A study of the COVID-19 pandemic's knowledge and impact on ongoing fixed orthodontic treatment in adults

Abstract

Background:

Due to the characteristics of dental practices and hospitals, all dental professionals, including orthodontists, are at an elevated peril of SARS-CoV-2 infection. If adequate safety actions are not taken, cross-contamination risk among dentists, orthodontists, and patients can be extremely high. For orthodontic patients, a high level of cognizance and consideration of the COVID-19 epidemic is required. The goal of this study was to assess adult patients' knowledge of the coronavirus disease 2019 (COVID-19) pandemic and its impact on their continuing fixed orthodontic treatment.

Methodology:

A cross-sectional in addition to a descriptive survey of 100 adult patients enduring fixed orthodontic treatment was done. All of the candidates were over the age of 18 years and were in lockdown due to the COVID-19 epidemic, with no therapy available.

Results:

Among the patients, 35% were male and 65% were female; 22.3% were unaware that the COVID-19 virus unfurls speedily in a dental setting; 64.8% were unquestionably keen to disclose their status and undertake pretreatment screening; 71.3% were undeniably prepared to stick to stringent appointment timings for passable sanitization of the clinical area; 70% believed that skipping appointments all through the COVID-19 pandemic would be costly; 70% believed that skipping appointments during the pandemic would prolong the treatment; and 59% thought of financial burden.

Conclusion:

COVID-19 cross-infection was not known to all adult orthodontic patients. The vast majority were aware of the situation and eager to follow infection-prevention guidelines. COVID-19 had a psychological and financial impact on patients' perceptions of overall orthodontic therapy.

INTRODUCTION

COVID-19 has evolved into a global public health emergency, prompting the World Health Organization (WHO) to designate it as a pandemic. It is now thought that the virus spreads mostly through respiratory droplets/secretions (cough, sneeze), saliva, and contact transmission, in which the virus passes into the mucous membranes of the mouth, nose, and eyes. Because of the characteristics of dental practices and hospitals, such as aerosol generation, sharps handling, and proximity to patients' oropharyngeal area, all dental practitioners, including orthodontists, are at advanced peril of SARS-CoV-2 infection. Cross-contamination risk among dentists, orthodontists, and patients can be significant if adequate safety measures are not performed.[1,2,3,4,5] For orthodontic patients, a high level of cognizance and consideration of the COVID-19 epidemic is required so that it does not negatively affect their psychological well-being. Teleconsultation, for example, can solve the majority of minor-to-moderate orthodontic issues. In this pandemic, however, dealing with orthodontic issues may be an additional financial strain as dental installations must be kept to a precise high degree of sterilization, infection prevention, and control routine. The goal of the trial is to see how much people know about the COVID-19 pandemic and how it affects individuals who are still receiving fixed orthodontic treatment.

METHODOLOGY

The questionnaire had 12 closed questions. The questions address the critical standing of adult patients' acquaintance and consideration of the COVID-19 epidemic, as well as the financial liability in addition to its influence on continuous fixed orthodontic treatment. To send their response, the patients were required to answer all 12 questions. The questionnaire's test–retest reliability was determined by presenting it to the same group of participants and calculating Cronbach's alpha 0.86 based on their responses. The online questionnaire was sent to 100 adult patients who were getting orthodontic treatment and were chosen at random. As an online plotting source, Google Forms® was employed; the questionnaire's URL was delivered by WhatsApp or email to the patients on the department's orthodontic database's contact list. The results of the survey were analyzed using SPSS Version 20.0 (SPSS Corporation, Chicago, IL).

RESULTS

To conduct the survey, 100 adult patients receiving fixed orthodontic treatment were addressed. Among the patients, 35% were males and 65% were females. It was found that 17.5% of patients were slightly conscious and 22.3% were completely unaware that the COVID-19 virus spreads swiftly in a dental setting; 5.6% were unlikely to seek treatment from an orthodontic team that has been infected with COVID-19. Further, 68% of the patients were certain that they want to participate, while the rest were undecided about reporting their COVID-19 status and completing pretreatment screening before each session. Due to missing appointments during the COVID-19 epidemic, 34.3% of all patients experienced no pain or suffering. In the event of unanticipated orthodontic complications, 46.3% of patients preferred telecommunication. For proper sanitization of the clinical area, 71.3% of patients were willing to stick to rigorous appointment schedules. Seventy percent believed that missing visits because of the COVID-19 pandemic would lengthen their treatment duration. Although 59% said their financial status had been impacted, they believed they will be able to pay for future therapy. While protective clothing and equipment may upsurge future treatment expenses, 42% said they could not afford the increased cost, and 41% said they want the dental institution/clinic/government/insurance companies to cover the cost.

DISCUSSION

To conduct the survey, 100 adult patients were addressed who were receiving fixed orthodontic treatment. Among the patients, 35% were males and 65% were females. It was found that 17.5% of patients were slightly conscious and 22.3% were completely unaware that the COVID-19 virus spreads swiftly in a dental setting. As a result, regardless of gender, it is still a prerequisite to educate and raise awareness among patients about the COVID-19 epidemic. Further, 5.6% of the patients were unlikely to accept treatment from an orthodontic team that had been infected with COVID-19. The majority of patients believed that viral infections can be spread by dentists. Furthermore, recurrence of COVID-19 has been described in the literature, with a previously infected person capable of transmitting the virus to others even after a second negative test.[1,2,3,4,5] This could be one of the reasons why patients avoid orthodontists who have previously been affected. Sixty-eight percent of the patients were certain that they wanted to participate, while the rest were undecided about reporting their COVID-19 status and completing pretreatment screening before each session. This is a worrisome indicator that could expose many people to the infection. As a result, we must educate patients on the need of disclosing their health state and participating in a pretreatment triage. Due to missing appointments during the COVID-19 epidemic, 34.3% of the patients reported no pain or suffering. According to the literature, there is a nonlinear link between age, gender, and psychological state, in addition to cultural background in pain perception after orthodontic appliance insertion. Patients receiving fixed orthodontic treatment, on the other hand, frequently feel mild to moderate pain or discomfort. In the event of unanticipated orthodontic complications, 46.3% of patients preferred telecommunication. The responses of the participants showed a gender difference (P = 0.06). Males exhibited preparedness to attend the dental office and seek care, but most females articulated curiosity in teleconsultation with the dental office. Teledentistry services should be promoted during this epidemic to reduce the number of unneeded dental consultations.[6,7] This would assist patients in settling a new orthodontic condition that may be handled at home, as well as determining which patients require in-person treatment. For proper sanitization of the clinical area, 71.3% of patients were willing to stick to rigorous appointment schedules. Further, 70% believed that missing appointments as a result of the COVID-19 outbreak would lengthen their overall treatment duration [Figure 1]. The relationship between the epidemic and orthodontic treatment time and outcome has not been studied before. The virus has spread throughout the world's inhabited areas, causing enormous financial meltdowns. Fifty-nine percent of patients said their financial status had been impacted, but that they will be able to afford future treatment. Economic crises, on the other hand, are dependent on a number of circumstances, including the length of the lockdown, the category of profession, and social class.[7,8,9,10] Although protective clothing in addition to equipment may upsurge forthcoming treatment expenses, 42% said they cannot afford the higher cost [Figure 2], and 41% said they assume the dental institution/clinic/government/insurance corporations to cover the cost.

Figure 1.

Missed appointments due to COVID-19 would prolong treatment time

Figure 2.

Protective gear and equipment might increase future treatment costs

CONCLUSION

Our research found that adult orthodontic patients' awareness of cross-infection, the need for status disclosure, and pretreatment COVID-19 investigation were lacking. The majority of patients believed that missing visits because of the COVID-19 epidemic would lengthen their overall treatment duration; in addition, they were willing to endure supplementary treatment measures to compensate for the unutilized period. The majority of adult orthodontic patients stated that the lockdown had a negative influence on their financial status, but that they can still afford treatment in the future. Some patients cannot afford the additional cost of protective equipment and gear, and they expect the dental institution/clinic/government/insurance corporations to embrace it.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.