Document Type : Original Article
Assistant Professor, Department of Dental Public Health, School of Dental Medicine, Medical University of Sofia, Sofia, Bulgaria
BACKGROUND AND AIM: One year after the novel coronavirus pandemic, there is a sustained risk of further global spread and most countries continue to impose preventive measures to mitigate the spread of coronavirus disease 2019 (COVID-19). The current situation outlined a specific reformulation of dental education in Medical University of Sofia, Sofia, Bulgaria – initial transition of face-to-face classes towards electronic learning (e-learning) processes, and subsequently, a transition from online teaching toward hybrid education. Therefore, the aim of the present study was to investigate preclinical dental students’ knowledge and attitude towards COVID-19 precautions as well as cross-infection control strategies.
METHODS: This descriptive cross-sectional study was conducted online on 258 out of 516 preclinical dental students at the School of Dental Medicine, Sofia, using a self-administered questionnaire. Survey items were grouped in 3 general sections: educational experiences, students’ knowledge and perceptions of COVID-19 precautions and sources of relevant information as well as students’ personal experiences during the current pandemic.
RESULTS: A total of 169 students participated in the study (response rate: 65.5%). Of them, 98 (57.9%) were second-year students, 42.6% were men, and their mean age was 21 ± 1 years. Almost one-third of the participants indicated violation of disinfection and sterilization protocols (28.9%) and the presence of aerosol-generating procedures (27.2%) as the most important COVID-19 predisposing factors in dental practice. Vaccination was suggested as the most effective way of prevention against the COVID-19. Proposed infection control practices included strict cleaning, disinfection, and sterilization (87.6%), personal protective equipment (PPE) (85.8%), frequent ventilation (53.3%), and treatment after a negative polymerase chain reaction (PCR) (or other) test (46.2%). Social media was considered as the main source for pandemic-related information (68.0%).
CONCLUSION: In the light of COVID-19, dental students demonstrated a satisfactory level of knowledge regarding standard precautions in dental practice; however, more attention should be paid to additional transmission-based precautions to ensure the safety of educational and working environment.
- Johns Hopkins University and Medicine. COVID-19 Map - Johns Hopkins Coronavirus Resource Center [Online]. [cited 2020]; Available from: URL: https://coronavirus.jhu.edu/map.html
- Chang TY, Hong G, Paganelli C, Phantumvanit P, Chang WJ, Shieh YS, et al. Innovation of dental education during COVID-19 pandemic. J Dent Sci 2021; 16(1): 15-20.
- Haroon Z, Azad AA, Sharif M, Aslam A, Arshad K, Rafiq S. COVID-19 Era: Challenges and Solutions in Dental Education. J Coll Physicians Surg Pak 2020; 30(10): 129-31.
- Wilcha RJ. Effectiveness of virtual medical teaching during the COVID-19 Crisis: Systematic review. JMIR Med Educ 2020; 6(2): e20963.
- Wang K, Zhang L, Ye L. A nationwide survey of online teaching strategies in dental education in China. J Dent Educ 2021; 85(2): 128-34.
- Al-Taweel FB, Abdulkareem AA, Gul SS, Alshami ML. Evaluation of technology-based learning by dental students during the pandemic outbreak of coronavirus disease 2019. Eur J Dent Educ 2021; 25(1): 183-90.
- Machado RA, Bonan PRF, Perez DEDC, Martelli JH. COVID-19 pandemic and the impact on dental education: Discussing current and future perspectives. Braz Oral Res 2020; 34: e083.
- Jum'ah AA, Elsalem L, Loch C, Schwass D, Brunton PA. Perception of health and educational risks amongst dental students and educators in the era of COVID-19. Eur J Dent Educ 2021; 25(3): 506-15.
- Agius AM, Gatt G, Vento ZE, Busuttil A, Gainza-Cirauqui ML, Cortes ARG, et al. Self-reported dental student stressors and experiences during the COVID-19 pandemic. J Dent Educ 2021; 85(2): 208-15.
- Deery C. The COVID-19 pandemic: Implications for dental education. Evid Based Dent 2020; 21(2): 46-7.
- Loch C, Kuan IBJ, Elsalem L, Schwass D, Brunton PA, Jum'ah A. COVID-19 and dental clinical practice: Students and clinical staff perceptions of health risks and educational impact. J Dent Educ 2021; 85(1): 44-52.
- Sukumar S, Dracopoulos SA, Martin FE. Dental education in the time of SARS-CoV-2. Eur J Dent Educ 2021; 25(2): 325-31.
- Majeed MM, Durrani MS, Bashir MB, Ahmed M. COVID-19 and dental education in Pakistan. J Coll Physicians Surg Pak 2020; 30(10): 115-7.
- Al JR, Al SM, Al OD, Al OS. Awareness toward COVID-19 precautions among different levels of dental students in King Saud University, Riyadh, Saudi Arabia. J Multidiscip Healthc 2020; 13: 1317-24.
- Amir LR, Tanti I, Maharani DA, Wimardhani YS, Julia V, Sulijaya B, et al. Student perspective of classroom and distance learning during COVID-19 pandemic in the undergraduate dental study program Universitas Indonesia. BMC Med Educ 2020; 20(1): 392.
- Elangovan S, Mahrous A, Marchini L. Disruptions during a pandemic: Gaps identified and lessons learned. J Dent Educ 2020; 84(11): 1270-4.
- Haridy R, Abdalla MA, Kaisarly D, Gezawi ME. A cross-sectional multicenter survey on the future of dental education in the era of COVID-19: Alternatives and implications. J Dent Educ 2021; 85(4): 483-93.
- Ghai S. Are dental schools adequately preparing dental students to face outbreaks of infectious diseases such as COVID-19? J Dent Educ 2020; 84(6): 631-3.
- Esmaeelinejad M, Mirmohammadkhani M, Naghipour A, Hasanian S, Khorasanian S. Knowledge and attitudes of Iranian dental students regarding infection control during the COVID-19 pandemic. Braz Oral Res 2020; 34: e121.
- Umeizudike KA, Isiekwe IG, Fadeju AD, Akinboboye BO, Aladenika ET. Nigerian undergraduate dental students' knowledge, perception, and attitude to COVID-19 and infection control practices. J Dent Educ 2021; 85(2): 187-96.
- Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM. Guidelines for infection control in dental health-care settings - 2003. MMWR 2003; 52(RR-17): 1-61.
- Miller CH. Infection Control and management of hazardous materials for the dental team. 5th Philadelphia, PA: Elsevier; 2013.
- Palenik CJ. Dental instrument sterilization: A six-step process. J Contemp Dent Pract 2001; 2(1): 84.
- Ali S, Alam BF, Farooqi F, Almas K, Noreen S. Dental and medical students' knowledge and attitude toward COVID-19: A cross-sectional study from Pakistan. Eur J Dent 2020; 14(S 01): S97-S104.
- Atas O, Talo YT. Evaluation of knowledge, attitudes, and clinical education of dental students about COVID-19 pandemic. PeerJ 2020; 8: e9575.
- Aragao MGB, Gomes FIF, Pinho Maia Paixao-de-Melo, Corona SAM. Brazilian dental students and COVID-19: A survey on knowledge and perceptions. Eur J Dent Educ 2021.
- Sharaf RF, Kabel N. Awareness and knowledge of undergraduate dental students about the signs and symptoms of Corona viral infection (COVID-19), and the required infection control measures to prevent its spread. Bull Natl Res Cent 2021; 45(1): 32.
- Vergara-Buenaventura A, Castro-Ruiz C. Use of mouthwashes against COVID-19 in dentistry. Br J Oral Maxillofac Surg 2020; 58(8): 924-7.
- Mustafa RM, Alrabadi NN, Alshali RZ, Khader YS, Ahmad DM. Knowledge, Attitude, behavior, and stress related to COVID-19 among undergraduate health care students in Jordan. Eur J Dent 2020; 14(S 01): S50-S55.
- Dong L, Bouey J. public mental health crisis during COVID-19 Pandemic, China. Emerg Infect Dis 2020; 26(7): 1616-8.
- Torales J, O'Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int J Soc Psychiatry 2020; 66(4): 317-20.
- Jakovljevic M, Bjedov S, Jaksic N, Jakovljevic I. COVID-19 pandemia and public and global mental health from the perspective of global health securit. Psychiatr Danub 2020; 32(1): 6-14.
- Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L, et al. Epidemiology of mental health problems in COVID-19: A review. F1000Res 2020; 9: 636.
- Nearchou F, Flinn C, Niland R, Subramaniam SS, Hennessy E. Exploring the impact of COVID-19 on mental health outcomes in children and adolescents: A systematic review. Int J Environ Res Public Health 2020; 17(22).
- Hertz MF, Barrios LC. Adolescent mental health, COVID-19, and the value of school-community partnerships. Inj Prev 2021; 27(1): 85-6.
- Tang S, Xiang M, Cheung T, Xiang YT. Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parent-child discussion. J Affect Disord 2021; 279: 353-60.
- Guessoum SB, Lachal J, Radjack R, Carretier E, Minassian S, Benoit L, et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res 2020; 291: 113264.
- Silva Junior FJGD, Sales JCES, Monteiro CFS, Costa APC, Campos LRB, Miranda PIG, et al. Impact of COVID-19 pandemic on mental health of young people and adults: a systematic review protocol of observational studies. BMJ Open 2020; 10(7): e039426.
- Huang Y, Zhao N. Retraction notice to "Chinese mental health burden during the COVID-19 pandemic" [Asian J. Psychiatr. 51 (2020) 102052]. Asian J Psychiatr 2020; 54: 102482.
- Riedel-Heller S, Richter D. COVID-19 Pandemic and Mental Health of the General Public: Is there a Tsunami of Mental Disorders? Psychiatr Prax 2020; 47(8): 452-6. [In German].
- Wong SYS, Zhang D, Sit RWS, Yip BHK, Chung RY, Wong CKM, et al. Impact of COVID-19 on loneliness, mental health, and health service utilisation: A prospective cohort study of older adults with multimorbidity in primary care. Br J Gen Pract 2020; 70(700): e817-e824.
- Webb L. COVID-19 lockdown: A perfect storm for older people's mental health. J Psychiatr Ment Health Nurs 2021; 28(2): 300.
- El Hayek S, Cheaito MA, Nofal M, Abdelrahman D, Adra A, Al Shamli S, et al. Geriatric mental health and COVID-19: An Eye-Opener to the Situation of the Arab Countries in the Middle East and North Africa Region. Am J Geriatr Psychiatry 2020; 28(10): 1058-69.
- Lee K, Jeong GC, Yim J. Consideration of the psychological and mental health of the elderly during COVID-19: A theoretical review. Int J Environ Res Public Health 2020; 17(21).
- Gustavsson J, Beckman L. Compliance to recommendations and mental health consequences among elderly in Sweden during the Initial Phase of the COVID-19 Pandemic-A Cross Sectional Online Survey. Int J Environ Res Public Health 2020; 17(15).
- Sepulveda-Loyola W, Rodriguez-Sanchez I, Perez-Rodriguez P, Ganz F, Torralba R, Oliveira DV, et al. Impact of social isolation due to COVID-19 on health in older people: Mental and physical effects and recommendations. J Nutr Health Aging 2020; 24(9): 938-47.
- Suryavanshi N, Kadam A, Dhumal G, Nimkar S, Mave V, Gupta A, et al. Mental health and quality of life among healthcare professionals during the COVID-19 pandemic in India. Brain Behav 2020; 10(11): e01837.
- Giorgi G, Lecca LI, Alessio F, Finstad GL, Bondanini G, Lulli LG, et al. COVID-19-related mental health effects in the workplace: A narrative review. Int J Environ Res Public Health 2020; 17(21).
- Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland SO, et al. The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Res 2020; 293: 113441.
- Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun 2020; 89: 531-42.
- Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. investigating mental health of us college students during the COVID-19 pandemic: Cross-sectional survey study. J Med Internet Res 2020; 22(9): e22817.
- Elmer T, Mepham K, Stadtfeld C. Students under lockdown: Comparisons of students' social networks and mental health before and during the COVID-19 crisis in Switzerland. PLoS One 2020; 15(7): e0236337.
- Pan KY, Kok AAL, Eikelenboom M, Horsfall M, Jorg F, Luteijn RA, et al. The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: A longitudinal study of three Dutch case-control cohorts. Lancet Psychiatry 2021; 8(2): 121-9.
- Mesa VC, Franco OH, Gomez RC, Abel T. COVID-19: The forgotten priorities of the pandemic. Maturitas 2020; 136: 38-41.
- Gao J, Zheng P, Jia Y, Chen H, Mao Y, Chen S, et al. Mental health problems and social media exposure during COVID-19 outbreak. PLoS One 2020; 15(4): e0231924.
- Qiao S, Friedman DB, Tam CC, Zeng C, Li X. Vaccine acceptance among college students in South Carolina: Do information sources and trust in information make a difference? medRxiv 2020.
- Rzymski P, Borkowski L, Drag M, Flisiak R, Jemielity J, Krajewski J, et al. The strategies to support the COVID-19 vaccination with evidence-based communication and tackling misinformation. Vaccines (Basel) 2021; 9(2).