Impact of Coronavirus 19 (COVID-19) disease pandemic on surgical dental emergencies and related surgical interventions in Albania

Background/Aim: Dentists are considered particularly at risk of disease transmission due to aerosol generation during manipulations, patient proximity, and operating environment. To prevent the diffusion of the virus all dental clinics in Albania were closed by the order of the Ministry of Health during the lockdown period. The University Dental Clinic (UDC) was reorganized from a more academic to a dental emergency institution. This study aimed to analyze the impact of the COVID-19 pandemic on the pattern of presentation and management of surgical dental emergencies in UDC. Material and Methods: A retrospective analysis of all consecutive patients with surgical dental emergencies and urgencies presenting in our surgical service of University Dental Clinic in Tirana during COVID19 lockdown 2020 (9th of March to 17th of May) in Albania and used as a control period the same weeks in 2019. Results: During the 10-week COVID-19 period we observed a 5.2-fold increase in the incidence of emergency presentations (181 patients in 2020 versus 35 patients in 2019 with a significant increase in mean event incidence difference (MID) 14.6 (95%CI 10.59 - 18.61); p<0.0001. For dental abscess was observed a 4.4-fold increase during COVID-19 compared to the control period with a significant increase of MID 5.8 (4.32 - 7.28); p<0.0001. Compared to 2019, during the COVID-19 period were also observed a 7.1-fold increase in reacutization of chronic periodontitis. Compared to 2019 we observe a 3.5fold increase in overall surgical treatments during the COVID-19 pandemic with a significant increase of MID 6.40 (4.83 - 7.97); p<0.0001. For dental Extractions was observed a 2.85 fold increase with a significant increase of MID 3.70 (2.61 - 4.79); p<0.0001. And also compared to 2019 we observed a 10-fold increase in conservative strategy during the COVID-19 period. Conclusions: During the COVID-19 pandemic outbreak, a significant increase in surgical emergencies/urgencies and related interventions was observed in our center. The main possible reason is the restricted activity of all other dental clinics in Albania and eventually because of the later stage disease presentation during the COVID-19 pandemic outbreak.