Dentists’ Perspective on the Impact of COVID-19 on the Utilization of Emergency Dental Services in Kuwait: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sampling
2.2. Survey Instrument
2.3. Statistical Analysis
3. Results
Dentist Characteristics
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. Available online: https://covid19.who.int/ (accessed on 16 February 2022).
- Baskaradoss, J.K.; Alsumait, A.; Malik, S.; Ariga, J.; Geevarghese, A.; Francis, R.; Vazhiyodan, A.; Alexander, R.; Menon, P.; Behzadi, S.; et al. Epidemiological characteristics of COVID-19 cases among Indians residing in Kuwait. East. Mediterr. Health J. 2021, 27, 745–754. [Google Scholar] [CrossRef] [PubMed]
- Ministry of Health-Kuwait. Coronavirus Disease 2019 (COVID-19): Updates. Available online: https://corona.e.gov.kw/En/ (accessed on 16 February 2022).
- United States CDC. How COVID-19 Spreads. 16 June 2020. Available online: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html (accessed on 20 February 2022).
- Baskaradoss, J.K.; Al-Asfour, A. Dental Education in an Era of COVID-19: Kuwait’s Experience. Int. J. Environ. Res. Public Health 2021, 18, 5606. [Google Scholar] [CrossRef] [PubMed]
- American Dental Association. ADA Develops Guidance on Dental Emergency, Nonemergency Care. Available online: https://www.ada.org/en/publications/ada-news/2020-archive/march/ada-develops-guidance-on-dental-emergency-nonemergency-care (accessed on 24 April 2020).
- Royal College of Surgeons England. Recommendations for Paediatric Dentistry during COVID-19 Pandemic. Available online: https://www.rcseng.ac.uk/-/media/files/rcs/fds/guidelines/paediatric-dentistry-covid19.pdf (accessed on 24 April 2020).
- Al-Halabi, M.; Salami, A.; Alnuaimi, E.; Kowash, M.; Hussein, I. Assessment of paediatric dental guidelines and caries management alternatives in the post COVID-19 period. A critical review and clinical recommendations. Eur. Arch. Paediatr. Dent. 2020, 21, 543–556. [Google Scholar] [CrossRef] [PubMed]
- Falahchai, M.; Hemmati, Y.B.; Hasanzade, M. Dental care management during the COVID-19 outbreak. Spéc. Care Dent. 2020, 40, 539–548. [Google Scholar] [CrossRef] [PubMed]
- Kuehne, A.; Lynch, E.; Marshall, E.; Tiffany, A.; Alley, I.; Bawo, L.; Massaquoi, M.; Lodesani, C.; Le Vaillant, P.; Porten, K.; et al. Mortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014–2015 in Monrovia Results from a Mobile Phone Survey. PLOS Neglected Trop. Dis. 2016, 10, e0004899. [Google Scholar] [CrossRef] [PubMed]
- Vygen, S.; Tiffany, A.; Rull, M.; Ventura, A.; Wolz, A.; Jambai, A.; Porten, K. Changes in Health-Seeking Behavior Did Not Result in Increased All-Cause Mortality during the Ebola Outbreak in Western Area, Sierra Leone. Am. J. Trop. Med. Hyg. 2016, 95, 897–901. [Google Scholar] [CrossRef] [PubMed]
- Bennardo, F.; Antonelli, A.; Barone, S.; Figliuzzi, M.M.; Fortunato, L.; Giudice, A. Change of Outpatient Oral Surgery during the COVID-19 Pandemic: Experience of an Italian Center. Int. J. Dent. 2020, 2020, 8893423. [Google Scholar] [CrossRef] [PubMed]
- Yang, J.; Gong, H.; Chen, X.; Chen, Z.; Deng, X.; Qian, M.; Hou, Z.; Ajelli, M.; Viboud, C.; Yu, H. Health-seeking behaviors of patients with acute respiratory infections during the outbreak of novel coronavirus disease 2019 in Wuhan, China. Influ. Other Respir. Viruses 2021, 15, 188–194. [Google Scholar] [CrossRef] [PubMed]
- Guo, H.; Zhou, Y.; Liu, X.; Tan, J. The impact of the COVID-19 epidemic on the utilization of emergency dental services. J. Dent. Sci. 2020, 15, 564–567. [Google Scholar] [CrossRef] [PubMed]
- Wang, C.; Miao, L.; Wang, Z.; Xiong, Y.; Jiao, Y.; Liu, H. Emergency Management in a Dental Clinic During the Coronavirus Disease 2019 (COVID-19) Epidemic in Beijing. Int. Dent. J. 2021, 71, 32–39. [Google Scholar] [CrossRef] [PubMed]
- Petrescu, N.B.; Aghiorghiesei, O.; Mesaros, A.S.; Lucaciu, O.P.; Dinu, C.M.; Campian, R.S.; Negucioiu, M. Impact of COVID-19 on Dental Emergency Services in Cluj-Napoca Metropolitan Area: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2020, 17, 7716. [Google Scholar] [CrossRef] [PubMed]
- Whyte, F.; Chan, W.-Y.; Silverstein, D.-K.; Conrad, H.; Lee, B. Dental Utilization in a Pediatric Emergency Department and Urgent Care Centers Before, During, and After Shutdown of a Pediatric Dental Clinic During the COVID-19 Pandemic, 2019–2021. Public Health Rep. 2023, 2023, 333549221148176. [Google Scholar] [CrossRef] [PubMed]
- Samuel, S.R.; Mathew, M.G.; Suresh, S.G.; Varma, S.R.; Elsubeihi, E.S.; Arshad, F.; Elkareimi, Y.; Elsahn, N.A.; Khalil, E. Pediatric dental emergency management and parental treatment preferences during COVID-19 pandemic as compared to 2019. Saudi J. Biol. Sci. 2021, 28, 2591–2597. [Google Scholar] [CrossRef] [PubMed]
- Rodriguez, P.A.; Gatti, P.; Cabirta, M.L.; Baquerizo, N.R.; Prada, S.; Gualtieri, A.; Puia, S.; Squassi, A. Dental Emergency Admissions in Emergency Oral Health Care Centers during COVID-19 Pandemic in Buenos Aires, Argentina. Int. J. Environ. Res. Public Health 2022, 19, 1528. [Google Scholar] [CrossRef] [PubMed]
- Wu, J.-H.; Lee, M.-K.; Lee, C.-Y.; Chen, N.-H.; Lin, Y.-C.; Chen, K.-K.; Lee, K.-T.; Du, J.-K. The impact of the COVID-19 epidemic on the utilization of dental services and attitudes of dental residents at the emergency department of a medical center in Taiwan. J. Dent. Sci. 2021, 16, 868–876. [Google Scholar] [CrossRef] [PubMed]
- von Elm, E.; Altman, D.G.; Egger, M.; Pocock, S.J.; Gøtzsche, P.C.; Vandenbroucke, J.P.; STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Int. J. Surg. 2014, 12, 1495–1499. [Google Scholar] [CrossRef] [PubMed]
- Hahn, B.; Hollenberger, L.; Schlagenhauf, U.; Böhm, H.; Haubitz, I.R.; Soliman, S.; Jockel-Schneider, Y. The utilization of dental emergency services during COVID-19 pandemic in a German university center: Do we lose vulnerable patients? Quintessence Int. 2021, 52, 828–836. [Google Scholar] [CrossRef] [PubMed]
- Hong, L.; Ahmed, A.; McCunniff, M.; Liu, Y.; Cai, J.; Hoff, G. Secular Trends in Hospital Emergency Department Visits for Dental Care in Kansas City, Missouri, 2001–2006. Public Health Rep. 2011, 126, 210–219. [Google Scholar] [CrossRef] [PubMed]
- Tramini, P.; Nassar, B.A.Q.; Valcarcel, J.; Gibert, P. Factors associated with the use of emergency dental care facilities in a French public hospital. Spéc. Care Dent. 2010, 30, 66–71. [Google Scholar] [CrossRef] [PubMed]
- De Stefani, A.; Bruno, G.; Mutinelli, S.; Gracco, A. COVID-19 outbreak perception in Italian dentists. Int. J. Environ. Res. Public Health 2020, 17, 3867. [Google Scholar] [CrossRef] [PubMed]
Variables | Total n (%) | Years of Experience | ||
---|---|---|---|---|
<10 Years n (%) | ≥10 Years n (%) | p-Value * | ||
Total | 268 (100.0) | 117 (43.7) | 151 (56.3) | 0.116 |
Dental centers | ||||
Al-Amiri | 45 (16.8) | 19 (16.2) | 26 (17.2) | |
Al-Adan | 33 (12.3) | 12 (10.3) | 21 (13.9) | |
Jahra | 46 (17.2) | 15 (12.8) | 31 (20.5) | |
Farwaniya | 12 (4.5) | 4 (3.4) | 8 (5.3) | |
Jaber | 37 (13.8) | 20 (17.1) | 17 (11.3) | |
Bneid Al Gar | 37 (13.8) | 13 (11.1) | 24 (15.9) | |
SOHP | 43 (16.0) | 25 (21.4) | 18 (11.9) | |
Others | 15 (5.6) | 9 (7.7) | 6 (4.0) | |
Gender | 0.030 | |||
Male | 164 (61.2) | 63 (53.8) | 101 (66.9) | |
Female | 104 (38.8) | 54 (46.2) | 50 (33.1) | |
Age | <0.001 | |||
21–40 | 187 (69.8) | 114 (97.4) | 73 (48.3) | |
41–60 | 68 (25.4) | 3 (2.6) | 65 (43) | |
≥60 | 13 (4.9) | 0 (0.0) | 13 (8.6) | |
Nationality | 0.002 | |||
Kuwaiti | 162 (60.4) | 83 (70.9) | 79 (52.3) | |
Non-Kuwaiti | 106 (39.6) | 34 (29.1) | 72 (47.7) | |
Marital status | <0.001 | |||
Single | 75 (28.0) | 59 (50.4) | 16 (10.6) | |
Married | 184 (68.7) | 56 (47.9) | 128 (84.8) | |
Divorced | 9 (3.4) | 2 (1.7) | 7 (4.6) | |
Number of children | <0.001 | |||
<3 | 109 (40.7) | 34 (29.1) | 75 (49.7) | |
3 or more | 64 (23.9) | 9 (7.7) | 55 (36.4) | |
No children | 95 (35.4) | 74 (63.2) | 21 (13.9) | |
Level of education | <0.001 | |||
Bachelor | 86 (32.1) | 64 (54.7) | 22 (14.6) | |
Master | 89 (33.2) | 31 (26.5) | 58 (38.4) | |
Board/PhD | 93 (34.7) | 22 (18.8) | 71 (47.0) | |
Field of practice | <0.001 | |||
General dentist | 64 (23.9) | 54 (46.2) | 10 (6.6) | |
Pediatric dentistry | 47 (17.5) | 17 (14.5) | 30 (19.9) | |
Prosthodontics | 30 (11.2) | 10 (8.5) | 20 (13.2) | |
Orthodontics | 31 (11.6) | 10 (8.5) | 21 (13.9) | |
Periodontics | 21 (7.8) | 6 (5.1) | 15 (9.9) | |
Surgery | 33 (12.3) | 9 (7.7) | 24 (15.9) | |
Endodontics | 30 (11.2) | 9 (7.7) | 21 (13.9) | |
Others | 12 (4.5) | 2 (1.7) | 10 (6.6) |
Variables | Total n (%) | Before Lockdown n (%) | After Lockdown n (%) | p-Value |
---|---|---|---|---|
How many dental emergency patients do you attend to in a day? | ||||
1–2 | 92 (17.2) | 49 (18.3) | 43 (16.0) | <0.001 |
3–4 | 160 (29.9) | 73 (27.2) | 87 (32.5) | |
≥5 | 269 (50.2) | 140 (52.2) | 129 (48.1) | |
What is the most common age group of emergency patients you see? | ||||
<18 years old | 206 (38.4) | 99 (36.9) | 107 (39.9) | <0.001 |
18–40 years old | 196 (36.6) | 102 (38.1) | 94 (35.1) | |
40–65 years old | 41 (7.7) | 20 (7.5) | 21 (7.8) | |
>65 years old | 4 (0.8) | 1 (0.4) | 3 (1.1) | |
All age groups | 51 (9.6) | 27 (10.1) | 24 (9.0) | |
>40 years old | 30 (5.6) | 16 (6) | 14 (5.2) | |
What is the most common chief complaints of the patients you see? | ||||
Trauma | 21 (3.9) | 13 (4.9) | 8 (3.0) | <0.001 |
Pain | 173 (32.3) | 90 (33.6) | 83 (31) | |
Bleeding | 10 (1.9) | 8 (3.0) | 2 (0.7) | |
Swelling | 6 (1.2) | 1 (0.4) | 5 (1.9) | |
Pain, Swelling and Bleeding | 80 (14.9) | 40 (14.9) | 40 (14.9) | |
Pain and bleeding | 27 (5.0) | 10 (3.7) | 17 (6.3) | |
Pain and swelling | 83 (15.5) | 34 (12.7) | 49 (18.3) | |
Trauma, pain & swelling | 53 (9.9) | 32 (11.9) | 21 (7.8) | |
Others | 72 (13.4) | 36 (13.4) | 36 (13.4) | |
What were the most common dental diagnosis made at the emergency clinics for acute tooth ache? | ||||
Acute pulpitis | 178 (33.2) | 97 (36.2) | 81 (30.2) | <0.001 |
Acute periapical periodontitis | 38 (7.1) | 16 (6.0) | 22 (8.2) | |
Combined periodontic endodontic lesions | 19 (3.6) | 9 (3.4) | 10 (3.7) | |
Periodontitis | 26 (4.9) | 12 (4.5) | 14 (5.2) | |
Acute pulpitis, acute periapical periodontitis and combined periodontic endodontic lesions | 60 (11.2) | 31 (11.6) | 29 (10.8) | |
Pulpitis and periodontitis | 56 (10.5) | 30 (11.2) | 26 (9.7) | |
Acute pulpitis and apical periodontitis | 64 (11.9) | 28 (10.4) | 36 (13.4) | |
Others | 34 (6.3) | 17 (6.3) | 17 (6.3) | |
What were the most common dental diagnosis made at the emergency clinics for maxillofacial and dental trauma? | ||||
Dental trauma | 190 (35.5) | 96 (35.8) | 94 (35.1) | <0.001 |
Soft tissue injury | 42 (7.9) | 24 (9.0) | 18 (6.7) | |
Jaw fracture | 25 (4.7) | 9 (3.4) | 16 (6) | |
Trauma, soft tissue injury and jaw fracture | 25 (4.7) | 15 (5.6) | 10 (3.7) | |
Others | 26 (4.9) | 13 (4.9) | 13 (4.9) | |
Maxillofacial trauma | 42 (7.9) | 20 (7.5) | 22 (8.2) | |
What were the most common dental diagnosis made at the emergency clinics for dental infections? | ||||
Abscess | 229 (42.8) | 120 (44.8) | 109 (40.7) | <0.001 |
Pericoronitis | 50 (9.35) | 27 (10.1) | 23 (8.6) | |
Maxillofacial space infection | 19 (3.6) | 3 (1.1) | 16 (6.0) | |
Others | 21 (3.9) | 10 (3.7) | 11 (4.1) | |
All the above | 50 (9.4) | 26 (9.7) | 24 (9.0) |
Variables | Total | Lockdown | p-Value | |
---|---|---|---|---|
n (%) | Before | After | ||
How were the emergency cases managed? | ||||
Using dental procedures that do not produce droplets | 55 (10.3) | 20 (7.5) | 35 (13.1) | <0.001 |
Using dental procedures that produce droplets | 177 (33.0) | 110 (41.0) | 67 (25.0) | |
Prescribing Antibiotics only | 32 (5.9) | 15 (5.6) | 17 (6.3) | |
Prescribing antibiotics with non-aerosol generating procedures | 246 (45.9) | 114 (42.5) | 132 (49.3) | |
You were afraid of being infected with COVID-19 from your patients? | ||||
Always | 240 (44.8) | 92 (34.3) | 148 (55.2) | <0.001 |
Rarely | 189 (35.3) | 116 (43.3) | 73 (27.2) | |
Never | 101 (18.8) | 58 (21.6) | 43 (16) | |
You tried to avoid performing high risk procedures | ||||
Always | 115 (21.5) | 40 (14.9) | 75 (28.0) | <0.001 |
Rarely | 191 (35.6) | 92 (34.3) | 99 (36.9) | |
Never | 225 (42.0) | 135 (50.4) | 90 (33.6) | |
You record patient temperature | ||||
Always | 250 (46.7) | 78 (29.1) | 172 (64.2) | <0.001 |
Rarely | 98 (18.3) | 56 (20.9) | 42 (15.7) | |
Never | 176 (32.8) | 128 (47.8) | 48 (17.9) | |
You use full PPE before attending to your patients | ||||
Always | 374 (69.8) | 154 (57.5) | 220 (82.1) | <0.001 |
Rarely | 112 (20.9) | 78 (29.1) | 34 (12.7) | |
Never | 46 (8.6) | 35 (13.1) | 11 (4.1) | |
You ask patient to use mouthwash before treatment | ||||
Always | 161 (30.1) | 72 (26.9) | 89 (33.2) | <0.001 |
Rarely | 192 (35.9) | 98 (36.6) | 94 (35.1) | |
Never | 171 (31.9) | 93 (34.7) | 78 (29.1) |
Unstandardized Coefficients | Standardized Coefficients | p-Value | 95.0% Confidence Interval for B | |||
---|---|---|---|---|---|---|
B | Std. Error | Beta | Lower Bound | Upper Bound | ||
(Constant) | 6.655 | 1.332 | <0.001 | 4.031 | 9.28 | |
Dental center | −0.044 | 0.051 | −0.058 | 0.392 | −0.144 | 0.057 |
Gender | 0.761 | 0.35 | 0.146 | 0.031 | 0.071 | 1.451 |
Age group | 0.256 | 0.469 | 0.057 | 0.585 | −0.667 | 1.18 |
Nationality | 1.044 | 0.411 | 0.201 | 0.012 | 0.234 | 1.854 |
Educational status | 0.121 | 0.271 | 0.039 | 0.657 | −0.413 | 0.654 |
Specialty | −0.011 | 0.072 | −0.011 | 0.883 | −0.153 | 0.132 |
Years of work experience | −0.361 | 0.329 | −0.119 | 0.274 | −1.009 | 0.287 |
Received covid vaccine | −1.001 | 0.741 | −0.088 | 0.178 | −2.461 | 0.458 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Alonaizi, N.; Alharran, S.; Baskaradoss, J.K. Dentists’ Perspective on the Impact of COVID-19 on the Utilization of Emergency Dental Services in Kuwait: A Cross-Sectional Study. Clin. Pract. 2023, 13, 638-647. https://doi.org/10.3390/clinpract13030058
Alonaizi N, Alharran S, Baskaradoss JK. Dentists’ Perspective on the Impact of COVID-19 on the Utilization of Emergency Dental Services in Kuwait: A Cross-Sectional Study. Clinics and Practice. 2023; 13(3):638-647. https://doi.org/10.3390/clinpract13030058
Chicago/Turabian StyleAlonaizi, Nour, Sarah Alharran, and Jagan Kumar Baskaradoss. 2023. "Dentists’ Perspective on the Impact of COVID-19 on the Utilization of Emergency Dental Services in Kuwait: A Cross-Sectional Study" Clinics and Practice 13, no. 3: 638-647. https://doi.org/10.3390/clinpract13030058