Appointment impact and orthodontic emergency occurrence during the COVID-19 pandemic: A retrospective study

Xiang, Jie; Xin, Yilin; Wang, Raokaijuan; Zhou, Hongling; Zou, Yiran; Shim, Sangbeom; Zhao, Lixing

Introduction This retrospective study aimed to quantify the impact of COVID-19 on the orthodontic appointment and make an analysis of orthodontic emergencies that occurred during the pandemic. Methods A total of 628 patients were randomly sampled from 3489 subjects who were undergoing active orthodontic treatment of fixed appliances and the medical records were reviewed. Orthodontic emergency (OE) occurrence was analyzed from 617 patients who had explicit return-visit records after the COVID-19 outbreak. Wilcoxon signed-rank tests, Chi-square tests and a binary logistic regression were performed. Results The return-visit of 98.6% patients was delayed significantly with an increase over 8.98 ± 4.76 weeks (P < 0.001). In general, 32.3% patients suffered from various OEs while waiting for their first return-visit and bracket/band debonding was the most frequently reported category. Most of OEs didn’t receive timely treatments due to the lockdown. The incidence was nearly twice higher than that of the normal appointment times. No correlation was found between OE occurrence and different demographic/clinical characteristics of patients. The therapeutic progress of patients, especially those in stage 3, was postponed due to the occurrence of OEs. Conclusions Regardless of the limitations, our study suggested it’s highly possible that the COVID-19 pandemic has delayed appointments of fixed orthodontic patients. Orthodontic emergencies did bother a minority of patients and couldn’t be settled in time during the lockdown, which had a negative impact on the near-term treatment progress and should be prevented. Further studies are required to investigate the long-dated influence of COVID-19 on orthodontic practices.