Simoni Eriseldaa, Bardhoshi Meritab
aUniversity Dental Clinic, Dental Surgery Service, Tirana, Albania
bUniversity of Medicine, Faculty of Dental Medicine, Tirana, Albania
Summary
Background/Aim: Dentists are considered particularly at risk of disease transmission due to aerosol generation during manipulations, patient proximity, and operating environment. To prevent the diffusion of the virus all dental clinics in Albania were closed by the order of the Ministry of Health during the lockdown period. The University Dental Clinic (UDC) was reorganized from a more academic to a dental emergency institution. This study aimed to analyze the impact of the COVID-19 pandemic on the pattern of presentation and management of surgical dental emergencies in UDC. Material and Methods: A retrospective analysis of all consecutive patients with surgical dental emergencies and urgencies presenting in our surgical service of University Dental Clinic in Tirana during COVID19 lockdown 2020 (9th of March to 17th of May) in Albania and used as a control period the same weeks in 2019. Results: During the 10-week COVID-19 period we observed a 5.2-fold increase in the incidence of emergency presentations (181 patients in 2020 versus 35 patients in 2019 with a significant increase in mean event incidence difference (MID) 14.6 (95%CI 10.59 – 18.61); p<0.0001. For dental abscess was observed a 4.4-fold increase during COVID-19 compared to the control period with a significant increase of MID 5.8 (4.32 – 7.28); p<0.0001. Compared to 2019, during the COVID-19 period were also observed a 7.1-fold increase in reacutization of chronic periodontitis. Compared to 2019 we observe a 3.5fold increase in overall surgical treatments during the COVID-19 pandemic with a significant increase of MID 6.40 (4.83 – 7.97); p<0.0001. For dental Extractions was observed a 2.85 fold increase with a significant increase of MID 3.70 (2.61 – 4.79); p<0.0001. And also compared to 2019 we observed a 10-fold increase in conservative strategy during the COVID-19 period. Conclusions: During the COVID-19 pandemic outbreak, a significant increase in surgical emergencies/urgencies and related interventions was observed in our center. The main possible reason is the restricted activity of all other dental clinics in Albania and eventually because of the later stage disease presentation during the COVID-19 pandemic outbreak.
Keywords: COVID-19 pandemic; surgical dental emergencies; abscess; dental extraction
Reference
World Health Organization Official Website. Rolling Updates on Coronavirus Disease (COVID-19). Available online: https:// www.who.int/emergencies/diseases/novel-coronavirus-2019/ events-as-they-happen?fbclid=IwAR2Kk1KFnISKO-TTnWdgEi3rCni0QmJyIo98Pqw-vlPGkq9kf23mR6D4wR4
Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature, 2020;579:265-269
Jewett DL, Heinsohn P, Bennett C, Rosen A, Neuilly C. Blood-containing aerosols generated by surgical techniques: a possible infectious hazard. Am Ind Hyg Assoc J, 1992;53:228-231
Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet, 2020;395:e39
Coulthard P. Dentistry and coronavirus (COVID-19)moral decision-making. Br Dent J, 2020;228:503-505
Spagnuolo G, De Vito D, Rengo S, Tatullo M. COVID-19 outbreak: an overview on dentistry. Int J Environ Res Public Health, 2020;17:2094
Mars 2020/ Informacion i përditësuar për Koronavirusin COVID_19 https://shendetesia.gov.al/9-mars-2020-informacion -i-perditesuar-per-koronavirusin-covid_19
Për marrjen e masave të veçanta në parandalimin e përhapjes së infeksionit të shkaktuar nga covid-19 (order of minister of health and social protection in Albanian) https:// qbz.gov.al/eli/urdher/2020/03/10/156/ef6f88e4-2dde-4c03-86d8-dca1d58275d5
Për marrjen e masave të veçanta administrative gjate kohezgjatjes se periudhes se infeksionit te shkaktuar nga COVID-19 (normative act of Prime Minister in Albanian) https://qbz.gov.al/eli/akt-normativ/2020/03/15/3/333da18e-47fd-4cc7-b38c-562ec56da463
26 Maj 2020/ Informacion i përditësuar për koronavirusin COVID-19″. shendetesia.gov.al (in Albanian). 26 May 2020. https://new.shendetesia.gov.al/26-maj-2020-informacion -i-perditesuar-per-koronavirusin-covid-19
Urdher per mbylljen e kabineteve dhe klinikave dentare. (Order of ministy of health and social protection -in Albanian) https://new.shendetesia.gov.al/wp-content/uploads/ 2020/03/ URDHER-165-mbylljen-e-kabineteve.klinikavedentare.pdf
Urdher për ofrimin e shërbimeve stomatologjike në klinika/kabinete dentare. https://qbz.gov.al/eli/ urdher/2020/05/08/300/27b31b9f-0cde-4a12-8d7d-35e6601567c8
American Dental Association Official Website. What Constitutes a Dental Emergency? Available online: https:// success.ada.org/~/media/CPS/Files/Open%20Files/ADA_ COVID19_Dental_Emergency_DDS.pdf
Faccini M, Ferruzzi F, Mori AA, Santin GC, Oliveira RC, Oliveira RCG, et al. Dental Care during COVID-19 Outbreak: A Web-Based Survey. Eur J Dent, 2020;14:S14-S19
Bennardo F, Antonelli A, Barone S, Figliuzzi MM, Fortunato L, Giudice A. Change of Outpatient Oral Surgery during the COVID-19 Pandemic: Experience of an Italian Center. Int J Dent, 2020;2020:8893423
Petrescu NB, Aghiorghiesei O, Mesaros AS, Lucaciu OP, Dinu CM, Campian RS, et al. Impact of COVID-19 on Dental Emergency Services in Cluj-Napoca Metropolitan Area: A Cross-Sectional Study. Int J Environ Res Public Health, 2020;17:7716
Politi I, McParland E, Smith R, Crummey S, Fan K. The impact of COVID-19 on cervicofacial infection of dental aetiology. Br J Oral Maxillofac Surg, 2020;58:1029-1033
Balkan Journal of Dental Medicine, 2022, vol. 26, br. 3, str. 176-182