What Do the Dental Students Know about Infection Control? A Cross-Sectional Study in a Teaching Hospital, Rawalpindi, Pakistan

The Investigation of Clinical Guidelines and Standards on Infection Control in Specialized Dental Departments

Background: It is important to adhere to infection control measures in dental procedures due to direct contact with blood and saliva. During the Coronavirus disease 2019 pandemic, regular surveillance is imperative to ensure adherence to the standards. This study aimed to assess the level of adherence to infection control guidelines in specialized dental clinics in different working shifts. Materials and Methods: This study was assessed the level of adherence of 45 selected dental departments to three main guidelines released by (I) the Center for Disease Control (CDC), (II) Ministry of Health (MOH), and (III) armed forces organization (AFO) in three different working shift. The CDC checklist had eight domains. Thus, the items of each domain were individually scored, and considering the weighting coefficient of each item, the total score was calculated. The same procedure was carried out for the two remaining guidelines. Possible effect of working shifts and different specialties on infection control practice was also calculated. Results: The mean rate of adherence was 70.7% to the CDC, 93.8% to the MOH and 84.4% to the AFO guidelines indicating that adherence to the CDC guidelines was lower than the other two domestic guidelines. Individual assessment of each item revealed that hand hygiene (39%) and safe handling and disposal of sharp instruments (46%) acquired the lowest, and sterilization (79%) and safe injection (97%) acquired the highest score according to the CDC checklist. There was no relationship between working shifts and dental specialties regarding the adherence to infection control standards. Conclusion: Dental clinics had different performances regarding infection control guidelines. Further emphasis should be placed on hand hygiene and disposal of sharp instruments.

Modeling the Behavioral Response of Dentists to COVID-19 and Assessing the Perceived Impacts of Pandemic on Operative Dentistry Practices in Pakistan

COVID-19 pandemic has affected dentistry in unprecedented ways. This study investigates the perceived effects of the pandemic on operative dentistry procedures and dentistry profession in Pakistan and the factors that determine the behavioral changes among dentists to adapt to the “new normal.” A Capability Opportunity Motivation-Behavioral model (COM-B) was utilized to investigate the factors that determine the behavior of dentists in Punjab, Pakistan to adhere to COVID-19 standard operating procedures (SOPs). Using social media, an online questionnaire was sent to operative dentistry professionals in Pakistan, and 312 responses were received. 81.4% of the respondents believed that the COVID-19 pandemic has severely affected the level of care provided to the patients, 66% were extremely worried about the risk of contagion during clinical practices, and more than 75% of the respondents opined that the pandemic has led to an increased emphasis on disinfection and oral hygiene instructions. The multiple regression model suggests that the behavior of Pakistani dentists to adhere to the COVID-19 SOPs is significantly affected by their Capabilities (β = 0.358) and Opportunities (β = 0.494). The study concluded that dentists in Punjab, Pakistan are concerned about the risk of contagion and report a serious concern about consequences such as financial loss and inappropriate care of patients. The current study results can feed the policymaking in Pakistan and other developing countries. Facilities and training to improve dentists' opportunities and capabilities can improve their ability to cope with the COVID-19 challenges.

Knowledge Level on Infection Control among Romanian Undergraduate and Postgraduate Dental Students

Background and Objectives: Infection control practices in dentistry should be continuously evaluated. The aim of the present study was to assess the knowledge of dental students from Iași, Romania about infection control in the dental office. Materials and Methods: Dental students and resident dentists attending the “Grigore T. Popa” University of Medicine and Pharmacy in Iași were randomly selected in accordance with ethical guidelines, and a cross-sectional, questionnaire-based online study was conducted. The questionnaire included 21 items about infection control in dentistry. A descriptive statistical analysis was performed, and the chi-square test was used for data comparison, with a cutoff point of 0.05 for statistical significance. Results: The study sample included 150 subjects (75.3% female and 24.7% male) with a mean age of 25.71 ± 4.54 years. Mode of infection transmission was known by 74% of the subjects, and 76% were aware of standard precautions, with significant differences by the year of study (p = 0.012, r = 0.002). A percentage of 20% of subjects knew the means of transmission of the hepatitis B virus (HBV) (p = 0.032, r = 0.166). Most of the subjects were not vaccinated against HBV (p = 0.002, r = −0.274). Notions of high-level disinfection and sterilization were confused by 19.5% of the subjects. Only 22% of the subjects knew the correct processing of handpieces (p = 0.048, r = −0.071). The sources of information were diverse for 64.66% of the respondents, while 31.33% of them used courses and seminars only. Conclusions: There is a need for improvement in the level of knowledge on infection control for both dental students and residents.

Cross-infection and infection control in dental clinics in Nablus and Tulkarm districts

BACKGROUND

Infection control had many developments in the COVID 19 (Coronavirus Disease 2019) pandemic, despite this, there were many complications in different health care facilities as well as dentists' clinics due to the lack of infection control knowledge and compliance failure. This study aimed to assess the level of knowledge and compliance with the infection control measures in the dental clinics in the Nablus and Tulkarm districts.

RESULTS

The results showed that the total positive response regard all infection control domains were (70.0 %). Whereas the participants gave the highest positive response for personnel protective equipment i.e. gloving was (96.10 %). They gave the instruments related to controls the lowest responses, i.e. instruments sterilization was (59.40 %). The analyzed data showed significant statistical differences in the compliance with infection control measures between Nablus and Tulkarm districts "p < 0.05" in the interest of dentists from Tulkarm.

CONCLUSIONS

In conclusion, the findings of this study showed that there is moderate compliance to infection control protocol in Nablus and Tulkarm dental clinics. Thus, there is a need to strengthen adherence to infection control measures.

METHOD

A universal sampling was used to assess the infection control program at the dental clinics in Nablus and Tulkarm Districts. The study sample involved 265 dentists. Data was collected using a questionnaire which has been sent via email between July and August 2020. Descriptive statistics, Chi-square test, One-way ANOVA and Post-Hock tests have been used. Statistical significance was set at ″P <0.05″. Cronbach's alpha has been conducted to ensure the reliability and validity of the questionnaire.

Dental Students in Egypt: To What Extent Do They Perceive and Comply with Infection Control Measures?

This study was carried out in the dental school of Ahram Canadian University in Egypt to investigate the knowledge and compliance of senior students and interns toward infection control practices. A self‑administered questionnaire was employed with questions pertinent to the participants’ knowledge of risks in the dental settings, the practice of hand hygiene, the use of protective equipment, and the management of sharp injuries, among others. Although the knowledge and practice of the 240 surveyed participants were good; they were not up to the coveted standards. Despite being an integral part of their curriculum, an alarming percentage (19.6%) of the participants denied receiving knowledge about infection control instructions. Meanwhile, only 72.5% were aware of being at risk in the dental settings, and 78.3% confirmed their practice of hand hygiene. On the other hand, 84.6% of the surveyed participants confirmed the availability of protective equipment and 94.2% of them expressed their willingness to apply infection control measures in the future. The defects in the knowledge and practice mandate corrective actions to promote and upgrade the students’ compliance. Meanwhile, other gaps can be rectified via developing state-of-the-art communicative strategies. Efforts are warranted to enhance the attitude and motivate the students to conform to the protective safety measures. With all the infection control procedures already established in dental schools, the challenge lies in improving the students’ compliance with these recommendations.

Impact of COVID-19 on Pakistani dentists: a nationwide cross sectional study

Background

The COVID-19 outbreak which developed into a public health crisis has raised concerns regarding infection control among health care workers particularly dentists all over the world. The aim of this survey was to assess awareness, fear and compliance with practice modification according to CDC guidelines during COVID-19 pandemic among Pakistani dentists.

Methods

A cross-sectional study was conducted using an online survey questionnaire. The questionnaire was designed on Google Forms and was distributed among all seven regions of Pakistan through social media and WhatsApp after carrying out the reliability analysis. Statistical analysis was performed using SPSS 20.0. Question wise analysis using frequencies and percentages was done. Pearson correlation and Kruskal Wallis test was applied to check association of awareness level with qualification and workplace setting.

Results

A total of 313 dentists participated and submitted the form online from all regions of Pakistan. The response rate was quite satisfactory as Pakistan was under an official lockdown and most of the hospitals/clinics were either closed or operating with minimum staff. Most of the dentists were well aware of the CDC guidelines. However, 75% of the dentists were afraid of getting infected and 88% of them were anxious while providing treatment. Sixty-eight percent of them were avoiding aerosol generating procedures and only 28% were using rubber dam isolation. Regional analysis was also done and areas of poor compliance were identified. Only 38.5% dentists in Balochistan were using N95 masks and none of the dentists (0%) were using rubber dam isolation. A large number of dentists (80.9%) were afraid and wanted to close their dental practice in Khyber Pakhtunkhwa. Furthermore, a positive correlation was seen between the designation and awareness level (p = 0.01). Similarly, significant correlation (p = 0.03) was seen between qualification and workplace setting.

Conclusion

The results of the study can help devise strategies to ensure adherence with infection control guidelines in regions with poor compliance. Initiation of awareness programs to help overcome fear and train the faculty and staff in the targeted areas would greatly contribute towards reducing the spread of infection and thus lowering the healthcare burden in a third world country like Pakistan.