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Study reports low SARS-CoV-2 infection rate among dental hygienists in the US

By Franziska Beier, Dental Tribune International
March 12, 2021

CHICAGO, U.S.: As no studies have reported on the SARS-CoV-2-associated experiences of dental hygienists in the U.S., the American Dental Hygienists’ Association (ADHA) and the American Dental Association (ADA) together conducted a survey to investigate infection prevalence, infection prevention and control procedures, and associated trends in mental health. They found that the infection rate among dental hygienists was lower than in nondental health care workers, but higher than in the general U.S. population. A significant number of respondents reported elevated anxiety and depression.

In October, a study regarding the prevalence of SARS-CoV-2 among U.S. dentists based on a web survey was published by the ADA. The current survey was conducted between Sept. 29 and Oct. 8 and a total of 4,776 dental hygienists from all 50 U.S. states and from Puerto Rico participated in it.

The survey questions covered probable and confirmed SARS-CoV-2 infection results, COVID-19 related symptoms experienced in the last month, and level of concern about SARS-CoV-2 transmission to patients and the dental hygienists themselves. The questionnaire screened respondents for depression or anxiety and asked about their use of personal protective equipment (PPE).

The researchers found that, at the time of the survey, an estimated 3.1% of the dental hygienists had or had had a SARS-CoV-2 infection. In the month preceding the survey, 70.3% of the respondents had provided dental care to patients, and for 90.7% of them, this care included dental procedures likely to generate aerosols.

Of the respondents who had provided care in that month, 99.1% reported at least one enhanced infection prevention or control effort in their primary dental practice in response to the pandemic; however, 28.2% reported not following the Centers for Disease Control and Prevention (CDC) interim guidelines for PPE use for patient care. At the time of the survey, these CDC guidelines included wearing eye protection in addition to a mask during all patient care encounters and using an N95 respirator or the equivalent during dental procedures likely to generate aerosols. Among the respondents, PPE use was significantly associated with years of experience as a dental hygienist, level of concern about SARS-CoV-2 infection and level of PPE supplies available, but was not associated with any particular type of dental practice.

“These practices and the low infection rate assure the public that seeking dental and dental hygiene care is safe”

“The low infection rate among dental hygienists can be attributed to following many of the national guidance practices in dental practice settings, including telescreening patients, taking temperatures of patients and frequent hand sanitizing, incorporating appropriate disinfection practices, screening all dental team members and taking their temperatures, using face coverings and practicing physical distancing for all dental team members while in the office setting, avoiding aerosol-generating procedures when possible and wearing appropriate personal protective equipment,” said Dr. JoAnn R. Gurenlian, a lead author of the study and chair of the ADHA Task Force on Return to Work.

She added: “These practices and the low infection rate assure the public that seeking dental and dental hygiene care is safe.”

The survey also asked participants about their mental health and found that approximately 25.70% experienced elevated symptoms of anxiety and about 16.05% experienced increased symptoms of depression. These symptoms were significantly associated with age, the highest levels of symptoms being among those aged between 18 and 29 years and the lowest levels among those aged 64 years or older.

When asked how these mental health concerns may be addressed by authorities, Gurenlian responded: “One of the most important things to address elevated symptoms of anxiety and depression is to acknowledge that these symptoms exist and to then encourage seeking of support. National organizations can encourage our professional colleagues to pursue activities that relieve stress and sadness through either professional mental health counseling or engaging in experiences such as mindfulness, stress reduction, yoga, exercise, etc. that provide a sense of being centered, calm and at peace.”

She went on to say that it is important to appreciate the fact that this is an exceptional time in the lives of dental hygienists and that no one should feel shame or embarrassment about feeling anxious or depressed. “Taking care of ourselves allows us to continue to be able to care for others,” she emphasized.

The researchers highlighted the need to further support access to and use of PPE. This may improve adherence to CDC interim guidelines on PPE use during dental procedures, the researchers said.

The study, titled “COVID-19 prevalence and related practices among dental hygienists in the United States,” was published in the February 2021 issue of the Journal of Dental Hygiene.

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