Attitudes and knowledge of dental radiography amongst students of dentistry and related fields.

OBJECTIVES: This study aimed to evaluate the level of knowledge and attitude towards quality control in dental radiography amongst students of dentistry, allied dental sciences and radiologic technology programmes. METHODS: A cross-sectional survey was conducted using self-administered questionnaire on a convenience sample of 580 students from three universities in Jordan. The questionnaire was divided into sections that include personal sociodemographic variables, knowledge about quality assurance in dental radiography and attitude towards quality assurance in dental radiography. RESULTS: A total of 286 students completed the questionnaire (response rate = 49.3%), of whom 70% were women. The respondents' knowledge scores ranged from 12.2% (n = 35) to 35.2% (n = 100). The mean of the quality assurance knowledge scores for the whole study sample was 20.3% ± 14.5%, with no significant difference between men and women (p = .643). Allied dental sciences students showed significantly higher knowledge scores (25.0 ± 13.0) than dentistry (17.8 ± 14.40) or radiologic technology students (20.9 ± 14.8). The average attitude scores towards quality assurance in dental radiography were fairly good (69.5 ± 26.4) with no statistically significant differences by study programme. CONCLUSION: Knowledge of students about quality assurance in the three programmes is inadequate. The participants' attitude towards quality assurance was fairly good. The study provides feedback to dental schools to improve their curriculum by including quality assurance into student clinical practices. Further studies are requested to investigate the reasons behind this low level of knowledge.

Changes at global and site-specific DNA methylation of MLH1 gene promoter induced by waterpipe smoking in blood lymphocytes and oral epithelial cells.

Objective: Cigarette tobacco smoking has been shown to cause cancer through different mechanisms that include epigenetic modulation of tumor-suppressor genes. In the present study, the association between global and MLH1 gene promoter methylation and waterpipe tobacco smoking was investigated. Materials and Methods: Blood lymphocytes and oral epithelium were sampled from 150 pure waterpipe smokers and 150 never-smokers from Jordan. Methylation assessment was performed using the methylation-specific PCR technique for MLH1 gene and ELISA for global DNA methylation. Results: Significant increases were shown in global DNA methylation as measured in blood lymphocytes (p < 0.01). In addition, increases in MLH1 gene promoter methylation among waterpipe smokers compared to nonsmokers (p < 0.001) in both oral epithelium and blood lymphocytes was also observed. In addition, strong correlation was found between LWDS-10J dependence score and magnitude of promoter specific methylation of MLH1 (r2 = 0.74-0.78, p < 0.001). Moreover, the percentage of methylated MLH1 promoter was not affected by age or gender (p > 0.05). Discussion and Conclusion: Collectively, the results indicate that waterpipe tobacco use is associated with epigenetic changes that might predispose users to lung and blood cancers. The results highlight the need for actions to discourage waterpipe smoking and can be used in cessation interventions that target this type of smoking.

Plasma and saliva levels of three metals in waterpipe smokers: a case control study.

In this case-control study, the influence of waterpipe tobacco smoking on the plasma and saliva levels of cadmium, lead and zinc was examined in participants who were waterpipe tobacco smokers (WS) or never-smokers (NS). The concentration of metals was higher in WS relative to NS. The mean (SEM) cadmium concentration in plasma was 3.3 (0.18) µg/dL in WS versus 0.82 (0.09) µg/L in NS (p < .001) and in saliva was 5.1 (0.36) µg/L in WS versus 0.64 (0.2) µg/L in NS (p < .001). The mean (SEM) lead concentration in plasma was 5.2 (0.25) µg/dL in WS versus 3.4 (0.41) µg/dL in NS (p < .01) and in saliva was 4.8 (0.58) µg/L in WS versus 2.8 (0.27) µg/L in NS (p < .05). Similarly, a significant difference in zinc concentration was observed, with a mean of 2.0 (0.17) µg/mL in WS plasma versus 1.49 (0.16) µg/mL in NS (p < .05) and a mean 0.94 (0.07) µg/mL in WS saliva versus 0.45 (0.06) µg/mL in NS (p < .01). In conclusion, waterpipe tobacco smoking is associated with elevated levels of metals in body fluids. These results provide another demonstration of how waterpipe tobacco smoking exposes smokers to harmful toxicants.

The Effect of Waterpipe Smoking on Periodontal Health.

PURPOSE: To determine the effect of waterpipe smoking on periodontal health. MATERIALS AND METHODS: The study included 190 participants who were categorised into four groups; cigarette smokers, waterpipe smokers, dual smokers and nonsmokers. Intraoral examination included plaque (PI), gingival (GI) and calculus (CI) indices, probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP). RESULTS: The four groups differed significantly in the prevalence and extent of periodontal disease. Pairwise comparison tests showed that the means of percentages of sites with PPD > 3 mm, PPD > 4 mm, CAL > 1 mm and bleeding on probing were significantly higher among smoking groups compared to the nonsmoking group (p < 0.05). After adjusting for age, cigarette smokers (OR = 4.6), waterpipe smokers (OR = 4.3) and dual smokers (OR = 4.9) were significantly more likely to have periodontal disease compared to nonsmokers. When data were analysed according to the smoking method, no significant differences in the odds of periodontal disease were detected between different smoking groups (p > 0.05). CONCLUSION: Waterpipe tobacco smoking is not an alternative, safe way of smoking considering periodontal disease. Thus, global actions against waterpipe smoking are required.

Smoking-cessation practice guidelines: awareness and implementation among medical teams.

OBJECTIVES: The aim was to evaluate the awareness and implementation of the Smoking Cessation Clinical Practice (SCCP) guidelines. METHODS: A self-reported questionnaire based on the updated version of the SCCP guidelines was completed by 422 healthcare providers (HCPs) including physicians, dentists, dental hygienists and pharmacists recruited from both public and private sectors in Jordan. KEY FINDINGS: The majority of HCPs reported good smoking-cessation practices. However, their awareness about the SCCP guidelines was inadequate. Approximately 68% of HCPs lacked knowledge of the 5As; about 74% lacked knowledge of the 5Rs of the clinical guidelines for smoking cessation, which are the principal guidelines for smoking intervention and motivation to quit smoking. Fortunately, about 70% of participants from all groups examined and applied most of the steps in the guideline spontaneously without previous knowledge of the guideline. This spontaneous practice could be due to their vast practical experience, and the use of logic and/or basic knowledge about smoking cessation. Compared to physicians, pharmacists and dental hygienists showed significantly more frequent practice of most steps with patients willing to quit smoking. CONCLUSIONS: Jordanian HCPs showed good, spontaneous smoking-cessation practice. However, this practice could have been better if HCPs had adequate awareness of the SCCP guidelines.

Practices of Infection Control Among Dental Care Providers: A Cross Sectional Study.

BACKGROUND: A wide range of microorganisms poses a threat to patients and dental care teams. Implementation of safety guidelines is thus essential to prevent infection in dental clinics. AIM: To investigate the level of infection-control practices among dental health-care providers in Jordan. METHODS: A self-administered questionnaire was distributed to dental care providers from hospitals, academic institutions, and dental centres. The questionnaire covered sociodemographic variables, professional characteristics, and recommended guidelines of infection control. RESULTS: A total of 190 questionnaires were obtained out of 500 distributed questionnnaires (response rate: 38%). Females accounted for 62.6% of the sample and 64.7% were dentists. The majority was vaccinated against hepatitis B (82.1%) and wash their hands as usual behavior before (66.3%) and after (83.2%) treatment. Approximately 87.9% wear gloves and 78.9% wear masks while performing dental procedures. Autoclave sterilization and puncture-resistant containers for sharp instruments were used by 90.5% and 88.4%, respectively. The majority (81.0%) had protocols for emergency treatment of needle stick or other sharps accidents. High volume evacuation was used in 28.6% of public hospitals compared to 19.4% in academic institutions (P<0.01). In addition, surface barriers for dental unit surfaces were used by 70.2% of private dental clinics, 50% of public hospitals, and 36.1% of academic institutions (P<0.001). Finally, compared to dentists, dental support staff showed low compliance with infection-control guidelines. CONCLUSION: The overall practice of infection-control measures among the participants is very good. Educational programs and training strategies should be implemented to maximize and enhance the compliance of the dental care providers with infection-control guidelines.

Disinfection of dental impressions: knowledge and practice among dental technicians.

Background: Dental impressions are a common source for transmission of infection between dental clinics and dental labs. Dental impressions can be cross-contaminated by patient's saliva and blood, which then cross-infect the dental casts poured from the impressions. Objective: To evaluate the current practices of disinfection of dental impressions and their protocols and to assess the knowledge of cross-infection control among dental technicians in Jordan. Method: Dental technicians (n=85) completed a self-administered questionnaire about their practices of disinfection for dental impressions. Results: The distribution of dental technicians was 63.8% fixed prosthodontics, 23.5% removable prosthodontics, 7.8% orthodontics, and 4.8% maxillofacial prosthodontics. The majority of the laboratories did not have instructions related to disinfection of impressions. About 50% of technicians were vaccinated against HBV. About 44.7%, and 42.9% of labs reported that they never disinfect alginate or silicon impressions, respectively. In addition, the majority of lab owners (53%) believed that the dentist should disinfect the impressions before shipping them to dental laboratories, while (45%) believed that disinfecting the impressions is the responsibility of the dental assistant. Moreover, about 38% of this study population reported not using gloves in their labs. In those labs were disinfection was used, 51% used spray disinfection whereas 32.6% used immersion disinfection. The cost of disinfectant was ranked as the most important factor (51.3% of the cases) for the dental technician to choose the disinfectant followed by its effectiveness. Conclusion: Dental technician practices in impression disinfection was not satisfactory, therefore, education programs about impression disinfection are needed.

Comparison of Overall Fit of Milled and Laser-Sintered CAD/CAM Crown Copings.

BACKGROUND AND AIMS: The aim of this study was to investigate the effect of computer-aided design/computer-aided manufacturing (CAD/CAM) procedures on the overall fit of metal copings. MATERIALS AND METHODS: A standardized die was made in die stone of an upper right molar prepared for a full crown. The die was digitalized by an Identica Blue Light Scanner, and the coping substructure was designed using CAD software. Ten milled specimens and ten laser-sintered specimens were manufactured by Renishaw plc based on the generated file by the software. All twenty copings were digitized by the Identica scanner, and the data were superimposed with the original premanufacturing data file of the prepared full crown. Using the Geometric Modelling Library (GML) package, the fit discrepancies were displayed as colour maps showing discrepancies in three dimensions. Each map was made up of thousands of data points carrying numerical error values allowing detailed analyses. RESULTS: The milled group displayed a mean of fit discrepancies of 42.20 µm (SD 3.04 µm), while the laser-sintered group showed a mean of 42.24 µm fit discrepancies (SD 2.94 µm). Thus, a small difference of 0.04 µm between the two groups was detected. CONCLUSIONS: The evaluated manufacturing systems can be used in dental practice as a small and insignificant discrepancy of fit between the two manufacturing methods was detected.

Considerations and beliefs in tooth donation to research in Jordan.

BACKGROUND: Research that involves dental pulp stem cells (DPSCs) is growing rapidly. DPSCs can be used for the treatment of craniofacial bone abnormalities and tooth repair. The procedure requires a donation of sound teeth, which might be associated with ethical and moral issues. The purpose of this study was to understand the attitudes and awareness of patients with respect to the donation of their teeth to research. PATIENTS AND METHODS: This study involved 500 patients recruited from Dental Care and Dental Teaching Center in Irbid during May 2017-July 2017. RESULTS: A well-structured questionnaire was administered and prepared using Google forms and filled out using a tablet device. The majority of patients (62.8%) were willing to donate their teeth to research with significant association with educational level. Half of the patients considered that the donated tooth belongs to them even after extraction, whereas 19% believed that the researcher owns it after donation. Almost half (53.6%) of the participants wished to be informed about the type of scientific research that will be carried out on their teeth. The majority (66.5%) preferred to sign a consent document on tooth donation to research during the consultation visit before extraction. Finally, about 61% were worried that their tooth might be extracted for research purposes rather than medical purposes. CONCLUSION: A good fraction of Jordanian is willing to donate their teeth to research. Educational programs are demanded to enhance the awareness and attitudes of patients on the ownership of extracted teeth, consent process, and donation of teeth.

The role of PAX9 promoter gene polymorphisms in causing hypodontia: a study in the Jordanian population.

BACKGROUND: The congenital absence of one or few teeth, hypodontia, is considered one of the utmost dental ageneses in human beings. Several genes have been shown to be involved in the development of hypodontia such as paired box gene 9 (PAX9). The expression of PAX9 is controlled by several polymorphic elements in the promoter region of the gene on 14q13.3 locus. The aim of this study was to find any association between PAX9 c.-912T>C (rs2073247) and c.-1031G>A (rs2073244) promoter polymorphisms and the development of hypodontia among the Jordanian population. METHODS: Genotyping of the polymorphisms in 72 unrelated subjects with hypodontia was performed using PCR-restriction fragment length polymorphism (RFLP) technique and compared with that of 72 normal healthy unrelated control individuals. RESULTS: The hypodontia group had a significantly higher -1031GG genotype (P<0.01) and a significantly lower -912TC genotype (P<0.01) compared with the control group. The results suggest that the transcriptional activity of PAX9 gene is affected by polymorphisms in the promoter region of this gene and is associated with hypodontia phenotype. CONCLUSION: The rs2073247) and rs2073244 promoter polymorphisms of PAX9 might play a role in the development of hypodontia in the Jordanian population.

Patterns of self-medication among medical and nonmedical University students in Jordan.

BACKGROUND AND OBJECTIVE: Self-medication practice involves consumption of medicines by one's own initiative or on the consultation of others without the guidance of a physician. Self-medication and use of over-the-counter drugs are prevalent worldwide public health concerns. University students of medical and nonmedical disciplines may have different levels of health education. This study evaluated the prevalence and patterns of self-medication and the attitudes toward this practice among medical and nonmedical university students in Jordan. METHODS: A descriptive cross-sectional study was conducted in 504 students (medical: 248 and nonmedical: 256). The students were invited to complete a questionnaire that included questions primarily related to patterns of physician visits, self-medication practice, symptoms provoking self-medication, and sources of advice. RESULTS: Self-medication was highly prevalent and comparable between medical and nonmedical students (~96%). Headache (81.9%), cold (58.3%), and flu (53%) were the frequent symptoms provoking self-medication among students. Self-medication for headache (86.7% vs 77.3%) and tooth pain (53.1% vs 27%) was significantly higher among medical vs nonmedical students, respectively. Self-treatment with painkillers (82.3% vs 73%) or antiallergy (11.3% vs 5.9%) drugs was significantly higher among medical students, while the use of anti-flu decongestants (47.6% vs 60.2%) was lower compared to nonmedical students, respectively. Nonmedical vs medical students were significantly more dependent on friends (14.8% vs 7.7%) and own experience (7.4% vs 2.4%) as a source of self-medication advice. CONCLUSION: Self-medication is common among Jordanian university students of medical and nonmedical disciplines. This practice, if used irrationally, may constitute a health problem that needs awareness and interventions by health care regulators in Jordan. Future studies are warranted to examine the impact of self-medication on students' health.

Prevalence, social acceptance, and awareness of waterpipe smoking among dental university students: a cross sectional survey conducted in Jordan.

BACKGROUND: Waterpipe tobacco smoking is increasing in popularity especially among young adults. This spread could be related to limited knowledge of the negative health effects of waterpipe smoking. In this study, prevalence, social acceptance, and awareness of waterpipe smoking were examined among dental university students. METHODS: This is a cross-sectional survey study, where a self-administered questionnaire was completed by a sample of dental university students in Jordan. RESULTS: Students (n=547) reported current tobacco use of 54.3% for males versus 11.1% for females (P<0.005). Among current smokers, 3.5% used only cigarettes (22.0% males, 2.3% females), 12.6% used only waterpipe (36.6% males, 88.6% females), and 6.9% used both (41.5% males, 9.1% females). Approximately, 70% of males and 42.5% of females who used waterpipe reported smoking mostly at a café. Nearly half of the females reported that they smoke at home in the presence of parents. Among participants, 33.3% of males and 62.5% of females reported indifferent parents' reaction regarding their waterpipe smoking. Approximately one third of students agreed with the statement that waterpipe smoking is less harmful to oral health than cigarette smoking. About 50-70% of students agreed that waterpipe smoking causes halitosis, delays wound healing time, is associated with dental implant failure, and increases the risk of dental decay. CONCLUSIONS: In this sample, waterpipe tobacco smoking was more common than cigarette smoking among dental students, especially females. This could be an implication of social acceptance of waterpipe leading to its predominance, and thus, the gradual replacement of cigarette smoking with waterpipe smoking. Additionally, dental students' awareness about the harms of waterpipe is not optimal, and steps are needed to ensure providing such knowledge to students.