Oral health awareness, attitude towards dental treatment, fear of infection and economic impact during COVID-19 pandemic in the Middle East

Abstract

Objectives: To assess the impact of COVID-19 on oral hygiene (OH) awareness, attitude towards dental treatment, fear of infection and economic impact in the Middle East.

Methods: This survey was performed by online distribution of questionnaires in three countries in the Middle East (Jordan, Iraq and Egypt). The questionnaire consisted of five sections: the first section was aimed at collecting demographic data and the rest sections used to assess OH awareness, attitude towards dental treatment, degree of fear and economic impact of COVID-19. The answers were either multiple choice, closed-end (Yes or No) or 5-point Likert scale for the last four sections.

Results: A total of 3782 respondents completed the questionnaire. Overall, OH awareness was low (mean ±SD; 1.84 ± 1.03), while attitude towards dental treatment (5.04 ± 1.68) and economic impact (11.29 ± 4.37) were moderately affected. In addition, fear of infection showed moderately high level (14.04 ± 4.11). All subgroups of the demographic variables showed significant differences among them in relation to OH awareness and attitude towards dental treatment. The regression model suggested country, gender, age, education level, income level and fear as predictors for OH awareness (R² 0.036) and attitude towards dental care (R² 0.141).

Conclusions: The pandemic negatively impacted the level of OH awareness. However, the attitude towards dental treatment was moderately affected. Increasing public fear and compromised economy influenced OH awareness and the attitude towards dental treatment.

Keywords: COVID-19; attitude to health; dental care; dental health; oral health.

FIGURE 1

Flow diagram of the study.

FIGURE 2

Responses to the sections of the questionnaire. The highest positive responses to questions about OH awareness showed that 88% brush their teeth (Q1) but only 20% follow the correct frequency (Q2) and 32% brush their teeth for 2–3 min (Q3). About 80% were not using interdental aids (Q4) and almost similar per cent not following dentist's instruction to use mouthwash (Q5) (A). For attitude to dental treatment, responses to most of questions (Q6, 8, 10, 12 and 13) were >60%. The highest positive answers were associated with tendency of the respondents to leave the clinic if any threat was noted (Q10, 87%). Responses to visiting the dentist in case of having serious non‐urgent issues (Q7) and cancellation of dental appointments during pandemic (Q9) showed the lowest responses (B). Responses to fear section were relatively high for most of questions (C), while self‐reported economic impact was reported to be moderately affected, between 25 and 50% for most of the respondents (D).

FIGURE 3

Comparison of response to the section of the questionnaire according to different demographic variables (gender, age, employment status, level of education and income). Analysis showed significant differences among all subgroups of all demographic variables in relation to OH awareness (A), attitude to dental care (B) and economic impact (D). The only exception was associated with analysis of fear section where significant differences were observed between males and females and older subjects (>25 years) than younger ones (C). Significance at * p<0.05, **p<0.01 and ***p<0.001.