United States Dental Health Care Workers' Mental Health During the COVID-19 Pandemic.

Purpose: The purpose of this study was to assess the prevalence of anxiety and depression symptoms and understand factors influencing mental health among dental health care workers (DHCWs) in the United States (US) during the COVID-19 pandemic.Methods: Beginning in June 2020, dentists (DDS) and dental hygienists (DH) in the US were invited to participate monthly in an anonymous, longitudinal, web-based survey. The Patient Health Questionaire-4 (PHQ-4) was used to estimate rates of anxiety and depression symptoms. Changes in mental health over time and differences by demographic and practice characteristics, COVID-19 community transmission level and COVID-19 vaccination status were tested using χ2 tests and multilevel multivariable logistic regression.Results: A total of 8,902 DHCWs (DH, DDS) participated in the survey for a response rate of 6.7%. Anxiety symptom rates peaked in November 2020 (28% DH; 17% DDS) and declined to 12% for both professions in May 2021. Depression symptoms were highest in December 2020 (17% DH; 10% DDS) and declined to 8% in May 2021. Controlling for gender, age, race, ethnicity and community COVID-19 transmission levels, DDS respondents had lower odds of anxiety symptoms (aOR 0.82; 95% CI 0.70 to 0.95) and depression symptoms (aOR 0.79; 95% CI 0.67 to 0.93) than DHs. Compared to vaccinated respondents, DHCWs who were unvaccinated but were planning on getting vaccinated had significantly higher rates of anxiety (aOR 1.71; 95% CI 1.20 to 2.44) and depression symptoms (aOR 1.57; CI 1.07 to 2.29).Conclusions: The mental health status of DHCWs fluctuated during the COVID-19 pandemic. Anxiety and depression were associated with the demographic and professional characteristics of the DHCW as well as the perceived risk of COVID-19 infection. Mental health support should be made available for all DHCWs.

US dental health care workers' mental health during the COVID-19 pandemic.

BACKGROUND: This study was designed to assess the prevalence of anxiety and depression symptoms and understand factors influencing mental health among dental health care workers (DHCWs) during the COVID-19 pandemic. METHODS: Beginning in June 2020, 8,902 DHCWs participated monthly in an anonymous longitudinal, web-based survey (response rate, 6.7%). The Patient Health Questionnaire-4 was used to estimate rates of anxiety and depression symptoms. Changes in mental health over time and differences by demographic and practice characteristics, COVID-19 community transmission level, and COVID-19 vaccination status were tested using χ2 tests and multilevel multivariable logistic regression. RESULTS: Anxiety symptom rates peaked in November 2020 (28% of dental hygienists, 17% of dentists) and declined to 12% for both professions in May 2021. Depression symptom rates were highest in December 2020 (17% of dental hygienists, 10% of dentists) and declined to 8% in May 2021. Controlling for gender, age, race or ethnicity, and COVID-19 community transmission level, the authors found that dentists had significantly lower odds of anxiety symptoms (adjusted odds ratio [aOR], 0.82; 95% CI, 0.70 to 0.95) and depression symptoms (aOR, 0.79; 95% CI, 0.67 to 0.93) than dental hygienists. Compared with vaccinated respondents, those who were unvaccinated but planning on getting vaccinated had significantly higher rates of anxiety (aOR, 1.71; 95% CI, 1.20 to 2.44) and depression (aOR, 1.57; 95% CI, 1.07 to 2.29) symptoms. CONCLUSIONS: DHCWs' mental health fluctuated during the pandemic. Anxiety and depression in DHCWs were associated with demographic and professional characteristics as well as perceived risk of COVID-19. PRACTICAL IMPLICATIONS: Mental health support should be made available for DHCWs. This clinical trial was registered at ClinicalTrials.gov. The registration numbers are NCT04423770 and NCT04542915.

Employment Patterns of Dental Hygienists in the United States During the COVID-19 Pandemic: An update

Purpose: Despite recovery in dental practices' patient volume, dentists in the United States (US) continue to report difficulties in hiring dental hygienists due to the COVID-19 pandemic. This study updates previous data on US dental hygienists' employment patterns and attitudes concerning returning to work. Methods: Licensed dental hygienists were invited to participate in monthly web-based surveys between September 2020 and August 2021. Employment questions included current and pre-pandemic work status as well as reasons for not currently working as a clinical dental hygienist. Descriptive statistics were used to describe dental hygienists' employment status and reasons for not currently working. Cross tabulation analysis included employment status and reasons for not working by age group. Results: As of August 2021, 4.9% (n=59) of the participants reported that they were not currently employed as a dental hygienist. Most reported that the reason for non-employment as a dental hygienist was voluntary (74.1%;n=43). Safety concerns for self and others were the primary reasons for not returning to work;participants also indicated retirement or that they no longer wished to practice due to the pandemic. However, the percentage of respondents citing insufficient childcare, wanting the COVID-19 vaccine but not obtaining it, and having an underlying health condition, decreased between the beginning and the conclusion of the study. Conclusion: A measurable degree of hesitancy among US dental hygienists to return to work has persisted over a year and a half into the pandemic and may continue despite some improvements in workplace safety and vaccine uptake. Future research should examine workforce levels after the pandemic resolves.

COVID-2019 among dentists in the United States: A 6-month longitudinal report of accumulative prevalence and incidence.

BACKGROUND: In 2020, the Centers for Disease Control and Prevention and the America Dental Association released COVID-19 infection control interim guidance for US dentists, advising the use of optimal personal protection equipment during aerosol-generating procedures. The aim of this longitudinal study was to determine the cumulative prevalence and incidence rates of COVID-19 among dentists and to assess their level of engagement in specific infection control practices. METHODS: US dentists were invited to participate in a monthly web-based survey from June through November 2020. Approximately one-third of initial respondents (n = 785) participated in all 6 surveys, and they were asked about COVID-19 testing received, symptoms experienced, and infection prevention procedures followed in their primary practice. RESULTS: Over a 6-month period, the cumulative COVID-19 infection prevalence rate was 2.6%, representing 57 dentists who ever received a diagnosis of COVID-19. The incidence rates ranged from 0.2% through 1.1% each month. The proportion of dentists tested for COVID-19 increased over time, as did the rate of dentists performing aerosol-generating procedures. Enhanced infection prevention and control strategies in the dental practice were reported by nearly every participant monthly, and rates of personal protection equipment optimization, such as changing masks after each patient, dropped over time. CONCLUSIONS: US dentists continue to show a high level of adherence to enhanced infection control procedures in response to the ongoing pandemic, resulting in low rates of cumulative prevalence of COVID-19. Dentists are showing adherence to a strict protocol for enhanced infection control, which should help protect their patients, their dental team members, and themselves. PRACTICAL IMPLICATIONS: COVID-19 infections among practicing dentists will likely remain low if dentists continue to adhere to guidance.

Employment Patterns of Dental Hygienists in the United States During the COVID-19 Pandemic.

Purpose: The COVID-19 pandemic has led to drops in patient volume and staffing in dental practices in the United States (US). This study aimed to provide insights on dental hygienists' employment patterns as well as their attitudes toward working as dental hygienists during a pandemic.Methods: Licensed dental hygienists were invited to participate in a web-based 30-question survey between September 29 and October 8, 2020. Employment questions included current and pre-pandemic work status, reasons for not currently working as a dental hygienist, and estimated levels of personal protective equipment (PPE) in the primary work location. All statistical analysis was conducted in Qualtrics Core XM; cross tabulation was used to examine dental hygienist working patterns and attitudes by age, practice PPE supply, and other factors.Results: The COVID-19 pandemic has led to an estimated 8% reduction in dental hygienist employment. The majority (59.1%, n=205) of this reduction is voluntary, with the main reason being general concerns over COVID-19 (48.3%, n=100). Other reasons include issues surrounding childcare and concerns over safety measures in the workplace. Dental hygienists aged 65 and older were most likely to have left the workforce voluntarily. More than half of respondents reported that their work locations had more than a two-week supply of most PPE items, although about 10% did not know supply levels. Dental hygienists working in settings with lower supplies of PPE were more concerned with COVID-19 transmission risk to themselves or to patients.Conclusion: COVID-19 has led to a reduction in the dental hygienist workforce that is likely to persist until the pandemic passes.The dental hygienist labor market has tightened and employers may continue to experience difficulties in filling vacant dental hygienist positions until the pandemic subsides. There is also likely to be a longer term, yet smaller, impact on dental hygiene employment levels.

COVID-19 Prevalence and Related Practices among Dental Hygienists in the United States.

Purpose: Throughout the COVID-19 pandemic, health care professionals have been challenged to provide appropriate preventive and therapeutic measures while using precautions to minimize disease transmission. The purpose of this study was to estimate the prevalence of COVID-19 among United States (US) dental hygienists, describe infection prevention and control procedures and any associated trends in mental health.Methods: Registered dental hygienists (RDHs) licensed in the US were invited to participate in a 30-question web-based survey. COVID-19 infection items included probable and confirmed results, COVID-19 related symptoms experienced in the last month, and level of concern about COVID-19 transmission to patients and themselves. The validated Patient Health Questionnaire 4 screened respondents for depression or anxiety. Personal protective equipment (PPE) use when treating patients was assessed. The research protocol and survey were approved by the American Dental Association IRB and registered at clinicaltrials.gov (NCT04542915). Kruskal-Wallis and X2 tests were used to test for associations between PPE use, PPE supply, mental health symptoms, and concern about COVID-19 transmission.Results: As of October 8, 2020, a total of 4,776 dental hygienists from all 50 states and Puerto Rico participated in the study. Respondents reported elevated symptoms of anxiety and depression. Of the respondents, 3.1% (n=149) had ever tested positive or been diagnosed with COVID-19. The majority of respondents (99.1%; n=3,328) who practiced dental hygiene reported their primary dental practice had enhanced infection prevention or control efforts in response to the pandemic. PPE use was significantly associated with years of experience as a dental hygienist, level of concern about COVID-19, and level of PPE supplies available (p-values<0.01), but not type of dental practice (p-value 0.1).Conclusion: As of October 2020, the estimated prevalence rate of dental hygienists in the US having had COVID-19 was low. There is a need for further support for dental hygienists' use of PPE and mental health.

Estimating COVID-19 prevalence and infection control practices among US dentists.

BACKGROUND: Understanding the risks associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during oral health care delivery and assessing mitigation strategies for dental offices are critical to improving patient safety and access to oral health care. METHODS: The authors invited licensed US dentists practicing primarily in private practice or public health to participate in a web-based survey in June 2020. Dentists from every US state (n = 2,195) answered questions about COVID-19-associated symptoms, SARS-CoV-2 infection, mental and physical health conditions, and infection control procedures used in their primary dental practices. RESULTS: Most of the dentists (82.2%) were asymptomatic for 1 month before administration of the survey; 16.6% reported being tested for SARS-CoV-2; and 3.7%, 2.7%, and 0% tested positive via respiratory, blood, and salivary samples, respectively. Among those not tested, 0.3% received a probable COVID-19 diagnosis from a physician. In all, 20 of the 2,195 respondents had been infected with SARS-CoV-2; weighted according to age and location to approximate all US dentists, 0.9% (95% confidence interval, 0.5 to 1.5) had confirmed or probable COVID-19. Dentists reported symptoms of depression (8.6%) and anxiety (19.5%). Enhanced infection control procedures were implemented in 99.7% of dentists' primary practices, most commonly disinfection, COVID-19 screening, social distancing, and wearing face masks. Most practicing dentists (72.8%) used personal protective equipment according to interim guidance from the Centers for Disease Control and Prevention. CONCLUSIONS: COVID-19 prevalence and testing positivity rates were low among practicing US dentists. This indicates that the current infection control recommendations may be sufficient to prevent infection in dental settings. PRACTICAL IMPLICATIONS: Dentists have enhanced their infection control practices in response to COVID-19 and may benefit from greater availability of personal protective equipment. ClinicalTrials.gov: NCT04423770.