Out of 1,033 responses, 20 were omitted as they were from outside Saudi Arabia. Some of the responses were missing due to incomplete reporting by some of the participants. Respondents with more than one missing response were not considered for analysis.
3.1. Reliability and validity
A pilot sample size of 100 participants was selected for the reliability and validity of the research instrument. After standardizing all items, reasonably good interrater reliability was found (Cronbach’s alpha = 0.788). Questionnaire face validation was performed by two independent local experts.
3.2. Demographic results
More than half of the participants were female, accounting for 53.5% (n = 542) of the study sample, while men accounted for 46.5% (n = 471) of the study sample. Half of the participants were in the age group of 20 to <30 years of age (50%). Followed by 301 participants in the age group of 30 to <40 years (29.7%), 134 were in the age group of 40 to <50 years (13.2%), and 71 were in the age group of ≥ 50 years of age (7%). Among the professions, the highest number of responders were specialists/consultants (n = 271, 26.8%), followed by dental students (n = 197, 19.5%), general dentists (n = 181, 17.9%), dental assistants (n = 156, 15.4%), postgraduate residents (n = 92, 9.1%), dental interns (n = 76, 7.5%), and dental hygienists (n = 37, 3.7%).
3.3. Awareness of SARS-CoV-2 and bivariate analysis results
When evaluating the awareness of the survival period of SARS-CoV-2 outside a host, approximately half of the responders (n = 496, 49.2%) believed that the survivability of the virus outside the host was a couple of hours. The remaining responders were as follows: 360 (35.7%) believed that the survivability of the virus was a couple of days, 71 (7%) believed it was a couple of weeks, and 82 (8.1%) did not know. In the between-group comparison, the survivability of SARS-CoV-2 outside a host among different work settings and sectors was not significantly different (p > 0.05). However, when evaluating the various dental professions, a statistically significant difference was found among the various professions (p < 0.001). Among dental assistants, 17.9% (n = 28) believed that the survivability of SARS-CoV-2 was a couple of weeks, whereas only between 2.8% and 7.6% of the rest of the dental professionals believed the same concept. Furthermore, 48.3% (n = 131) of specialists and consultants believed that the survivability of SARS-CoV-2 was a couple of days, while only 23.7% (n = 18), 25.6% (n = 40), and 26.4% (n = 52) of the interns, assistants, and students believed the same concept. This indicates a statistically significant disagreement among dental professionals on the survivability of SARS-CoV-2 outside the host.
The awareness of the recommended hand-soap cleaning time to prevent SARS-CoV-2 infection was distributed as follows: 561 (55.6%) responded as 40 s; 277 (27.4%), 20 s; 155 (15.3%), 60 s; and 17 (1.7%), not knowing the recommended hand-soap cleaning time for prevention. Again, in the between-group comparison, the recommended hand-soap cleaning time to prevent SARS-CoV-2 infection among different work settings and sectors was not significantly different (p > 0.05). However, when evaluating the various dental professions, a statistically significant difference was found among the various professions with regard to the recommended hand-soap cleaning time (p < 0.001). The majority of dental professionals, except for dental assistants, responded in the range of 55.9%–69.4% on a recommended time of 40 s, whereas only 25% (n = 39) of dental assistants answered the recommended 40 s of hand-soap cleaning time to prevent SARS-CoV-2 contamination.
Regarding the questions about willingness to treat a suspected COVID-19 patient, approximately three-quarters of dental professionals (n = 756, 75.1%) did not want to treat a suspected COVID-19 patient. Bivariate analyses for between-group comparisons among the various groups of work settings and sectors and dental professions for this question were not statistically different (p > 0.05). Tables 2 and 3 illustrate the knowledge and awareness of SARS-CoV-2 and COVID-19 by work settings and sectors and dental professions. The Pearson chi-square results are shown as well.
The majority of the 1,013 participants (n = 932, 92%) believed that the route of transmission was through droplet spread (sneezing or coughing). Approximately half of the participants (n = 548 dental professionals, 54.1%) believed that the virus could be transmitted through direct contact with saliva, blood, or other body fluids. Moreover, only approximately a third of the respondents believed that transmission could occur via direct skin-to-skin contact and airborne transmission with 312 (30.8%) and 305 (30.1%) responses, respectively.
Almost all of the respondents believed fever to be a sign and symptom of COVID-19 with 1,000 responses (98.7%). Furthermore, 944 (93.2%) respondents believed coughing to be among the signs and symptoms. In addition, 940 (92.8%) respondents believed shortness of breath to be among the common signs and symptoms of the disease. The response for the remaining COVID-19 signs and symptoms were as follows: 736 (72.7%) responses for headache; 671 (66.2%), shortness of breath; 492 (48.6%), muscle pain; 323 (31.9%), diarrhea; 295 (29.1%), nasal congestion; 187 (18.5%), vomiting; and 32 (3.2%), skin rash.
The methods of SARS-CoV-2 transmission prevention in dental clinics among participants were believed to be as follows (from the highest response to the lowest): PPE (gloves, masks, and wrapping) with 973 (96.1%) responses; hand-soap cleaning, 960 (94.8%); clinic surface disinfection, 877 (86.6%); hand sanitizers, 873 (86.2%); rubber dam isolation, 620 (61.2%); utilization of an isolated clinic, 592 (58.4%); adequate ventilation, 579 (57.2%); use of preoperative chlorhexidine mouthwash, 360 (35.5%); and use of preoperative hydrogen peroxide mouthwash, 207 (20.4%). Table 4 summarizes the responses of all dental professionals with regard to the awareness of the route of SARS-CoV-2 transmission, signs and symptoms of COVID-19, and methods of transmission prevention in dental clinics.
Logistic regression analysis was performed by taking willingness of the dentist to treat suspected covid-19 patients as independent binary variable and gender, age, practice status, work sector, dental service set up as independent covariates to evaluate the effect of these covariates on outcome variable related to the perception of dentist to practice and treat COVID-19 suspected patients.
The analysis revealed 2 predictors of willingness of dental professionals for treatment of COVID-19 suspected patients i.e. dental assistants (p=0.047) and dental hygienist (p=0.012). Postgraduate residents were the lowest willing to treat covid-19 suspected patients whereas dental assistant were 2 times (OR=1.92) and dental hygienist were 3 times (OR=3.02) more likely willing than PG residents to treat covid-19 suspected patient. There was non-significant association of willingness of dentist to treat covid-19 patients with regards to gender (OR=1.12), younger than older age (OR=1.07), academic sector (OR=1.34) and government sector (OR=1.22) than the private sector, hospital versus non-hospital set up (OR=1.11). Table 5 highlights the odds ratio of willingness to treat suspected COVID-19 patients by various variables.