June 01, 2020

Patient perceptions of Orthodontics and COVID-19 pandemic

Most dental offices have been closed to all but emergency appointments because of the COVID-19 pandemic.  Currently, governments are starting to lift some restrictions. As a result, orthodontic offices are beginning to open.  But what do our patients think?

This new paper looked at patients’ perceptions and concerns about restarting orthodontic treatment.  A team in Brazil did the study. Orthodontics and Craniofacial Research published the article. It is great to see that it is open access.

What did they ask?

They did the study to ask this question:

“What is the level of anxiety and concerns of orthodontic patients regarding the coronavirus and the impact of lockdown on their orthodontic treatment”?

What did they do?

They did a cross-sectional survey of patients who were attending two private dental clinics in two separate metropolitan districts in Brazil.  They sent the survey form via Google forms.  The questionnaire was directed to finding out information on their:

  • Demographics
  • Views of quarantine
  • Levels of anxiety about treatment.

Finally, they asked them what they would like to see from orthodontic offices when they return for treatment?

What did they find?

They sent out 471 questionnaires. Three hundred fifty-four patients returned the information.  This resulted in a response rate of 75.1%.  Two hundred thirty-one of the patients were female, and 123 were males.

88.2% of respondents were only going out when needed, 13.0% were not leaving their homes, and 8.8% were not respecting the quarantine.

When they asked about overall anxiety about the pandemic, they found that 44.7% are calm, 23.4% reported to be afraid, and 22.9% are anxious.

Most patients (60.2%) would attend an orthodontic appointment, and 25.1% would go only in an emergency.

Their most significant concern about the impact of the quarantine was the delay in orthodontic treatment (48.3%) followed by breakage of appliances worsening their malocclusion (13.3%).

Patients who were willing to go to an orthodontic appointment had lower levels of anxiety than those who would not attend or only attend in an emergency.

Finally, when they asked about measures to avoid contamination when offices opened. Most patients reported PPE being essential: surgical masks (88.7%), medical cap (81%), the use of a face shield (55%).

Social distancing was also critical (78%). Interestingly, 91.8% of the patients stated the availability of alcohol gel was important.

Their overall conclusions were:

“The coronavirus pandemic has had an impact on patient’s anxiety about their orthodontic treatment. Delay in treatment was the greatest concern of patients undergoing treatment”.

What did I think?

This is one of the first refereed papers about the COVID-19 pandemic. I thought that they provided a large amount of useful information about the patient’s feelings about their orthodontic treatment. Importantly, they drew attention to the patients’ concerns about seeing visible PPE as dental and orthodontic offices open.

They also pointed out that a fairly high proportion of our patients are likely to be anxious of returning for treatment.

The authors drew attention to some shortcomings in the study.  The greatest was that these findings were relevant to two orthodontic offices in Brazil. Importantly, this may only make their conclusions pertinent to Brazil.  Nevertheless, this paper does provide us with useful information, particularly as many offices are currently opening or due to open in the next few weeks.

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Have your say!

  1. Its good to know that people are careful and would expect their dentists and staff to use PPE and follow the protocols. On the other hand in countries like Pakistan where we have nt even reached our peak yet and the cases are still on the rise, I’m skeptical of reopening of orthodontic practices soon although the lockdown has already been eased by the government and patients are rather restless to have their next orthodontic appointment. Many orthodontists have started reopening their practices especially the private clinic owners but I still think it’s quite risky yet.

  2. How interesting! So…almost 50% are fairly rational and 50% are anxious/concerned. It could be that they are medically at risk or frightened by what they have seen/read/heard or directly experienced. It would be interesting to know the age, profile, medical and social circumstances of these people.
    Working on Guernsey, we are in the lucky position of no new cases for over fours weeks, with no current active cases. We are opening up clinics very slowly and carefully, following the New Zealand/Australian models. There are still anxious parents, even in this relatively ‘happy’ scenario. I feel there is more angst remaining and certain there is more angst to come.The psychologists maintain you can only be frightened for so long…..what next? I also fear for the poor souls in the very busy NHS practices trying to keep their heads above water in the deluge of treatment backlog, trying to adhere to the new safer protocols and guidelines.

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