Dental and Medical Problems

Dent. Med. Probl.
Index Copernicus (ICV 2020) – 128.41
MNiSW – 70 pts.
CiteScore (2020) – 1.2
Average rejection rate (2020) – 88.71%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

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doi: 10.17219/dmp/131115

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Stress and anxiety among dental practitioners during the COVID-19 pandemic: A cross-sectional survey

Adeel Tahir Kamal1,C,D,E,F, Rashna Hoshang Sukhia1,A,B,C,E,F, Dinaz Ghandhi1,B,E,F, Hoshang Rumi Sukhia2,B,E,F

1 Orthodontics, Section of Dentistry, Department of Surgery, Aga Khan University, Karachi, Pakistan

2 Department of Orthodontics, Dental Section, Sir Syed College of Medical Sciences, Karachi, Pakistan


Background. Dental professionals are at great risk of contracting coronavirus disease 2019 (COVID-19).
Objectives. The objectives of this study were to determine the levels of stress and anxiety among dental professionals, and to determine which dental procedures cause the greatest amount of stress and anxiety during the COVID-19 pandemic.
Material and Methods. This cross-sectional survey was conducted by requesting voluntary participation of dental healthcare workers through the authors’ own e-form, which consisted of our self-developed questionnaire, the Perceived Stress Scale (PSS) and the Generalized Anxiety Disorder-7 scale (GAD-7). The simple and multiple linear regression analyses were used to assess the effect of dental procedures and other factors associated with stress and anxiety among the participants. A p-value ≤0.05 was considered statistically significant.
Results. This survey included 85 participants (32 males, 53 females) with a mean age of 31.6 ±6.0 years. Significant associations were found between severe stress for scaling (p < 0.001; p < 0.001), complex fillings (p < 0.001; p < 0.001), root canal treatment (RCT) (p = 0.001; p = 0.007), crown and bridge work (p < 0.001; p < 0.001), denture work (p = 0.034; p = 0.001), third molar extractions (p < 0.001; p < 0.001), surgical procedures (p < 0.001; p = 0.001), and implant placement (p = 0.001; p = 0.022) and the PSS and GAD-7 scores, respectively.
Conclusion. Dental healthcare workers exhibit severe stress and anxiety associated with elective dental procedures. Dental emergencies should take precedence and elective dental treatment should be carried out with utmost caution, ensuring all protective measures. Psychological support for dental healthcare professionals should be made accessible.

Key words

anxiety, stress, psychological, dentistry, COVID-19

References (27)

  1. World Health Organization. Weekly epidemiological update – November 24, 2020. Accessed November 24, 2020.
  2. Chan JFW, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet. 2020;395(10223):514–523. doi:10.1016/S0140-6736(20)30154-9
  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(5):568–576. doi:10.1007/s12630-020-01591-x
  4. Lan L, Xu D, Ye G, et al. Positive RT-PCR test results in patients recovered from COVID-19. JAMA. 2020;323(15):1502–1503. doi:10.1001/jama.2020.2783
  5. Ather A, Patel B, Ruparel NB, Diogenes A, Hargreaves KM. Corona­virus disease (COVID-19): Implications for clinical dental care. J Endod. 2020;46(5):584–595. doi:10.1016/j.joen.2020.03.008
  6. Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. J Dent Res. 2020;99(5):481–487. doi:10.1177/0022034520914246
  7. Spagnuolo G, De Vito D, Rengo S, Tatullo M. COVID-19 outbreak: An overview on dentistry. Int J Environ Res Public Health. 2020;17(6):2094. doi:10.3390/ijerph17062094
  8. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):386–396.
  9. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097. doi:10.1001/archinte.166.10.1092
  10. Nguyen LH, Drew DA, Graham MS, et al. Risk of COVID 19 among front-line health-care workers and the general community: A prospective cohort study. Lancet Public Health. 2020;5(9):e475–e483. doi:10.1016/S2468-2667(20)30164-X
  11. Gamio L. The workers who face the greatest coronavirus risk. Accessed November 26, 2020.
  12. Syal A. As dentists reopened in late spring, very few got COVID-19, survey finds. Accessed November 26, 2020.
  13. Pugle M. Dentists are reporting a low rate of COVID-19: Here’s why. Accessed November 26, 2020.
  14. Center for Clinical Research and Biostatistics. Sample size calculator: One sample mean. Accessed May 15, 2020.
  15. Izzetti R, Nisi M, Gabriele M, Graziani F. COVID-19 transmission in dental practice: Brief review of preventive measures in Italy. J Dent Res. 2020:99(9);1030–1038. doi:10.1177/0022034520920580
  16. American Dental Association. ADA Coronavirus COVID-19 Center for Dentists. Accessed August 6, 2020.
  17. Centers for Disease Control and Prevention. Guidance for dental settings. Interim infection prevention and control guidance for dental settings during the coronavirus disease 2019 (COVID-19) pandemic. Accessed August 6, 2020.
  18. Khader Y, Al Nsour M, Al-Batayneh OB, et al. Dentists’ awareness, perception, and attitude regarding COVID-19 and infection control: Cross-sectional study among Jordanian dentists. JMIR Public Health Surveill. 2020;6(2):e18798. doi:10.2196/18798
  19. Ahmed MA, Jouhar R, Ahmed N, et al. Fear and practice modifications among dentists to combat novel coronavirus disease (COVID-19) outbreak. Int J Environ Res Public Health. 2020;17(8):2821. doi:10.3390/ijerph17082821
  20. Gambarini G, Galli M, Gambarini E, et al. Fine aerosols and perceived risk of COVID-19 among Italian dental practitioners: An experimental survey. J Contemp Dent Pract. 2020;21(6):599–603.
  21. Watson J, Whiting PF, Brush JE. Interpreting a covid-19 test result. BMJ. 2020;369:m1808. doi:10.1136/bmj.m1808
  22. Tahamtan A, Ardebili A. Real-time RT-PCR in COVID-19 detection: Issues affecting the results. Expert Rev Mol Diagn. 2020;20(5):453–454. doi:10.1080/14737159.2020.1757437
  23. 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(1):9. doi:10.1038/s41368-020-0075-9
  24. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of corona­virus on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020;104(3):246–251. doi: 10.1016/j.jhin.2020.01.022
  25. Ge ZY, Yang LM, Xia JJ, Fu XH, Zhang YZ. Possible aerosol transmission of COVID-19 and special precautions in dentistry. J Zhejiang Univ Sci B. 2020;21(5):361–368. doi:10.1631/jzus.B2010010
  26. National Health Service. Urgent dental care guidance and standard operating procedure. Accessed August 6, 2020.
  27. Mallineni SK, Innes NP, Raggio DP, Araujo MP, Robertson MD, Jayaraman J. Coronavirus disease (COVID-19): Characteristics in children and considerations for dentists providing their care. Int J Paediatr Dent. 2020;30(3):245–250. doi:10.1111/ipd.12653