Oral Health Care Delivery for Children During COVID-19 Pandemic—A Retrospective Study

Abstract

Aim: COVID-19 outbreak and the lockdown period following was a very challenging time for pediatric dentistry. We aimed to find whether the characteristics of dental care provided to children at the Department of Pediatric Dentistry at Hadassah medical center, Jerusalem, Israel, differed between the periods, before COVID-19 outbreak, during the lockdown period and during the period that followed it.Materials and Methods: We retrospectively reviewed computerized records of patients who visited the pediatric dental clinic at three different periods: pre-lockdown period, lockdown period, and post-lockdown period.Results: Nine-hundred and forty-nine children were included in the study; most of them were healthy children between 3 and 6 years old. During lockdown, all scheduled appointments except for treatments under general anesthesia and deep sedation were canceled due to the government's restrictions; the frequency of treatments with non-pharmacological behavior management, general anesthesia or deep sedation was higher than in the previous or subsequent periods and the use of inhaled/conscious sedation was significantly lower. During lockdown most of the children were diagnosed with dentoalveolar abscess (32.3%), compared to 14 and 21% at the previous or subsequent periods, respectively (P < 0.001). Treatments combination during lockdown included more extractions, pulpectomies and pulp extirpation and less permanent restorations (P < 0.001). None of the staff members was infected with COVID-19 at the clinic during these periods. We concluded that dentists should be updated about Covid-19 modes of transmission and the recommended infection control measures in dental settings. Effective management protocols can help the dental staff to continue to provide efficient treatment and prevent Covid-19 contamination.

Pediatric Dental Emergency Visits and Treatment during Lockdown in the COVID-19 Pandemic: A Retrospective Study

“…During the lockdown, the purposes of pediatric patients’ visits in the clinic due to trauma, infection, and treatment continuation were reduced ( Table 2 ). Similar to the studies by Üstün et al [ 29 ] and Fux-Noy et al [ 35 ], herein, the patients’ visits due to pain were higher during the lockdown. Another study reported many trauma cases in males and acute pericoronitis and acute gingivitis cases in females during the lockdown [ 40 ].…”

“…Nonetheless, in China [ 37 ] and Turkey [ 29 ], a 38% reduction in pediatric dental emergency cases was reported. Other studies in Israel also reported a decrease in dental emergency cases [ 35 , 38 ]. A total of 20.8% of dental emergency cases were treated in South India [ 36 ].…”

“…The dental professionals are usually in direct contact with the patient’s saliva, nasal, eye, and oral droplets, which require appropriate conscientiousness [ 35 , 36 ]. Thereby, the CDC allowed emergency cases with proper care to prevent the virus from spreading during the lockdown period [ 30 ].…”

“…Dental procedures such as extraction, filling, fluoride, and pulp treatment were significantly higher during the lockdown ( Table 4 ). For example, a study reported higher dental procedures of extractions, pulp extirpation, and pulpectomies during lockdown [ 35 ]. Another study stated 51.8% of patients were treated with extraction [ 39 ].…”

The impact of covid-19 lockdown on maxillofacial related services at tertiary dental institution

“…Several studies confirm that during the pandemic dental extractions were performed most frequently. 18 We attribute the decline in the utilization of maxillofacial services in our facility to several reasons: Firstly, the hard lockdown severely restricted the movement of people including visits to healthcare facilities. Secondly, during this period of total shutdown, the world was overwhelmed by anxiety and fear of the virus.…”