Posted: November 13th, 2022

Oral Health and COVID-19

Oral Health and COVID-19
Introduction
The COVID-19 pandemic increases the risk of oral health disparities due to lack of quality access to oral care services during the pandemic. During the lockdown, patients experience poor access to oral care services. The problem started when the American Dental Association declared postponement of elective dental care. Handling only emergency healthcare services increases the risk of complications. The purpose of the study was to analyze medical literature PubMed and Dentistry and Oral Science Source from 2014 to 2019. 11 studies met the inclusion and exclusion criteria of peer-reviewed research. The results of the research show that the pandemic has a negative impact on oral health. The prevalence of oral health complications is high among minority and vulnerable groups. Discussion of the findings emphasize that dentists should align their healthcare delivery with the new reality. Teledentistry is one of the strategies that can reduce the risk of infection. The negative effect of the pandemic on oral health requires non-aerosol-generating procedures, quality lifestyles, and limited surgical interventions.
Background and significance
In March 2020, the World Health Organization (WHO) declared a global outbreak of the coronavirus disease 2019 (COVID-19) a pandemic; on March 13, 2020, the Center for Disease and Prevention Center (CDC) declared a national emergency in the United States concerning the COVID-19 outbreak. The American Dental Association (ADA) then recommended all dentists to postpone elective dental procedures to April 6, 2020 and perform only emergency procedures due to transmission of the COVID-19 through the droplet. On March 18, 2020, ADA provided its members with detailed guidance on emergency and non-emergency to prevent the spread of COVID-19 disease to reduce the burden on hospitals, so not only access to dental and oral health decreased; also it has led to the closure of almost 19,800 active dentists in the United States (Solana, 2020). The ADA Health Policy Institute (HPI) has launched a biweekly survey of economic conditions during the COVID-19 pandemic. The week of March 23, 2020, only five percent of dental offices remained open. The survey was conducted to determine the impact of pandemic and lockdown on dental practices over time, the finding by analyzing data , shows the U.S. dental care spending decline by up to 38 percent in 2020 and this spending decline will be 20 percent in 2021(Nasseh & Vujicic, 2021).
Due to the closure during pandemic , dental /oral healthcare and dentistry encountered many challenges such as infection control and prevention in dental office setting , access for patients who need oral/ dental care , and re-configure dental practice.
This paper is an overview of the literature describing oral and dental challenges during the COVID-19 pandemic and how to use what we learned during the pandemic to prevent future lockdown challenges.
Method
Search strategy
Medical literature from 2019 to 2014 was searched, using PubMed and Dentistry & Oral Science Source. The following keywords were used to retrieve articles related to oral and dental challenges during COVID-19 pandemic lockdown: COVID-19 prevention, Teledentistry COVID-19, COVID-19 dental emergencies, dental challenge during COVID-19, online dentistry consultation during Covid-19, and dental care during SARS. The search of databases using all keywords identified 126 articles. All articles were reviewed. 48 duplicated articles was removed, 37 articles were excluded as non-relevant on the content, bias, design, abstract, and lack of relevance, and 11 articles remained.
Inclusion and exclusion
The search was limited to an original peer-reviewed paper in the English language and was limited to 2016 to 2021. Case reports, abstracts, and literature reviews were excluded.
Meta-Analysis
Three of 11 studies were conducted in the UK. ( Crawford & Taylor 2020 ; Dziedzic et al, 2020 ; Rahman et al., 2020), and other articles were conducted in Australia (Hopcraft & Farmer, 2020), China (Yang et al. 2020) Germany (Hajek et al. 2020) , India (Mathivanan, et al. 2020), Italy (Giudice et al. 2020), Pakistan (Abbas et al. 2020), Turkey (Sirin & Ozcelik, 2021), and the U.S. (Kranz et al. 2021). 10 studies were quantitative studies (Abbas et al. , 2020; Crawford & Taylor, 2020 ; Giudice et al. , 2020 ; Hajek et al. , 2020 ; Hopcraft & Farmer , 2020 ; Kranz et al. , 2021; Mathivanan et al. , 2020; Rahman et al. , 2020 ; Sirin & Ozcelik ,2021; Yang et al., 2020) and one study was qualitative study (Dziedzic et al. 2020).
Studies were conducted in different age group including children and adult; the age pediatric group was under 18 years old and age adult group was 18 years and / or older. Eight of 11 studies evaluated adult patients (Abbas et al. , 2020; Crawford & Taylor, 2020 ; Giudice et al. , 2020 ; Hajek et al. , 2020 ; Kranz et al. , 2021; Mathivanan et al. , 2020; Rahman et al. , 2020 ; Sirin & Ozcelik , 2021), one study was conducted in the vulnerable adult population (Dziedzic et al. 2020) , and two studies evaluated pediatrics’ oral health (Hopcraft & Farmer, 2020 ; Yang et al. , 2020).
Five studies were directly related to teledentistry (Abbas et al, 2020; Crawford & Taylor, 2020; Giudice et al., 2020; Mathivanan et al., 2020; Rahman et al., 2020), three studies evaluated e-dentistry or teledentistry (Giudice et al., 2020; Yang et al., 2020; Mathivanan et al., 2020), one study evaluated patient’s satisfaction when using teledentistry (Rahman et al. 2020), and one study accessed knowledge and awareness of dentists about the role of teledentistry during COVID-19 pandemic (Abbas et al., 2020).
Two studies evaluated people who postponed their dental care due to the COVID-19 infectious virus (Hajek et al., 2021; Kranz et al., 2020).One study discussed and evaluated the importance of oral health as a part of health and continuous support in the vulnerable population during the COVID-19 pandemic (Dziedzic et al. 2020), One study indicated a remarkable relationship between the risk of COVID-19 with the dental damage stage (Sirin, & Ozcelik, 2021), Two articles discussed pediatric oral health as a population at risk due to the pandemic and evaluated online emergency visits for children. (Luzzi et al., 2020; Yang et al., 2020).
Criteria for reviewing articles and studies were as follows;
 Implementation Teledentistry
 Oral health COVID-19
 Prevention measures
 Dental challenges during pandemic
The reviewed articles have been conducted in different countries and in diverse populations. The purpose of the study is to discuss oral/dental challenges during the COVID-19 pandemic and evaluate how the challenges can be prevented in future lockdown.
The figure 1 shows the selection process of the articles that met the criteria for review.

PRISMA Flow Diagram
Figure 1. The literature
selection process

Result
Impact of COVID-19 on Oral Health
The COVID-19 pandemic has significantly negatively impacted the population’s oral health (Ren et al., 2020). Individuals affected by COVID-19 are at higher risk of acquiring oral disease ( Brian & Weintrub, 2020). The direct effects of COVID-19 on oral health include ageusia (lose of taste), vesiculobullous lesion, and necrotizing periodontal disease (Ren et al., 2020). The direct effects of COVID-19 are likely to have significant effects on the population’s oral health because the oral mucosa has been indicated as a potential route of entry for SARS-CoV-2, which causes COVID-19 (Ren et al., 2020). The presence of angio-tension converting enzyme 2 (ACE2) acts as a receptor for SARS-CoV-2 and allows it to infect the cells (Sirin & Ozcelik, 2021). Poor oral health contributes to an increase in ACE2 receptors and increasing the risk of infection with COVID-19; Oral and dental hygiene are essential factors in the prevention of COVID-19 infections.
During the COVID-19 pandemic, oral health facilities were closed down, which negatively impacted oral health. Studies have shown that oral healthcare services increase viral infections such as COVID-19 diseases (Brian & Weintrub, 2020; Ren, 2020). The American Dental Association (ADA) recommended that all dentists postpone elective dental care to prevent patients from burdening hospital emergency departments. ADA recommended that only emergency dental care be provided due to the virus’s overall risk of transmission (ADA, 2020), due to this recommendation, oral and dental healthcare decrease substantially during the pandemic period (Brian & Weintrub, 2020).
Oral health for vulnerable populations and minority group
A systematic literature review was conducted to determine the effects of the COVID-19 pandemic on oral health of vulnerable populations and minority groups. An analysis of the literature retrieved was conducted and themes were formulated. In their studies, Brian and Weintrub (2020) and Dziedzic et al. (2020) indicated that the pandemic has led to decline in access to healthcare services such as oral care because it plays a significant role in patient’s health with comorbidities. Population at a higher risk of acquiring COVID-19 , such as individuals in low socioeconomic groups, low literacy, the elderly , those in rural areas, and the uninsured, have an increased likely hood of acquiring oral disease during pandemic (Brian & Weintrub, 2020; Dziedzic et al. ,2020).Vulnerable populations such as older people and those with chronic illnesses are at higher risk of COVID-19 infection and have higher risk of acquiring oral diseases due to the postponement of oral care visits (Dziedzic et al. ,2020).Poor oral health results in other chronic health complication for patients; these health complications lower the immunity of a patient and increase the risk of infection with COVID-19, improving oral health will reduce morbidity and mortality related to COVID-19 (Dziedzic et al. ,2020).Minority groups such as non-Hispanic blacks, American Indians, Hispanics, and Alaska natives are also at a higher risk of oral health problems due to healthcare disparities. Unequal healthcare provision has increased the rate of oral health diseases among minority groups during the COVID-19 pandemic; consequently, the same minority groups have higher COVID-19 infection and mortality rates than other groups (Brian & Weintrub, 2020).
Teledentistry on oral health during the COVID-19 pandemic
Four of 10 studies discussed teledentistry teledentistry (Crawford & Taylor, 2020; Giudice et al., 2020; Mathivanan et al., 2020; Yang et al., 2020), while three of four studies (Crawford & Taylor, 2020; Giudice et al., 2020; Yang et al., 2020) directly evaluated e-dentistry or teledentistry during COVID-19 pandemic. The chief dental officer for England recommended that all routine and non-urgent dental routines should be stopped. The recommendation was in line with evidence that aerosol-generating procedures performed in dental healthcare result in airborne particle’s production that can increase the transmission of COVID-19 (Crawford & Taylor, 2020).To reduce the chances of infection among patient , an e-dentistry service during the pandemic required providing quality oral care to patients with computers, the internet , and software ( Mathivanan et al., 2020). Creating a remote e-dentistry service during the COVID-19 pandemic required teamwork and management support (Crawford & Taylor, 2020). There are two distinct approaches to e-dentistry, including the storage and forwarding of images or texts and the use of real-time communications such as video consulting (Crawford & Taylor, 2020; Giudice et al., 2020). The use of teledentistry can significantly improve oral and dental healthcare (Crawford & Taylor, 2020; Giudice et al., 2020; Mathivanan et al., 2020; Yang et al., 2020).Teleconsultations have been essential in facilitating patient compliance and establish stronger doctor-patient relationship (Giudice et al.,2020). Emergency consultation related to oral health issue has been reduced with the use of telemedicine. Before the COVID-19 pandemic, patients used to call the health facilitates to book emergency consultations. For instance, in the study conducted by Giudice et al. (2020), a generic email address was sent to patients during the pandemic through answer-phone message and a trust website. Patients were also advised to take photos of them and send them via email to help diagnose the oral health problem and reduce their infection chance with COVID-19. One clinician was responsible for emergencies each day, and the email was checked by secretaries working remotely.
COVID-19 related postponement of oral and dental care and fear of infection by dentist
Two studies of 10 studies evaluated postponed dental care visits (Hajek et al., 2021; Kranz et al., 2021), while one study (Ahmed et al., 2020) evaluated the fear of infection by health care professionals. Some patients postponed or canceled visits to the healthcare facilities if the oral health condition was not an emergency to reduce human contact chances, reducing COVID-19 infection rate. Hajek et al. (2021) evaluated 974 participants, and the finding shows that 22% of the respondents postponed dental care visits. Among the 22%, 72% of the participants postponed regular dental care examination while 19.6 percent postponed planned therapy. The study by Kranz et al. (2021) suggested that nearly 50 percent of American adults postponed their dental care due to the COVID-19 infectious virus.
According to Ahmed et al. (2020), of 650 dental care professionals across 30 countries, 87% of dentists were afraid of getting infected with a patient’s virus, 72% of respondents reported that they feel nervous when talking to patients in close vicinity. The study showed that 66% of the respondents wanted to keep their clinics closed. Healthcare providers are at high risk of infection due to their close contact with infected patients (Ahmed et al., 2020). Once dentists acquire the COVID-19 virus, they risk spreading it to their peers, families, and other patients. Therefore, it is natural for dentists to develop the fear of infection with the COVID-19 virus. Overwhelming repots given on the COVID-19 pandemic on social, electronic, and print media also contribute to fear and anxiety among oral healthcare providers. Therefore, they develop safeguarding behavior by preferring to have their clinics remain closed to minimize the risk of getting infected with COVID-19 (Ahmed et al., 2020). The postponement of the dental care services impacts the health of the adults negatively. Hajek et al. (2021) show that postponed dental care can increase the risk of adverse health outcomes, postponed dental care can cause poor oral health and increase the risk of adverse health outcomes and also increase developing the same medical conditions, therefore, improving oral health may reduce the morbidity of COVID-19.
Impact of COVID-19 on classification of dental emergencies and non-emergencies
In two of the studies by Yang et al. (2020) and Crawford and Taylor (2020), the researchers evaluated the effect of classification of dental emergencies and non-emergencies on oral health during the COVID-19 pandemic. A particular classification of dental emergencies and non-emergencies was developed and is crucial in guiding oral health provision during the COVID-19 pandemic (Yang et al., 2020). Dental emergencies that require immediate intervention include uncontrolled bleeding, diffuse soft-tissue bacterial infection, and maxillofacial fractures. Dental non-emergencies do not require immediate intervention and can be managed using palliative measures to reduce emergency visits and consequently minimize infection risk with COVID-19 (Yang et al., 2020). Treatment review clinics were set up, and they were essential in supporting the patients, reassuring them help was available, and educating them on the new emergency protocols introduced during COVID-19 pandemic. Patients were advised on appropriate oral hygiene and diet to maintain dental health (Crawford & Taylor, 2020).
Impact of COVID-19 on Pediatric Oral Health
While eight of 10 studies evaluated adult patients, two studies evaluated pediatrics oral health during the COVID-19 pandemic (Luzzi et al., 2020; Yang et al., 2020). Luzzi et al. (2020) argued that pediatric oral health is at risk due to the pandemic. Also, children were more prone to injury, poor oral hygiene, and high intake of desserts due to their lively nature and irregular living habits compared to adults (Yang et al., 2020). During the pandemic, children spent most of their time at home, which contributed to unhealthy eating habits with increased risk of caries and traumatic events. Therefore, there has been a contradiction between the vast pediatric demands and the limited medical resources during the COVID-19 pandemic (Yang et al., 2020). Luzzi et al. (2020) indicated that the first way of spreading the COVID-19 virus among pediatric patients was direct transmission through the respiratory droplets. There was a possibility of transmitting the COVID-19 virus between the patient, dentist, and the dentist Helpant. The virus could be transmitted by coughing , sneezing , or the dental procedures (Luzzi et al .,2020), there can also be an indirect transmission when droplets containing the virus settle on instrument surfaces, with the consequent transmission when the pediatric dentist, dental Helpant , or other patients come into contact with the contaminated surface (Luzzi et al .,2020). When high-speed turbine , ultrasonic scaler , and spray guns are used, an aerosol of saliva, blood , and other fluids that remain in air suspension for long periods increase the risk of infection with COVID-19 in pediatric oral care facilities ((Luzzi et al .,2020).
The failure of parents to take children for dental care increases the risk of adverse oral health outcomes. Pediatricians indicate that children are high-risk transmitters of the virus, and thus dentists are shy to accept non-emergency pediatric dental care services during a pandemic. Luzzi et al. (2020) developed consultation and orientational tool on operative protocols in pediatric dental practices during the COVID-19 pandemic to manage and limit infection spread in the pandemics. Yang et al. (2020) demonstrated that consultation for regular and emergencies and pediatric dentistry management could increase when dentists embrace the online approach. A study conducted on 474 online consultations by Yang et al. (2020) within 59 days of lockdown indicated that 190 (40.1%) were dental emergencies while 284 (59.9%) were non-emergencies (Yang et al., 2020). The study also confirmed the adoption of teledentistry to facility access for reduced the virus’s transmission risk.
Relationship between Dental Stage Damage and COVID-19
One of 10 studies (Sirin & Ozcelik, 2021) examined the relationship between dental stage damage and the symptoms associated with COVID-19. In the past, various scales have been developed as indicators of oral and dental status. The most commonly used scales include the total dental index, the modified total dental index, the dental asymptomatic score, the global oral health scale, and the brief oral health status examination.
These scales require intraoral examination and measurements to gouge dental damage. Sirin and Ozcelik (2021) developed a classification score based on more rational radiographic data to sow dental health status comprehensively. The classification designed by Sirin and Ozcelik (2021) does not require direct contact between patients and dentist during COVID-19 pandemic, thus reduced infection risk. The classification scale also has a practical and easy algorithm that provides broad information about a patient’s dental health status. According to the classification, there was a significant correlation between the DD stg (Differential diagnosis short-term goal) and the mortality and morbidity cause by COVID-19 disease. COVID-19 related mortality and morbidity were significantly higher in DD stg 2 and 3 (Sirin & Ozcelik, 2021), it is essential to emphasize oral and dental healthcare of patients over 50 years old. Nutrition plays a significant role in oral and dental health (Sirin & Ozcelik, 2021).Elderly patients in DD stg 3 were most likely to have poor nutrition, thus increasing their risk of infection with COVID-19. Sirin and Ozcelik (2021) also stated that the higher the DD stg, the higher the rate of hospitalization and chance of infection with COVID-19 because an individual resistance to viral disease depends on overall well-being, including both immune system and dental health status. Therefore, oral, and dental hygiene can be used to measure resistance to viral diseases such as COVID-19 (Sirin & Ozcelik, 2021).
Strategies to Enhance Access to Dental Care
Strategies to enhance access to dental care were assessed in 6 out of 10 articles (Brian & Weintraub, 2020; Dziedzic et al., 2020; Crawford & Taylor, 2020; Giudice et al., 2020; Mathivanan et al., 2020; Yang et al., 2020). The dental care crisis requires a proactive approach to improve the oral health of the population. Communication between patients and healthcare providers is critical and should be improved to reduce the rate of COVID-19 infections (Brian & Weintraub, 2020). Effective communication plays a significant role in in reducing anxiety among healthcare providers and patients. Healthcare providers may be anxious about returning to work amidst COVID-19 pandemic, and patients may be hesitant to enter a dental care office. Clear communication is also essential for low-literacy patient population. Message can also be used by providers to communicate with patients effectively to promote oral health (Brian & Weintraub, 2020). Surveillance and monitoring should be conducted to determine whether COVID-19 infections occur in the dental office. The availability and effectiveness of personal preventive equipment (PPE) should be monitored and determined (Brian & Weintraub, 2020).
According to Brian and Weintraub (2020), the public should eat healthy diets, and take dental sealant to improve health quality. During pandemic, many states modified public policies to meet the demand of their most vulnerable residents by protecting and enhancing Medicaid reimbursement. Advocacy efforts will be essential for secure continuity of these provisional changes. However, given current circumstance, policymakers must consider expanding adult dental benefits under Medicaid rather than reducing them.
Dziedzic et al. (2020) argued that taking care of the population embraces continuous care for vulnerable populations. Some of the vulnerable people affected by poor access to dental care services include minority groups, low-income families, low literacy individuals, and the elderly.
The provision of care for the vulnerable populations needs to match with the new reality. According to Dziedzic et al. (2020), the empathy scale needs to be broader during the COVID-19 pandemic leading to an extensive knowledge of patient problems. Genuine empathy and effective resolve should be shown for patients with difficulties or vulnerable patients (Dziedzic et al., 2020).
The pandemic offers dental care professionals an opportunity to shift to non-aerosol-generating procedures, prevention-centric approaches, and limit surgical interventions. According to Crawford and Taylor (2020), the effective use of e-dentistry service during the COVID-19 pandemic can increase the response measures against the virus. According to three studies (Crawford & Taylor, 2020; Giudice et al., 2020; Mathivanan et al., 2020; Yang et al., 2020), teledentistry can enhance patients’ access and monitoring during the COVID-19 pandemic. The studies emphasize that dentists should align their healthcare delivery with the new reality, which comprises the adoption of teledentistry to minimize facility visits and reduce the transmission rates of COVID-19. Teledentistry has been used during the COVID-19 pandemic for education, consultation, and triage (Brian & Weintraub, 2020; Dziedzic et al., 2020). A virtual office approach can increase access to healthcare services related to dental care during the COVID-19 pandemic. Crawford and Taylor (2020) show that healthcare workers can provide dental services and prescribe medication to patients without physical contact using video conferencing.
Conclusion
The suspension of oral healthcare services by the American Dental Association led to the high risk of oral heal disparities. Medical literature research of 11 studies shows the minority and vulnerable groups are at risk of severe oral dental damage. Population at a higher risk of acquiring the viral disease, such as individuals in low socioeconomic groups, low literacy, the elderly, people living in rural areas, and the uninsured, have an increased likelihood of oral diseases. The risk is higher due to poor access to the oral care and suspension of elective oral care services during the pandemic. A meta-analysis of the peer-reviewed studies shows the need to implement teledentistry to reduce the risk of infection. Proactive measures are necessary to prevent the risk of infection such as maintaining oral hygiene, eating healthy meals, limited surgical interventions, and using non-aerosol-generating procedures. Dentists should align their healthcare service delivery with the new reality during and post-pandemic.

References
Abbas , B. , Wajahat, M., Saleem, Z., Imran, E., Sajjad, M. & Khurshid , Z. (2020). Role of
Teledentistry in COVID-19 pandemic: A nationwide comparative analysis among dental professional. European journal of dentistry, 14 (S 01), p 116-122. DOI: 10.1055/s-0040-1722107
American Dental Association, Health Policy Institute (2020). COVID-19: Economic impact on
dental practices, retrieved from https://surveys.ada.org/reports/RC/public/YWRhc3VydmV5cy01ZWQ2NjRiNzBhNzI3MTAwMGVkMDY2ZTQtVVJfNWlJWDFFU01IdmNDUlVO
Brian, Z & Weintraub, J.A. (2020). Oral health and COVID-19: Increasing the need for
prevention and access, Preventing chronic disease, DOI: http://dx.doi.org/10.5888/pcd17.200266
Botros, N., Iyer, P. & Ojcius, M.D. (2020). Is there an association between oral health and
the severity of COVID-19 complications? Biomedical Journal, 43 (4), P 325-327 https://doi.org/10.1016/j.bj.2020.05.016
Crawford, E. & Taylor, N. (2020). The effective use of an e-dentistry service during the
COVID-19 crisis. Journal of Orthodontics 47 (4), 330-337. DOI: 10.1177/1465312520949557
Center for Disease Control and Prevention (CDC), (2021). People with certain medical
conditions, Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html
Dziedzic, A., Tanasiewicz, M., & Tysiac-Mista, M. (2020). Dental care provision during
Coronavirus disease 2019 (COVID-19) pandemic: The importance of continuous support for vulnerable patients. Medicine (Kaunas, Lithuania), 50 (6), 294. DOI: 10.3390/medicina56060294
Giudice, A., Barone, S., Muraca, D., Averta, F., Antonelli, A. & Fortunato, L. (2020). Can
teledentistry improve the monitoring of patients during the Covid-19 dissemination? A descriptive pilot study. International Journal of Environmental Research and Public Health, 17 (10). p 3399. https://doi.org/10.3390/ijerph17103399
Hajek, A., De Bock, F., Huebl, L., Kretzler, B. & Konig, H.H. (2021). Postponed dental visits
during the COVID-19 pandemic and their correlations. Evidence from the nationally representative COVID-19 snapshot monitoring in Germany (COSMO). Healthcare, 9 (1), 50, https://doi.org/10.3390/healthcare9010050
Hopcraft, M. & Farmer, G. (2020). Impact of COVID-19 on the provision of paediatric dental
care: Analysis of the Australian child dental benefits schedule. Community dentistry and oral epidemiology, Advanced online publication. DOI: 10.1111/cdoe.12611
Kranz, A.M., Gahlon, G. Dick, A.W. & Stein, B.D. (2021). Characteristics of U.S. adults
delaying dental care due to COVID-19 pandemic, JDR Clinical and Translational Research, 6 (1), 8-14. DOI: 10.1177/2380084420962778
Luzzi, V., Lerardo, G., Bossu, M. & Polimeni, A. (2020). Pediatric oral health during and after
the COVID-19 pandemic. International Journal of Pediatric Dentistry, 31(1), p 20-26, https://doi.org/10.1111/ipd.12737
Mathivanan, A. Gopalakrishnan, J.R., Dhayanithi, A., Narmatha, M., Bharathan, K., & Saranya,
(2020). Teledentistry: is it the future of rural dental practice? A cross-sectional study. Journal of Pharmacy & Biogllied Sciences, 12 (suppl 1), p 304-307. DOI: 10.4103/jpbs.JPBS_91_20
Nasseh, K. & Vujicic, M. (2020). COVID-19’s impact on the dental care sector , Modeling the
impact of COVID-19 on U.S. dental spending – June 2020 update, (HPI) Health Policy Institute , (ADA) The American Dental Association (ADA) , retrieved from https://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0620_1.pdf?la=en
Rahman, N., Nathwani, S. & Kandiah, T. (2020). Teledentistry from a patient perspective during
the coronavirus pandemic. British dental journal, 229 (3) 1-4. Advance online publication. DOI: 10.1038/s41415-020-1919-6
Ren, Y. F., Rasubala, L., Malmstrom, H., & Eliav, E. (2020). Dental care and oral health under the clouds of COVID-19. Journal of Dental Research Clinical & Translational Research, 5(3), 202-210. https://doi.org/10.1177%2F2380084420924385
Sirin, D.A. & Ozcelik, F. (2021). The relationship between Covid-19 and the dental damage
stage determines by radiological examination. Oral Radiology, 3: 1-10. Advance online publication 17: 200266, DOI: 10.1007/s11282-020-00497-0
Solana, K. (2020). ADA develops guidance on dental emergency, non-emergency care. retrieved
from https://www.ada.org/en/publications/ada-news/2020-archive/march/ada-develops-guidance-on-dental-emergency-nonemergency-care
Yang, F., Yu, L., Qin, D., Hua, F. & Song, G. (2020). Online consultation and emergency
management in paediatric dentistry during the COVID-19 epidemic in Wuhan: A retrospective study. International Journal of Pediatric Dentistry, 31 (1), 5-11, https://doi.org/10.1111/ipd.12722

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