Urgencies and emergencies in orthodontics during the coronavirus disease 2019 pandemic: Brazilian orthodontists' experience

Introduction: The present study aimed to evaluate the most common urgencies and emergencies in orthodontics during the coronavirus disease 2019 (COVID-19) pandemic and to assess how orthodontists in Brazil were dealing with patients and challenges.

Methods: Early in 2020, as the COVID-19 pandemic spread around the world, routine dental care was suspended in many countries, and only patients needing urgent or emergency care could be seen. During this period, orthodontists in Brazil were invited to participate in an anonymous online survey. Over 48 hours (May 1-3, 2020), 395 orthodontists (specialists, MScs, and PhDs) responded. They answered questions regarding dental office and appointments during the pandemic, the type of urgency or emergency care provided, the type of appliance and urgencies, etc. The level of concern about the impact of the pandemic on patients' orthodontic treatments and the financial impact on the dental office was also evaluated. Descriptive statistics were performed with percentages, and responses were compared between specialists, MScs, and PhDs, using chi-square tests.

Results: Specialists were the majority of respondents. Most orthodontists were handling only emergencies or urgencies. The most frequent urgencies were bracket breakage, archwire breakage, and breakage of molar tubes and/or bands. Stainless steel fixed appliances were the most common type of appliance related to unscheduled appointments. The majority of patients got in touch with the orthodontist using the professional WhatsApp messenger (WhatsApp Inc, Menlo Park, Calif). Orthodontists were more concerned with the financial impact of the pandemic than with the orthodontic treatment itself.

Conclusions: Breakage of brackets, archwires, or tubes and/or bands were the most common causes of urgency and/or emergency appointments during the pandemic. The level of concern about the financial impact of the stay-at-home orders and the COVID-19 pandemic was significantly greater for specialists and MScs than for PhDs.