Challenges, limitations, and solutions for orthodontists during the coronavirus pandemic: A review

Abstract

Objectives Orthodontic patients around the world had to miss appointments during the early months of the COVID-19 pandemic. A significant problem with this virus is its high transmission power. Asymptomatic patients can transmit the virus. This aim of this review is to examine orthodontic emergency situations and the necessary strategies and measures for emergency and non-emergency during the coronavirus pandemic. Methods The following databases were comprehensively searched: PubMed, MEDLINE, Scopus, and Google Scholar. Up-to-date data released by major health organizations such as WHO and major orthodontic associations involved in the pandemic were also evaluated. Results Few studies are conducted on how to manage orthodontic offices or clinics during the pandemic and mostly are not of high quality. Appropriate communication is the most important issue in managing orthodontic patients, particularly virtual counseling. Many cases of orthodontic emergencies can be managed in this way by patients themselves. Most studies recommend using the FFP2 masks, equivalent to N95 masks for non-COVID-19 cases undergoing aerosol-generating procedures and all suspected or confirmed COVID-19 cases in orthodontic visits. Conclusions At this time, there are no definitive clinical protocols supported by robust evidence for orthodontic practice during COVID-19 pandemic. Orthodontists should not rush to return to routine orthodontic work and should follow state guidelines. Non-emergency orthodontic visits should be suspended during the SARS-CoV-2 pandemic in high-risk areas. Resuming orthodontic procedures during the pandemic requires paying special attention to screening, performing maximum efforts to reduce aerosol, appropriate PPE, proper ventilation, and full adherence to sterilization and disinfection principles.

The Implications of the COVID-19 Pandemic on the Interest in Orthodontic Treatment and Perspectives for the Future. Real-Time Surveillance Using Google Trends

“…Quite unexpectedly, in the present study, there was no substantial increase observed in the interest according to the phrase “braces pain” during the first lockdown period that occurred in the spring of 2020. A lot of orthodontics offices were closed due to the COVID-19 disease [ 18 ], which caused the cancellation of orthodontic visits, especially in the early phase of pandemic outbreak [ 6 ] as it was recommended to consider only urgent cases [ 2 ]. The same measure to control the viral spread was undertaken in the year 2003; dental visits were postponed for at least a one-month period for patients with SARS [ 19 ].…”

“…If they were to be carried out, dedicated screening of the patients as well as triage, stringent infection control protocols and higher ventilation and disinfection should be introduced in orthodontics offices. The federal, state or local public health guidelines should be followed as well during the pandemic [ 2 , 5 , 6 ]. According to Bilder et al, 85% of orthodontic patients experience an emergency visit during the orthodontic treatment [ 7 ].…”

A Knowledge-Based Algorithm for Automatic Monitoring of Orthodontic Treatment: The Dental Monitoring System. Two Cases

“…In the present clinical cases, the DM system was crucial and essential to achieve an appropriate interceptive therapy in a growing subject, thus avoiding a more complex treatment (in case 1), and to closely monitor (every 7 days) an adult patient who was in a hurry to improve the esthetics of his smile (in case 2). It can be concluded for these particular cases that without the DM system, it would not have been possible to achieve the same results, considering the period of the pandemic lockdown, which increased the use of virtual consultation [ 17 ]. Above all, the orthodontic treatments were monitored with periodic scans at every alignment change.…”

Desinfección de Alicates de Ortodoncia. Actualización de Recomendaciones en Contexto de COVID- 19. Revisión de la Literatura

“…Tiene como desventaja el nivel de toxicidad, que puede causar irritación, ulceración y quemaduras de la piel y las mucosas; también puede causar irritación a los ojos y al sistema respiratorio. Aparte de los problemas de toxicidad, la solución a base de aldehídos causa corrosión y oxidación de los instrumentos de acero inoxidable que comprenden la mayoría de los instrumentos dentales y de ortodoncia (Cabrera-Tasayco et al;Carvalho et al;Khatri et al;Ministerio de Salud, 2018;Turkistani;Marín;Malekshoar et al, 2021).…”