Knowledge, attitude and practices of Saudi dental hygiene students towards novel corona virus disease (COVID-19): A nation-wide study.

INTRODUCTION: Healthcare workers involved in procedures that generate aerosol or handling patient specimens are associated with a high possibility of COVID-19 infection. Thus, it is very important for the health workers to understand the knowledge related to transmission, prevention and protocols of COVID-19. METHODS: Cross-sectional questionnaire study was conducted on dental hygiene students in Saudi Arabia. An online version of pre-tested and validated questionnaire was used to test the KAP for COVID 19. RESULTS: The mean score for knowledge-related questions was found to be 2.91 ± 1.59, attitude-related questions to be 2.84 ± 1.41 and for practice-related questions to be 4.20 ± 1.36. After converting the scores into percentages, any score <60% was categorized as poor score, 60%-80% as average score and >80% as good score. Students showed poor knowledge and attitude towards COVID-19. But the practice of dental hygiene students towards COVID-19 was found to be good with the score of 83.4%. CONCLUSION: The outcome of this cross-sectional study shows that most of dental hygiene students studying in Kingdom of Saudi Arabia are following good practices towards COVID-19 inspite of having poor knowledge and attitude.

In vitro assessment of the effect of probiotic lactobacillus reuteri on peri-implantitis microflora.

BACKGROUND: Probiotics affect both the development and stability of microbiota by altering the colonization of pathogens and thus helps in stimulating the immune system of the individual. The aim of the present study is to assess the effect of probiotics on peri-implantitis microflora, by determining the minimum inhibitory concentration (MIC) of Lactobacillus reuteri, that can be effectively administered as an antimicrobial agent on specific peri-implantitis pathogens. Hence, this study will be helpful in finding the MIC of L. Reuteri that can be effectively administered as an antimicrobial agent on specific peri-implantitis pathogens. METHODS: This experimental research was conducted on patients visiting the periodontology department in M. A. Rangoonwala college of dental sciences and research centre. Sub-gingival plaque samples were collected from peri-implantitis patients to identify various peri-implantitis microorganisms. The identified microorganisms were compared to each other and Chi-Square test was used to calculate statistical significance. The isolated microorganisms were subjected to the effect of probiotic Lactobacillus reuteri in-vitro. Minimum inhibitory concentration (MIC) was assessed using serial dilution method. RESULTS: The research results showed the presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Streptococcus salivaris and Staphylococcus aureus in the subgingival samples from peri-implantitis patients. Statistically, significantly higher proportion of samples had Porphyromonas gingivalis. When subjected to the effect of L. reuteri, all the microorganisms were affected by L.reuteri except Aggregatibacter actinomycetemcomitans. CONCLUSION: This study provides the various MIC value for each isolated pathogen against L.reuteri. The authors recommend to avoid using standard guidelines for probiotic dose in the treatment of peri-implant infections as the antimicrobial profile is different for each periodontal pathogen.

Prevalence of dental caries in Pakistan: a systematic review and meta-analysis.

BACKGROUND: Optimum oral health is impossible to achieve without managing dental caries. The first step to manage dental caries at a community level is to know its prevalence and trend. Unfortunately, the prevalence of dental caries at the national/regional level is not known in many developing countries. Pakistan is no exception. The present meta-analysis was planned to document the prevalence of dental caries at the national, as well as regional level. This paper will serve as a baseline for making future health policies, and health promotion activities in the country. METHODS: Literature was searched through various databases, such as PubMed, SCOPUS, and Web of science using: "Prevalence", "Dental Caries", "Dental Decay" and "Severity" as keywords. Any study that reported the prevalence of dental caries, and was conducted in the Pakistani population was included. Thirty studies fulfilled the inclusion criteria. Quality assessment of all the included studies was performed using Joanna Briggs Institute (JBI) critical appraisal checklist for prevalence studies. MedCalc software was used to analyze the data. RESULTS: In total 27,878 subjects were included in a meta-analysis from 30 studies. The prevalence estimate of dental caries at the national level was 56.62% (95% CI: 49.54 to 63.57). The I2 value was 99.07% (95% CI: 98.94 to 99.18), (I2 > 75%) indicating heterogeneity, hence pooled proportion was reported using a random-effect model. The prevalence estimate of dental caries in Sindh was 58.946% (95% CI: 43.796 to 73.274), and in Punjab, it was 55.445% (95% CI: 44.174 to 66.44), whilst in Baluchistan and KPK combined was 51.168% (95% CI: 22.930 to 79.004). CONCLUSION: Based on the existing data nearly 60% of the Pakistani population have dental caries. The proportion is almost the same in all provinces. Most of the included studies were found to be of high risk.

Psychological Impact of the COVID-19 Pandemic on Dental Hygiene Students in Saudi Arabia: A Nation-wide Study.

AIM: Worldwide healthcare professionals are experiencing constant stress during their day-to-day work due to coronavirus disease-2019 (COVID-19) pandemic. Students' anxiety tendency has also been increased due to the disturbance of education. This study aims to evaluate the anxiety and depression levels of dental hygiene students in Saudi Arabia during COVID-19 lockdown period. MATERIALS AND METHODS: A cross-sectional study was conducted among the dental hygiene students in Saudi Arabia to assess the psychological impact of the COVID-19 outbreak. Questionnaire was distributed to the students, which consisted questions regarding demographics, knowledge, and fear related to COVID-19 and validated self-reported anxiety screening scale (GAD-7), to assess the psychological impact. All the data were then subjected to statistical analysis. RESULTS: Students from King Abdul Aziz University and Prince Sattam University showed statistically higher anxiety score when comparing the GAD-7 questions. Students whose parents were unemployed during pandemic and the students from rural area had statistically greater anxiety level when compared to others. Also, anxiety levels were found to be significantly higher among students who slightly feared contacting the disease because of their profession. CONCLUSION: The present results demonstrate that dental hygiene students suffered from some form of anxiety ranging from mild anxiety to severe anxiety, reporting that they frequently felt nervous and were scared that something terrible would happen. Psychological well-being of healthcare professionals is necessary for the optimal treatment of patients. CLINICAL SIGNIFICANCE: Anxiety is considered as an important factor for healthcare students that may influence negatively on their personal and academic life. Thus appropriate assessment and offering immediate treatment will prove beneficial to prevent serious consequences.

Assessment of Role of Bisphosphonates on Dental Implant Treatment in Post-menopausal Ladies.

Objectives: To examine the impact of bisphosphonates (BPs) on dental implant treatment and alveolar bone in post-menopausal ladies. Materials and Methods: Twenty post-menopausal ladies who had at least one dental implant within the previous 5 years participated in the current study. Ten subjects were categorized into two groups: Group A had BP medication for 1.5 years, and group B received parathyroid hormone (PTH). Both groups' bone thickness and bone mineral density (BMD) were measured. Result: Group A had 5%, and group B had 5% of dental implants failures. BMD of cortical bone was 1468 ± 136 mg/mL and 1008 ± 84 mg/mL in groups A and B, correspondingly. The cortical and cancellous bone densities in both the groups were statically significant. Cortical bone thickness was insignificant in comparison. Conclusion: Both cortical and cancellous bones' bone mineral density decreased in both groups. With continued usage of BPs, the cortical bone thickness increased.

Human papillomavirus, tobacco, and poor oral hygiene can act synergetically, modulate the expression of the nuclear factor kappa B signaling pathway for the development and progression of head and neck cancer in the Pakistani population.

BACKGROUND: Head and neck cancers (HNCs) are a heterogeneous group of tumors that progress owing to varied enviromental and genetic risk factors. Viral infections are threatening and adept at altering the expression of cellular transcription factors such as nuclear factor kappa B (NF-κB) and deregulation of other cellular proteins like NF kappa B inhibitor alpha (IκBα). The present study was conducted to detect high-risk genotypes of human papillomavirus (HPV) and protein expression of NF-κB signaling pathway in HNC patients with HPV infection. METHODS: For HPV detection, genomic DNA from 152 HNC tumors was extracted formalin-fixed paraffin-embedded tissue DNA kit. For genotyping, polymerase chain reaction (PCR) using a general primer, HPV type-specific primers and agarose gel electrophoresis were performed. Immunohistochemistry (IHC) was also performed on 4-µm thick tissue sections using HPV E6 monoclonal antibody. Protein expression analysis of NF-κB signaling pathway including p50, p65, and IκBα was performed using IHC. RESULTS: PCR analysis showed that 24.3% (37/152) of HNC cases were HPV positive. Among HPV positive, 86.5% (32/37) were tobacco users, while among HPV negative, 66.9% (77/115) were tobacco users. A significant association of HPV positivity and tobacco user was observed by univariate analysis [ P   <  0.01; odds ratio (OR): 0.310, 95% confidence interval (CI): 0.110 to 0.870]. More HPV positive patients were with poor oral hygiene (78.3%) when compared with patients with good oral hygiene (21.6%) [ P  < 0.03, OR: 2.440, 95% CI: 1.650 to 3.600]. The results of the logistic regression analysis showed that age, tobacco use and oral hygiene are significant predictors ( P  < 0.02). PCR and IHC staining results confirmed that HPV16 was predominant among HNC cases (64.8%) when compared with HPV18 (35.2%). Expression of NF-κB proteins (p50, p65, and IκBα inhibitor) were also observed in HPV and non-HPV infected HNC tissues. IHC expression of p50, and p65 showed nuclear staining, while IκBα inhibitor showed cytoplasmic staining. Protein expression in HPV cases was higher as compared to HPV naive cases ( P  < 0.05). CONCLUSIONS: From the study, it can be established that the use of tobacco, oral hygiene, and HPV infection may be synergistically involved in modulating the expression of NF-κB signaling pathway for the development and progression of HNC in the Pakistani population.

Impact of Oral Diseases and Conditions on Oral Health-Related Quality of Life: A Narrative Review of Studies Conducted in the Kingdom of Saudi Arabia.

Oral health-related quality of life (OHRQoL) is a novel concept that has evolved over the past two decades. The World Health Organization (WHO) has also recognized it as a significant part of the Global Oral Health Program (2003). Information on OHRQoL gives better understanding about feelings and perceptions on an individual level. It also helps us to understand the impact of oral health on the lives on the patients and their family. It is now well documented that oral diseases and conditions impact people's life. Some of the oral diseases/conditions like caries, dental fluorosis, tooth loss, periodontal disease, dental injuries, oral cancer, dental anomalies, craniofacial disorders, and many more have got negative impact on QoL. This paper identifies the various literatures published on the impact of oral diseases and conditions on OHRQoL in the population of Saudi Arabia. Although numerous researches can be found in other countries, the data on Saudi Arabian population are limited, leading to the need for carrying out more research in this area.

Effect of Probiotic Lactobacillus salivarius on Peri-Implantitis Pathogenic Bacteria: An In Vitro Study.

Background Varied treatment modalities have been described in the past for the management of peri-implant diseases but the evidence of the use of probiotics for the treatment of peri-implantitis is limited. The aim of this study was to determine the antagonistic growth effects of Lactobacillus salivarius on the growth of peri-implantitis pathogens. Material and method Anin vitroassessment of probiotic L. salivarius on peri-implantitis pathogens was done using the serial tube dilution method. Minimum inhibitory concentration was calculated for five subgingival pathogens namely Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Streptococcus salivarius, and Staphylococcus aureus. Minimum inhibitory concentration (MIC) is defined as the lowermost concentration of any drug that prevents the noticeable growth of the test organism. In vitro assessment to determine the MIC is necessary for an in vivo application. The MIC value will also help to find the drug's accurate dosage. Results Peri-implantitis pathogens were cultured from individuals diagnosed with peri-implantitis. Except for A. actinomycetemcomitans, all other pathogens were susceptible to the probiotic. S. salivarius had the lowest MIC (0.8mg/mL). Conclusion The MIC value for pathogens will help to determine the effective mode and form of probiotic that can be used for the treatment of peri-implantitis.