COVID-19 outbreak: An overview on dentistry.
Coronavirus disease 2019, also called COVID-19, is the latest infectious disease to rapidly develop worldwide […].
Dual-light photodynamic therapy administered daily provides a sustained antibacterial effect on biofilm and prevents Streptococcus mutans adaptation
Antibacterial photodynamic therapy (aPDT) and antibacterial blue light (aBL) are emerging treatment methods auxiliary to mechanical debridement for periodontitis. APDT provided with near-infrared (NIR) light in conjunction with an indocyanine green (ICG) photosensitizer has shown efficacy in several dental in-office-treatment protocols. In this study, we tested Streptococcus mutans biofilm sensitivity to either aPDT, aBL or their combination dual-light aPDT (simultaneous aPDT and aBL) exposure. Biofilm was cultured by pipetting diluted Streptococcus mutans suspension with growth medium on the bottom of well plates. Either aPDT (810 nm) or aBL (405 nm) or a dual-light aPDT (simultaneous 810 nm aPDT and 405 nm aBL) was applied with an ICG photosensitizer in cases of aPDT or dual-light, while keeping the total given radiant exposure constant at 100 J/cm2. Single-dose light exposures were given after one-day or four-day biofilm incubations. Also, a model of daily treatment was provided by repeating the same light dose daily on four-day and fourteen-day biofilm incubations. Finally, the antibacterial action of the dual-light aPDT with different energy ratios of 810 nm and 405 nm of light were examined on the single-day and four-day biofilm protocols. At the end of each experiment the bacterial viability was assessed by colony-forming unit method. Separate samples were prepared for confocal 3D biofilm imaging. On a one-day biofilm, the dual-light aPDT was significantly more efficient than aBL or aPDT, although all modalities were bactericidal. On a four-day biofilm, a single exposure of aPDT or dual-light aPDT was more efficient than aBL, resulting in a four logarithmic scale reduction in bacterial counts. Surprisingly, when the same amount of aPDT was repeated daily on a four-day or a fourteen-day biofilm, bacterial viability improved significantly. A similar improvement in bacterial viability was observed after repetitive aBL application. This viability improvement was eliminated when dual-light aPDT was applied. By changing the 405 nm to 810 nm radiant exposure ratio in dual-light aPDT, the increase in aBL improved the antibacterial action when the biofilm was older. In conclusion, when aPDT is administered repeatedly to S. mutans biofilm, a single wavelength-based aBL or aPDT leads to a significant biofilm adaptation and increased S. mutans viability. The combined use of aBL light in synchrony with aPDT arrests the adaptation and provides significantly improved and sustained antibacterial efficacy.
A Plausible “Penny” Costing Effective Treatment for Corona Virus Ozone Therapy.
Many viruses require reduced sulfhydryl groups for cell fusion and entry. Corona viruses, including SARS-CoV-2 (the cause of the condition now named coronavirus disease 2019 or COVID-19), are rich in cysteine, which residues must be intact for viral activity. Sulfhydryl groups are vulnerable to oxidation. Ozone therapy, a very inexpensive and safe modality may safely exploit this critical vulnerability in many viruses, inclusive of SARS-CoV-2.
Fear and practice modifications among dentists to combat Novel Coronavirus Disease (COVID-19) outbreak.
An outbreak of novel coronavirus disease (COVID-19) in China has influenced every aspect of life. Healthcare professionals, especially dentists, are exposed to a higher risk of getting infected due to close contact with infected patients. The current study was conducted to assess anxiety and fear of getting infected among dentists while working during the current novel coronavirus diseases (COVID-19) outbreak. In addition, dentists’ knowledge about various practice modifications to combat COVID-19 has been evaluated. A cross-sectional study was conducted using an online survey from 10th to 17th March 2020. The well-constructed questionnaire was designed and registered at online website (Kwiksurveys) and validated. A total of 669 participants from 30 different countries across the world responded. After scrutiny, completed questionnaires (n = 650) were included in the study. Statistical analysis was performed using SPSS version 25. Chi-Square and Spearman correlation tests were applied to control confounders and assess the relation of dentists’ response with respect to gender and educational level. More than two-thirds of the general dental practitioners (78%) from 30 countries questioned were anxious and scared by the devastating effects of COVID-19. A large number of dentists (90%) were aware of recent changes in the treatment protocols. However, execution of amended treatment protocol was recorded as 61%. The majority of the dentists (76%) were working in the hospital setting out of which 74% were from private, and 20% were from government setups. Individually we received a large number of responses from Pakistan and Saudi Arabia, but collectively more than 50% of the responses were from other parts of the world. Despite having a high standard of knowledge and practice, dental practitioners around the globe are in a state of anxiety and fear while working in their respective fields due to the COVID-19 pandemic impact on humanity. A number of dental practices have either modified their services according to the recommended guidelines to emergency treatment only or closed down practices for an uncertain period.
Dental Practice Integration into Primary Care: A Microsimulation of Financial Implications for Practices
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
Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020.
To determine distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards in Wuhan, China, we tested air and surface samples. Contamination was greater in intensive care units than general wards. Virus was widely distributed on floors, computer mice, trash cans, and sickbed handrails and was detected in air ≈4 m from patients.
Could IL-17 represent a new therapeutic target for the treatment and/or management of COVID-19-related respiratory syndrome?: This paper is dedicated to Sofia Maione born during COVID-19 outbreak.
Since 2003, outbreaks of Coronavirus have caused multiple public health epidemics including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). The first case of infection in response to a new strain of Coronaviridae, designated Coronavirus disease-19 (COVID-19) was recorded in Wuhan, China [1]. This virus appears to be weaker than SARS, in terms of pathogenesis but more sustained in its transmission behavior [2]. COVID-19 is transmittedthrough droplet inhalation, saliva, nasal and mucous membranes of eyes. Symptoms include fever, continuous coughing and shortness of breath.
COVID‐19: its impact on dental schools in Italy, clinical problems in endodontic therapy and general considerations.
Dear Editor
COVID-19 is a novel disease caused by a member of the coronavirus family that originated in Wuhan, Hubei, China in December 2019. Over the last few months, the infection has spread to several countries worldwide. Coronaviruses are described by the World Health Organisation (WHO) as a large family of viruses, which may cause illness in animals or humans (https://www.who.int/news-room/q-a-detail/ q-a-coronaviruses). Although COVID-19 infections in humans most often present with mild symptoms, in a variable percentage of cases, it can cause an acute
respiratory syndrome, which has led to patient fatalities (Phan 2020, Lu et al. 2020). COVID-19 appears to be a particular risk for patient with pre existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer or diabetes; https://www.who.int/news-room/q-a-detail/q-a-coronaviruses).
Mercury-induced autoimmunity: Drifting from micro to macro concerns on autoimmune disorders.
Mercury (Hg) is widely recognized as a neurotoxic metal, besides it can also act as a proinflammatory agent and immunostimulant, depending on individual exposure and susceptibility. Mercury exposure may arise from internal body pathways, such as via dental amalgams, preservatives in drugs and vaccines, and seafood consumption, or even from external pathways, i.e., occupational exposure, environmental pollution, and handling of metallic items and cosmetics containing Hg. In susceptible individuals, chronic low Hg exposure may trigger local and systemic inflammation, even exacerbating the already existing autoimmune response in patients with autoimmunity. Mercury exposure can trigger dysfunction of the autoimmune responses and aggravate immunotoxic effects associated with elevated serum autoantibodies titers. The purpose of the present review is to provide a critical overview of the many issues associated with Hg exposure and autoimmunity. In addition, the paper focuses on individual susceptibility and other health effects of Hg
The first case of COVID-19 infection in a 75-day-old infant in Jahrom City, south of Iran.
In late December of 2019, a new coronavirus was discovered in China. On 11 February 2020, the World Health Organization named the disease caused by this virus COVID-19. The disease quickly spread to Chinese cities and other parts of the world, including Thailand, Japan, Taiwan and Iran.1 The number of infected patients increased daily until the World Health Organization in June declared the outbreak a serious and urgent threat to public health. Most people infected with the virus recover well, but some also may experience fatal complications, such as acute organ failure, septic shock, acute pulmonary edema, acute pneumonia, and acute respiratory distress syndrome.1 As infection has been transmitted from individual to individual,2 the first cases of the disease in areas outside of Wuhan, occurred in travelers from Wuhan; as The First Case of COVID-19 was confirmed to be a 35-year-old woman living in Wuhan who traveled to Korea.3 On January 20, 2020, a 55-year-old woman working in Wuhan, arrived at Taiwan and was referred to quarantine authorities with symptoms of sore throat, dry cough, fatigue, and feeling low-grade fever on January 11.4 While COVID-19 infection seems to be more prevalent in adults than in children, rare cases of children infection are being reported, mainly seen in family clusters.5 The presented case is a 75-day-old infant that was referred to the pediatric emergency department, with a history of severe dry cough and abnormal noisy breathing sound (heard without a stethoscope) during the last 11 days.