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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 132-133

The pandemic for women in dentistry: A hard row to hoe


1 Departments of Psychiatry, Level III IFH MONUSCO, Goma, DR Congo
2 Resident, UCSF School of Dentistry, California, United States
3 Department of Anaesthesiology and Critical Care, Command Hospital, Western Command, DR Congo
4 Paediatrics, Military Hospital, Jammu, Jammu and Kashmir, India
5 Department of Radiodiagnosis and Imaging, Ojas Hospital, Panchkula, Haryana, India

Date of Submission03-Jun-2021
Date of Decision19-Jun-2021
Date of Acceptance09-Jul-2021
Date of Web Publication30-Nov-2021

Correspondence Address:
Shibu Sasidharan
Department of Anaesthesiology and Critical Care, Level III IFH MONUSCO, Goma

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/dmr.dmr_18_21

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How to cite this article:
Dhillon HS, Manalikuzhiyil B, Sasidharan S, Dhillon GK, Babitha M. The pandemic for women in dentistry: A hard row to hoe. Dent Med Res 2021;9:132-3

How to cite this URL:
Dhillon HS, Manalikuzhiyil B, Sasidharan S, Dhillon GK, Babitha M. The pandemic for women in dentistry: A hard row to hoe. Dent Med Res [serial online] 2021 [cited 2022 Jan 23];9:132-3. Available from: https://www.dmrjournal.org/text.asp?2021/9/2/132/331392



The coronavirus disease 2019 (COVID-19) pandemic has affected the health-care system drastically, without exception to dental care practice. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread via close contact through respiratory droplets and aerosols. Owing to specific characteristics of dental care such as aerosol generation as well as close proximity to patients, dentistry is thought to be associated with the nosocomial spread of infection. The risk of bidirectional spread of infection between patient and dental care providers makes it critical to take additional precautionary measures to mitigate the spread of COVID-19. This single strand of RNA has wreaked havoc in the social, political, economic, and psychological realms of the world. The consequences of this scenario following the first wave of the COVID-19 pandemic, with limited access to healthcare services, altered routine care, suspended general anesthesia sessions and untreated oral disease, are relevant to special care dentistry (SCD) and lead to the deterioration of medical and dental conditions . Although the coronavirus-2 (SARS-CoV-2) did not discriminate, the devastating effects of the pandemic and consequent lock-downs have disproportionately affected women worldwide. As of 2020, according to the American Dental Association (ADA)Health Policy Institute, of the about 201,000 active dentists, 34.5% are female, up from 16% in 2001. And more and more women are pursuing dentistry. According to the HPI, more than 50% of those enrolled in their first year of dental school are female.

At the beginning of the pandemic, it was expected that men would be affected more owing to their gender role of venturing out of home to earn for their families. However, as the pandemic worsened with ensuing lockdowns, the situation reversed. Despite lockdown, women still had to step out of the house for groceries and other household errands. Women are tasked with collecting drinking water from crowded community water pumps in certain states where onsite drinking water is unavailable. There are additional pandemic-specific factors such as juggling household and work from home duties. With the closure of schools and daycares, women are taking care of children for the entire day, their online teaching, looking after the elderly with more family members inside the house, making the routine household, and caregiving burden an endless work. This is a gender-specific unpaid job with no economic security and in pandemic times like these, can jeopardize a women's source of livelihood.

At the start of the COVID-19 crisis, after the initial shock and numbness, the realisation hit that dentistry as we know it would change forever, especially for women. These changes still aren't set in stone as we wait for industry guidelines. While the new normal became all consuming, the power of collaboration have became even more important, albeit digitally. Reaching out to networks replacing conversations with patients with conversations with peers from across the globe. This commentary aims to present an overview of the dynamics of COVID-19 transmission and its impact on women in dentistry and discuss measures to provide dental care during the time of the COVID-19 outbreak effectively. The pandemic has further worsened the financial divide, which could be attributed to the additional familial and societal obligations expected from the women. In Asia and the Pacific, 50% of women have reported drops in working time, compared to only 35% of men.[1] The International Labor Organization has estimated a loss of 17% of working hours with a 19% higher risk for women's employment compared to men's employment.[2]

Gender-related factors have amplified the differential economic impact on women working in industries with a predominant women workforce such as the garment industry, hotel and tourism sectors, food industry, and the health sector. This differential setback to the industry has severely affected women's employment and forced them to venture into informal employment sectors. The informal employment sector does not ensure job security and poses a greater risk for harassment and exploitation with no state-sponsored social protection leading to financial insecurities and psychological maladjustments.

In the health-care sector, women are the default health-care workers, especially in unorganized/quasi-organized community health-care systems. They constitute the majority of the midwives, social and health-care workers, and nurses, especially in the developing countries where they work without adequate protective gear and are at higher risk of exposure to viral transmission.[3] In addition, access to health-care facilities has become more difficult as most of the community outreach resources and workforce have been diverted to tackle the COVID pandemic. Women find it difficult to access health care in view of financial hardships, transportation costs, and the fear of contracting the illness. The existing outreach programs for children, adolescent girls, and pregnant women have been severely disrupted, interrupting the supply of sanitary care products, contraceptives, iron/calcium supplements, etc.[4] Thus, there is an enhanced risk for sexually transmitted diseases, unwanted pregnancies, and poor maternal and child outcomes. These factors not only predispose the women to increased risk of contracting the illness but also negatively impact the recovery from the same.

The violence against women has existed since time immemorial and has peaked during the previous outbreaks of Ebola and Zika virus, but it has become a major public health issue during the current pandemic. There was an increase in the number of distress calls to emergency services, increase in the number of deaths, increase in sexual violence, and difficulty in accessing the support and protective services due to lockdown. An Indian study by Ravindran and Shah, 2020, revealed a higher incidence of domestic and cybercrime (abuse and bullying) complaints, although the complaints for rape and sexual assault were less.[5] There could be a multitude of factors including limited/no access to community/state support services during lockdown, being locked down with aggressive/abusive partners, increased alcohol consumption, online gambling, financial insecurities, etc.

The pandemic is also expected to differentially worsen the already existing gender disparities in the medical and psychological conditions in women.[6],[7] The impact on mental health during the COVID-19 pandemic has been ubiquitous across race, religion, and countries; however, it again impacted women more than men because of the differential perceived burden borne by women. Working women including those in health-care industry, suffered more stress, anxiety, and psychological maladjustments. They were found to be more worried about contracting the illness and transmitting it to their family members. The mental health of women working from home has been adversely affected due to the dual role of work from home and working for home.[8] There has been an increase in psychosomatic complaints such as headaches, backaches, myalgias, neck pain, and eyestrain.[8] Sexual health also experienced a decline in terms of reduction in the frequency of sexual intercourse and sexual intimacy during the pandemic and lockdown period in India.[9] Moreover, patients with existing psychiatric conditions deteriorated further due to stress, disruption in outpatient department consultations/medicine supplies, and diversion of already limited mental health resources in India to pandemic relief measures.

It is imperative to utilize a gender lens to study the already existing and rapidly widening gender disparities owing to the current pandemic. Women representatives should be included in decision-making capacity from the policy levels to the grassroots situations to identify the trends at local levels. Equitable sharing of responsibility between man and woman at both household and workplace should be encouraged with equal pay and care-related leaves. The government should provide for paid leave, flexible working and childcare services, social and state-sponsored protection in the informal employment sectors, grant economic relief packages for industries with a predominantly female workforce, and ensure continuity of the existing health and social services supporting women. To combat physical and mental exhaustion, stress management techniques such as meditation, mindfulness, balanced diet, optimal sleep, and behavioral scheduling should be cultivated and practised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Azcona G, Bhatt A, Encarnacion J, Plazaola-Castaño J, Seck P, Staab S, et al. From insights to action: Gender Equality in the Wake of COVID-19. New York: UN Women; 2020.  Back to cited text no. 1
    
2.
Sasidharan S, Singh H. PPE - A Hindrance to Therapeutic Alliance!. Turkish journal of anaesthesiology and reanimation 2021;49:183–5. https://doi.org/10.5152/TJAR.2021.883.  Back to cited text no. 2
    
3.
Women UN. COVID-19 and its economic toll on women: the story behind the numbers. Retrieved from UN Women: https://www. unwomen. org/en/news/stories/2020/9/feature-covid-19-economic-impacts-on-women. 2020.  Back to cited text no. 3
    
4.
Chakravarthy V. Women at the center of the COVID-19 pandemic: Insights from rural contexts in India. Demogr India 2020;49:132-9.  Back to cited text no. 4
    
5.
Ravindran S, Shah M. Unintended Consequences of Lockdowns: Covid-19 and the Shadow Pandemic. NBER Working Paper, No. 27562. Cambridge, MA: National Bureau of Economic Research; 2020.  Back to cited text no. 5
    
6.
Connor J, Madhavan S, Mokashi M, Amanuel H, Johnson NR, Pace LE, et al. Health risks and outcomes that disproportionately affect women duringtheCovid-19 pandemic: A review. Soc Sci Med 2020;266:113364.  Back to cited text no. 6
    
7.
Singh V, Sasidharan S, Naseer A, Singh-Dhillon H, Manalikuzhiyil B, Singh S, Sinha D, Kaur-Dhillon G, Singh S. Invasive Mechanical Ventilation of COVID-19 ARDS Patients. Revista Peruana de Investigación en Salud 2021;5:113-26.  Back to cited text no. 7
    
8.
Sharma N, Vaish H. Impact of COVID-19 on mental health and physical load on women professionals: An online cross-sectional survey. Health Care Women Int 2020;41:1255-72.  Back to cited text no. 8
    
9.
Grover S, Vaishnav M, Tripathi A, Rao TSS, Avasthi A, Dalal PK, et al. Sexual functioning during the lockdown period in India: An online survey. Indian J Psychiatry 2021;63:134-41.  Back to cited text no. 9
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