Fear and Practice Modifications among Dentists to Combat Novel Coronavirus Disease (COVID-19) Outbreak

Infection Concerns and Economic Burden: Dentists' Cancellations During COVID-19

OBJECTIVES

During the COVID-19 pandemic, dental appointments were cancelled or postponed by both patients and dentists. This study investigated the associations between German dentists' concerns on cross infection and their emotional burden due to personal economic impact on dentist-initiated appointment cancellations.

METHODS

Data were collected using an anonymous cross-sectional online survey of outpatient physicians in Germany from March through April 2020. Dental treatments were divided into 3 treatment categories (plannable treatments, acute treatments without COVID-19-like symptoms, and acute treatments with COVID-19-like symptoms). Descriptive analyses and multivariate logistic regression models were performed.

RESULTS

A sample of 269 self-employed dentists was considered. Cancellations of prophylaxis appointments were reported by 82% of dentists, whilst 49% reported cancellations of appointments for acute complaints with simultaneous patient-side COVID-19-like symptoms. Further, 58% of respondents stated high or very high concerns about COVID-19 self-infection; 81% stated to be emotionally burdened by the personal economic impact. Dentists' concern of infecting themselves significantly decreased the likelihood of maintaining appointments, with odds ratios of 0.635 (95% confidence interval [CI], 0.426 to 0.932) for plannable treatments and 0.587 (95% CI, 0.367 to 0.916) for treatments of patients with acute complaints and simultaneous COVID-19-like symptoms. In addition, there was a significant negative association between dentists who reported emotional distress due to personal economic impact and the likelihood to maintain appointments, with odds ratios of 0.291 (95% CI, 0.123 to 0.695) for plannable treatments and 0.231 (95% CI, 0.053; 0.706) for treatments of patients without acute complaints and simultaneous COVID-19-like symptoms.

CONCLUSION

Dentists' fear of infecting themselves with COVID-19 played a role in terms of practice-related appointment cancellations. Dentists differentiated their appointment cancellations according to different treatment categories and patient needs. If dental care is to be maintained in pandemic times, physicians' personal factors such as concerns about infection and perceived pandemic-related personal economic impact need to be considered.

Generalized anxiety disorder in Brazilian undergraduate dental students during the COVID-19 pandemic: A cross-sectional study

OBJECTIVE

Explore the prevalence of generalized anxiety disorder (GAD) and associated factors in undergraduate dental students during the first wave of the COVID-19 pandemic in Brazil.

MATERIALS AND METHODS

Cross-sectional study. A semi-structured questionnaire addressing the variables of interest was shared with dental students between July 8 and 27 2020. The outcome was determined using the seven-item generalized anxiety disorder (GAD-7) scale. A 'positive' diagnosis was defined as a total of ≥10 points on the scale. Statistical analysis involved descriptive, bivariate and multivariate analyses, with the significance level set at 5%.

RESULTS

Among the 1050 students evaluated, 53.8% had a positive diagnosis for GAD. The multivariate analysis revealed that the prevalence of symptoms was higher among individuals who resided with more than three people, those enrolled at teaching institutions that suspended all clinical and laboratory activities, those who did not have an adequate home situation to maintain distance learning, those who had been diagnosed with COVID-19, those who felt anxious about having to see patients with a suspicion or diagnosis of COVID-19 and those who preferred to interrupt in-person academic activities until the population is vaccinated for the COVID-19 virus.

CONCLUSION

The prevalence of GAD was high. Aspects related to the composition and organization of the home, the suspension of academic activities, a history of COVID-19 contamination, feelings of anxiety in providing dental care to patients with symptoms/suspected of COVID-19 infection and the preference to interrupt in-person academic activities until the population is vaccinated for COVID-19 were factors predisposing the students to anxiety during the first wave of the pandemic.

Personal protective equipment during COVID-19: A natural history of dental and dental hygiene regulatory guidance in Canada

BACKGROUND

Due to the evolving nature of COVID-19, there is evidence that COVID-19-specific infection prevention and control guideline (IPCG) documents formulated for oral health care settings are also changing rapidly. To better inform future policies, a comprehensive review of all IPCG documents across different phases of restrictions for oral health care practitioners is required.

TYPES OF STUDIES REVIEWED

A search was performed for documents shared from March 2020 through January 2022 on websites of oral health regulatory authorities in Canada's 10 provinces and 3 territories. The authors performed a narrative review of the identified IPCG documents for dentists (n = 78) and dental hygienists (n = 57).

RESULTS

Overall findings from more than 100 IPCG documents distributed during a period of 23 months revealed that the frequency of these updates differed among jurisdictions and between the 2 oral health care practitioners (ie, dentists and dental hygienists) within the same jurisdiction. The most notable observation was the different face-covering recommendations for dentists and dental hygienists within the same jurisdiction during the same timeframe. A common document was sometimes observed for dentists and dental hygienists, however, most jurisdictions had separate IPCG documents.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The different approaches could have been justified on the basis of prevalence of COVID-19 and availability of personal protective equipment; however, there was a risk of creating confusion about IPCG best practices. The findings of this review will support decision makers when planning future development and dissemination of regulations for all oral health care practitioners.

The COVISTRESS oral-health study: Dental-care access in France during the COVID-19 pandemic

The COVID-19 pandemic led to an interruption in dental-care services during the initial lockdown period. This study assesses the impact of this period on the perception of oral health and accessibility to dental care in France. A questionnaire survey was carried out (COVISTRESS.ORG) to study the stress and health behaviors of adults before, during, and after the first lockdown, i.e., at the time of the response. An “oral health” questionnaire assessed changes in the perceived difficulties for accessing dental care. Between November 2020 and April 2021, 339 adults completed the “oral health” section. The perceived-difficulty-in-accessing-dental-care score (on a scale of 0 to 100) was 21.6 ± 26.7 before the pandemic, 52.9± 39.5 during lockdown, and 38.1± 35.3 after it. Before the pandemic, this score was linked to an unfavorable perception of oral health and to difficulties in accessing health care. During lockdown, the score was associated with high dental care needs (RR=4.1; CI95%=1.2–13.8), and perceived difficulties in accessing the health care system (5.06; 1.8–14.1), particularly transport difficulties (3.0; 1.1–9.1). The factors explaining the change in difficulties from before to after the lockdown differ according to when the assessment was done. This study demonstrates the negative impact of the pandemic on perceived difficulties for accessing dental care, within a population with few socially disadvantaged people.

Deployment of dentists in COVID-19 case investigation and contact tracing: An example from Turkey

Aim

In Turkey, dentists working in public dental care centers were deployed in COVID-19 case investigation and contact tracing (CICT) teams during the pandemic. This study aims to explore the experiences of the dentists assigned to teams undertaking COVID-19 CICT practices to determine how healthcare workers should be supported when working in pandemic response and other crises.

Material and method

The sample of this qualitative, phenomenological study consisted of thirty four public dentists assigned to COVID-19 CICT practices in four metropolitan areas of Turkey. Data were collected through semi-structured in-depth interviews that were conducted online in August and September 2020. The data were analyzed using thematic content analysis.

Results

Six themes were revealed: preparation for CICT, basic requirements, work relations, working conditions, being a dentist assigned to CICT and COVID-19 pandemic management. The dentists complained that they were not appropriately assigned to CICT, as they lacked the preparations and sufficient training. They had to acquire personal protective equipment and other basic needs at their own expense. The working conditions were severe, and they had negative relations at work. The State and the Ministry of Health were criticized for inadequate implementation of institutional measures for COVID-19 pandemic management.

Conclusions

The study showed that dentists were motivated to participate in the management of pandemics and similar crisis situations, but in a negative work environment - where they were deployed without adequate training, preparation, and ensuring their basic needs and requirements were met - they lost this motivation, and experienced stress and feelings of inadequacy.

Toward safe dental service: risk perception and practice modification among Egyptian dental students during the COVID-19 pandemic

BACKGROUND

COVID-19 was declared a major public health crisis and a challenge to healthcare systems especially dental services where dentists working close to patients face a greater risk of infection. This cross-sectional study aimed to assess the risk perception and practice modifications of undergraduate dental students at Tanta University to ensure safe dental practice during the COVID-19 pandemic.

METHODS

A convenience sample of 450 dental students from practical academic years at Tanta University, Egypt responded to a self-administered pre-designed validated and pretested questionnaire from the 11th of February 2022 to the end of April 2022 to assess some sociodemographic data, risk perception, and their practice during the COVID-19 pandemic.

RESULTS

Females reported significantly higher levels of fear than males concerning; contracting COVID-19 infection from patients (97.3% vs. 93%) (P = 0.028, 95% CI = 95.6(93.2-97.3), anxiety while treating symptomatic patients (95.1% vs. 90.3%) (P = 0.050, 95% CI = 93.1(90.4-95.3), and fear of infecting their families (94.7% vs. 89.8%) (P = 0.049, 95% CI = 92.7(89.9-94.9). More than half of the students (53.7%) had good practice scores, followed by 44% with average practice and 2.2% with poor practice. A good practice score was significantly associated with the age and academic year (P = 0.044, P = 0.044). Significant predictors of a good practice score in the logistic regression analysis were; updating knowledge with current guidelines for cross-infection regarding COVID-19 (P = 0.001, 95% CI = 53.20, 2.733), asking every patient's travel history before performing treatment (P = 0.021, 95% CI = 21.149, 1.286), deferring patients showing suspicious symptoms (P = 0.042, 95% CI = 20.688, 1.054), following routine universal precautions of infection for every patient (P = 0.016, 95% CI = 36.469, 1.438), using high-volume suction for every patient (P = 0.025, 95% CI = 20.826, 1.226) and using safety glasses or visor (P = 0.036, 95% CI = 21.673, 1.106).

CONCLUSION

The dental students exhibited anxiety and fear while caring for patients during the COVID-19 pandemic. Additionally, considerable changes in dental practices based on the standard guidelines were observed among the students. It is strongly advised that all dental schools have student counselors who are accessible for in-person and online counseling sessions. Peer support is a great approach to spot problems with stress and anxiety in pupils and start solving them.

Association between dental environment stress and sense of coherence in dental students: a cross-sectional study

The aim of this study was to explore associated variables with sense of coherence (SOC), and dental environment stress (DES) in a sample of dental students. All undergraduate (n = 474) and graduate (n = 105) dental students enrolled in the first semester of 2020 at a public university in southern Brazil were invited to participate. Data collection was performed by an online questionnaire, which included information related to sociodemographic and educational characteristics, biopsychosocial factors, aspects related to feelings experienced in the COVID-19 pandemic, and the SOC scale. The study outcome (DES) was measured by a validated tool. Linear regression analyses were performed to identify the associations between the outcome and all independent variables. A total of 408 students were included (response rate: 70.5%). The overall mean score of the DES scale was 73.95 (SD: 24.13). Students with higher SOC scores were observed to have significantly lower DES scores (βGRADUATE: -0.376; 95%: -0.482 to -0.271; βUNDERGRADUATE: -0.478; 95%:-0.658 to -0.297). Female undergraduate students (β: 11.788; 95%CI: 7.161-16.415) had higher DES scores compared with undergraduate male students. In addition, the presence of anxiety symptoms when providing dental care to patients with symptoms or suspected COVID-19 infection was associated with higher DES scores (β: 10.460; 95%CI: 5.644-15.277) among undergraduate dental students. The level of stress was higher in non-white undergraduate students than white (β: 8.912; 95%CI: 3.581-14.244). Among both undergraduate and graduate dental students, higher SOC scores were associated with lower DES.

Association between history of academic failure during dental school and self-reported depression, anxiety, and stress: A retrospective cohort

OBJECTIVE

To investigate the association between history of academic failure (HAF) and self-reported depression, anxiety, and stress among undergraduate dental students.

METHODS

This study involved 244 dental students from one university. An online questionnaire collected information on the following variables: socioeconomic status, behavior, use of licit/illicit drugs, and the choice of dentistry as an undergraduate field of study. The 21-item Depression Anxiety Stress Scale (DASS-21) was applied. HAF in at least one subject during a participant's undergraduate tenure was defined as the main outcome. Bivariate and multivariate analyses were performed using Poisson regression with robust variance. In addition, a subgroup analysis was performed for the variable "dentistry as the first choice for undergraduate studies."

RESULTS

The prevalence of HAF was 25.00% (n = 61). Among those students, the mean number of academic failures was 5.41 ± 6.38 (range: 1-33). Higher rates of HAF were observed among older and non-white dental students. Moreover, those who self-reported at least severe depression presented a 79% higher HAF prevalence ratio (PR) (95% confidence interval [95% CI]: 1.15-2.80). Similar findings were detected among those who reported (PR: 1.79; 95% CI: 1.06-4.46) or did not report (PR: 2.21; 95% CI: 1.10-4.46) interest in dentistry as a first undergraduate option. Conversely, among women and students who did not choose dentistry as their first option, HAF was significantly lower (PR: 0.41; 95% CI: 0.21-0.80).

CONCLUSION

Higher HAF rates are observed in students who are older, non-white, and self-report at least severe depression. However, dentistry as a first option for undergraduate studies was not associated with HAF.

Validity and reliability of the COVID-19 Anxiety Syndrome Scale in Canadian dentists

BACKGROUND

The COVID-19 pandemic has resulted in a high level of mental health problems for the population worldwide including healthcare workers. Several studies have assessed these using measurements for anxiety for general populations. The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a self-report measure developed to assess maladaptive forms of coping with COVID-19 (avoidance, threat monitoring and worry) among a general adult population in the United States. We used it in a prospective cohort study of COVID-19 incidence rates in practising Canadian dentists. We therefore need to ensure that it is valid for dentists in French and English languages. This study aimed to evaluate the validity of the C-19ASS in that population.

METHODS

Cross-sectional data from the January 2021 monthly follow-up in our prospective cohort study were used. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed.

RESULTS

The results of EFA revealed a 2-factor structure solution that explained 47% of the total variance. The CFA showed a good model fit on the data in both English and French languages. The Cronbach's alpha indicated acceptable levels of reliability. Furthermore, the C-19ASS showed excellent divergent validity from the Generalized Anxiety Disorder-7 (GAD-7) scale.

CONCLUSIONS

The C-19ASS is valid and reliable instrument to measure COVID-19-related anxiety in English and French among Canadian dentists.

PRACTICAL IMPLICATIONS

This validated measure will contribute to understanding of the mental health impact of the pandemic on dentists in Canada and enable the dental regulatory authorities and organizations to intervene to help dentists.

Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Background

China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.

Methods

A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."

Results

A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).

Conclusion

This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

One year of COVID-19 in dental health services in Norway: psychological impact, risk perceptions and vaccination status

BACKGROUND

Increased psychological pressure on oral healthcare professionals (OHP) due to COVID-19 has been shown, yet little is known about the long-term psychological impacts. We aimed to study the psychological impact of COVID-19 and associated factors including perceived risk and preparedness and vaccination status among OHP in the first year after the lockdown period in Norway.

METHODS

A structured questionnaire sent electronically to dentists, dental hygienists and dental assistants inquired experiences and perceptions during the second year following the outbreak in Norway. The questionnaire comprised a COVID-19 fear scale and questions about risk perception, preparedness and vaccination status. Exploratory factor analysis (EFA) and Structural Equation Modeling (SEM) were used to assess psychological impact, perception of risk and preparedness according to vaccination status of the respondents.

RESULTS

The majority of the 708 respondents were female (92.8%), had ten or more years of work experience (67.1%), and worked in public dental clinics (95.9%). Fears and concerns related to COVID-19 were common, 72.6% feared getting infected and 85.4% feared infecting others. Of the 642 respondents who agreed that their workplaces handled the situation well, 55.6% were fully vaccinated. Three factors were retrieved from EFA: Insecurity, Instability and Infection. SEM showed that females were more concerned with Infection, and respondents with long clinical experience were less likely to express fear about Instability. Fully vaccinated individuals felt more insecure about becoming infected, and those agreeing that their workplaces handled the current situation well were concerned with Insecurity.

CONCLUSIONS

Despite widespread perception of adequate preparedness and high vaccine coverage, a considerable psychological impact and high levels of fear of COVID-19 were observed among the majority of OHP. Fully vaccinated individuals had a larger psychological burden than not fully vaccinated and those with unknown vaccination status. These findings can inform means and interventions to reduce negative impacts of fear in populations with a high psychological burden.

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.

Thought Believability and Anxious Feelings about COVID-19: A Case-Control Study in Northeastern Iran

Background

Believability and thoughts are considered as the pillars of behaviors over time, and anxious feelings are a risk factor for mental disorders, especially during the coronavirus disease (COVID-19) pandemic. This study aimed to explore the thought believability and anxious feelings of COVID-19 among infected and healthy families.

Methods

In this hospital-based matched case-control study, health surveillance files of COVID-19 patients were collected from January to June 2021 and were analyzed statistically. In this study, two questionnaires of demographic characteristics and the Believability of Anxious Feelings and Thoughts (BAFT) were used. Data were analyzed using the One-way ANOVA.

Results

Of 600 participants, 300 (50%) were PCR-confirmed and 300 (50%) were non-infected. Overall, 163 (54.33%) of infected people were male, 146 (48.67%) single, and 156 (52.00%) government employees. The results showed that the mean scores of physical anxiety (PA) and negative evaluation (NE) in the case group is significantly higher than the control group (P = 0.001); while emotional regulation (ER) in the control group was significantly higher than the case group (P = 0.001).

Conclusion

Having high believability to the risks of COVID-19 may be a predictor of preventive behaviors in individuals. Worrying about COVID-19 can increase the perceived risk of a pandemic in societies and consequence, increase the general public health.

The Impact of COVID-19 on Infection Control Measures in Dental Settings: A Cross-Sectional Study

The COVID-19 pandemic has had a significant impact on every aspect of life, especially for healthcare professionals. Dentists are the most at risk of infection due to close contact with patients. This study aimed to assess the level of awareness, perception, and attitude of Palestinian dentists towards COVID-19 and infection control. A cross-sectional online survey was conducted from 17-30 July 2020, and 349 dentists from the West Bank participated. The survey assessed demographic variables, participation in infection control training, prevention methods used in dental clinics, patient preparation for dental work, cross-infection control and sterilization before and after the pandemic, and sources for guideline protocols for dental workers. The results of the study showed that 54 (14.4%) dentists had received training in infection control in dentistry and 121 (34.3%) had attended training specifically regarding COVID-19. During a partial lockdown, 60% of dentists treated only urgent cases. Overall, the dentists in the West Bank demonstrated good knowledge and a positive attitude towards COVID-19 and infection control measures in dental clinics, as there were significant differences between replacing a medical apron or mask and wearing a face shield, cover shoes, head cap, and goggles before and after COVID (p < 0.05). Moreover, there were significant differences between wrapping the chair and using purification devices to disinfect the clinic before and after COVID (p < 0.05). However, dentists' knowledge could be improved by increasing their accessibility to materials and provided training. Dental associations should provide guidelines regularly to dentists during a crisis to inform them of best practices and disease management. In conclusion, dentists need to update their knowledge, continuing education and training to guarantee the proper handling of COVID-19. The study's findings show the importance of updating infection control protocols and training programs that address the specific needs and challenges faced by dentists in the West Bank.

Fear of COVID-19, risk perception and preventive behavior in health workers: a cross-sectional analysis in middle-income Latin American countries

The aim of this study was to examine the association between fear of COVID-19 and risk perception with preventive behavior in health professionals from four Latin American countries. An analytical cross-sectional study was conducted. Health professionals with on-site care in Colombia, Ecuador, Guatemala, and Peru were surveyed. Information was collected through an online self-report questionnaire. The main variables were preventive behavior as the dependent variable and fear of COVID-19 and risk perception as independent variables. Linear regression was used, and unstandardized beta coefficient and value of ps were calculated. Four hundred and thirty-five health professionals were included, the majority were aged 42 years or older (45.29, 95%CI: 40.65-50.01) and female (67.82, 95%CI: 63.27-72.05). It was shown that the greater the fear of COVID-19, the greater the preventive behavior of COVID-19 infection (B = 2.21, p = 0.002 for total behavior; B = 1.12, p = 0.037 for additional protection at work; B = 1.11, p < 0.010 for hand washing). The risk perception of COVID-19 infection had a slight direct relationship with preventive behaviours (B = 0.28, p = 0.021 for total behavior; B = 0.13, p = 0.015 for hand washing), with the exception of the preventive behavior of using additional protection at work (p = 0.339). We found that fear and risk perception are associated with increased practice of hand washing and use of additional protection at work. Further studies are required on the influence of working conditions, job performance and the occurrence of mental health problems in frontline personnel with regard to COVID-19.

Is the effect of COVID-19 on periodontal treatment similar to that in general dental care and primary medical care? an observational study in Brazil

The present study aimed to analyze the effect of the COVID-19 pandemic on the rates of periodontal procedures, and provide a comparison with general dental care and primary medical care procedures carried out in the Brazilian Public Health System. The study had an ecological, retrospective design with data from 5,564 Brazilian municipalities (99.9%). A multilevel mixed-effects linear regression was used to analyze the longitudinal associations between the COVID-19 pandemic and the rate of procedures. There was a significant reduction in the number of periodontal procedures (Coef. -428.6 [95%CI -774.3/-82.9]) during the COVID-19 pandemic, although this reduction was no greater than that of medical and general dental procedures. Medical procedures witnessed the sharpest drop in procedures (Coef. -2831.5 [95%CI -3964.1/-1699.0]). A lower rate of general dental procedures was also identified during the pandemic (Coef. -2,110.6 [95%CI -3,400.8/-820.4]). The COVID-19 pandemic has had a negative effect on the rate of periodontal procedures carried out in the Brazilian Public Health System. The highest recutions were observed in general dental and medical procedures.

Exploring the linkage between workplace precaution measures, covid-19 fear and job performance: The moderating effect of academic competence

The coronavirus disease 2019 (Covid-19) has created emerging mental health challenges around the world. Like other countries, Pakistan is also confronted with covid-19 calamities. The aim of the study is to examine the impacts of workplace measures (WM) on the job performance (JP) and covid-19 fears (CF) along with the moderating role of academic competence (AC) based on the organizational support theory (OST) and job demand and resources (JDR) theory. A quantitative approach was applied to collect data from 333 banking employees in Gujranwala (Pakistan), and the hypothesis were tested via structural equation modeling using SPSS and AMOS. The study findings indicate that workplace measures significantly affect covid-19 fears except for individual preventive measures (IPM). Similarly, workplace measures significantly impact on job performance apart from information about the pandemic (IAP). Moreover, academic competence insignificantly moderates between workplace measures and covid-19 fears, but a significant moderation is found between information about pandemic (IAP) and covid-19 fears. Meanwhile, academic competence significantly moderates between workplace measures and job performance instead of a relationship between information about pandemic and job performance. However, this study was limited only to the banking sector of Pakistan. So, it will open the doors for future researchers to investigate other cultural contexts and sectors. This research gives a holistic understanding of workplace measures and contributes to the body of knowledge by enlightening the moderating role of academic competence in the banking sector of Pakistan. These useful insights would enable practitioners and policy makers to develop more efficient strategies and workplace measures to enhance job performance and reduce the fears of covid-19 among employees.

Aspects Regarding Sustainability among Private Dental Practitioners from Bucharest, Romania: A Pilot Study

Oral health professionals' knowledge of sustainability is essential for promoting environmental protection in dental healthcare. This pilot study involved an online survey addressed to 70 dental private practitioners from Bucharest, Romania, to evaluate their awareness of the concept of sustainability in dentistry. The performed statistical analysis revealed that 41.4% of the participants were well aware of sustainability in dentistry, with older participants demonstrating significantly higher levels of such awareness (p = 0.001). Sustainability awareness among participants correlates positively with their knowledge of the negative environmental impacts of dental activity (p < 0.001) and with the concern for sustainable dentistry implementation in their workplace (p = 0.037). Improper biohazardous waste disposal was identified as the primary cause of negative environmental impact of dental practices by 87.1% of participants. Installing high energy-efficient dental equipment was selected as the most important action to implement sustainability in participants' dental practices (64.3%). Overall, 51.4% of the participants reported that the COVID-19 pandemic had a medium impact on their dental activity in terms of sustainability. Our study found that participants have a moderate level of awareness regarding sustainability in dentistry, highlighting the need for education on sustainability for oral health professionals.

Stigmatization, panic disorder, and death anxiety among patients of Covid-19: Fourth wave of pandemic in Pakistan

BACKGROUND

In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus.

METHODS

The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory.

RESULTS

Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates.

CONCLUSION

This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time.

Anxiety sensitivity elevates the risk of mental health problems in employees with higher probability of contacting COVID-19 at work

Individuals with increased risk of being in contact with COVID-19 cases at work have been reported to suffer from higher fear of infection and associated mental health problems. The present study examines whether this risk is further increased by higher anxiety sensitivity (AS, i.e., fear of bodily symptoms such as breathlessness, which also are core symptoms of COVID-19) that is also known to be associated with an increased risk of psychopathology. In spring 2020, 783 German health care and social workers participated in a cross-sectional online-survey, in which anxiety sensitivity, depression, anxiety, health anxiety, fear of a COVID-19 infection as well as panic symptoms were assessed. Of these participants, 28.7% affirmed contact with COVID-19 cases, which was associated with greater fear of the virus. Individuals with high AS reported more severe anxiety, health anxiety, depressive symptoms, as well as incident and recurrent panic symptoms. Moreover, the risk association of exposure to COVID-19 cases at work with health anxiety, general anxiety, and panic symptoms was further increased by higher levels of AS. These findings suggest that especially employees with contact to COVID-19 cases who also are high in AS might profit from targeted interventions to prevent excessive fear and associated mental health problems.

Oral health related quality of life and the prevalence of ageusia and xerostomia in active and recovered COVID-19 Patients

Background

Salivary disturbance is associated with patients who either have an active coronavirus disease 2019 (COVID-19) or have recovered from coronavirus infection along with loss of taste sensation. In addition, COVID-19 infection can drastically compromise quality of life of individuals.

Objective

This study aimed to analyze xerostomia, ageusia and the oral health impact in coronavirus disease-19 patients utilizing the Xerostomia Inventory scale-(XI) and the Oral Health Impact Profile-14.

Methods

In this cross-sectional survey-based study, data was collected from 301 patients who suffered and recovered from COVID-19. Using Google Forms, a questionnaire was developed and circulated amongst those who were infected and recovered from coronavirus infection. The Xerostomia Inventory (XI) and Oral Health Impact Profile-14 were used to assess the degree and quality of life. A paired T-test and Chi-square test were used to analyze the effect on xerostomia inventory scale-(XI) and OHIP-14 scale scores. A p-value of 0.05 was considered as statistically significant.

Results

Among 301 participants, 54.8% were females. The prevalence of xerostomia in participants with active COVID-19 disease was 39.53% and after recovery 34.88%. The total OHIP-14 scores for patients in the active phase of infection was 12.09, while 12.68 in recovered patients. A significant difference was found between the mean scores of the xerostomia inventory scale-11 and OHIP-14 in active and recovered COVID patients.

Conclusion

A higher prevalence of xerostomia was found in COVID-19 infected patients (39.53%) compared to recovered patients (34.88%). In addition, more than 70% reported aguesia. COVID-19 had a significantly higher compromising impact on oral function of active infected patients compared to recovered patients.

Assessment of the willingness of Nigerian Orthodontists to offer face-to-face orthodontic services to patients infected with Covid-19

Introduction

Efforts to contain the spread of the COVID-19 disease led to suspension of many services which caused orthodontists to resort to providing only emergency services. The aims of this study were to assess the willingness of Nigerian Orthodontists and Orthodontic resident doctors to treat patients infected with Covid-19 as well as to ascertain advice given regarding traumatic arch wires and aligners during the pandemic.

Participants and study design

This was a descriptive cross-sectional study. We included dentists who were Orthodontists and orthodontic resident doctors practicing in Nigeria. Data was collected via an online questionnaire (Google form) which was sent three times weekly throughout May/June, 2020 and analysed using SPSS version 23. Descriptive statistics were used to analyse the data.

Results

Forty-eight out of the 90 members of the WhatsApp group responded within the allotted time, giving a response rate of 53.3%. Out of a total of 48 respondents, 39 (81.3%) were unwilling to treat patients infected with COVID-19 during the pandemic. The major reason was fear of infection with the virus (12, 25.0%). Most of the respondents (41, 55.4%) suggested the use of wax for relief of trauma from arch wires.

Conclusion

Majority of Orthodontists and orthodontic residents practicing in Nigeria expressed unwillingness to treat patients infected with COVID-19. Aligner therapy was proffered as an alternative to bracket therapy.

Psychological impact of COVID-19 Pandemic on dentists

BACKGROUND

The Covid-19 pandemic seems to have an incessant out-turn on the people in every field in some or the other way. It has been reported that maximum number of deaths in the countries during this pandemic are caused due to a term called death anxiety or phobia. There are certain parameters such as anxiety, apprehension, depression which if influence a person can alter one's well-being.

OBJECTIVE

The steadfast intent of this review article is to narrate the psychological impact of this pandemic on dentists. The eloquence and emergence of this topic will alarm all the medicos and paramedics to have a check on this scenario.

METHODS

The article consists of detailed study from several articles from PubMed publications. Articles written only in English language were referred. Various keywords such as "Covid-19 pandemic" or "Psychological Impact" were used.

RESULTS

The Covid-19 Pandemic has adversely affected all of us physically as well as psychologically. This article signifies the psychological impact of this pandemic on dentists.

CONCLUSION

The current studies that are carried out till date show an extensive impact on the psychology of the dental professionals. The following review article elaborates the importance of the same.

Influence of the Sanitary, Economic, and Social Crisis of COVID-19 on the Emotional State of Dentistry in Galicia (Spain)

The main objective of this research was to analyze the economic, social, and emotional repercussions among Galician dentists (Spain) as a consequence of the COVID-19 pandemic. A survey was filled out by 347 professionals. After verifying the survey's reliability using Cronbach's alpha = 0.84, the professional activity and emotional state of the participants were assessed based on aspects related to their personal and family data. The economic impact of the pandemic was considerable, and all participants experienced a decrease in income. In total, 72% of the participants considered that working with personal protective equipment (PPE) made their clinical activities difficult, and 60% expressed concern about being infected during their professional practice. Among the professionals, women (p = 0.005), and separated, divorced, or single professionals (p = 0.003) were the most strongly affected. Separated or divorced professionals were the group that most frequently raised the need to make a radical change in their lives. Finally, it was observed that the emotional consequences varied substantially in the lives of these professionals, mainly among female dentists (p = 0.010), separated and divorced men (p = 0.000), and those with fewer years of professional practice (p = 0.021). The COVID-19 pandemic had an economic impact, due to the decrease in the number of patients and hours of attention, as well as an emotional impact, mostly expressed in the form of sleep disorders and stress. The most vulnerable professionals were women and professionals with fewer years of experience.

[COVID-19 Pandemic: Psychosocial impact among healthcare professionals in Tunisia]

OBJECTIVE

To determine the psycho-affective impact of the Covid-19 pandemic on the mental health of health professionals in Tunisia and to estimate the associated factors.

METHODS

This is a multicenter, cross-sectional, descriptive and analytical study of health professionals carried out from May 2, 2020 to June 30, 2020 in Tunisia. Healthcare professionals included doctors, nurses, dentists and pharmacists. The participants answered a pre-established questionnaire using an electronic "Google Form". This questionnaire gathered demographic data and medical history. It included two psychometric scales, the GAD-7 (General Anxiety Disorder-7) and the PHQ-9 (Patient Health Questionnaire-9) to assess the prevalence and intensity of anxiety symptoms and depressive symptoms respectively.

RESULTS

The study included 203 healthcare professionals. The professionals had a mean age of 30.74±6.33years, 69.5 % were women, and the majority were doctors (77.8 %). Among professionals, 9.4 % were nurses, 7.4 % were dentists, and 5.4 % were pharmacists. A third of the participants 34.3 % worked in departments with Covid-19 patienfor having moderate to severe anxiety symptoms.

CONCLUSION

In order to ensure better patient care, early detection of psychiatric disorders and the implementation of specific strategies to ensure better mental health among healthcare professionals are priorities not only during the current pandemic but also in the event of a future similar pandemic.

Effect of the COVID-19 pandemic on depression, perceived stress and hypochondria of frontline dental staff (FDS): A cohort study

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic had several mental effects on medical staff.

OBJECTIVE

This study intended to evaluate deviations in Frontline Dental Staff (FDS) depression, perceived stress and hypochondria during the COVID-19 outbreak, and to assess whether the existence of potential risk-factors influenced these symptoms over time.

METHODS

This prospective cohort study surveyed FDS three periods from February 1, 2021 to April 8, 2022. FDSs' mental health was assessed through Beck Depression Inventory, Cohen Perceived Stress and the Evans Self-Illness Questionnaires; multivariate linear regression were used to identify potential factors associated with changes on each outcome (depression, perceived stress and hypochondria) over time. All analyses were performed in STATA ver.14.

RESULTS

In a total of 635 FDS, about 69%, 83%, and 71% reported relative depression, 77%, 87%, and 64% reported moderate to high stress level, and 60%, 76% and 74% reported moderate hypochondriac from first, second, and third survives, respectively. The mean and standard deviation of the variables increased dramatically at second survive (July 17 to October 21, 2021) and decreased again at third survive significantly. Being female, working in public sector, and low socioeconomic level were main predictors of higher levels of depression (p < 0.001) and perceived stress (p < 0.001). Perceived stress was a strong predictor of high-level depression (t  =  7.79, p < 0.001).

CONCLUSION

FDSs' depression, stress and hypochondria were high and positively associated with being female, working in public-sector, and low socioeconomic level. To increase the effectiveness and decrease work burnout, psychological support should be provided.

Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil

The aim of this study was two-fold: (1) to describe the surveillance and biosafety measures adopted by dentists, dental hygienists, and dental assistants who worked in the Southern Region of Brazil and (2) to evaluate access to information in the context of the COVID-19 pandemic. This was a multicenter and cross-sectional design, using a self-applied and validated online questionnaire. The availability of health-care-related supplies and the adoption of biosafety measures recommended by the Technical Note of the National Health Surveillance Agency No. 04/2020 were analyzed. A total of 2560 Brazilian workers participated (75.8% dentists, 15.7% dental assistants and 8.5% dental hygienists), 52.7% from the public and 37.7% from the private sector. Approximately 70% of the individuals reported being away from work during the pandemic. The surveillance measures adopted with higher mean scores were the investigation of respiratory infection symptoms when scheduling appointments and the adoption of distancing in the waiting room. Of the biosafety measures to avoid aerosols, the procedures with lower compliance were those related to the use of intraoral radiographs and rubber dams. Moreover, the correct use of personal protective equipment at work seems to be related to self-perceived stress and anxiety. Worryingly, high access to information through non-governmental documents was observed. Permanent health education policies should reinforce safe practices and encourage workers to implement biosafety and surveillance measures in health services.

Poor Quality of Sleep is Associated with Lower Academic Performance in Undergraduate Dental Students: A Cross-Sectional Study

Purpose

This study aimed to assess the quality of sleep and associated factors among dental students.

Methods

All dental students regularly enrolled at the Federal University of Pelotas, Brazil, were invited to participate. A structured online questionnaire was applied to collect the independent variables, including academic performance. Quality of sleep was assessed by the validated version of the Pittsburgh Sleep Quality Index. Sample was dichotomized as good sleep quality (total score: ≤ 4) and at least poor quality (total score: ≥ 5). Adjusted analyses were performed using Poisson regression with robust variance to detect the association between sleep quality and independent variables. Independent adjusted models were performed to the whole-sample, only undergraduate and only graduate dental students.

Results

Poor quality of sleep was detected in 266 (65.2%) dental students, of which 228 (68.9%) and 38 (49.4%) were undergraduate and graduate dental students, respectively. Female students presented a prevalence ratio (PR) 19% higher compared to males (95% confidence interval [CI] 1.01-1.41). When only graduate students were considering, those that reported not being the head of the family presented a PR 4.39 higher for poor quality of sleep (95% CI 1.91-10.09). Poor quality of sleep was associated with lower academic performance among undergraduate students (PR: 0.94; 95% CI 0.89-0.99), but not significantly associated when graduate students are considered (PR: 0.99; 95% CI 0.96-1.03).

Conclusion

It was concluded that dental students, mainly female ones, have high prevalence of poor quality of sleep, which is associated with undergraduate student's worst academic performance.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41782-022-00223-2.

Effects of wearing personal protective equipment (PPE) and its role in affecting the work efficiency of dentists during the COVID-19 pandemic

BACKGROUND

The risk of exposure to COVID-19 infection through droplets/aerosol in dental clinics has renewed focus on the utility and possible adverse effects of using personal protective equipment (PPE) on dentists.

OBJECTIVE

To obtain information from a cross-section of dentists regarding their PPE usage and to evaluate the possible risk factors that can influence their work efficiency.

METHODS

A 31-item cross-sectional survey with a structured multiple-choice questionnaire was designed. Social media and emails were used to circulate the questionnaire among dental professionals worldwide. A total of 317 respondents returned the completed forms.

RESULTS

A total of 184 (55%) participants reported getting soaking wet while wearing PPE at the end of the working hours (approximately eight hours of working). Many respondents (n = 286, 90%) reported that the use of PPE resulted in reduced visibility of the operating field. The majority of respondents (84%) felt that their overall work efficiency had reduced after using PPE. Binary logistic regression had shown that two significant factors that were associated with reduced work efficiency included, pre-existing systemic illness and getting soaking wet from wearing a PPE.

CONCLUSION

Definite protocols should be introduced that mandate the doffing of PPE for every patient, in a separate well-ventilated area where the skin can recuperate from the heat and pressure points caused by the PPE. Dentists should take greater care in choosing the appropriate PPE to prevent exacerbation of pre-existing illnesses, which may reduce their work efficiency.

Medical appointments and provision of medical care during the COVID-19 pandemic in Mainz, Germany

Previous evidence suggested that non-COVID-19-related medical care was reduced during the first wave of the COVID-19 pandemic, but it remained unclear whether or to which extent this effect lasted beyond the first wave, or existed in a longer time frame. Here, we consider questionnaire data of the Gutenberg-COVID-19 study together with pre-pandemic baseline data of the Gutenberg Health Study concerning the region around Mainz, Germany, to study the effects of the pandemic on the provision of medical care until April 2021. We observed that the proportion of cancelled medical appointments was low and that the fraction of participants with a medical appointment as an indicator for the number of appointments being made was in line with pre-pandemic levels. Appointments were more likely cancelled by the patient (rather than the provider), and more likely cancelled by medical specialists such as dentists or ophthalmologists (rather than GPs). In conclusion, we found some evidence that, at least with regard to realized appointments, the medical system and the provision of medical care were not harmed by the COVID-19 pandemic on a longer time scale.

Dental trainees' mental health changes, sources of stress, coping strategies, and suggestions for mental health improvement 1 year into the pandemic

OBJECTIVES

The goal of this study was to assess how the mental health of dental trainees has changed during the pandemic and to identify the most stressful aspects of trainees' programs, stress coping strategies, and suggestions for individual and institution-driven solutions to improve wellness.

METHODS

The study focused on dental trainees at the University of Washington who completed a wellness survey in fall 2020 (n = 126; response rate = 35.5%) and spring 2021 (n = 105; response rate = 29.6%). The survey included self-report measures assessing four mental health outcomes: depression, anxiety, isolation from peers, and burnout. Stressful aspects of the training program, coping strategies, and institution-driven solutions were measured with open-ended survey items. The chi-square test was used to compare mental health outcome measures between fall and spring and open-ended survey responses were inductively coded.

RESULTS

The prevalence of self-reported depression and anxiety did not change between fall 2020 and spring 2021 (17.2% vs. 21.1%, p = 0.473; 22.4% vs. 23.7%, p = 0.818). Isolation from peers and burnout each significantly increased by almost 20% from fall 2020 to spring 2021 (46.8% vs. 64.3%; p = 0.009 and 26.6% vs. 43.9%; p = 0.017). Trainees identified workload as the most stressful aspect of their program and described using exercise and social support to cope with stress. Trainees suggested institution-supported increases in social events and mental health resources.

CONCLUSIONS

One year into the coronavirus disease 2019 pandemic, poor mental health outcomes were common among dental trainees because of high workload and isolation from peers. Dental schools should promote targeted programs and services aimed at improving dental trainees' well-being.

Comparison of conventionally and digitally completed patient consent-anamnesis forms in terms of surface contamination

BACKGROUND

With the development of modern technology, the use of software-based applications in the field of health has become increasingly widespread. For this reason, computer-assisted personal registration forms have been developed using software programs.

OBJECTIVE

The aim of this study was to compare surface contamination during the filling of orthodontic anamnesis-consent forms, traditionally on paper and digitally on a tablet equipped with a software application, measured in confined spaces using the 3M Clean-Trace Luminometer device.

METHODS

In order for the participants to complete the orthodontic anamnesis-consent forms, two separate identical cabins with standard flat surfaces were prepared. In the first cabin, the participants conventionally completed these forms on paper (conventional group), while in the second cabin, the other group used a tablet equipped with a software program for this purpose (digital group). After the form completion process, surface pollution of the predetermined areas was measured in both cabins using a 3M Clean-Trace Luminometer device.

RESULTS

Surface contamination was found to be statistically significantly higher in all measurement areas in the conventional group than in the digital group. Despite a statistically significant difference between the two groups in relation to the measurements performed using the pens (conventional or electronic), this was not as strong as those found for the remaining surfaces.

CONCLUSION

The completion of orthodontic anamnesis-consent forms over tablets significantly reduced surface contamination in the close environment. This study reflects the importance of digitization - which has become beneficial in many fields - in reducing the spread of infections.

Pandemic Financial Stress in Dental Medicine in Croatia

The aim of this cross-sectional research was to investigate how the COVID-19 pandemic affected the activity of dental medicine in the Republic of Croatia in 2020. It included 136 doctors of dental medicine who completed an online survey regarding their personal and professional information; work in dental offices; and level of fear for their own health, the health of others, and financial existence; and their attitude about vaccination. There was a significantly higher decrease in patient visits in dental offices that do not have a contract with public health insurance (70% vs. 37%; p < 0.001) and in dental offices that have a higher percentage of profit from dental tourism (32% vs. 14%; p < 0.001). Fear of financial existence was significantly higher in the group of dentists who do not have a contract with public health insurance (p = 0.0) and is positively correlated with the percentage of profit from dental tourism (r = 0.299; p < 0.001). Dentists with a higher level of fear that they or their loved ones would get infected due to the nature of their job are more likely to get vaccinated (p ≤ 0.007). The decision to get vaccinated and wearing a disposable coat/apron was related to fear when all other parameters were controlled for (R = 0.44; p = 0.037). In conclusion, the COVID-19 pandemic had a minimal impact on the profession of dental medicine in Croatia but represented a larger financial stress for dentists working in dental offices that do not have a contract with public health insurance and have a higher percentage of income from dental tourism.

Canadian dental hygienists' experiences and perceptions of regulatory guidelines during the COVID-19 pandemic: a qualitative descriptive analysis

BACKGROUND

In Spring of 2020, due to the COVID-19 pandemic, Canadian provincial dental hygiene regulatory bodies implemented new practice guidelines. Reports of stress, anxiety and conflict experienced by dental hygienists have been linked to miscommunication between oral health regulators at this time. Limited data exists on the perceptions and experiences of dental hygienists navigating new guidelines for dental hygiene care during the pandemic. Therefore, the objective of our study was to explore via descriptive thematic analysis how dental hygienists experienced and perceived: i) dental hygiene practice during the COVID-19 pandemic, and ii) their regulatory body's COVID-19 guidelines.

METHODS

Participants were identified through provincial dental hygiene licensing bodies. Online bi-monthly questionnaires were administered to participants (n = 876) from December 2021 to January 2022. Two open-ended questions were asked in the questionnaire. A qualitative descriptive thematic analysis was applied to these two questions.

RESULTS

Major themes at baseline relayed challenges related to workplace compliance, patient treatment and communication of practice protocols. Across responses, hygienists confirmed conflicting messaging from regulators and guideline interpretations as stressors impacting their professional practice and satisfaction within the profession. Participant responses at endpoint cited increased satisfaction with regulatory guidelines as the pandemic evolved, yet inconsistencies in regulators' messaging was noted as a prevailing issue.

CONCLUSION

Inconsistent guideline messaging reflects an increased need for collaboration amongst oral health care regulators to streamline protocols for practice and reduce interprofessional conflict in pandemic circumstances. A national unified approach is warranted in establishing guidelines for dental hygiene practice in Canada.

Response to the coronavirus disease 2019 pandemic of dental hygienists in South Korea-Part II: Fear and anxiety

OBJECTIVES

The purpose of this cross-sectional study was to evaluate the mental fear and anxiety about coronavirus disease 2019 (COVID-19) among Korean clinical dental hygienists and to investigate factors influencing the anxiety felt after the outbreak of COVID-19.

METHODS

A questionnaire on mental fear (Fear-C) and anxiety for COVID-19 was conducted among 500 clinical dental hygienists in South Korea. Fear-C was identified with eight questions. The General Anxiety Disorder-7 (GAD-7) questionnaire was scored for the pre-COVID-19 situation (GAD_Before ) and the current situation going through the pandemic (GAD_After ). The scores for the responses to the questionnaire were 0 points for strong negative and 3 points for strong positive. Higher scores indicate higher levels of fear and anxiety. All data were analysed using IBM SPSS Statistics, and the statistical significance was set at α = 0.05.

RESULTS

The average Fear-C was 16.11 ± 3.89 out of 24.00. There were significant differences in Fear-C when the type of work organization and symptoms related to COVID-19 (Sx-C) differed. Significant differences were confirmed in GAD_Before according to age range, systemic diseases, and Sx-C (p < 0.05). There was no difference in GAD_After for all general characteristics, except Sx-C (p > 0.05). In the regression model of GAD_After , Sx-C (β = 0.526), Fear-C (β = 0.358), and GAD_Before (β = 0.515) were positively related to GAD_After (p < 0.001), respectively.

CONCLUSIONS

Most dental hygienists complained of Fear-C. GAD_After was significantly higher than GAD_Before . The factor that had the greatest impact on GAD_After was Sx-C.

Apprehensions and Optimism among Dental Professionals during the COVID-19 Pandemic-A Nationwide Cross-Sectional Evaluation

Globally, the pandemic of the coronavirus disease, which started in Wuhan, China, has become a major issue for public health. The COVID-19 epidemic notably causes health professionals to experience significantly more emotional stress than the general populace. The present study proposes to investigate the fear aspect in dentists in the initiation of clinical practice during these times. An online cross-sectional study was conducted among dental practitioners based on a pre-validated questionnaire. The data were expressed as frequency and percentage analyzed using the chi-square test using SPSS version 25. The data was obtained from 271 participants, where clinical practice after the first wave was mostly by freelancers (p-value = 0.01); most of whom were married (p-value = 0.065); 19.1% attached to institutes did not have changes in earnings; 28.1% of private practitioners had less than 10% reduction in cases. A total of 62% of private practitioners are concerned about the vaccine's preventative effects (p-value = 0.026), and 57% of private practitioners worry about being sued for the delay in treatment (p-value = 0.036). Only 33.1% of employees in institutions worry that becoming sick could endanger their family. As dentists continue to work their way through this pandemic, these pressures only occasionally have an impact on them. According to the researchers, this is the first study that has captured the anxiety and apprehensions that dental practitioners experienced during the height of the COVID-19 outbreak in India in April 2021. The study's findings demonstrate that the study population was generally upbeat and confident that they could quickly overcome their fear.

Comparison of General Anxiety among Healthcare Professionals before and after COVID-19 Vaccination

Vaccination plays a crucial role in controlling the rate of coronavirus transmission and infectivity. Healthcare professionals are, in fact, at the greatest risk of contracting coronavirus due to their proximity and prolonged exposure to infected patients; this certitude alone enhances the stress and anxiety among patients and professionals alike. In this study, we aimed to assess the levels of anxiety experienced by healthcare professionals in their practices before and after getting vaccinated. This cross-sectional study was carried out in 2021. An electronic survey was distributed among the non-vaccinated and vaccinated healthcare workers. The survey consisted of the following parts: demographic characteristics, coronavirus-related questions, questions related to the specific field of healthcare professions, general anxiety questions, and working-hour-related questions. The Modified General Anxiety Scale (GAD-7) was used along with the paired t-test, Mann-Whitney U test, and Spearmen's test for comparison. p ≤ 0.05 was considered statistically significant. A total of 798 healthcare professionals participated in the study. In this study, the majority of participants were females, with 598 (74.9%) being between the ages of 21 and 30, and 646 (80.9%) participants were graduates, with the majority being dentists. Non-vaccinated healthcare professionals had severe anxiety (30.9%), whereas, in vaccinated participants, anxiety levels were minimal (56.9%). A statistically significant correlation was discovered when comparing the scores of the vaccinated and non-vaccinated individuals as well as when comparing the professions of vaccinated participants, whereas no association was found with the gender and education level of participants. Vaccination is necessary for all entitled individuals to control the spread of coronavirus. It was discovered that there was an increase in anxiety levels before the vaccination was introduced. The anxiousness was greatly lessened following mass immunizations. Our research will help to raise public awareness of stigmatized mental health disorders in the healthcare industry.

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.

Psychological Impact of the COVID-19 Pandemic on Dentists in Latin America's Epicenter: São Paulo, Brazil

The present study aimed to assess the prevalence and associated factors of stress and anxiety symptoms among dentists during the COVID-19 pandemic in the state of São Paulo, Brazil. A structured questionnaire was sent electronically to 93,280 dentists with active registration in the Dental Council of São Paulo, Brazil, enquiring about information regarding the first-wave peak period in Brazil. Descriptive analyses of background characteristics, perceptions of preparedness, and psychological impact were calculated. Multiple logistic regression analysis was performed, and independent variables that showed p < 0.20 were used in the adjusted logistic regression model to compare the psychological impact on dental professionals. Among the 2113 respondents, female participants had 63% lower chance of reporting anxiety than males. Older dentists had a lower likelihood of reporting anxiety compared to 21-30-year-old dentists (p ≤ 0.05). Dentists working in the public health service were 1.78 times more likely to report anxiety than those who worked in private practice. Finally, dentists in the COVID-19 high-risk group and those with a family or team member with a positive COVID-19 diagnosis were more likely to have anxiety. This study can help dental and other healthcare professionals to better understand the consequences of COVID-19 in terms of mental health.

Prevalence of depressive symptoms among dental students is influenced by sex, academic performance, smoking exposure, and sexual orientation

Aim: To estimate the prevalence and associated factors of self-reported depressive symptoms in undergraduate and graduate dental students. Methods: The Depression, Anxiety and Stress Scale (DASS-21) was applied, and only the depression domain was verified. A structured questionnaire was used to collect sociodemographic, behavioral, and COVID-19 pandemic-related fear variables. Academic performance was assessed based on academic records, ranging from 0 (worst possible grade) to 10 (best possible grade). Respondents included 408 regularly enrolled dental students. Bi- and multivariate analyses were performed using Poisson regression with robust variance to verify the association between at least moderate depressive symptoms and independent variables. Results: The prevalence of at least moderate depression was 40.5% among undergraduate students and 26% among graduate students. The prevalence of fear and anxiety due to the COVID-19 pandemic was 96.1% among undergraduate students and 93.5% among graduate students. In the final multivariate analysis, being female (prevalence ratio [PR]:2.01; 95% confidence interval [95%CI]:1.36–2.96) was associated with a higher PR for depression. Conversely, no exposure to smoking (PR:0.54; 95%CI:0.36–0.82) and a final academic performance average ≥7.0 (PR:0.56; 95%CI:0.41–0.76) was associated with a lower PR for depression. Finally, among graduate students, a non-heterosexual orientation was associated with a higher PR for depression (PR:6.70; 95%CI:2.21–20.29). Conclusion: Higher rates of depression symptoms were observed in female undergraduates, students with lower academic performance and smoking exposure, and graduate dental students with a non-heterosexual orientation.

Opportunities and threats of e-learning in dental education in viewpoints of faculty members: A Mixed method study

BACKGROUND

The aim of the study was to assess the opportunities and threats of e-learning in dental schools and explore the experiences of dental faculty members in the coronavirus disease-19 (COVID-19) epidemic conditions.

MATERIALS AND METHODS

The present study was a sequential exploratory mixed method study (quantitative-qualitative). In the quantitative phase, a survey study was conducted to investigate the perspectives of faculty members regarding the opportunities and threats of e-learning during the COVID-19 epidemic. The data were analyzed by descriptive indicators (frequency, percentage, mean, and standard deviation) and analytical tests (t-test and analysis of variance). In the qualitative phase, data were collected through semi-structured interviews. In the qualitative phase, the inductive content analysis approach of Graneheim and Lundman was used to analyze the interviews.

RESULTS

In this study, 213 faculty members of dental schools of Iran participated; among whom 100 were men (46.9%) and 133 were women (53.1%). The results indicated the mean scores of the perspectives of faculty members regarding the opportunities and threats of e-learning in dentistry (4.05 ± 0.49 out of 5). Experiences of the participants in the qualitative phase were explored in the theme of "ups and downs of e-learning in dentistry" with three categories "unaccountability of e-learning in dental education," "challenges of human resource empowerment in the e-learning process," and "planned education."

CONCLUSION

The majority of the faculty members agreed with the use of e-learning in dental education and considered it as an opportunity. However, educational design for blended learning, creation of appropriate infrastructures, and empowerment of human resources as e-teacher and e-student were emphasized as key requirements for e-learning development in dental schools.

Pandemics and Suicide Risk: Lessons From COVID and Its Predecessors

ABSTRACT

In its mortality and global reach, COVID-19 is among the worst pandemics to hit the globe since the 1918 influenza. During a pandemic, it is not uncommon for deaths from suicide to be downplayed as communities respond to the immediate mortality of the disease. In this analysis, we review pandemic history to uncover its impact on suicide rates, a frequent proxy for community mental health, and whether public health responses were effective. We incorporate lessons from more than 100 years of epidemics to assess whether the current public health response can benefit from the lessons of history.

Occupational Stress and Stress Busters Used Among Saudi Dental Practitioners During the COVID-19 Pandemic Outbreak

OBJECTIVE

This study aims to assess the stress levels, stress busters (stress relievers), and coping mechanisms among Saudi dental practitioners (SDPs) during the coronavirus disease (COVID-19) pandemic outbreak.

METHOD

A self-administered questionnaire was sent to SDPs via Google Forms. Cohen's stress score scale was used for stress evaluation, and the mean scores were compared based on age, gender, qualification, and occupation. In addition, comparisons of the utilization of stress coping mechanisms and stress busters based on gender, age, and occupation were evaluated. Descriptive statistics were carried out using SPSS Version 21.0 (IBM Corp, Armonk, NY).

RESULTS

A total of 206 SDPs (69% males and 31% females) participated in the study. Male SDPs showed a higher score than females (P > 0.05). SDPs around age 50 years and above obtained high stress scores (25 ± 7.4) as compared with other age groups (P < 0.05). The occupational level showed higher stress scores (22.6 ± 4.6 than the other occupation groups (P < 0.05). The majority of the SDPs used watching TV/mobile/computer (80%) as a stress buster, followed by binge eating (64%), exercise (44%), smoking (32%), do-it-yourself (DIY; 23%), and meditation (17%).

CONCLUSION

SDPs are experiencing stress levels during the COVID-19 pandemic. Male SDPs above age 50 years and private practitioners showed higher levels of stress scores. An overall commonly used stress buster was smoking in males and meditation in females.

Stress, anxiety and depression in dental students: Impact of severe acute respiratory syndrome-coronavirus 2 pandemic

INTRODUCTION

With the emergence of COVID-19, dental medicine students were faced with a new reality, as a modification of the learning methods in Dentistry colleges happened. The aim of this study was to characterise the possible effects of Covid-19 pandemic in terms of anxiety, depression, and stress among students of dentistry.

MATHERIALS AND METHODS

This cross-sectional study was conducted between October 2020 and May 2021. A total of 1115 participants from a total of approximately 3000 students from the seven university institutions that teach the master's degree in dentistry in Portugal, agreed to participate. An online self-reported questionnaire was applied through Google Forms® platform. The questionnaire was divided in three sections: the students' sociodemographic characterisation, pedagogical aspects, and questions about anxiety, depression, and stress using the Depression, Anxiety, and Stress-21 Scale.

RESULTS

Normal levels of anxiety, depression, and stress, were found in 41%, 36.7%, and 22.7% of the participants, respectively. Being female was the most significant and strong predictor of anxiety and stress, and for depression, not feeling fulfilled in the course they were in was the most significant variable.

CONCLUSION

The participants presented high values of anxiety, depression, and stress, during the pandemic state. Gender and not feeling fulfilled in the course were important predictors.

Assessing the Compliance of Dental Clinicians towards Regulatory Infection Control Guidelines Using a Newly Developed Survey Tool: A Pilot Cross-Sectional Study in India

Adherence to the dental practice regulatory guidelines instituted during the COVID-19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase I- developing survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis (EFA) on the responses collected in Spring 2021. The EFA was achieved using a traditional unweighted least squares extraction method through a varimax rotation with Kaiser normalization. A six-factor solution with 18 items (with the global reliability of 86%) related to screening, regular infection prevention measures, infection control inside the dental operatory, disinfection of the dental unit, disposal, and other COVID-19-specific preventive measures were extracted. Our sample had higher compliance with regard to providing alcohol-based hand scrubs, providing protective gear to attendees, collecting travel/medical history, and screening patients for COVID-19 symptoms. In contrast, less compliance was observed regarding the use of paperless forms of practice and rubber dams in the operatory. The use of a validated survey tool ensures the collection of reliable and valid data, which can serve as baseline data to measure the uptake and effectiveness of dental practice regulatory guidelines in a clinical setting and community dental health clinics.

Paradigm shift in infection control practices in dental clinics in response to COVID-19 among dental professionals in Thailand

Infection control (IC) practice routines depend mainly on knowledge, perception, and awareness of a disease among dental professionals. However, there has been no report on the perception, awareness, and adaptability to the new practice guidelines of Thai dental professionals (dentists, dental nurses, dental assistants, and dental technicians) to the COVID-19 pandemic. This study aims to investigate how dental professionals in Thailand perceive and are aware of COVID-19, and how they have changed their IC practices in response to the pandemic. Online cross-sectional surveys using convenience sampling during September 2021 were sent to Thai dental professionals. The data were analyzed using descriptive statistics and the Chi-square test. Statistical analysis was performed using the Statistical Package for Social Sciences, version 22.0. The tests were two-tailed, with a significance level of p < 0.05 and 95% confidence intervals (CIs). The 1,177 dental professionals who completed the questionnaire were from the public and private sectors. Most respondents obtained their knowledge about COVID-19 from social media (91.8%). 86.7% had adapted to the new IC practice guidelines. The respondents reported that they had modified their work practices in several aspects; changes in administrative control, 1,039 (88.3%); enhancing local source control of dental aerosols, 1,031 (87.6%); heightening sterilization and disinfection procedures, 1,032 (87.7%); and improving the ventilation system, 994 (84.5%). As of October 2021, 1,162 (98.7%) respondents were vaccinated, and 47 (3.99%) had tested positive for COVID-19 compared with 2.30% in the general population. Among infected individuals, 10 (21.3%) were suspected of being infected while working in the dental setting. In conclusion, with an average worry score well over 4.10 out of 5, more than 96% of Thai dental professionals reported seeking updated knowledge and agreed that escalation of IC measures was needed. However, only 86.7% improved their COVID-19 infection prevention practices in 4 aspects and appropriate PPE use. The infection rate in dental professionals was 3.99%, with the highest infection rate in dental assistants. Despite statistical insignificance of infection rate between changed and unchanged group, it cannot be concluded that stricter IC measures are negligible as ones might contract disease from setting other than work.

Trends in dental visits during the state of emergency for COVID-19 in Japan: a retrospective observational study

OBJECTIVES

To determine national medium-term trends in dental visits during three COVID-19 emergency declaration periods in Japan and to analyse how these trends varied according to prefectural emergency measures and COVID-19 incidence.

DESIGN AND SETTING

A retrospective observational study of Japan's dental claims from January 2017 to December 2021.

DATA SOURCES

Data from a monthly report by the Health Insurance Claims Review and Reimbursement Services (HICRRS) in Japan. HICRRS handles the claims of employer-based health insurance.

DATA ANALYSIS

We determined the number of monthly dental claims nationwide from January 2017 to December 2021 and the percentage change in the number of monthly dental claims based on the difference in the COVID-19 alert level between the three emergency declaration periods in 2020-2021 and the corresponding periods in 2019. Results were analysed using descriptive statistics, multiple regression model, graphical figures, and narrative synthesis.

OUTCOME MEASURES

The main outcome was the change in the number of dental visits between the emergency declaration periods in 2020-2021 and the corresponding periods in 2019. We also assessed the difference in the number of dental visits based on the COVID-19 alert level.

RESULTS

The data set included a total of 736 946 088 dental claims. Until the end of 2021, the greatest decrease in monthly dental claims was in April 2020, which was 22.3% lower than that in April 2019. As indicated by the coefficient in the regression model, the percentage change in monthly dental claims decreased by 5.01% (95% CI -8.27 to -1.74) depending on the difference between the prefectures designated as being under special precautions and other prefectures.

CONCLUSIONS

The decrease in dental visits was greater during the first state of emergency, ie, April-May 2020, and in prefectures designated as being under special precautions. Further efforts to promote appropriate dental visits at different alert levels are necessary.

Dentists’ perceptions on present and future dental practice during the COVID-19 pandemic: An embedded study

Background: The emergence of the COVID-19 pandemic has placed a significant burden on everyone. Although dental professionals are at an increased risk of COVID-19 infection, currently, very little is known about how oral health professionals and their professions could be affected by the pandemic. This study aims to investigate dentists' perceptions on present and future dental practice in light of the COVID-19 pandemic. 

Methods: We conducted an embedded mixed-methods study at Manipal College of Dental Sciences, Mangalore, with Indian dentists registered with the Dental Council of India.  

Results: Of the 976 participating dentists, 61% were females, 32% were 40 years of age or younger. Nearly half of the respondents (54%) acknowledged that the lockdown measures caused them a severe financial burden, and 56% were seriously concerned about being a source of infection to their family, friends, and community. Although 79% felt very comfortable or somewhat comfortable going back to work, they were all worried that Personal Protective Equipment (PPE) use would increase their financial burden and impact the number of patients seeking care. Even though a vast majority received the necessary information regarding returning to practice from their concerned dental regulatory bodies, some were unsure about the reuse of the PPEs because of the conflicting information they received. 

Conclusion: The COVID-19 pandemic affected participants' professional lives negatively. Their major concerns were being a source of infection to their families and community. Providing information to dental professionals in a timely manner may prepare dentists to provide safe care to their patients while protecting themselves, their staff, and their families.

COVID-19 Impact on Public Dental Healthcare in Bosnia and Herzegovina: Current Situation and Ongoing Perspectives

BACKGROUND

As the pandemic time went by in Bosnia and Herzegovina (B&H), various patterns toward COVID-19 itself and its impacts, implementation of prescribed preventive measures among the team members, and those of their patients, including immunization process, have been revealed. These patterns were of both empirical and evidence-based kind and consequently formed dental personnel behavior. The aim was to evaluate and compare the COVID-19 status of dentists in B&H, implementation of prescribed preventive measures, and usage of various kinds of PPE, at the beginning of the pandemics and now, 2.5 years later, including dentists' current vaccination status, and their opinions and attitudes toward the national COVID-19 economic impact on dental practice.

METHODOLOGY

Study research was in a form of a cross-sectional longitudinally designed online survey and was conducted in two parts.

RESULTS AND CONCLUSIONS

Dental professionals in B&H had a high frequency of COVID-19 symptoms in the second pandemic year. The vaccination status of dentists in B&H was in line with the global average values of vaccinated professionals. Dentists used patient management preventive measures and PPE recommended by WHO, but some preventive measures have been changed and prioritized recently. The economic impact of pandemics on dentistry was predominantly negative.