in Scotland. Children in Remote and Rural areas appear to have better dental health and a higher proportion of filled teeth when compared with those living in Cities. Possible reasons for these differences and recommendations for future research are discussed.Scotland Oral health Urban-rural Socioeconomic inequalities Children Multilevel modelling UK