Investigation

Cover Story
Willingness and ability of oral health care
workers to work during the COVID-19
pandemic
Allison C. Scully, DDS, MS; Ajay P. Joshi, DDS, MSD; Julia M. Rector, DDS;
George J. Eckert, MAS

ABSTRACT

Background. The COVID-19 pandemic continues to disrupt dental practice in the United States.
Oral health care workers play an integral role in societal health, yet little is known about their
willingness and ability to work during a pandemic.
Methods. Oral health care workers completed a survey distributed on dental-specific Facebook
groups during an 8-week period (May 1-June 30, 2020) about their willingness and ability to work
during the COVID-19 pandemic, barriers to working, and willingness to receive a COVID-19
vaccine.
Results. Four hundred and fifty-nine surveys were returned. Only 53% of dentists, 33% of dental
hygienists, 29% of dental assistants, and 48% of nonclinical staff members would be able to work a
normal shift during the pandemic, and even fewer (50%, 18%, 17%, and 38%, respectively) would
be willing to work a normal shift. Barriers included caring for family, a second job, and personal
obligations, and these were faced by dental assistants and hygienists. Dentists were more likely than
hygienists (P < .001), assistants (P < .001), and nonclinical staff members (P ¼ .014) to receive a
COVID-19 vaccine.
Conclusions. Oral health care workers have a decreased ability and willingness to report to work
during a pandemic, and dentists are significantly more able and willing to work than hygienists and
assistants. Dentists are more likely than staff to receive a COVID-19 vaccine.
Practical Implications. The results of this study may help inform future initiatives of dental
workforce readiness during a pandemic. Dentists should be prepared to discuss alterations to stan-
dard operating procedures to allay staff members’ fears and improve retention rates during pan-
demics, allowing for improved access to oral health care.
Key Words. Dental staff members; access to care; auxiliaries/dental personnel; practice
management.
JADA 2021:152(10):791-799
https://doi.org/10.1016/j.adaj.2021.04.021

he coronavirus pandemic began in the city of Wuhan in Hubei Province, China.1 The

T central disease of this pandemic, COVID-19, has affected the world in all realms of life. As of
December 30, 2020, the John Hopkins Coronavirus Resource Center reported there were
19.5 million COVID-19 infections in the United States and 273,799 deaths due to the disease.2
Worldwide, health care workers (HCWs) are among the groups most likely to contract the vi-
This article has an
rus.3 COVID-19 has put a tremendous amount of physical and mental stress on HCWs across the
accompanying online
world.4 China’s National Health Commission reported more than 3,300 HCWs were infected in continuing education
that country, and Italy reported that 20% of their HCWs had been infected with severe acute activity available at:
respiratory syndrome coronavirus 2, the virus that causes COVID-19.5 Damery and colleagues6 http://jada.ada.org/ce/home.
reported that a person’s sense of duty to work during a pandemic can often become conflicted
Copyright ª 2021
with their sense of duty to protect their family from illness. Owing to the higher risk among HCWs
American Dental
of becoming infected during a pandemic, the factors affecting the ability and willingness of HCWs Association. All rights
to work during a pandemic in the United States have been studied. Gershon and colleagues7 found reserved.

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 that more than 50% of the participants in their study would have been absent from work due to
noneillness-related factors.
Similarly, the effects of the COVID-19 pandemic on dentistry in the United States have been
ongoing. Disruptions to the supply chain for pharmaceuticals, personal protective equipment (PPE),
medical devices, medical supplies, and blood have caused stress on the health care system at large.8
After careful analysis in the month of March 2020, the American Dental Association recommended
all dental procedures for patients be halted, other than emergency oral health care. Offices and
clinics eventually reopened for routine dental procedures in all parts of the country. Spikes in
COVID-19 infections continued to rise sporadically within regions, and different states reopened
their dental offices at different times per local and state health department guidelines.
To meet the oral health needs of the public, US oral health care workers (OHCWs) must be
available and willing to serve during a pandemic. After an extensive literature review, we found no
literature about the ability and willingness of US OHCWs to work during a pandemic. The purpose
of our research was to assess OHCWs’ ability and willingness to work during the COVID-19
pandemic and what factors are affecting that ability and willingness.

METHODS
Design and sample
The Institutional Review Board of Indiana University, Indianapolis, Indiana, granted our cross-
sectional study exempt status and consent was obtained from participants by means of their
agreeing to participate after reading the study information sheet. Survey questions were adapted
from previous research done by Gershon and colleagues7 on the ability and willingness of
medical HCWs to work during a pandemic. The survey was open to OHCWs in the United
States for completion during an 8-week period (May 1-June 30, 2020). A link to our survey was
available via multiple US dental groups on Facebook, as it was posted to those groups’ Face-
book pages with permission from the groups’ administrators. The groups were chosen to reach a
wide range of OHCWs, including dentists, dental hygienists, dental assistants, and front-office
personnel. Groups included “Dental Peeps Network,” “Nifty Thrifty Dentist,” “Dental Hygienist,
Business Specialist & Dentist in Indiana,” and “The Collaborative Pediatric Dentist (iPEDO).”
Each Facebook group has administrators that have vetted its members and their affiliation with
dentistry.

Variables
Ability of OHCWs to Work During a Pandemic
The ability of OHCWs to work during a pandemic was measured using a Likert scale of whether the
OHCW would be able to report for their usual shift, would be able to report for a condensed shift,
would be able to report for emergency oral health care only, or would not be able to report.

Willingness of OHCWs to Work During a Pandemic

The willingness of OHCWs to work during a pandemic was measured using a Likert scale of
whether the OHCW would be willing to report for their usual shift, would be willing to report for a
condensed shift, would be willing to report for emergency oral health care only, or would not be
willing to report at all.

Self-Perceived Barriers for OHCWs to Ability or Willingness to Work During the Pandemic
To determine the self-perceived barriers that might impede an OHCW’s ability or willingness to
work during a pandemic, the respondents were prompted to check all of the items that might apply.
Items were adapted from a previous survey by Gershon and colleagues.7 The list of items (or bar-
riers) can be found in Box 1.
ABBREVIATION KEY
HCW: Health care worker. Self-Perceived Items for OHCWs That Would Increase Their Ability or Willingness to Work
NA: Not applicable. During the Pandemic
OHCW: Oral health care To determine the self-perceived items that might increase the ability or willingness to work during a
worker.
PPE: Personal protective pandemic, the respondents were prompted to check all of the items that might apply. Items were
equipment. adapted from a previous survey.7 The list of items can be found in Box 1.

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 Box 1. Self-perceived barriers and factors that would affect oral health
care workers’ ability and willingness to work during the pandemic.

BARRIERS TO REPORTING TO WORK

n I am responsible for other family members (or pets) who live with me
n I have obligations to a second employer or volunteer commitments
n I have a personal chronic health problem that would prohibit extra duty
n I have other personal obligations that would prohibit my ability to work in an
emergency situation
n I have no obligations or restrictions

FACTORS THAT WOULD INCREASE ABILITY AND WILLINGNESS TO REPORT

TO WORK
n A vaccine was available
n I knew I would be safe from infection
n I could stay in touch with my family
n I had child care available
n I had care for elders or other family members available
n I had pet care available
n I could leave work when I needed to
n My coworkers also came to work
n I thought no one else was going to report
n I felt It was my duty to report
n I received hazard duty pay
n My employer gave me an N95-type respirator
n I was trained properly to use an N95-type respirator
n I had a constant, steady stream of information during the pandemic
n I had more knowledge about the pandemic (how it is spread, how to protect
myself)
n Knowing no aerosols would be created during the emergency appointment
Other

Statistical analysis
Summary statistics were calculated and summarized using number and percentage. Associations
between provider characteristics and outcomes were evaluated using Pearson c2 tests when both
variables were nominal and Mantel-Haenszel c2 tests for ordered categorical responses when at least
1 variable had ordered response categories. A 5% significance level was used for all tests. Analyses
were performed using SAS, Version 9.4 (SAS Institute).

RESULTS
Survey responses were received from 459 respondents, for an estimated response rate of 1%. Eighty-
eight percent of respondents were women, 12% were men, and 9% were younger than 30 years, 39%
were aged 30 through 39 years, 29% were aged 40 through 49 years, and 24% were 50 years or older.
Respondents races included White (87%), Asian (4%), Black (2%), multiracial (2%), and 1% or
fewer were American Indian or Alaska Native, other, and not reported. Three percent reported that
they were Hispanic or Latino. Most respondents were from the Great Lakes and Midwest region
(59%), 14% were from the Pacific Coast, 9% were from the South, and 5% or fewer were from the
Rocky Mountain (5%), Northeast (5%), Mid-Atlantic (4%), and Southwest (3%) regions.

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 Table. Ability and willingness to work during the COVID-19 pandemic according to job title.

NONCLINICAL
DENTAL DENTAL STAFF
VARIABLE DENTIST HYGIENIST ASSISTANT MEMBER P VALUE*
Ability to Work .001

Report for my usual shift, no. (%) 71 (53) 73 (33) 19 (29) 14 (48) NA†

Report for a condensed shift, no. (%) 10 (7) 54 (25) 5 (8) 2 (7) NA

Report for emergency oral health 44 (33) 32 (15) 21 (32) 3 (10) NA

care only, no. (%)

Not report at all, no. (%) 9 (7) 59 (27) 20 (31) 10 (34) NA

Versus dentist, odds ratio (95% CI) NA 0.50 (0.34 to 0.75) 0.33 (0.19 to 0.57) 0.56 (0.27 to 1.17) NA

Willing to Work < .001

Report for my usual shift, no. (%) 66 (50) 40 (18) 11 (17) 11 (38) NA

Report for a condensed shift, no. (%) 15 (11) 47 (22) 6 (9) 3 (10) NA

Report for emergency oral health 43 (32) 46 (21) 25 (39) 10 (34) NA

care only, no. (%)

Not report at all, no. (%) 9 (7) 85 (39) 22 (34) 5 (17) NA

Versus dentist, odds ratio (95% CI) NA 0.25 (0.17 to 0.38) 0.23 (0.13 to 0.39) 0.57 (0.28 to 1.19) NA

* Mantel-Haenszel c2 test used to calculate P values. † NA: Not applicable.

Responses were received from dentists (30%), dental hygienists (49%), dental assistants (14%),
midlevel providers (1%), and nonclinical staff members (7%). Ninety-five percent of respondents
could not work from home. For the purpose of analyses, midlevel provider data were not considered
owing to the low response rate (n ¼ 4).

Bivariate analysis
Association With Job Title and Ability to Work
Fifty-three percent of dentists, 33% of dental hygienists, 29% of dental assistants, and 48% of
nonclinical staff members reported that they would be able to report for their usual shift. Only 7% of
dentists reported that they would not be able to report to work at all, and 27% of hygienists, 31% of
assistants, and 34% of nonclinical staff members reported that they would not be able to report to
work (Table). Although from 7% through 34% of participants answered that they would not be able
to report to work at all, positive responses to specific reasons were limited.

Association With Job Title and Willingness to Work

The percentage of respondents who would be willing to work during a pandemic was lower than
the number who were able to work during a pandemic, with 50% of dentists’, 18% of hygienists’,
17% of assistants’, and 38% of nonclinical staff members’ being willing to work their normal
shift. Only 7% of dentists reported that they would not be willing to report to work at all, and
39% of hygienists, 34% of assistants, and 17% of nonclinical staff members said they would not
be willing to report (Table). The survey results also showed that dentists were significantly less
concerned than dental hygienists (odds ratio [OR], 0.23; 95% CI, 0.15 to 0.35; P < .001) and
dental assistants (OR, 0.27; 95% CI, 0.15 to 0.49; P < .001) that they would contract COVID-
19 at work.

Association With Job Title and Self-Perceived Barriers to Reporting to Work

Reasons for inability to work are found in Figure 1. The most cited self-perceived barriers to
reporting work was responsibility for other family members and pets, with 53% of total respondents
agreeing. Dentists were significantly less likely than dental hygienists (OR 0.41; 95% CI, 0.26 to
0.63; P < .001) and dental assistants (OR, 0.40; 95% CI, 0.22 to 0.73; P ¼ .003) to agree that
caring for family members was a barrier. Hygienists were more likely to have obligations to a second
employer or volunteering than dentists (OR, 12.90; 95% CI, 3.05 to 54.50; P < .001) and assistants
(OR, 12.32; 95% CI, 1.66 to 91.69; P ¼ .002) and were more likely than dentists (OR, 5.10; 95%
CI, 1.50 to 17.32; P ¼ .004) to have other personal obligations that would prohibit their ability to

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 †‡
I am responsible for other family members (or pets) *
who live with me *
Self-perceived barriers

I have obligations to a second employer or †

*‡
volunteer commitments †

§
I have a personal chronic health problem that §
§
would prohibit extra duty *†‡
†
I have other personal obligations that would prohibit my *
ability to work in an emergency situation
†‡§
I have no obligations or restrictions *
*
*

0 10 20 30 40 50 60 70
%
Dentist Hygienist Dental assistant Nonclinical staff member

Figure 1. Self-perceived barriers to reporting to work during the COVID-19 pandemic by job title. P values were
calculated using Pearson c2 tests. * Significant difference from dentists. † Significant difference from dental hygienists.
‡ Significant difference from dental assistants. § Significant difference from nonclinical staff members.

report to work in an emergency situation. Nonclinical staff members were significantly more likely
to have a personal chronic health problem that would prohibit extra duty than were dentists (OR,
4.43; 95% CI, 1.66 to 11.80; P ¼ .002), dental hygienists (OR, 2.76; 95% CI, 1.15 to 6.58; P ¼
.018), and dental assistants (OR, 4.21; 95% CI, 1.34 to 13.27; P ¼ .010).

Association With Job Title and Items That Would Increase Willingness to Work
Items that would increase OHCWs willingness to work are provided in Figure 2. Receiving hazard
duty pay would increase the willingness to work of hygienists (OR, 4.33; 95% CI, 2.33 to 8.04; P <
.001), dental assistants (OR, 14.89; 95% CI, 7.05 to 31.46; P < .001), and nonclinical staff
members (OR, 3.17; 95% CI, 1.19 to 8.44; P ¼ .017) significantly more than dentists. Having a
steady stream of information during the pandemic would also increase dental hygienists’ (OR, 3.55;
95% CI, 2.27 to 5.55; P < .001) and dental assistants’ (OR, 2.58; 95% CI, 1.41 to 4.73; P ¼ .002)
willingness to report significantly more than dentists’ willingness to report. Knowing that no
aerosols would be produced during treatment would also increase the willingness of both dental
hygienists (OR, 2.50; 95% CI, 1.61 to 3.87; P < .001) and dental assistants (OR, 2.31; 95% CI,
1.26 to 4.26; P ¼ .007) significantly more than dentists.
Survey participants were asked whether they would receive a vaccine against COVID-19 if one
became available, and 78% of dentists were likely to extremely likely to receive the vaccine, and
only 62% of hygienists and 58% of dental assistants were likely or extremely likely to receive the
vaccine. This difference was significantly different, with dentists more willing than dental hygienists
(OR, 1.79; 95% CI, 1.21 to 2.66; P ¼ .004) and dental assistants (OR, 3.32; 95% CI, 1.93 to 5.71
P < .001) (Figure 3).
Survey participants were also asked whether they would consider quitting their jobs or retiring
during a pandemic, and dentists were significantly less likely to agree than all other groups (dental
hygienists [OR, 0.23; 95% CI, 0.14 to 0.37; P < .001], dental assistants [OR, 0.28; 95% CI, 0.15 to
0.52; P < .001], and nonclinical staff members [OR, 0.36; 95% CI, 0.16 to 0.83; P ¼ .014]).

DISCUSSION
In our study, we assessed US OHCWs’ ability and willingness to work during a pandemic and,
to our knowledge, we are the first to do so. One of the goals of Healthy People 2020 is to
increase access to therapeutic and preventive services.9 Achieving this goal depends largely on
patients having access to trained OHCWs. At the time of the publication of this article,
COVID-19 infections were increasing daily in the United States with all areas of the country
affected by the virus.
Our study results suggest that dental hygienists and dental assistants are more concerned about
contracting COVID-19 at work than dentists. Bakaeen and colleagues10 reported that dentists are
neither uncomfortable nor comfortable with the guidance they have received from dental

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 A vaccine was available

I had childcare available

My coworkers also came to work

I thought no one else was going to report

Items

I felt it was my duty to report

†‡§
*‡
I received hazard duty pay *†§
*‡
†‡
I had a constant, steady stream of information during the pandemic *
*

I had more knowledge about the pandemic (how its spread, †

*§
how to protect myself) †

Knowing no aerosols would be created during the †‡

*
*
emergency appointment
0 10 20 30 40 50 60 70 80
%
Dentist Hygienist Dental assistant Nonclinical staff member

Figure 2. Items that would increase the willingness of oral health care workers to report to work during the COVID-19 pandemic by job title. P values
were calculated using Pearson c2 tests. * Significant difference from dentists. † Significant difference from dental hygienists. ‡ Significant difference from
dental assistants. § Significant difference from nonclinical staff members.

organizations and are somewhat uncomfortable with the availability of PPE, the patient screening
process, and measures to ensure patient safety. Those investigators surveyed dentists only, and did
not ask about their willingness to treat patients; however, those data combined with the findings
from our study suggest that dental hygienists and dental assistants might be even more uncom-
fortable with the availability of PPE, patient screening process, and measures to ensure patient
safety. These responses are likely affected by the timing of the survey (May 1-June 30, 2020), during
which time many dental offices in the United States were still seeing emergency patients only or
were just starting to open for routine care. Follow-up studies are needed for investigators to assess
how attitudes have changed as coronavirus became better understood and treatments and vaccines
became available throughout the course of the pandemic.
When the availability and willingness of OHCWs to work during a pandemic is lower, access to
therapeutic and preventive services could potentially decrease and impede the preventive goals set
forth by the dental profession. As Damery and colleagues6 reported, HCWs are often conflicted with
a “sense of duty to work” when it puts their family in harm’s way. With hygienists performing many
important preventive services in the United States, this conflict could cause problems for the overall
oral health of the public during a pandemic. In addition, Moraes and colleagues11 found that 90% of
dentists in Brazil feared contracting COVID-19 at work, with approximately 70% being moderately
or highly concerned. This is consistent with the 76% of US dentists in our study who were con-
cerned to extremely concerned about contracting COVID-19 at work. We also found that dental
hygienists and dental assistants were more concerned than dentists about contracting the disease.
Per our study results, hygienists found it harder to report to work for emergency oral health care
during a pandemic than dentists, owing to obligations to a second employer or voluntary com-
mitments. Hygienists also had other personal obligations that would prohibit their ability to work in
an emergency situation. The Health Resources and Services Administration reported that before
the pandemic there were 6,782 oral health care professional shortage areas in the United States.12
The impact of the COVID-19 pandemic on availability of OHCWs during and after the pandemic,
especially in underserved areas, should be a potential topic of research in the future. The results of
our study show that dentists were able and willing to work more during a pandemic than all other
OHCWs; this highlights a potential challenge for practices throughout the country. Most dental
practices rely on team members from all categories of OHCWs to function effectively. If there is a
mismatch among ability, willingness, and barriers to reporting to work, or concern about risk and
safety at work, then there might be a shortage of certain categories of OHCWs reporting to work.
This can lead to a decrease in appointment availability due to lack of OHCWs working. We also
found that dentists were less likely than all other OHCWs to quit their jobs during a pandemic,

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 Not at all likely to receive a COVID-19 vaccine

Somewhat likely to receive a COVID-19 vaccine

Likelihood
Likely to receive a COVID-19 vaccine

Very likely to receive a COVID-19 vaccine

Extremely likely to receive a COVID-19 vaccine

0 10 20 30 40 50 60
%
Dentist Hygienist Dental assistant Nonclinical staff member

Figure 3. Likelihood to receive a COVID-19 vaccine if a safe and effective vaccine becomes available during the pandemic. P values were calculated using
Mantel-Haenszel c2 tests. Dentists were significantly more likely than both dental hygienists and dental assistants to receive a COVID-19 vaccine.

which would further exacerbate a shortage of OHCWs, particularly dental hygienists, dental as-
sistants, and nonclinical staff members. Dentists should be aware that the concerns and barriers of
their team members might be perceived by those team members as more severe than the dentists’
concerns and barriers, and dentists should be prepared to discuss alterations to standard operating
procedures that have been made to ensure staff safety.
Dentists were also more likely to receive an available vaccine against COVID-19 than all other
OHCWs. To our knowledge, there is no other literature available about the likelihood of different
OHCWs being vaccinated. Investigators in a French study found that physicians were more likely to
be vaccinated against COVID-19 than nurses or assistant nurses, which is similar to our findings in
regard to dentists versus other OHCWs.13
Damery and colleagues6 reported that nearly 25% of physicians in their study did not consider it
their duty to work if it would pose a risk to themselves or their families. Similarly, 83% of re-
spondents in our study stated that they would be more willing to report for work if they knew they
would be safe from infection. The American Dental Association has made many recommendations
to increase the safety of providing oral health care during the COVID-19 pandemic, including
screening patients for symptoms and increasing use of PPE.14 Providing adequate PPE for dentistry is
essential for the protection of the overall oral health of the country. Increased costs and pent-up
demand for PPE due to the pandemic might hinder some dental practices from functioning dur-
ing this time. Specifically, practices that see a higher volume of patients per day or accept lower
reimbursement insurance plans, such as Medicaid, might not be able to continue “normal” practice
owing to lack of PPE. With oral health care already having the highest level of financial barrier
compared with other health services,15 this could be detrimental to the care provided for our most
vulnerable and underserved populations who often use these practices as their dental home.
Of the respondents in our survey, 95% could not work from home. This posed a considerable
challenge to their ability to work if a dependent required care from them at home due to illness
during the pandemic.
A major limitation of our study was the low estimated response rate. The response rate can only
be estimated due to the dynamic nature of social media and social media groups and people joining
and leaving those groups. It is also not possible to know how many of the members of each group are
also part of another group that was sent the survey, or how many members are actually active in the
groups and viewed the call for surveys.
The use of Facebook also limited our study because only those OHCWs that had access and
ability to navigate to Facebook were able to participate in our study; however, use of social media to
distribute surveys during the pandemic is not unprecedented and has had similarly low response
rates.10,11 Owing to the quickly evolving nature of the pandemic, social media offered a unique
opportunity to gather data quickly. In addition, although the survey had respondents from

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 Box 2.

The American Dental Association and the Centers for Disease Control and Pre-
vention have published recommendations related to practice staff member and
patient safety during the COVID-19 pandemic. These recommendations can be
found at
n https://success.ada.org/en/practice-management/patients/safety-and-clinical?
utm_source¼cpsorg&utm_medium¼covid-nav&utm_content¼nav-safety-
clinical&utm_campaign¼covid-19
n https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
Practitioners are also encouraged to stay updated with recommendations of their
state and local health departments. The Centers for Disease Control and Prevention
Health Department Directory can be found at
n https://www.cdc.gov/publichealthgateway/healthdirectories/index.html
The American Dental Association has provided and summarized resources related
to the COVID-19 vaccine. They can be found at the following links:
n https://success.ada.org/w/media/CPS/Files/COVID/ADA_Vaccine_Insight_Key_
Facts
n https://success.ada.org/en/practice-management/patients/covid-19-vaccine-
regulations-for-dentists-map

throughout the country, the proportion of respondents was higher from the Midwest region. This
might have affected our findings in correlation with the timing of the survey (May 1-June 30, 2020),
when COVID-19 cases were increasing in that region of the country. The timing of the survey
might also have affected responses. The American Dental Association released guidance before the
survey window; however, some states were still restricting oral health care to emergencies only, and
dental offices were facing shortages of PPE. In our study, we provided a “snapshot” of OHCWs’
attitudes at that specific time during the pandemic. In a 1-year follow-up study, we will assess
whether more information, access to PPE, and actual vaccine availability have changed these
attitudes.
In our study, we set the groundwork for future research into the oral health care workforce during
and after the coronavirus pandemic and future pandemics. Different sectors of the workforce can
have different viewpoints that must be explored in future studies. Strategies must be implemented to
ensure continued access to care for patients’ oral health from the entire oral health care team.

CONCLUSIONS
Within the limitations of our study, we arrived at the following conclusions:
n OHCWs have a decreased ability to report to work during a pandemic, with dentists being
significantly more able to work than dental hygienists and dental assistants.
n OHCWs have a decreased willingness to report to work during a pandemic, with dentists being
significantly more willing to report to work than dental hygienists and dental assistants.
n The most frequently reported barrier to report to work was the obligation to care for a family
member, which was cited more frequently by dental hygienists and dental assistants than dentists.
n Dentists are more likely than hygienists and assistants, and hygienists are more likely than as-
sistants, to receive a COVID-19 vaccine.
n Dentists are the least likely OHCW group to consider quitting their jobs or retiring during a
pandemic.
n Dentists should be aware of the differences in ability and willingness to report to work and
perceived barriers and concerns between dentists and staff members and be prepared to discuss
alterations to standard operating procedures to allay staff members’ fears and improve retention
rate during pandemics (Box 2). n

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Dr. Scully is a clinical assistant professor, School of Dentistry, Indiana Dr. Rector is a pediatric dental resident, Riley Hospital for Children,
University, Indianapolis, IN. Address correspondence to Dr. Scully, Indianapolis, IN; and a pediatric dental resident, School of Dentistry, Indi-
Department of Pediatric Dentistry, Indiana University School of Dentistry, ana University, Indianapolis, IN.
1121 W Michigan St., Indianapolis, IN 46202, e-mail [email protected]. Mr. Eckert is a biostatistician, Department of Biostatistics, School of
Dr. Joshi is a dentist in private practice, Fishers, IN; and an adjunct clinical Medicine, Indiana University, Indianapolis, IN.
assistant professor, School of Dentistry, Indiana University, Indianapolis, IN. Disclosure. None of the authors reported any disclosures.

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