General dentists' readiness and barriers in intimate partner violence screening: a cross-sectional study in Jeddah City.

BACKGROUND: Intimate partner violence (IPV) has varying prevalence rates and risk factors based on cultural, social, and economic backgrounds. However, it is common for IPV victims to be seen in dental settings on a regular basis. Identifying IPV victims in dental settings might help address this overlooked global dilemma. This study was conducted to evaluate general dentists' readiness and potential barriers to performing IPV screening in a dental setting. METHODS: A cross-sectional study was conducted using the Domestic Violence Healthcare Providers Survey (DVHPS). This validated and structured questionnaire was adopted, modified, and self-administered to evaluate general dentists' readiness and barriers to IPV screening. General dentists were recruited for the study population from 5 administrative territorial regions in Jeddah, Saudi Arabia. The questionnaire consists of 7 domains that assess general dentists' readiness and barriers to performing IPV screening for all dental patients. RESULTS: Out of the 273 dentists approached, a total of 200 participated in the study, with a total response rate of 73.3%. The percentages of female and male dentists were 54% and 46%, respectively. Almost 73% of the study population believed they could identify IPV in a dental setting. The multiple linear regression model indicated a substantial decrease in general dentists' readiness to perform IPV screening due to fear of offending patients, an increased number of patients treated per day, and professional role resistance. CONCLUSION: The current study suggests the high readiness of general dentists to perform IPV screening for all patients. However, prominent barriers to implementing IPV screening for all patients include fear of offending patients, an increased number of patients treated per day, and professional role resistance. Postgraduate continuous education is encouraged to re-enforce the importance of IPV screening in dental settings.

Prevalence of Intimate Partner Violence and Endodontic Treatment Needs: Pilot Study.

Objective: The aim of this study was to assess the prevalence and potential association between intimate partner violence (IPV) with traumatic dental injuries (TDIs) and the subsequent need for root canal treatment (RCT). Methods: A total of 100 subjects with TDIs presented at emergency or postgraduate restorative clinics at University Dental Hospital, King Abdulaziz University, Jeddah, Saudi Arabia post-TDI. All study subjects completed the Hurt-Insult-Threaten-Scream (HITS) domestic violence screening tool and were clinically and radiographically examined to determine the type of TDI they suffered along with the pulp and periapical status of affected teeth. Demographic data were also recorded. Based on the findings, management included regular follow-up, splinting, reattachment of broken tooth part, vital pulp therapy and/or RCT as seen appropriate. Results: Mean age of participants was 28.4±5.7 years. Prevalence of IPV among subjects presented with TDIs was 18%. Most of the IPV victims held a bachelor's degree (67%) and were unemployed (61%). Most of TDI cases were crown fracture (84%) followed by luxation and avulsion (10% and 6%, respectively). Among all TDI cases, 73% required RCT. Crown fracture was the most prevalent TDI among IPV victims followed by luxation and avulsion with prevalence of 56%, 33%, and 11%, respectively. Out of a total of 73 patients requiring RCT, nine were IPV victims (12.3%) which indicated that one of each eight TDI cases requiring RCT might be a potential IPV victim. Half of the IPV victims required RCT to manage their TDIs. Conclusion: Prevalence of IPV among TDIs was 18%. IPV screening should be included as routine assessment part for TDIs. Identification of IPV victims could be difficult, however, employment status, type of TDI, and RCT needs were suggested as potential predictors of positive IPV cases.

The Effect of Number of Patients Treated, Dental Loupes Usage, Stress, and Exercise on Musculoskeletal Pain among Dentists in Jeddah.

OBJECTIVES: The aim of this study was to investigate the prevalence of musculoskeletal pain (MSP) and to explore its potential risk factors among dentists in Jeddah, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional survey of private and government dentists in Jeddah, Saudi Arabia was undertaken between January and December 2018. A self-administered questionnaire was distributed randomly to consenting participants. Descriptive data analysis involved measures of central tendency and percentages, t test, chi-square, and logistic regression analysis were used to evaluate relationships among the variable "having MSP experience after dental work" and other potential predictors among dentists. RESULTS: A total of 300 dentists completed the questionnaires. The overall prevalence of MSP was 68%, with back pain as the most frequently reported symptom (54%). The results revealed significant association of MSP with number of patients treated per day, nonuse of dental loupes during dental work, stress, and lack of regular exercise (P < 0.05). CONCLUSION: The prevalence of MSP among dentists in Jeddah is high attributable to poor ergonomics and stress, which further impact the quality of life of practitioners.

Effect of light irradiation condition on gap formation under polymeric dental restoration; OCT study.

OBJECTIVE: To investigate the effect of two light-curing systems; quartz tungsten-halogen (QTH) and light-emitting diode (LED), and irradiation time on interfacial gap formation of dental composite resin restorations bonded with an adhesive resin using optical coherence tomography (OCT). MATERIALS AND METHODS: Forty cavities were prepared in extracted human molar teeth and divided into four groups (n=10) based on the type of light curing system QTH (LITEX 680A) and LED (Demi Plus) and curing duration (10 s or 40 s). A single-step self-etching dental adhesive (Tetric® N-Bond; Ivoclar Vivadent AG, Schaan, FL, Liechtenstein) was applied and polymerized with QTH for 10 s (QTH-10), or for 40 s (QTH-40). Similarly, the adhesive in LED-10 and LED-40 groups was polymerized with an LED for 10 s or 40 s, respectively. Then, all specimens were restored with Filtek™ Z350 XT flowable composite (3M ESPE AG, St. Paul, MN, USA) and immersed in ammoniacal silver-nitrate contrasting solution. Cross-sectional images were recorded at every 250µm using cross-polarization OCT system (CP-OCT; IVS-300, Santec, Komaki, Aichi, Japan). Image analysis to quantify the percentage of gap at resin-dentin interface was performed using a custom plugin for ImageJ software. RESULTS: Data analysis using one-way ANOVA showed a significant difference in mean gap percentage between the four test groups (p<0.0001). Mean gap percentage values were 75.8%, 53.2%, 9.9% and 5.6%. The highest for LED-10 followed by LED-40 (p <0.05). QTH-40 revealed a slightly better adaptation compared with QTH-10, but the difference between them was not significant (p <0.05). CONCLUSION: CP-OCT with a contrast agent is a useful non-invasive imaging tool for dental composite resin materials. QTH showed better results than LED under the experimental conditions. When using an LED light-curing unit, prolonged irradiation improved interfacial adaptation of dental composite bonded with a self-etching adhesive.

A Cross-Sectional Study of Empathy Among Dental Students at King Abdulaziz University.

Empathy is the fundamental substructure of moral behavior. Skillful clinicians may not necessarily be successful dentists if they do not have sufficient empathy. The aim of this study was to assess the level of empathy among dental students at King Abdulaziz University with an emphasis on the effect of gender and study level. A cross-sectional study was carried out among third- to sixth-year dental students of King Abdulaziz University in Jeddah, Saudi Arabia. A validated, self-administered Jefferson Scale of Empathy-Health Care Provider Student Version was distributed in academic year 2016-17 to all 380 students in the third to sixth years. A total of 300 students responded, for a response rate of 78.9%. The results showed that the students' mean empathy score was 84.84±11.28 on a range from 20 to 140. The fifth- and sixth-year students had higher scores than the third- and fourth-year students although the differences were not statistically significant. The mean empathy score of women students was significantly higher (p<0.001) than that of men students, and the women demonstrated significantly better perspective-taking (p<0.001) than the men. This study found that the students were empathetic and had a sense of moral obligation although their mean empathy score was not as high as expected. Integrating empathic, ethical, and professional elements into the dental curriculum is needed.

Evaluation of microleakage in class-II bulk-fill composite restorations.

BACKGROUND/PURPOSE: Despite the clinical appeal of restoring deep class II cavities in single increment using bulk-fill resin composite, sealing of bulk-filled composite restorations is a concern. This study evaluated interfacial adaptation of bulk-fill composite restoration to axial wall and gingival floor of class II cavities using cross-polarization optical coherence tomography (CP-OCT). MATERIALS AND METHODS: Box-shaped class II cavities were prepared in extracted molars and divided into three groups (n = 7) according to adhesive used; Clearfil SE Bond 2 (SE2), Tetric-N Bond Self-Etch (TSE) or Tetric-N Bond Universal (TNU). All adhesives were applied in self-etch mode and according to manufacturers' recommendation. Then, preparations were bulk-filled with Filtek Bulk Fill Posterior Restorative resin composite and immersed in a contrast agent. Tomographic images of axial wall and gingival floor of each restoration were obtained by CP-OCT (IVS-300, Santec) with a central wavelength of 1330 nm and were imported to an image analysis software to quantify microleakage. RESULTS: Mann-Whitney U test showed statistically significant difference in microleakage percentage between the groups at both axial wall and gingival floor (p < 0.05). SE2 group had the lowest percentage of microleakage (p < 0.05), as only few cross-sections showed areas of reflections from contrast agent penetrating into axial wall (8.23 ±â€¯6.8) and gingival floor (7.07 ±â€¯4.1), followed by TNU group (18.13 ±â€¯12.9 axially and 30.61 ±â€¯11.9 gingivally). Microleakage was frequently observed at the axial wall and gingival floor of TSE group, showing the highest percentages of 25.50 ±â€¯12.5 and 36.97 ±â€¯10.2, respectively (p < 0.05). CONCLUSION: All tested groups exhibited different extent of interfacial microleakage, however, two-step self-etch adhesive yielded superior adaptation in comparison to one-step self-etch adhesive and universal adhesive.

HIV-Related Discrimination among Senior Dental Students in Jeddah.

AIMS AND OBJECTIVES: Advances in the medical management of HIV infection have increased life expectancy and reduced the mortality rate of infected individuals. As a result, dental and medical health-care workers have a higher chance to meet HIV-positive patients in their clinics. People living with HIV and AIDS (PLWHA) are frequently experiencing discrimination. That negative attitude toward HIV remains quite common among health-care professionals. The purpose of this study was to assess students' attitudes toward PLWHA. MATERIALS AND METHODS: The present study was a cross-sectional survey to assess the attitudes of senior dental students toward HIV/AIDS in Jeddah, Saudi Arabia. Data were collected using an online self-administered questionnaire. Data analysis was done using the statistical package of social sciences. Descriptive statistics including means, standard deviations, frequencies, and percentages were calculated and used to present the data. A binary logistic regression model was constructed to estimate the effect of different predictors on the level of HIV-related discrimination. RESULTS: A total of 400 individuals took part in the study. Bivariate analysis of HIV discrimination in relation to other variables showed that those reluctant to treat HIV patients, the majority (82%) showed a negative tendency toward HIV/AIDS patients, while 75% who were willing to treat them exhibited more positive attitudes, which was statistically significant (P < 0.0001). The discrimination was high, almost 87%, among those who feared accidental exposure to HIV patients; however, 73% of those who did not experience fear, felt nondiscriminative, which was also statistically significant (P < 0.0001). CONCLUSIONS: Stigmatizing views toward PLWHA exist among senior dental students in Jeddah. The most significant predictors of discrimination included fear of accidental exposure, reluctance to provide treatment to these patients, and self-protective concerns.

Masking a Metal Cast Post and Core Using High Opacity e.max Ceramic Coping: A Case Report.

RATIONALE: Advancements in dental biomaterials have led to the introduction and application of ceramic-based restorations in dental practice. Currently, ceramic restorations are used in crowns and fixed partial dentures. The optical properties of ceramic restorations are comparable to natural teeth in terms of light scattering and transmission. However, the translucency of ceramic restorations could be a limitation if cemented over metal posts or severely discolored dentin. Therefore, accomplishing the maximum esthetic outcome mandates adequate management of severely discolored foundation. PATIENT CONCERNS: The patient wanted to improve the esthetic of his anterior teeth. DIAGNOSIS: This case report describes a clinical case in which the patient had defective restoration in his upper anterior teeth and base-metal cast post and core in his left lateral incisor (tooth #22). INTERVENTIONS: Metal-free full crowns were used in the anterior zone of the maxilla with the help of e.max HO (high opacity) coping to mask the dark core buildup of the base-metal post and core on tooth #22. OUTCOMES: The color of the substrate was masked completely. The esthetic of the anterior teeth was improved and the patient was highly satisfied with the outcome. LESSONS: e.max HO coping offers clinically acceptable masking ability.

Human immunodeficiency virus related discrimination in general dentistry.

OBJECTIVES: To investigate HIV related discrimination among general dentists in Jeddah, Saudi Arabia; and to list factors affecting or causing healthcare providers to discriminate people living with HIV (PLWH). Methods: The current study takes place in Jeddah, western Saudi Arabia. The duration for accepting all responses was between March and November, 2017. In this cross-sectional study, we used a self-administered, structured questionnaire. The sample size was 430 general dentists practicing in Jeddah, Saudi Arabia. Descriptive statistics, mean, and standard deviation were calculated. Bivariate and multivariate analysis was carried out at p less than 0.05 level of significance. The Statistical Package for the Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY, USA) was used for data analysis.  Results: In our study population, the total HIV related discrimination was 67.4%. Approximately 98.1% defer PLWH to the last appointment of the day, while 84.7% refer them to specialists. Furthermore,100% reported wearing double gloves, and 94.7% where wearing protective eye shields if they encounter HIV-patient in the clinic. Male participants were found to be 23% more likely to be discriminative compared to female participants, Moreover, participants who are confident to provide both surgical and non-surgical dental treatment for PLWH were found to be 52% less likely to be discriminative towards PLWH. Also, HIV discrimination is 33% higher in the private practice compared to the governmental practice.   Conclusion: Human immunodeficiency virus related discrimination in the study population was affected by dentists' gender, type of practice, and self-protective attitudes.

Effect of anterior crowding or spacing on oral health-related quality of life: a cross-sectional study.

INTRODUCTION: Oral health-related quality of life (OHRQoL) involves many aspects such as chewing ability, sleeping, social interactions, self-esteem, and satisfaction with life and oral health. The increasing research interest in OHRQoL began only after the shortcomings of previous approaches of treating symptoms only and neglecting the patient's self-perception were revealed. PATIENTS AND METHODS: The current study design is a cross-sectional study of patients who attended King Abdulaziz University Dental Hospital (Jeddah, Saudi Arabia) and King Saud University Dental Hospital (Riyadh, Saudi Arabia). After obtaining their verbal consent, young adult and adult patients (mean age 25.19±7.29 years old) with anterior spacing or crowding were recruited to participate in the study. They filled the Arabic short version of the oral-health impact profile-14 questionnaire after a clinical evaluation of the severity of their spacing or crowding. Parameters of spacing/crowding severity assessment were as follows: <4, mild; 4-8, moderate; and >8, severe. Data were analyzed using the chi-square test in SPSS statistical package. The level of significance was set to <0.05. RESULTS: The sample size of this study was 308 subjects. Findings indicated a statistically significant (p=0.001) association between anterior spacing malocclusion (ASM) with Q5 "self-consciousness", since 64.2% of patients with ASM reported being self-conscious. Results indicated a statistically significant association between educational level with anterior crowding malocclusion (ACM; p=0.02) and ASM (p=0.01) with Q3 "painful aching". Moreover, findings indicated a statistically significant association (p=0.04) between income and ACM with Q5 "self-consciousness". On the other hand, results showed no significant association between gender with either ACM or ASM. CONCLUSION: This study sheds light on how anterior malocclusion (crowding or spacing) impacts OHRQoL negatively, especially heightening self-consciousness about their appearance. These effects should be addressed by the orthodontist during the course of treatment.

Innovative Integration of Facebook Groups in Biomaterials Course: Perception of Dental Students.

BACKGROUND: Calls for incorporating Facebook into the academic process to achieve educational purposes were done since more than 10 years. OBJECTIVES: This study was designed to assess the perception of the dental students towards the use of Facebook in learning of the Biomaterials course and to determine if there is a gender-based difference in the students' perception. SUBJECTS AND METHODS: This cross sectional study was conducted on the 3rd year undergraduate dental students, at one of Saudi universities during the academic year 2016-2017 using a self-administered questionnaire that was distributed to all students with a response rate 100%. Data was analyzed using the SPSS version 16. RESULTS: The female students were significantly more satisfied with the course than the male as they wanted to use Facebook to study the other topics of the Biomaterials course (p=0.01) as well as to study the other subjects (p=0.012) and they thought that Facebook can be used for scientific discussion (p=0.01).The willing to use Facebook in future learning was high among the female students but with no significant difference between both males and females. It was unexpected to find low agreement score among the participants on their preference to have assignments, movies, feedback or even reminders on Facebook with no significant difference between males and females. CONCLUSION: Integrating learning through Facebook groups into the dental courses was generally well-perceived among the dental students and specifically accepted for the Biomaterials course. Students were willing to apply such model in other dentistry subjects. Further investigation of the impact of the approach on students' performance is recommended.

Dentists awareness and action towards domestic violence patients. A cross-sectional study among dentists in Western Saudi Arabia.

OBJECTIVES: To identify the potential factors that would predict a dentist's awareness of domestic violence (DV), as well as the factors that influence the probability of dentists to take the required action. Also, to list the common barriers that dentists face when managing DV victims. Methods: In this cross-sectional study, a self-administered, structured questionnaire was sent randomly to dentists practicing in Jeddah, Saudi Arabia. The online survey link was emailed with a cover message that illustrated the study context. Responses were accepted from January 2016 until the end of February 2016. The Statistical Package for the Social Sciences version 22 was used for data analysis. Descriptive statistics, bivariate and multivariate analysis carried out to identify significant variables at p less than 0.05 level of significance.  Results: A sample size of 151 responses were recruited. The result of multivariate models indicated that the odds of dentists' awareness and taking actions towards DV victims were influenced by their education, clinical experience, gender, practicing sector, and qualification. Lack of training in identifying DV and embarrassment to bring up DV with patients were the most common barriers for the respondents when treating DV victims. Conclusion: Continuing education with regards to DV was found to be the most relevant predictor. More educational courses in this regard would empower dentists to support DV victims.