1. Demographic characteristics of preschool children
By 7 May 2020, a total of 4495 valid nationwide questionnaires from nationwide had been received, reflecting a recovery rate of 99.7%. In the survey, 2392 (53.2%) and 2103 (46.8%) of the preschool children were males and females, respectively. A total of 669 (14.9%) 3-year-olds, 1272 (28.3%) 4-year-olds, 1296 (28.8%) 5-year-olds and 1258 (28.0%) 6-year-olds were participated. A total of 1601 (35.6%) preschool children were Wuhan residents during Wuhan lockdown.
2. Impact of oral health status
This was a multiple choice topic. During Wuhan lockdown, 519 (11.7%) pre-schoolers had oral diseases. A total of 316 (60.8%), 184 (35.5%), 95 (18.3%), 28 (5.4%), 65 (12.5%), 7 (1.4%) and 27 (5.2%) children had self-reported dental caries, toothache, halitosis, gingival bleeding, gingival swelling, tooth trauma and fillings removal, respectively.
3. Impact of oral health attitudes
Because the number of participants who chose “Never” and “I don't know” was very little, we chose the data of remaining answers to analyze. Compared with that before epidemic, a greater number of caregivers would increase (rather than decrease) the attention they gave to oral health (P<0.001), and they would increase their attention to their children’s oral health from 1620 (36.5%) to 2829 (63.8%) in the future (Table 1). More caregivers would increase the preventive measures they took with respect to oral health (2335, 54.2%) than decrease such measures (31, 0.7%) in the future (P<0.001) (Table 2).
Table 1. The impact of COVID-19 on oral health attention during Wuhan lockdown and in the future (N, %)
|
Oral health attention (in the future)
|
Total
|
|
Increase
|
Decrease
|
No change
|
Oral health attention (during)
|
|
|
|
|
Increase
|
1411 (31.8)a
|
18 (0.4)b
|
191 (4.3)c
|
1620 (36.5)
|
Decrease
|
129 (2.9)a
|
16 (0.4)b
|
52 (1.2)a
|
197 (4.4)
|
No change
|
1289 (29.1)a
|
20 (0.5)a
|
1310 (29.5)b
|
2619 (59.0)
|
P value
|
0.000
|
|
|
|
Total
|
2829 (63.8)
|
54 (1.2)
|
1553 (35.0)
|
4436 (100.0)
|
Notes: unknown data were deleted. a,b,c mean there were significantly different (P<0.05).
Table 2. The impact of COVID-19 on oral health attention and preventive measures in the future (N, %)
|
Preventive measures
|
Total
|
|
Increase
|
Decrease
|
No change
|
Oral health attention
|
|
|
|
|
Increase
|
2118 (49.2)a
|
17 (0.4)b
|
602 (14.0)c
|
2737 (63.6)
|
Decrease
|
23 (0.5)a
|
5 (0.1)b
|
19 (0.4)a
|
47 (1.1)
|
No change
|
194 (4.5)a
|
9 (0.2)b
|
1318 (30.6)c
|
1521 (35.3)
|
P value
|
0.000
|
|
|
|
Total
|
2335 (54.2)
|
31 (0.7)
|
1939 (45.0)
|
4305 (100.0)
|
Notes: unknown data were deleted. a,b,c mean there were significantly different (P<0.05).
4. Impact of oral health behaviour
4.1 Impact of oral hygiene behaviour
During Wuhan lockdown, there was a significant difference in oral hygiene behaviour with respect to place of residence places (P<0.01). For brushing teeth, the percentage of Wuhan residents who brushed (96.9%) was higher than that of non-Wuhan residents (95.0%). For brushing frequency, 861(55.5%) Wuhan residents brushed their teeth twice a day, which was more than other residents (Table 3).
Table 3. Comparison of the effects of COVID-19 on the oral hygiene behaviour of preschool children (N, %)
Items
|
City
|
P value
|
|
Wuhan
|
Others
|
|
Brushing
|
|
|
0.002
|
|
Yes
|
1552 (96.9)a
|
2749 (95.0)b
|
|
|
No
|
49 (3.1)a
|
145 (5.0)b
|
|
|
Brushing frequency
|
0.000
|
|
|
|
Over twice per day
|
861 (55.5)a
|
1276 (46.4)b
|
|
|
Once per day
|
616 (39.7)a
|
1196 (43.5)b
|
|
|
Not everyday
|
75 (4.8)a
|
277 (10.1)b
|
|
|
Brushing frequency change 0.000
|
|
Increase
|
147 (9.5)
|
292 (10.6)
|
|
|
Decrease
|
97 (6.3)a
|
273 (10.0)b
|
|
|
No change
|
1303 (84.2)a
|
2178 (79.4)b
|
|
|
Help brushing
|
0.008
|
|
|
|
Everyday
|
432 (27.8)
|
708 (25.8)
|
|
|
Often
|
384 (24.7)a
|
771 (28.0)b
|
|
|
Occasionally
|
416 (26.8)
|
787 (28.6)
|
|
|
Never
|
320 (20.6)a
|
483 (17.6)b
|
|
|
Notes: a,b mean there were significantly different.
4.2 Utilization of dental services behaviour
There was a significant difference between Wuhan children and non-Wuhan children, with respect to the utilization of dental services. This included the previous dental visit, the solutions for oral diseases during Wuhan lockdown (multiple-choice topic) and, in the future, worries about the contagiousness of the disease during treatment (Tables 4 and 5).
Table 4. Comparison of the effects of COVID-19 on the utilization of dental services of preschool children (N, %)
Items
|
City
|
P value
|
|
|
|
Wuhan
|
Others
|
|
|
Previous dental visit (before epidemic)
Yes
|
176 (63.8)a
|
24 8 (54.3)b
|
0.012
|
|
No
|
100 (36.2)a
|
209 (45.7)b
|
|
|
Solutions (in the future)
|
0.000
|
|
|
Dental visit directly
|
584 (36.5)a
|
1507 (52.1)b
|
|
|
Solve by themselves and have dental visit unless necessary
|
394 (24.6)a
|
537 (18.6)b
|
|
|
Consultation online and have dental visit unless necessary
|
585 (36.5)a
|
821 (28.4)b
|
|
|
Solve by themselves without dental visit
|
32 (2.0)a
|
21 (0.7)b
|
|
|
Don’t deal with it
|
6 (0.4)
|
8 (0.3)
|
|
|
Worried about contagious disease during treatment
|
0.004
|
|
|
Very worry
|
439 (27.8)a
|
695 (24.6)b
|
|
|
Moderate worry
|
449 (28.4)
|
747 (26.4)
|
|
|
Mild worry
|
518 (32.8)
|
1003 (35.4)
|
|
|
No worry
|
173 (11.0)a
|
385 (13.6)b
|
|
|
Protection during dental visit
|
0.000
|
|
All operations are acceptable with appropriate precautions
|
446 (28.5)a
|
995 (34.7)b
|
|
|
Partial operations are acceptable with appropriate precautions
|
1104 (70.6)a
|
1845 (64.4)b
|
|
|
All operations are acceptable without precautions
|
9 (0.6)
|
15 (0.5)
|
|
|
Nevermind
|
4 (0.3)
|
10 (0.3)
|
|
|
Notes: a,b mean there were significantly different.
Table 5. The solutions of oral diseases during Wuhan lockdown (N, %)
Items
|
City
|
|
P value
|
|
Wuhan
|
Others
|
|
|
Dental visit as emergency
|
13 (7.0)
|
69 (20.7)
|
|
0.000
|
Online consultation
|
32 (17.3)
|
38 (11.4)
|
|
0.059
|
Searching methods online
|
42 (22.7)
|
45 (13.5)
|
|
0.007
|
Taking medicine
Asking relatives and friends
Endure with observation at home
|
23 (12.4)
13 (7.0)
83 (44.9)
|
41 (12.3)
29 (8.7)
119 (35.6)
|
|
0.958
0.508
0.039
|