Psychological Distress during COVID-19 Lockdown among Dental Students and Practitioners in India: A Cross-Sectional Survey

Psychosocial and mental health concerns among elderly people during COVID-19: Findings from national helpline in India

Background

WHO reported that the epidemic SARS-CoV-2 spread was a public health emergency of international tension in January 2020 and pandemic in March 2020. In this regard, National Institute of Mental Health and Neuro Sciences (NIMHANS) launched a national helpline with the support of the Ministry of Health and Family Welfare for addressing psychosocial issues and mental health concerns of people during the COVID-19 pandemic. The recorded calls made to the National Psychosocial Support helpline were analysed to elicit the psychosocial issues seen among the elderly during the pandemic.

Methods

The data of 70 randomly selected helpline callers were collected by using the sociodemographic data sheet and the semistructured questionnaire. The study employed descriptive research design.

Results

In total, 71.1% of callers belonged to the 60-70 years' age group. 57.1% of callers had approached the helpline by themselves. 38.6% of the callers had reported a preexisting mental illness, of which the majority (33%) reported anxiety and/or sleeplessness. 28.6% of callers complained of comorbid medical issues. Interventions provided to the callers were in the form of supportive psychotherapy (84.28%), the COVID-19-related information (72.85%), referral services (62.9%), lifestyle modifications (41.42%), and behavioural activation (35.71%).

Conclusion

Study findings indicate that the older population encountered several mental health issues during COVID-19, and the telephonic interventions were the most feasible, accessible, and helpful method to reach out to them.

Dental and dental hygienist trainee satisfaction with their veterans affairs clinical training experiences during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic rapidly altered dental practice, training, and education. This study investigates the pandemic's impacts on the clinical training experiences of dental and dental hygienist trainees at the US Department of Veterans Affairs (VA).

METHODS

Using data from post-doctoral general practice dentists, dental specialists, and dental hygienist trainees who completed the VA Trainee Satisfaction Survey before and during COVID-19, we performed logistic regression and thematic content analyses to determine whether COVID-19 was associated with training satisfaction and likelihood of considering future VA employment.

RESULTS

While post-doctoral dentist and dental specialty trainees did not report significant differences, dental hygienist trainees reported increased overall satisfaction and an increased likelihood to consider future VA employment during the pandemic compared to before the pandemic. Similar reasons for dissatisfaction were identified for both the pre-pandemic and pandemic groups.

CONCLUSIONS

Research outside VA indicates the pandemic's association with trainees' intentions to leave health profession education programs. Our results suggest the likely existence of factors that could lead to positive changes for at least some portion of the dental workforce. Future studies should explore those potential factors as some may be replicable in other settings or may apply to other health professions.

Depressive symptoms and their correlates among predoctoral dental students in the United States

OBJECTIVE

To investigate the prevalence of self-reported depressive symptoms among predoctoral dental students in the United States and examine potential correlates.

METHODS

A survey was emailed to all 66 dental schools in the United States, inviting them to distribute it to their predoctoral students. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Data collection occurred from February to April 2020. Multivariable ordinal logistic regression was used to assess associations between demographic variables and depressive symptom severity category, adjusting for potential confounding.

RESULTS

Of an estimated 25,000 predoctoral dental students at the 66 schools, 631 students from 21 schools completed the survey. A total of 24.1% were categorized as having minimal or no depressive symptoms, 33.6% as having mild depressive symptoms, and 42.3% as having moderate, moderately severe, or severe depressive symptoms. Gender (p = 0.015) and race/ethnicity (p = 0.002) were significant predictors of severity, adjusting for other variables. Students identifying as female had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as male. Students identifying as African American/Black (non-Hispanic) and Asian/Pacific Islander had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as White.

CONCLUSION

There is evidence of a high prevalence of depressive symptoms among predoctoral dental students in the United States. Demographic variables may be risk indicators within this population. Approaches to reduce depressive symptoms among US predoctoral dental students are needed.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Psychological Distress and Food Insecurity among International Students at a Hungarian University: A Post-Pandemic Survey

The aim of the present study was two-fold: Firstly, to estimate the prevalence of psychological distress among international students at a Hungarian university two years after the COVID-19 outbreak; and secondly, to identify its demographic and socioeconomic factors, with special regard to the students' food-security status. A cross-sectional study using a self-administered questionnaire was carried out from 27 March to 3 July 2022 among international students at the University of Debrecen. The questionnaire included information on demographic and socioeconomic characteristics, food-security status (six-item United States Department of Agriculture Food Security Survey Module (USDA-FSSM)), and psychological distress (Depression, Anxiety and Stress Scale (DASS-21)). Bivariate analysis was conducted to examine the potential associations between demographic/socioeconomic factors and psychological distress. Additionally, multiple logistic regression was employed to further analyze these associations. Of 398 participants, 42.2%, 48.7%, and 29.4% reported mild to extremely severe depression, anxiety, and stress, respectively. The ages 18-24 (AOR = 2.619; 95% CI: 1.206-5.689) and 25-29 (AOR = 2.663; 95% CI: 1.159-6.119), reporting a low perception of health status (AOR = 1.726; 95% CI: 1.081-2.755), and being food insecure (AOR = 1.984; 95% CI: 1.274-3.090) were significantly associated with depressive symptoms. Being female (AOR = 1.674; 95% CI: 1.090-2.571), reporting a low perception of health status (AOR = 1.736; 95% CI: 1.098-2.744), and being food insecure (AOR = 2.047; 95% CI: 1.327-3.157) were significantly associated with anxiety symptoms. Furthermore, being female (AOR = 1.702; 95% CI: 1.026-2.824)), living with roommates (AOR = 1.977; 95% CI: 1.075-3.635), reporting a low perception of health status (AOR = 2.840; 95% CI: 1.678-4.807), and being food insecure (AOR = 2.295; 95% CI:1.398-3.767) were significantly associated with symptoms of stress. Psychosocial programs combined with strategies to alleviate food insecurity are required to enhance international students' mental health and well-being.

Psychological well-being of young adults during COVID-19 pandemic: Lesson learned and future research agenda

Psychological and mental well-being has become a topic of concern worldwide after the hit of the COVID-19 pandemic. It has triggered enormous global health care vulnerabilities and resulted in full and partial lockdowns to prevent the new case. This research study provides a comprehensive overview of the published international scientific studies on the effect of COVID-19 on the psychological well-being of young adults. This study aims to review the top-cited authors, documents, journals, productive countries, the most used keywords, and trending themes in this area. Articles related to psychological well-being during the COVID-19 pandemic from January 2020 to December 2022 were extracted from the Scopus database with specified keywords. In total, 482 documents were retrieved as original articles and bibliometric analysis, thematic analysis and content analysis are performed and analyzed. The results show that the United States has contributed the largest publications followed by the United Kingdom and Italy. Through the cluster analysis, it is found that many articles have been published and considered the psychological and mental impact of COVID-19. Young adults from both developed and developing countries are majorly affected by the COVID-19 pandemic. The pandemic prioritizes the importance of global psychological well-being and health care. This study focused on different aspects, such as stress, resilience, and the mental health of young adults. The research findings of this study put forth the urgent need to provide preventive policies and intervention procedures to address the psychological health of young adults and proposed a conceptual framework.

Stressors and mental health impacts of COVID-19 in dental students: A scoping review

OBJECTIVE

The COVID-19 pandemic has led to mental health hazards to healthcare providers in general and to undergraduate dental students. The present study undertakes a scoping review to identify and discuss the mental health issues and stressors impacting dental students globally during the COVID-19 pandemic.

METHODS

A systematic search following the Joanna Briggs Institute's framework for scoping reviews was conducted on Embase, MEDLINE by Ovid, Web of Science, PsycInfo, CINAHL, and ERIC to identify peer reviewed publications published globally since the onset of the COVID-19 pandemic in March 2020 until June 22, 2021. Manual search was also performed on Google scholar. Eligible studies were selected based on the predetermined set of criteria and focused specifically on mental health issues experienced by undergraduate dental students in the context of COVID-19.

RESULTS

Fifty-five publications were retained. Fifty-one reported stress, anxiety, or depression experienced by undergraduate dental students during the pandemic. Twenty-five studies employed validated psychometric instruments to explore mental health status among the same students. A total of 28 publications reported that the predominant concern for students was fear of infection, especially during patient interaction. Adapting to virtual learning, clinical skill deficit due to lack of/limited practical training and social isolation were other majorly reported stressors.

CONCLUSIONS

Many mental health issues and stressors related to the COVID-19 pandemic have been identified. Mitigation of COVID-19-related stressors on dental students' mental health should be a priority across all dental academic institutions. Continued efforts should be made to create a supportive learning environment.

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.

Challenges and Opportunities for Dental Education from COVID-19

With the ongoing COVID-19 pandemic, dental education has been profoundly affected by this crisis. First of all, COVID-19 brought physical and psychological health problems to dental students and educators. In addition, both non-clinical teaching and clinical-based training experienced challenges, ranging from fully online educational content to limited dental training, students’ research was delayed in achieving project milestones and there was hesitancy in respect of the COVID-19 vaccine. On the other hand, the COVID-19 pandemic has increased the demand for teledentistry and dental emergency treatment, and brought awareness of the advantages and high-speed development of distance education. This review aims to present these challenges and opportunities for dental education, and suggest how dental institutions should prepare for the future demand for dental education.

Professional motivations and perceptions of senior dental students in the distance education period during the first year of the Covid-19 pandemic

Purpose

Dental students are particularly prone to be affected by the global emergency of Coronavirus-19 (Covid-19) pandemic. The aim of this study was to evaluate the professional motivations and perceptions of senior dental students during the distance education period due to pandemic.

Materials and methods

The data was collected via an online questionnaire, including questions related to students' professional motivation and perceptions, and views about preventive dentistry. For identifying the distress levels, Turkish version of Depression Anxiety Stress Scale (DASS)-21 was used. Descriptive statistics and marginal homogeneity test were used for statistical analysis.

Results

A total of 114 (83 female, 31 male) students, with the mean age of 23.7±1.03 participated the study. Statistically significant changes were observed on the students' career plans (p<0.001); fear about getting and transmitting infectious diseases (p<0.001); and satisfaction about their profession (p<0.001) during the Covid-19 pandemic. Motivation loss was determined on the participants.

Conclusion

There is an urgent need for revision on dental education in order to ensure the students be competent to provide oral health service that can meet the latest needs and achieve professional self-confidence without deterioration on their professional motivation and perceptions. Crisis-oriented psychological support programs should be provided for students. Some improvements should be structured in terms of preventive dentistry issues, both for dental education and dental health service aspects.

Mental Health Risk Factors and Coping Strategies among Students in Asia Pacific during COVID-19 Pandemic-A Scoping Review

The impact of COVID-19 has forced higher education institutes to go into lockdown in order to curb the situation. This sudden change caused students within the institutions to forgo traditional face to face classroom settings and to attend immediate online classes. This review aims to summarize the evidence of the social demographic mental health impacts of the COVID-19 pandemic on students in higher education institutes within the Asia Pacific region and identify the coping mechanisms adopted during these times. A systematic literature search was conducted using three databases (PubMed, Google Scholar, and Scopus), out of which 64 studies met the inclusion/exclusion criteria. The findings revealed that the social demographic groups most at risk were female students, those who were in the final years of their studies (i.e., students who were almost graduating), and postgraduate students as well as students studying medical fields (nursing, dental, medicine, health sciences etc.). The majority of the studies identified that students were relying on mobile devices and extended screen time to cope with the pandemic. Having proper social support, be it through a network of friends or positive family cohesion, can be a good buffer against the mental impacts of COVID-19. Students in higher education institutes are at risk of mental consequences due to COVID-19. By reducing their screen time, finding a healthier coping system, increasing the availability of support within the family and community, as well as actively engaging in beneficial activities students may be able to alleviate general negative emotions, specifically during the pandemic.

Impact of the COVID-19 pandemic on graduating dental interns: the students' perspective

Background

COVID 19 pandemic has caused an unprecedented change in the way of life of the individual as well as of the society globally. Medical and healthcare education has become virtual, complex, and challenging with minimal real-time experience. Dental education has faced major impacts affecting the skills and preparedness of the graduates. This study aimed to assess the overall impact of the COVID 19 pandemic on graduating dental interns.

Methods

This cross-sectional survey was conducted among the graduating dental interns from various states across India. A specially designed questionnaire was used in our study which consisted of multiple-choice, Likert scale, dichotomous response, open-ended response questions. The 15 item questionnaire focused on 5 domains (i) demographic details (ii) perceptions regarding disrupted academic schedule and switch to E-education (iii) perceptions on its impact on the career (iv) items concerning the mental health and stress (v) potential solutions suggested by the interns.

Results

316 dental interns responded to this survey. Only 13.6% of them felt that the e-platforms were useful tools for learning. The dental interns felt that Conservative Dentistry and Oral Surgery postings had the maximum impact on clinical skills. Less than one-fourth (23.1%) of them agreed with the fact that they were under parental pressure; 43.4% agreed that the pandemic had affected the confidence and preparedness to start their clinical practice.

Conclusion

It was observed that the interns faced major challenges due to the missed hours of clinical practice, which affected them in terms of preparedness and confidence in facing their future.

COVID-19 Contraction Among Dental Healthcare Workers in the Department of Conservative Dentistry and Endodontics - A Retrospective Analysis During the Pandemic

Introduction

The COVID-19 pandemic has led to major challenges for the healthcare sector across the globe including dental healthcare workers (DHCWs) due to the increased risk of transmission of virus during aerosol-generating procedures. We conducted the present retrospective analysis determining the risk of contraction of COVID-19 infection among DHCWs since the outbreak of the pandemic for a year (March 2020 through March 2021) in Mumbai.

Methods

In total, 18,058 patients visited the Nair Hospital Dental College for dental treatment related to the Department of Conservative Dentistry and Endodontics during the assessed year. All the patients were subjected to intensive triage, which included recording their body temperature, oxygen saturation level, travel, and COVID-19 exposure history.

Results

A total of 26 DHCWs were responsible for attending and treating the patients with all the standard infection control measures. Seventy-four (0.40%) patients out of 18058 were referred for a nasal rapid antigen test (RAT) on giving a positive affirmation about COVID-19 like symptoms when screened at the triage. Of those 74 patients referred, 20 reported a positive nasal rapid antigen test and the infection was confirmed by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Among 26, 9 (34,7%) DCHWs were found to have contracted the infection during the assessed year.

Conclusion

The analysis found that the risk of COVID-19 infection contraction amongst the DHCWs is considerably less. This could be attributed to the intensive triage and the preventive measures taken while rendering treatment.

Mental health status of dentists during COVID‐19 pandemic: A systematic review and meta‐analysis

Background

The effect of coronavirus disease-2019 (COVID-19) on the mental health status of dentists has been studied in various studies. The aim of this study was to review the mental health status of dentists during COVID-19 pandemic.

Methods

English databases including PubMed, Web of Science and Scopus were systematically searched till July 2021. Studies that examined the mental health status of dentists during COVID-19 pandemic were included. The heterogeneity of articles was assessed with the Cochran Test and I ² statistics. The prevalence rates of anxiety, fear, sadness, concern, and anger were calculated using the random-effect model.

Findings

Of 560 initial searched articles, 15 articles were eligible to include. The prevalence of anxiety, fear of carrying the infection, fear of getting infected, fear of getting quarantined, and fear of dying people by COVID-19 were 64%, 92%, 85%, 61%, and 65%, respectively. The distribution frequency of light, moderate, and intense sadness was 22%, 25%, and 30%, respectively; light, moderate, and intense anger was 21%, 14%, and 23%, respectively; light, moderate, and intense concern was 30%, 30%, and 34%, respectively; light, moderate, and intense fear was 38%, 24%, and 15%, respectively.

Conclusion

Fear of COVID-19 and anxiety was very high among dentists. A significant proportion of dentists had moderate to intense COVID-19-associated sadness, concern, and anger. Providing educational content along with providing the necessary personal protective equipment and extensive vaccinations will help maintain the mental health of dentists and provide better quality services.

Online teaching, quality of life and anxiety of Brazilian dental professors during the COVID-19 outbreak

The COVID-19 pandemic led to changes in academic teaching and dental education, but the impact on dental professors' mental health and quality of life remains poorly understood. Thus, the objective of this study was to evaluate the impacts of social distancing and online teaching related to COVID-19 on the quality of life and anxiety of Brazilian dental professors. This was a cross-sectional study conducted from August 2020 to October 2020. Three instruments were used in an online version: a questionnaire about personal data, academic information and online teaching activities, the Generalized Anxiety Disorders 7 (GAD7) scale, and the Abbreviated World Health Organization Quality of Life (WHOQOL-bref) scale. All instruments were sent by e-mail, social media, and messaging apps to private and public universities and professors. Of the 318 responses, 187 (58.8%) were from female professors. Moreover, lack of good internet access and adequate place for online teaching, difficulties in producing teaching materials, and housework roles had a significant impact on the quality of life and anxiety scores (all p-values < 0.05). Also, Brazilian dental professors who declared that they would make greater efforts if the activities were face-to-face had significantly worse quality of life and anxiety scores, and female professors had significantly higher anxiety scores (all p-values < 0.05). These results provide evidence of a negative effect of social distancing and online teaching activities related to COVID-19 outbreak on the health-related quality of life and mental health of Brazilian dental professors.

Sustainable development and health assessment model of higher education in India: A mathematical modeling approach

The Coronavirus Disease 2019 has resulted in a transition from physical education to online learning, leading to a collapse of the established educational order and a wisdom test for the education governance system. As a country seriously affected by the pandemic, the health of the Indian higher education system urgently requires assessment to achieve sustainable development and maximize educational externalities. This research systematically proposes a health assessment model from four perspectives, including educational volume, efficiency, equality, and sustainability, by employing the Technique for Order Preference by Similarity to an Ideal Solution Model, Principal Component Analysis, DEA-Tobit Model, and Augmented Solow Model. Empirical results demonstrate that India has high efficiency and an absolute health score in the higher education system through multiple comparisons between India and the other selected countries while having certain deficiencies in equality and sustainability. Additionally, single-target and multiple-target path are simultaneously proposed to enhance the Indian current education system. The multiple-target approach of the India-China-Japan-Europe-USA process is more feasible to achieve sustainable development, which would improve the overall health score from .351 to .716. This finding also reveals that the changes are relatively complex and would take 91.5 years considering the relationship between economic growth rates and crucial indicators. Four targeted policies are suggested for each catching-up period, including expanding and increasing the social funding sources, striving for government expenditure support to improve infrastructures, imposing gender equality in education, and accelerating the construction of high-quality teachers.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Meta-Analysis of Prevalence of Depression in Dental Students during COVID-19 Pandemic

Background and Objectives: The COVID-19 pandemic has a negative impact on the mental health of the population in general, and in college students in particular. Dental students have seen their teaching altered and their clinical practice reduced. This study was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among dental students during the COVID-19 and estimating the pooled prevalence of depression. Materials and Methods: Medline via PubMed and other databases were searched for studies on the prevalence of depression in dental undergraduates, published from 1 December 2019 to 1 September 2021. The pooled proportions of depression were calculated with random effects models. Results: We identified 13 studies from 9 countries. The pooled prevalence of depression in dental students was 37% (95% CI: 26-49%) with no variation due to gender, response rate or methodological quality. We only found a significantly higher prevalence of depression in studies from Asia compared to Europe and America. Conclusions: Our results suggest that dental students are suffering from higher levels of depression compared with the general population or other college students during the COVID-19 pandemic, with differences across regions. Measures to improve mental health and wellbeing of dental students during the pandemic are needed.

Impact of COVID-19 on dental education- a scoping review

BACKGROUND

A new corona virus called COVID-19 and its epidemic has affected health care systems in many ways. There have also been significant changes in dental education. The present study summarizes the findings about dental education resulting from a scoping review of COVID-19 and dentistry.

METHODS

First, a comprehensive search of five databases (Google Scholar, Medline through PubMed, Embase, Scopus, and Cochrane Central) was conducted with the keywords: COVID-19 and its equivalent terms, dentistry, education, oral, students, curriculum, and academics. Articles related to oral health and COVID-19 were searched. Then articles on the subject of dental education were screened and reviewed.

RESULTS

Of the 1389 articles investigating COVID-19 and dentistry, 135 articles were related to dental education and its relationship with COVID-19. The most articles in this field were from the United States, India, and Saudi Arabia. Most of the articles were cross-sectional and then review articles. Based on the review the articles were divided into two main categories of changes and concerns, and opportunities and solutions. Moreover, the following themes were extracted: teaching-learning quality and methods, study career and how students are prepared, infection control policies, theses, exams and assessments, financial and economic security, students and staff's mental health, school's policies and curricula, knowledge of students and staff about COVID-19.

CONCLUSIONS

Dental education now faces big challenges, some of which have never been experienced before. On the other hand, the epidemic has created opportunities for dental education as well. Most of these challenges and opportunities are the same around the world, and the findings of the present study can be a good help to overcome the challenges ahead as well as a good reference to find the right questions to be answered in future studies.

Psychological Outcomes and Associated Factors Among the International Students Living in China During the COVID-19 Pandemic

Background: The emergence of coronavirus disease 2019 (COVID-19) has created a severe mental health problem for international students living in China. Despite the little information on the psychological impact on international students, we aimed to assess the psychological outcomes and associated factors among international students currently living in China during the COVID-19 pandemic. Methods: An online cross-sectional survey was conducted from May 28, 2020 to June 12, 2020 on 402 full-time international students across 26 provinces in China. The frequency of symptoms of depression, anxiety, stress, insomnia, psychological distress, loneliness, and fear was assessed with the English versions of the Depression Anxiety Stress Scale (DASS-21), Insomnia Severity Index (ISI), Kessler Psychological Distress Scale (K6), University of California, Los Angeles, Loneliness Scale (UCLA-LS), and Fear of COVID-19 scale (FCV-19S) scales, respectively. Results: The prevalence of symptoms of depression (73.4%), anxiety (76.6%), stress (58.5%), insomnia (77.6%), psychological distress (71.4%), loneliness (62.4%), and fear (73.1%) among international students during the COVID-19 pandemic was shown. The prevalence of moderate to extremely severe symptoms of all psychological outcomes was significantly associated with 26-30-year-old students, students who lived with roommates, and students who stayed in China shorter than 2 years. Participants in the central region reported significantly moderate to extremely severe symptom levels of all the psychological outcomes except fear symptoms. Univariate analysis indicated that a significant association of all psychological outcomes was found among 26-30-year-old students and students who stayed in China shorter than 2 years. Multivariate analysis showed that Engineering, Business, Social Sciences and Law, and Language students were significantly associated with the symptoms of depression, anxiety, insomnia, and fear. Participants staying in China for shorter than 2 years were associated with a higher risk of all psychological outcomes except psychological distress and loneliness symptoms. Conclusions: We found a higher prevalence of psychological outcomes and risk factors among international students during the COVID-19 pandemic. We immediately appealed to university authorities, mental health professionals, and government officials to provide mental health interventions and strategies for their international students, particularly young, central region students, living with roommates, different study backgrounds, and short time staying during the pandemic.