Effects of the COVID-19 Pandemic on Orthodontic Practices in Europe: Findings From a Survey by the European Federation of Orthodontics

Background: The COVID-19 pandemic created major disruptions for healthcare systems globally, with dentistry, especially orthodontics, facing challenges due to the nature of close-contact treatments and procedures that generate aerosols. This research, conducted by the European Federation of Orthodontics (FEO), aimed to assess the pandemic's impact on orthodontic practices across Europe and to identify the clinical, financial, and operational adjustments made during this period. Methodology: An online cross-sectional survey was conducted among orthodontists who are members of national societies associated with the FEO from June to September 2022. The questionnaire gathered demographic information and insights on clinical adaptations, infection control measures, patient management, and financial implications. Descriptive and inferential statistics were used to assess the correlations between responses and variables, including gender, country, years of experience, practice type, and vaccination status. Results: A total of 428 orthodontists from various European countries and countries with national orthodontic associations affiliated with the FEO participated in the survey. The majority observed significant changes in their clinical operations, such as lengthier appointments, the implementation of triage protocols, and an increased reliance on PPE and ventilation strategies. While teleorthodontics was broadly embraced, many practitioners discontinued its use after the lockdown. Financially, most respondents reported experiencing revenue losses and a lack of government support. Stress levels differed across regions, with Greece and the UK showing the highest levels. Treatment delays and compromises in outcomes occurred more frequently in countries that enforced stricter lockdowns. Private practitioners recovered more swiftly than those working in public or academic environments. Additionally, younger orthodontists reported greater patient loads and higher income recovery. Conclusions: The COVID-19 pandemic had a major impact on orthodontic practices in Europe, revealing regional differences in resilience and recovery. Key elements for ensuring continuity of care included infection control, digital transformation, and financial planning. These findings emphasize the necessity of developing localized support strategies and coordinated international responses to strengthen orthodontic practices in the event of future public health emergencies.