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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 7
| Issue : 2 | Page : 289-293 |
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Dental professional's understanding of COVID-19 management: Can they contribute to medical care?
Akanksha Juneja, Amina Sultan
Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| Date of Submission | 10-Feb-2022 |
| Date of Decision | 26-Apr-2022 |
| Date of Acceptance | 20-May-2022 |
| Date of Web Publication | 09-Sep-2022 |
Correspondence Address:
Akanksha Juneja
Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/bjhs.bjhs_29_22
BACKGROUND: The sudden appearance of the highly infectious novel coronavirus in December 2019 has created global havoc in a short time. In the present scenario where the cases are rising explosively and medical health care professionals are losing their lives to coronavirus disease 2019 (COVID-19), the role of dental surgeons needs to be redefined.
OBJECTIVE: Keeping all these things into consideration; this questionnaire-based cross sectional survey was planned to understand how dental surgeons managed COVID-19 once they got infected, and how confident they are if in future they need to treat cases of COVID-19.
MATERIALS AND METHODS: A cross-sectional survey was done to assess the knowledge of practising dental surgeons infected with COVID-19 of the disease and its management.
RESULTS: One hundred and one respondents completed the questionnaire. Of those 81% were vaccinated while 19% were not vaccinated. Of these 50.5% felt confident that they had adequate knowledge regarding COVID-19 and can treat mild-to-moderate infections. 84.2% believed that short-term courses and workshops should be designed for dental surgeons to improve their knowledge, keeping in mind their future role in pandemic.
CONCLUSION: Short-term courses need to be designed to improve the current knowledge of dental surgeons regarding COVID-19 and prepare them for future.
Keywords: Coronavirus disease 2019, cross-sectional survey, dental surgeons, health care professionals, management
How to cite this article:
Juneja A, Sultan A. Dental professional's understanding of COVID-19 management: Can they contribute to medical care?. BLDE Univ J Health Sci 2022;7:289-93 |
The sudden appearance of the highly infectious novel coronavirus in December 2019 has created global havoc in a short time. After its detection in China, within 2 months, World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern. On March 11, 2020, COVID-19 was declared a pandemic by WHO.[1],[2] Coronavirus disease 2019 (COVID-19) is caused by this highly infectious novel coronavirus called severe acute respiratory syndrome coronavirus 2; which is primarily associated with pneumonia being mild to deadly.[2] However, in severe cases, COVID-19 can be associated with an acute inflammatory response (cytokine storm) and respiratory failure, multiple organ failure, etc.
As of May 18, 2021, more than 16,21,84,263 confirmed cases of COVID-19 and 33,64,446 associated deaths have been reported worldwide.[3] It has been almost 1 ½ years and the entire world is still struggling to curtail it. As the number of infected cases is rising day by day, researchers all over the world are struggling at every front to control this disease.
Since the outbreak of COVID-19, health care systems around the world have been stretched to the limit. The rapid increase in the number of positive cases has resulted in a significant increase in demand for health care.
Although the hospitals are actively scaling up their capacity of basic and critical care beds, the number seems to be inadequate. Moreover, to add to that, medical workforce is also limited. Across the globe, hospital-based healthcare workers are working over hours and doing extra shifts. This has caused a tremendous increase in the viral load of medical workers and has also been a cause of death of many from COVID-19. In India alone, more than 1492 doctors have lost their lives due to this pandemic.[4] With health care workers succumbing to COVID-19 worldwide, the United Nations have called for voluntary support from professionals with medical backgrounds to provide support in managing the pandemic.[5]
Dental professionals, though having a different area of practice, know basic human science and sterile surgical techniques. Also, they are trained to manage dental issues in medically compromised patients and other medical emergencies. This makes them an invaluable resource in the COVID-19 management. In many countries, dental professionals have been called upon for various supportive assistance such as nasopharyngeal and oropharyngeal swabs collection for COVID-19 testing. However, in the present scenario, where the cases are rising explosively and medical health care professionals are losing their lives to COVID-19; the role of dental surgeons needs to be redefined. The second wave of COVID-19 has been more lethal than the first, and with vaccination of the entire population taking years; we have many more waves to come which may be more lethal. The type of crisis we are heading towards, there will be a demand where dental surgeons might have to play an independent role other than just dealing with dental patients and providing basic support to medical professionals. UN called upon professionals of other backgrounds to provide support; however, are we ready to share the load with dental professionals. Are dental professionals confident that they can manage cases of COVID-19 single-handed and not just remain a supportive arm to the system?
Keeping all these things into consideration; this self structured questionnaire-based study was planned to assess the knowledge of practising dental surgeons, infected with COVID-19, of the disease and its management and how confident they are if in future they need to treat cases of COVID-19.
| Materials and Methods | |  |
The present study was planned in the Department of Pediatric and Preventive Dentistry of a dental college in Delhi and was reviewed and approved by an Institutional Ethics Committee. It was conducted as a questionnaire-based cross-sectional survey on 101 Dental surgeons. The questionnaire designed included general information on respondents, information on education, years of practice, vaccination status, types of symptoms, management, and knowledge of investigations and management of COVID-19 and the necessity for further education on the management. Informed consent was taken from each participant before the commencement of the study. Practicing Dental surgeons who had got infected with COVID-19 and agreed to participate in the survey were included. Dental surgeons who never had COVID-19 infection and were not practicing were excluded. The questionnaire was delivered to them by Google forms via E-mail and WhatsApp (social media application).
Data analysis included frequency and percentage distribution and cross-tabulation. Results were expressed as a number and percentage of respondents for each question.
| Results | | |
This questionnaire was sent to practicing dental surgeons as Google form via E-mails and of those 101 dental surgeons completed the questionnaire. The participants had varied clinical experience. 45.5% ranged in the age group of 31–40 years, while 39% were above the age of 40 years. Forty-one percent were into practice for more than 10 years while 16% were into practice for more than 20 years. Of the entire group of respondents more than 90% were actively seeing patients with dental problems during COVID-19 pandemic. Of these almost 78% were regularly performing aerosol and non aersosol dental procedures on patients [Figure 1]. Ninety-five percent of all the participants were infected with COVID-19 once while a small percentage of 5% was infected twice. | Figure 1: Percentage of dental surgeons performing various procedures during coronavirus disease 2019
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The data on vaccination when analysed showed that 81% were vaccinated with either Covishield or Covaxin while 19% were not vaccinated as yet [Figure 2]. The assessment of symptoms of the respondents during COVID-19 infection highlighted that only 3 respondents had moderate symptoms and required hospitalization; while none of the respondents presented with severe symptoms requiring hospitalization [Figure 3].
[Table 1] displays how the dental surgeons managed self as well as family members when they were infected with COVID-19. [Table 2] mentions findings related to the knowledge and awareness regarding COVID-19 and how confident they are if given a situation to treat mild and moderate cases of COVID-19 infections. | Table 1: Management of self/family members during coronavirus disease 2019 infection
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 | Table 2: Knowledge and awareness about coronavirus disease 2019 management
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| Discussion | | |
India has a population of 1.38 billion, where there is always a shortage of medical as well as dental health care workers to cater to the needs of entire country. In the pandemic, which has taken a total on the total health-care system, the burden on medical practitioners is even more. AlThough it seems an impossible task; the government is working on a warfront to vaccinate the entire population of the country above 18 years by December 2021. As the COVID-19 third wave is expected in near future, it is evident that the burden of medical professionals will further increase. Hence, this study was planned to the knowledge and understanding of the dental professionals who have already been infected with COVID; as to how confident they are if in future the need arises to treat mild and moderate COVID-19 cases without any assistance. Furthermore what all can be done to strengthen their knowledge regarding the disease and its management.
The current study involved practicing dental surgeons, who had got COVID-19 infection and their experience as to how they went ahead with the management of the disease for self and for their family members. 73.3% consulted a Physician and followed their prescription for the treatment of COVID-119. A small percentage (12.9%) did not consult anyone and went ahead with self medication, while 9.9% did not take any medication [Table 1]. The results focus on the fact that though being a health care professional, they preferred to consult a General physician for their treatment; thereby indirectly increasing the burden of the Medical health professionals.
However, the study did give a positive sign, with more than 50% of the respondents considering themselves to be confident in treating the cases with mild to moderate symptoms of COVID-19. It was encouraging to see that more than 70% actively read and followed latest research and guidelines regarding management of COVID-19. Also the most common guidelines to which the respondents referred was ICMR/AIIMS guidelines (88.9%), followed by Centers for Disease Control and Prevention guidelines (44.4%).
84.2% of the respondents believed that there should be short term courses for the dental surgeons; so as to prepare them in a better manner to handle COVID-19 cases in future. This also signifies that the dental fraternity of India completely believes in shouldering the responsibility of the pandemic with medical professionals. Respondents had different opinion regarding the different aspects of such courses with 83.2% wanting focus on Diagnosis and Medical management; while 71.3% wanting to focus on preventive aspects and home care. Almost 30% wanted that management of intensive care unit (ICU) complication and setting up Home ICU should be a part of this course.
The practice of dentistry has been significantly affected during this pandemic. Since dental procedures produce considerable amount of aerosol and droplets mixed with patient's saliva; the risk of infection increases for the dental surgeons.[6],[7] However, the dental surgeons across the globe as well as in India, have been actively performing their responsibilities.
Their role in assisting the medical counterparts in the hospital setting has been well accepted now. Duties like monitoring of the vital signs, administering oxygen and injectables, collecting the nasal and oral swabs for screening of COVID infection are being regularly performed by dental surgeons. In Singapore, as a part of the massive operation to control COVID-19 spread, National Dental Centre Singapore deployed dental clinicians to work in collaboration with other professionals of various backgrounds like clinicians, nurses, pharmacists, radiographers, and medical social workers etc.[8]
In the UK and states of US like Virginia and California dental surgeons have been assisting with critical emergency care needs, and have been working in co-ordination with the health care workers.[6],[9],[10]
The role that needs exploration is that can dental surgeons take up the active role of treating mild to moderate cases of COVID-19, so that the current load of medical practitioners can be reduced. This current study is a first step in this direction, where the knowledge and confidence has been assessed. However, our study has a few limitations, that the sample size is small and also dental surgeons who have not contacted COVID-19, have not been included in this study.
However, the study has given positive results and has given directions as to how we can develop short-term courses for practicing dental surgeons; what all can be included in these courses, so that they can also be made a part of teaching curriculum for our undergraduate and postgraduate students. The government also needs to play active role by bringing a change in the law and providing immunity to these dental healthcare workers. Only together, the battle against this COVID-19 pandemic can be won.
| Conclusion | | |
Volunteering and being selfless in this time of crisis is something that is being expected from the dental professionals. Moreover, it is really admirable that dental professionals across the globe have accepted this challenge to fight against COVID-19. This pandemic has made the entire health care sector realise that the role of the dental surgeon cannot be just limited to dentistry. By their training and practical experience, dental professionals can provide services in various ways to reduce the strain on the healthcare sector. The results of studies like this can help us in designing specific training programs which can increase the knowledge of dental professionals regarding pandemic COVID-19, making them more confident to handle cases in this time of crisis.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 6. | Seneviratne CJ, Lau MW, Goh BT. The role of dentists in COVID-19 is beyond dentistry: Voluntary medical engagements and future preparedness. Front Med (Lausanne) 2020;7:566. |
| 7. | Harrel SK, Molinari J. Aerosols and splatter in dentistry: A brief review of the literature and infection control implications. J Am Dent Assoc 2004;135:429-37. |
| 8. | Healthprofessionals.gov.sg (homepage on internet). Ministry of Health Singapore Gradual Resumption of Dental Services after COVID-19 Circuit Breaker Period; 2020. Available from: https://www.healthprofessionals.gov.sg. [Last accessed on 2021 Jul 07]. |
| 9. | Cda.org (homepage on internet). California Dental Association Dentists Can Register to Help with State's COVID-19 Pandemic Response; 2020. Available from: http://www.cda.org. [Last accessed on 2021 Jul 10]. |
| 10. | Coulthard P. Dentistry and coronavirus (COVID-19) – Moral decision-making. Br Dent J 2020;228:503-5. |
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]
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