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| ORIGINAL ARTICLE |
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| Year : 2021 | Volume
: 10
| Issue : 3 | Page : 193-199 |
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Knowledge, attitude and practices towards COVID-19 among dental professionals: A cross-sectional survey
Alekhya Kanaparthi1, Tejaswi Katne2, Dukkireddy Divya3, Srikanth Gotoor2, Srikar Muppirala4, Beedam Bhargavi5
1 Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
2 Department of Oral Medicine and Radiology, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
3 Public Health Dentist, RR Digital Dental Hospital, Hyderabad, Telangana, India
4 Consultant Oral and Maxillofacial Radiologist, Sree Dental Clinic, Hyderabad, Telangana, India
5 Consultant Oral and Maxillofacial Radiologist, Smile Dental Clinic, Kadapa, Andhra Pradesh, India
| Date of Submission | 18-Dec-2020 |
| Date of Decision | 13-Mar-2021 |
| Date of Acceptance | 20-Mar-2021 |
| Date of Web Publication | 17-Mar-2022 |
Correspondence Address:
Dr. Alekhya Kanaparthi
Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy - 502 001, Telangana
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/JDRNTRUHS.JDRNTRUHS_74_20
Background: Coronavirus disease (COVID-19) is an extremely alarming situation across the world. Researchers have identified it to be transmitted by direct/indirect contact through droplets from body fluids like saliva. Dental professionals are considered to be at high risk.
Aim: The aim of the current study was to evaluate the knowledge, attitude, and practice regarding COVID-19 pandemic among dental professionals.
Materials and Methodology: A self-administered, structured, pilot-tested close-ended 21 questionnaire was distributed among the dental professionals (Bachelor of Dental Surgery (BDS) students, internship, postgraduates, and practitioners. Data obtained was analyzed using SPSS 17.0 (SPSS Inc., Chicago, IL, USA) for descriptive analysis of the data.
Results: A total of 513 participants completed the survey, of which 217 (42.2%) were BDS students, 64 (12.5%) were interns, 88 (17.2%) were postgraduates, and 144 (28.1%) were practitioners. Out of 513 respondents, 144 (71.9%) were males and 369 (28.1%) were females.
Conclusion: All the respondents seem to have sufficient knowledge regarding COVID-19 and the adoption of World Health Organization and dental association guidelines. However, a difference in viewpoint was observed and the possible explanation could be the level of education and understanding. We believe that this survey may have reemphasized the importance of vigilance and practice by the dental care workers, in preventing the transmission of novel viral disease.
Keywords: Corona virus, COVID-19, dental, knowledge. questionnaire, WHO
How to cite this article:
Kanaparthi A, Katne T, Divya D, Gotoor S, Muppirala S, Bhargavi B. Knowledge, attitude and practices towards COVID-19 among dental professionals: A cross-sectional survey. J NTR Univ Health Sci 2021;10:193-9 |
How to cite this URL:
Kanaparthi A, Katne T, Divya D, Gotoor S, Muppirala S, Bhargavi B. Knowledge, attitude and practices towards COVID-19 among dental professionals: A cross-sectional survey. J NTR Univ Health Sci [serial online] 2021 [cited 2023 Mar 21];10:193-9. Available from: https://www.jdrntruhs.org/text.asp?2021/10/3/193/339810 |
| Introduction | |  |
Coronavirus disease (COVID-19) is a respiratory illness caused due to a new infectious agent known as novel β-coronavirus (2019-nCo/SARS-CoV-2).[1] It has been deemed as a pandemic by World Health Organization and has affected more than 213 countries, including India, so far.[1] The outbreak of this novel viral infection started in Wuhan city, China, followed by rapid spread to other countries.[2] The number of confirmed COVID-19 cases in India is also rising at an alarming rate.[1] One of the main concerns in a pandemic outbreak would be the overwhelming burden on the medical resources and its impact on the morbidity and mortality rate. This situation places healthcare professionals to be frontline saviors in managing this condition.
It has been reported that the common routes of transmission of this viral infection include direct (droplet spread in the form of cough and sneeze) and contact transmission (contact with oral, nasal, and eye mucous membranes).[3],[4],[5],[6],[7] Among the healthcare professionals, dentists are placed in a high-risk groups of getting exposed to COVID-19 due to direct face-to-face communication and also increased frequency to the exposure to saliva, blood, and the handling of sharp instruments in their clinical practice.[3] Besides this, in the dental setting, there are chances of transmission of such infective organisms due to the spread in the form of aerosols created by high-speed dental instruments and irrigation systems.
In 2020, American Dental Association,[8] Centre for Disease Control and Prevention of the United States of America (CDC)[9] and Indian Dental Association[10] suggested guidelines for infection control in dental settings. Knowledge, awareness, and compliance with these recommendations are important for the prevention of contagious viral infections in healthcare workers as well as dental patients.[3] Although there is an abundance of information available on the current scenario, there is still a lack of reliable knowledge and awareness towards this dreadful pandemic. Owing to the alarmingly increasing spread of COVID-19, the current study aimed to evaluate and assess knowledge, attitude, and practices of dental professionals with different educational levels in dentistry (BDS student, interns, postgraduate student, and practitioners), and to estimate the efforts made by them in preventing the transmission of this novel infection.
| Materials and Methodology | | |
A cross-sectional survey was conducted in March 2020, wherein a questionnaire consisting of 21 questions (3 demographic data and the 18 questions under Knowledge, attitude, and practice category) was prepared and distributed to BDS studentsinterns, postgraduate students and practitioners in tertiary health centers and dental institution of Telangana state. The study design was a cross-sectional survey using a self-administered, pilot-tested closed-ended questionnaire.
The questionnaire was prepared in English language and the content was adapted from the interim guideline published by the US Centres for Disease Control and Prevention[9] and precautionary guidelines by the IDA.[10] The content validity of the questionnaire was thoroughly evaluated for clarity, readability, and comprehensives by the subject experts.
The survey was prepared in the form of an online form and sent to potential responders who included students and staff at various healthcare institutions in the state of Telangana, India. The survey instrument was pilot tested on 50 dental professionals and revised according to their feedback. Later, their final results were also used for the study.
The period of the survey was March 12–26, 2020, and only those responses received during this period were included in the study. A total of 513 responders completed the survey.
Informed consent was obtained by all the study participants. The Institutional Ethics Committee reviewed and analyzed the study-related documents (11/03/2020). A convenient sampling method was used for data collection, and the data were tabulated for further analysis. SPSS for Windows release 17.0 (SPSS Inc., Chicago, IL, USA) was used for descriptive analysis of the data.
| Results | | |
Based on the inclusion criteria, 513 respondents were included in the study. Among them, 71.9% (369) were females and 28.1% (144) males [Graph 1]. The age of the participants included in the study were grouped as <25 years and >45 years, of those most of them belonged to <25 years age-group [Graph 2]. In all, 42.2.7% of the respondents were BDS students, 12.5% were interns, 17.2% were postgraduate students, and 28.1% were practitioners [Graph 3] and [Table 1].
The main mode of transmission of the virus is via respiratory droplets that were answered correctly by 93.2% of the responder. When asked about the incubation period 86.8% of the respondents reported it to be 7–14 days, while 12% reported it to be 1–7 days. 80.4% of them were aware of the typical clinical symptoms of COVID-19, however, 16.1% reported to be only fever, sore throat, and cough.
When asked about infection control in the dental setting, 98.4% reported to be patient screening, travel history assessment, hand hygiene, and use of personal protective measures. In all, 96.8% were aware of all the possible routes of COVID-19 transmission in dental hospital/clinics, while 12.4% reported it to be only due to the patients interaction without personnel protective measures.
When asked 65.9% of them replied that they attained knowledge regarding COVID-19 from internet and social media, while 25.1% of the participants reported they attained the knowledge from mass communications and newspapers.
Under attitude category, 90.7% of responders felt coronavirus outbreak to be a dangerous situation affecting the world, 68.7% of them reported that they would not be afraid if a vaccine was present.
About 58.1% of the respondents reported that the protective measures suggested by WHO were enough for prevention, while 29.9% reported not enough. Moreover, 90.5% of the respondents were aware of the need of rescheduling the appointments for patients not requiring immediate care.
In all, 49.5% of the respondents reported that media updates are creating panic rather than awareness, while 27.1% said no and 23.5% reported may be. Also, 80.3% of the respondents reported that COVID-19 pandemic has a negative impact on your academics, finance, and social life.
Under practice category, 97.3% of the respondents reported following the personal protection guideline issued by WHO for the prevention of COVID-19. About 98.0% of the respondents reported dental professionals at the highest risk for COVID-19 infection; 97.5% were aware of disinfecting used instruments, equipment and following correct waste disposing techniques.
In all, 98.3% reported educating and motivating patients to maintain etiquette to stop the spread of COVID-19, 87.2% were not providing non-emergency dental treatments in the dental office/clinics. Of them, 78.1% reported patients screening in the dental office/clinics, who may show symptoms of flu and directing them to state helpline medical centers. The summary of the frequency and percentage of responses on knowledge, attitude, and practice regarding the COVID-19 pandemic is shown in [Table 2], [Table 3], [Table 4]. | Table 2: Distribution of Frequency and Percentages to Questions Under Knowledge Category
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 | Table 3: Distribution of Frequency and Percentages to Questions Under Attitude Category
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 | Table 4: Distribution of Frequency and Percentages to Questions Under Practice Category
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| Discussion | | |
The emergence of the novel viral infections and the increasing number of infected patients globally has obligated the healthcare workers and the dental professionals to have in-depth knowledge of contagious infections and dental management of patients with such diseases.[3] Though there are substantial information and literature regarding the knowledge and attitude of dentists toward other infectious diseases, a few studies have assessed the dental healthcare professionals alone and their attitude towards COVID-19.
This questionnaire study assessed the knowledge (which included general information, transmission, symptoms) and attitude (which included perception towards COVID-19) and practices (which included control measures in the dental setup, role of the dentist in creating public awareness and impact) of the dental professionals.
From the results, it can be inferred that most of the respondents have adequate knowledge, attitude, and practices except for the responses to Q.f (how did you attain the knowledge regarding the COVID-19) in the knowledge category and to Q. b-f (attitude towards COVID-19) under attitude category. However, the results should not be generalized as the information being upgraded rapidly also has an impact on the understanding and practice by the dentist. The differences in responses could be a reflection of the updated information by media, news and evidence-based research from time to time, further enhancing their perception about COVID-19 at the time of the study. The results of our study are in accordance with an Indian study by Modi PD et al.[11] who reported among 1562 healthcare professionals 142 were dentists and 73.9% reported overall correct answers and seemed to have adequate knowledge in their study.
In this study, nearly 93.2% of the dental professionals thought that direct spread from infected person (e.g., cough and sneeze) and surface contact as a possible transmission route, not knowing this information is crucial as it may unnecessarily risk their patients to COVID-19.
When asked, 65.9% of them replied that they attained knowledge regarding COVID-19 from the internet and social media, while 25.1% of the participants reported that they attained the knowledge from mass communications and newspapers. The results from this study suggest social media campaigns to be an effective means to raise awareness among the public in combating this novel infection. However, evidence-based research should be the reliable source of attaining education and this should be the prime area of focus for a medical expert to validate the information available on the media and relay only on the information that is scientifically acceptable.
An important finding in the current study was the fact that 68.7% of the respondents believed that they would not be afraid if a vaccine was present to COVID-19. Vaccination is an approach that can induce protective immunity against the corresponding infectious pathogen. The development of an effective vaccine is an important strategy against the spread of COVID-19. Of them, 98.3% are educated and motivated their patients regarding COVID-19 suggesting that the dental professionals were responsible to raise awareness, in the pandemic outbreak and have the social responsibility of clearing the myths and misconceptions regarding the pandemic.
In all, 98.0% of the participants are in agreement with the fact that dental care professionals are at higher risk of getting infection. All the respondents are from dental background and may have adequate knowledge regarding the preventive measures followed in the past, for respiratory infections like influenza, H1N1, and the agreement in the responses could be a possible explanation.
Diagnostic and treatment facilities were provided by the Government of India at selected hospitals in the states following pandemic alert by WHO in order to curb the misuse of the facilities by false positive cases. The state helpline numbers assist in providing the treatment at such centers and 78.1% of the respondents were aware of such a facility.
Due to the novelty of the pandemic, at present very few studies have been published in this regard and each researcher has a different set of study population with varied questionnaire pattern. At the time of study, to our knowledge, a Jordanian study was published wherein, the authors reported that 96.2% of the dentist reported to be aware of all the protocols to prevent transmission and spread of COVID-19 and the results of our study are in accordance.[12]
Respiratory infections are a major threat due to the rapid and extensive spread.[3] While providing dental treatment to patients, the knowledge regarding the novel viral infections along with the right attitude and practice aid in prevention and spread among themselves and to the patient.
Despite, our best efforts there are a few limitations in our study. Firstly, we could not supervise the respondent's practice, and also the distribution of the questionnaire was through online sources with a limited time of collection of responses. Hence, we had to rely on their subjective self-assessment, and the responses might not have accurately reflected the true levels of knowledge, attitude, and practices of all dental professionals. Secondly, we recognize that the study represented only descriptive data regarding the knowledge of the dental professionals, and studies with comparative data post-training and education program on the changing guidelines and protocols needs to be assessed.
| Conclusion | | |
The level of knowledge of the dental professionals about COVID-19 pandemic seems to be adequate. It is clear from the survey that dental professionals are adequately following the guidelines issued by the healthcare authorities and this survey may have enlightened them to seriously rethink about the possible risks that their patients or themselves might face during the treatment procedures. We hope this survey may pave way for future studies encompassing.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 2. | Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33.  |
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| 4. | Liu T, Hu J, Kang M, Lin L, Zhong H, Xiao J, He G, Song T, Huang Q, Rong Z, Deng A. Transmission dynamics of 2019 novel coronavirus (2019-nCoV). |
| 5. | To KK, Tsang OT, Yip CC, Chan KH, Wu TC, Chan JM, et al. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Diseases Clin Infect Dis 2020;71:841-3. |
| 6. | Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents. J Hosp Infect 2020;104:246-51. |
| 7. | Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. |
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| 11. | Modi PD, Nair G, Uppe A, Modi J, Tuppekar B, Gharpure AS, et al. COVID-19 awareness among healthcare students and professionals in Mumbai metropolitan region: A questionnaire-based survey. Cureus 2020;12:e7514. |
| 12. | Khader Y, Al Nsour M, Al-Batayneh OB, Saadeh R, Bashier H, Alfaqih M, 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:e18798. |
[Table 1], [Table 2], [Table 3], [Table 4]
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