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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 26-29

Awareness, perception, and attitude of dental practitioners toward COVID-19 and their role in its prevention in central Madhya Pradesh: A questionnaire study


1 Mansarovar Dental College, Bhopal, Madhya Pradesh, India
2 ITS Dental College, Greater Noida, Uttar Pradesh, India

Date of Submission18-Feb-2021
Date of Acceptance01-Mar-2021
Date of Web Publication29-Mar-2021

Correspondence Address:
Dr. Sagar Gupta
Mansarovar Dental College, Kolar Road, Bhopal, Madhya Pradesh.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_12_21

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  Abstract 

Introduction: In 2019, an unknown virus was reported in the city of Wuhan, China and later it was declared as a global pandemic, now known as severe acute respiratory syndrome (SARS-CoV-2). The suggested route of this virus transmission is through aerosols, touching contaminated surfaces, or coming in contact with an infected person. Dentists are first-line diagnosticians for oral diseases and are in close contact with patients and, hence, they are at a higher risk of infection. Aim: To assess the level of awareness, perception, and attitude of dentists regarding preventive guidelines and change in their clinical work due to COVID-19. Materials and Methods: In this study, 831 (597 females and 234 males) participants were included. This multiple-choice questionnaire study was conducted among dental professionals of Central India working in private clinics, hospitals, and health centers. An online questionnaire was made available using a Google Form, and a link was circulated among dentists in October 2020. Questions asked in the survey were regarding the participants’ characteristics, their awareness about the incubation period, symptoms of the disease, mode of transmission, impact of COVID-19 on clinical practice, measures taken by them for the prevention of coronavirus disease transmission, perception of dentists regarding rapid testing, and change in their attitude toward treating patients in the midst of this pandemic. Statistical analysis was done using the IBM SPSS version 22.0 (IBM Corporation, Statistical Package for the Social Sciences. N.Y., USA). Chi-square test was applied to find differences in the measures of prevention between variables. P < 0.05 was considered statistically significant. Results: This study consisted of a total of 831 (597 females and 234 males) dentists. The majority of dentists (92.4%) were working in the private sector; 63.9% of dentists were not aware of the correct incubation period. The majority of dentists knew about the mode of transmission and symptoms of COVID. Overall, 96.4% of dentists followed the routine of regularly cleaning and disinfecting the surfaces in contact with patients and experienced that this significantly helped in decreasing the disease transmission. Conclusions: Dentists were well informed of COVID-19 symptoms, its mode of transmission and they were prepared to do the changes needed to be done during the pandemic.

Keywords: Aerosols, COVID-19, dental professionals, infection, pandemic


How to cite this article:
Gupta S, Agrawal R, Grover SD, Soorgani N, Reddy SS, Aila SK. Awareness, perception, and attitude of dental practitioners toward COVID-19 and their role in its prevention in central Madhya Pradesh: A questionnaire study. Int J Oral Care Res 2021;9:26-9

How to cite this URL:
Gupta S, Agrawal R, Grover SD, Soorgani N, Reddy SS, Aila SK. Awareness, perception, and attitude of dental practitioners toward COVID-19 and their role in its prevention in central Madhya Pradesh: A questionnaire study. Int J Oral Care Res [serial online] 2021 [cited 2021 Aug 6];9:26-9. Available from: https://www.ijocr.org/text.asp?2021/9/1/26/312534




  Introduction Top


A novel human coronavirus, earlier referred to as the Wuhan coronavirus (COV), is now designated as SARS-CoV-2, and it is responsible for the latest pandemic that is affecting human health and economy across the world. The World Health Organization (WHO) declared this outbreak of COVID-19 as a public health emergency of international concern on 30 January 2020 due its rapid spread, thus posing a high risk to countries with vulnerable health systems.[1] The mode of transmission of the novel coronavirus (COVID-19) can be through direct transmission (sneezing, coughing, and droplet inhalation transmission) and contact transmission (contact with oral, nasal, and eye mucous membranes).[2] Studies have suggested that 2019-nCoV may be airborne through aerosols formed during medical procedures.[3] Dentists are in frequent direct or indirect contact with human fluids and contaminated dental instruments or environmental surfaces, making a possible route to the spread of viruses. Every dentist should be aware of how 2019-nCoV is spread, how to identify patients with 2019-nCoV infection, and what extra-protective measures should be taken to prevent the transmission of 2019-nCoV during their practice.[4] Certain guidelines, such as use of personal protective barriers, have been provided by the WHO for infection control in dentistry during this pandemic era.[5]


  Materials and Methods Top


Study population

Our study was a multiple-choice questionnaire and it was conducted among dental professionals of Central India working in private clinics, hospitals, and health centers. The online questionnaire was structured using a Google Form. For easier collection of the data the questionnaire was designed as a four-eye survey. A total of 831 dentists participated in the study. Initially, a pilot study was conducted, including 50 dentists in Madhya Pradesh. The questionnaires were anonymous to take care of the privacy and confidentiality of all information collected within the study. The questions on the survey were developed after reviewing pertinent literature of both national and international guidelines for COVID-19. Ethical approval was taken.

Study instrument

The questions on the survey were prepared following the guidelines on COVID-19 issued by the WHO and the Dental Council of India for health-care professionals. This questionnaire was designed in English and comprised a series of 25 questions. The survey was divided into sections: dentist’s demographic and profession-related characteristics, dentist’s awareness of time period, the symptoms of the disease, the mode of transmission, infection control measures for preventing COVID-19, and dentist’s attitude toward treating infected patients. The survey was structured into a multiple-choice questionnaire divided into sections, which included eight questions about awareness, six questions about the attitude of dental professionals toward COVID-19, and six questions about the perceptions of dentists toward the transmission of infection.

Data analysis

For statistical analysis, data entry, validity checks, and formation of desired results (as per the analysis plan) were done using the IBM SPSS version 22.0. The percentage of participants in categories was calculated, and a Chi-square test was applied to find differences in the measures of prevention between variables. P < 0.05 was considered statistically significant.


  Result Top


This study included a total of 831 (597 females and 234 males) dentists; most of the dentists were younger than 35years of age (801 dentists, 96.4%). Overall, 747 (89.9%) of the dentists possessed experience of less than five years. A total of 675 (81.2%) BDS and 156 (18.8%) MDS dentists were involved in this survey and most of them (771, 92.4%) were working in the private sector. The awareness of dentists about the incubation period, symptoms, and mode of transmission of the coronavirus disease infection was measured; about one third of the dentists (300, 36.1%) believed that the incubation time was 1–14 days whereas many participants (681, 81.9%) had reported that all clinical symptoms of COVID-19 are important, proper protocol should be maintained, and all the modes of transmission are important in the spread of COVID transmission.

The majority of participants believed that both dental professionals and patients were at a higher risk of infection during treatment and the dental occupation particularly was at a higher risk. Nearly all dentists believed that the government should bear the expenses for the screening test done of patients suspected to be having COVID-19 and who visit dental clinics [Table 1].
Table 1: Perception of dentists toward COVID-19

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Most of the participants, that is, around 789 (94.9%) reported that cleaning hands frequently by using alcohol-based hand rub or soap and water, routine cleaning and disinfecting surfaces in contact with known or suspected patients, and wearing personal protective equipment can help prevent the transmission of disease from patients who are known or suspected for COVID-19. A high percentage of dentists, that is, around 759 (91.3%) enquired about travel history of the patients and measured the temperature of patients to rule out the suspected exposure of patients to COVID-19. Around 498 (59.9%) dental surgeons wore surgical gowns, dental goggles, face shield, and N-95 mask and 285 (34.3%) participants agreed to the wearing of PPE kit and N-95 mask. The percentages of dentists who reported other measures are shown in [Table 2].
Table 2: Awareness of measures for the prevention of coronavirus disease transmission

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  Discussion Top


COVID-19 has affected community health and has a great potential to spread across the world. The first case was reported in the Wuhan City of China in late December 2019.[6] The WHO named the novel viral pneumonia as “Corona Virus Disease (COVID-19)” on 11 February 2020 whereas the International Committee on Taxonomy of Viruses (ICTV) named it as “SARS-CoV-2.”[7] The spread of COVID-19 infection is mainly via respiratory droplets or through direct/indirect contact. Air-borne spread occurs due to coughing and sneezing of an infected person (radius approximately six feet).[8] Infection transmission is also possible through infected inanimate objects. According to studies, the virus remains viable at room temperature for up to three days on inanimate surfaces.[9] SARS-CoV-2 binds to human angiotensin-converting enzyme 2 (ACE-2) cells of human salivary glands.[10] The primary route of spread of COVID-19 is via respiratory droplets, which makes dental professionals more vulnerable to it. Dental setups invariably carry the risk of COVID-19 infection due to the specificity of its procedures (aerosol production), proximity to the oropharyngeal region, and frequent exposure to saliva. Moreover, if adequate precautions are not taken, the dental office can potentially expose patients to cross-contamination.[8] This questionnaire study provides an insight of the dentists regarding their awareness, perception, and attitude toward COVID-19 infection and its prevention. The incubation period of COVID-19 as per the WHO is upto 14 days.[5] The responses of the participants in this study varied in their knowledge about the incubation period of the disease but it is necessary to know the right incubation period to reduce the chance of getting infected by treating suspected patients. Most of the dentists are using personal protective equipment to ensure protection, washing hands frequently by using alcohol-based hand rub or soap and water, cleaning and disinfecting surfaces in contact with known or suspected patients, and always asking for the travel history of the patients. The majority of the participants believe that both dental professionals and patients are at a higher risk of infection during treatment and, hence, are at a higher risk of getting infected with COVID-19 due to close proximity during treatment. Most of the dentists also feel that the government should bear the expenses of the screening test done for patients suspected of having COVID-19 and who come to dental clinics. During the survey, 90.6% participants expressed that screening tests and rapid testing are important in preventing the exposure of dentists and patients to the infection as frequent testing helps in quick identification and isolation of patients in time.[11] The only way of reducing the risk of infection transmission is by controlling the source of infection; providing early diagnosis; and using infection prevention, isolation, and supportive care for affected patients.[12] During treatment, dentists should take care of strict personal protection measures and either limit or avoid procedures that may produce aerosols and also follow the guidelines given by the WHO and the Dental Council of India.[13] The limitation of this study is fewer samples, hence further studies are needed to be conducted in future with a larger sample size.


  Conclusion Top


It can be concluded from this study that the dentists in Central Madhya Pradesh were well aware of the preventive measures to be taken against the transmission of COVID-19 infection. However, many participants were unaware of the disease incubation period and fewer dentists were using extra-oral suction while doing dental procedures and providing the other staff working in dental clinics with proper PPE kits. Hence, for effective disease management and for breaking the chain of disease transmission, the need of the hour is to circulate the guidelines released by the WHO and the Dental Council of India among all registered dentists and to ensure that these are being followed strictly. Though COVID-19 vaccines have been successfully introduced in the country, yet till everyone gets vaccinated, it is the people’s responsibility to still follow the protocols for disease prevention and to continue taking all precautions. The purpose of this study was well justified, as it provided an absolute insight of dentists’ views on COVID-19.

Financial support and sponsorship

Nil.

Conflicts of interest

Nil.



 
  References Top

1.
Bhanushali P, Katge F, Deshpande S, Chimata VK, Shetty S, Pradhan D COVID-19: Changing trends and its impact on future of dentistry. Int J Dent2020;2020:1-6.  Back to cited text no. 1
    
2.
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;12:9.  Back to cited text no. 2
    
3.
Wax RS, Christian MD Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-ncov) patients. Can J Anaesth 2020;67:568-76.  Back to cited text no. 3
    
4.
Cleveland JL, Gray SK, Harte JA, Robison VA, Moorman AC, Gooch BF Transmission of blood-borne pathogens in US dental health care settings: 2016 update. J Am Dent Assoc 2016;147:729-38.  Back to cited text no. 4
    
5.
World Health Organization. Available from: https://www.who.int/health- topics/coronavirus#tab=tab_1  Back to cited text no. 5
    
6.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33.  Back to cited text no. 6
    
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Wu Y, Ho W, Huang Y, Jin DY, Li S, Liu SL, et al. SARS-cov-2 is an appropriate name for the new coronavirus. Lancet 2020;395:949-50.  Back to cited text no. 7
    
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How COVID-19 Spreads. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html.  Back to cited text no. 8
    
9.
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-cov-2 as compared with SARS-cov-1. N Engl J Med 2020;382:1564-7.  Back to cited text no. 9
    
10.
Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-cov-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271-80.e8.  Back to cited text no. 10
    
11.
Gambarini E, Galli M, Di Nardo D, Miccoli G, Patil S, Bhandi S, et al. A survey on perceived COVID-19 risk in dentistry and the possible use of rapid tests. J Contemp Dent Pract 2020;21:718-22.  Back to cited text no. 11
    
12.
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. JAMA2020;323:1061-9.  Back to cited text no. 12
    
13.
Sarate S, Pawar B, Salavadi S, Sarate K, Dubey Y, Wankhede T, et al. Awareness and attitude of dental professionals towards pandemic outbreak of covid-19 in central India- A questionnaire study. Int J Periodontol Implantol 2020;5:124-8.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2]



 

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