Knowledge and Attitude of Dental Practitioners Related to Disinfection during the COVID-19 Pandemic

Global prevalence of anxiety and depression among medical students during the COVID-19 pandemic: a systematic review and meta-analysis

PURPOSE

As future physicians, medical students have experienced tremendous pressure during the ongoing COVID-19 pandemic, which is associated with a high risk of depression and anxiety. We aimed to investigate an overview of the prevalence of anxiety and depression among medical students in various countries during the global COVID-19 pandemic, and discuss associated stressors.

METHODS

We systematically searched CINAHL, EMBASE, MEDLINE, PubMed, and Web of Science for relevant articles from December 1, 2019 to March 15, 2023. We performed meta-analysis using a random-effects model with REML method to calculate the pooled prevalence of anxiety and depression. Begg's and Egger's tests were used to identify the potential risk of publication bias. Meta-regression was used to explore potential sources of heterogeneity.

RESULTS

We identified 130 studies reporting anxiety and depression among 132,068 medical students during the COVID-19 pandemic. Eight screening tools were identified for anxiety and six for depression. The pooled prevalence of mental health outcomes for anxiety and depression was 45% (95% confidence interval [CI], 40%-49%) and 48% (95% CI, 43%-52%), respectively. The pooled prevalence of mental health outcomes for moderate and severe anxiety and moderate and severe depression was 28% (95% CI, 24%-32%) and 30% (95% CI, 26%-35%), respectively. There was high heterogeneity between studies, with I2 ranging from 99.58%-99.66%. Continent and survey date were included in the meta-regression model. The results of meta-regression revealed that medical students in Asia had a lower prevalence of anxiety, and depression than those in other regions. The survey date (from February to June, 2020) showed a significantly positive correlation with the prevalence of anxiety and depression.

CONCLUSIONS

We demonstrated the global prevalence of anxiety and depression among medical students during the COVID-19 pandemic. The data highlight that medical students worldwide are at high risk of experiencing anxiety and depression. The reported stressors can be categorized into personal, academic, environmental and cultural, and pandemic factors. Schools and institutions should ensure optimal alternative learning environments for uninterrupted provision of medical education. The appropriate authorities should prioritize the provision of adequate protection for medical students and establish policies to promote new methods of training and education during a disaster, such as via distance learning.

Viewing of clinical cases on social media by dentists: A cause of motivation or dissatisfaction?

Objective

To evaluate the thoughts and feelings of dentists viewing posted clinical cases (PCCs) on various social media (SM) platforms.

Methods

A questionnaire was developed, validated and its reliability was established. It was distributed (in 2022) to 355 dentists who had graduated at least 2 years prior. It had three sections consisting of 20 items pertaining to general information, SM usage, and feelings. Descriptive data were reported using percentages. The chi-squared test was used for inferential analysis. P ≤ 0.05 was considered statistically significant.

Results

The response rate was 92%. The majority of respondents were non-post-graduates (63%), and aged ≤40 years (90%) with clinical experience <5 years (41%). Dentists with the most clinical experience (>15 years) shared their clinical work significantly more than their counterparts (p < 0.05). Most of the dentists did not feel motivated after viewing the PCCs (41%), especially those aged >40 years (p = 0.037), and thought that viewing the PCCs was the reason for personal dissatisfaction (50%). They had a belief that they possess skills (36%) and knowledge (42%), but not the necessary equipment to replicate the PCCs (39%).

Conclusions

The majority of dentists felt that viewing the PCCs on SM can cause personal dissatisfaction and lack of motivation. They had a belief that they possess the skills and knowledge to replicate the PCCs, but lack equipment. Investing resources in clinical workshops, mentorship, and the procurement of modern equipment early in the career of dentists may improve their mental well-being, satisfaction, and quality of treatment delivered to patients.

Nurses' Attitudes and Factors Affecting Use of Electronic Health Record in Saudi Arabia

(1) Background: Nurses' attitudes toward electronic health records (EHRs) is a very valuable issue that needs to be evaluated, understood, and considered one of the main factors that can lead to its improvement or handicap its implementation. This study aimed to assess nurses' attitudes toward EHRs and associated factors that affect the implementation of EHRs in different hospitals in Saudi Arabia. (2) Methods: A cross-sectional study was utilized to collect data from 297 nurses working in public hospitals and primary healthcare centers in Ha'il Province from January to May 2023. Data were collected using the Nurses' Attitudes Towards Computerization questionnaire and a sociodemographic and work-related characteristics sheet. (3) Results: Most of the participants' attitude scores (81.1%, n = 241) were more than or equal to 60, representing positive attitudes, whereas 18.9% (n = 56) of the nurses' scores were less than 60, which is interpreted as negative attitudes. There was a significant relationship between nurses' attitudes toward EHRs and a participants' sex, where males had a more positive attitude than females (p < 0.001). Particularly, young nurses and those who had previous computer experience had a more positive attitude than older nurses and those who had no computer experience (p = 0.044 and < 0.001, respectively). Saudi nurses holding a master's degree had significantly more positive attitudes toward EHRs than non-Saudi nurses holding a bachelor's or diploma degree (p = 0.007 and 0.048, respectively). Nurses with less experience (less than five years) in the nursing field had a significantly positive attitude. Multiple linear regression showed that sex (p = 0.038), level of education (p = 0.001), and previous computer experience (p < 0.001) were independent factors of nurses' knowledge of EHRs. (4) Conclusion: The majority of nurses had positive overall attitudes toward using EHRs. Nurses who are Saudi nationals, male, younger, have previous computer experience, and have less than five years of experience had a more positive attitude toward EHRs than nurses who are non-Saudi, female, older, have no computer experience, have bachelor's or diploma degree, and have less than five years of experience, respectively. Sex, education level, and previous computer experience were independent factors of nurses' knowledge of EHRs.

Vaccine Acceptance, Knowledge, Attitude and Practices Regarding the COVID-19 Pandemic: Cross-Sectional Study among Dentists in Trinidad and Tobago

Background: This study’s aim was to assess Trinidad and Tobago dentists’ vaccine acceptance, knowledge, attitude and practices regarding the COVID-19 pandemic. Methods: All dentists registered with the Trinidad and Tobago Dental Association were invited to complete an online anonymous questionnaire between June and October 2021. Results: A total of 46.2% of dentists responded. The majority of respondents had excellent knowledge of COVID-19 (94.8%), use of personal protective equipment (98.7%) and N95 masks (93.5%), but had poor knowledge about the reuse of N95 masks (27.5%). A total of 34.9% were comfortable providing emergency care to positive or suspected cases of COVID-19, and 64.5% were afraid of becoming infected from a patient. PPE usage was reported at 97.4% and 67.3% for N95 masks. All surfaces of waiting areas were disinfected every 2 h by 59.2%. A total of 90.8% agreed to be vaccinated straight away if a vaccine were made available. Conclusion: Dentists in Trinidad and Tobago have good levels of knowledge, attitude, practices regarding COVID-19. Dentists also have high levels of vaccine acceptance and can play a role in advocating for the COVID-19 vaccine.

Dental students' knowledge about protective guidelines for clinical practice during the COVID-19 pandemic

Objective

The coronavirus disease 2019 (COVID-19) originated in China, in December 2019, spread worldwide promptly and turned into an outbreak which caused an international public health concern. The novel coronavirus which is also called SARS-CoV-2 transmits predominantly by respiratory droplets and the spread pattern of this infection throughout the community became a big challenge encountering the dental profession. Recently several guidelines have been developed for dental clinicians to protect both patients and practitioners, agents this infection. The aim of this study was to estimate the knowledge of dental students about the content of protective guidelines for clinical practice during the COVID-19 pandemic.

Methods

An online questionnaire was developed by a team of specialists which were the faculty member of Tehran University of Medical sciences according to the content of the protective guidelines of ADA for dental practice during the COVID-19 pandemic. The questionnaire was validated and its reliability was confirmed by retesting 10 samples after 2 weeks with a cronbach alpha of 0.9. The online questionnaire was sent to 4 dental schools in the city of Tehran and was fill out by 170 dental students.

Results

The mean knowledge score for all 170 participants was 16.23 out of 32 (50.72%) with the maximum score of 24 (75.0%) and the minimum score of 1 (3.1%). There was a significant relationship between the gender of participants and their knowledge score (p = 0.032) in the way that male students had significantly higher score than females. Students with more advanced educational level achieved higher knowledge scores. (p = 0.038) However, there were no significant correlation between other variables and the students' knowledge score. (p > 0.05).

Conclusion

Dental students had acceptable knowledge about the general protocols against corona virus in terms of hand hygiene, wearing face masks, surface sanitization and diagnostic symptoms of a patient susceptible to be infected by corona virus. However, mostly they were not aware of the details of the guideline's items which makes it crucial to add related content in the dental students' educational curriculum.

Guidelines on the use of disinfectants: comparison between Malaysia and other countries

Aim

Sanitation and cleanliness are essential factors in reducing the spread of pathogens and preventing healthcare-associated infections. Disinfectants are associated with better hygiene outcomes to reduce pathogen transmission risk and minimize risks to healthcare workers (HCWs) and patients.

Methods

A literature search was undertaken using the electronic databases Scopus, Web of Science, Ovid and Google Scholar. The inclusion criteria for this study are observational and original research studies dating from the five-year period 2017-2021. Other inclusion criteria are full text, English language, qualitative or quantitative studies relevant to the research question. The exclusion criteria are animal studies, systematic reviews, conference proceedings, abstracts, projection modelling studies, in-vivo or in-vitro studies, and books.

Results

Five study nations included the United States of America (USA), the United Kingdom (UK), China, India and South Korea, together with Malaysia. These nations have existing policies, regulations and guidelines regarding the use of disinfectants. HCWs should be aware of the national laws and guidelines that govern the purchase, distribution and use of disinfectants. They should also understand the different roles of the agencies involved, so the context for the guidance provided is clear. Coordination and collaboration across various stakeholders are required for creating solid policies.

Conclusion

Product research and innovation are indispensable, as appropriate personal protective equipment and safety measures for HCWs and patients have top priority in every nation. Hence, clear guidelines for handling disinfectants, in addition to health education about scientific-evidence-based disinfectants, are required.

Aerosols generated by high-speed handpiece and ultrasonic unit during endodontic coronal access alluding to the COVID-19 pandemic

To investigate the dispersion and contamination of aerosols generated during coronal access performed by high-speed handpiece and ultrasonic device. To measure the aerosol dispersion, a red dye or an Enterococcus faecalis culture broth inside the bottle of the water system of the dental and ultrasonic unit were used. Bovine extracted teeth were allocated in six groups according to the coronal access: G1: diamond bur in high-speed handpiece (HS) with aspiration (A); G2: ultrasonic (US) inserts with aspiration; G3: combined coronal access with HS and US with aspiration; and G4, G5, and G6 were performed without aspiration (WA). The distance reached by the aerosol with the dye was measured in centimeters, and for environment contamination, agar-plates were arranged at standardized distances for counting colony-forming units (CFU/mL). The ANOVA followed by the Tukey tests were applied (α = 0.05). The coronal access with HS generated higher aerosol dispersion and contamination, even with simultaneous A (P < 0.05), while US generated less aerosol even WA (P < 0.05). The aspiration did not reduce the aerosol statistically. HS is a great source of aerosols in dental clinic during the coronal access and the use of US device should be encouraged.

Knowledge of COVID-19 Infection Guidelines among the Dental Health Care Professionals of Jazan Region, Saudi Arabia

BACKGROUND

This study aimed to assess the knowledge about guidelines related to COVID-19 infection control procedures among dental health care professionals (DHCPs) in the Jazan region.

METHODS

A cross-sectional study involving DHCPs (dental students, interns, and dentists) of the Jazan region between January and March 2021. A questionnaire with 35 items was developed and circulated online among the DHCPs. The dimensionality of the questionnaire was assessed using exploratory factor analysis (EFA). The level of awareness (LOA) was compared across the genders, level of professional experience, and exposure to guidelines. Participants were considered to have high LOA when they responded to 26 or more items correctly.

RESULTS

A total of 363 DHCPs participated in the survey. The questionnaire was found to be valid and reliable. EFA revealed a distinct three-factor structure. Moreover, 61.2% of the respondents had high LOA related to COVID-19 infection prevention. Among those who had high LOA, dentists (65.5%) were relatively more than the students (62.5%) and interns (46.2%). Among the six guideline statements related explicitly to operative dentistry, more than 50% of the respondents were aware of 3 guideline statements, while less than 50% of the respondents were aware of the remaining statements.

CONCLUSIONS

Most DHCP had a high LOA for general COVID-19 infection prevention and control guidelines. Dentists, males, and those who read the guidelines had higher LOA than their counterparts.

Australian dentists' knowledge, preparedness, and experiences during the COVID-19 pandemic

BACKGROUND

COVID-19 is a global health crisis. Close contact with the mucous membranes and respiratory secretions of patients and aerosol-generating procedures renders dentists and other oral health professionals at high risk of exposure to SARS-CoV-2. We examined dentists' knowledge, preparedness, and experiences of managing COVID-19 in Australia.

METHODS

A cross-sectional online survey of dentists with a current membership with The Australian Dental Association (ADA) was conducted between March and April 2021.

RESULTS

Of the 368 survey responses, most dentists (72.3%) reported having a good level of knowledge about COVID-19, with most visiting the ADA Federal COVID-19 (74.7%) and state/territory department of health websites (62.8%), respectively to source up-to-date information. Most dentists (87.6%) felt prepared to manage COVID-19 into the future, although 66% reported not receiving training or certification in the use of PPE. Over half (58.7%) reported not being concerned about contracting SARS-CoV-2 at work, with some (28.9%, n = 98/339) feeling more stressed than usual and having heavier workloads.

CONCLUSION

COVID-19 had significant impact in oral healthcare in Australia. Dentistry has adapted to the varied challenges raised by the pandemic. Comprehensive training and detailed guidelines were fundamental for successful patient management during the COVID-19 outbreak.

Impact of COVID-19 pandemic on the practice of pediatric dentistry in the United Arab Emirates: a cross-sectional survey

Background

The aim of this study was to assess the impact of COVID-19 epidemic circumstances on the practice of pediatric dentistry in the United Arab Emirates.

Methods

An online questionnaire was distributed among members of Emirates Club of Pediatric Dentistry. The questionnaire was divided into three sections: (1) dentists’ demographic characteristics, (2) general knowledge and attitude toward COVID-19, (3) practice of pediatric dentistry during COVID-19 pandemic.

Results

Female pediatric dentists were double the males and the age distribution tended towards the younger age group. Most of the participants had a satisfactory level of knowledge about COVID-19 and 100% of them obtained this knowledge from the health authorities. Around one third of the participants were not confident of their ability to work safely during the epidemic. There was a marked diversity between pediatric dentists regarding the priority services to be delivered to children during the COVID-19 peak.

Conclusion

A majority of pediatric dentists in the UAE are well informed regarding COVID-19 and its prevention. The economic impact of the epidemic has disrupted pediatric dentists’ willingness to prioritize certain dental services over others. This is related to safety concerns, financial urge, and patient needs.

Pros and Cons of CAD/CAM Technology for Infection Prevention in Dental Settings during COVID-19 Outbreak

The purpose of this commentary is to update the evidence reported in our previous review on the advantages and limitations of computer-aided design/computer-aided manufacturing technology in the promotion of dental business, as well as to guarantee patient and occupational safety. The COVID-19 pandemic led to an unprecedented focus on infection prevention; however, waves of COVID-19 follow one another, asymptomatic cases are nearly impossible to identify by triage in a dental setting, and the effectiveness of long-lasting immune protection through vaccination remains largely unknown. Different national laws and international guidelines (mainly USA-CDC, ECDC) have often brought about dissimilar awareness and operational choices, and in general, there has been very limited attention to this technology. Here, we discuss its advantages and limitations in light of: (a) presence of SARS-CoV-2 in the oral cavity, saliva, and dental biofilm and activation of dormant microbial infections; (b) the prevention of SARS-CoV-2 transmission by aerosol and fomite contamination; (c) the detection of various oral manifestations of COVID-19; (d) specific information for the reprocessing of the scanner tip and the ward from the manufacturers.

COVID-19 Myth Busters: Comparing knowledge and perceptions amongst the dental workforce at an institution in the Eastern Province, Saudi Arabia

BACKGROUND

Currently, world is suffering from a respiratory disease names as COVID-19. This is a novel coronavirus (n-CoV), a new strain which has not been previously identified in humans and it has spread in more than 100 locations internationally due to which it is termed as "public health emergency of international concern" (PHEIC) by the World Health Organization So far, no study done as yet to assess whether the dental workforce is aware about the facts and myths related to Covid-19 awareness.

OBJECTIVE

This study aims to analyze and compare the level of awareness about the facts and myths related to COVID-19 amongst faculty, dental students and prep year students of the College of Dentistry (COD) as part of an awareness campaign.

METHODS

An awareness test about COVID-19 was designed using information from the World Health Organization's (WHO) Myth Busters Awareness webpage. The questionnaire was administrated online to faculty and students, of the College of Dentistry and preparatory year students who had applied for the admission to the dental college using a secure enterprise online assessment platform (Blackboard). The tests were administered over a period of three months from March to June 2020. A written informed consent was obtained.

RESULTS

The online COVID-19 awareness test was administered to 810 participants, out of which 325 (40%) were prep year students, 429(53%%) were dental students, and 56 (7%) were faculty members. Analysis of the results showed that 86% of the Faculty were able to correctly identify the facts and the myths related to COVID-19 followed by 81% of the prep year students and 74% of the dental students. Preparatory year student's knowledge related to COVID-19 was found to be high when compared to dental students (26.47±4.27, 23.67±6.2). Student to faculty knowledge score did not differ significantly (p = 0.808).

CONCLUSION

This study reports about a successful pilot test conducted to assess the perceived knowledge about facts and myths related to corona virus amongst the dental workforce.

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

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

The Impact of Coronavirus Information-Seeking Behavior on Dental Care Access: A Cross-Sectional Questionnaire-Based Study

Health information-seeking behavior provides a variety of benefits, such as reducing knowledge gaps and educating individuals outside the medical office. This study aimed at evaluating if different sources used to gather information on COVID-19 could affect the willingness to undergo dental appointments. An anonymous survey was posted on social media. The 1003 respondents used several channels of communication, clearly distinguishing reliable from unreliable ones. Multiple logistic regression estimated the effect of different information channels on the probability of being strongly influenced by COVID-19 in accessing upcoming dental appointments. Newspapers were the most-used channel of information (61.2%), blogs and forums the least used (11.2%). Overall, the more an individual was informed, the higher was the risk of missing upcoming dental care appointments (OR 2.05, CI 1.45–2.90, p < 0.001). The two most reliable channels of communication were identified in journals/websites of medicine and healthcare professionals. Women proved to be more active in gathering information and relying on less secure but more personal channels, such as social media and friends and family, thus having an increased risk of being influenced by COVID-19 information regarding upcoming dental care appointments (OR 3.62, CI 0.85–15.52, p < 0.1 and OR 1.60, CI 1.00–2.58, p < 0.1, respectively). Social media should have a greater presence on the side of medical service providers to avoid distortions of information and fake news that ultimately cause fear among citizens and compromise their health. Healthcare professionals and institutions should adapt their communication channels based on the audience they want to address to optimize the education and information of the final users.

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

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

Dental Healthcare Amid the COVID-19 Pandemic

The hustle and bustle of the planet Earth have come to a halt thanks to the novel coronavirus. The virus has affected approximately 219 million people globally; taken the lives of 4.55 million patients as of September 2021; and created an ambiance of fear, social distancing, and economic instability. The purpose of this review article is to trace the historical origin and evolution of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). The virus is highly contagious with a unique feature of rapid mutations-the scientific research is paving the way for discoveries regarding novel coronavirus disease (COVID-19) diagnosis, features, prevention, and vaccination. The connections between the coronavirus pandemic and dental practices are essential because COVID-19 is transmitted by aerosols, fomites, and respiratory droplets, which are also produced during dental procedures, putting both the patient and the dentist at risk. The main emphasis of this paper is to highlight the psychological, economic, and social impact of this pandemic on dental practices throughout the world and under what circumstances and guidelines can dental health care be provided. In the current situation of the pandemic, an appropriate screening tool must be established either by using rapid molecular testing or saliva point-of-care technology, which will be effective in identifying as well as isolating the potential contacts and carriers in hopes to contain and mitigate infection. The blessing in disguise is that this virus has united the leaders, scientists, health care providers, and people of all professions from all around the world to fight against a common enemy.

A study on the severity and prevention measures of COVID-19 among dental professionals in clinical practice management

BACKGROUND

Medical professionals, especially dental professionals, have been adversely affected by the pandemic of COVID-19 due to an increased chance of exposure to patients because of close contact during treatments.

OBJECTIVES

This study aimed to evaluate knowledge about the disease and assess ways of precautions to be taken during the pandemic.

METHODS

A questionnaire was developed and registered at Google Forms. The study population included dental practitioners, working in hospitals and clinics. A total of 495 dental practitioners from 14 different countries across the world responded. Most dentists were aware of the required modifications in the management of patients. The points allotted for each correct/best answer by participants for a group of questions regarding each component (Knowledge, Perceptions, and Practices) were added/summed to generate an overall score for each of the three components.

RESULTS

Both univariate and multivariate analysis employed for the evaluation of results. Moreover, the total practice score was significantly associated with gender and sector of practice. Multivariable analysis model using multiple linear regressions was formulated by including those variables which were significant at the univariate stage. Hence, the practice sector was the only variable found to be significantly associated with the total knowledge score (p-value < 0.05).

CONCLUSION

This study, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and infection in dental settings.

Dentist-patient communication on dental anxiety using the social media: A randomized controlled trial

The purpose of the present study was to assess the effects of dentist-patient communication via social media on dental anxiety and to determine the appropriate timing of such communications. In this randomized, double-blinded and controlled trial, we used Instagram's quick replies system to answer patients' questions to alleviate dental anxiety for patients undergoing impacted teeth extraction under local anesthesia. Patients were assigned randomly into four groups according to the timing of such communications: only after (group 1, n = 36), only before (group 2, n = 35), before and after the operation (group 3, n = 36), and a control group who received no communication on social media (group 4, n = 36). Dental anxiety was evaluated one week before (pre-op) and after the operation (post-op) using recognized assessment scales -the Spielberger's State-Trait Anxiety Inventory, Modified Dental Anxiety Scale (MDAS), and Visual Analogue Scale (VAS). The results showed that the post-op values of group 4 had higher anxiety scores than the groups 2 and 3 according to VAS (p < 0.05). Within the groups, the anxiety levels showed a decreasing trend after surgery according to MDAS and VAS scores (p < 0.05). The results of this study suggest that communication with patients before the operation is sufficient to reduce their dental anxiety.

Pedagogy and innovative care tenets in COVID-19 pandemic: An enhancive way through Dentistry 4.0

The global oral healthcare sector has now woken to implement Dentistry 4.0. The implementation of this revolution is feasible with extensive digital and advanced technologies applications and the adoption of new sets of processes in dentistry & its support areas. COVID-19 has bought new challenges to dental professionals and patients towards their customised requirements, regular dental health checkups, fast-paced and safe procedures. People are not visiting the dentist even for mild cases as they fear COVID-19 infection. We see that this set of technologies will help improve health education and treatment process and materials and minimise the infection. During the COVID-19 pandemic, there is a need to understand the possible impact of Dentistry 4.0 for education and innovative care. This paper discusses the significant benefits of Dentistry 4.0 technologies for the smart education platform and dentistry treatment. Finally, this article identifies twenty significant enhancements in dental education and effective care platforms during the COVID-19 pandemic by employing Dentistry 4.0 technologies. Thus, proper implementation of these technologies will improve the process efficiency in healthcare during the COVID-19 pandemic. Dentistry 4.0 technologies drive innovations to improve the quality of internet-connected healthcare devices. It creates automation and exchanges data to make a smart health care system. Therefore, helps better healthcare services, planning, monitoring, teaching, learning, treatment, and innovation capability. These technologies moved to smart transportation systems in the hospital during the COVID-19 Pandemic. Modern manufacturing technologies create digital transformation in manufacturing, optimises the operational processes and enhances productivity.

Covid-19 Knowledge and Perceptions Among Dental Specialists: A Cross-Sectional Online Questionnaire Survey

Background

The recent outbreak of coronavirus (COVID-19) caused a significant impact on dentistry. It is imperative to have sufficient knowledge of COVID-19 to manage patients in the dental operatory.

Aim

To assess the knowledge and perceptions of dentists from different specialities about COVID-19 disease.

Settings and Design

Cross-sectional online survey.

Materials and Methods

This study used a descriptive cross-sectional study design with a self-administered questionnaire. The questionnaire included three sets of 23 questions [Demographic-4; Source of information-1; Knowledge-10 and Perceptions-8]. The comparison of mean scores of knowledge and perceptions were interpreted based on the occupation of dental specialists.

Statistical Analysis Used

The association between demographic variables and dental specialists’ knowledge and perception scores was carried out using SPSS (Version IBM 21.0, NY, USA).

Results

A total of 429 dentists from various specialties participated in the present study. The study had obtained a overall good knowledge score (92.7%) with a mean value of 8.86 + 0.22, and a perception score (70.7%) with a mean value of 5.4+0.3. The present study reports a statistically significant difference between age (p=0.03) and knowledge source (p<0.05). The multi variate regression analysis showed that dentists’ specialty had no significant effect on knowledge and perception.

Conclusion

The study reports sufficient knowledge and perception scores. Oral maxillofacial surgeons showed higher knowledge scores, while prosthodontics and periodontics achieved good mean scores for perception on COVID-19. Social media and health authorities played an equally important role in the overall knowledge of the source of information related to COVID-19.

The impact of social media on dental practice promotion and professionalism amongst general dental practitioners and specialists in KSA

OBJECTIVE

This study primarily assesses the social media use patterns of general dental practitioners and specialists in KSA. To fulfil its secondary objective, the study evaluates the social media preferences of the selected cohort for promoting their practice, and their extent of professionalism while using social media.

METHOD

An electronic questionnaire was developed and administered to all registered dentists and specialists in KSA through the Saudi Dental Association platform. The questionnaire comprised closed-ended items with a choice of predefined answers that covered demographics, reasons for using social media, and the ways in which social networking might affect professionalism.

RESULTS

A total of 238 general dental practitioners and specialists from various age groups answered the questionnaire. The data revealed that 41% of the respondents used social media equally for personal, professional, and business purposes. Instagram was the most commonly used social media platform for dental practice promotion, and also regarded as the most powerful platform by all respondents (p = 0.0009). Thirty-four percent of the respondents rarely posted their own clinical cases on social media. However, a significant difference was observed amongst the specialities (p = 0.01).

CONCLUSION

Inappropriate use of social media can cause ethical issues regarding patient confidentiality and data protection that may lead to negative perceptions of dental professionalism. Therefore, guidelines and policies should be established to regulate dental practitioners' use of social media for sharing clinical data.

Dental Professional's Knowledge, Preventive Awareness and Attitude Towards COVID-19 in Saudi Arabia: A Cross-Sectional Survey

BACKGROUND

Given the COVID-19 pandemic, it is necessary to assess the dentist's knowledge, preventive awareness, and attitude towards COVID-19 in Saudi Arabia. This study aimed to assess dental professionals' knowledge, preventive awareness, and attitude towards dental care during the COVID-19 pandemic in Saudi Arabia.

STUDY SUBJECTS AND METHODS

The study participants consisted of dental professionals working in government, private and academic sectors in Saudi Arabia. An online questionnaire (Whatsapp and Twitter) was sent to dental professionals in July 2020. The questionnaire consisted of questions on dental professional's demographic variables, their knowledge of the incubation period, the symptoms, mode of transmission, preventive awareness of COVID-19, and their attitude toward treating patients with COVID-19. Mann-Whitney U and Kruskal-Wallis tests were applied to compare mean ranks and a p<0.05 is considered statistically significant.

RESULTS

This study included a total of 356 dental professionals (dentists and dental students) aged 22-60 years (mean±SD, 32.14±7.48 years). Majority of the participants were graduates/general practitioners (GP) 145 (40.7%), followed by post graduate (PG) student 108 (30.3%), undergraduate students 23 (6.5%) and specialist 80 (22.5%). Dental professionals showed a high level (>90% correct responses) of knowledge of COVID-19 except for the infection among comorbid patients 283 (79.5%) and incubation period of COVID-19, 164 (46.1%). An overall high knowledge of COVID-19 (87.26%), preventive awareness (88.64%) and a positive attitude (65.26%) towards dental care were observed among the study participants. The mean knowledge ranks differed significantly in different genders (p=0.029) and marital status (p=0.023), whereas preventive awareness differed significantly across various qualifications (p=0.004). The mean attitude rank was significantly higher among Saudi (182.29) compared to non-Saudi (141.36) study participants (p=0.025).

CONCLUSION

The dental professionals participated in this study demonstrated adequate knowledge of symptoms, preventive awareness, and a positive attitude towards dental care of the COVID-19 infected patients.

Determinants of knowledge and prevention measures towards COVID-19 pandemic among Lebanese dentists: a cross sectional survey

BACKGROUND

Coronavirus Disease 2019 (COVID-19) is a major global threat. Healthcare professionals including dentists are facing real challenges during this pandemic. This study aimed to evaluate knowledge, attitudes, and prevention measures of Lebanese dentists towards COVID-19 and determinants of high level of knowledge and prevention practices.

METHODS

A cross-sectional study was conducted between May and August 2020 in Lebanon on a random sample of 323 Lebanese dentists. Data were collected through an online survey questionnaire. A multivariate linear regression model was used to evaluate factors associated with COVID-19 knowledge. A multivariate logistic regression was conducted to evaluate the factors associated with high level of prevention measures towards COVID-19.

RESULTS

The mean COVID-19 knowledge index was 24.5 over 38 with only 15% achieving high knowledge level. The mean prevention measures index was 11.4 over 16 with only 35% achieving high prevention level. Higher knowledge index was associated with younger age, being employed, and considering dentist's role significant in teaching others about COVID-19. General dental practitioners, dentists living with family members and concerned about their family members to get infected because of their occupational exposure were more likely to report higher level of adopted prevention measures. Higher knowledge was associated with high level of prevention measures.

CONCLUSIONS

Given the rapid evolution of information related to COVID-19 pandemic, dentists should be regularly educated through trainings, workshops, and updates of national guidelines for dental healthcare.

Assessment of Knowledge, Attitude, and Practice of Security and Safety Workers Toward the COVID-19 Pandemic: A Cross-Sectional Study

Aim: This study aimed to assess the knowledge, attitude, and practice (KAP) of security and safety workers toward the COVID-19 pandemic in Saudi Arabia.

Methods: A cross-sectional survey was conducted between April and July 2020 using a self-developed structured questionnaire that was randomly distributed online among security and safety employees in government or private sectors.

Results: Among the 712 participants, 53.9% were female and the respondents' mean age was 39.43 years. Television was chosen as the most reliable source of information by 75.0% of the participants. Most of the respondents had a sufficient knowledge about the COVID-19 pandemic, as the majority of them answered the knowledge questions correctly. The significant predictors for their knowledge were their educational level, age, marital status, parenthood status, and employment sector (private or government). Our study revealed an overall 98.6% positive attitude of safety and security workers toward COVID-19. Majority of the respondents were following good and safe COVID-19 prevention practices.

Conclusion: High level of knowledge was reflected in both the attitude and practice of the participants toward the COVID-19 pandemic.

Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition

BACKGROUND

The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work.

METHODS

Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic.

RESULTS

Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents "agreed/strongly agreed" that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic.

CONCLUSIONS

A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings.

KNOWLEDGE TRANSFER STATEMENT

The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

Knowledge, preventive behaviors and risk perception of the COVID-19 pandemic: A cross-sectional study in Turkish health care workers

The coronavirus disease 2019 (COVID-19) outbreak spread to over 100 countries with a total of 100,000 cases during the first week of March 2020. Health care workers, as those on the frontline of the COVID-19 pandemic, are more susceptible to infection. Inadequate related knowledge and preventive behaviors among health care workers might lead to delayed treatment and result in the rapid spread of the infection. Therefore, this study evaluated the knowledge of health care workers with regard to COVID-19. A cross-sectional study was conducted from June 10-18, 2020. Participants were general practitioners, specialists, and nurses working at the forefront of the pandemic. Their knowledge, preventive behaviors, and risk perceptions concerning COVID-19 were evaluated using an online questionnaire created by our medical specialists. The questionnaire consisted of 29, 5, and 4 items about COVID-19 knowledge, preventive behaviors, and risk perceptions, respectively. A total of 251 health care workers completed the questionnaire. The mean age of the participants was 33.88±8.72 years old, and the sample consisted of 68 males (27.08%) and 183 females (72.91%). While there was no difference between the percentage of correct answers given by female and male participants to knowledge-based questions (p>0.05), the percentage of correct answers to the questions on preventive behaviors was significantly higher in female participants than in males (p<0.001). The overall average percentages of correct responses were 91.66% for knowledge-based questions and 85.96% for preventive behavior questions. The scores for knowledge-based questions were higher for medical specialists, whereas nurses scored higher on preventive behavior questions. Government hospital staff showed a significant difference in preventive behaviors compared to that of university hospitals (p<0.05). In addition, there was a positive correlation between knowledge scores and preventive behaviors. Although all the participants (100%) knew that contracting COVID-19 can lead to death, only 66.93% of them were willing to get vaccinated themselves. The knowledge level of health care workers concerning COVID-19 was above 90%, but the level of competence in terms of preventive behaviors was found to be low, especially in males.

Awareness of COVID-19 Before and After Quarantine Based on Crowdsourced Data From Rabigh City, Saudi Arabia: A Cross-Sectional and Comparative Study

Background: Infection prevention and control measures are critical for the prevention of the spread of COVID-19.

Aim: In this study, we aimed to measure and evaluate the level of awareness and knowledge of the prevention, symptoms, and transmission control of COVID-19 before and after quarantine among the residents of Rabigh city and adjacent villages in Saudi Arabia.

Methods: A cross-sectional online survey was conducted in two stages: the first stage took place before quarantine and the second stage took place after quarantine. The survey was filled out electronically.

Results: A total of 448 participants responded and filled out the questionnaires. Females (73.70%) formed the largest number of participants for both stages. The majority of the participants were <30 years old (50.90%) and had a high education level in various sectors and levels (97.1%). It was noticeable that during the first stage, the participants' awareness of COVID-19 symptoms was not very high: 13.62% did not know about the symptoms. However, by the second stage, awareness about symptoms had increased (9.6%).

Conclusion: The residents of Rabigh city and the surrounding villages had good levels of knowledge about COVID-19.

Dental Practitioners' Knowledge, Attitude and Practices for Mouthwash Use Amidst the COVID-19 Pandemic

Introduction

COVID-19 created a peculiar situation worldwide, thus altering the fundamental dynamics of clinical dentistry. This KAP survey was carried out to evaluate the knowledge, attitude and practices among dental practitioners regarding the use of mouthwashes and emphasize on pre-procedural utilization of mouthwashes.

Methodology

A descriptive, cross-sectional study was conducted during 1st to 15th July 2020, among working dental practitioners across the globe. A questionnaire was formed on Kwiksurveys.com, it comprised of demographic details, it further investigated the level of knowledge and new precautionary measures adopted. A total number of 707 dental practitioners from eighteen different countries responded.

Results

Data were analyzed using SPSS version 23. A "fisher exact test" was applied to assess the difference between the mouthwashes prescribed by various countries. Knowledge section revealed a requisite understanding regarding the disease and its transmission. Only 38.9% of the participants knew that Povidone-iodine (PVP-I) mouthwashes are more efficient in reducing coronaviruses in contrast to mouthwashes made of chlorhexidine (CHX). Whereas 33.9% knew that 0.23% of PVP-I had substantial virucidal activity against SARS-COV, MERS-CoV, influenza virus and rotavirus while 31.1% recognized that oral rinses of Cetylpyridinium chloride (CPC) remained successful in the oral cavity for up to 180-300 minutes.

Conclusion

There is an immense need to raise awareness among practitioners, regarding the viricidal activity of commercially available mouthwashes as demonstrated by numerous in-vitro studies and urge health workers to carry out more clinical trials and to get a translational step towards clinical practice.

COVID-19 Pandemic and Its Impact on Pediatric Dentistry in Austria: Knowledge, Perception and Attitude Among Pediatric Dentists in a Cross-Sectional Survey

Introduction

The Novel Coronavirus Disease (COVID-19) outbreak is affecting people worldwide. Given the frequent production of aerosols, dentists are a high-risk group for infection. The aim of this study was to assess the knowledge, perception and attitude regarding COVID-19 among pediatric dentists in Austria.

Methods

An online survey was distributed among the 128 pediatric dentists that are members of the Austrian Society of Pediatric Dentistry. The questionnaire was divided into three sections: 1) dentists’ demographic characteristics, 2) general knowledge and attitude, 3) COVID-19 with a focus on pediatric dentistry.

Results

Seventy-five dentists replied; 58 questionnaires could be included in the analysis (93.1% female). Pediatric dentists were found to have good general knowledge of COVID-19. However, only 10% had attended training or lectures and 36.2% rated their role in teaching patients about COVID-19 as being very significant. At the beginning of the outbreak, 78.6% only offered emergency services. Currently, only 10.3% of the dentists work without FFP2/3 mask when producing aerosols.

Discussion

Austrian pediatric dentists were aware of the general aspects of COVID-19. Those, who had their practice open mostly followed national and international recommendations given and only offered emergency visits.

Alsalhani A, Alqhtani NR, Bin Nabhan A, Alenzi A, Alrafedah A. COVID-19-Awareness and Practice of Dentists in Saudi Arabia

Dental professionals have a major role in the fight against the spread and transmission of COVID-19. This study aimed to evaluate awareness and practice of dentists in Saudi Arabia regarding COVID-19 and the utilization of infection control methods. A 24-item questionnaire was developed and distributed through social media to 627 dentists working in Saudi Arabia. 177 questionnaires were completed (28.2% response rate). Most dentists were aware about the transmission, incubation time and main clinical symptoms of COVID-19. Almost 83% of the respondents appreciate the risk of droplets, aerosols and airborne particles in transmission of COVID-19 in the dental clinic. Among the common practices of participants are measuring patient’s body temperature before undertaking a dental treatment (88.7%), cleaning the environmental surfaces at the dental clinic after each patient (91.5%) and restriction of dental treatment to emergency cases (82.5%). It seems that practicing dentists in Saudi Arabia are fairly aware about COVID-19. The practices of the surveyed dentists appear to be mostly consistent with the current guidelines and recommendations for infection control of COVID-19 in the dental clinic. Some drawbacks in knowledge and a number of inappropriate practices can be identified and require the attention of health authorities.

Effect of COVID-19 Pandemic on the Levels of Empathy among Undergraduate Dental Students in Pakistan

Objective  The purpose of our study is to determine the effect of coronavirus disease 2019 (COVID-19) on the levels of empathy toward patients among undergraduate dental students in Pakistan.

Materials and Methods  A cross-sectional, survey-based study was conducted at Islamic International Dental College, Islamabad, Pakistan. After taking an informed consent, a validated and pretested Toronto Empathy Questionnaire (TEQ) was distributed amongst the undergraduate dental students at two points, one before the COVID-19 existed, and the other after August 7th, 2020, when the COVID-19 cases dropped in Pakistan. Responses were indicated on a five point Likert Scale.

Statistical Analysis  A one-way ANOVA (analysis of variance) was used to compare the TEQ scores between the different years of education at the dental school. Difference within the groups was analyzed using the post-hoc Tukey test. Pre- and post-COVID-19 comparison was done using the Chi-square test (significance level p < 0.05).

Results  A total of 221 out of 260 students in the pre-COVID-19 group, while 210 out of 260 students in the post-COVID-19 group enrolled in the dentistry program participated in the study. Significant difference in the empathy levels was observed in the pre- and post-COVID-19 groups of the same population, i.e., ( p < 0.05). The response rate was 85%.

Conclusions  This study showed an increase in mean empathy scores among the undergraduate dental students after COVID-19, indicating a significant improvement in their empathy levels during the time of COVID-19. It highlights the impact of the pandemic, whereby death and chaos seem to have brought about an improvement in interpersonal harmony.

Awareness on Preventive Measures taken by Health Care Professionals Attending COVID-19 Patients among Dental Students

OBJECTIVES

 Coronavirus disease is an infectious disease caused by a newly discovered coronavirus. This virus primarily spreads through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. This virus was named after its shape, which takes the form of a crown with protrusions around it. The World Health Organization has recommended personal protective equipments (PPE) to doctors and health care workers attending COVID-19 patients. PPE generally includes masks, goggles, respirators, gloves, face shields, and isolation gowns. The principle aim of this study is to create awareness among dental students about the preventive measures taken by health care professionals while attending patients affected with COVID-19.

MATERIALS & METHODS

 A questionnaire comprising 15 questions was created using an online Google forms website and was circulated among 100 dental students. The survey was conducted within a week in the months of April to May 2020. The results and observations were recorded in the form of pie charts.

RESULTS

 Ninety-three percent of the participants have stated that health care professionals must clean their hands often, cover their nose and mouth, and maintain safe distance from everyone in order to prevent the virus from affecting them. Sixty-three percent of the participants are familiar with the term PPE. Majority assume that health care professionals are given enough safety precautions while treating a patient with coronavirus.

CONCLUSION

 Hence, to conclude, health care professionals play a vital role in improving access and quality health care for the population, and hence, they must be protected as well. Since dental students treat patients, they are vulnerable to infection as well, and must take proper safety measures.

Knowledge, attitudes and practices regarding COVID-19 among dental health care professionals: a cross-sectional study in Saudi Arabia

OBJECTIVES

With the increasing severity of the coronavirus disease (COVID-19) pandemic, it is essential that dental health care professionals (DHCPs) are prepared. The study aim was to assess the knowledge, attitudes and practices (KAP) regarding COVID-19 among DHCPs in Saudi Arabia.

METHODS

A cross-sectional study using a web-based survey was conducted. A validated and reliable questionnaire was developed that comprised 44 questions. Using Qualtrics survey software, DHCPs working in different settings were approached across five geographical regions of Saudi Arabia.

RESULTS

A total of 318 respondents voluntarily participated in the survey. Most DHCPs showed a moderate level of knowledge (51.6%), a positive attitude (92.1%) and adequate practice standards (86.5%). We found that 94.7% of DHCPs had an adequate overall level of KAP. DHCPs with a doctorate significantly outscored DHCPs with other educational levels with respect to knowledge and practice. Older (51-60 years) DHCPs reported significantly more knowledge than younger DHCPs.

CONCLUSION

DHCPs displayed an average level of knowledge that needs to be enhanced through continuing education programmes. However, they showed a positive attitude and an acceptable level of practice, as they were abiding by guidelines issued from various international and national health agencies.

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

OBJECTIVE

 In response to the coronavirus disease 2019 (COVID-19) pandemic, the Indian Government imposed a countrywide lockdown of 21 days from March 25 to April 14, 2020, which was further extended to 60 days. The sudden draconian measures changed the delivery of dental education and practice throughout the country. The study aimed to screen for depression during the COVID-19 lockdown and the factors associated with it among dental students and practitioners in highly COVID-19 infected states of India.

MATERIALS AND METHODS

 The current study is an online cross-sectional survey performed in Delhi NCR, Maharashtra, and Tamil Nadu during May 2020. The participants were recruited by convenience sampling. The main outcome measure was the screening of depression using the Patient Health Questionnaire (PHQ-9), which was categorized as mild, moderate, and severe depression. The data analysis was performed with IBM SPSS Version 23.0. A multivariable logistic regression model was fitted to identify the independent predictors of depression.

RESULTS

 In total, 335 dental students and practitioners participated in the survey. Among this, a significant number of the dental students (54%) and practitioners (44%) scored moderate to severe depression in terms of depression severity according to the PHQ-9 scores. Those who were screened depressed were likely to be males and younger than 30 years old. The results of correlation analysis indicated that worry about the professional growth, concerns regarding setbacks in clinical and research experiences, previous history of mental health issues, and fear of contracting COVID-19 from patients were positively related to higher depression scores in students. Moreover, for practitioners, fear of contracting COVID-19 from the patients scored higher levels of depression. The practitioners who reported less concern about their practice/job post COVID-19 lockdown and those who were able to meet their financial expenses during the lockdown were the least likely to be depressed.

CONCLUSION

 The results of this study indicate a high level of depression among a significant number of dental students and practitioners. It is important to monitor and address the mental health needs of dental students and practitioners during and after the lockdown.

Knowledge, Attitudes, and Clinical Practices of Dental Professionals during COVID-19 Pandemic in Pakistan

OBJECTIVE

 The aim of this study is to assess knowledge, attitudes, and clinical practices of dental professionals regarding the prevention and control of coronavirus disease 2019 (COVID-19) in Pakistan.

MATERIALS AND METHODS

 General dentists and dental specialists working in public and private dental practices, hospitals, and academic institutions participated in this cross-sectional study. A pilot-tested questionnaire was sent to dental professionals through an online link in Pakistan and data collection was completed in April-May 2020. The knowledge score was calculated from 22 variables about the COVID-19.

RESULTS

 The study included data of 343 dental professionals with 47.2% of males and 52.8% of females. The mean knowledge score was 16.78 ± 2.25, and it significantly differed between general dentists (16.55 ± 2.36) and dental specialists (17.15 ± 2.04) (p = 0.020), and those with up to 10 years of experience (16.58 ± 2.28) and those with more than 10 years of experience (17.05 ± 2.2) (p = 0.026). Only 15.5% of the participants were comfortable in treating patients during the COVID-19 pandemic. A workshop/seminar on the COVID-19 was attended by 23% of the participants. In multivariate analysis, being comfortable in treating patients (odds ratio = 3.31, 95% confidence interval = 1.63, 6.73) was associated with the attendance of workshop/seminar on COVID-19.

CONCLUSIONS

 Dental professionals had adequate knowledge about COVID-19, but a few of them were comfortable in treating patients during the pandemic. A minority of dental professionals attended a workshop/seminar on the COVID-19. Continuous education activities should be provided to dental professionals to enhance their role in the prevention of COVID-19 spread and promotion of oral health.

Pivoting Dental Practice Management during the COVID-19 Pandemic-A Systematic Review

Background and Objectives: The aims of this systematic review were to identify additional infection control measures implemented in dental practice globally to prevent cross-infection and evaluate the psychological impacts of the pandemic among dental professionals. Materials and Methods: A sequential systematic literature search was conducted from December 2019 to 30 April 2020 through PubMed, CINAHL, Scopus, Google Scholar, Embase, and Web of Science databases. The search yielded the following results: "COVID-19" (n = 12,137), "Novel corona virus" (n = 63), "COVID-19 and dentistry" (n = 46), "COVID-19 and oral health" (n = 41), "Novel Corona virus and Dentistry" (n = 0), "dental health and Novel Coronavirus" (n = 26), and "dental practice and Novel Coronavirus" (n = 6). Results: After a careful review and eliminating articles based on inclusion and exclusion criteria, the final review included 13 articles. Management of infection control is discussed extensively in the literature and remains the main theme of many Coronavirus Disease 2019 (COVID-19) articles on dentistry. Telephone triage using a questionnaire, hand hygiene, personal protective equipment (PPE) for clinical and nonclinical staff, a preprocedural mouth rinse, and aerosol management have been discussed and implemented in few countries. Three studies recommended that elective treatments for patients with a temperature of >100.4 F or 38 °C should be postponed or performed in an airborne infection isolation room (AIIR) or negative-pressure room. Limiting the number of patients in the waiting area, the removal of shared objects, proper ventilation, and physical distancing were highly recommended. Psychological distress among dental professionals in relation to existing medical conditions and self-efficacy has been discussed. Conclusions: Although the COVID-19 pandemic has had a substantial impact on the dental profession worldwide, our review highlights many practice management approaches to adopt the new norm. More research highlighting evidence-based safety practices and multisectoral collaboration is required to help dental professionals make informed decisions and make the profession safe, both for the patient and dental professionals.

Factors Associated with Infection-Control Behavior of Dental Health-Care Workers During the COVID-19 Pandemic: A Cross-Sectional Study Applying the Theory of Planned Behavior

OBJECTIVE

The objective of this study was to evaluate the usefulness of the extended theory of planned behavior (TPB) in predicting COVID-19-infection prevention and control (IPC) among a sample of dental health-care workers (DHCWs) in Saudi Arabia and to examine their behavioral beliefs, normative beliefs, and control beliefs to better understand their views about COVID-19 IPC.

METHODS

An online cross-sectional survey was administered among DHCWs in Saudi Arabia using convenience sampling. A questionnaire collected data on demographic characteristics and the 43 items from the TPB construct. One-way ANOVA and Independent sample t-tests were used to establish factors associated with TPB-construct scores. Multiple regression analyses with adjusted effects were used to identify significant predictors for intention from attitudes, subjective norms, and perceived behavioral control variables. The significance level was set at 0.05.

RESULTS

A total of 324 study participants completed the questionnaire for a response rate of 40.5%. The majority of respondents were male (59.8%) and aged 25-30 years (32.7%), followed by 31-35 years (31.2%). Only 28.4% reported having participated in IPC activities. With a mean of 41.60±6.26), it was evident that study participants had a favorable attitudes toward COVID-19 IPC. Subjective norms and perceived behavioral control subscale scores were low, with the means of 28.95±5.44) and 34.89±6.49), respectively. The constructs of attitude toward behavior (p<0.001) and subjective norms (p<0.001) significantly predicted the DHCWs' intention to practice COVID-19 IPC behavior, accounting for 44.3% of the variance.

CONCLUSION

The current study suggests that the attitudes and subjective norms of DHCWs significantly predicted their intentions regarding COVID-19 IPC behavior. As such, it is recommended that comprehensive education and training programs on infection control pertaining to COVID-19 be implemented among DHCWs in Saudi Arabia so that their attitudes and behavior toward infection prevention are amplified.

Increased Levels of Anxiety Among Medical and Non-Medical University Students During the COVID-19 Pandemic in the United Arab Emirates

Introduction

The COVID-19 pandemic is likely to increase anxiety levels within the community and in particular medical students who are already considered psychologically vulnerable groups. Since the COVID-19 outbreak, no study has yet estimated the effect of this pandemic on university students in the UAE or its impact on the psychological well-being of medical students.

Methods and Materials

We surveyed 1485 medical (comprising medical and dental) and non-medical university students across 4 emirates within the UAE. We used an online platform to assess knowledge, sources of information, changes in hygienic behavior, perceptions of fear and worry and anxiety levels using the generalized anxiety disorder 7 (GAD-7) scale. The GAD-7 score was measured at three time points: during hospital visits for medical/dental students, before the introduction of online learning and after online learning for all students.

Results

The majority of students demonstrated high levels of knowledge and utilized reliable sources of information. Non-medical students exercised higher compliance with social restrictions, while medical students practiced better hand hygiene. Almost half of students reported anxiety levels ranging from mild to severe with females reporting higher anxiety scores during hospital visits (OR=2.02, 95% CI, 1.41 to 2.91) and medical students reporting lower anxiety levels in comparison to dental students (OR=0.61, 95% CI, 0.45 to 0.84). Medical students reported higher levels of anxiety during their clinical rotations which decreased with the introduction of online learning, yet, non-medical students’ anxiety levels increased with online learning.

Conclusion

This study provides important information on the initial response and anxiety levels in university students across the UAE during the COVID-19 pandemic. The findings from our study can be used to support the development of effective screening strategies and interventions to build psychological resilience among university students during the COVID-19 pandemic or any other public health emergencies in the future.

Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey

BACKGROUND

COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries.

METHODS

We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants' background variables. Multilevel linear models were used to assess the association between dental academics' knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries.

RESULTS

Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007).

CONCLUSIONS

Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.

Impact of novel coronavirus disease (COVID-19) on Egyptian dentists' fear and dental practice (a cross-sectional survey)

Objectives

This study aimed to evaluate the fear of infection among Egyptian dentists practicing during the current coronavirus disease 2019 (COVID-19) pandemic and to explore the dentist’s knowledge about guidelines to fight the virus and to assess various modifications in dental practice.

Methods

An online survey was submitted to dental professionals. Data were collected through a validated questionnaire consisting of 23 closed-ended questions. The gathered data were statistically analyzed.

Results

An overall 216 dentists completed the survey. A total of 200 (92.6%) dental professionals were afraid of becoming infected with COVID-19 while 196 (90.7%) became anxious to treat patients showing suspicious symptoms. The majority of the participants were aware of the mode of transmission of COVID-19 and a lot of them were updated with the current Disease Control and Prevention (CDC) or World Health Organization (WHO) guidelines for cross-infection control.

Conclusions

COVID-19 pandemic has a significant impact on dental professionals.