Rating communication skills in dental practice: the impact of different sociodemographic factors.

BACKGROUND: Communication abilities are essential for the successful operation of a dental business and significantly influence outcomes, compliance, and patient satisfaction. AIMS AND METHODS: The aim of our study was to evaluate the knowledge and practice of doctor-patient communication among Jordanian dentists. This evaluation was conducted through a survey based on the key components of the Calgary Cambridge Observation Guides. Additionally, the impact of several sociodemographic characteristics on communication abilities was investigated. This cross-sectional study was conducted from January to June 2022. The data collection tool was an online questionnaire developed by the researchers, consisting of three sections: self-reported demographic and professional data, the practice of doctor-patient communication, and knowledge of doctor-patient communication. RESULTS: The study included 305 dentists, comprising 106 males and 199 females, with a mean age of 32.9 ± 9.0 years. The mean score for communication skills knowledge was 41.5, indicating a moderate level of communication skills knowledge. Female dentists demonstrated significantly higher communication scores compared to their male counterparts, and those working in the private sector scored significantly higher than those in the governmental sector or in both sectors (P ≤ 0.05). In general, older and more experienced dentists exhibited better communication skills. Educational level had a positive impact on certain communication skills items. 58.4% believed that communication skills can always be developed and improved through training sessions, while 48.9% reported never having attended such courses. 95.1% believed that training courses on communication skills are always necessary as part of the educational curriculum. The main obstacles that may deter dentists from considering communication skills courses were limited time (62.3%), course availability (37.7%), cost (28.2%), and perceived lack of importance (8.2%). CONCLUSION: Among a sample of Jordanian dentists, there appears to be a discrepancy between knowledge and self-reported practices regarding communication abilities. In certain crucial, evidence-based areas of doctor-patient communication, there are fundamental deficiencies. Considering the significant role dentists play in oral health and prevention, communication skills should be a top educational priority for them.

Dentists' knowledge and preference regarding gingival displacement methods.

INTRODUCTION: An accurate impression is an essential procedure for fabricating indirect fixed restorations. To achieve a precise final impression, the management of gingival tissue is without doubt a crucial. AIM: To evaluate the use of different gingival displacement techniques among dental clinicians and to assess their associated knowledge and technique preferences. METHODS: A self-designed survey was created electronically and sent to a list of dentists. The survey was composed of multiple sections. Participants who stated that they do not use GD methods were asked to answer the survey questions based on their knowledge. Descriptive statistics were generated, andChi-square test was used to examine the association between the different variables. RESULTS: A total of 188 dentists participated in this study. The majority 144 (76.6%) use GD in their practice. When asked which technique yields a more accurate impression with lower incidence of repeating the impression, 93 (64.6%) reported retraction cord technique with a hemostatic agent results in a higher impression accuracy, while only 14 (9.7%) declared the retraction paste technique as being more accurate. CONCLUSION: The cordless GD technique is believed to be easier, faster, and less traumatic to the gingival tissues, nevertheless, the outcome of dental impressions is believed to be more predictable with the use of conventional retraction cords and hemostatic medicaments.

Pattern, frequency and causes of dental extraction among children/adolescents Syrian refugees: an observational study.

BACKGROUND: The Syrian conflict has had a massive impact on the dental health of refugees. Dental extraction is a good indicator of socioeconomic position and degree of oral hygiene, however there is a scarcity of evidence in the scientific literature that characterizes the reasons for extraction in refugees. AIMS AND METHODS: The current study looked at the extraction causes and related sociodemographic variables of 322 Syrian refugees (46.3% females, 53.7% males) who were treated in a dental clinic in Zaatari camp (Jordan), from September to December 2019. All child Syrian refugees (aged 4-16) visiting the facility were eligible to participate. A validated semi-structured survey was used to collect clinical and sociodemographic data from the research sample. Chi-square test, Independent sample t-test, and ANOVA test were used to examine associations between the different variables. The significance level was set at P < 0.05. RESULTS: The total number of teeth extracted was 397: 25 (6.3%) permanent teeth, 371 (93.5%) primary teeth, and one mesiodens (0.2%). Overall, lower teeth were most commonly extracted (56.9%). The most common teeth that required extraction were the lower primary molars, with lower left primary second molars being the most commonly extracted (15.9%). As the level of parental education increased, the mean number of extracted teeth decreased (P = 0.035), additionally, as the frequency of toothbrushing increased extractions due to caries decreased significantly (P = 0.027). CONCLUSIONS: Dental caries and pulpal diseases were discovered to be the most prevalent causes for primary and permanent tooth extraction, with no difference between males and females. The lower left primary molar was the most commonly afflicted tooth.

Comparison of imaging modalities in the diagnosis of external cervical resorption (ECR): an in-vitro study.

External cervical resorption is a pathological condition affecting the cervical margins of teeth. Due to the increased prevalence and the area it affects, it can be easily misdiagnosed. The ability of clinicians to diagnose ECR and subcategorise the lesions using periapical radiographs and cone beam-CT scans has not been investigated in-depth. This study aims to assess if diagnostic ability to detect ECR lesions with the two modalities was different and if there was a change in the diagnosis when CBCT was used. A human skull, including the mandible was used for this study. The teeth were randomly allocated to the different subcategories, then pre and post-preparation radiographs with CBCT were taken. Statistical analysis was done using IBM SPSS version 16.0 (SPSS Inc., Chicago, IL, USA). The study sample was composed of 60 participants, the overall sensitivity of intraoral radiographs was significantly lower than CBCT. When the participants were told the radiograph and the CBCT were of the same tooth 60% said they would change their diagnosis. The use of intraoral radiographs alone might not be enough to identify and correctly diagnose ECR lesions. CBCT can give a better idea about the nature and the extent of the lesion.

Satisfaction with healthcare services among refugees in Zaatari camp in Jordan.

BACKGROUND: Feedback on satisfaction regarding healthcare services is vital for continuous improvement of the service delivery process and outcome. AIMS AND METHODS: The objective of this study was to assess the satisfaction of refugees with the medical and dental services in Zaatari camp, under 3 domains with 20 key indicators (human and physical health resources, interaction and reactivity, and administration) using a self-administered questionnaire. RESULTS: Of the 500 participants, the satisfaction rate was 72.5%. Young participants and participants with a shorter stay in the camp showed higher overall satisfaction rates (P ≤ 0.01). Within the domains, 'interaction and reactivity' achieved the highest satisfaction score, whereas 'administration efficiency' was ranked the lowest. As for elements within the domains, the most acceptable were the sufficient number of staff and the working hours, availability of radiological services and proper care for children, reasonable waiting time and asking for medical history in every visit. Whereas difficulty to access healthcare services, difficulty to be referred to hospitals, lack of follow up and lack of dental services were the least acceptable. CONCLUSION: In conclusion, whereas refugees were generally satisfied with the provided services, this study indicates that there are areas for further service improvement. This study highlights a significant gaps in healthcare services which if not addressed have the potential to amplify oral/medical health problems.

Impact of COVID-19 pandemic on dental education: online experience and practice expectations among dental students at the University of Jordan.

BACKGROUND: The quarantine associated with the COVID-19 pandemic forced dental schools to suspend their clinical training and to shift to distant learning methods. The aim of this study is to investigate the impact of quarantine on the self-perceived preparedness of dental graduates and to explore the efficacy of online education from students' perspectives. METHODS: The questionnaire distributed to dental students comprised of two main sections. The first part covered the online education experience, and the second part measured the level of self-perceived preparedness for a range of cognitive, communication and professional skills. RESULTS: The survey yielded a response rate of 72%. The majority of students (77%) agreed that they missed educational experiences as a result of the lockdown. More than half of them felt less motivated to follow-up with distant e-learning and believed that online assessment is not a good method for evaluation. A high percentage of the students (66%) thought that online group discussions had a positive value while 67% preferred online lectures compared to theatre lectures. Majority of students particularly 5th year (78.7%) (p < 0.001) stated that the quarantine increased their collaboration with their colleagues. According to 87% of students, the experience most negatively affected was their clinical training. In general, students showed satisfactory self-perceived preparedness related to a range of attributes and professional skills. CONCLUSIONS: The data showed that students partially appreciated the online system, whereas they did not consider it a substitute for face to face clinical practice. The overall self-perceived preparedness level was promising; however students had reservations regarding independent practice following graduation.

Measuring the social impact of nursing research: An insight into altmetrics.

AIMS: The objectives of this study were to (a) identify nursing journal articles that provoked the most online activity and discussion and (b) assess the association between these articles' altmetric scores and publication characteristics, citation counts; and publishing journals metrics. BACKGROUND: Altmetrics, or alternative metrics, have recently emerged as a complementary way of measuring the societal impact of research by assessing the public engagement with research output. To date, no studies have yet investigated the online attention about scientific papers published in the nursing field. DESIGN: Integration of quantitative and qualitative synthesized evidence. DATA SOURCES AND REVIEW METHODS: InCites Journal Citation Report was used to identify a list of nursing journals indexed in the Web of Science Core Collection. Altmetric Explorer was selected as an altmetrics harvesting tool. The search in Altmetric Explorer yielded 66,608 research outputs from 118 nursing journals. The articles with the top 100 altmetric attention score (AAS) were identified and a new search, limited to only those 100 articles, was run to produce aggregate metrics specific to those articles. The articles were also exported for thematic analysis. RESULTS: The median AAS for the 100 articles was 248, ranging from 138 - 649. The articles were mostly discussed on Twitter, followed by news outlets and Mendeley. Articles indexed in the nursing journals category attracted low online attention compared with articles published in other health journal categories. Twitter remained the dominant source of attention over the years 2012-2018, followed distantly by news outlets. Most online attention came from the USA and the UK. Of the top 100 articles included in the study, the Journal of Advanced Nursing published the highest number of articles (N = 26; Median AAS = 179). The AAS was not significantly different between articles published in Q1 journals and those published in Q2 and Q3 journals. There was a significant relationship between articles' AASs and their citation counts on Scopus and Web of Science. Publication date was significantly related to citation counts on Scopus and Web of Science but not with AASs. CONCLUSION: Altmetrics will likely continue to evolve alongside the rapidly expanding use of social media and online platforms. As nursing continues to strive to have our research and scholarship inform policy, translated into practice and recognized for its scientific merit, we have to remain vigilant about the best ways to disseminate the important work we are doing. Research, such as this study, will allow nursing scholars to benchmark our progress as we adapt to the changing environment for measuring impact and quality in the digital age.

Nursing research in the Arab Region: A bibliometric analysis.

AIMS: Scientific discovery in general, and nursing research specifically, is an increasingly global effort consistent with changing demographics and the need to provide culturally competent care in a diverse society. Given that Arabs account for an increasing proportion of the populations in many Western countries, this study presents findings from the first bibliometric analysis of nursing research conducted through December 2017 in the Arab region. METHODS: We used quantitative and qualitative indicators to analyse bibliometric data from Scopus. RESULTS: We provided significant data on Arab nursing publication output and growth trends; types of published documents; publication geographic loci, focus, and subject categories; authors' collaboration patterns; core publishing journals and their impact; and citation patterns. CONCLUSIONS: Our findings highlighted the need for Arab policy makers and funding agencies to allocate research funding that supports the dissemination of Arab nursing research into the broader scientific community so that Western researchers, policymakers, and health care providers can appropriately address the health care needs of Arab individuals and families. The insights gleaned regarding the performance of journals, authors, countries, and institutions are discussed in relation to the potential impacts of the publish-or-perish culture of the current academic world.

Dental students' knowledge and attitudes toward patients with epilepsy.

BACKGROUND: Inadequate knowledge and negative attitudes toward epilepsy can affect the provision of health services for patients with epilepsy. AIM: The aim of the present study was to assess the knowledge and attitudes toward epilepsy among clinical dental students in Jordan. METHOD: The study was conducted using a 21-item questionnaire to assess professional experience with epilepsy, knowledge about epilepsy, social tolerance, and willingness to care for patients with epilepsy among dental students at the University of Jordan. RESULTS: More than one-third of dental students believed that epilepsy is due to insanity or mental illness. Only 45% were able to identify convulsion or shaking as a sign of epilepsy, and more than one-third did not know how to act in case of an epileptic seizure in the dental clinic. Disappointingly, 43.4% of the respondents were of the opinion that people with epilepsy should not have children, and only 38.6% thought that people with epilepsy should be employed at the same jobs as other people. About 50% indicated that their families would be concerned about them treating patients with epilepsy, and 30% believed that knowing that patients with epilepsy were treated in their clinic might make other patients reluctant to continue their treatment there. CONCLUSION: The results revealed an inadequate level of knowledge and negative attitudes toward epilepsy among dental students at the University of Jordan. There is an urgent need to educate dental students about epilepsy.

Pattern, frequency and causes of tooth extraction among adult Syrian refugees.

AIMS OR OBJECTIVES: The Syrian crisis has resulted in a significant impact on refugee oral health status, but the scientific literature lacks information characterizing the pattern of tooth extraction in refugees. MATERIALS AND METHODS: The current study analyzed the pattern of tooth extraction and the associated sociodemographic factors among 626 (53.4% females, 46.6% males) Syrian refugees who were treated in dental clinics in the Zaatari camp. All adult Syrian refugees attending the dental unit at Zaatari camp were eligible to participate. Clinical and sociodemographic data were collected from the study sample using a validated semi-structured survey over a period of 4 months. Descriptive statistics were generated and Chi-square test, independent sample t-test, ANOVA test and Bonferroni Post Hoc test were used to examine associations between the different variables. RESULTS: More than one third of the attendees (33.9%) were young adults (18-29 years), and nearly two thirds (69.8%) had no or very basic education. The mean number of teeth that needed extraction was (1.46 ± 0.84) and was significantly higher in males, smokers, older patients, and those with no or basic education. The most common cause for tooth extraction was dental caries (54.8%), followed by tooth fracture/un-restorability (38.5%), and periodontitis (3.4%); while the least common reason was tooth extraction for orthodontic treatment (0.20%). CONCLUSIONS: Dental caries and its sequelae were the leading cause of tooth extraction in this refugee population. Molar teeth were found to be the most frequently extracted and lower anteriors were the least. Older age, smoking, patients with lower educational level, poor oral hygiene and male gender all predispose to a higher incidence of tooth extractions.

A Cone Beam CT Study on the Correlation between Crestal Bone Loss and Periapical Disease.

The aim of this study was to determine whether the degree of bone loss around teeth can be linked to the loss of vitality of adjacent teeth and periapical disease, which necessitates root canal treatments. Three hundred and twenty-one full maxilla cone-beam computed tomography scans were examined. The parameters investigated included the degree of crestal bone loss in relation to the cementoenamel junction, the presence/absence of apical periodontitis, and the presence/absence of root canal treatments. Out of the 2001 teeth examined, 696 (34.8%) showed evidence of crestal bone loss. The degree of crestal bone loss was classified as mild, moderate, or severe. A significant association (p < 0.001) was found between the presence of crestal bone loss around a tooth and root canal treatment of that tooth. It was found that it is more likely for teeth with crestal bone loss to be root canal treated compared to teeth with existing root canal treatment and healthy crestal bone levels. Furthermore, teeth with buccal or lingual crestal bone loss were significantly associated with a higher rate of periapical disease than teeth without crestal bone loss (p < 0.001). CBCT identified the severity of bone loss on all surfaces of the teeth, and the most common presentation was bone loss to the mid-root level. Teeth with crestal bone loss were significantly more likely to be associated with a higher rate of periapical disease. Teeth with crestal bone loss were more likely to be root treated than teeth with healthy crestal bone levels.

Oral cancer in Myanmar: a preliminary survey based on hospital-based cancer registries.

The occurrence of oral cancer is not clearly known in Myanmar, where betel quid chewing habits are widely spread. Since betel quid chewing has been considered to be one of the important causative factors for oral cancer, the circumstantial situation for oral cancer should be investigated in this country. We surveyed oral cancer cases as well as whole body cancers from two cancer registries from Yangon and Mandalay cities, both of which have representative referral hospitals in Myanmar, and we showed that oral cancer stood at the 6th position in males and 10th in females, contributing to 3.5% of whole body cancers. There was a male predominance with a ratio of 2.1:1. Their most frequent site was the tongue, followed by the palate, which was different from that in other countries with betel quid chewing habits. About 90% of male and 44% of female patients had habitual backgrounds of chewing and smoking for more than 15 years. The results revealed for the first time reliable oral cancer frequencies in Myanmar, suggesting that longstanding chewing and smoking habits are etiological backgrounds for oral cancer patients.

Oral Hygiene Awareness, Practices and Attitudes among Syrian Refugees in Zaatari Camp and Their Impact on Oral Health Status.

PURPOSE: To characterise the oral hygiene habits, attitudes, and oral health practices in relation to sociodemographic factors among refugees in Jordan and to investigate their impact on the oral health status of these refugees. MATERIALS AND METHODS: This cross-sectional study consisted of two parts. First, a face-to-face interview was conducted using a structured questionnaire including demographic and oral health-related questions. Second, clinical oral examination was performed using WHO criteria, DMFT and oral health indices (OHI-S). The participants were adults, aged 18 and older. All patients attending dental clinics and accompanying personnel in the waiting areas at Zaatari camp during the study period were invited to participate, with a sample size of 547 refugees (males = 212, females = 335). RESULTS: 547 adult refugees participated. 75.3% reported toothbrushing less than twice daily, while flossing was uncommon (9.5%). Toothbrushing habits were significantly associated with gender and smoking status. Untreated carious lesions had a high incidence (94.1%); the mean number of decayed teeth was 5.4 and was statistically significantly higher in males and smokers. The mean number of missing teeth was 3.2 and was significantly associated with males, age, smoking, and presence of chronic disease. Participants who reported conditions that had persisted 1 year or more and required ongoing medical attention or limited activities of daily living or both (e.g. diabetes mellitus, hypertension, heart diseases, thyroid disease, chronic renal disease, rheumatoid arthritis, anemia, peptic ulcer, or asthma) were recorded as having chronic disease. The mean number of filled teeth was 3.2 and was statistically significantly associated with age and presence of chronic disease. The mean DMFT was 11.8 and was statistically significantly higher in males, older people, smokers, and those with chronic disease. The OHI-S was 2.2. The most common complaint was pain (92.2%), and only 1.1% visited a dentist for a check-up. CONCLUSION: The prevalence of caries was extremely high, with poor oral hygiene practices among refugees, justifying the urgent need to develop and implement targeted oral health promotion, preventive programs and curative strategies and to enable collaboration of the oral healthcare providers and funding agencies to design the most appropriate interventions for this disadvantaged population. In addition, this information can be used as a basis upon which preventive programs can be assessed for efficacy.

Reframing Perceptions in Restorative Dentistry: Evidence-Based Dentistry and Clinical Decision-Making.

OBJECTIVES: The worldwide interest of both dentists and patients in esthetic dentistry has affected decision-making in dental practice. The aim of this study was to investigate contemporary dental practice in restorative dentistry and the relationship between evidence-based dentistry in caries research and decision-making in clinical practice in restorative dentistry. METHODS: The study was conducted through a structured questionnaire distributed randomly at the Jordanian Dental Association registered dentists in Jordan. The questionnaire aimed to clarify the degree of knowledge and practice of evidence-based dentistry in caries research the dentists hold regarding clinical decision-making in restorative dentistry. RESULTS: The majority of the surveyed dentists (77%) treat teeth with irreversible pulpitis with root canal treatment rather than vital pulp therapy. 13.8% routinely insert a post and 23% routinely crown the tooth after root canal treatment regardless of the remaining tooth structure. Badly damaged teeth are treated with full crowns in 72% of the cases. Regarding Hollywood smile or smile makeover, the majority of dentists choose conservative approaches, and implants were the first choice to replace missing teeth for 93.8% of the surveyed dentists. CONCLUSION: A higher degree of implementation of evidence-based dentistry in clinical decision-making was found in Prosthetic Dentistry than in Endodontics. Yet, the gap between evidence-based data and clinical practice needs bridging. More emphasis on communicating these data to educators to integrate them into the dental curriculum is a must.

Observance of proper mercury hygiene practices by Jordanian general dental practitioners.

OBJECTIVES: To assess the knowledge and observance of proper mercury hygiene and amalgam waste management (AWM) among Jordanian general dental practitioners (GDPs). SUBJECTS AND METHODS: Interviews were conducted with randomly selected 250 Jordanian GDPs, using a specially designed questionnaire. Out of the total of 250 GDPs, 228 (91.2%) agreed to participate. The questionnaire covered aspects related to professional information and total amalgam contact (TAC) of these practitioners. The second part focused on the degree of awareness of the protocols related to mercury hygiene and safe AWM. RESULTS: Mean TAC was 3.2+/-3.6 hours per week. Of the Jordanian practitioners, 22.6% reported no undergraduate training in amalgam safety measures. Almost a quarter of GDPs did not have proper ventilation in their clinics, around 20-25% did not use protective clothing or eye protection, 5.3% were mixing amalgam manually, and 13.9% used their bare fingers for inserting the freshly mixed amalgam. Most of unused amalgam ends up through the drain or in trash; there are no recycling facilities to be used. CONCLUSIONS: Most Jordanian GDPs do not strictly follow the mercury hygiene and AWM guidelines. Promoting the American Dental Association (ADA) guidelines through undergraduate and postgraduate training will help GDPs acquire proper attitude towards the proper hygiene practices described in these recommendations.

Satisfaction of optional pairing in clinical dental training.

PURPOSE: The aim of this study was to investigate the perceived satisfaction of optional pairing in undergraduate clinical dental training of fourth- and fifth-year dental students and newly graduated intern dentists in the subject of conservative dentistry and endodontics. METHODS: Data were collected through a paper-based 2-part questionnaire. The first part was made of 3 questions; gender, undergraduate dental year, and grade point average (GPA). The second part involved 9 questions about assistant student-year level preference, satisfaction of optional pairing and main advantages and disadvantages of pairing. Statistical analysis was performed using descriptive statistics and Chi-square test to investigate any statistically significant differences. RESULTS: A total of 92.4% were satisfied with optional clinical pairing. Satisfied respondents reported most prevalent advantages were speeding things up (88.5%) and helping in transferring instruments and materials (85.6%). Unsatisfied respondents reported the most prevalent disadvantages were like to work independently (56.8%) and the assistant was not always cooperative (32.4%). Students with low grade point averages (GPAs) felt incompetent to work in pairs compared with high GPA students (P = 0.001). Only 32.4% of participants thought that the assistant student should be given an evaluation mark. About 75% of respondents reported that clinical pairing improved their diagnostic skills and treatment planning. CONCLUSIONS: Optional pairing in clinical dental training had a high satisfaction percentage. Allowing students to choose their own assistants may reduce pairing disadvantages and enhance its advantages. Students may gain a mentoring benefit from being encouraged to optionally pair with similar or higher study-year students.

Assessment of self-medication of antibiotics in a Jordanian population.

OBJECTIVE: To assess the extent of self-medication with antibiotics (SMA) in a Jordanian population, and to evaluate the sociodemographic factors affecting this behaviour. SUBJECTS AND METHODS: Face-to-face interviews were conducted with 477 patients aged 16-65 years attending the Department of Dentistry, University of Jordan Hospital. Socio-demographic data were collected and interviewees were asked about their SMA behaviour during the last 6 months, the reasons and motives for this behaviour, and the source and dose of the antibiotics were noted. RESULTS: The prevalence rate of SMA in the sample during the 6 months preceding the interview was 40.7% (194/477). Patients aged 36-55 years and those in the middle-class income group were most likely to perform SMA. SMA was mainly for sore throats, common colds and dental infections, and community pharmacies were the major source (104, 53.6% cases). Amoxicillin was the most commonly used antibiotic, and only 73 (37.6%) patients followed the correct dosage guidelines. Previous experience with similar illness and saving time were the most common reasons for SMA. Ninety-four (19.7%) patients admitted that they consulted another physician to obtain antibiotics when their first physician did not prescribe any. CONCLUSION: The findings showed that SMA was a frequent practice among Jordanians, signifying the need for an educational campaign on the proper use of antibiotics in this population.

Has the implementation of the Minamata convention had an impact on the practice of operative dentistry in Jordan?

OBJECTIVE: To assess Jordanian dentists' current perception and attitudes towards amalgam and composite restorations four years after the Minamata treaty was endorsed and suggest decision making factors that may influence the type of restoration requested by patients. METHODS: The cross-sectional study was conducted through structured questionnaires distributed to dentists in Amman, Jordan from June 2017 to February 2018. RESULTS: Of the 1686 dentists who were contacted 758 dentists (response rate 45%) responded to the questionnaire either by email or via field visits. Jordanian dentists used more composite restorations than amalgam. Recurrent caries followed by fracture of the restoration were the main reasons for replacement of both fillings by dentists. However, dentists suggested that the main reason patients requested replacement of amalgam was for 'staining'. In addition, a large proportion of the dentists had experienced patients who had asked either for replacement of amalgam (77%) or refused an amalgam filling (99%) for aesthetic reasons. In the opinion of the dentists, only 20% patients requested replacement of amalgam because of the mercury content. CONCLUSION: The findings of this survey suggest that a 'phase-down' of dental amalgam is being implemented in Jordan's dental clinics but it is not associated with commitment to the Minamata Convention, rather to current dental practice trends and patients' aesthetic demands.

Hematologic status in patients with recurrent aphthous stomatitis in Jordan.

OBJECTIVE: To determine the prevalence of hematinic deficiencies in patients with recurrent aphthous stomatitis. METHODS: The study took place in the Oral Medicine Clinic of the Jordan University Hospital in Amman, Jordan, between January 1993 and December 2000. We studied the hemoglobin, serum ferritin, vitamin B12 and folate levels in 143 patients with recurrent aphthous stomatitis. We compared the results with a control group of 143 age- and gender-matched patients with a range of other oral diseases. RESULTS: In recurrent aphthous stomatitis patients, 14% were anemic and 37.8% showed hematinic deficiencies; 16.8% showed low serum ferritin; 26.6% showed low serum vitamin B12 and 4.9% showed low serum folate. In the control group, 10.5% were anemic and 18.2% showed hematinic deficiencies; 9.8% showed low serum ferritin; 12.6% showed low serum vitamin B12 and none showed serum folate deficiency. CONCLUSION: Patients with recurrent aphthous stomatitis have more hematinic deficiencies, particularly vitamin B12 deficiency, compared with controls. Correction of these hematinic deficiencies could help in the management of the disease.

Phase down of amalgam. Awareness of Minamata convention among Jordanian dentists.

OBJECTIVES: To assess the knowledge of Jordanian dentists toward phase down of dental amalgam as recommended by the Minamata Convention, and their training and competency in placing posterior composites.  Methods: This study was conducted through structured questionnaire interviews with randomly selected cohort of dentists in Jordan between March 2015 and June 2015. Out of 230 dentists who were invited, 196 (85.2%) agreed to participate. Dentists were asked if they know about the Minamata Convention. They were also asked about their training in placement of posterior composite.  Results: Out of the 196 interviewed, only 13.8% know about Minamata Convention and 17% had an undergraduate training in favor of placing composites in posterior teeth. Approximately 50% of those dentists were not trained in using rubber dam when placing posterior composites, while only 38.3% had training in sectional matrix placement. Undergraduate training did not influence (p=0.00) the dentists' decision to remove old amalgam based on patient's demands. Only 28.1% were of the opinion of discontinuing the use of amalgam due to its alleged health and environmental hazards. There was no general agreement on the type of composite, liner, and bonding strategy when placing posterior composites. Conclusion: Dentists are not well informed on the Minamata Convention and the phase down of amalgam. Training in posterior composite placement should be given more room in undergraduate curriculum and continuous dental education.