Abstract
The unprecedented COVID-19 pandemic has indelibly impacted routine healthcare provision across the globe. Nevertheless, management of traumatic injuries has remained a priority patient care service of oral and maxillofacial (OMF) practice. This study aimed to explore the pattern and mechanisms of OMF injuries presenting at a major public dental hospital during a COVID-19 lockdown period in Sri Lanka. An enhanced OMF injury surveillance system was established at the National Dental Hospital (Teaching) Sri Lanka (NDHTSL) on 1 March 2020. OMF injury surveillance data from 1 March 2020 to 31 May 2020 were collated from the “enhanced injury surveillance form”. This period overlapped with the strictly imposed island-wide COVID-19 community lockdown. Pre-COVID-19 period (November 2017 to January 2020) OMF injury data were compared with this period. OMF injuries were categorized as hard tissue, extra-oral or intra-oral soft tissue, upper and middle face fractures and mandibular fractures. Data were analyzed with descriptive statistics, Fisher’s exact and Chi-square tests of significance. A total of 361 OMF injuries were identified among 208 patients who were predominantly males (71.6%); mean age was 24.95 ± 2.76 years. Injuries to gingivae and oral mucosa (26.9%) were the leading type, followed by extra-oral soft tissues (22.1%), periodontal injuries (20.7%) and hard tissue injuries (20.2%). Upper face and mandibular fractures accounted for 2.9% and 1.9%, respectively. Most patients sustained their injuries due to falls at their homes and surrounds. This was significantly increased compared to the pre-COVID-19 period (p = 0.0001). The significant increase in OMF injuries associated with falls around the home during the COVID-19 lockdown scenario in Sri Lanka compared to the pre-COVID-19 period may need further investigation in order to understand the how these injuries may be prevented.
Highlights
The COVID-19 pandemic, the unprecedented global public health emergency caused by the Severe Acute Respiratory Syndrome (SARS)-CoV-2 virus, has indelibly impacted healthcare systems, economies and societies across the globe [1]
This paper describes the impact of COVID-19 community lockdown on oral and maxillofacial (OMF) injuries and healthcare provision in the country, which is characterized by an efficient pro-poor public healthcare delivery model
82.4% were among 11–20-year-old adolescents, 79.5% were among preschool children aged up to 5 years and another 77.8% belonged to children aged 6–10 years
Summary
The COVID-19 pandemic, the unprecedented global public health emergency caused by the SARS-CoV-2 virus, has indelibly impacted healthcare systems, economies and societies across the globe [1]. Clinical treatments which use high-speed hand-pieces and ultrasonic scalers generate copious small droplets, known as aerosolized droplet nuclei or aerosols. These aerosols are able to remain suspended in the air for prolonged periods and may be inhaled by people working beyond the immediate clinical treatment zone [4,5,6,7,8]. Workflows, based on the firsthand experiences of countries that reported high burden of the infection, such as Italy, have been developed for dental patient triage, patient and staff entrance into the dental clinic, dental treatment and post-treatment management [13,14]
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