Perceptions of Patient Safety Competence Using the Modified Version of the Health Professional Education in Patient Safety Survey (H-PEPSS) Instrument Among Dental Students in Riyadh, Saudi Arabia.

Aim: To investigate dental students' self-reported confidence in learning about various domains of patient safety during their clinical training years. Methods: The Health Professional Education in Patient Safety Survey (H-PEPSS) was distributed to the fourth- and fifth-year undergraduate students, interns and postgraduate dental students. The survey explores how the seven domains of the Canadian Patient Safety Institute Safety Competencies Framework and wider cases of patient safety issues are presented in dental education, as well as participants' self-reported comfortability regarding revealing about patient safety issues. A comparison of the patient safety domains scores were assessed through learning scenarios (classroom and clinical), gender, level of study and type of institution. Results: Out of 409 participants, 359 undergraduate dental students and 131 postgraduate dental students responded to the survey. Irrespective of the groups, all dental students were most confident regarding their learning aspects about skills pertaining to clinical safety and effective communication and least confident in learning related to managing safety risks. All the patient safety factors irrespective of the scenario, scored above 75% and thus interpreted as good competence. Statistically significant differences were reported among the genders in the classroom scenario for learning about communicating effectively with the patients regarding patient safety issues (p < 0.05). Male dental students, undergraduates and those in the private institution were significantly less confident about recognizing and reporting to immediate risks in the clinical scenario compared to their respective counterparts (p < 0.05). Conclusion: Based on the results, the dental students are quite confident with regard to the learning aspects of clinical patient safety, nevertheless, their confidence in learning certain patient safety aspects warrants further improvement. This implies a need to address the impact of regular interventions, extra motivation and repeated mentoring in both the classroom and clinical scenarios on improving dental students' confidence about patient safety.

Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh, Kingdom of Saudi Arabia compared to non-diabetic children.

OBJECTIVE: The aim of this study was to compare the prevalence of dental caries among groups of 6-12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. METHODS: The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. RESULTS: The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5-5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). CONCLUSION: The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of "critical" pH values (pH = 4.5-5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.

Effectiveness of oral health education intervention among female primary school children in Riyadh, Saudi Arabia.

OBJECTIVE: This study aimed to examine the effectiveness of oral health intervention on the improvement in knowledge and self-reported oral health behavior among 6-8 year old female primary school children in Riyadh, Saudi Arabia. MATERIALS AND METHODS: The sample consisted of 1661 girls in primary schools who are 6 to 8-year-olds (first, second and third graders). The children's level of knowledge was assessed by a self-administered questionnaire that was formulated for this specific age and divided into two parts; oral health knowledge and self-reported oral health behavior. There were seven multiple choice questions and one true/false question with five underlying parts in the questionnaire which contained basic information about oral health knowledge, oral hygiene practices and certain habits that affect teeth. The questionnaires were distributed before and six weeks after implementation of the oral health educational program to measure the level improvement of knowledge regarding oral health among these children. RESULTS: All the questions showed statistically significant improvement in knowledge and self-reported behavior in the post intervention group. There was a significant increase in the level of knowledge by 11.24% and level of self-reported behavior by 25% after intervention (P < 0.001). The highest net change in the knowledge due to intervention was noted among third graders (13.3%), whereas for self-reported oral health behavior, it was noted among first graders (28.3%). CONCLUSION: The results of this study showed that an easy-to-organize and inexpensive school-based intervention can, on a short-term basis, be effective in improving the knowledge and self-reported oral health behavior of children.

Dental specialty, career preferences and their influencing factors among final year dental students in Saudi Arabia.

OBJECTIVE: The purpose of this study was to investigate evolving trends in dental post graduate specialty preferences and career aspirations among final year dental students in Saudi Arabia. MATERIALS AND METHODS: A cross sectional survey using a self-administered questionnaire was conducted among final year dental students from seventeen universities in Saudi Arabia. The questionnaire enquired about socio-demographic details and the ranking of three of their best preferences among the list of specialties/general dentistry and career options. They were also enquired about their opinion regarding the total time required to become a dentist and their intention to go for further studies abroad. The questionnaire assessed factors influencing their choices using a 5 point Likert scale ranging from extremely important to not important. Binary logistic regression to examine the combined effect of several independent variables on the likelihood of choosing a dental specialization/general dentistry and career option were analyzed. RESULTS: The overall response rate was 64.6%. Restorative and Aesthetic Dentistry was the most preferred specialty (n = 98; 17.7%) followed by Endodontics (n = 78; 14.1%); Prosthodontics (n = 65; 11.7%) and Orthodontics (n = 63; 11.4%). The two most preferred careers were 'Civilian dentist in public sector' followed by 'Academic services dentist'. Overall, students reported that the influence of family members in the dental profession, preference for private practice and specific interest in patient population as the most important factors in choosing a specialty/general dentistry. Intellectual content of the specialty was ranked the least important. On the other hand, the most important factors for choosing a career were variety of non-clinical duties, access to child care facilities and research opportunities. CONCLUSION: The results of this study show the top preferred specialties and career choices which can be a baseline for establishing national policies and for the improvement of graduate programs. There seems to be a need to promote mentoring activities and provide guidance and encouragement to pre-doctoral dental students in selecting the most appropriate specialty within their capability domain.

Knowledge about permanent tooth avulsion and its management among dentists in Riyadh, Saudi Arabia.

BACKGROUND: There is a lack of adequate information on dentists' knowledge about tooth avulsion and its management in Saudi Arabia. The aim of this study was to evaluate the level of knowledge about permanent tooth avulsion and its management among dentists working in Riyadh, Saudi Arabia. METHODS: A total of 550 dentists were contacted to request their participation in this 19-item questionnaire survey over a three-month period starting in January 2015 using convenience sampling methodology. A questionnaire consisting of demographic items and multiple-choice questions regarding knowledge of avulsion and its management was used. The level of knowledge was assessed using a scoring system that assigned one point for each correct answer and zero points for wrong answers, with a maximum possible score of ten points. An independent t-test was used to compare the level of knowledge (mean score) based on particular variables, such as sex, nationality, type of practice, current employment, working hours and whether the respondents had attended a continuing dental education (CDE) programme on avulsion management. The level of significance was set at P< 0.05. RESULTS: A total of 470 completed questionnaires were collected with data suitable for statistical analysis. The majority of the respondents were Saudi (n = 331; 72.1 %) and general practitioners (n = 278; 59.3 %). Most of the participants correctly responded to the knowledge-based questions, except the questions regarding the best storage medium (milk: 24.1 %) and the duration of follow-up by clinical and radiographic examination (5 years: 15.6 %). The mean knowledge score was 5.94 ± 1.57. Gender (P = 0.001), current employment (P = 0.045) and working hours per day (P = 0.020) had a significant effect on the mean knowledge score. CONCLUSIONS: The surveyed dentists were found to have a moderate knowledge of avulsion and its management, although a relative lack of knowledge was observed regarding the duration of follow-up after replantation.

The efficacy of Salvadora persica extracts in preserving the viability of human foreskin fibroblasts.

OBJECTIVE: To evaluate the efficacy of Salvadora persica hexane and ethanol extracts in preserving the viability of human foreskin fibroblasts. MATERIALS AND METHODS: Normal human foreskin cells were cultivated in Dulbecco modified Minimum Essential Medium (D-MEM) supplemented with 10% fetal bovine serum and 2 mM of l-glutamine. Cell pellets were suspended in the following test solutions: (1) Hank's Balanced Salt Solution (HBSS); (2) homogenized milk; (3) hexane extract of S. persica; or (4) ethanol extract of S. persica. D-MEM with no serum was used as a positive control. For each condition, cell count was adjusted to 8 × 10(5) cells/ml, and the cells were incubated in the solutions for either 30, 60, or 120 min. Subsequently, the nonviable cells were separated from the viable cells using the trypan blue dye stain. The ratio of viable to nonviable cells was recorded using a cell counter. Statistical analysis of the data was accomplished by one-way analysis of variance using SPSS Version 16. The level of significance was 5% (p < .05). RESULTS: We did not detect a significant difference when comparing the percentage of viable cells in test solutions at the three incubation periods (30 min, p = 0.478; 60 min, p = 0.606; 120 min, p = 0.091). Homogenized milk preserved the viability of foreskin fibroblasts better than all other tested solutions. Incubation of cells in S. persica hexane and ethanol extracts resulted in a similar percentage of viable cells to incubation of cells in HBSS for each incubation period. CONCLUSIONS: S. persica hexane and ethanol extracts should be considered an alternative storage medium to HBSS.

Bioactivity and Surface Characteristics of Titanium Implants Following Various Surface Treatments: An In Vitro Study.

This study compared the surface topography, hydrophilicity, and bioactivity of titanium implants after 3 different surface treatments (sandblasting and acid etching, modified sandblasting and acid etching, and thermal oxidation) with those of machined implants. One hundred indigenously manufactured threaded titanium implants were subjected to 3 methods of surface treatment. The surface roughness of the nontreated (Group A) and treated samples (Groups B through D) was evaluated with a scanning electron microscope (SEM) and profilometer. The wettability was visually examined using a colored dye solution. The calcium ions attached to the implant surface after immersing in simulated body fluid (SBF) were assessed on days 1, 2, and 7 with an atomic electron spectroscope. The data were analyzed statistically. The SBF test allowed the precipitation of a calcium phosphate layer on all surface-treated samples, as evidenced in the SEM analysis. A significantly higher amount of calcium ions and increased wettability were achieved in the thermally oxidized samples. The mean roughness was significantly lower in Group A (0.85 ± 0.07) compared to Group B (1.35 ± 0.17), Group C (1.40 ± 0.14), and Group D (1.36 ± 0.18). The observations from this in vitro study indicated that surface treatment of titanium improved the bioactivity. Moreover, results identified the implants that were sandblasted, acid etched, and then oxidized attracted more calcium ions.

Knowledge about tooth avulsion and its management among dental assistants in Riyadh, Saudi Arabia.

BACKGROUND: Studies evaluating dental assistants' knowledge about tooth avulsion and its management are rare. The purpose of this study was to evaluate the level of knowledge about tooth avulsion and its management among dental assistants in Riyadh, Saudi Arabia and to assess its relationship with their educational background. METHODS: A convenience sampling methodology was employed for sample selection. Over a period of four months starting in February, 2013, 691 pretested 17-item questionnaires were distributed. A total of 498 questionnaires were returned for an overall response rate of 72.1%. Six questions were related to knowledge about permanent tooth avulsion and one question was related to knowledge about primary tooth avulsion. Correct answers to these questions were assigned one point each, and based on this scoring system, an overall knowledge score was calculated. An analysis of covariance was used to test the association between the level of knowledge (total score) and the educational qualifications of the respondents (dental degree and others). A P-value of 0.05 was considered the threshold for statistical significance. RESULTS: The majority of the respondents (n = 387; 77.7%) were non-Saudis (377 were from the Philippines), and 79.1% (n = 306) of the Filipinos had a dental degree. The question about recommendations for an avulsed tooth that is dirty elicited the highest number of correct responses (n = 444; 89.2%), whereas the question about the best storage media elicited the lowest number of correct responses (n = 192; 38.6%). The overall mean score for knowledge about tooth avulsion was 6.27 ± 1.74. The mean knowledge score among the respondents with a dental degree was 6.63 ± 1.37, whereas that among the respondents with other qualifications was 5.71 ± 2.08. CONCLUSIONS: The educational qualifications of the surveyed dental assistants were strongly correlated with the level of knowledge about tooth avulsion and its management.

Factors affecting job satisfaction and their correlation with educational standards among dental assistants.

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.

Oral cancer awareness and perception of tobacco use cessation counseling among dental students in four Asian countries.

BACKGROUND: The scientific evidence relating to the burden of oral diseases attributable to tobacco use has been reviewed and the need for a well-structured dental teaching program concentrating on oral cancer education and tobacco cessation interventions has been emphasized. The aim of our study was to evaluate the awareness of oral cancer and perception of tobacco use cessation counseling among dental students at all study levels in India, Saudi Arabia, the United Arab Emirates, and Yemen. MATERIALS AND METHODS: A structured, pre-tested, self-administered 15-item questionnaire was used to conduct a cross-sectional survey. Data analyses including percentages, frequency distributions and tests of chi-square were generated. RESULTS: A total of 621 (97.6%) Indian, 493 (96.5%) Saudi, 194 (96.5%) Yemeni and 187 (98.4%) United Arab Emirates respondents recognized the association between oral cancer and cigarette smoking. Although more than 96% of the students surveyed recognized the association between oral cancer and cigarette smoking and about 55% reported cigarette smoking as one of the etiological factors of oral cancer, more than 66% of students who reported cigarette smoking as an etiological factor of oral cancer disagreed/strongly disagreed with all the statements concerning tobacco use cessation. CONCLUSIONS: A higher level of oral cancer awareness did not have a positive impact on the perception of tobacco use cessation counseling among the sample surveyed.

Sealing ability of mineral trioxide aggregate, calcium phosphate cement, and glass ionomer cement in the repair of furcation perforations.

OBJECTIVES: The purpose of this study was to evaluate the in vitro sealing ability of three repair materials. Mineral trioxide aggregate (MTA; Group A), calcium phosphate cement (CPC; Group B), and light cured glass ionomer cement (GIC; Group C) when used to repair the perforation created in the pulpal floor of fifty extracted human permanent molars. MATERIALS AND METHODS: Preparation of access openings and furcation perforations were done, and the teeth divided into five experimental groups (A, B, C) including two controls (D, E) with ten samples in each group randomly. Following the repair procedure, the pulp chambers and access openings were filled with composite resin and immersed in 2% methylene blue solution for 48 hours. The teeth were sectioned longitudinally and the linear dye penetration measured under a stereomicroscope. RESULTS: The comparison of the linear length of micro-leakage (mm) among the experimental groups revealed no significant difference (p = 0.332). On calculating the percentage of depth of leakage to the total length of the perforation, it was observed that the mean leakage was 35.5% in Group A, 53.6% in Group B and the highest, 87.5% in Group C. The mean of leakage percentage was statistically significant by Kruskal-Wallis test (p = 0.003). The results indicated that the dye penetration used as furcation perforation repair material was least with mineral trioxide aggregate. Comparing the depth of penetration of dye, 50% of the Group A samples showed less than 25% of depth penetration. While 40% of Group B cases had more than 50% dye penetration. In our study, all Group C teeth had > or = 50% dye penetration. CONCLUSIONS: The present study indicated that GIC had the greatest dye penetration followed by CPC and MTA. Mineral trioxide aggregate and calcium phosphate cement had comparatively better sealing ability than glass ionomer cement.

A review on miswak (Salvadora persica) and its effect on various aspects of oral health.

Plants have been used for centuries to improve dental health and to promote oral hygiene, and this practice persists in several communities throughout the world. "Miswak" is an Arabic word meaning "tooth-cleaning stick," and Salvadora persica miswak has a wide geographic distribution. It was used by ancient Arabs to whiten and polish the teeth. This review discusses the history and chemical composition of S. persica miswak and its influence on oral health, including the advantages and disadvantages of its use.