Dental practice closure during COVID-19 and associated professional, practice and structural determinants: a multi-country survey

Abstract

Background: The outbreak of novel coronavirus disease (COVID-19) in China has influenced every aspect of life worldwide. Due to the characteristics of dental settings, the risk of cross infection may be high between dental practitioners and patients. Being on the list of high-risk professions, dentists are very much expected to develop severe anxiety about the current pandemic situation. In addition, the limited provision of services and closure of dental practices raised concerns among dental professionals about the financial consequences of this closure. Therefore, the study assessed the extent of dental practice closure in various countries around the world, factors associated with this closure and whether closure and associated factors differed between private and non-private sectors.Methods: From April to May 2020, a web-based survey was sent to dentists in several countries. The survey assessed professional factors, practice factors and country-level structural factors. Multilevel logistic regression was used to assess the association of practice closure with these factors. Effect modification due to private and non-private sectors was assessed. Results: Dentists (n= 3243) participated from 29 countries. The majority (75.9%) reported practice closure with significantly higher percentage in the private than non-private sector. Fears were associated with significantly higher likelihood of closure in private (OR= 1.54, 95%CI= 1.24, 1.92) and non-private sectors (OR= 1.38, 95%CI= 1.04, 1.82). Non-private, governmental sector dentists (OR= 0.54, 95%CI= 0.31, 0.94) and those in rural areas (OR= 0.58, 95%CI= 0.42, 0.81) and those in hospitals (overall OR= 0.60, 95%CI= 0.36, 0.99) reported low likelihood of closure. High likelihood of closure was reported by those in academia (OR= 2.13, 95%CI= 1.23, 3.71). More hospital beds were associated with lower likelihood of closure in the non-private sector (OR= 0.65, 95%CI= 0.46, 0.91) and private sector dentists in high income countries (HICs) reported less closure than in non-HICs (OR= 0.55, 95%= 0.15, 1.93).Conclusions: Most dentists reported practice closure because of COVID-19 with greater impact in the private than non-private sectors with professional, practice and country-level factors associated.