January JADA looks at dentists' pandemic preparedness across globe


Dentists from around the world reported a lack of preparedness to confront COVID-19 early in the pandemic, according to a study published in the January issue of The Journal of the American Dental Association.

The cover story, "Dentists' Knowledge, Attitudes, and Professional Behavior Toward COVID-19 Pandemic: A Multisite Survey of Dentists' Perspectives,"  looked at the responses of 1,251 dentists from 49 countries to an online survey conducted from March 28 through April 10, 2020. The breakdown of respondents included 37.8% from Europe, 29.2% from the Eastern Mediterranean region, 19.7 % from North America and 13.3% from the Western Pacific region.

The survey assessed respondents' level of comfort with preventive measures and provision of treatment in the dental practice setting during the pandemic; understanding of the benefits and use of N95 respirators; and attitudes toward treating patients with known or suspected COVID-19. It also looked at the effect of the pandemic on dentists’ workplace status and finances.

Overall, responses related to dentists' level of comfort with preventive measures and provision of treatment fell between "somewhat uncomfortable" and "neither comfortable nor uncomfortable." There were statistically significant differences among dentists from different regions, with Eastern Mediterranean dentists generally reporting the most comfort and European dentists reporting the least.

About one-half of respondents reported they were familiar with the use of N95 or other high-level respirators, and 92.3% indicated N95 masks were necessary when attending to a patient with known or suspected COVID-19. However, only 20.5% used an N95 mask in practice. When asked about their attitudes toward delivery of care, 51.7% of respondents "strongly agreed" they would "prefer not to treat and would refer a known or suspected COVID-19 patient."

Nearly 81% of respondents reported their workplaces were closed as a result of the pandemic, and 76% of those who continued to work deferred "elective" treatment. About three-quarters of the surveyed dentists "strongly agreed" there was a substantial financial impact on their income, and 47.9% expected compensation, with 77% of those respondents expecting it to come from a public authority.

By region, there were statistically significant differences relating to N95 familiarity and use; preference for not treating patients with known or suspected COVID-19; workplace closure and delay of "elective" dental treatment; and financial impact and expected financial compensation. For example, North American dentists were most accustomed to N95 respirators, and the governments of developed and wealthy countries offered stimulus packages to businesses, including dental practices.

Some of the limitations of the study include that it was randomly distributed, leading to varying representation by country; responses from the same region could have differed as cases continued to rise during the survey period and additional guidance was released; some practitioners may not have felt comfortable replying to questions that would put them in an unfavorable position; and some questions were ambiguous and created overlapping categories.

Other articles in the January issue of JADA discuss implications for diabetes screening by dentists , risk of bleeding during oral surgery in patients with liver cirrhosis and template-guided endodontic access .

Every month, JADA articles are published online at in advance of the print publication.

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