*Iwona Grzesiak-Gasek1, Katarzyna Dębska-Łasut2, Katarzyna Herman3
Influence of the COVID-19 pandemic on access to dental benefits for children – a questionnaire parent’s study
Wpływ pandemii COVID-19 na dostępność do świadczeń stomatologicznych u dzieci – badania ankietowe rodziców
1Medical Innovation Center in Wroclaw
Head of Center: Sadri Mateusz Rayad
1Uniwersyteckie Centrum Stomatologiczne we Wrocławiu
Dyrektor Centrum: Sadri Mateusz Rayad
2Department of Periodontology, Medical University of Wroclaw
Head of Department: Professor Tomasz Konopka, MD, PhD
2Katedra i Zakład Periodontologi, Uniwersytet Medyczny im. Piastów Śląskich we Wrocławiu
Kierownik Zakładu: prof. dr hab. n. med. Tomasz Konopka
3Department of Paediatric Dentistry and Preclinical Dentistry, Medical University of Wroclaw
Head of Department: Professor Maciej Dobrzyński, MD, PhD
3Katedra i Zakład Stomatologii Dziecięcej i Stomatologii Przedklinicznej, Uniwersytet Medyczny im. Piastów Śląskich we Wrocławiu
Kierownik Zakładu: dr hab. n. med. Maciej Dobrzyński
Streszczenie
Wstęp. Pandemia COVID-19 spowodowała utrudnienia w funkcjonowaniu opieki zdrowotnej. Zabiegi stomatologiczne, wykonywane w jamie ustnej i generujące potencjalnie zakaźny aerozol, uznano za szczególnie ryzykowne w aspekcie rozprzestrzeniania zakażenia. Spowodowało to znaczne ograniczenia pracy placówek stomatologicznych w okresie pandemii.
Cel pracy. Poznanie opinii rodziców odnośnie do leczenia stomatologicznego dzieci w okresie pandemii z uwzględnieniem dostępności gabinetów, ich zabezpieczenia epidemicznego i obaw dotyczących zakażenia w czasie odbywania wizyty.
Materiał i metody. Badanie ankietowe przeprowadzono wśród 146 rodziców dzieci zgłaszających się do Poradni Stomatologii Dziecięcej przy Katedrze i Zakładzie Stomatologii Dziecięcej i Stomatologii Przedklinicznej Uniwersytetu Medycznego we Wrocławiu.
Wyniki. 45% badanych oceniło dostępność do świadczeń stomatologicznych na poziomie podobnym jak przed pandemią, 51% doświadczyło trudności (21% – konieczność przesunięcia terminu wizyty, 18% – pomoc tylko w nagłych wypadkach, 8% – brak możliwości leczenia, 3% – wyłącznie kontynuacja leczenia, 1% – wyłącznie teleporada). Zabezpieczenie gabinetu przed transmisją zakażenia 88% respondentów uznało za wystarczające. Obawy dotyczące zakażenia dziecka w trakcie wizyty zgłaszało 35% badanych. 19% rodziców uznało, że trudności w dostępie do leczenia negatywnie wpłynęły na stan zdrowia jamy ustnej ich dzieci.
Wnioski. Należy wypracować procedury umożliwiające zminimalizowanie ryzyka zakażenia w placówkach stomatologicznych w czasie epidemii, przy zachowaniu optymalnej dostępności do leczenia.
Summary
Introduction. The COVID-19 pandemic has caused difficulties in the functioning of healthcare. Dental procedures performed in the oral cavity and generating a potentially infectious aerosol were considered to be particularly risky in terms of spreading infection. This has resulted in significant reductions in the work of dental offices during the pandemic.
Aim. Getting to know the opinions of parents regarding the dental treatment of children during the pandemic, considerate the availability of dental offices, their epidemic protection and concerns about infection during the visit.
Material and methods. A survey study was conducted among 146 parents of children visiting the Pediatric Dentistry Clinic at the Department of Pediatric Dentistry and Preclinical Dentistry of the Medical University in Wroclaw.
Results. 45% of respondents assessed the availability of dental services at level similar to that before the pandemic, 51% experienced difficulties (21% – need to postpone the appointment, 18% – help only in emergency cases, 8% – no possibility of treatment, 3% – only continuation of treatment, 1% – teleconsultation only). Securing office against the transmission of infection was considered sufficient by 88% of the respondents. Concerns about the infection of the child during visit were reported by 35% of the respondents. 19% of parents felt that difficulties in accessing treatment had negative impact on their children’s oral health.
Conclusions. Procedures should be developed to minimize the risk of infection in dental facilities during an epidemy, while maintaining optimal access to treatment.
Introduction
The new type of coronavirus, SARS-CoV-2, the causative agent of COVID-19, was previously found in Wuhan, China in 2019. On March 11, 2020, the World Health Organization declared the pandemic (1). The pandemic of the caused by the coronavirus, severe acute respiratory syndrome 2 (SARS-CoV-2) has caused a serious threat to worldwide public health, and therefore limited access to many specialist doctors (2).
Dental procedures are strictly connected with oral control, examination, and possible treatment in the nasopharyngeal area, with the simultaneous failure to keep a distance between the doctor and the patient longer than one meter and exposure to saliva, blood and other oral fluids, especially during surgical procedures, the risk of COVID-19 infection in dentists is very high (3, 4). In everyday clinical practice, the patient’s oral fluids as well as the surfaces of dental equipment (dental units) can be the sources of infection for both the dentist, the assistant and the patient himself. Saliva and blood deposited on surfaces, aerosol produced by rotating tips (turbine, contra-angle), ultrasonic scalers with water cooling systems and air-water tips pose a threat to those who stay or watch in their environment. The virus can stay in aerosols for hours and on surfaces for a few days (5). Due to the unique features of dental procedures, during which a large amount of potentially virus-infected saliva is released and aerosolized, the standard protective measures used in everyday clinical practice are not effective enough to prevent the spread of COVID-19. The incubation period is particularly dangerous, when patients are unaware of their infection or decide to hide their infection (6). Direct contact between a healthcare professional and a patient carries a high risk of disease transmission (7). Regardless of the type of planned treatment, healthcare professionals, especially dentists, hygienists and dental assistants, must follow rigid protocols for treatment and personal protective equipment in potentially affected for infection areas (6). As a result of the restrictions, during the ongoing pandemic, most routine dental procedures around the world have been suspended and only emergency dental treatments and surgeries have been performed. In addition, the frequency of dental visits by patients has decreased, which was dictated by fears of COVID-19 infection in the office. Suspension of the activities of dental offices at the time when the incident occurs, as well as the reaction itself before the occurrence of a potential source, but at the same time increasing the number of people requiring intervention in emergency cases (8). One of the ways to prevent the spread of the disease in the dental office was to identify patients with mild symptoms of COVID-19 using a telephone survey carried out when making an appointment, as well as on-site when completing the survey just before the visit (9).
During the pandemic, teleconsultation ensured remote selection of patients with suspected COVID-19 and reduced the exposure of healthy people to infection. It also made it possible to continuing dental practice through teleconsultation or telediagnostic (10).
The result of the decreasing number of infections in Poland was the replacement in May 2022 state of epidemic by state of epidemic threat. The obligation to isolate the sick and quarantine was lifted, and the dental treatment returned to the planned procedure, with special precautions (11).
Aim
The aim of the study was the impact of the pandemic of COVID-19 on the availability of dental services among children on the basis of a survey.
Material and methods
The survey covered 146 parents of 218 children attending a dental visit at the Department of Pediatric Dentistry and Preclinical Dentistry of the Medical University in Wroclaw. The study was conducted in 2022, after the restrictions on access to medical services related to the COVID-19 pandemic were lifted. The survey concerned children both joining and not joining the National COVID-19 Vaccination Program. It contained 15 questions about the number and age of children in the family, the type of dental office the child used before and during the pandemic, the frequency of visits before and during the pandemic, the reason for the visit before the pandemic, availability and waiting time for a visit during the greatest restrictions, concerns about infection in a dental office, subjective assessment of the security of the office in terms of COVID-19 infection. The next questions concerned the possible change of a medical office during the pandemic, the reason for such a decision and the type of new medical/dental office. They were also asked about a subjective assessment of the impact of this period on the oral health of the child. The last question concerned the proposal to improve dental care in the event of possible further epidemic situations.
Results
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Piśmiennictwo
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