A perspective on dental activity during COVID-19: The Italian survey

A systematic review of dentists' psychological wellbeing during the COVID-19 pandemic

Background The COVID-19 pandemic presented significant challenges to healthcare workers worldwide, including the effect on the psychological wellbeing of dentists.Aims To evaluate the impact of the early phases of the pandemic on the psychological health, long-term wellbeing and clinical service provision of dentists, as well as the identification of the key risk and protective factors for adverse mental health outcomes (MHOs) in this group.Methods A systematic review of cross-sectional studies (n = 53) from public and private dentistry sectors was employed to delineate the risk and protective factors for adverse MHOs.Results Self-reports from these studies (1 December 2019 to 31 December 2021), involving 45,671 dentists worldwide were analysed. Study findings were classified according to their psychological impact (as risk or protective factors), categorised as 'operational' or 'organisational' and subdivided into 'psychosocial', 'occupational', 'sociodemographic' and 'environmental' elements. A GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) certainty of evidence score was calculated for all the identified factors.Conclusions This review confirmed the negative impact of the pandemic on the MHOs of dentists worldwide. Pivotal risk factors included fear of infection, transmission to families, lack of personal protective equipment and possible direct contact with infected patients. Enhanced infection control protocols, individual resilience and organisational support were identified as important protective factors.

Impact of the COVID-19 Pandemic on the Dental Preferences of Patients at Private University Hospitals in Riyadh, Saudi Arabia

Studies that particularly look into how the pandemic has affected Saudi Arabian patients' dental preferences are scarce. The majority of the research done so far has focused on the pandemic's broad effects on oral health rather than the specific changes in patient preferences for dental care. Therefore, the primary goal of the study was to examine how patients at a private university dental hospital underwent dental procedures both before and after the pandemic. The study is a retrospective analysis of patient data from March 2019 to February 2022 obtained from electronic hospital records (Dentoplus). The data extracted information pertaining to the number of patients and their periodic visits. The data was examined via statistical tests. At 0.05, the significance level was chosen. According to the research, compared to non-lockdown times, lockdown times saw a considerable drop in the number of patients scheduling appointments. There was also a significant decrease in the number of first-time patients during lockdown periods. The study also revealed a significant increase in the number of cancelled appointments and patients who discontinued treatment during lockdown periods. The age and gender of the patients did not have a significant effect on these findings. The study's findings suggest that dental professionals need to be aware of these changes in patient behavior and adapt their services accordingly. Dental clinics may need to focus on promoting their services and ensuring that patients feel safe and comfortable seeking dental care during the pandemic.

A Survey on forensic odontologists' activity in Italy during the COVID-19 pandemic

Few information on virus contagion at the beginning of the covid-19 pandemic led to severe restrictions in the dental and forensic activity in Italy, the introduction of procedural guidelines and implementation of preventive measures. A specific survey on Italian forensic odontologists (FOds) activity was conducted to investigate the COVD-19 pandemic impact on daily practices, the preventive measures adopted to manage the risks of contagion procedures performed on living and dead people and the possible peculiar cases that required the intervention of a medical examiner. A total of 122 FOds answered, mostly males over 46 years coming from northern Italy. The results highlight the lack of specific guidelines for the procedures on living people compared to those on the dead but the regulations for the daily clinical practice resulted more than sufficient: in fact, more than 80% of FOds adopted the preventive and safety measures provided for dental practices. The forensic activity significantly decreased during the initial period (more than 75%) and gradually normalized to pre-pandemic numbers in approximately 50% of cases after the implementation of the vaccination campaign. 13 cases of occupational contagion have been reported, most of them (more than 85%) in northern and central Italy. In two cases members of the dental staff sued the employer for responsibility in the contagion. The decrease of the overall ID activity during the pandemic time can be more likely attributed to the of the dental data than the real impact of the pandemic regulations. The use of telematic tools, such as teleconferences, for many procedures proved to be an important resource useful for application even in post-pandemic times.

The COVID-19 outbreak on dental practice in State of São Paulo, Brazil

Brazil has become the epicenter of coronavirus disease, and the São Paulo State has the worst scenario. This study evaluated the effect of the COVID-19 in dentists of São Paulo State, Brazil. A self-administered web-based survey with 33 multiple-choice questions was sent to dentists. Descriptive statistics were used to assess the 302 valid responses. Data were analyzed by Chi-square, McNemar and Wilcoxon tests (α = 0.05). Most of the participants aged until 34 years (61.6%) and were female (74.5%). They reduced work to less than 20 h per week. Monthly remuneration was reduced (86.8%). Personal protective equipment at the office was changed (p < 0.05). A few dentists (7.6%) had COVID-19, and more than 99% were aware of the disease. Most of the participants (90.2%) were insecure about being contaminated. The dentists of São Paulo State had coronavirus knowledge and have adopted strict biosafety protocols, but the pandemic affected their financial and psychological features.

Coronavirus disease 2019 (COVID-19) vaccines: A concise review

The development of a successful vaccine against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the agent of coronavirus disease 2019 (COVID-19), in an unmatched period of ten months, is a tribute to human ingenuity in the face of a vicious pandemic. A return to pre-pandemic "normalcy" depends on the successful delivery of the vaccine to a majority (~70%) so as to develop herd immunity critical to arrest the community spread of infection. Vaccination against COVID-19 is particularly important for dentistry as the dental team works in an environment replete with aerosol-generating procedures (AGP) that facilitate virus spread. Hence, a COVID-19 vaccine is likely to be an obligatory requirement for the dental practice, and the latest addition to the extensive list of vaccines required for dental professionals for the safe delivery of dental care. Here, we review the currently available major candidate vaccines against SARS-CoV-2 and their benefits and risks. These include the vaccines developed on next-generation platforms (mRNA, DNA, and viral vector vaccines), and the classic platforms (the live-attenuated virus, and the protein subunit vaccines) The review concludes with a summary of impending issues and challenges facing the provision of COVID-19 vaccines for all stakeholders in dentistry.

COVID-19 Vaccination among Czech Dentists

This work describes and evaluates vaccination against COVID-19 among members of the Czech Dental Chamber during the pre-booster vaccination phase. A cross-sectional online survey was conducted between 23 June and 4 September 2021, among 2716 participants, representing 24.3% of all chamber members. A total of 89.5% of respondents stated that they were registered for vaccination against COVID-19, their vaccination had started or been completed, or had a medically relevant reason to avoid vaccination. A total of 79.6% of respondents stated that they were fully vaccinated, most of them with the Comirnaty (Pfizer−BioNTech) vaccine (88.3%). The vaccination rate among males was significantly higher than among females (p = 0.001, OR 1.48). The main reasons for vaccination were professional (91.5%). The share of fully vaccinated participants was significantly higher (p < 0.0001, OR = 8.17) compared to the Czech general population (30.8%). A COVID-19 vaccine breakthrough infection rate was 0.42%. The study shows that both the willingness to vaccinate and the proportion of fully vaccinated individuals among Czech dentists are high, and only about 10% of them refused vaccination based on reasons classified as not medically relevant.

Impact of the COVID-19 Pandemic on the Dental Preferences of Patients in the Private Sector

Proper oral health care has an impact on the health of the entire body. The COVID-19 pandemic has affected the functioning of the healthcare sector, including dental services. The aim of this study was to analyse the behaviour of patients with regard to their use of dental services during the pandemic. The data were obtained from paper registration forms taken from five dental offices in the city of Cracow between March 2019 and February 2021. During the analysed periods, interest among first-time patients in dental services decreased to 37% (during the month when interest in dental services was at its lowest) compared to the year preceding the COVID-19 pandemic. The number of cancelled visits increased by between 15% and 50% compared to the pre-pandemic period. During the pandemic, appointments made by existing patients increased by up to 84% compared to 2019. The decision by patients to postpone dental treatment not only has adverse effects on their oral and body health, but in turn results in higher health care costs. Given the potential for another pandemic, further long-term research is required to develop and implement special protocols to make the public aware of the safety of health care.

Dental Emergency Admissions in Emergency Oral Health Care Centers during COVID-19 Pandemic in Buenos Aires, Argentina

This study aimed to describe patients’ demographic characteristics and treatment delivered in private and public dental emergency clinics and to compare them with a pre-pandemic period. A retrospective cross-sectional study was carried out on patients attending the University Dental Hospital of the University of Buenos Aires and on one private dental clinic, situated in Buenos Aires, between March and June of 2019 and 2020. The sample considered all the patients’ medical records of those requiring emergency dental treatment at these centers during that period. We systematize the treatments required and delivered by the emergency providers into categories. In 2019, 36,071 patients were treated at the university dental hospital and the private clinic. In 2020, 7485 patients received emergency treatment, showing a fivefold reduction. During a pre-pandemic period, in 2019, both oral care centers provided 44,894 treatments, around three times the treatments provided in 2020 during the same period. We have found significant differences in the age groups of people who required emergency treatment in the pandemic period compared to the pre-pandemic period. During the pandemic period, the most represented types of treatment were radiographic exams (3061) and tooth extractions (2583). Conversely, during the pre-pandemic period, the most frequent treatments were radiographic examinations (16,649) and general consultations (10,591). The percentages of all types of treatments differ significantly between the two years except for pediatric consultations and prosthetics emergencies. As the pandemic is still an ongoing sanitary problem, urgent dental care patterns should be considered.

COVID-19 Prevalence among Czech Dentists

This work evaluates the prevalence of coronavirus disease (COVID-19), a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), among members of the Czech Dental Chamber. The assessment was based on an online questionnaire filled out by 2716 participants, representing 24.3% of all chamber members. Overall, 25.4% of the participants admitted they were diagnosed with COVID-19 by 30 June 2021, with no statistical differences between the sexes. While in the age groups under 50 the reported prevalence was around 30%, with increasing age, it gradually decreased to 15.2% in the group over 70 years. The work environment was identified as a place of contagion by 38.4% of the respondents. The total COVID-19 PCR-verified positivity was 13.9%, revealing a statistically lower prevalence (p = 0.0180) compared with the Czech general population, in which the COVID-19 PCR-verified positivity was ~15.6% (fourth highest rank in the world). The total infection–hospitalization ratio (IHR) was 2.8%, and the median age group of hospitalized individuals was 60–70 years. For respondents older than 60 years, the IHR was 8.7%, and for those under 40 years, it was 0%. Of the respondents, 37.7% admitted that another team member was diagnosed with COVID-19, of which the most frequently mentioned profession was a nurse/dental assistant (81.2%). The results indicate that although the dentist profession is associated with a high occupational risk of SARS-CoV-2 infection, well-chosen antiepidemic measures adopted by dental professionals may outweigh it.

Knowledge and Attitude of Polish Dental Healthcare Professionals during the COVID-19 Pandemic

Objectives: This study analyzed Polish dentists’ knowledge of the SARS-CoV-2 virus and the main problems in their work during the early phase of the pandemic. Methods: Dentists responded to an online anonymous survey consisting of 57 questions relating to socio-demographics, knowledge about COVID-19, and office procedures. The obtained data were analyzed using basic descriptive statistics, significance of dependencies and Chi square and Mann–Whitney tests; p < 0.05. Results: Ultimately, responses from 730 dentists were included. The mean age was 43.62 ± 11.57. Almost 3/4 of the respondents followed the information on COVID-19. A total of 95.5% had knowledge about COVID-19. Genetic testing was the basic test according to 69.2%. Further, 56.0% were concerned about the pandemic, and 23.6% were significantly anxious. In addition, 42.1% considered a risk of infection with the SARS-CoV-2 in the workplace as very high. A total of 84.0% admitted patients performing a triage and using personal protective equipment (PPE). Further, 44.5% planned to become vaccinated. Continuing the work during the pandemic was strongly correlated with age, sector, and location and duration of work. Conclusions: Most Polish dentists follow the information on the COVID-19 protocol and have sufficient knowledge about COVID-19. Dentists are concerned and anxious about the situation. The vast majority admitted patients during the pandemic and use PPE. Only almost half plan to be vaccinated.

Clinical Experience, Knowledge, Attitudes and Practice of Turkish Pediatric Dentists during the COVID-19 Pandemic

Background and Objectives: “Coronavirus Disease 2019” (COVID-19) is a critical public health problem that has affected all fields, including dentistry. The dental management of children has become even more difficult during the COVID-19 pandemic. The purpose of this study was to evaluate the current knowledge, attitudes and practices of Turkish pediatric dentists who have been providing dental treatments to children during the COVID-19 pandemic. Materials and Methods: After receiving ethical approval, this cross-sectional study was conducted using the Google Forms online survey instrument. An online questionnaire link was sent to all the members of the Turkish Society of Paediatric Dentistry by e-mail and through social media. Statistical analyses were performed using descriptive statistics and Chi-square test; a p-value less than 0.05 was considered statistically significant. Results: A total of 200 pediatric dentists participated in this study and most of them (82%) only performed emergency dental treatments, whereas 18.5% performed both emergency and routine dental practices during the COVID-19 pandemic. The vast majority (72.5%) of pediatric dentists prescribed antibiotics and analgesics to their patients who were not cooperative with non-pharmacological behavior management techniques. The findings of the current study showed that the Turkish pediatric dentists had a good level of knowledge about COVID-19, satisfactorily conducted most of the infection control measures before and after the dental treatments, and attached importance to the use of PPEs; however, infection control measures during the dental treatments could be implemented better. Conclusions: Along with all precautions, the vaccination of healthcare workers and requesting a recent test result from patients showing a lack of COVID-19 disease before dental appointments could be used as effective infection control measures. Additionally, pediatric dentists should continue to follow local and universal guidelines, and education programmes should be frequently implemented in order to keep their COVID-19 management strategies up to date.

Impact of COVID-19 on Czech Dentistry: A Nationwide Cross-Sectional Preliminary Study among Dentists in the Czech Republic

This work evaluates the impact of the COVID-19 pandemic on Czech dentistry from March 2020 to March 2021. The assessment was based on questionnaires filled out by 3674 Czech dentists representing 42.6% of practicing dentists in the country. During March-May, 2020 (the first COVID-19 wave), 90.7% of dental practices remained open; however, only 22.8% of the practices continued to operate with no changes, 46.5% had fewer patients, 21.4% treated only acute cases, and 3.8% were closed. During September 2020-May 2021 (the second wave of COVID-19), 96.1% of dental practices remained open, 60.8% operated with no changes, 34.5% had fewer patients, 0.8% treated only acute cases, and 0.5% were closed. The reasons leading to the closure of Czech dental practices during the whole pandemic were a shortage of personal protective equipment (50.5%), a COVID-19 outbreak in the workplace (24.5%), fear of a possible self-infection (24.0%), and quarantine (20.5%). The time range of Czech dental practices closure during the whole pandemic was: 1-2 weeks (49.9%), 2-4 weeks (21.2%), and >1 month (0.8%). The greatest professional difficulties of Czech dentists during the pandemic were crisis operating management (55%), health safety and hygiene concerns (21%), shortage of personal protective equipment (21%), and difficulty working with the protective equipment (15%). In addition, 47.3% of dentists also observed a declining interest in preventive dental care, and 16.9% of them observed worse oral care of patients. These results show that despite the lack of protective equipment, dental care was maintained throughout the pandemic. Additionally, the pandemic negatively affected the patients' approach to dental care, indicating a deterioration in oral health as a possible delayed outcome of the COVID-19 pandemic.

How dental activity has changed following COVID-19: single centre experience

BACKGROUND

COVID-19 outbreak had an extremely relevant impact on dental activity. Since the beginning of the pandemic, a previously unseen change in terms of procedures, organization of patient flow, and personal protective equipment (PPE) employed led to a reorganization of all the aspects of patient management. The aim of the present study was to report and compare current dental activity with pre-COVID era.

METHODS

Data on the dental activity in the period 9th March - 9th September 2020 were retrieved and compared with the same period of the previous year. The differences with pre-COVID era in terms of patient schedule and PPE were evaluated using Student t-test for independent data. Significance was set at p<0.05.

RESULTS

During the lockdown, dental activity was reduced by almost the 90%, although emergencies and urgent treatments were still performed in a high number of patients. In the six months comprised between March and September 2020, the overall activity decreased by the 50% compared to the same period of the previous year. The access to the department was modified in order to guarantee a safe patient flow. Triage and temperature measurement were performed in all patients to exclude both the presence of symptoms and potential contact with infected subjects. Moreover, appointments were scheduled every 45 minutes, and the waiting rooms reorganized. A higher number of PPE items was employed by dental health care workers.

CONCLUSIONS

Overall, the measures adopted appear effective in guaranteeing a safe dental activity both for patients and dental health care workers.

Influence of the COVID-19 Pandemic on Dental Emergency Admissions in an Urgent Dental Care Service in North Italy

A retrospective study was performed to verify if the number of admissions for urgent dental care in the Urgent Dental Care Service of San Paolo Hospital in Milan (Italy) was directly related to the different phases of the COVID-19 pandemic. Different periods were analyzed: 25 March-5 April 2019 (pre-COVID); 23 March-3 April 2020 (lockdown); 8 June-19 June 2020 (reopening); and November 9-November 20 (second wave). Raw data regarding admissions, diagnoses, and treatments were extracted. Descriptive and bivariate analyses were performed. The survey included 901 admissions, 285 in pre-COVID, 93 during lockdown, 353 in reopening, and 170 in the second wave. In each time period, statistically significant differences were found in the prevalence of each kind of diagnoses (χ2(3) = 20.33 p = 0.01 for endodontic emergencies, χ2(3) = 29.05 p < 0.01 for cellulitis/phlegmon, χ2(3) = 28.55 p < 0.01 for periodontal emergencies, Fisher's Exact Test p < 0.01 for trauma, and χ2(3) = 59.94 p < 0.01 for all other kinds of diagnosis). A remarkable increase in consultations (+186.36%) and other treatments (+90.63%) occurred during reopening. Tooth extraction was the most frequently delivered treatment, but suffered the largest reduction during lockdown (-79.82%). The COVID-19 pandemic has highly affected dental activity in north Italy, underling the weaknesses of a private dental system in a pandemic scenario.

COVID-19 Vaccine Acceptance Among Dental Professionals Based on Employment Status During the Pandemic

The COVID-19 pandemic spread rapidly across the globe, leading governments to impose prolonged lockdowns on both movement and commerce. Although lockdowns decrease the rates of novel infections, they can have devastating consequences on the economy and employment levels. One of the most severely affected sectors during this crisis has been dental medicine. Dental professionals are uniquely exposed to environments with high levels of occupational hazards, conferring additional risks of viral exposure and transmission. We analyzed 506 anonymous questionnaires completed by dentists and residents regarding acceptance of a future potential SARS-CoV-2 vaccine. Our results demonstrate a statistically significant correlation between the individual's unemployment rate and their willingness to inoculate with a SARS-CoV-2 vaccine when it becomes available. This information can be used to predict trends of vaccine acceptance or rejection based on economic burden during the COVID-19 pandemic by different sectors as part of the preparedness toward global vaccination programs.

Evaluating the Influence of COVID-19 Among Dental Practitioners After Lockdown

Clinical activities at dental premises after the COVID-19 lockdown period or post-COVID-19 are likely to be a challenge for all practicing dentists. To assess the impact of the COVID-19 pandemic on dentists and change in dental practice following lockdown, a total of 1150 participants were approached through online survey forms registered on www.surveys.google. A link containing details of the questionnaire and a consent form was sent to dentists through emails and social media forums. The questionnaire included 3 domains comprising of seventeen questions. The first section focused on demographics. The second section inquired about the change in dental practice, that is, clinical hours, use of PPE, type of treatment, and patient flow. The third section investigated the impact of COVID-19 on dentistry. Means, standard deviation, and percentages were calculated using descriptive statistics. Chi-square was used to find an association between different variables. The response rate was 87%. Demographic factors revealed participants aged from 20.45 to 40.55 years. The data showed around 89.6% (896) of dentists have altered their clinical working hours post lockdown and, approximately, 59.7% (597) of dentists provided only emergency treatments. 88.1% (881) of the dentists wore PPE during dental procedures. Overall, a huge negative impact of the COVID-19 pandemic was observed among practicing dentists in terms of the dental supply chain, cost, and availability of dental equipment, treatment cost, and bill payments.COVID-19 pandemic compromised dental care. Though dentists were taking precautionary measures and have changed their practice according to the guidelines provided by the ADA and World Health Organization, they were still experiencing monetary loss due to decrease patient influx post lockdown.