Background. An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated clinical recommendations for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical periodontitis, pulp necrosis and symptomatic apical periodontitis, or pulp necrosis and localized acute apical abscess using antibiotics, either alone or as adjuncts to definitive, conservative dental treatment (DCDT) in immunocompetent adults. Types of Studies Reviewed. The authors conducted a search of the literature in MEDLINE, Embase, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature to retrieve evidence on benefits and harms associated with antibiotic use. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and the Evidence-to-Decision framework. Results. The panel formulated 5 clinical recommendations and 2 good practice statements, each specific to the target conditions, for settings in which DCDT is and is not immediately available. With likely negligible benefits and potentially large harms, the panel recommended against using antibiotics in most clinical scenarios, irrespective of DCDT availability. They recommended antibiotics in patients with systemic involvement (for example, malaise or fever) due to the dental conditions or when the risk of experiencing progression to systemic involvement is high. Conclusion and Practical Implications. Evidence suggests that antibiotics for the target conditions may provide negligible benefits and probably contribute to large harms. The expert panel suggests that antibiotics for target conditions be used only when systemic involvement is present and that immediate DCDT should be prioritized in all cases.

PurposeThis study aimed to investigate the association between self-reported depressive symptoms and oral diseases in US adults, including periodontitis, caries, missing teeth and untreated dental caries.DesignThis study was designed as a secondary data analysis of a cross-sectional survey. We conducted descriptive, multivariable logistic and Poisson regression analyses on weighted data.SettingUS National Health and Nutrition Examination Survey 2009–2014 data.ParticipantsIndividuals aged ≥30 years who completed a periodontal examination and depression screening (n=9799).Results21.6% (28.9 million) of adults aged ≥30 years reported depressive symptoms, with a higher prevalence among females, current smokers and participants with lower income and education status. More than half of the adults with moderate depressive symptoms had periodontal diseases, and more than one-third had teeth with untreated dental caries. After adjusting for sociodemographics, behavioural factors, having diabetes and psychotherapeutic medication use, depressive symptoms were associated with poorer oral health. Severe depressive symptoms were associated with higher odds of mild periodontitis (2.20; 99% CI 1.03 to 4.66). For those with mild depressive symptoms, the mean number of missing teeth was 1.20 (99% CI 1.06 to 1.37) times the average of non-symptomatic individuals; and 1.38 times (99% CI 1.15 to 1.66) among individuals with moderate depressive symptoms.ConclusionsDepressive symptoms were associated with mild periodontitis and a greater number of missing teeth, while having teeth with untreated dental caries was attributed to sociodemographic factors. Awareness of oral health status among patients with depressive symptoms can inform both dental and mental health providers to develop tailored treatment and help patients achieve overall wellness.

Background. Patients with pulpal and periapical conditions often seek treatment for pain, intraoral swelling, or both. Even when definitive, conservative dental treatment (DCDT) is an option, antibiotics are often prescribed. The purpose of this review was to summarize available evidence regarding the effect of antibiotics, either alone or as adjuncts to DCDT, to treat immunocompetent adults with pulpal and periapical conditions, as well as additional population-level harms associated with antibiotic use. Type of Studies Reviewed. The authors updated 2 preexisting systematic reviews to identify newly published randomized controlled trials. They also searched for systematic reviews to inform additional harm outcomes. They conducted searches in MEDLINE, Embase, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. Pairs of reviewers independently conducted study selection, data extraction, and assessment of risk of bias and certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results. The authors found no new trials via the update of the preexisting reviews. Ultimately, 3 trials and 8 additional reports proved eligible for this review. Trial estimates for all outcomes suggested both a benefit and harm over 7 days (very low to low certainty evidence). The magnitude of additional harms related to antibiotic use for any condition were potentially large (very low to moderate certainty evidence). Conclusions and Practical Implications. Evidence for antibiotics, either alone or as adjuncts to DCDT, showed both a benefit and a harm for outcomes of pain and intraoral swelling and a large potential magnitude of effect in regard to additional harm outcomes. The impact of dental antibiotic prescribing requires further research.

Purpose/objectives This study aimed to understand the impact of the COVID‐19 pandemic on dental school faculty's self‐reported burnout, loneliness, and resilience. Methods A 34‐item questionnaire composed of three previously validated scales – adapted Copenhagen Burnout Inventory, the brief resilience scale, and a short loneliness scale – and demographic information was sent by email to dental school faculty in four dental schools across the US during the sixth and seventh months of the COVID‐19 pandemic. Results Two‐hundred sixteen (19.63%) of faculty invited to participate completed the survey. On a scale of five, with five indicating extreme burnout and one indicating no burnout, the average personal burnout was 2.7 (SD = 0.83), and work‐related burnout (WRB) was 2.8 (SD = 0.83). Personal and WRB decreased with increasing age. WRB was significantly higher among full‐time faculty, females, and those living alone. Faculty who lived alone experienced more loneliness than those who lived with others. Resilience was not a statistically significant difference across demographic groups. Regarding the impact of COVID‐19 pandemic on their burnout, loneliness, and resilience on a scale ranging from “Never” (scored as 1) to “A great deal” (scored as 5), the average response for burnout was 3.3 (SD = 1.01), loneliness was 2.6 (SD = 1.10), and resilience was 2.8 (SD = 0.99). Conclusion(s) While self‐reported burnout and resilience scores did not show a significant increase during the pandemic, the rates of burnout and loneliness remain higher than the public. Dental education has real challenges and opportunities to explore individual and organizational interventions to combat burnout and loneliness and enhance resilience among faculty.