key: cord-0770968-ah1be4ge authors: Dong, Qingshan; Kuria, Angelica; Weng, Yanming; Liu, Yu; Cao, Yang title: Impacts of the COVID‐19 epidemic on the department of stomatology in a tertiary hospital: A case study in the General Hospital of the Central Theater Command, Wuhan, China date: 2021-07-16 journal: Community Dent Oral Epidemiol DOI: 10.1111/cdoe.12680 sha: 19a7ebb9d822706d6c326d5f41c4c84016949a89 doc_id: 770968 cord_uid: ah1be4ge OBJECTIVE: The impact of the worldwide COVID‐19 pandemic on the dental community is evident. Dental education programmes and academic activities have suffered from the ramifications of the pandemic. This study aimed to depict the impacts of the COVID‐19 epidemic on the clinical services and academic activities in the department of stomatology of a tertiary hospital in Wuhan, China. METHODS: We obtained historical data of the Department of Stomatology from the Health Information System of the General Hospital of Central Theater Command, Wuhan, China between January 2018 and June 2020. Mean, standard deviation and median with interquartile range were used to summarize the variables. Line plots were used to illustrate the temporal trend. The Kruskal‐Wallis equality‐of‐populations rank test was used to compare the difference between groups. RESULTS: A significant decrease was noted in the monthly average number of patients seeking outpatient services for the year 2020, which were decreased by two‐thirds from 2018 to 2020. The number of emergency cases also decreased significantly by 57.6% in 2020. The monthly number of teaching hours decreased from 3.8 ± 1.5 in 2018 and 4.7 ± 1.4 in 2019 to 1.7 ± 1.9 in 2020. The number of interns also decreased by more than 77.0% in 2020. CONCLUSIONS: The impacts of COVID‐19 in the stomatology clinic were significant with notable decreases in clinical services and education offered to the stomatology students. There is a need to find solutions to keep as many dental professionals as needed remaining on the frontline of oral health care. As a public health emergency of international concern, the severe acute respiratory syndrome coronavirus 2 (COVID- 19) pandemic has resulted in millions of confirmed cases and deaths worldwide. 1, 2 According to the current evidence, the COVID-19 virus is primarily transmitted between people through respiratory droplets and person-to-person contact routes. 3, 4 Dental patients who cough, sneeze, or receive dental treatment including the use of high-speed handpieces or ultrasonic instruments make their secretions, saliva, or blood aerosolize to the surroundings. 5 Due to the characteristics of dental settings, the risk of cross-infection may be high between dental practitioners and patients, and dental practitioners are at high risk of acquiring an infection while treating patients. 6 The impact of COVID-19 on the dental community is evident. Dental education programmes and academic activities have also suffered from the ramifications of the pandemic. The big challenge is how we can maintain sufficient dental personnel despite the outbreak. 6, 7 Because of the nature of dental outpatient treatment, dentists Pneumonia' and organized experts of oral health care to improve the public's oral health awareness and common disease management awareness. 8, 9 The Prevention throughout the epidemic. 10, 11 Wuhan has been gradually reopened since 1 April 2020. 12 The aim of this study was to depict the impacts of the COVID-19 epidemic on the clinical practices and academic activities of the department by examining data from January 2018 to June 2020. We obtained historical data of the department from the Health Only aggregated data were used in the analysis, and no private and confidential information was disclosed; therefore, ethical approval was not applicable. There was a statistically significant decrease in the number of patients seeking clinical services in the stomatology clinic beginning January 2020. The month of February 2020 recorded almost zero patients in all variables for clinical services. Figure 1 shows a continuous trend of all the clinical services until January 2020 when a decrease began. However, from April 2020, an increase in the number of patients was observed again. The monthly number of patients seeking outpatient services between January and June decreased by two-thirds, which are 3561. 3 There is a decreasing trend for teaching hours and the number of interns in the year 2020. This decrease was noted from January 2020 ( Figure 2 ). The monthly number of teaching hours decreased by 60%, from 3. Because academic activities/communication is usually undertaken in summer and autumn and much fewer take place in other seasons; in general, there was no statistically significant difference found across the three years (Table 1 ). Stomatology clinics are among the departments in the health sector that may be severely affected by infectious diseases that are mostly transmitted by respiratory droplets. COVID-19 is one of the diseases, which is mainly due to the nature of dental interventions and the proximity of the dental care provider to the oral region of the patient. 6, 13 Our study indicates a significant decrease in the number of patients seeking dental services in the studied hospital during the COVID-19 epidemic in 2020 in Wuhan, and education offered to the stomatology students was decreased significantly during the same period. Meanwhile, as shown in Figure The reduction of oral healthcare services and demands has been seen and has raised concern around the world. The recent identification of COVID-19 in saliva has also intensified the need for strict and effective infection control protocols for hospitals and dental practices in areas that are affected by COVID-19. 15 A study conducted in Beijing, China, indicated that overall dental emergency patients reduced by 38% in February 2020 as most of the routine dental care was not available during the epidemic. 16 In Italy, stomatologists wor- reports of the first human to human transmission seem to have also severely affected these services as this was first reported in late January 2020. 22 Our study, in conjunction with other studies, shows that during the epidemic, the clinical services in stomatology clinics were severely affected. 6, 13, 16 A recently published study indicated that during three months (January to March 2020) of the COVID-19 outbreak, deaths in Wuhan significantly increased by 56%. The excess mortality rates were greater in central than suburban districts and coincided with the increase and decrease of the COVID-19 epidemic. Outside of Wuhan, however, no increase was found in overall mortality. 23 Almost during the same period, we observed the dramatic reduction in hospital visits for oral health care in our study. The reduction of hospital visits and admissions in the current study is mainly due to limited oral healthcare services available and the travel restriction during the lockdown, and people's worry of being infected in a hospital environment. Unless an emergency, people would not go to hospitals for non-essential and non-urgent conditions. We do not have specific statistics regarding the types of dental visits in our hospital, but according to the statistics of other hospitals in Wuhan, the majority of oral emergency patients are suffering from maxillofacial trauma, followed by pulpitis and periapical inflammation, interstitial infection, and pericoronitis, temporomandibular joint dislocation, oral ulcers and gingival bleeding. 24 To avoid and reduce infection and transmission, it is necessary to communicate with and educate non-emergency dental patients through phone or online solutions. Teledentistry, a combination of telecommunications and dentistry, has seen an increased application in recent years. Teledentistry involves the exchange of clinical information and images over remote distances for dental consultation and treatment planning, which may improve the accessibility and delivery of oral health care, lower its costs, and reduce its disparities between rural and urban communities. In the COVID-19 pandemic, face-to-face classroom educational activities with dentistry students were nearly interrupted world- In the Department of Stomatology, dental education was af- At the same time, we need to encourage people to continue to seek oral healthcare services and, as a result, keep as many dental professionals as needed on the frontline of oral health care. No conflict of interest to report. All relevant data are within the manuscript. 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