The available data regarding the short and long-term consequences of COVID-19 is still insufficient. This narrative review aims to provide information on the prolonged COVID-19 symptoms in recovered patients and their implications during dental management. Additionally, this manuscript highlights the oral manifestations of COVID-19 and its management. A systematic search was conducted in PubMed, Embase, Cochrane Library and Web of Science databases, WHO and CDC websites, and grey literature was searched through Google Scholar. Clinical articles (clinical trials, case-reports, cohort, and cross-sectional studies) were included, reporting prolonged post-COVID-19 symptoms. Although COVID-19 is an infectious disease primarily affecting the lungs, its multi-organ involvement is responsible for several prolonged symptoms, including oral implications. In recovered patients with prolonged COVID-19 symptoms, considerations for providing dental treatment has to be made as they can present with assortment of symptoms. These prolonged post-COVID-19 symptoms can affect the delivery of the required dental treatment. Hence, the recommendations proposed in this narrative review can be a useful starting point to aid dental teams providing adequate care for such recovered patients.

Objective In response to the coronavirus disease 2019 (COVID-19) pandemic, the Indian Government imposed a countrywide lockdown of 21 days from March 25 to April 14, 2020, which was further extended to 60 days. The sudden draconian measures changed the delivery of dental education and practice throughout the country. The study aimed to screen for depression during the COVID-19 lockdown and the factors associated with it among dental students and practitioners in highly COVID-19 infected states of India.Materials and Methods The current study is an online cross-sectional survey performed in Delhi NCR, Maharashtra, and Tamil Nadu during May 2020. The participants were recruited by convenience sampling. The main outcome measure was the screening of depression using the Patient Health Questionnaire (PHQ-9), which was categorized as mild, moderate, and severe depression. The data analysis was performed with IBM SPSS Version 23.0. A multivariable logistic regression model was fitted to identify the independent predictors of depression.Results In total, 335 dental students and practitioners participated in the survey. Among this, a significant number of the dental students (54%) and practitioners (44%) scored moderate to severe depression in terms of depression severity according to the PHQ-9 scores. Those who were screened depressed were likely to be males and younger than 30 years old. The results of correlation analysis indicated that worry about the professional growth, concerns regarding setbacks in clinical and research experiences, previous history of mental health issues, and fear of contracting COVID-19 from patients were positively related to higher depression scores in students. Moreover, for practitioners, fear of contracting COVID-19 from the patients scored higher levels of depression. The practitioners who reported less concern about their practice/job post COVID-19 lockdown and those who were able to meet their financial expenses during the lockdown were the least likely to be depressed.Conclusion The results of this study indicate a high level of depression among a significant number of dental students and practitioners. It is important to monitor and address the mental health needs of dental students and practitioners during and after the lockdown.

Background: Although well recognized for its scientific value, data sharing from clinical trials remains limited. Steps toward harmonization and standardization are increasing in various pockets of the global scientific community. This issue has gained salience during the COVID-19 pandemic. Even for agencies willing to share data, data exclusivity practices complicate matters; strict regulations by funders affect this even further. Finally, many low- and middle-income countries (LMICs) have weaker institutional mechanisms. This complex of factors hampers research and rapid response during public health emergencies. This drew our attention to the need for a review of the regulatory landscape governing clinical trial data sharing. Objective: This review seeks to identify regulatory frameworks and policies that govern clinical trial data sharing and explore key elements of data-sharing mechanisms as outlined in existing regulatory documents. Following from, and based on, this empirical analysis of gaps in existing policy frameworks, we aimed to suggest focal areas for policy interventions on a systematic basis to facilitate clinical trial data sharing. Methods: We followed the JBI scoping review approach. Our review covered electronic databases and relevant gray literature through a targeted web search. We included records (all publication types, except for conference abstracts) available in English that describe clinical trial data–sharing policies, guidelines, or standard operating procedures. Data extraction was performed independently by 2 authors, and findings were summarized using a narrative synthesis approach. Results: We identified 4 articles and 13 policy documents; none originated from LMICs. Most (11/17, 65%) of the clinical trial agencies mandated a data-sharing agreement; 47% (8/17) of these policies required informed consent by trial participants; and 71% (12/17) outlined requirements for a data-sharing proposal review committee. Data-sharing policies have, a priori, milestone-based timelines when clinical trial data can be shared. We classify clinical trial agencies as following either controlled- or open-access data-sharing models. Incentives to promote data sharing and distinctions between mandated requirements and supportive requirements for informed consent during the data-sharing process remain gray areas, needing explication. To augment participant privacy and confidentiality, a neutral institutional mechanism to oversee dissemination of information from the appropriate data sets and more policy interventions led by LMICs to facilitate data sharing are strongly recommended. Conclusions: Our review outlines the immediate need for developing a pragmatic data-sharing mechanism that aims to improve research and innovations as well as facilitate cross-border collaborations. Although a one-policy-fits-all approach would not account for regional and subnational legislation, we suggest that a focus on key elements of data-sharing mechanisms can be used to inform the development of flexible yet comprehensive data-sharing policies so that institutional mechanisms rather than disparate efforts guide data generation, which is the foundation of all scientific endeavor.

Health literacy (HL), the ability to deal with information related to one's health, may affect oral health via several routes. Therefore, this study aimed to examine the association of HL with oral diseases, and whether this association is mediated by oral health behaviour and dental care utilisation. We included 26,983 participants from the prospective multigenerational Dutch Lifelines Cohort Study to estimate the association between limited health literacy, and self-reported oral health outcomes (edentulism and gingivitis), and mediation by oral health behaviour and dental care utilisation. Structural equation modelling was used to assess HL's direct, indirect, and total effects on oral health outcomes. Limited health-literate participants had increased odds of having poor oral health outcomes, i.e. edentulism (odds ratio: 1.41; 95 %-confidence interval: 1.24 to 1.58) and gingivitis (1.22; 1.14 to 1.30). After adjustment for age, income, and education, brushing behaviour and dental care utilization showed a significant mediation effect. Brushing behaviour mediated 7.4 % of the association between HL and edentulism and 6.7 % for gingivitis. Dental visits accounted for 38.0 % of the association between HL and edentulism and 16.4 % for gingivitis. Limited HL makes edentulism and gingivitis more likely, with poor oral health behaviour and inadequate dental care utilisation being important mediators. The findings suggest that interventions should focus on helping dental professionals recognize patients with limited HL and providing training in patient-centered communication to improve oral health outcomes. This study demonstrates that limited health literacy significantly increases the risk of edentulism and gingivitis, mediated by inadequate oral health behaviours and dental care utilization. These findings highlight the need for targeted interventions to improve HL, thereby enhancing oral health outcomes and reducing disparities in clinical dental practice.

India, which has a growing base of 350 million social media users and large proportion of which are unaware about fact checking of the sources. This study aims to assess the impact of COVID-19 misconceptions on knowledge, attitude and preventive (KAP) practices in India using an online cross sectional survey and using semi-structured interviews. The 5 sections of the e-form collected the demographic profile, COVID-19 information profile, knowledge, preventive practices and attitude toward COVID-19. Also, this study aims to assess the impact of misinformation on individual and social behavior through 24 semi structured open ended interview questions and suggests mitigation measures. The misinformation question included “Coronavirus is airborne disease,” Frequent washing clothes can reduce spreading of COVID-19”, “Consuming herbal products, home cures and supplements can prevent COVID-19” and “Gargling with salt water or vinegar can prevent COVID-19.” Among the 520 responses, 44%, 51%, 44% and 32% agreed to these questions respectively. Binomial regression model was fitted to identify the predictors of KAP of COVID-19 prevention by taking the level of KAP separately and it revealed that the predictors for poor knowledge, negative attitude and noncompliance to preventive measures were associated with the misconceptions. The descriptive analysis in Tableau revealed that the trusted sources of information is majorly mass media. The content analysis of the interviews revealed that religious preventive methods, consumption of daily supplements, risk factors of the infection, disease statistics; treatments and conspiracy theory, are the subjective categories of the current outbreak. The consequences of misconceptions include stigma of discrimination, psychological distress and increased hygiene practices. The antidote to infodemics should include analyzing the information propagation and understanding the cognition and behavior of the population. In the era of the internet, health bodies can educate and address the people’s concern with the help of digital and e- health literacy.

Multimorbidity may affect oral health, especially in individuals with limited health literacy (HL), or specific multimorbidity patterns; however, evidence remains scarce. Understanding these associations could improve early detection and prevention, both in clinical care and public health strategies. This study aimed to assess the association of multimorbidity and multimorbidity patterns with complete tooth loss, i.e. edentulism, and whether HL moderates this association. A total of 42 357 participants from the prospective multigenerational Dutch Lifelines Cohort Study were included. Multimorbidity was defined by ≥2 affected disease domains. Multimorbidity patterns were constructed with latent class analysis. Associations between multimorbidity (and patterns) with edentulism were assessed using logistic regression, with HL as a potential moderator. Models were adjusted for age, household income, and education. Edentulism prevalence was 9.5% and was higher among limited than adequate HL (14.5% vs. 7.9%) and among multimorbid vs. absent (19.5% vs. 7.7%). We identified five patterns: (1) Endocrinological + Psychiatry; (2) Cardiovascular + Endocrinological; (3) Neurological + Otorhinolaryngologic; (4) Endocrinological + Otorhinolaryngologic, and (5) Otorhinolaryngologic + Psychiatric. The odds of edentulism were 2.26 higher (95% CI: 2.06—2.47) in multimorbid. Pattern 2 (Cardiovascular + Endocrinological) had the highest odds ratio of edentulism (OR: 3.52, 95% CI: 3.03; 4.08) compared to multimorbidity absent. HL did not moderate the associations between multimorbidity and edentulism. Edentulism is more likely in the case of multimorbidity, especially if cardiovascular and endocrinological conditions co-occur, an explanation being the shared risk factors. This association remains the same across different HL levels. Our findings support collaborative medical and oral healthcare.