Dental practices in Hong Kong under the outbreak of COVID-19

Abstract

Background: The novel pandemic of coronavirus disease 2019 (COVID-19) has posed a public health crisis across the globe. Healthcare professionals, including dental practitioners, are thus anticipated to face the new challenges regarding infection control and clinic operation. Aims: This project set out to investigate the impacts of the COVID-19 outbreak on Hong Kong dentists, including the challenges faced and the protective measures adopted by the profession, as well as the effects on the utilisation of local dental services. Method: A cross-sectional online questionnaire was conducted during 11-27 March 2020. Total population sampling was employed, reaching out to 2014 registered private dentists in Hong Kong through mails. Data on background information, clinic suspension, change in operating hours, challenges faced, and precautions for infection control during the outbreak of COVID-19 were collected. Results: The response rate was 19.1% (n=378). Challenges experienced by dentists were in general the inadequacy of personal protective equipment (PPE) (92.2%), worry over cross-transmission in practice (94.2%) and business hardship (reflected in various aspects). Dentists with >20 years of practice were found to be less worried about the risk of infection when compared to those with less experiences (p=0.013). A high level of compliance to local suggested infection control protocols was noted in terms of patient- and clinic-oriented measures, while staff-oriented measures were relatively less practised. Dentists with >20 years of practice had a higher tendency to screen patients without the use of health questionnaires (p=0.03), measure and record patients’ body temperature (p=0.004), perform hand hygiene before wearing gloves (p=0.046) and provide no treatments to patients with no suspicious symptoms and history (p=0.026), than those with ≤20 years of experience. The use of health questionnaires, measurement of patients’ body temperature and pre-procedural rinses were found to be significantly more adopted by dentists who were more worried (p<0.001). Dental service utilisation during this period was largely reduced, where 86.9% of the dentists had a drop in average patient number and 75.2% had reduced operating hours due to fewer appointments. 30.5% of the dentists had suspended clinic operation due to the outbreak and 8.5% had not yet resumed their operation at the time of the survey, mostly due to worries of infection (>80%). Conclusion: Hong Kong dentists have an overall promising compliance to local infection control protocols suggested for COVID-19 but require more attention to particular staff-oriented measures. Dentists’ years of practice and level of worry appear to have certain impacts on the implementation pattern. The face of challenges from the epidemic including PPE shortage, safety concern and reduced service demand reflects that the profession is in need of more resources sharing, security for a safer working environment, and financial aid.