Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Believers Church Medical College,
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On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : September | Volume : 16 | Issue : 9 | Page : ZC11 - ZC17 Full Version

Parents Attitude Towards Approaching the Paediatric Dentists During COVID-19 Pandemic: A Cross-sectional Study


Published: September 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/57057.16885
Varshitha Yendodu, SVSG Nirmala, Sivakumar Nuvvula

1. Postgraduate Student, Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India. 2. Professor, Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India. 3. Professor and Head, Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.

Correspondence Address :
Dr. SVSG Nirmala,
Professor, Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore-524 003, Andhra Pradesh, India.
E-mail: nimskrishna2007@gmail.com

Abstract

Introduction: The infection potential of Coronavirus Disease 2019 (COVID-19) is remarkable due to its airborne transmission through droplets and aerosols. Paediatric dental needs were severely compromised during the COVID-19 lockdown period.

Aim: To assess parents’ attitudes and concerns towards approaching paediatric dentists during the COVID-19 pandemic.

Materials and Methods: This cross-sectional study was conducted in Department of Paediatric and Preventive Dentistry at Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India, from August 2021 to October 2021. The study included 200 parents to assess the attitudes and concerns towards approaching Paediatric dentists during the COVID-19 pandemic. A structured questionnaire was used through Google forms to collect from parents, information regarding precautions, mode of transmission of the virus and type of treatment option. The Chi-square test and Fischer-exact test were used to compare the parameters such as education and occupation with parents’ attitude and knowledge.

Results: Out of the 200 parents, 37 were males and 163 were females with mean age of the parents was 34.8 years. Out of total 200, 153 (76.5%) of the parents were worried to visit a paediatric dentist. Only 56 (28%) of the children suffered from toothache during the pandemic. About 28 (14%) of parents believed that the virus is transmitted through the air and 70% of the parents preferred teledentistry. A 152 (76%) of them were willing to pay extra costs and 123 (61.5%) of respondents expected to treat the emergency condition alone. A statistically significant difference was not observed between different occupation in the answers given about transmission paths of a virus (p-value=0.39), extra payment (p-value=0.77), and preference of approach (p-value=0.223).

Conclusion: Majority parents were worried to visit a Paediatric dentist and preferred teledentistry. They were ready to pay extra costs for the sanitisation.

Keywords

Coronavirus disease 2019, Cost, Children, Cross infection control, Dental treatment, Teledentistry

The recent novel coronavirus outbreak was first detected in Wuhan city of China in late December of 2019. By the end of November 2021, there have been 261,435,768 confirmed cases of Coronavirus Disease 2019 (COVID-19), including 5,207,634 deaths, globally reported to World Health Organization (WHO) (1),(2). This new pandemic was officially determined by WHO to be a novel coronavirus disease caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) (2). Where infection rate is concerned, young children seem to be less susceptible to COVID-19 infection than adults. The most common clinical manifestations in children are fever, cough, and shortness of breath followed by headache. Although, the evidence has proved that the children can get COVID-19 like the adults, and Paediatric COVID-19 cases increase gradually in different countries (3),(4),(5). Current investigations have confirmed that SARS- CoV-2 enters cells by binding to the Angiotensin Converting Enzyme-2 (ACE-2) cell receptor and facilitating the internalization of the virus into human cells. This explains the different infection rates between adults and children because of having low ACE-2 expression in children (6),(7),(8). In comparison to adult patients, most of the children diagnosed with the disease experience mild symptoms, faster recovery, shorter detoxification time, and good prognosis (9). However, a new fatal multisystem inflammatory syndrome which is related to COVID-19 has been found and that is because of over activity of immune system in old children and adolescents, and the number of these atypical cases in Paediatric patients has been increasing since the middle of April 2020 in countries like Europe, Canada, and the United States (10),(11).

Children who required dental care were restricted from approaching the Paediatric dentist due to fear of contracting COVID-19 by their parents attitude and also due to the unavailability of emergency dental services near their residential areas. Most parents missed their child’s routine dental visits. It is of utmost importance for Paediatric dentists to know what are their concerns and knowledge regarding the preventive measure and transmission of the virus in the dental environment. Also due to the nature of the dental treatment, the dentist has to work close to the patient and aerosols are present in many dental procedures. It is reported that the coronavirus can survive in aerosol for three hours, on different surfaces such as plastic and stainless steel, it can survive for two to three days, albeit in small amounts (12). So, the main goal of the Paediatric dentist is to prevent transmission of the virus from patients and dental health care professionals.

To prevent the transmission of the disease to other patients and health care personnel every Paediatric patient should be handled as potential as COVID-19 positive and maximum Personal Protective Equipment (PPE) should be used (13),(14). Usually, Filtering Face Masks (FFP2) OR FFP3, face shields, double gloves, waterproof disposable gowns should be used. It is evident that the more positive is the parents’ attitudes, the better will be the oral health of their children (15). Henceforth, parental education and provision of preventive measures for maintenance of oral hygiene are preferred options during COVID-19 for Paediatric patients. Since, the literature is scarce about the COVID-19 and parents, the produced study was conducted to understand parents’ needs and concerns regarding the treatment during the COVID-19 pandemic.

Material and Methods

This cross-sectional study was conducted in Department of Paediatric and Preventive Dentistry at Narayana Dental College and hospital, Nellore, Andhra Pradesh, India, from August 2021 to October 2021. The Institutional Ethical Committee Clearance was obtained (IEC/NDCH/2021/OCT-NOV/P-20).

Inclusion and Exclusion criteria: Participants who were parents of paediatric patients, who have mobile phones with internet and WhatsApp access and were willing to participate in the study were included in the study. Paediatric patients who were having systemic diseases were excluded from the study because their parents might have worried about dental treatments and also parents who had basic mobile where WhatsApp and email could not be accessed were excluded.

Sample size calculation: A pilot study was conducted among 30 parents who visited Paediatrics department at Narayana medical hospital. The sample size was estimated based on the perception of the parent to visit a dentist during COVID-19 and these 30 participants were not included in the main study. The sample size was estimated using th formula:

4PQ/L2
P=86
Q=14
P is prevalence
Q is 1-P
L is least allowable error

The overall sample achieved was 193 and was rounded to 200 to avoid attrition.

Questionnaire

A questionnaire was developed based on COVID-19 pandemic, to obtain information about the various aspects of parents’ concerns on visiting dentists, the transmission of the virus in dental clinic, precautions they take and expect the Paediatric dentist to take and their expectations regarding the sanitization. The questions were validated by four experts (two Paediatric dentists, one community dentist, one Biostatistician) before the study to assess the content adequacy of the questonnaire and how clear the statement of the items was and pilot tested to assess clarity. The questions were evaluated based on the comments made by these experts the final version of the questionnaire was designed as 13 questions including demographic information. The questionnaire initially was designed was first given to 20 individuals parents to determine whether the questions were clear and understandable. After the completion of each questionnaire it was asked if there were any questions or difficulties encountered while completing it and parents’ commented on the questionnaire. Then, questionnaire in the Google form was circulated to the parents through mail and WhatsApp [Annexure-1].

Statistical Analysis

The data was collected using google forms and was entered in to Microsoft Excel 2010. The Statistical Package for Social Sciences (SPSS) version 25.0 was used to analyse all statistical data. Chi-square test and Fischer-exact test were used to compare the parameters like education and occupation with parents’ attitude and knowledge. The Chi-square test was used for the values greater than five and Fischer-exact test was performed for the values less than five.

Results

The total number of respondents was 200 parents. Among 200 parents there were 37 males and 163 females, mean age of the parents was 34.8 years. Among them 136 (68%) were graduates, 48 (24%) were postgraduates and only 16 (8%) were matriculated Regarding the occupation of the parents, 82 (41%) were house makers, 72 (36%) were private jobholders, and the rest 26 (13%) and 20 (10%) were in business and health professionals respectively (Table/Fig 1). In this study, 79.5% of the parents whose children belonged to the age group of 5-8 years were included.

Out of total 200, 153 (76.5%) 76.5% of parents were worried to visit the Paediatric dentist during the COVID-19 period. During this pandemic majority of the children that was 72% did not experience any toothache and 28% had experienced a toothache (Table/Fig 2).

Homemakers were highly worried (81.7%) to visit paediatric dentist during COVID-19 when compared to private job holders (79.2%), business (73.1%), doctors (50%) and statistically significant difference was observed (p-value=0.02) (Table/Fig 3).

Parents who passed 10th class (61.5%) used home remedies to avoid visiting a paediatric dentist when compared to post graduates and graduates which was statistically significant (p-value<0.001). Matriculated parents (75%) believed that transmission occurred through the dental chair which was statistically significant (p-value=0.002) when compared with graduate and post graduate parents. Most of the matriculated parents (56.3%) agreed to meet the paediatric dentist in person compared to graduates and post graduates which was statistically significant (p-value=0.007). When compared to graduates and postgraduates most of matriculated parents (93.8%) opted to get treated the condition compared to medication which was statistically significant (p-value=0.03) (Table/Fig 4).

Discussion

Regarding the concern about visiting the dental clinic, the majority (76.5%) of the parents were worried to visit a dental clinic during the COVID-19 pandemic. The current study results were inconsistent with a previous study (16),(17),(18) which concluded that the majority of the parents were willing to take their children to the dentist during this pandemic.

Concerning the child who experienced toothache during the pandemic, the present study shows that only 28% of them experienced dental pain. Among them, 67.9% tried home remedies. It may be due to increased awareness to prevent a dental visit and also consuming a healthy diet during the lockdown and time present due to not having schools. This is congruent with other study (19),(20) where it was found that most of the parents took extra efforts to maintain their child’s oral hygiene. Parents increased their child’s brushing frequency, added mouthwash, flossing, and decreased the frequency of cariogenic diet as new oral health practices for better protection of their child’s oral hygiene during the lockdown period in COVID-19 pandemic. On the other hand caries could have increased due to prolonged screen dependency and frequent snacking increased the chances of caries activity (21).

In terms of the transmission of the virus, parents opinionated that virus is transmitted through the air (14%) followed by dental chairs (27%), Instruments (23%), and dentists (36%) in this study. When parents’ occupation was compared with knowledge of transmission there was no significant difference was observed. These findings were in contradiction with other study (18) where the parents believed the transmission is through instruments followed by droplets of the blood and the dentist. This disparity of results may be due to misinformation given by social network (22).

Concerning sanitisation and protection, in the present study majority (92.5%) of the parents expected the Paediatric dentist to provide proper sanitization before the treatment. The precautions parents anticipated from dentists were the Provision of a PPE kit, fumigation of the room, sterilisation of the instruments, sanitizing the dental chair. When parents approached dentists they believed that wearing mouth masks (37.5%) and face shields (32.5%) can give protection from the coronavirus. This results were similar with other study where Surme K et al., concluded that almost all the parents thought using PPE during dental treatment of their children would make them feel safe (17). Three fourth of the population agreed to pay extra for the sanitization protocol this might be due to parents’ concern regarding their children’s oral health as there was no significant difference regarding the level of education. Children may find the PPE attire uncomfortable, and this can affect the consultation and treatment. Children should be made aware of the dentist’s appearance when the pre-appointment consultation is provided. It is suggested to have modified PPE kits that use colors, designs, and other appropriate modifications to make them child friendly (23),(24).

In this study, many parents (56%) opted to consult a dentist through a phone call followed by direct consultation in person. When parents’ occupation and preference of approach were compared there was no significant difference found. Similar results were found in a study conducted by Sharma P et al., where it was concluded that parents were more concerned to visit the dentist directly during pandemic (24). The present study results were inconsistent with a previous study (20), which reported that the parents prefer to contact nearby dental hospitals followed by phone calls. This could be attributed to parents’ level of education and socio-economic status.

In the current study, regarding the treatment options, 65% of parents preferred the treatment, than medications (35%). However, 61.5% of respondents opted treatment of emergency condition instead of other dental conditions. The present study results were similar to a study by Sen Tunc E et al., where the parents preferred the self medication for their children during pandemic (25). The present study results are contradicting to a previous study (18) which concluded that the parents preferred only examination followed by extraction procedures and other restorative treatments. The reason might be due to parents motive to relieve their child’s distress. Similar studies have been tabulated in (Table/Fig 5) (17),(24),(25).

In the current study house makers and matriculated parents were more worried to visit paediatric dentist with their child, the reason could be people rely heavily on social media channels such as Facebook and Twitter for the latest news. However, people need to be careful regarding the information that is presented in these and other resources (26). Most of the matriculated parents tried home remedies. Gargling with salt water, clove oil, gargling with garlic juice and application of cryotherapy are traditional methods used for centuries. The use of natural products for orofacial pain has a significant empirical effect (27). In the present study they had less knowledge regarding transmission pathway, precautions to prevent the transmission. These findings were similar to the study done by Surme K et al., (17). In the present study matriculated parents opted to visit paediatric dentist in person, which this can be attributed to lack of knowledge regarding teledentistry.

COVID-19 is a new disease that infects children of all ages. Paediatric dentists should follow the sanitization protocols and also address the parents’ concerns and create awareness of maintaining good oral hygiene practices and diet in the home to prevent the dental visit at these vulnerable times.

Limitation(s)

This online survey could not be used among the parent populations that do not have access to the Internet.

Conclusion

In this study 76.5% of the parents were worried to visit a paediatric dentist and most parents had knowledge regarding the transmission of coronavirus. Majority of the parents preferred to approach the dentist through a phone/video call during the COVID-19 pandemic. More studies with larger sample size must be carried out to validate the results of this study

References

1.
World Health Organization (WHO), The Coronavirus disease (COVID-19) pandemic. 2019, https://covid19.who.int/.
2.
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DOI and Others

DOI: 10.7860/JCDR/2022/57057.16885

Date of Submission: Apr 12, 2022
Date of Peer Review: Jun 01, 2022
Date of Acceptance: Jul 22, 2022
Date of Publishing: Sep 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 02, 2022
• Manual Googling: Jul 21, 2022
• iThenticate Software: Aug 30, 2022 (15%)

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