Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Bhavna Shroff

Second Advisor

Steven Lindauer

Third Advisor

Caroline Carrico

Fourth Advisor

Vincent Sawicki


Purpose: To determine what adaptations orthodontists made in their practices during the COVID-19 pandemic in response to safety recommendations and to determine which of these adaptations orthodontists plan to continue to implement after resolution of the COVID-19 pandemic.

Methods: An original 34-question survey was sent by mail to a randomized and geographically proportionate selection of actively practicing orthodontic specialists (N = 1000). Questions asked orthodontists about the changes they made during the pandemic in four overarching categories (infection control, social distancing, appliance use, and tele-orthodontics) and whether they anticipated keeping those changes post-pandemic. The data were compared between categorical responses using chi-squared and Fisher’s exact test as appropriate.

Results: 160 orthodontists responded to the survey from 38 states (16% response rate). Use of nearly all forms of personal protective equipment (PPE) were reported to be used at high percentages during the pandemic, with a significant decrease anticipated after the pandemic. 92% of orthodontists modified their aerosol protocol, with the most common modification during the pandemic and predicted after the pandemic being the use of an assistant with high volume suction (61% and 49% respectively). Ninety six percent of orthodontists changed their waiting room protocol during the pandemic to keep patients and parents outside the practice, but few plan to continue that practice (23%). Forty two percent of orthodontists increased the use of clear aligners during the pandemic and the main reason for doing so was due to patient demand (91%). The number of orthodontists who used tele-orthodontics increased from 8% prior to the pandemic to 68% during the pandemic and is expected to decrease significantly post-pandemic. Moving forward, virtual appointments are anticipated to be used for screening and consultations of new patients and monitoring of active patients in clear aligners, but not fixed appliances.

Conclusions: The orthodontic sector utilized many modifications to address the safety and infection control recommendations given during the COVID-19 pandemic. Following the pandemic, use of enhanced PPE is expected to decrease and high-volume suction will likely be continued in many practices for aerosol-producing procedures. Less than half of orthodontists anticipate using tele-orthodontics in the future, but it will likely remain in use for virtual screenings and consultations as well as monitoring of clear aligners.


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VCU Theses and Dissertations

Date of Submission