key: cord-324075-8r7v0g29 authors: Jiang, Yuanyuan; Tang, Tianyi; Mei, Li; Li, Huang title: COVID‐19 affected patients' utilization of dental care service date: 2020-08-04 journal: Oral Dis DOI: 10.1111/odi.13568 sha: doc_id: 324075 cord_uid: 8r7v0g29 The novel coronavirus disease 2019 (COVID-19), characterized by symptoms of fever and pneumonia, was reported in Wuhan, China at the end of 2019 (Phelan, Katz, & Gostin, 2020). Given the likely transmission of COVID-19 via droplets and aerosols during dental clinical procedures, dental practitioners are at a high risk of COVID-19 infections (Ather, Patel, Ruparel, Diogenes, & Hargreaves, 2020). According to the guidelines of the Chinese Stomatological Association (CSA), dental clinics in China suspended the routine dental services and only provided emergency dental care between January and April 2020 (CSA, 2020). The objective of the study was to investigate the influence of COVID-19 on patients' utilization of dental services during the COVID-19 pandemic. included orthodontic treatment (28.4%), followed by dental pulpal lesion (17.3%) and tooth extraction (11.9%). Table 2 showed patients' psychological state, behaviour, and awareness of COVID-19 and their evaluations on the current dental service. Respondents showed different caution levels to COVID-19 after the outbreak. Most of them (69.1%) were a little worried about the risk of infection in the clinic, and 87.1% thought there was a moderate risk of infection during the dental visit. All patients were required to wear a facial mask in the hospital, and some of them (19.5%) also used their own personal protective equipment (PPE). Almost all of the patients (98.9%) increased the frequency of hand-washing. Their satisfaction with the current appointment system and online consultation system was 47.6% and 42.2%, respectively. Factors associated with patients' psychology of COVID-19 were summarized in Table 3 . Females were significantly associated with an increased level of stress and fear (p = .005). There were few elderly respondents in the study, which may be because the elderly people were reluctant to use the online appointment system and the young people were more used to and familiar with the online platform (Jung & Padman, 2014 ). There were more revisit patients came for orthodontic treatment and more first-visit patients for pulpal lesion and tooth extraction. This may be because the orthodontic patients usually have regular adjustment visits, and the dental pulpal lesion and tooth extraction were most common reasons for the first-visit dental service in the hospital. This study was conducted after the prevailing peak period of COVID-19, when the general population already experienced sufficient alerts and essential preventive measures were in place. But most respondents in the study still showed worries about the potential risk of COVID-19 during their dental visits. It has been found that females were more apprehensive about the risk of an aerosolized spreading of infection during dental procedures (Ashok et al., 2016) and suffered a greater psychological impact and a higher level of stress during dental visits (Wang et al.., 2020) . The online consultation and appointment systems have shown benefits for medical and dental services (Dave, Seoudi, & Coulthard, 2020; Yang, Zhou, Liu, & Tan, 2020) . About half of the respondents in the study were satisfied with the current online platforms; however, the characteristics of these online healthcare users and the improvement in patient's experience need further study in the future (Jung & Padman, 2014) . The awareness of personal protection rose up since the COVID-19 outbreak. All patients in the study followed the hospital regulation to wear facemasks, and most of them increased their hand-washing frequency. Enhancing patient's awareness and personal protection could be beneficial for the management of a virtual pandemic (Ather et al., 2020; Warnakulasuriya, 2020). In summary, the COVID-19 pandemic significantly affected patients' dental care-seeking psychology and behaviour. The lone-term impact of the virtual pandemic still needs further study. The bold entries indicated the statistical significance when the p-value was below .05. Factors associated with patients' psychology of COVID-19 Guidelines of clinical dental care during the COVID-19 epidemic. Chinese Stomatological Association Web Urgent dental care for patients during the COVID-19 pandemic Virtualized healthcare delivery: Understanding users and their usage patterns of online medical consultations The novel coronavirus originating in Wuhan. China: Challenges for Global Health Governance Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China Protecting dental manpower from COVID-19 infection Health services provision of 48 public tertiary dental hospitals during the COVID-19 epidemic in China Additional supporting information may be found online in the Supporting Information section.