Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region


  • Osama Abu-Hammad
  • Shaden Abu-Hammad
  • Shadia Elsayed
  • Safa Jambi
  • Aishah Alhodhodi
  • Ahmad Othman
  • Abdel Aziz Baiomy Abdullah
  • Hisham Al-Shorman
  • Mostafa Fayyad
  • Duaa Taim
  • Basant Hamdy Abouzaid
  • Najla Dar-Odeh


Cellulitis, COVID-19, Delivery of Health Care, Emergencies


Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Country- and sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies.


Rabaan AA, Al-Ahmed SH, Haque S, Sah R, Tiwari R, Malik YS, et al. SARS-CoV-2, SARS-CoV, and MERS-COV: a comparative overview. Infez Med 2020; 28(2):174-84.

Barbarossa MV, Bogya N, Dénes A, Röst G, Varma HV, Vizi Z. Fleeing lockdown and its impact on the size of epidemic outbreaks in the source and target regions - a COVID-19 lesson. Sci Rep 2021; 11(1):9233. https://doi.org/10.1038/s41598-021-88204-9

Dar-Odeh N, Babkair H, Alnazzawi A, Abu-Hammad S, Abu-Hammad A, Abu-Hammad O. Utilization of teledentistry in antimicrobial prescribing and diagnosis of infectious diseases during COVID-19 lockdown. Eur J Dent 2020; 14(S 01):S20-S26. https://doi.org/10.1055/s-0040-1717159

Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020; 25(10):2000180. https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180

Nishiura H, Kobayashi T, Miyama T, Suzuki A, Jung SM, Hayashi K, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis 2020; 94:154-5. https://doi.org/10.1016/j.ijid.2020.03.020

Dar-Odeh N, Babkair H, Abu-Hammad S, Borzangy S, Abu-Hammad A, Abu-Hammad O. COVID-19: Present and future challenges for dental practice. Int J Environ Res Public Health 2020; 17(9):3151. https://doi.org/10.3390/ijerph17093151

American Dental Association. 2020. Available from: https://success.ada.org/en/practice-management/patients/infectious-diseases-2019-novel-coronavirus? [Accessed on November 05, 2021].

Kün-Darbois JD, Kahn A, Corre P. Influence of the containment on the epidemiology of maxillo-facial emergencies during the COVID-19 pandemic. Why no more cellulites of odontogenic origin? J Stomatol Oral Maxillofac Surg 2020; 121(4):467-8. https://doi.org/10.1016/j.jormas.2020.05.005

Madi M, Kumar M, Varchas P, Vineetha R, Pentapati KC. Changing trends in the outpatient dental visits during the COVID - 19 pandemic in a tertiary care hospital. Saudi J Biol Sci 2021; 28(8):4437-41. https://doi.org/10.1016/j.sjbs.2021.04.038

Kumar U, Gupta A, Goyal A, Gauba K. Impact of covid-19 pandemic on characteristics of dental emergencies and treatment services at tertiary care centre. Saudi Dent J 2021; 33(8):1018-23. https://doi.org/10.1016/j.sdentj.2021.06.004

Obeidat L, Masarwa N, AlWarawreh A, El-Naji W. Dental treatments during the COVID-19 pandemic in three hospitals in Jordan: retrospective study. Interact J Med Res 2020; 9(4):e24371. https://doi.org/10.2196/24371

The World Bank Group. The World by Income and Region. Available from: https://datatopics.worldbank.org/world-development-indicators/the-world-by-income-and-region.html. [Accessed on November 02, 2021].

Kün-Darbois JD, Kahn A, Khonsari RH, Gueutier A, Baldini N, Corre P, et al. Significant decrease of facial cellulitis admissions during COVID-19 lockdown in France: a multicentric comparative study. J Stomatol Oral Maxillofac Surg 2022; 123(1):16-21. https://doi.org/10.1016/j.jormas.2021.02.001

Meisha DE, Alsolami AM, Alharbi GM. Social determinants of seeking emergency and routine dental care in Saudi Arabia during the COVID-19 pandemic. BMC Oral Health 2021; 21(1):212. https://doi.org/10.1186/s12903-021-01577-1

Dar-Odeh N, Fadel HT, Abu-Hammad S, Abdeljawad R, Abu-Hammad OA. Antibiotic prescribing for oro-facial infections in the paediatric outpatient: a review. Antibiotics 2018; 7(2):38. https://doi.org/10.3390/antibiotics7020038

El Khateeb SM, Abu-Hammad O, Fadel H, Dar-Odeh N. A Retrospective analysis of radiographic jaw findings in young women: prevalence and predictors. J Int Soc Prev Community Dent 2017; 7(1):22-7. https://doi.org/10.4103/2231-0762.200707

Dar-Odeh N, Othman B, Bahabri R, Alnazzawi A, Borzangy S, Fadel H, et al. Antibiotic self-medication for oral conditions: characteristics and associated factors. Pesqui Bras Odontopediatria Clin Integr 2018; 18(1):e3890. https://doi.org/10.4034/PBOCI.2018.181.27

Obeidat SR, Alsa'di AG, Taani DS. Factors influencing dental care access in Jordanian adults. BMC Oral Health 2014; 14:127. https://doi.org/10.1186/1472-6831-14-127

Dar-Odeh NS, Gasim RA, Binsaad SM, Abu-Hammad S, Abu-Hammad OA. Use of natural remedies to treat oral diseases among female patients in Al Madinah, western Saudi Arabia. J Complement Integr Med 2019; 16(3):/j/jcim.2019.16.issue-3/jcim-2018-0032/jcim-2018-0032.xml. https://doi.org/10.1515/jcim-2018-0032

Wu K, Li C, Yang Z, Yang S, Yang W, Hua C. Changes in the characteristics of dental emergencies under the influence of SARS-CoV-2 pandemic: a retrospective study. BMC Oral Health 2021; 21(1):174. https://doi.org/10.1186/s12903-021-01499-y

Hahn B, Hollenberger L, Schlagenhauf U, Böhm H, Haubitz IR, Soliman S, et al. The utilization of dental emergency services during COVID-19 pandemic in a German university center: Do we lose vulnerable patients? Quintessence Int 2021; 52(9):828-36. https://doi.org/10.3290/j.qi.b1702163

Eggmann F, Haschemi AA, Doukoudis D, Filippi A, Verna C, Walter C, et al. Impact of the COVID-19 pandemic on urgent dental care delivery in a Swiss university center for dental medicine. Clin Oral Investig 2021; 25(10):5711-21. https://doi.org/10.1007/s00784-021-03872-1

Thiem DGE, Polsak M, Römer P, Gielisch M, Blatt S, Al-Nawas B, et al. The impact of the COVID-19 pandemic on the dental-maxillofacial emergency service of a German university hospital in the year 2020. Clin Oral 2022; 26(1):385-95. https://doi.org/10.1007/s00784-021-04010-7

Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet 2019; 394(10194):249-60. https://doi.org/10.1016/S0140-6736(19)31146-8. Erratum in: Lancet 2019; 394(10203):1010.

Kreimer AR, Clifford GM, Boyle P, Franceschi S. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiol Biomarkers Prev 2005; 14(2):467-75. https://doi.org/10.1158/1055-9965.EPI-04-0551

Al Ryalat N, Ryalat S, Al-Abdalla M, Al-Shayyab MH, Samara O, Taimeh D, et al. Women in maxillofacial surgery and otolaryngology: career obstacles and success factors. J Craniofac Surg 2021; 32(3):874-7. https://doi.org/10.1097/SCS.0000000000007132

Abu-Hammad S, Elsayed SA, Nourwali I, Abu-Hammad O, Sghaireen M, Abouzaid BH, et al. Influence of gender on career expectations of oral and maxillofacial surgeons. J Craniomaxillofac Surg 2020; 48(4):458-62. https://doi.org/10.1016/j.jcms.2020.02.023

Shahbaz S, Ashraf MZ, Zakar R, Fischer F. Psychosocial, emotional and professional challenges faced by female healthcare professionals during the COVID-19 outbreak in Lahore, Pakistan: a qualitative study. BMC Women’s Health 2021; 21(1):197. https://doi.org/10.1186/s12905-021-01344-y

Wong CY, Wong MYZ, Tan TL, Tan YS. A survey on the impact of COVID-19 on incomes and practice patterns of private-sector physicians in Singapore. Ann Acad Med Singap 2021; 50(4):336-8. https://doi.org/10.47102/annals-acadmedsg.202119

Novaes TF, Jordão MC, Bonacina CF, Veronezi AO, de Araujo CAR, Olegário IC, et al. COVID-19 pandemic impact on dentists in Latin America's epicenter: São-Paulo, Brazil. PLoS One 2021; 16(8):e0256092. https://doi.org/10.1371/journal.pone.0256092

Ali S. Dental practice during the era of COVID-19 pandemic: an Egyptian experience. Oral Dis 2022; 28(Suppl 2):2586-7. https://doi.org/10.1111/odi.13898

British Medical Association. COVID-19: Working in Private Practice. 2021. Available from: https://www.bma.org.uk/advice-and-support/covid-19/adapting-to-covid/covid-19-working-in-private-practice. [Accessed on November 18, 2021].




How to Cite

Abu-Hammad, O., Abu-Hammad, S., Elsayed, S., Jambi, S., Alhodhodi, A., Othman, A., Abdullah, A. A. B., Al-Shorman, H., Fayyad, M., Taim, D., Abouzaid, B. H., & Dar-Odeh, N. (2023). Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 23, e210219. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/2475



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