Malocclusion: Prevalence and Determinants among Adolescents of Karachi, Pakistan.

OBJECTIVES: The aim of this study was to determine the prevalence of malocclusion and its associated demographic and clinical factors in young adolescents (13-15 years) of Karachi, Pakistan. MATERIALS AND METHODS: An epidemiological survey included 500 young adolescents of registered schools, madrassas (Islamic education system), and shop workers of Gulshan-e-Iqbal Town. It was a cross-sectional analytical study design. Multistage random sampling technique was used to enroll participants. The pattern of occlusion was recorded with other related features using Angle's classification. Health status was recorded through World Health Organization-guided indices (decayed, missing, and filled permanent teeth [DMFT], community periodontal index of treatment needs [CPITN], and body mass index [BMI]). The information, thus, obtained was analyzed through SPSS using the chi-squared test and regression models. RESULTS: Forty four percent of the participants were female, while overall estimated prevalence of malocclusion in young adolescents of Karachi was 57.4%. After adjustments, participants going to any kind of education system had less malocclusion in comparison to those who were not going to any education system (adjusted odds ratio [aOR] = 0.305, 95% confidence interval [CI] = 0.12-0.73); mother's education especially higher level (aOR = 2.02, 95% CI = 1.08-3.75) and presence of periodontal disease (aOR = 1.57, 95% CI = 1.06-2.33) were significantly associated with malocclusion. CONCLUSION: This study showed that the class I malocclusion is prevalent in the local community. Demographic factors like gender, age, self-reported ethnicity, and BMI did not show any significant role. Education or knowledge of parents and young adolescents does play an influential role in decreasing malocclusion. Young adolescents, who are more prone to oral health problems at an early age, would have more chances to develop occlusal discrepancies.

Analysis of occupational stress, burnout, and job satisfaction among dental practitioners.

BACKGROUND: Dental practitioners can be prone to stress because of the long working hours, high patient expectations, and work environment. OBJECTIVE: To investigate dimensions of occupational stress among dental practitioners leading to burnout and to model its causality with job satisfaction. METHODS: An analytical cross-sectional study was conducted for five months. A sample of 302 practicing dental practitioners was selected using the consecutive sample technique. This sample included dental practitioners working in clinical and non-clinical departments of public and private sector universities as well as those doing private general practice. A self-administered structured questionnaire based on the Work Stress Questionnaire was sent using Survey Monkey. Descriptive statistics were calculated. Spearman correlation was applied between stress scores and job satisfaction. A Chi-square test was applied to look into the association between stress levels and different categories. Univariate and multivariate analysis was performed. RESULT: The prevalence of overall occupational stress was high among dental practitioners (83.4%). Occupational stress was greatest in females (55.8%), dental practitioners in the private sector (55.7%), and general dental practitioners (GDPs) (47%). The overall prevalence of job satisfaction among dental professionals was 30%. Occupational stress was significantly associated with burnout and job dissatisfaction in dentistry. Stress levels and working hours were statistically and positively associated, whereas the association between stress levels and job satisfaction was inversely and significantly associated. CONCLUSION: The prevalence of occupational stress among dental practitioners was high and the level of job satisfaction was moderate. The model between these variables was well-fitted.

Dimensional changes in alginate impression during immersion in a disinfectant solution.

OBJECTIVE: To determine the effect of a commercially available disinfectant solution (Perform ID) on the dimensional stability of two different commercially available alginate impression materials. METHODS: Linear changes in standardized impression samples (1.5 mm & 3.0 mm thickness) made in two commercial alginates were recorded at 5 minute intervals, over a period of an hour after immersion in a disinfectant. The alginate impression samples were prepared placing the alginate mixes into a wax mould. After the material had set, each of the samples was removed from the mould. It was then placed in a Polytetraflouroethylene (PTFE) trough before measuring the dimensional changes using a Chesterman travelling microscope. RESULTS: 3mm BluePrint Cremix showed greater shrinkage than 3mm Hydrogum. While, 1.5mm Hydrogum appeared to have uniformly greater shrinkage as compared to 1.5mm BluePrint Cremix. There was significant difference between 1.5 and 3mm thicknesses of both Hydrogum and BluePrint Cremix (PAIRED SAMPLE t test p < 0.05). The 1.5mm samples showed much higher shrinkage than 3mm samples. CONCLUSION: Immersion of the alginates in the same disinfectant showed variable linear shrinkage indicating that slight changes in composition could lead to variable results. In addition, there were significant differences in the linear shrinkage between the two thicknesses of the same alginate material; this indicates the possibility of distortion in actual impressions where the geometry is complex.

Relationship between work-related ocular events, facial injuries and associated factors amongst dental professionals during COVID-19.

BACKGROUND: In dental settings, COVID-19 can be transmitted directly from patients to dentists through small droplets, saliva splashes, blood, and other body fluids liberated as a result of dental procedures. OBJECTIVE: To determine the prevalence of ocular and facial injuries in dental professionals and to investigate factors in dental practice contributing to ocular injuries. METHODS: An analytical cross-sectional study was performed in public and private sector universities. The study had 301 participants including final year undergraduate students, interns, postgraduate trainees, general practitioners, and dental specialists. Data were gathered online using Google forms. Information on sociodemographic, practice details, history of ocular and facial encounters during the clinical experience, and protective measures adopted by the dentists were collected. Means and standard deviations were calculated for continuous variables whereas frequencies and percentages were calculated for categorical variables. A Chi-square test was applied for association between variables. RESULTS: Ocular events and facial injuries occurred more in females 204 (67.8%) than in males 97(32.2%). Final year students reported more incidence of ocular encounters than specialists (40.9%, 3.3%). Dentists working in the government sector underwent more ocular encounters than those in private sectors 185(61.4%) and 96 (31.8%). Majority of participants reported that scaling was the procedure in which dentists experienced an ocular event. A significant association was found between ocular events, qualification, years of experience in clinical practice, number of patients treated per day, improper posture, and proper armamentarium (p < 0.05). However, no association was found between ocular events, gender, working sector, and dental procedures. CONCLUSION: Occurrence of ocular injuries were high compared to facial injuries and these outcomes were dependent on dental expertise and experiences. Appropriate measures should be adopted to minimize the risk of disease transmission and COVID-19 through the eyes among practicing dentists.

Association of Dental Caries and Anthropometric Measures among Primary School Children.

Aim: This study aimed to investigate an association between dental caries status and anthropometric measures in primary school children. Methods and Materials: An analytical cross-sectional study (n = 376) was conducted among primary school children (age range = 6-9 years) registered in private schools. Non-clinical data was gathered from parents of participating children through a self-administered structured questionnaire as well as from the children through an interviewer-administered questionnaire. Clinical data included the examination of dental caries using dmft/DMFT index and anthropometric measures including calculated z-scores of height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BAZ), and physical examination. Inferential statistics included Kruskal Wallis and linear regression for univariate and multivariate analysis respectively. Results: The proportion of dental caries in primary and secondary dentition was 67.6% and 8.2% respectively. A significant association was observed between dental caries status and HAZ, WAZ, and BAZ (p < 0.001). An inverse relation was found between low, medium, and high dental caries categories and anthropometric measures. Conclusions: In the primary dentition, dental caries were significantly and inversely related to weight-for-age, height-for-age, and BMI-for-age. Hence, it can be concluded that among the low-income population dental caries is associated with lower anthropometric outcomes in children and therefore caries management should be considered an approach impacting overall health and quality of life.

Association of Self-Perceived Psychological Stress with the Periodontal Health of Socially Deprived Women in Shelter Homes.

The present study aimed to assess the effect of self-perceived psychological stress on the periodontal health of socially deprived women. The study included three hundred and eighty-five socially deprived women residing in shelter homes. The presence of stress and its severity was assessed by using Sheldon Cohen's 10-item perceived stress scale (PSS), and periodontal health status was assessed utilizing the community periodontal index. Statistical analyses were performed using an independent sample t-test, a one-way ANOVA, the Pearson chi-Square test, and binary logistic regression. Results: A total of 385 samples were included, the majority of whom (n = 297; 72.5%) belonged to the age group of 15-30 years. There were 34 (8.8%) participants who were educated up to graduate level. A total of 47.8% of the women were found with healthy periodontal status, and 52.5% of the samples were diagnosed with major psychological stress. Half of the samples (201-52.2%) had a periodontal problem. The mean PSS was found statistically significant concerning age group, education, and psychological stress level. In the univariate logistic regression analysis, a significant association of periodontal status was observed with the age group 31-45 years [(OR = 1.76; 95% C.I (1.11-2.78)] and with a major psychological stress level [(OR = 2.60; 95% C.I (1.72-3.93)]. Psychosocial stress among socially deprived women was found to be a risk factor for periodontal disease.

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 salivary gland hypofunction with diabetes mellitus and drugs among the elderly in Karachi, Pakistan.

AIM: Studies from Pakistan on salivary dysfunction are lacking, and the Pakistani elderly population is rapidly growing. Among the most common problems in the elderly that could have a deleterious impact on their quality of life are salivary gland hypofunction (SGH), diabetes mellitus (DM), and the intake of drugs with adverse effects on salivary function. In the present study, we aimed to find the association of SGH with DM and drugs among the elderly in Karachi, Pakistan. METHODS: The inclusion criterion was affirmative answers to a series of standardized questions related to the symptoms of dry mouth. A total of 110 individuals were selected from a convenience sample of 200 people aged between 60 and 70 years. Diabetes, drug use, and SGH in the participants were determined by detailed medical and drug history, clinical examination, and sialometry. RESULTS: Similar to their international counterparts, the majority of the study participants demonstrated objective evidence of SGH. More importantly SGH was found to be statistically significant with respect to DM and medication (P < 0.05). For participants on medication, the minimum and maximum salivary flow rates were found to be 0.09 mL/min and 0.3 ml/min, respectively, whereas the minimum and maximum salivary flow rates in diabetic participants were 0.01 mL/min and 0.09 mL/min, respectively. CONCLUSION: In the present study, the majority of elderly participants whose presenting complaint was oral dryness was found to have objective evidence of SGH, with a statistically-significant association with DM and drugs.