Patients’ perceptions of orthodontic treatment experiences during COVID-19: a cross-sectional study

Abstract

Background COVID-19 has impacted the care of patients undergoing orthodontic treatment. We aimed to provide an overall view of patients’ perspectives, concerns, and expectations towards their treatment throughout the clinic lockdown during the pandemic; and to assess patients’ levels of mental distress and its association with their confidence in resuming care. Methods An anonymous, validated, in-person paper questionnaire was distributed to adult orthodontic patients’ post-lockdown at an academic institution. The survey focused on the clinical aspects and patients’ perspectives regarding orthodontic treatment during the pandemic. The Kessler Mental Distress Scale (K10) was used to evaluate their psychological status. Survey responses were descriptively summarized and confidence in resuming care was compared between normal patients and patients with mental distress using Mann-Whitney tests. Results One hundred fifty-four patients were surveyed from July to October 2020. Mean age of the participants was 29.30 (SD = 12.01) years and 62% were females. Emergencies during the closure (21%, 32/154) involved primarily irritation with protruding wires. Patients were neutral regarding tele-dentistry and preferred their current fixed appliances over clear aligners. Upon resuming care, 80.51% were extremely pleased with the restrictive protocols and with high level of confidence in resuming treatment. The average level of anxiety was low, and a modest association was found between mental distress and reduced confidence in resuming treatment. Conclusions Few numbers of minor emergencies occurred during the clinic closure. Despite the rising interest in tele-dentistry, patients were neutral on considering this option to monitor treatment and were content with fixed appliances. Patients had high confidence levels to resume their care based on the protocols established upon reopening. The association of mental distress and confidence in resuming care is suggestive and needs further investigation.

Dental Patients’ Perspective on COVID-19: A Systematic Review

“…The overall risk of bias assessment of the included studies is presented in Tables S1 and S2 in Supplementary Materials. Five studies reported a moderate level of bias [21][22][23][24][25], while the remaining five studies showed low quality [26][27][28][29][30].…”

“…In surveys administered through online platforms (Table S1 in Supplementary Materials), all studies reported the survey design describing the target population or sample frame. For IRB approval and informed consent process, IRB approval was obtained by seven out of eight studies [21][22][23][24]26,29,30], informed consent was obtained by four studies [22,25,28,29], and data protection was reported by only one study [22], while it was not applicable by four surveys [21,23,27,29]. Development and pre-testing were performed by only two studies [22,30].…”

“…Two studies were evaluated through SUrge [25,27]. Although with slight differences, both studies lacked information regarding many items.…”

“…We provide a descriptive summary of the study design, period, setting, sample size, gender, age, types of dental emergency/urgency treated during the period of interest, and the questionnaire structure in Table 1. We included a total of 10 studies: 2 carried out in Brazil [26,29], 2 in the U.S.A. [22,25], 1 in Spain [21], Turkey [27], Italy [28], Saudi Arabia [23], China [24], and Nigeria [30], respectively. [26,29] did not report the period of questionnaire administration but referred to that period being before the COVID-19 peak in Brazil: we presume before June 2020.…”

“…Three investigated COVID-19 and patient-related problems such as quarantine, COVID-19 symptoms, and COVID-19 infection [21,23,26]. Six studies investigated patients' anxiety toward dental treatments through different validated or not-validated psychometric scales [21,[23][24][25][26][27]. Nine studies investigated the risk perceptions, attitudes, avoidance behaviors, and beliefs toward the COVID-19 infection during dental treatments [21][22][23][24][25][26][28][29][30].…”