Paradigm shift in dental practice ergonomics during coronavirus disease 2019 (COVID-19) and its effects on dental practitioners of Kerala: A cross-sectional study

Introduction: Dental practitioners, being the highest risk category of healthcare workers for contracting COVID-19, are required to practice in compliance with the revised infection control guidelines as recommended by the Centers for Disease Control and Prevention (CDC). Objectives: The objectives of this study were to assess the compliance of general dental practitioners of Kerala toward the CDC infection control guidelines, especially personal protective equipment (PPE) usage, and if such modifications had any effect on the occurrence of musculoskeletal (MS) pain, accessibility, visibility, and overall operator efficiency. Materials and Methods: This cross-sectional study using a structured questionnaire prepared in Google forms was conducted among 49 dental practitioners across Kerala who were selected by simple random sampling. Data were entered into Excel sheets, and analysis of data was done using IBM SPSS Statistics for Windows (Version 25.0, IBM Corp., Armonk, NY, USA). Results: There was a statistically significant (P-value=.001) increase in the usage of PPE from 20.8% (n = 10) during the pre-COVID period to 67.3% (n = 33) during the pandemic. About 85.7% (n = 42) of the practitioners reported to have difficulty using PPE mostly attributed to decreased visibility, accessibility, and communication gap. About 67.3% (n = 33) of the participants experienced an onset or increase in MS pain while practicing with PPE, head and neck region (81.8%, n = 27) being most affected. About 32.7% (n = 16) of the dental practitioners did not receive any form of training to work with PPE, and 56.5% (n = 26) were physically strained, whereas 43.5% (n = 20) were physically and emotionally strained while working with PPE. Conclusion: The results of the study suggest that lack of proper training, cumbersome nature of PPE, long procedures demanding increased accessibility and visibility, and extra time spent on donning and doffing have all added to increased strain on dental practitioners and occurrence of MS pain and affected their operative efficiency.