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 Table of Contents  
Year : 2021  |  Volume : 8  |  Issue : 4  |  Page : 288-294

Awareness of COVID-19 pandemic among dental outpatients: A knowledge-based survey

Department of Oral Medicine and Radiology, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation, Salem, Tamil Nadu, India

Date of Submission30-Jun-2021
Date of Decision10-Aug-2021
Date of Acceptance13-Aug-2021
Date of Web Publication20-Dec-2021

Correspondence Address:
Suganya Ravi
Department of Oral Medicine and Radiology, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation, Salem, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdrr.jdrr_117_21

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Aim: The aim of this study is to assess the awareness and infection control practices among dental outpatients of COVID-19 who is visiting the department of oral medicine and radiology. Objectives: The objective of the study is to assess awareness about COVID-19 among dental patients visiting Vinayaka Missions Sankarachariyar Dental College, Salem. Background: Healthcare personnel must analyze the behavior of the general public and dental patients to raise awareness and guide patients through their treatments. The current study's goal is to examine dental patients' awareness and knowledge. Methodology: A cross-sectional study of 315 people was done using a questionnaire that analyzed the individual's knowledge of the COVID-19 pandemic, its impact on patients, and the preventive actions taken by the individual. Results: The survey shows that, though many respondents (n = 280; 88.89%) were aware of the virus and its spread throughout the country, a considerable number of dental patients (n = 37; 11.75%) were uninformed of the virus's secondary symptoms and other characteristics including incubation duration. The COVID-19 infection caused the majority of patients to experience a change in their overall quality of life. Conclusion: Majority of dental patients (36.19%) were aware of the virus's impacts on a person's health. Since few individuals (n = 16; 5.08%) chose to visit dental clinics despite possessing the virus, it is possible that the individual and those who come in contact with the patient are at risk. In spite of the role of social media and the news in spreading awareness, such cases are prevalent in society. Hence, we advocate the implementation of teledentistry and exercise the mandatory precautions for increasing awareness about COVID-19 infection among the public.

Keywords: Awareness, community knowledge, COVID-19, dental patients, healthcare workers

How to cite this article:
Ravi S, Gokulraj S, Mohan KR, Appusamy K, Thangavelu RP. Awareness of COVID-19 pandemic among dental outpatients: A knowledge-based survey. J Dent Res Rev 2021;8:288-94

How to cite this URL:
Ravi S, Gokulraj S, Mohan KR, Appusamy K, Thangavelu RP. Awareness of COVID-19 pandemic among dental outpatients: A knowledge-based survey. J Dent Res Rev [serial online] 2021 [cited 2022 Aug 10];8:288-94. Available from: https://www.jdrr.org/text.asp?2021/8/4/288/332915

  Introduction Top

Since its emergence in Wuhan, China, in 2019, the SARS-CoV-2 virus, a single-stranded RNA virus, has wreaked havoc worldwide.[1] The transmission of viral genetic material via the spike surface glycoprotein through contact with the host cell is the main mechanism of viral propagation.[2]

The virus uses a nasal route as the primary method of illness transmission. Because the close homolog of the enzyme angiotensin-converting enzyme (ACE) 2 receptor is abundant in the lungs, it affects the alveolar cells when the COVID-19 virus invades the lungs. The virus, which is mostly found in the infected person's nasopharyngeal and salivary secretions, can readily be transferred to anyone who comes into touch with them, putting anyone in danger. SARS-CoV-2, also known as the coronavirus, has resulted in an alarming number of deaths, with 2,452,582 deaths as of February 19, 2021. The lack of awareness, lethargy, and disdain for social distancing and other WHO-implemented standards are the primary drivers of the virus's rapid spread and increase in mortality. At the country level, this entails planning, monitoring, and coordination.[3]

In numerous sectors of science, including dentistry, the current situation has created unforeseen obstacles. Because there is a higher risk of cross-infection between practitioners and patients, it is now necessary to take safeguards for both groups.[4] The most effective method for limiting the COVID-19 epidemic is public health awareness.

With our first-hand experience, earlier orthodontal SARS-CoV-2 reports, and existing literature in mind, the current article was formulated. We have created a simple, yet efficient questionnaire for evaluating individuals who are both aware and unaware of the virus's spread. This may make it easier for future practitioners to take the required safeguards and prevent the virus from spreading no socially.

  Methodology Top

Preparation of questionnaire

This survey's questionnaire was developed by Pandey et al. and Zaid et al.[2],[5] and consisted of 25 questions designed to assess the surveyee's COVID-19 awareness. The questions were separated into three sections, with questions 1–10 focusing on basic information, socioeconomic position, and the dental patient's medical history.

Questions 11–19 tested the individual's knowledge of the SARS-CoV-2 virus. Patients who tested positive for the virus were the focus of questions 20–22. In addition, questions 23–25 dealt with the patient's unique dental concerns. When possible, multiple-choice questions were selected.

Sample collection and data acquisition

The survey was conducted on patients who visited the dental institutions and clinics between October and December 2020. Random sampling was done who were visiting the oral medicine and radiology department. Group I: Patients visiting dental outpatient. Before the survey, the patient consent was obtained, some of the answers were written down by the surveyor, and some were filled out by the participants. Gender, age, and medical history[6] were used to categorize participants [Table 1]. A total of 315 patients were surveyed in this study.
Table 1: General characteristics of study sample

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Following the manual survey, an electronic evaluation was undertaken using the Statistical Package for the Social Sciences (SPSS, version 21, Chicago, IL, USA) software to code and assess the data. For further statistical analysis [Table 2], the SPSS software was employed, which included percentage and frequency distribution analysis for each question.
Table 2: Assessment of the knowledge, attitude, and behavior of the public toward COVID-19

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  Results Top

Characteristics of study sample

A total of 315 patients who came to the hospital for a dental checkup and gave their agreement to participate in the study verbally or in writing were included. Males account for half of the participants (50.16%), while females made up the other half (49.84%).

Based on the nature of their employment, the respondents were divided into five categories: student, executive, corporate officer, professional-individual self-employed individuals, and others [Table 1]. Among the five categories, student's responses were about one third (31.43%), followed by undefined working applicants (55.87%).

A clinical history of chronic health issues was also verified on the subjects. High blood pressure, heart disease, diabetes mellitus, asthma, and other respiratory disorders were among the parameters [Table 1], and the majority of the individuals did not have any health problems (69.84%). They were also questioned about their travel plans throughout the outbreak. While three participants (0.95%) came from foreign countries, the majority of the participants (71.27%) did not travel between states or districts [Table 1].

Participants knowledge regarding COVID-19

Following the first questionnaire for the individual evaluation, a series of questions were asked to investigate the impact of COVID-19 on the subject [Table 2]. Only 8.25% of respondents said that they had no prior awareness of the virus, while 88.89% said that they knew. When asked how to prevent the virus from spreading, the majority (61.90%) suggested hand hygiene, wearing a mask/face shield, wearing gloves, and social isolation [Figure 1]. Similarly, over half of the respondents were aware that COVID-19 was linked to cold, fever, cough, sour throat, shortness of breath, and a variety of other symptoms [Figure 2].
Figure 1: What are the ways to prevent the spread of coronavirus?

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Figure 2: What are the main symptoms of the coronavirus?

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While 51.75% of the respondents agreed that COVID-19 testing, increased test centers, and other preventive measures should be used to diagnose the disease, about 29.21% of those polled were ignorant of the initiatives [Figure 3]. When asked who was most vulnerable to the coronavirus, 55.24% of the participants said elderly persons, while only 13.97% said immunocompromised people [Figure 4]. The final section of the questionnaire examined the level of awareness and understanding of dental patients to determine the virus's impact on their lifestyle and health. While 76.51% of the participants [Figure 5] claimed to be free of the virus, only 8.89% of the patients had previously tested negative for the virus. Finally, to cope with the pandemic, the patients reported that they had changed their lifestyles [Figure 6].
Figure 3: What do you think that can be done to prevent the spread of coronavirus?

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Figure 4: Who is more vulnerable to coronavirus?

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Figure 5: Are you infected with the coronavirus?

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Figure 6: How has the COVID-19 virus affected your daily routines?

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This included restrictions on travel, the use of public transportation, the avoidance of meat, the consumption of solely home-cooked meals, and the implementation of work from home [Table 3].
Table 3: Analysis of COVID-19's effect on the dental patients

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The majority of the responders (53.02%) felt that if the infection could not be averted, it could be controlled. Moreover, nearly half of the participants (46.98%) said that the virus always displayed symptoms that could be detected. When asked about the virus's incubation time, 39.37% said that the infection might extend up to 2 weeks [Table 2]. 12.38% of individuals received dental treatment during the curfew period, despite the fact that 40% of participants suspected an increase in risk from visits to dental clinics. When asked about infected neighbors, 14.29% confirmed positive COVID-19 cases in the area, and the majority of the participants (87.62%) said they were unaware of any.

  Discussion Top

Following the SARS-CoV-2 virus epidemic in Wuhan, China, in 2019, the globe was confronted with a catastrophic problem.[7] Since then, India and its healthcare sector have gone a long way from the first case recorded in January 2020,[8] with lockdowns and curfews proving effective in controlling the infection to some extent.

Although dental hygiene assessments and frequent checkups are required for overall oral hygiene, visits to a dental clinic during a pandemic should be limited to inevitable oral diseases.[9] Most patients, according to the report, are not in this situation, since 2.86% of those tested positive for the coronavirus and 2.22% of those suspected of having the virus have still sought treatment through public facilities such as hospitals and dental clinics.

The purpose of this study was to determine the general public's knowledge and awareness, particularly among dental patients. The knowledge score were assessed under three categories, 101(32.06%) respondents were less than score 10, 100(31.75%) were between score 11 and 20, and 114(36.19%) were between score 21 and 30 [Table 4], indicating that most patients were well aware of the virus and its impact on human health. The impact of social media has also been significant as it serves as a knowledge dissemination medium even in the early stages of the pandemic,[10] as evidenced by our study, which found that 15.87% of the respondents said that social media provided the necessary information about the pandemic. However, the majority of the people claimed that newspapers and television were their primary sources of information on the pandemic [Figure 7].
Figure 7: How did you come to know about the coronavirus?

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Table 4: Knowledge and attitude score for overall patients

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Given that a high proportion of respondents had confirmed or suspected that their neighbors were infected, a thorough understanding of the virus's spread was required. However, 87.62% of the respondents were unaware of preventive measures, underlining the need for more information on viral spread propagation. We recommend that social media and news channels be used more extensively in this regard. COVID-19 transmission via dental clinics has already been documented in countries such as Italy,[9] India, and Germany.[11],[12]

The Dental Council of India has provided a standard procedure for treating patients during the pandemic, which has been followed in larger cities such as Chennai.[13] We recommend that the same standards be adopted even in distant areas and other states. To stop the virus from spreading, we advocate using teledentistry to diagnose and treat patients.[14]

Teledentistry is the use of information technology to facilitate remote dental care, guidance, education, or treatment rather than direct face-to-face contact with patients. This project was started by the US military in 1994 to serve the US troops all around the world.

The word “tele” means “distant;” therefore, teledentistry meets the need for social distance, which has been promoted by health authorities all over the world to stop the spread of the SARS-CoV-2 virus.

It has subunits.


Teleconsultation has been demonstrated to minimize referrals from primary health centers to higher facilities by more than 45%. It may help patients continue their treatment during quarantine and lockdown in the current COVID-19 outbreak.


Telediagnosis is the use of technology to exchange images and data to establish an oral lesion diagnosis. Using cell phones to detect dental caries is widely recommended; it has also proven to be a useful tool for screening oral potentially malignant diseases.


Teletriage refers to the safe, appropriate, and prompt treatment of patient symptoms by specialists using a smartphone. It has been used in many countries for remote assessment of school students and prioritization of those who require dental care without extra travel, despite socioeconomic and geographical challenges.


Dental patients must visit their dentist on a regular basis to have their treatment progress monitored. Telemonitoring can be used to replace frequent physical visits with virtual visits to track treatment outcomes and disease progression.[14]

For patients with confirmed or suspected COVID-19 who need to receive emergency or urgent dental care, various treatment guidelines have been developed by the Centers for Disease Control and Prevention, the American Dental Association, the Occupational Safety and Health Administration, and others to prevent spread of infection. Dental care providers are advised to:

  • If possible, perform procedures in a negative pressure room (airborne infection isolation room) for aerosol-generating dental procedures
  • Follow standard, contact, and airborne precautions including hand hygiene practice
  • Consider taking extraoral radiographs instead of intraoral (e.g., panoramic radiography) to avoid gag reflex
  • Limit the number of dental healthcare providers present during the procedure to only those essential for patient care and procedure support. Visitors should be limited to those who are necessary
  • Use a dental handpiece with antiretraction function, four-handed dentistry, high evacuation suction, and rubber dams to minimize droplet splatter and aerosol generation
  • Minimize the use of ultrasonic instruments, high-speed handpieces, and three-way syringes.
  • Perform endodontic procedures with dilute (1%) solutions of sodium hypochlorite to extend supplies without adverse effects on outcomes
  • Use resorbable sutures (i.e., sutures that last 3–5 days in the oral cavity) to eliminate the need for a follow-up appointment
  • Disinfect surfaces with EPA-approved chemicals and maintain a dry environment
  • Wear an N95 or equivalent or higher-level respirators such as a disposable-filtering face-piece respirator, a powered air-purifying respirator, or an elastomeric respirator; eye protection (e.g., goggles, reusable face shields); gloves; and a gown.

  Conclusion Top

According to the present study, dental patients and the general public have the required amount of the necessary information to protect themselves and their neighbors from the virus. Social media and other news reporting channels have had a bigger influence than expected. Overall, this has helped reduce the public's anxiety and apprehension. Despite the importance of dental analysis, we recommend that visits to hospitals and dental clinics be limited to unavoidable instances and that teledentistry be used instead. As a result, the virus's overall transmission may be reduced.

Ethical clearance

Vinayaka mission sankarachariyar dental college, IEC (Approval no: VMSDC/IEC/approval no: 189).

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed 2020;91:157-60.  Back to cited text no. 1
Pandey S, Gupta A, Bhansali R, Balhara S, Katira P, Fernandes G. Corona virus (COVID-19) awareness assessment – A survey study amongst the Indian population. J Clin Med Res. 2020;2:1-11.  Back to cited text no. 2
Ather A, Patel B, Ruparel NB, Diogenes A, Hargreaves KM. Coronavirus disease 19 (COVID-19): Implications for clinical dental care. J Endod 2020;46:584-95.  Back to cited text no. 3
Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. J Dent Res 2020;99:481-7.  Back to cited text no. 4
Zaid AA, Barakat M, Al-Qudah RA, Albetawi S. Knowledge and awareness of community toward COVID-19 in Jordan: A cross-sectional study. Sys Rev Pharm 2020;11:135-42.  Back to cited text no. 5
Vellingiri B, Jayaramayya K, Iyer M, Narayanasamy A, Govindasamy V, Giridharan B, et al. COVID-19: A promising cure for the global panic. Sci Total Environ 2020;725:138277.  Back to cited text no. 6
Ahmad T, Khan M, Haroon, Musa TH, Nasir S, Hui J, et al. COVID-19: Zoonotic aspects. Travel Med Infect Dis 2020;36:101607.  Back to cited text no. 7
Panigrahi M, Pattnaik JI, Padhy SK, Menon V, Patra S, Rina K, et al. COVID-19 and suicides in India: A pilot study of reports in the media and scientific literature. Asian J Psychiatr 2021;57:102560.  Back to cited text no. 8
Izzetti R, Nisi M, Gabriele M, Graziani F. COVID-19 transmission in dental practice: Brief review of preventive measures in Italy. J Dent Res 2020;99:1030-8.  Back to cited text no. 9
Chan AK, Nickson CP, Rudolph JW, Lee A, Joynt GM. Social media for rapid knowledge dissemination: Early experience from the COVID-19 pandemic. Anaesthesia 2020;75:1579-82.  Back to cited text no. 10
Kinariwala N, Samaranayake LP, Perera I, Patel Z. Concerns and fears of Indian dentists on professional practice during the coronavirus disease 2019 (COVID-19) pandemic. Oral Dis 2021;27 Suppl 3:730-2.  Back to cited text no. 11
Mekhemar M, Attia S, Dörfer C, Conrad J. The psychological impact of the COVID-19 pandemic on dentists in Germany. J Clin Med 2021;10:1008.  Back to cited text no. 12
Ashok NG, Devadoss P, Aishwarya K, Marlecha RB. Knowledge of dental practitioners toward the treatment protocol given by the Dental Council of India during COVID-19 pandemic in Chennai. Drug Invent Today 2020;14.  Back to cited text no. 13
Ghai S. Teledentistry during COVID-19 pandemic. Diabetes Metab Syndr 2020;14:933-5.  Back to cited text no. 14


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]

  [Table 1], [Table 2], [Table 3], [Table 4]


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