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SARS-CoV-2: An obstacle for the next generation of dentists and dental hygienists?

In an online survey, conducted by a U.S. dental school, more than 10% of the dental and dental hygiene students who responded reported that their plans for future dental practice have changed since the SARS-CoV-2 outbreak. (Image: Krakenimages.com/Shutterstock)
By Franziska Beier, Dental Tribune International
February 02, 2021

RICHMOND, Va., U.S.: The ongoing SARS-CoV-2 pandemic continues to create insecurity around the world. A survey of dental and dental hygiene students enrolled at the Virginia Commonwealth University School of Dentistry, U.S., has investigated whether their post-graduation career plans have been affected by the pandemic. A considerable number stated that the current situation caused anxiety and concern about the security of the dental profession.

The SARS-CoV-2 pandemic and the resulting disruption to dental care has had a considerable impact on dental education and training. Instead of classroom instruction, academic dental institutions moved to online formats and temporarily closed clinics. As reported by Dental Tribune International (DTI), this has caused worry among dental students that they may lack important skills. In addition, there is some concern about the readiness of dental students to provide dental care during the pandemic.

The online survey consisted of 81 questions that covered demographics, anticipated educational debt, career plans after graduation, readiness to enter clinical practice or residency, student wellness and how students’ career plans have changed during the pandemic. It was administered from the end of April to the middle of May 2020 and was emailed to 436 dental and dental hygiene students at the university.

A total of 252 students completed the survey. Of those, more than 10% reported that their plans for future dental practice have changed since the SARS-CoV-2 outbreak. The researchers found that students who stated an intention to change their career plans had higher stress and anxiety scores and lower resilience scores than those who did not report a career change.

Although dentistry was recently voted one of the ten best jobs in the U.S., the survey participants expressed concerns about limited employment opportunities and long-term stability of the dental profession consequent to the pandemic. In addition, the interruptions to clinical education and licensure examinations and the inability to communicate with practice owners during practice closures were given as reasons for anxiety. However, the study authors noted that the last point did not come as a surprise, given that at the time the survey was conducted, only 3% of dental practices in the U.S. were open regularly.

“Given that the COVID-19 pandemic is still ongoing, we currently do not know its long-term impact on dental and dental hygiene students’ career plans and consequently the future provision of dental care”
– Dr Dina Tamar García, Virginia Commonwealth University

The number of survey participants who reported a change in their career post-graduation plans was especially high among final-year dental and dental hygiene students (40%), as they were not able to secure their desired post-graduation employment. A third-year student said that she was concerned that neither dental schools nor dental offices would be hiring, owing to the financial strain of the pandemic. She commented: “I may not be able to find employment and may need to find a residency program to continue to practice dentistry, which will require me to take on more student loan debt.”

Other students were also concerned about their ability to pay off dental school loans as a result of reduced patient volume in dental practices. “The biggest concern is patient volume, increased cost of care [and] reduced hiring for associate dentists,” a first-year male student commented.

Overall uncertainty regarding the stability of the dental profession was also reported. A first-year student said that she had believed dentists to have a high job security and had not foreseen any reason dentists would have to close their practices for an extended period. “Not knowing what the future ‘normal’ will look like when the COVID-19 outbreak settles down makes me slightly anxious about the future and has made me question whether my plan for the future is as secure as I thought it was or if I need to do more,” she clarified.

DTI contacted the lead author of the study, Dr Dina Tamar García, assistant professor in the Department of Health Behavior and Policy at the university, to ask whether dental and dental hygiene students changing their post-graduation plans might negatively impact the provision of dental care in the future. She responded: “Given that the COVID-19 pandemic is still ongoing, we currently do not know its long-term impact on dental and dental hygiene students’ career plans and consequently the future provision of dental care. Career-shocking events like this pandemic can have a different career impact in the short term compared with the long term.”

Pandemic makes inequalities even more visible

Another adverse finding was that racially minoritized students (31% Black and 19% Latino) were more likely to report a change in career plans than white students were (7%). The study authors stated that their results may reflect the “underlying inequities in education and the broader sociopolitical context that minoritized students experience, including the pervasive prominence of racism compounded with the disproportionate burden of the pandemic on minoritized communities.”

A decrease in the number of dental and dental hygiene professionals from minority backgrounds may result in negative consequences for the delivery of dental care in underserved communities, as dental providers from underrepresented groups are more likely to work in racially and ethnically minoritized communities than white dental providers are.

When asked how minoritized students changing their career plans may be addressed and prevented, García replied: “The dual pandemics of COVID-19 and racial injustice further amplified long-standing racial trauma (a form of race-based stress) among indigenous communities and communities of color. Academic institutions have the responsibility to support students by integrating racial trauma-informed and resiliency-promoting practices into all aspects of daily operations, including student mentorship and training, faculty development, and curriculum development, revision and evaluation.”

She continued: “A commitment to fostering a diverse and resilient dental workforce also includes intentional sustained investment in pathway, recruitment and retention programs along the education continuum, from pre-dental to beyond.”

Time to get proactive

The study authors highlighted certain measures that should be undertaken to support dental and dental hygiene students during this challenging time. In addition to incorporating resilience practices and wellness interventions, counselling services were named as a great help in understanding the needs of students, as well as creating “an environment more sensitive and receptive to dental students’ mental health needs.”

García added that dental schools have to be proactive in creating academic training institutions and dental workplaces that are better prepared to address future disruptive events and their impact on students. “This presents an opportunity for institutional transformation where student wellness programs and initiatives are not just an add-on or optional resource, but instead are fully integrated within the training curriculum,” she said.

Future may look better after all

The results having revealed a rather negative picture, the researchers emphasized that much has changed since the survey was conducted and more recent studies have shown, for example, low infection rates with SARS-CoV-2 for dentists and patients in the U.S. The situation for practicing dental professionals looking more promising than at the beginning of the pandemic, the researchers hope the same will be true for dental and dental hygienist students’ prospects. As the global crisis is still ongoing, further studies will have to conduct a longitudinal assessment to examine how student career intentions continue to evolve in the future.

“The impact of the COVID-19 pandemic on the career plans of dental and dental hygiene students may negatively affect the future dental workforce,” said JDR Clinical and Translational Research Editor-in-Chief Prof. Jocelyne S. Feine in a press release by the International Association for Dental Research. “We lack understanding of both the short-term and long-term effects of prolonged and unanticipated public health crises on the dental workforce. More studies are needed to provide this information so that these issues can be appropriately addressed,” she added.

The study, titled “COVID-19 and dental and dental hygiene students’ career plans,” was published online on Jan. 6, 2021, in JDR Clinical and Translational Research, ahead of inclusion in an issue.

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