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ORIGINAL ARTICLE
Year : 2023 | Volume
: 50
| Issue : 1 | Page : 66-70
Attitude of parents toward child's dental health during the COVID-19 pandemic among the population of visnagar, Gujarat: A cross-sectional study
Yash Bafna, Ruchir Mehta, Shoba Fernandes, Dharati Patel, Harsh Mistry, Kavya Shah
Department of Pediatric and Preventive Dentistry, Sankalchand Patel University, Mehsana, Gujarat, India
Correspondence Address:
Yash Bafna
A 304 Samruddhi Residency, Near Ashok Vihar Circle, Motera - 380 005, Gujarat
India
Source of Support: None, Conflict of Interest: None
CheckDOI: 10.4103/jss.jss_157_22
Aims: This questionnaire-based survey was designed to assess the acquaintance, apprehension, and perceptions of parents toward the COVID-19 pandemic and toward seeking dental care for their children in Visnagar, Gujarat, India. Settings and Design: This was a questionnaire-based cross-sectional study. Subjects and Methods: The online Google survey form included 6 units with 27 close-ended questions in twin languages (regional and English). Inquiries covered demographics, changes in daily acts, dietary traditions, and preparedness to seek child oral care during November 2020 to January 2021. Results: Out of 400 parents, 172 responded to the electronic survey form. Over half of the guardians affirmed that alveolar treatment could fan out COVID-19. Around 90% resorted to medication (self-medication – 39%, home remedies – 32.6%, and teledentistry – 17.4%) to evade personal dental visits for their children. Conclusions: The awareness about COVID-19 and precautions was significantly high. Though parents were unaware about safeguards practiced by dentists during Covid19. Measures were taken to correct misconceptions among parents about safe dental procedures.
Keywords: Child, COVID-19, dental practice, parental anxiety
On March 11, 2020, the World Health Organization (WHO) professed the novel coronavirus (COVID-19) eruption a global pandemic. On the evening of March 24, 2020, the Indian Prime Minister implemented a nationwide lockdown restraining activities of the entire 1.38 billion citizens of India as a precautionary step in contradiction of the COVID-19 pandemic in India.[1]
The coronavirus blowouts through close interaction between people, especially through respiratory dews. In addition, it is suggested that when people tincture an object contaminated by transmittable droplets and then touch their mouth, nose, or eyes, the virus can be communicated.[2] The disposition of alveolar dealings characteristically harvests aerosols and splatters, which can cover huge totals of spittle or gore from patients and thus bring the jeopardy of extensive communication of the virus.[3] Hence, several vigor agencies advised dental specialists to implement strict protective measures that consist of teledentistry, provision of emergency treatment, restricting aerosol operation, using personal protection equipment, and frequent fumigation of dental operatories.[4]
COVID-19 had an influence on an individual's mental welfare due to the augmented demise counts, no clinically proven dealing choices, and the variations in day-to-day schedules caused by the lockdown.[5] Apprehension was the maximum impact, observed among various inhabitants such as vigor experts, community sample, children, college students, and their parents.[6]
In times of ambiguity, governing and community well-being officialdoms have made plentiful and occasionally debatable commendations to consultants and to the civic about methods to safe their alveolar care requirements. The WHO, the Centers for Disease Control and Prevention guidance, the Cochrane Community, and the Ministry of Health and Family Welfare recommended delaying routine dental care. Announcements by the competent authorities restricting dentists from regular practice led to a lot of misinterpretation among the general public.[7]
The high aerosol generation in dental operatories with a greater risk of spread of COVID-19 infection was a real concern for parents seeking dental care for their children. Hence, the aim of this survey was to assess acquaintance, apprehension of parents toward COVID-19, and perceptions toward seeking alveolar maintenance in a rural town of Visnagar in the state of Gujarat, India.
Subjects and MethodsIn this cross-sectional survey, parents of children (0–15 years) from Visnagar, Gujarat, participated. An online survey (Google Inc., Menlo Park, CA, U.S.A) form was formulated. It was fractionalized into six sections as mentioned below.
Language selection (English/Gujarati)Details of the responding parentDetails of the child/childrenSources of information and knowledge about the COVID-19 pandemicReason for seeking dental treatmentReason for fear.The form comprised 27 questions which were pretested and validated. The questionnaire covered various aspects of demographics, fluctuations in daily acts, nutritional modifications, personal safety precautions, oral health management, parental anxiety about child's dental visit, and preparedness to seek pediatric alveolar maintenance during the COVID-19 pandemic. A modified Kuppuswamy scale (2020) was implemented for the assessment of socioeconomic status.[8] For parental anxiety assessment, a 5-point Likert scale was included [Table 1].[9]
Circulation of form among parents residing in the town of Visnagar via various messaging applications, i.e., WhatsApp and Facebook Messenger (Facebook Inc., Hacker Way, CA, U.S.A), was performed in the study duration from November 2020 to January 2021. The enclosure criteria for this survey were as follows: (1) parents of kids aged 0–15 years; (2) parents residing at Visnagar town, Gujarat; and (3) parents seeking dental care for their children. Whereas the exclusion criteria were as follows: (1) parents unable to operate the smartphone applications and (2) parents who were illiterate. The distribution of online forms was randomly done among the aforementioned parental population via the school teachers, principals, and well-being employees who were regularly in interaction with the parents. The total number of forms distributed was 400.
ResultsOut of 400 parents, 172 replied to the survey form (response rate = 43%). [Table 2] highlights the overall responses of parents. More than half of the guardians (54.1%) avowed that alveolar dealing could lay out COVID-19 [Figure 1].
Figure 1: The answers selected by parents when asked “Can dental treatment cause child/children to be infected by coronavirus?”More than 38% of them agreed that dental visit may lead to coronavirus infection which could be spread through dental instruments (39%) and dental auxiliary staff (32.6%) [Figure 2].
Figure 2: Different modes of transmission opined by the parents regarding COVID-19 infectionMost of the parents (79%) were very anxious about the child's dental visit. Most of them scored 3 (30%), 4 (37.80%), and 5 (11%) scores on the 5-point Likert scale which indicates moderate-to-extreme anxiety levels [Figure 3] and [Table 1].
Figure 3: Engraving parental anxiety level in 5-point Likert scale with percentage of respondents on X-axis and Likert 5-point anxiety rating scale on Y-axisAround 70% utilized self-medicament (home pharmaceuticals – 44.4% and teledentistry – 24.6%) to escape in-person alveolar care for their children [Figure 4]. Predominantly, dental pain management during the pandemic was preferred with naturopathy followed by teledentistry medications.
DiscussionOral health is quintessential for maintenance of general well-being. Admittance to alveolar care is obligatory for the primary uncovering, anticipation, and control of alveolar diseases. The COVID-19 pandemic resulted in a momentous interruption in the delivery of alveolar services worldwide.[10]
Since information in modern multimedia is easily accessible, people receive much information on various topics inclusive of COVID-19. In our study, the main source of COVID-related information was either television/radio (78.4%) followed by digital newspapers (66.7%) and the Internet (46.8%). These are similar findings to a previous survey conducted by Yip et al. during the 2003 severe acute respiratory syndrome (SARS) outbreak where around 80% of the defendants gave hid to SARS via often viewing or hearing to the bulletin in Hong Kong[11] On the contrary, social media accounts (3.27 ± 0.9) topped as a source of COVID-19 information for parents in a study done by Ebrahim et al. in 2020.[12]
Among the respondents in our survey, most of them (90.6%) taught the safety precautions against COVID-19 to their offspring, represented that they extremely worried for their kids. The root of COVID-19 is presumed to be SARS-CoV-2. This has similar characteristics to the SARS virus found in the SARS pandemic (2003).[13] The virus can spread through spittle, gore, feces, and aerial dews when people cough or sternutation, which is the foremost path of spread.[14] Since alveolar treatment can include substantial spittle or gore splash from the patient, it can convey a high jeopardy of virus transmission.[15],[16] Hence, the alveolar clinic may have an advanced danger of contamination compared to other clinical settings. Accordingly, 38.4% of the parents perceived that the alveolar clinics were more hazardous than other chairs. Though, not all parents were able to appreciate the accuracies of the alveolar clinics.
In our study, around two-third (73.7%) of the parental population affirmed that they avoided pediatric dental visits during the pandemic. These are similar findings in a Turkish retrospective study by Üstün et al. (2021) where an 81.6% reduction in the general alveolar nonemergency appointments in the pediatric dentists' clinic was observed. Authors found 50 % decrease in daily visits for emergency dental care in the pandemic period compared non-pandemic period. These results indicate heightened protectiveness of parents toward their children at the same time negligence toward pediatric oral health care during the pandemic.[17]
A total of 71.5% of the parents settled that their progenies could be infested with the virus while getting alveolar treatment. Further questions revealed that only 11% of parents could correctly differentiate the source of the infection as dews, gore, or aerosol, whereas rest of them (89%) argued that it may be a dental apparatus as well as dentists themselves. These are similar findings to a study performed by Jin Sun et al. (2020) where authors found that most of the parents affirmed dental apparatus (66%) as well as dentists (69%) themselves can spread the coronavirus infection, but parents in this study correctly identified blood (73%) and droplets (96%) as a potential source of infection from coronavirus. This may indicate that guardians have been deprived of faith in the safety dealings of the infirmary, and were concerned for the decontamination and cleansing of dental devices, as well as the separate safeguards adopted by the dentists.[18]
Various revisions unswervingly supported the connotation between dissimilar kinds of nervousness in guardians and off springs.[19],[20] Brown et al. observed high-grade anxiety and child dental neglect of parents toward the COVID-19 pandemic in the United States.[21] Dhiman et al. also observed high-grade anxiety (62.5%) among Indian parents and caregivers toward kids with special health-care needs during coronavirus outbreak.[22] The affiliation between progeny and parent apprehension can be explained by genomic legacy, ecological apparatuses in which activities of children and parents inspire anxiety in each other, and a collective adverse atmosphere.[23] Therefore, it is probable that anxiety among parentages and offspring would possibly influence each other during COVID-19.
In our study, most of the parents (79%) were anxious about visits to pediatric dentists during the pandemic since the anxiety levels they opted were 3 (30%), 4 (37.80%), and 5 (11%) on the 5-point Likert anxiety scale. These findings are in correlation with the study accomplished by Talaat and Elkhatib during the third wave of COVID-19 outbreak where parents exhibited high anxiety levels on 10-point Likert anxiety scale.[24] It is important to note here that parental anxiety was the prime etiological factor (36%) noticed for poor oral health-related quality of life for progenies by Samuel et al. during the COVID-19 pandemic among Indian population.[25]
Although 74.8% required immediate dental attention (pain, swelling, and trauma), only 24.6% of them sought help via teledentistry. Most of them resorted to naturopathy and self-medication (54.9%). These are similar findings to the study accomplished by Sen Tunc et al. (2021) where around 70% of parents adopted self-medicaments for their kids' alveolar glitches during the pandemic with formerly given pharmaceuticals (62.2%) as the prime source. These results show lack of awareness as well as high anxiety levels among parents seeking dental care for their children.[26]
In our survey, the 172 ancestors were a comparatively limited sample and did not completely replicate the acquaintance and apprehension of the Visnagar population. Nevertheless, this survey befallen all through the outburst of COVID-19, tied with a deficiency of awareness and the confines of available dealing modes. Therefore, this study has research significance.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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