Temporomandibular Disorders among Dental Students in Pakistan: Assessment of Prevalence, Severity, and Associated Factors Based on Questionnaire.

Objective: To evaluate the prevalence, severity, and associated factors of temporomandibular disorder (TMD) among dental students. Methods: This cross-sectional study was performed on undergraduate dental students from four dental colleges in Punjab, Pakistan. Fonseca's questionnaire was used to measure the prevalence and severity of the TMD among the study participants. Bivariate and multiple logistic regression analyses were performed. Results: Of 364 dental students, 323 returned the completed questionnaires and the response rate of the study was 88.7%. The study included 52.6% males and 47.4% females. The prevalence of TMD was 66.9% with mild TMD in 40.90%, moderate TMD in 14.6%, and severe TMD in 11.50% of the participants. Psychological stress (29.6%), malocclusion (20%), and hypersensitivity (19.5%) were common among participants. The mean TMD score of the sample was 31.54 ± 24.86 which was significantly higher among participants with no/school-educated mothers (P=0.021) and fathers (P=0.002). The participants with arthritis (72.81 ± 32.19) and malocclusion (59.46 ± 31.09) and those who received orthodontic treatment (53.21 ± 34.21) demonstrated higher TMD. After controlling for other study variables, the participants with arthritis were 4.71 times more likely to have moderate/severe TMD (P=0.042) than those without arthritis. Similarly, the participants with malocclusion had significantly higher odds (OR = 3.57, P=0.029) of having moderate/severe TMD than those without malocclusion. Conclusion: This sample of dental students demonstrated a high prevalence and severity of TMD. The participants with arthritis and malocclusion demonstrated higher TMD. The study findings underscore the importance of prevention, early diagnosis, and management of TMD among the dental students.

Physicians' awareness of oral-systemic links and its association with physician-reported patient referral to dentists.

INTRODUCTION: Physicians promote oral health by screening for oral pathologies, providing emergency help, and referring patients to dentists. The literature consistently reports a robust association between periodontal disease and systemic diseases. However, it is not fully known if physicians in Saudi Arabia are aware of the oral-systemic disease links. Therefore, the study aimed to evaluate physicians' awareness of the oral-systemic disease links and their association with patients' referral to dentists and patients' access to oral care. METHODS: This cross-sectional study was conducted (June 2019-January 2020) on physicians working in private and public hospitals in the Eastern province of Saudi Arabia. The physicians (n = 333) responded to a paper-based self-administered and pilot-tested questionnaire which inquired about their awareness of oral-systemic disease links and patient referral to dentists. The reliability of items of oral-systemic disease links was evaluated by calculating Cronbach's alpha (0.84). RESULTS: Most participants (92.8%) agreed/strongly agreed that oral health is associated with systemic health. Half of the sample (50.8%) referred patients to dentists during the last month. Almost 80.5% believed that more patients will be referred to the dentists because of their awareness of the oral-systemic disease links and 84% believed that more patients will access oral care services if patients were aware of the oral-systemic disease links. The participants who referred patients to the dentists during the last month (P = 0.038), believed that more patients will be referred (P = 0.001), and believed that more patients will access oral care (P = 0.003) demonstrated significantly higher oral-systemic disease links awareness score. The adjusted model showed patients' referral to dentist (OR = 1.96.10, P = 0.006) and believing in more patients accessing oral care (OR = 2.05, P = 0.044) were associated with significantly increased awareness of the oral-systemic disease links. CONCLUSION: Most physicians in the study were aware of the oral-systemic disease links. Increased awareness of the oral-systemic disease links was significantly associated with the referral of patients to dentists and belief in improved patients' access to oral care services.

Test Anxiety and Related Factors among Health Professions Students: A Saudi Arabian Perspective.

The study aimed to evaluate test anxiety and its relationship with demographic factors among undergraduate medical, dental, and pharmacy students in Dammam, Saudi Arabia. The health professions students from Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia participated in this cross-sectional study. Test Anxiety Inventory (TAI) by Spielberger was used to evaluate test anxiety and the score on the scale ranges from 20 to 80. Of the total 1098 participants, 878 returned completed questionnaires and the response rate of the study was 79.9%. In response to the items of TAI, 33% of participants reported that they almost always "wished examinations did not bother so much". The mean TAI score of the sample was 43.17 (SD = 10.58). There were statistically significant differences in the mean scores of TAI among dental (44.15 ± 0.48), medical (41.64 ± 1.31), and pharmacy (43.44 ± 9.29) students (p = 0.003). The students with high grade point average (GPA) (mean TAI = 41.91 ± 10.43) demonstrated significantly lower test anxiety than those with low GPA (mean TAI = 44.05 ± 10.67) (p = 0.006). Academic grade in the previous year (GPA) remained a statistically significant factor associated with test anxiety (B = -2.83, p = 0.003) in multivariate analysis. This study showed that test anxiety was common among health professions students, and dental students and students with low GPA demonstrated high test anxiety. Students with high test anxiety should be the target of preventive strategies.

Oral health-related interdisciplinary practices among healthcare professionals in Saudi Arabia: Does integrated care exist?

BACKGROUND: There is a bidirectional relation between oral and general health, therefore collaboration between healthcare providers is needed. This study investigated current interdisciplinary practices (IDP) and the associated factors among healthcare professionals in Saudi Arabia. METHODS: A cross-sectional study was conducted in the Eastern Saudi Arabia recruiting four groups of health professionals (nurses, physicians, pediatricians and Ear-Nose and Throat (ENT) specialists). A validated, self-administered questionnaire was distributed online and shared through social media platforms. The questionnaire explored predisposing factors (demographics) and facilitating factors (knowledge, attitudes, attendance of oral health training and source of knowledge) associated with IDP. RESULTS: A total of 1398 health professionals were recruited. Participants showed fair oral health knowledge (7.1 ± 2.1) and attitudes (22.2 ± 3). Three-fourths (74.6%) reported always providing oral health education (OHE) to their patients, more than half (59.6%) reported always conducting an oral health screening (OHS), two-thirds (66.7%) reported responding to patients' questions about oral health or conditions and 58.7% reported referring patients to dentists. Pediatricians and physicians had greater odds of IDP compared to other health professionals. Source of oral health knowledge (Ministry of Health (MOH) and formal education) was significantly associated with increased odds of IDP. Participants with good oral health knowledge had greater odds of responding to patients' oral health question as well as have more referral practices. CONCLUSION: The results reveal a discrepancy between participants' IDP, knowledge, and attitudes. Incorporating dental component to medical curricula, continuous education and training programs targeting health professionals through Ministry of Health should be considered.

Generalized Anxiety Disorder and Its Relationship with Dental Anxiety among Pregnant Women in Dammam, Saudi Arabia.

OBJECTIVE: To assess the relationship between generalized anxiety disorder (GAD), dental anxiety (DA), and other factors among pregnant women. METHODS: The Generalized Anxiety Disorder (GAD-7) scale and the Modified Dental Anxiety Scale (MDAS) were used to evaluate GAD and DA, respectively. Hard copies of self-administered questionnaires were distributed among 780 pregnant women attending hospitals/health centers in Dammam, Saudi Arabia. RESULTS: About 31.7% of the participants demonstrated minimal anxiety, 37.9% mild anxiety, 19.7% moderate anxiety, and 10.6% severe anxiety. The mean GAD score of the sample was 7.53 ± 5.16 which differed significantly among women in the first (7.74 ± 5.47), second (6.82 ± 4.64), and third trimesters (8.13 ± 5.37) (P=0.029). Pregnant women who performed routine dental visits demonstrated lower GAD (6.98 ± 5.23) than those who visited dentists for consultation, pain, or treatment (7.58 ± 5.07). The mean GAD score was significantly higher among participants with dental pain or discomfort during the last 12 months (8.12 ± 5.05) than among those without pain or discomfort (7.02 ± 5.2) (P 0.003). Similarly, the participants with DA showed a significantly higher mean GAD score (7.69 ± 5.17) than those without DA (5.93 ± 4.71) (P 0.006). Multivariate linear regression showed that GAD significantly correlated with DA (B = 0.225, P < 0.001). CONCLUSION: In the present study, GAD was common among pregnant women which significantly correlated with DA. Pregnant women with DA and dental pain demonstrated high GAD. Preventive and therapeutic measures should be taken to reduce GAD and DA during pregnancy.

An Assessment of Various Challenges Perceived by Dental Students amidst the COVID-19 Pandemic: A Digital Questionnaire Study.

The objective of our study was to evaluate dental students' perception of the challenges faced during the COVID-19 pandemic related to their clinical work, education, performance, online examinations, psychological health, and teamwork. A validated online questionnaire consisting of closed ended questions was sent to all the undergraduate dental students at our institute. Data were collected and analyzed statistically using a chi-square test to compare responses of male with female and junior with senior students. A total of 317 undergraduate dental students (N = 317) participated in this cross-sectional study. The most common challenges perceived by the participants were related to their exam duration (77.3%), patient availability (66.9%), difficulty in understanding online lectures (58.4%), and a fear of losing grades (57.4%). Participants reported that the COVID-19 pandemic affected their performance in the courses (75.4%), teamwork (72.2%), educational aspects (67.5%), and psychological health (51.1%). A significantly greater proportion of female students reported the adverse effects of COVID-19 on their psychological health than male students (p = 0.031). Senior students perceived the negative impact of COVID-19 on teamwork significantly more than the junior students (p = 0.004). The majority of students reported challenges during the COVID-19 pandemic. Female students and senior students perceived more challenges than their counterparts. Future studies from other institutes of this region are recommended to establish a clearer picture of COVID-19 related challenges faced by dental students.

Attitudes and satisfaction of dental faculty toward calibration: A cross-sectional study.

OBJECTIVE: To evaluate attitudes and satisfaction of faculty members about calibration efforts in the undergraduate dental program at Imam Abdulrahman Bin Faisal University, Saudi Arabia. METHODS: The cross-sectional study included faculty members (n = 75) who participated in calibration exercises for effective assessments in preclinical and clinical courses. The previously validated questionnaire was utilized. The questionnaire was composed of four sections: demographics, faculty members' attitude, quality of calibration efforts, and faculty satisfaction. The satisfaction score of faculty members was calculated and compared with their demographic data. Descriptive statistics included means, standard deviations, frequencies, and proportions. The data were analyzed using an independent sample t-test and one-way analysis of variance. RESULTS: The response rate was 92% (n = 69). Note that 97% participants agreed that faculty calibration was an important aspect of dental education and 88.10% were willing to attend calibration exercises even if not required by their institution. Most participants (82.1%) agreed students were more satisfied with their clinical education when faculty members were calibrated. In this study, the perception of 85.1% of the participants was that calibration efforts reduced faculty variations. Most participants (73.10%) were satisfied with the quality of faculty calibration exercises in the college. The mean satisfaction score of the sample was 13.21 ± 3.65, which was significantly higher among faculty members with a doctoral degree (13.88 ± 3.64) than those with a master's degree (12.08 ± 3.46) (p = 0.048). The study showed no significant relationship of gender, age, status, and year of experience with faculty's satisfaction with calibration efforts. CONCLUSION: Most faculty members recognized the importance of faculty calibration in dental education and were satisfied with the quality of calibration efforts. Satisfaction with calibration efforts was significantly related to the high education of faculty members.

Medical Conditions, Oral Health Practices, and Barriers to Treatment among Patients Visiting a Teaching Dental Hospital in Eastern Saudi Arabia.

OBJECTIVE: To assess the prevalence of medical conditions, oral hygiene practices, and dental visits among patients who attended a teaching dental hospital in Dammam, Saudi Arabia. Materials & Methods. This retrospective cross-sectional study used patient records from 2009 to 2015 from the dental hospital of the College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam. Patients' demographics, medical history, oral hygiene practices, reasons for attending the facility, attendance patterns, and smoking habits were studied. RESULTS: The study included 1502 records of patients with 65.1% of males and 34.9% of females. The prevalence of medical conditions was 25.7% in the study. The most common medical conditions included diabetes mellitus (7.2%), hypertension (6.5%), and anemia (4.7%). Only 21.8% reported visiting the dental hospital in the past one year. The prevalence of smoking was 16.7%, and this did not differ significantly between healthy and medically compromised patients (P=0.165). Fillings were the most common (21.6%) reason for visiting a dental hospital, followed by treatment for periodontal problems (12.9%) and oral lesions (12.6%), whereas treatment for braces (orthodontics) was the least common (5%) reason for visiting the hospital. The reasons for visiting the hospital did not differ significantly between healthy and medically compromised patients (P > 0.05). The three most common barriers to dental visits included long waiting time (18.1%), fear of dental treatment (14.4%), and difficulty in getting an appointment (11.3%). CONCLUSION: The study showed that dental patients had a high prevalence of medical conditions. Diabetes mellitus was the most prevalent problem. Most patients visited the dental hospital to receive restorative treatment, and a long waiting time was the most common barrier to dental visits. Public health measures should be taken to improve the general health and oral care of patients.

Dental Anxiety Screening and Management Practices in Dental Practice in Eastern Province, Saudi Arabia.

Purpose: The purpose of the study was to investigate dental anxiety (DA) screening and management practices among dental professionals in Saudi Arabia. The study also evaluated correlation between patients' self-reported DA and dentists' ratings of patients' DA. Participants and Methods: This cross-sectional observational study included dentist/patient pairs (N = 279) from the Eastern Province of Saudi Arabia. The dentists responded to a questionnaire about their DA screening and management practices and they evaluated patients' DA using the visual analogue scale (VAS). In addition, patients responded to the Modified Dental Anxiety Scale (MDAS) to measure their DA. Results: About 15.1% of dentists reported using a published scale for screening DA in dental practice and Corah's Dental Anxiety Scale and Dental Fear Survey were their main scales. However, 69.2% reported directly asking their patients about DA. The use of DA management technique was reported by 89.6% of the dentists. Approximately half of the participants (53%) reported receiving DA training in their undergraduate dentistry programs and 65.2% expressed their interest in continuing education courses related to DA. In multiple logistic regression analysis, statistically significant factors associated with DA screening practice included gender (AOR = 0.46, P = 0.037), place of work (AOR = 3.68, P = 0.039), and interest in continuing education courses (AOR = 3.21, P = 0.015). Monthly income (AOR = 0.20, P = 0.029) and directly asking patient about DA (AOR = 6.15, P = 0.025) were significant factors associated with management of patients with DA. The study also showed a significant but weak correlation between DA evaluated by the dentists and DA reported by the patients (rho = 0.185, P = 0.002). Conclusion: The present study showed a low prevalence of DA screening practices among dentists. Dentists' rating of patients' DA weakly correlated with patients' self-reported DA.

Global caries experience in children and its relationship with government expenditures on education and health, sugar consumption, and years of schooling: An ecological study.

OBJECTIVE: To evaluate the influence of gross domestic product (GDP), government expenditures on education and health (% of GDP), per capita sugar consumption, and years of schooling on caries experience (DMFT) in 12-year-old children globally. METHODS: The study analyzed global data of GDP, sugar consumption, years of schooling, expenditure on education and health, and DMFT from 69 countries. Information about DMFT and sugar consumption was retrieved from the World Health Organization while data of other study variables were available from the United Nations Development Program. Data were compared among low, middle, and high-income countries. RESULTS: Sugar consumption (p = 0.005) and years of schooling increased progressively from low-income to high-income countries (p < 0.001). The greater percentage of GDP was spent on health (6.55 ± 2.94) than on education (3.48 ± 2.60). Upper-middle-income countries had the highest mean DMFT score (2.23 ± 1.23) and per capita sugar consumption (33.28 ± 14.06). High-income countries spent 4.33% of their GDP on education followed by low-income countries (3.92%) (p = 0.037). Similar trends were observed with regards to the percentage of GDP spent on health (p = 0.003). Univariate analysis showed a significant negative correlation between the percentage of GDP spent on education (r = -0.252, p = 0.037) and DMFT. Significant correlation remained in multivariate analysis; the percentage of GDP spent on education and DMFT in children (B = -0.128, p = 0.028). CONCLUSION: Low, middle, and high-income countries demonstrated significant inequalities regarding caries experience, sugar consumption, and share of GDP spent on health and education. Increasing the share of GDP on education may reduce caries burden in children globally.

Oral Health and Patterns of Dental Visits Among Diabetic Patients in the Eastern Province of Saudi Arabia.

PURPOSE: Diabetes is a big public health threat in Saudi Arabia. However, there is limited evidence about dental problems, oral hygiene practices, and dental visits among diabetic patients. The study aimed to evaluate self-perceived oral health status and patterns of dental attendance among diabetic patients in the Eastern province of Saudi Arabia. METHODOLOGY: This cross-sectional study included 486 diabetic patients (mean age 50.14±13.59 years) registered with the Saudi Diabetes Society, Saudi Arabia (October-November 2020). The World Health Organization's oral health questionnaire for adults was administered to collect information about oral health status, oral hygiene practices, and dental attendance, in addition to sociodemographic data. Descriptive and analytical statistics were performed. RESULTS: Most participants (66.3%) reported having dental pain or discomfort during the last year. Bad breath (60.50%), tooth cavities (55.10%), difficulty in biting hard food (55.10%), tooth sensitivity (53.30%), and bleeding gums (52.90%) were common oral problems among participants. More than half the sample (55.1%) reported visiting the dental office during the last year. However, pain or trouble with teeth, gums or mouth was the most common (40.5%) reason for the last dental visit. Only 7.8% of participants visited the dentist for a routine dental check-up. Multiple logistic regression analysis showed that Saudi nationality (AOR 2.68, P 0.008), family history of diabetes (AOR 1.88, P 0.022), and having pain during the last year (AOR 4.01, P <0.001) were the significant factors associated with the last dental visit due to pain. CONCLUSION: This sample of participants demonstrated a high prevalence of dental problems. Few participants performed routine dental visits and most visits were due to pain. Saudis and patients with family history of diabetes and dental pain were more likely to perform pain related dental visits. Multidisciplinary efforts are needed to develop and implement preventive educational and clinical care models for positive oral and general health outcomes.

Prevalence and Distribution of Nonsyndromic Dental Anomalies in Children in Eastern Saudi Arabia: A Radiographic Study.

OBJECTIVES: To report the prevalence and distribution of nonsyndromic dental anomalies in children in eastern Saudi Arabia. METHODS: This retrospective records review study involved radiographic examination of 6-18 years old pediatric patients who attended the Dental Hospital of the College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Four calibrated examiners recorded nonsyndromic dental anomalies from patients' digital orthopantomograms (OPG). The anomalies recorded were related to tooth number, shape, and location. Descriptive statistics, chi-square test, and Fisher exact tests were used to report prevalence and differences by gender, nationality, and medical history at the 5% significance level. RESULTS: Of 2226 reviewed patients' records, 1897 met the inclusion criteria and were included in the study. The study sample had equal distribution of males (52.6%) and females (47.4%) and comprised 81.2% Saudi children with a mean age of 8.8 ± 1.84 years. Most study subjects (97.8%) were in mixed dentition and 88.7% were healthy. The prevalence of dental anomalies was as follows: teeth rotations (24.5%), ectopically erupted teeth (6%), congenitally missing permanent teeth (5.4%), peg lateral (1.1%), supernumerary (0.5%), gemination (0.3%), and fusion (0.1%). No statistically significant differences were found in the distribution of dental anomalies by patients' gender, medical history, and nationality (p value ≥0.05). CONCLUSION: This study showed that teeth rotations were the most common dental anomalies followed by ectopic eruptions and congenitally missing teeth. The study findings may guide dental practitioners to better diagnose and manage children with dental anomalies in eastern Saudi Arabia.

Relationship Between Maternal Dental Anxiety and Children's Dental Caries in the Eastern Province of Saudi Arabia.

PURPOSE: Dental anxiety is a barrier to dental care utilization and is associated with poor oral health outcomes. The aim of the study was to assess the relationship between dental anxiety of mothers and dental caries of their children in the Eastern Province, Saudi Arabia. METHODOLOGY: A cross-sectional study was conducted on a sample of mother-child pairs (N= 199) in Dammam, AlKhobar, and Dhahran, Saudi Arabia. Dental caries experience among children was determined using dmft/DMFT indexes following the World Health Organization's guidelines. Maternal dental anxiety was assessed by using the Modified Dental Anxiety Scale (MDAS). RESULTS: The mean ages of mothers and children were 33.98 ± 5.41 and 6.74 ± 2.29 years, respectively. The mean dmft score was 4.3 ± 3.99 in primary dentition and the mean maternal dental anxiety score was 13.89 ± 5.33. Ninety-two percent of mothers had low to extreme dental anxiety and only 8% reported no dental anxiety. Dental caries experience in primary teeth was higher in children of dentally anxious mothers (mean dmft 4.45 ± 3.92) than the children of mothers who were non-anxious (mean dmft 2.56 ± 4.59) (P=0.07). The mean maternal anxiety score was significantly higher in children with untreated decay in primary dentition (14.49 ± 5.08) than those with sound primary dentition (12.24 ± 5.67) (P = 0.008). The study also found a statistically significant correlation between maternal dental anxiety and untreated decay in the primary dentition (Pearson's r =0.171, P = 0.015). CONCLUSION: Dental anxiety was highly prevalent among mothers in the present study. There was a significant relationship between maternal dental anxiety and untreated decay in the primary dentition. Awareness should be raised among dentally anxious mothers to reduce the burden of dental caries in their children.

Dental Visits and Predictors of Regular Attendance Among Female Schoolchildren in Dammam, Saudi Arabia.

PURPOSE: Regular dental visits are important for the maintenance of optimal oral health and improved quality of life. The purpose of the study was to evaluate patterns of dental visits and factors associated with routine dental attendance among female schoolchildren in Dammam, Saudi Arabia. PATIENTS AND METHODS: This cross-sectional study was performed on 449 female primary schoolchildren (6-11 years old) in Dammam, Saudi Arabia. The study included clinical examination for decay in the first permanent molars in children and questionnaire administration among their parents. The World Health Organization's oral health questionnaire was used to collect data about children's dental visits, oral hygiene behaviors, dental problems, and dietary practices. Bivariate and multivariate analyses were performed to evaluate factors associated with routine dental visits. RESULTS: Most children (64.1%) visited the dentist during the past one year, 22.1% performed no dental visit during the past one year, and 8.3% never visited the dentist. Among children who visited the dentist, the pain was the most common reason for dental visits (39.10%, N=170), followed by routine dental check-ups (18.60%, N=81). In bivariate analysis, education of parents, family income, daily tooth brushing, no decay in the first permanent molar, no toothache, no consumption of soft drinks, biscuits, cakes, and cream were significantly associated with routine dental attendance (P <0.05). However, the final logistic regression model showed that university education of mothers (OR 2.52, P = 0.005), not having toothache or discomfort (OR 2.88, P = 0.001), tooth brushing once or twice daily (OR 2.43, P= 0.034), and not consuming soft drinks (OR 1.96, P= 0.027) were significant predictors of routine dental visits. CONCLUSION: The study found that higher education of mothers, daily tooth brushing, not having dental pain, and not consuming soft drinks were significantly associated with routine dental visits in this sample of female schoolchildren. Routine dental attendance may be used to improve oral hygiene and reduce dental pain and consumption of soft drinks in children.

Patient safety culture amongst dental students and interns in Dammam, Saudi Arabia.

OBJECTIVE: To evaluate awareness and attitudes of dental students and interns about patient safety culture in Dammam, Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted on 272 undergraduate dental students and interns using the Safety Attitudes Questionnaire (SAQ) from November 2019 to January 2020. The SAQ consists of six domains: teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and work conditions. The score of SAQ ranges from 0 to 100, and a cut-off ≥75 is considered a positive attitude of patient safety. RESULTS: The study included 47.1% of males and 52.9% of females with a mean age of 22.58 ± 1.3 years. Few participants (9.9%) showed a positive attitude of patient safety culture. Nearly one-third of participants (35.7%) attended a course on patient safety and 31.6% reported experiencing adverse events by them or their families. Out of six domains, job satisfaction showed the highest mean score (70.25) and 75.4% of participants felt proud to practise in the dental clinic. Female students demonstrated a significantly higher mean score of stress recognition (64.28 ± 18.98) than male students (56.98 ± 22.53) (P 0.004). The mean SAQ score increased significantly from fourth year students to interns (P < .001). CONCLUSIONS: A small percentage of students demonstrated a positive attitude of patient safety and only one-third attended a patient safety course. The job satisfaction domain was highly rated and patient safety culture significantly improved from junior to senior students. Dental curricula should include patient safety courses to improve the quality and safety of patient care.

Knowledge, Attitudes, and Clinical Practices of Dental Professionals during COVID-19 Pandemic in Pakistan.

OBJECTIVE: The aim of this study is to assess knowledge, attitudes, and clinical practices of dental professionals regarding the prevention and control of coronavirus disease 2019 (COVID-19) in Pakistan. MATERIALS AND METHODS: General dentists and dental specialists working in public and private dental practices, hospitals, and academic institutions participated in this cross-sectional study. A pilot-tested questionnaire was sent to dental professionals through an online link in Pakistan and data collection was completed in April-May 2020. The knowledge score was calculated from 22 variables about the COVID-19. RESULTS: The study included data of 343 dental professionals with 47.2% of males and 52.8% of females. The mean knowledge score was 16.78 ± 2.25, and it significantly differed between general dentists (16.55 ± 2.36) and dental specialists (17.15 ± 2.04) (p = 0.020), and those with up to 10 years of experience (16.58 ± 2.28) and those with more than 10 years of experience (17.05 ± 2.2) (p = 0.026). Only 15.5% of the participants were comfortable in treating patients during the COVID-19 pandemic. A workshop/seminar on the COVID-19 was attended by 23% of the participants. In multivariate analysis, being comfortable in treating patients (odds ratio = 3.31, 95% confidence interval = 1.63, 6.73) was associated with the attendance of workshop/seminar on COVID-19. CONCLUSIONS: Dental professionals had adequate knowledge about COVID-19, but a few of them were comfortable in treating patients during the pandemic. A minority of dental professionals attended a workshop/seminar on the COVID-19. Continuous education activities should be provided to dental professionals to enhance their role in the prevention of COVID-19 spread and promotion of oral health.

Association of body mass index and gross national income with caries experience in children in 117 countries.

Objective: To evaluate the association of body mass index (BMI) and gross national income (GNI) per capita with dental caries experience in children at population levels.Methods: This ecological study used global data of decay, missing, and filled teeth (DMFT), BMI, and GNI. DMFT data of 12 years old children from 117 countries were obtained from the World Health Organization. BMI data of children and adolescents from the same 117 countries were retrieved from the NCD Risk Factor Collaboration and GNI per capita from the World Bank. ANOVA test, Pearson's correlation coefficient (r), and multivariable linear regression were performed.Results: Globally mean BMI ranged from 16.1 to 22.2 in children. Low-income countries had the lowest BMI (17.41 ± 0.57) and high-income countries had the highest BMI (20.14 ± 0.87) (p < .001). The highest mean DMFT was observed in upper-middle-income countries (2.48 ± 1.16) and the lowest in low-income countries (1.22 ± 0.83) (p = .001). There was no significant correlation between BMI and dental caries (DMFT) (r = .063; p = .498). However, there were significant correlations between GNI per capita and BMI (r = 0.366; p < .001) and GNI per capita and DMFT (r= -0.252; p = .007). In multivariable linear regression, GNI per capita was negatively associated with caries experience in children (B= -1.83; p < .001).Conclusion: The study found that BMI was associated with income levels of the countries. GNI per capita significantly and negatively correlated with DMFT in children. Further investigation into the association between BMI and dental caries is warranted.

Predictors of Routine Dental Check-up Among Male Adolescents in Saudi Arabia.

OBJECTIVE: To evaluate the association of socioeconomic factors and self-perceived oral conditions with routine dental check-up among male adolescents. METHODS: This cross-sectional study was conducted on male children (grade 10-12) from public schools in different cities of the Eastern province of Saudi Arabia. A multistage random sampling was used for the recruitment of study participants. A piloted questionnaire translated into the Arabic language was used for data collection. RESULTS: There were 586 students with mean age 16.86±0.87 years. The prevalence of routine dental visit within last year was 18.9%. Half of the entire sample had dental cavities (50.5%) and tooth sensitivity (50%) followed by dental pain (42.2%). Bivariate analyses found that the children with dental cavities (OR 0.4, 95% CI 0.26, 0.61), dental pain (OR 0.63, 95% CI 0.41, 0.97), and malodor (OR 0.41, 95% CI 0.23, 0.71) had significantly lower odds of routine dental visits than those without these conditions. The final model of multivariable logistic regression showed that dental cavities (OR 0.42, 95% CI 0.27, 0.66) and malodor (OR 0.45, 95% CI 0.25, 0.78) were significantly associated with lower likelihood of visiting dental office for a regular dental check-up. No significant influence of socioeconomic factors on routine dental attendance was observed. CONCLUSIONS: A small proportion of children performed routine dental visits. The children with dental cavities and malodor were less likely to perform routine dental visits. The awareness about the importance of regular dental check-up should be raised to reduce the burden of oral diseases in schoolchildren.

A Study of Dentists about Their Knowledge and Practice of Dentine Hypersensitivity.

OBJECTIVE: The aim of this study was to evaluate the knowledge and practice about dentine hypersensitivity (DH) among dental practitioners. MATERIALS AND METHODS: A pilot-tested questionnaire was sent to practicing dentists (n = 588) working in private and public sectors in Lahore, Pakistan. The questions assessed dentists' knowledge about type of pain and predisposing factors of DH. The dentists were asked about their preferred methods of diagnosing and managing the condition. STATISTICAL ANALYSIS: Basic statistics, chi-squared test, and multivariate logistic regression were performed. RESULTS: Most dentists (64.3%) reported examining one to five patients with DH per week in their dental clinics. A large majority (85.4%) indicated DH as a stimulated short pain from a tooth. Recession of gums (96.6%), aggressive brushing (88.2%), and frequent use of teeth whitening procedures (83.1%) were most frequently reported predisposing factors of DH. Among most commonly used methods of diagnosis, spontaneous pain after the application of air blast was reported by 74.8% of the participants and followed by spontaneous patient report confirmed by dental examination (57.7%). Most widely used management approaches of DH included the use of fluoride products (96.2%), use of desensitizing potassium nitrate toothpastes (75%), and application of bonding agents (56.2%). Female versus male dentists (odds ratio [OR]: 7.79, p < 0.001) and private practitioners versus public dentists (OR: 7.34, p < 0.001) were more likely to examine greater number of patients with DH. CONCLUSION: Dentists used various methods for diagnosing and managing patients with DH. Application of air blast to evaluate spontaneous pain and use of fluoride products were most widely used diagnostic and management preferences, respectively.

Determinants of knowledge and practice of forensic dentistry amongst dental practitioners.

OBJECTIVE: To evaluate the determinants of knowledge and practice of forensic dentistry (FD) amongst dental practitioners. METHODS: This cross-sectional study was conducted on dental practitioners working in private and public sectors in the Eastern province of Saudi Arabia. A pilot tested self-administered questionnaire was distributed amongst an estimated sample of 323 dentists. Bivariate and multivariable logistic regression analyses were performed. RESULTS: In the study, 72.4% of the estimated sample returned completed questionnaires. There were 142 male (60.7%) and 92 female dentists (39.3%) in the study. There were 59 (25.2%) dentists who had the knowledge of FD and 27 (11.5%) handled the cases related to FD. Multivariable logistic regression showed that receiving FD training in undergraduate program (Adjusted odd ratio [AOR] = 10.31, 95% CI = 4.67-22.76), and updating the information of FD (AOR = 6.68, 95% CI = 2.81-15.86) were significantly associated with increased odds of having the knowledge of FD. Similarly, updating the information of FD (AOR = 7.56, 95% CI = 2.54-22.51) and having ≥5 years of clinical experience (AOR = 4.64, 95% CI = 1.00-21.40) were significant determinants of handling the cases of FD. The adjusted odds ratio for the maintenance of dental records was 4.16 times higher for specialists and consultants than general dentists. CONCLUSION: The study found that the dentists who received FD training had greater chances of having FD knowledge. Updating information about FD was associated with improved knowledge and practice of FD. Dental curricula should provide knowledge and skills of FD to students in undergraduate programs and the dentists should learn about FD through different educational sources.