The COVID-19 pandemic and its global effects on dental practice. An International survey

COVIDental Collaboration Group

doi:10.1016/j.jdent.2021.103749

The COVID-19 pandemic and its global effects on dental practice. An International survey

J Dent. 2021 Nov:114:103749. doi: 10.1016/j.jdent.2021.103749. Epub 2021 Jul 17.

Author

COVIDental Collaboration Group

Collaborators

COVIDental Collaboration Group:
G Campus¹, M Diaz Betancourt², M G Cagetti³, R A Giacaman⁴, D J Manton⁵, Gva Douglas⁶, T S Carvalho², J C Carvalho⁷, A Vukovic⁸, F J Cortés-Martinicorena⁹, D Bourgeois¹⁰, V Machiulskiene¹¹, R Sava-Rosianu¹², J Krithikadatta¹³, N Sergeevna Morozova¹⁴, A M Acevedo¹⁵, A A Agudelo-Suarez¹⁶, G Aguirre¹⁷, K Aguirre¹⁷, I Alfonso¹⁵, H A Ghaffar¹⁸, R A El Fadl¹⁸, S A Al Maghlouth¹⁹, T Almerich-Torres²⁰, F Amadori²¹, K Antia²², E Bajric²³, D M Barbosa-Liz¹⁶, S Ben-Tanfous²⁴, H Bieber²⁵, S Bhusari²⁶, S Birch⁶, G Bontà³, P Bottenberg²⁷, J J Bruers²⁸, L Bustillos²⁹, P Bührens³⁰, J Cai³¹, J L Cairoli³², Fca Carrer³³, M B Correa³³, B Cortés-Acha³⁴, F Carrouel¹⁰, R de Carvalho Oliveira³³, F Cocco³⁵, F Crombie³⁶, J I Csikar⁶, D Declerck³⁷, M Denkovski³⁸, J Deschner³⁹, J Dopico-San Martin³⁴, O Viktorovna Dudnik¹⁴, W Y Escobar¹⁷, A Elwishahy⁴⁰, C E Fernàndez⁴, M Fontana⁴¹, A Frattaroli Pericchi¹⁵, M Ghorbe²⁴, E Gigineishvili²², A Garcia Quintana¹⁵, J Gray⁴², N Gugnani⁴³, K Gambetta-Tessini⁴, A Haider⁴⁴, M Hopcraft⁴⁵, J Hüttmann³⁰, N Hysenaj⁴⁶, A Jalal⁴⁴, M Jikia²², J John⁴⁷, G Kaps-Richter³⁰, T Kerber Tedesco³³, S Leòn⁴, K A Levin⁶, H Pau Lew⁴⁸, M Aperecida Moreira Machado³³, A Beneictovna MacLennan¹⁴, J Onome Mafeni⁴⁹, M Minatel Braga³³, J M Montiel-Company⁵⁰, A Malerba³, S Mandić-Rajčević⁵¹, A Askerovich Mamedo¹⁴, S A Mani⁴⁷, O Marouane²⁴, D Markovic⁸, E Paredes Martinez⁵², N Maroufidis⁵³, F Medeiros Mendes³³, C F Mendez⁵⁴, S Musa⁴⁷, A Necibi²⁴, N Azlida Mohd Nor⁴⁷, B Tochukwu Ojukwu⁴⁹, N Opdam⁵⁵, L Ottolenghi⁵⁶, J Owen⁶, A Pássaro³³, I F Persoon⁵⁷, T Peric⁸, E Pesaressi-Torres⁵², V Philippides⁵⁸, S P Plaza-Ruiz⁵⁹, D Procida Raggio³³, Fj Rivas Cartagena¹⁷, F Ramos-Gomez⁶⁰, M Sabashvili²², G Solis Sanchez⁵², R Villena Sarmiento⁵², H Schrader³⁰, S Serban⁶, R Bairstow⁶, A Senna³, B Shi³¹, Cpc Sim⁴⁸, E Slabsinskiene⁶¹, G Spagnuolo⁶², A F Squassi⁶³, O Olufemi Taiwo⁴⁹, A Thodhorjani⁴⁶, P Tietler³⁰, Cmc Volgenant⁵⁷, M H van der Veen⁵⁷, Z Vlahovic⁶⁴, A Visaria⁶⁵, Y Romero Uzcategui²⁹, E Xhajanka⁴⁶, Q Yan³¹, O Zeng³¹, O Zeyer⁶⁶, A Zukanovic⁸, T G Wolf⁶⁷

Affiliations

¹ Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland; School of Dentistry Sechenov University, Moscow, Russia. Electronic address: guglielmo.campus@zmk.unibe.ch.
² Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland.
³ Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy.
⁴ Cariology and Gerodontology Units, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile.
⁵ Cariology and Paediatric Dentistry, Centrum voor Tandheelkunde en Mondzorgkunde, University Medical Centre Groningen, Groningen, the Netherlands.
⁶ Department of Dental Public Health, School of Dentistry, University of Leeds, Leeds, UK.
⁷ Faculty of Medicine and Dentistry, UCLouvain, Louvain, Belgium.
⁸ Department of Pediatric and Preventive Dentistry School of Dental Medicine University of Belgrade, Belgrade, Serbia.
⁹ Pamplona; Ex-Facultad de Odontología, Universidad de Barcelona, Spain.
¹⁰ University Claude Bernard Lyon 1, Laboratory "Systemic Health Care," University of Lyon, Lyon, France.
¹¹ Clinic of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
¹² Department of Preventive, Community Dentistry and Oral Health, Faculty of Dentistry, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.
¹³ Department of Conservative Dentistry & Endodontics, Saveetha Dental College and Hospitals, Chennai, India.
¹⁴ School of Dentistry Sechenov University, Moscow, Russia.
¹⁵ Universidad Central de Venezuela, Facultad de Odontología, Caracas, Venezuela.
¹⁶ Faculty of Dentistry, University of Antioquia, Colombia, Medellín, Antioquia.
¹⁷ Facultad de Odontologia, Universidad de El Salvador, El Salvador.
¹⁸ Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
¹⁹ King Fahad Medical City, Riyadh, Saudi Arabia.
²⁰ Facultad de Odontología, Universidad de Valencia, Spain.
²¹ Dental Clinic, School of Pediatric Dentistry, University of Brescia, Brescia, Italy.
²² School of Health Sciences, University of Georgia, Tbilisi, Georgia.
²³ Department of Preventive and Pediatric Dentistry, Faculty of Dentistry with Clinics of Sarajevo University, Sarajevo, Bosnia Herzegovina.
²⁴ Faculty of Dental Medicine of Monastir, Monastir, Tunisia.
²⁵ Bundeswehr Medical Service Headquarters, Koblenz, Germany.
²⁶ Heidelberg Institute of Global Health (HIGH), Heidelberg, Germany.
²⁷ Oral Health Research Cluster, VUB, Bruxelles, Belgium.
²⁸ University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
²⁹ Universidad de Los Andes, Facultad de Odontología, Merida, Venezuela.
³⁰ Freier Verband Deutscher Zahnärzte, Bonn, Germany.
³¹ The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
³² Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
³³ Universidade de Sao Paulo- School of Dentistry - Department of Community Dentistry, Sao Paulo, Brazil.
³⁴ Private Practitioner, Pamplona, Spain.
³⁵ Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy.
³⁶ Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia.
³⁷ Department of Oral Health Sciences, Population Studies in Oral Health, KULeuven, Belgium.
³⁸ Private practioner, Kumanovo, North Macedonia.
³⁹ Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
⁴⁰ Heidelberg Institute of Global Health at Heidelberg University Hospital, Heidelberg, Germany.
⁴¹ University of Michigan School of Dentistry, Ann Arbor, USA.
⁴² King Fahad Medical City, Ryad, Saudi Arabia.
⁴³ Department of Pediatric and Preventive Dentistry, Dental college, Haryana, India.
⁴⁴ Department of Oral and Maxillofacial Surgery, Fatima Memorial Hospital, Lahore, Pakistan.
⁴⁵ Melbourne Dental School, Faculty of Medicine, Dentistry& Health Sciences, The University of Melbourne, Melbourne, Australia; eviDent Foundation, Melbourne, Australia.
⁴⁶ Department of Prosthodontic, Faculty of Dental Medicine, University of Medicine, Tirana, Albania.
⁴⁷ Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
⁴⁸ Department of Restorative Dentistry National Dental Centre Singapore, Singapore.
⁴⁹ Intercountry Center for Oral Health for Africa, Jos, Nigeria.
⁵⁰ School of Dentistry University of Valencia, Valencia, Spain.
⁵¹ Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy; Department of Pediatric and Preventive Dentistry School of Dental Medicine University of Belgrade, Belgrade, Serbia.
⁵² Facultad de Odontología - Universidad San Martin de Porres, Lima, Peru.
⁵³ Private Practioner, Athens, Greece.
⁵⁴ Instituto de Investigaciones Biomédicas INBIOMED, Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina.
⁵⁵ School of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands.
⁵⁶ Department of Dental and Maxillo-Facial Sciences, Sapienza Rome University, Rome, Italy.
⁵⁷ Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, the Netherlands.
⁵⁸ President Cyprus Dental Association, Nicosia, Cyprus.
⁵⁹ Orthodontic Department, Fundación Universitaria CIEO-UniCIEO Bogotá, Colombia.
⁶⁰ UCLA Center for Children's Oral Health (UCCOH) UCLA School of Dentistry, Los Angeles, USA.
⁶¹ Faculty of Odontology, Department of Pediatric and Preventive Dentistry, Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁶² School of Dentistry Sechenov University, Moscow, Russia; Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
⁶³ Instituto de Investigaciones en Salud Pública (IISAP), Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires, Argentina.
⁶⁴ Medical Faculty of Pristina - Kosovska Mitrovica, Serbia.
⁶⁵ Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore.
⁶⁶ Schweizerische Zahnärzte-Gesellschaft SSO, Bern, Switzerland.
⁶⁷ Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

Abstract

Objectives: A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and Personal Protective Equipment (PPE).

Methods: A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) Personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) Working conditions and PPE adopted after the outbreak. Countries' data were grouped by the Country Positive Rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items.

Results: A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n = 27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR = 1.80 _95%CI = 1.60/2.82 and OR = 5.20 _95%CI = 1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR = 1.09 _95%CI = 0.97/1.60). The same significant associations were observed in the multivariate analysis.

Conclusions: Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events.

Keywords: COVID-19; Dental professionals; Dentistry; Global Health; Infection control; Oral Health; Personal Protective Equipment (PPE); Public Health Dentistry; SARS-CoV-2.

MeSH terms

COVID-19*
Communicable Disease Control
Female
Humans
Male
Pandemics*
SARS-CoV-2
Surveys and Questionnaires