Knowledge, stress levels, and clinical practice modifications of Turkish dentists due to COVID-19: a survey study

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.

Effect of COVID-19 on dental service delivery in Fiji: Perspective of Dental Officers (Dos) and Dental Managers (DMs)

BACKGROUND

Corona Virus Disease 2019 (COVID-19) was declared a global pandemic by the World Health Organization (WHO) has had significant impact on dentistry in Fiji. Due to lack of previous study, this study aims to explore the perspective of Dental Officers (DOs) and Dental Managers (DMs) on the effects of COVID-19 on dental service delivery in Fiji Islands.

METHODS

This qualitative study was conducted amongst 30 DOs and 17 DMs between 9th August to 12th September, 2021. It was conducted in the government dental clinics, private dental clinics and the School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji. The study settings were randomly selected. Purposive sampling method was used for the selection of participants who met the study criteria. Semi-structure open ended questionnaires were used for data collection through in-depth interviews via zoom. Manual thematic analysis of the data was conducted to derive themes and codes.

RESULTS

The participants interviewed for the study included more female DOs (66.7%) and male DMs (58.8%). Seven themes emerged from data analysis: range of services delivered, appointment versus walk-in patients for aerosol generating procedures (AGPs), impact of pandemic on clinic opening hours, impact of COVID-19 on patient numbers, quality of services delivered, resources and infrastructure, perceptions about the burden of disease.

CONCLUSION

COVID-19 has significantly affected dental service delivery. Mostly emergency dental services were delivered. AGPs were delivered on appointment basis. Most participants stated the quality of services had improved. Participants stated that they were not given adequate resources and the infrastructure was not up to standard to provide dental services during the pandemic. The dental disease burden had increased during the pandemic as per the participants. Future research can be conducted amongst other dental professionals in other divisions of the country.

Pre-dental treatment screening in Indonesia during the COVID-19 pandemic: a questionnaire survey of dental practitioners

BACKGROUND

Dental practitioners have a high risk of contracting COVID-19 during the treatment of patients because of exposure to airborne droplets. However, the application of pre-procedure treatment screening in dental practices in Indonesia varied during the pandemic. The purpose of this study was to investigate the use of updated pre-procedure dental treatment protocols and procedures among dental practitioners in Indonesia.

METHODS

This study consisted of dentists registered as members of the Indonesian Dental Association who attended the Indonesian Dental Association webinar series in 2021. All the participants completed a questionnaire survey. The participants, who were from various regions in Indonesia, were granted password-protected access to a URL hosting the questionnaire. The questionnaire collected demographic information and contained questions on adherence to updated protocols and patient screening procedures, to which the respondents answered "Yes" or "No". For the analysis, the participants were divided into three groups based on the type of facility where they were employed: public (government) hospitals, private hospitals, or university hospitals (dental schools). A chi-square test was used to investigate the association between professional background and the implementation of updated protocols, including pre-procedure dental treatment screening. A value of P < 0.05 was considered statistically significant.

RESULTS

The age range of the participants was 20 - 60 years. The participants worked in facilities in 32 provinces in Indonesia. In total, there were 5,323 participants (males: n = 829; females: n = 4,494). In terms of professional backgrounds, 2,171, 2,867, and 285 participants were employed in government hospitals, private hospitals, and dental faculties, respectively. Among 5,232 participants who implemented updated COVID-19 prevention protocols, 5,053 (98%) participants performed pre-surgery procedures Among 151 participants who did not implement updated COVID-19 prevention protocols, 133 (88%) individuals carried out pre-rinse procedures.

CONCLUSIONS

Almost all the dental practitioners employed in government hospitals, private hospitals, and dental faculties in Indonesia performed pre-surgery patient screening procedures. There was an agreement between the dental professionals in all three settings on the need for COVID-19 pre-treatment screening procedures in dental practices during the COVID-19 pandemic.

Organizational Preventative Strategies Undertaken by Dental Clinics in Fiji during COVID-19 Pandemic: A Qualitative Study

Aim:

This research aims to determine the organizational preventative strategies implemented by dental clinics in Fiji during the COVID-19 pandemic.

Methods:

This qualitative study was conducted amongst Dental Officers (Dos) and Dental Managers (DMs) who were working at government dental clinics, private dental clinics, and the School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji. A semi-structured open-ended questionnaire was used for data collection through in-depth interviewsviazoom. A manual thematic analysis of the data was conducted.

Results:

Thirty Dos and 17 DMs participated in this study. 16 themes emerged from data analysis: Major Strategies implemented, Staff perception about strategies in place, Triaging and Screening, Hand hygiene, Waiting room changes, Operational Capacity, Universal precautions, Personal Protective Equipment (PPEs), Disinfection and decontamination protocols, Ventilation, Sterilization, Pre-procedural mouth rinse, Waste management, Vaccination status, Bubbles and Adaptation of Protocols. The Dos were generally satisfied with the strategies implemented by the DMs. The DMs along with other Dos had used various guidance documents to devise tailor-made ones suited for dental clinics in Fiji.

Conclusion:

Various strategies were adopted from several guidelines and tailor-made Standard Operating Procedures (SOPs) for each workplaces were developed by the various DMs. The majority of Dos were in favor of and satisfied with the protocols in place. Future research can be conducted in other divisions and include other health care professionals as well apart from just Dos and DMs.

Applicable of teledentistry and digital platforms during the COVID-19 pandemic among dentists in Fiji: A qualitative study

Objectives

This research aims to explore the perception of dental officers (DOs) and dental managers (DMs) on the use of teledentistry and digital platforms during the COVID-19 pandemic in Fiji.

Methods

This qualitative study was conducted among 30 DOs and 17 DMs. The study was conducted in private dental clinics, government dental clinics and the School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji that were selected randomly. The participants were selected using the purposive sampling method using the inclusion and exclusion criteria. Data was collected through in-depth interviews via zoom using a self-developed semi-structure open-ended interview questionnaire. Manual thematic analysis of the data was conducted.

Results

Five themes emerged from data analysis: utilization of teledentistry and media during the pandemic, usefulness of teledentistry, confidence with teledentistry and digital platforms-associated risks, digital platforms for record keeping, and teledentistry promotion and training. Teledentistry was mostly utilized by private practitioners and the oral surgery department. Practitioners were not in favour of teledentistry as they thought it was putting them at risk.

Conclusion

Majority of DOs and DMs were not utilizing teledentistry except for a few private dental practitioners and the oral surgery department. Future research can be conducted in other divisions and include other healthcare professionals.

Psychological Impact of COVID-19 in the Setting of Dentistry: A Review Article

The worldwide pandemic has exposed healthcare professionals to a high risk of infection, exacerbating the situation of uncertainty caused by COVID-19. The objective of this review was to evaluate the psychological impact of the COVID-19 pandemic on dental professionals and their patients. A literature review was conducted using Medline-Pubmed, Web of Science, and Scopus databases, excluding systematic reviews, narratives, meta-analyses, case reports, book chapters, short communications, and congress papers. A modified version of the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected studies. The search retrieved 3879 articles, and 123 of these were selected for the review (7 longitudinal and 116 cross-sectional studies). Elevated anxiety levels were observed in dental professionals, especially in younger and female professionals. Except for orthodontic treatments, patients reported a high level of fear that reduced their demand for dentist treatment to emergency cases alone. The results suggest that the COVID-19 pandemic has had psychological and emotional consequences for dental professionals and their patients. Further research is necessary to evaluate the persistence of this problem over time.

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.

General Labor Well-Being in Latin American Dentists during the COVID-19 Pandemic

This study aimed to determine the general labor well-being of Latin American dentists according to sociodemographic characteristics during the COVID-19 pandemic. A cross-sectional study was conducted in a final sample of 2214 participants from 11 countries. A validated online questionnaire on general work well-being was used (data collection period from 1 June to 10 July 2021), containing two dimensions: psychosocial well-being and collateral effects. The sociodemographic characteristics of the dentists and their perception of the economic impact of the pandemic were also recorded. A multivariate linear regression analysis was performed (hierarchical regression model) to evaluate the joint effect of the explanatory variables on labor well-being and the changes in the variance between each model. A score of psychosocial well-being of 233.6 + 40.2 and collateral effects of 45 + 20.1 was found. Psychosocial well-being was associated with sex, country of origin, academic training achieved, type of dental activity, and perceived impact during the pandemic (p < 0.05). Somatization was frequently manifested through back pain (88.2%) and muscular tensions (87.2%). Women, those who worked 41 or more hours and had between 1 to 15 years of professional experience presented a greater collateral effect (p < 0.001). The impact of the COVID-19 pandemic a year and a half after it began on the labor well-being of Latin American dentists was evidenced with important interactions with social characteristics.

Behavioral Preventative Strategies Undertaken by Dental Clinics in Fiji during COVID-19 Pandemic

INTRODUCTION

COVID-19 has created a significant impact on dentists and oral health professionals. This research aimed to explore the perspective of dental officers (DOs) and dental managers (DMs) on behavioral preventative strategies and recommendations for preventing the virus transmission in the dental clinics in Fiji.

MATERIALS AND METHODS

This qualitative study was conducted among DOs and DMs who worked in nine private dental clinics, eight government dental clinics, and one School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji between August 9 and September 12, 2021. The participants were selected using purposive sampling method using the inclusion and exclusion criteria. Self-developed semi-structured open-ended questionnaires were used for data collection through in-depth interviews via zoom. Manual thematic analysis of the data was conducted.

RESULTS

Thirty DOs and 17 DMs participated in this study. Seven themes emerged from data analysis: Risk perception-COVID-19 versus dentistry; Staff safety, satisfaction, and motivation; Breaking the chain of infection transmission; Adaptability, and acceptance; Shared responsibility; Roles and knowledge; and Importance of good planning. Majority of participants felt that dental professionals are at high risk, and hence, need to take extra precautionary measures. Participants also stated that more care should be provided to patients by accepting the situation and moving forward.

CONCLUSION

This study highlighted the importance of dentists in preventing disease transmission in a dental setting. Continuation with the protocols and strategies gave the participants more sense of protection. The importance of good planning, accepting the situation, and moving forward was highlighted. Future research is recommended in other divisions and other health-care professionals can be included.

[Difficulties encountered during the pandemic reported by dentists]

Objective

To evaluate the economic and psychological repercussions, among other difficulties encountered during the COVID-19 pandemic in a group of dentists.

Materials and methods

Cross-sectional descriptive observational study. An online questionnaire was applied to dentists from the "Rigoberto Caballero" Central Police Hospital (HCPRC) of Asunción-Paraguay that was distributed between July and September 2021. It consisted of 32 closed questions distributed in 5 sections: sociodemographic data, economic effects of the pandemic, psychological effects, contagion, and experiences with respect to the clinic. The data were analyzed with the Epi Info version 7 program and the results are represented in tables, the Fisher's exact test and the Chi-square test were also used.

Results

78 dentists participated, 78.2% female, 56.4% from the 35-45 age group. 88.5% reported a decrease in income in private practice and the majority had to resort to another source to be able to cover daily expenses. Most reported having suffered symptoms of anxiety and depression during the pandemic and felt the need to consult a psychiatrist. It was reported an increase in the demand for Personal Protective Equipment (PPE) and an increase in its costs. Almost half of all dentists reported getting COVID-19.

Conclusion

The pandemic had a considerable impact on HCPRC dentists, causing financial problems, psychological repercussions and difficulties with prices and a shortage of PPE.

The Relationship between Fear of Infection and Insomnia among Dentists from Oradea Metropolitan Area during the Outbreak of Sars-CoV-2 Pandemic

Various studies have shown the impact of COVID-19 pandemic on mental health, identifying that people with a strong fear of getting infected are more prone to become stressed, depressed, anxious and to experience sleeping disturbance. The present study focuses on the impact of fear of COVID-19 and its relationship with insomnia among dentists. 83 dentists from public and private clinics were included in the research. A questionnaire was especially constructed for this study, consisting of three parts: the first part gathered socio-demographic and medical data, and a succession of self-rated items collected opinions about lockdown and preventive behaviors; the second part evaluated the level of fear of infection with Coronavirus-19 using the Fear of Covid 19 Scale; the third part investigated the presence of insomnia using the Athens Insomnia Scale. Collected data were processed using SPSS (v. 25). The total scores for fear of COVID 19 and insomnia were assessed. A strong positive correlation was identified between the total score of AIS and the total score of FCV-19S. The fear of COVID-19 had a significant positive correlation with the practice of several preventive behaviors. Dentists with chronic diseases were found to be more prone to suffer from insomnia than healthy dentists. Significant differences between women and men in terms of night symptoms were discussed. The findings are useful for dentists and policy makers to evaluate the impact of fear of infection on mental health status.

Perceived Stress in Dentists and Dental Students of Latin America and the Caribbean during the Mandatory Social Isolation Measures for the COVID-19 Pandemic: A Cross-Sectional Study

This study aims to determine the impact of the COVID-19 pandemic, specifically considering the mandatory social isolation measures implemented, on the perceived stress of a sample of dentists and dental students from Latin America and the Caribbean, as well as the associated sociodemographic and pandemic-related variables. A cross-sectional survey was conducted with a sample of 2036 dentists and dental students (1433 women). For the main outcome, the 14-item Perceived Stress Scale (PSS-14) was used. The survey also questioned sociodemographic aspects, questions on the COVID-19 pandemic, health variables, and habits. Descriptive, bivariate, and multivariate analyses (linear regression) were applied to observe the factors associated with perceived stress. The PSS-14 mean score was 24.76 (±11.76). Hierarchical regression models showed significant variables associated with the PSS-14 scores: income level during mandatory social isolation, having older adults under care during mandatory social isolation, self-perceived level of concern regarding COVID-19, self-perceived health, Coffee consumption during mandatory social isolation. In general terms, the pandemic has influenced the personal, social, labor, and everyday life of dental staff and affected the mental health of this population specifically when perceived stress is considered. Public policies, strategies, and mental health surveillance systems are required for this population.

Attitudes and predictive factors of psychological distress and occupational burnout among dentists during COVID-19 pandemic in Turkey

The aim of this study was to evaluate the factors affecting the ability and willingness of dentists to work during the COVID-19 pandemic and the effect of this situation on occupational burnout. A 51-question survey, including demographic and pandemic questions and the Maslach Burnout Inventory (MBI), was used as a data collection method and administered to dentists in Turkey via the internet in two stages. A link to the survey (onlineanketler.com) was sent to the participants by e-mail or social media (WhatsApp©). A total of 442 dentists in the first stage and 264 dentists in the second stage answered the questionnaire. The second stage of the survey only applied to dentists who are assigned within the scope of COVID-19 measures in Turkey. Standard descriptive statistics, the chi-square test, independent samples t test and the Kruskal-Wallis test were used for statistical analysis. Most of the participants showed higher stress levels. Occupational burnout levels of participants according to filiation service (serve/FP, did not serve/FN) were 34.4% and 17.6%, respectively. The FP group showed significantly higher stress levels than the FN group. It is important to consider how these results, collected during an infectious disease epidemic, reflect the effects of psychological distress and burnout on dental staff.

Trial Registration Number and Date of Registration: NCT04605692–10/27/2020.