Did COVID-19 affect the loss to follow-up in long-term periodontal treatment: A retrospective study based on phone call survey

Abstract

Background COVID-19 and the subsequent intermittent lockdown measures from 2020 to 2022 in China critically disrupted regular medical activities, including dental care. This study aimed to investigate the impact of COVID-19 on long-term follow-up at the Stomatology Hospital, Zhejiang University School of Medicine and to evaluate potential causes of loss to follow-up. Methods A retrospective phone call survey based on a questionnaire of 19 questions was conducted among patients who met the eligibility criteria. Data were analyzed by binary logistic regression analysis using R (v4.2.3) software. Results A total of 536 (50.47%) valid questionnaires were collected from 1062 patients. Personal factors (42.5%), instead of the COVID-19 epidemic (20.0%), were the main factors that impacted the loss to follow-up in long-term periodontal treatment, while work factors (19.8%), hospital factors (16.4%), and transportation or distance factors (14.7%) were all important factors. A family history of periodontitis [odds ratio (OR) = 0.603, 95% confidence interval (CI): 0.414–0.878, p = 0.008)], as well as frequent use of dental devices (OR = 0.539, 95% CI: 0.371–0.784, p = 0.001), were significantly associated with a "negative" attitude toward follow-up visits. Conclusion This survey suggests that COVID-19 epidemic factors contributed to the loss to follow-up of periodontitis patients, but the subjective personal factor of lack of periodontal health awareness of the individual remained the most important reason. Patients had mostly negative attitudes toward subsequent continued participation in supportive care, something that was even more pronounced among patients with a family history of periodontitis and among those with better oral hygiene habits.