Mental distress in orthodontic patients during the COVID-19 epidemic

Xiong, Xin; Wu, Yange; Fang, Xinyi; Sun, Wei; Ding, Qin; Yi, Yating; Huang, Yanmei; Gong, Jinglei; Liu, Jin; Wang, Jun

Introduction The ongoing coronavirus disease 2019 (COVID-19) outbreak impacts the mental health of patients, health workers and the public. The level of impact on the mental health of orthodontic patients in treatment is unknown. The objective of the study was to evaluate the mental health of orthodontic patients in China during the early stage of the pandemic. Methods An online questionnaire type of survey was conducted on a convenien ce sample of anonymous participants. The questionnaire, in Chinese (Mandarin), comprised 5 sections. Sections 1 to 3 included demographic, epidemical, and orthodontic status of the patients. Section 4 assessed the mental health related to orthodontics. Section 5 was the Kessler-10 mental distress scale. A total of 48 orthodontists were invited to distribute the questionnaires to their patients. Descriptive statistics, principle component analysis, k-means cluster analysis and bivariate logistics regression analysis were performed with statistical significance set at P<0.05. Result s: Questionnaires were collected from 558 patients (104 males, 354 females; age 24.78 ± 6.33 years [mean ± standard deviation]). The prevalence of mental distress was 38% (174/458). Higher odds ratios were associated with female participants, missed appointments and Hubei residence. Types of orthodontic appliance were associated with anxiety of prolonged treatment duration. The manner of communication with patients regarding the postponement of appointments was associated with patients' concern of prolonged treatment duration. Frequency of contact from dentists was associated with patients' independence. Conclusion s: Over one third of orthodontic patients experienced mental distress during the pandemic. Multiple factors affected the level of anxiety of orthodontic patients, such as the type of orthodontic appliance, interval from the last dental visit, manner of communication with the orthodontist, and the localities of the pandemic progression.