Knowledge, attitude and practice of dentists in Coronavirus disease 2019 pandemic in Turkey

Abstract

Purpose: The aim was to assess the knowledge, attitudes and anxiety of the dentists in relation to COVID-19. Subjects and Methods: This cross-sectional survey was conducted amongst 590 dentists employed in Turkey from March to April 2020. The electronic survey consisted of 22 questions related to demographic profile, knowledge, clinical practice and anxiety level of the participants towards dental management of COVID-19. The survey was sent to participants by email and mobile phone messages to be filled electronically. Results: Majority of respondents pointed to aerosol (98.5%), saliva (90.6%) and mucosal contact (71.4%) as the transmission routes of COVID-19. Amongst all clinical symptoms of the disease questioned, fever (99.8%), dry cough (99.1%), fatigue (90.0%) were associated with COVID-19 by vast majority of population. 96.4% of respondents agreed the usage of gloves as personal protective equipment and it was followed by face shield (88.1%), disposable gown (83.4%), protective goggles (73.9%). Increased usage of FFP2/N95 (33.9%) and FFP3/N99 (10.9%) respirators, contrary to reduction of surgical mask usage (50.7%), were observed in aerosol-generating procedures comparing to dental procedures without producing aerosol and these differences were highly significant (p<0.001, p=0.004, p<0.001). The mean anxiety level of respondents was 3.35 ± 1.18 (ranging from 0 to 5). Conclusion: These results demonstrated an adequate knowledge, especially in clinical symptoms of COVID-19 amongst dentists. However, the respirator usage rate in aerosol-generating procedures was not satisfactory which suggesting to necessity of dentists’ education about pandemic.

Keywords

• COVID-19
• Dentistry
• Mask
• Respirator
• Attitude

References

1. 1. World Health Organization. Novel coronavirus (2019-nCoV), situation report 1, 21 January 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4 Accessed on 2 March 2020.
2. 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi:10.1016/S0140-6736(20)30183-5
3. 3. World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it, 12 February 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it Accessed on 2 March 2020.
4. 4. World Health Organization. Novel coronavirus (2019-nCoV), situation report 99, 28 April 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200428-sitrep-99-covid-19.pdf?sfvrsn=119fc381_2 Accessed on 29 April 2020.
5. 5. Paules CI, Marston HD, Fauci AS. Coronavirus infections- more than just the common cold. JAMA 2020;323(8):707–8.
6. 6. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. doi:10.1056/NEJMoa2001017
7. 7. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19), 16-24 February 2020. https://www.who.int/publications-detail/report-of-the-who-china-joint-mission-on-coronavirus-disease-2019-(covid-19) Accessed on 28 February 2020
8. 8. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China:A Report of 1014 Cases. Radiology 2020; [Epub ahead of print, 2020 Feb 26] Available from: https://pubs.rsna.org/doi/10.1148/radiol.2020200642?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&

9. 9. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425–434. doi:10.1016/S1473-3099(20)30086-4
10. 10. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; [Epub ahead of print, 2020 Feb 26] Available from: https://jamanetwork.com/journals/jama/fullarticle/2761044
11. 11. de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14(8):523–534. doi:10.1038/nrmicro.2016.81
12. 12. Wu A, Peng Y, Huang B, Ding X, Wang X, Niu P et al. Genome Composition and Divergence of the Novel Coronavirus (2019-nCoV) Originating in China. Cell Host Microbe. 2020;27(3):325–328. doi:10.1016/j.chom.2020.02.001
13. 13. Holshue ML, DeBolt C, Lindquist S, Wiesman J, Bruce H, Spitters C et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929–936. doi:10.1056/NEJMoa2001191
14. 14. Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis. Clin Oral Investig. 2020;24(4):1619–1621. doi:10.1007/s00784-020-03248-x
15. 15. Arshad Ali S, Baloch M, Ahmed N, Arshad Ali A, Iqbal A. The outbreak of Coronavirus Disease 2019 (COVID-19)-An emerging global health threat. J Infect Public Health 2020;13(4):644–646. doi:10.1016/j.jiph.2020.02.033
16. 16. Liu X, Xing B, Xue Z. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) in China (in Chinese). Chinese Journal of Surgery 2020;41(2):145–151. doi:10.3760/cma.j.issn.0254-6450.2020.02.003
17. 17. Xie X, Li Y, Sun H, Liu L. Exhaled droplets due to talking and coughing. J R Soc Interface. 2009;6:703–14.doi:10.1098/rsif.2009.0388.focus
18. 18. Samaranayake LP, Peiris M. Severe acute respiratory syndrome and dentistry: a retrospective view. J Am Dent Assoc. 2004;135(9):1292–1302. doi:10.14219/jada.archive.2004.0405
19. 19. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med 2020:5;382:970-971. doi: 10.1056/NEJMc2001468.
20. 20. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020;323(14):1406–1407. doi:10.1001/jama.2020.2565
21. 21 Nishiura H, Kobayashi T, Yang Y, Hayashi K, Miyama T, Kinoshita T et al. The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights. J Clin Med. 2020;9(2):419. doi:10.3390/jcm9020419
22. 22. Dai WC, Zhang HW, Yu J, Xu HJ, Chen H, Luo SP et al. CT Imaging and Differential Diagnosis of COVID-19. Can Assoc Radiol J. 2020;71(2):195–200. doi:10.1177/0846537120913033
23. 23. Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. J Dent Res. 2020;99(5):481-7. doi:10.1177/0022034520914246
24. 24. Centers for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings, 13 April 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Finfection-control%2Fcontrol-recommend.html Accessed on 18 April 2020
25. 25. Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci. 2020;12(1):9. doi:10.1038/s41368-020-0075-9
26. 26. Chughtai AA, Seale H, Islam MS, Owais M, Macintyre CR. Policies on the use of respiratory protection for hospital health workers to protect from coronavirus disease (COVID-19). Int J Nurs Stud. 2020;105:103567. doi:10.1016/j.ijnurstu.2020.103567,
27. 27. MacIntyre CR, Zhang Y, Chughtai AA, Seale H, Zhang D, Chu Y et al. Cluster randomised controlled trial to examine medical mask use as source control for people with respiratory illness. BMJ Open. 2016;6(12):e012330. doi:10.1136/bmjopen-2016-012330
28. 28. Wang X, Pan Z, Cheng Z. Association between 2019-nCoV transmission and N95 respirator use. J Hosp Infect 2020; [Epub ahead of print, 2020 Mar 3] Available from: https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(20)30097-9
29. 29. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976.