Percepção de Odontopediatras brasileiros em relação às mudanças nas suas rotinas de atendimentos e ao comportamento do paciente infantil e seu gerenciamento durante a pandemia de COVID-19

Abstract

The objective of this study was to evaluate the perception of Brazilian Pediatric Dentists regarding changes in their care routines and child patient behavior and their management during the COVID-19 pandemic. This observational and cross-sectional study was developed through a self-applied questionnaire by Brazilian dentists with a postgraduate degree in Pediatric Dentistry working in public and/or private services. Professionals who had clinical activity developed entirely as a professor at an educational institution were excluded. Dentists were recruited via e-mails and social networks. The collected data were: demographic information; if professionals adopted measures to control and prevent COVID-19; if there was an increase in service prices and additional costs during the pandemic and how did the search for care (urgent and elective) in the years 2020 and 2021 (manuscript 1); and if behavior changes were observed in children and adolescents during appointments; and in relation to the use of behavioral management techniques during this period (manuscript 2). Data analysis was performed using the Stata 16.0 program with descriptive data analysis with presentation of relative and absolute frequencies of the variables of interest. For the analysis of the association between the use of behavior management techniques and the perception of behavior in the consultation the Fisher's exact test was used (p<0.05) (manuscript 2). Among the main results of this study, more than half of the interviewed pediatric dentists interrupted elective care for certain periods and reduced the number of patients per shift during the pandemic. In relation to finances, 94.7% of participants reported having additional costs at their workplace and 51.8% increased the cost of their appointments. In 2020, 72.0% reported a decrease in searches for elective appointments and 58.7% an increase in searches for urgent care (manuscript 1). Regarding the management of child behavior, through the use of behavioral adaptation techniques, appropriate contact was the technique that had the greatest reduction/suspension of employment (77.6%) in routine care during the pandemic, followed by the distraction technique using toys and books (55.9%). In addition, 45.6% noticed a worsening in the behavior of children and adolescents during the pandemic period. There was a relationship between the behavior perception and the management techniques: protective stabilization (p<0.001) and positive reinforcement (p=0.002), where a higher prevalence of increased use of the aforementioned techniques was identified among those who noticed a worsening of the behavior (manuscript 2). Thus, it was verified that the COVID-19 pandemic affected the routine of Brazilian pediatric dentists and the search for appointments. For many, the potential financial impact was due to additional costs, periods without patients and without price correction of appointments (manuscript 1). It also showed that the pandemic period interfered with the dynamics of pediatric dental appointments with regard to the use of some behavioral management techniques, as well as the perception of child behavior (manuscript 2).