Association of COVID-19-imposed lockdowns and online searches for toothache in Iran
Abstract
Objective
To assess the association between the lockdowns due to COVID-19 and online searches for toothache in Iran using Google Trends (GT).
Methods
We investigated GT online searches for the search term<inline-formula><alternatives><inline-graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="20160515v1_inline1.gif"/></alternatives></inline-formula>within the past five years. The time frame for data gathering was considered as the initiation and end dates of lockdown in Iran. Relative search volumes (RSVs) for online Google Search queries in 2019 was considered as the control. We performed one-way ANOVA statistical test to identify whether there is a statistical difference for RSV scores between the year 2020 and 2016-2019 for the whole country. Then we investigated the possible association of RSVs in provinces with dentists’ density, prevalence of current daily smokers, Human Development Index (HDI), Internet access, and fluoride concentration in water with linear regression. A p-value<0.05 was considered as statistically significant.
Results
When comparing 2020 with previous four years, there is a statistically significant difference between RSVs of 2020 with all previous years combined and each of these years (P<0.001 for all of them). In the linear model for the year 2020, HDI (B=-3.29, 95% CI: (−5.80, - 0.78), P=0.012), fluoride concentration (B=-0.13, 95% CI: (−0.24, -0.03), P=0.017), and prevalence of daily smokers (B=0.33, 95% CI: (0.13, 0.53), P=0.002) were significantly associated with RSVs. These covariates were not statistically significant for other years, except for Internet access in 2016 (B=-1.13, 95% CI: (−2.26, 0.00), P=0.050).
Conclusion
The RSVs for toothache in 2020 have significantly increased due to COVID-19-imposed lockdowns compared to the same period of the year in the past four years. Knowing that this period mostly overlaps with the national holidays of Nowruz in Iran, reinforces the impacts of lockdowns on people’s CSB about the toothache. In the subnational scale, the RSVs were significantly correlated with HDI, fluoride concentration, and prevalence of daily smokers which emphasises the role of socioeconomic factors in dental health and care-seeking behaviour.
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