The survey was online for 3 weeks from 23 February 2020 to 15 March 2020. The link received 795 visits, but only 535 dentists responded to the survey by completing it.
The results of the descriptive statistics were collected in Table 2. Most dentists carried out their professional activity in a private practice (77.8%), while those who work in a public hospital represented the minority (less than 4%); those who performed clinical practice in both modalities represented a consistent number (18.9%).
The age group of up to 35 years old (yo) and the group between 46 and 60 yo were the most represented (respectively, between 32.5 and 33.5%); the intermediate group between 36 and 35 yo was slightly less represented (27.3%), while the age group over 60 was poorly represented (6.7%).
The distribution between the two sexes was equivalent (48.8% males and 51.2% females).
Over 41.9% of dentists were not specialists, at just over 28%, although nonspecialists preferred a specific dental branch (Italian Universities provide three years of postgraduate programs in Orthodontics, Oral Surgery and Pediatric Dentistry. They are the only recognized Dental Specialties). Among the specialists, 16.8% were orthodontists, approximately 12% were oral surgeons, and just over 2% were specialists in pediatric dentistry.
The answers related to the geographical location of the workplace mapped across the whole country, representing Italy from north to south and including the larger islands (Sicily and Sardinia) (Fig. 4).
Most of the respondents (40.6%) were from moderately or highly populated cities - between 10001 and 330000 inhabitants or over 1 million (24.7%). Cities with up to 10000 inhabitants (10.8%) or with an intermediate population density between medium and large cities were less represented (15.3 and 8.6%, respectively).
Fourty nine percent of the dentists who participated in the survey treat more than 10 patients per day. Just over 32% care for no more than 10 patients per day, and approximately 19% receive fewer than 10 patients per day.
Almost seventy percent of dentists completed the questionnaire when there were positive cases in their region of SARS-CoV-2 infection.
Fifty percent of respondents did not notice a decrease in visits since the outbreak spread, only less than 25% stated that visits have decreased since the spread of coronavirus in their territory, less than 20% responded generally in the affirmative way, while 10% did not know how to answer this question.
More than 65% of patients asked questions about coronavirus to their dentist.
According to the clinicians who participated in the study, the majority of patients (more than 61%) would not be worried about getting coronavirus infection during dental treatment.
Almost 47% of dentists said they were fairly informed about coronavirus, and between 28.4% and 9.3% felt that they were even very knowledgeable or had excellent knowledge of the subject. Only a low percentage admitted to being modestly (14.6%) or not at all (0.9%) informed.
Despite of the self-estimated knowledge about the infection, answers to the following questions assessing knowledge on the subject revealed a different reality.
Most respondents obtained scientific information about coronavirus through Italian institutions (37.6%); television, newspapers and social media (20.8%); professional associations (17%); scientific literature (l6.1%); and other colleagues (7.3%). Only a very small percentage (0.8%) specified other channels of information or that they were not fully informed (0.2%).
Almost 73% correctly answered the questions about the definition of coronavirus, the 63.2% correctly answered about nCoV and 44.1% about SARS-CoV-2.
Most respondents, on the other hand, incorrectly answered the question on the definition of COVID-19 (almost 69%).
Almost 87% of the subjects were very clear about the types of possible symptoms that accompany the infection, and in 60.9% of cases, they correctly indicated how the new coronavirus is transmitted from person to person.
However, the 63.2% of dentists knew that the National Federation of Surgeons and Dentists (Federazione Nazionale dei Medici Chirurghi ed Odontoiatri- FNOMCEO) has provided healthcare professionals with a free online course to disseminate useful information about the virus, and 53.1% say they want to do it, while 10.1%, even if they did not know about this opportunity, did not want to update themselves. Only 5.8% at the questionnaire respondents declared that they had taken this course, and less than 27% said they knew about it and would take the course, while less than 5% said they did not want to access it online.
Sixty nine percent of dentists who completed the questionnaire had taken safety and prevention measures against workplace infection since coronavirus spread.
Almost 26% of them had taken all the recommended safety measures (telephone history collection, increased frequency of washing hands and environmental surfaces, and personal protective equipment such as gloves, disposable gowns and facemasks with adequate filters). The remainder had taken only a few of these measures: more than 19% of cases more frequently and accurately cleansed their hands and contact surfaces only, more than 18% constantly used individual safety devices, while almost 15% refreshed the air of the workplace after each patient. Collecting the history of any recent trips to areas affected by contagion or direct contact with people affected by the virus seemed to be useful to only 10% of dentists. The use of alcohol disinfectants available to patients for hand cleaning was also a choice used by less than 10%. A total of 1.2% did not use any of the prevention methods indicated, and 0.8% indicated other preventive measures. Fifty point five percent of respondents were concerned 'enough' about the spread of infection in Italy, and the rest were 'very' and 'very much' concerned (16.6% and 8%, respectively). Only 1.5% of them were not worried at all.
Overall, almost 88% of dentists who took part in the survey considered the dental profession neither safe nor free from the risk of contagion for both patients and healthcare professionals.
The measures of association results were collected in Table 3. In regards to the sex, both χ2 test statistics show a significance level < 0.05 for quality of information (question number 10), level of information related to questions 12 and 17 and for risk perception related to question 23; so we can safely assume that some differences exist between groups. Therefore, we conclude that there is evidence of a statistically significant difference between male and female on these variables. We can confidently reject the null hypothesis that these two variables are statistically independent in that population. In other words, we can conclude that there is some relationship between sex and each of these four variables. In fact, for these variables the Cramér’s V values are > 0.13, which indicates a non-negligible association. Moreover, the Goodman and Kruskal’s lambda for the relationship between sex and level of information related to question number 12, and sex and risk perception related to question 23 is > 0.22, in line with previous results. All these findings are confirmed by Fisher’s exact test results, since in these four cases the hypothesis of variables’ independence is rejected, and we conclude that there is some kind of relationship between variables.
Table 3
| Pearson χ2 test | LR χ2 test | Cramér’s V | Goodman-Kruskal’s γ | Kendall’s τb | Fisher’s exact test |
1. Gender- QUALITY OF INFORMATION(10) | 9.6496** (0.047) | 9.8368** (0.043) | 0.1343 | -0.0319 (0.069) | -0.0185 (0.040) | (0.044) |
2. Gender- LEVEL OF INFORMATION(18) | 3.8129 (0.432) | 3.8238 (0.430) | 0.0844 | -0.0871 (0.071) | -0.0491 (0.040) | (0.434) |
3. Gender- LEVEL OF INFORMATION(12) | 9.2567*** (0.010) | 9.3697*** (0.009) | 0.1315 | 0.2681 (0.086) | 0.1254 (0.041) | (0.010) |
4. Gender- LEVEL OF INFORMATION(13) | 1.5626 (0.668) | 1.5670 (0.667) | 0.0540 | -0.0029 (0.079) | -0.0015 (0.041) | (0.674) |
5. Gender- LEVEL OF INFORMATION(14) | 0.7400 (0.946) | 0.7403 (0.946) | 0.0372 | 0.0243 (0.066) | 0.0145 (0.040) | (0.947) |
6. Gender- LEVEL OF INFORMATION(15) | 2.8786 (0.411) | 3.6511 (0.302) | 0.0734 | 0.0664 (0.088) | 0.0318 (0.042) | (0.492) |
7. Gender- LEVEL OF INFORMATION(16) | 5.1846 (0.269) | 5.6270 (0.229) | 0.0984 | 0.1794 (0.121) | 0.0623 (0.042) | (0.190) |
8. Gender- LEVEL OF INFORMATION(17) | 10.5200** (0.033) | 10.9648** (0.027) | 0.1402 | -0.1012 (0.081) | -0.0523 (0.042) | (0.015) |
9. Gender- CORRECT RISK MANAGEMENT(22) | 1.7211 (0.190) | 1.7214 (0.190) | -0.0567 | -0.1221 (0.092) | -0.0567 (0.043) | (0.192) |
10. Gender- RISK PERCEPTION(23) | 24.9374*** (0.000) | 25.7561*** (0.000) | 0.2159 | 0.2272 (0.067) | 0.1322 (0.040) | (0.000) |
11. Gender- RISK PERCEPTION(24) | 1.2709 (0.260) | 1.2717 (0.259) | 0.0487 | 0.1466 (0.128) | 0.0487 (0.043) | (0.296) |
12. Age- QUALITY OF INFORMATION(10) | 39.3684*** (0.000) | 38.2612*** (0.000) | 0.1566 | -0.0835 (0.055) | -0.0580 (0.038) | |
13. Age- LEVEL OF INFORMATION(18) | 17.6918 (0.125) | 18.1606 (0.111) | 0.1050 | -0.0814 (0.058) | -0.0547 (0.039) | |
14. Age- LEVEL OF INFORMATION(12) | 1.5170 (0.958) | 1.5206 (0.958) | 0.0377 | -0.0131 (0.070) | -0.0072 (0.039) | (0.947) |
15. Age- LEVEL OF INFORMATION(13) | 15.2818* (0.083) | 15.6249* (0.075) | 0.0976 | -0.2079 (0.060) | -0.1289 (0.038) | |
16. Age- LEVEL OF INFORMATION(14) | 20.0687* (0.066) | 19.5222* (0.077) | 0.1118 | -0.1332 (0.051) | -0.0948 (0.036) | |
17. Age- LEVEL OF INFORMATION(15) | 7.0758 (0.629) | 7.9172 (0.543) | 0.0664 | 0.1031 (0.068) | 0.0588 (0.039) | (0.488) |
18. Age- LEVEL OF INFORMATION(16) | 8.8334 (0.717) | 10.1643 (0.602) | 0.0742 | 0.0679 (0.093) | 0.0280 (0.038) | (0.545) |
19. Age- LEVEL OF INFORMATION(17) | 19.3533* (0.080) | 19.2796* (0.082) | 0.1098 | 0.0726 (0.063) | 0.0446 (0.039) | |
20. Age- CORRECT RISK MANAGEMENT(22) | 1.1150 (0.773) | 1.1188 (0.773) | 0.0457 | -0.0303 (0.072) | -0.0166 (0.040) | (0.777) |
21. Age- RISK PERCEPTION(23) | 13.6528 (0.552) | 13.6826 (0.550) | 0.0922 | -0.0193 (0.056) | -0.0132 (0.038) | |
22. Age- RISK PERCEPTION(24) | 6.8839* (0.076) | 5.9705 (0.113) | 0.1134 | 0.1004 (0.101) | 0.0402 (0.041) | (0.093) |
23. Region- QUALITY OF INFORMATION(10) | 63.4819 (0.912) | 68.3577 (0.820) | 0.1722 | -0.0254 (0.044) | -0.0197 (0.034) | |
24. Region- LEVEL OF INFORMATION(18) | 95.6957 (0.111) | 99.0171* (0.073) | 0.2115 | -0.0046 (0.047) | -0.0035 (0.035) | |
25. Region- LEVEL OF INFORMATION(12) | 43.3894 (0.329) | 47.8005 (0.186) | 0.2014 | -0.0396 (0.055) | -0.0246 (0.034) | |
26. Region- LEVEL OF INFORMATION(13) | 88.8741*** (0.009) | 97.3943*** (0.002) | 0.2353 | -0.0473 (0.049) | -0.0329 (0.034) | |
27. Region- LEVEL OF INFORMATION(14) | 114.5570*** (0.007) | 104.4948** (0.034) | 0.2314 | 0.0086 (0.044) | 0.0068 (0.035) | |
28. Region- LEVEL OF INFORMATION(15) | 77.3373* (0.065) | 50.7542 (0.797) | 0.2195 | -0.0732 0.058 | -0.0472 (0.037) | |
29. Region- LEVEL OF INFORMATION(16) | 77.2407 (0.567) | 64.3017 (0.900) | 0.1900 | -0.0493 (0.081) | -0.0229 (0.038) | |
30. Region- LEVEL OF INFORMATION(17) | 76.1563 (0.601) | 54.2159 (0.988) | 0.1886 | -0.0450 (0.053) | -0.0309 (0.037) | |
31. Region- CORRECT RISK MANAGEMENT(22) | 42.1485*** (0.003) | 44.5656*** (0.001) | 0.2807 | 0.0276 (0.061) | 0.0172 (0.038) | |
32. Region- RISK PERCEPTION(23) | 66.2305 (0.996) | 68.6691 (0.993) | 0.1574 | 0.0420 (0.045) | 0.0322 (0.035) | |
33. Region- RISK PERCEPTION(24) | 23.0833 (0.285) | 22.4473 (0.317) | 0.2077 | 0.0816 (0.089) | 0.0367 (0.040) | |
Notes: unequal variances assumed, after some checks. P-Values in parentheses. For Goodman-Kruskal’s γ and Kendall’s τ-b the Asymptotic Standard Errors (ASE) are reported. p < 0.10, p < 0.05, p < 0.01. |
Concerning the age, the Pearson and Likelihood-Ratio χ2 tests present a P-Value < 0.05 only for the relationship with the variable quality of information (question number 10). We reject the null hypothesis of no association at conventional level of statistical significance, because it emerges a dependence of the rows and columns. Thus, in this case we can conclude that some differences emerge between groups. Moreover, in this case Cramér’s V is > 0.15: there is a small but statistically significant association between these variables.
If we consider the region, the Pearson and LR χ2 tests show a P-Value < 0.05 for level of information related to questions number 13 and 14, and correct risk management related to question number 22; therefore, we conclude that some relationship exists between region and each of these three variables. Here, the Cramér’s V are > 0.23, which indicate a statistically significant association.