Self-harm, dentofacial features, and bullying.

INTRODUCTION: Self-harm is a growing public health problem. The study aimed to investigate the prevalence of self-harm among a representative sample of school children and the contribution of dentofacial appearance and being bullied because of dentofacial appearance to self-harm. METHODS: This was a cross-sectional study in which a representative sample of eighth-grade students (aged 13-14 years) from randomly selected schools was asked to complete anonymous questionnaires distributed in the classroom. The final sample size was 699 children (339 girls, 360 boys) with a mean age of 13.3 years, representing 1.26% of the target population. RESULTS: The prevalence of self-harm was 26.9% (n = 188), with no statistically significant gender differences (P >0.05). Among all the subjects who reported self-harm, 47.9% (n = 90) reported self-harm because of dentofacial features. A total of 41 subjects reported self-harm because of bullying targeted at dentofacial features, representing around one fifth of subjects who reported self-harm. The 3 most common dentofacial features contributing to self-harm and self-harm as a result of bullying were tooth color and shape, spacing between the teeth or missing teeth, and prominent maxillary anterior teeth. CONCLUSIONS: This study demonstrated a relatively high experience of self-harm reported by adolescent school children, with many reporting self-harm as a result of their dentofacial appearance and bullying because of dentofacial features. The present study provides baseline data to better understand the relationship between self-harm and dentofacial features.

A longitudinal study of psychological stress among undergraduate dental students at the University of Jordan.

BACKGROUND: The purpose of this study was to identify whether psychological stress increased as undergraduate dental students progressed through their studies from first to fifth year. Another objective was to determine if the perceived sources of stress have changed along the years. METHODS: To achieve these aims, a cohort of students at the University of Jordan were followed from first to fifth year of dental school. Fifth year students completed both the General Health Questionnaire 'GHQ-12' which was used to assess psychological stress and the Dental Environment Stress questionnaire 'DES' which was used to examine the perceived sources of stress. The same cohort of students had completed similar questionnaires during their first year of study. Chi-square analysis and independent t-test analysis were performed to compare GHQ-12 and DES scores between first and fifth year. RESULTS: Results showed that psychological stress increased from first to fifth year of study. Eighty- nine percent of fifth year students scored over the cut-off point of three in the GHQ-12 compared to 58 % in the first year. The difference between the years was statistically significant at p = 0.05. Mean score for DES also increased between first and fifth year of study and the difference was statistically significant at p = 0.05. CONCLUSIONS: Results of this study demonstrated that stress in dental students at the University of Jordan increased along the years. Fifth year students showed a high level of psychological stress and methods to reduce that stress should be further investigated and utilized.

Impact of bullying due to dentofacial features on oral health-related quality of life.

INTRODUCTION: The aim of this study was to investigate whether there is a relationship between self-reported bullying because of dentofacial features and oral health-related quality of life among a representative sample of Jordanian schoolchildren. METHODS: This was a cross-sectional study in which a representative sample of sixth-grade students (age, 11-12 years) from randomly selected schools in Amman, Jordan, were asked to complete questionnaires distributed in the classroom in the presence of the researchers. The questionnaire used for this purpose was the short form of the Child Perceptions Questionnaire for 11- to 14-year-old children. The final sample size was 920 children (470 girls, 450 boys). RESULTS: There were significant differences between the sexes for the total Child Perceptions Questionnaire score and for the oral symptoms and the social well-being subscales, with boys reporting higher scores and thus more negative effects on their oral health-related quality of life. Comparison of the total scores and subscales scores for boys and girls subdivided into those who reported being bullied and not being bullied about their teeth showed that bullied boys had significantly greater effects on overall oral health-related quality of life and on all subscales than did not-bullied boys (P <0.001 for all comparisons). Bullied girls also had significantly greater effects on the overall oral health-related quality of life and all subscales than did not-bullied girls (P <0.001 for all comparisons). However, bullied boys and girls reported similar scores for the different subscales of the Child Perceptions Questionnaire; there were no significant differences. CONCLUSIONS: This study demonstrated a significant relationship between bullying because of dentofacial features and negative effects on oral health-related quality of life. The results highlight the importance of addressing the bullying problem among schoolchildren and provide important data for educational authorities to create antibullying programs to help students receive education in a safe and healthy environment.

Traumatic dental injuries among 12-year-old schoolchildren in Jordan: prevalence, risk factors and treatment need.

PURPOSE: To assess the prevalence and related factors of traumatic dental injuries (TDI) among 12-year-old Jordanian schoolchildren. MATERIALS AND METHODS: For this cross-sectional study among schoolchildren, a sample of 2560 schoolchildren (1209 boys, 1351 girls) aged 12 years were randomly selected. The epidemiological classification adopted by the World Health Organization (WHO) and modified by Andreasen et al was used to record TDI on incisors. RESULTS: Of the children examined, 5.5% showed TDI. The difference in prevalence between boys and girls was statistically significant (P < 0.01). Maxillary central incisors were the most affected and the most common type of crown injury was enamel/dentin fracture. The relationship between dental injuries and geographic location, area, and socioeconomic indicators was not statistically significant. Most of the TDI occurred at home, followed by school; the most frequent cause was falls. No statistically significant association was found between TDI and dental caries experience (P > 0.05). There was a tendency for boys (P < 0.01), children with an incisal overjet > 3 mm (P < 0.01) and incompetent lip closure (P < 0.001) to have experienced dental injuries. Treatment need due to dental injuries was very high. CONCLUSION: The prevalence of traumatic injuries to permanent incisors in 12-year-old Jordanian schoolchildren was relatively low. TDI was associated with gender, overjet and lip competence, but was not influenced by dental caries experience. There was a great unmet treatment need.

Bullying among Jordanian schoolchildren, its effects on school performance, and the contribution of general physical and dentofacial features.

INTRODUCTION: The aims of this study were to investigate the experience of bullying in a representative sample of Jordanian schoolchildren in Amman, to look at its effect on school attendance and perception of academic performance, and to look at the contribution of general physical and dentofacial features to this phenomenon. METHODS: This was a cross-sectional study in which a representative sample of sixth-grade students (11-12 years of age) from randomly selected schools was asked to complete questionnaires distributed in the classroom in the presence of the researchers. The final sample size was 920 children (470 girls, 450 boys). RESULTS: The prevalence of bullying was 47% (n = 433); significantly more boys reported being bullied than girls (P <0.001). The percentage of students subjected to name-calling was 40.9%. A significantly greater proportion of victims of bullying reported playing truant from school and disliking school than those who were not bullied. Teeth were the number 1 feature targeted for bullying, followed by strength and weight. The 3 most commonly reported dentofacial features targeted by bullies were spacing between the teeth or missing teeth, shape or color of the teeth, and prominent maxillary anterior teeth. CONCLUSIONS: This study demonstrated a high prevalence of bullying in Jordanian schools, with many children experiencing bullying because of their dental or facial appearance.

Psychological stress among dental students at the University of Jordan.

The purpose of this study was to investigate the level of psychological stress as well as the perceived sources of stress among undergraduate dental students at the University of Jordan. The top perceived stressors were compared with those of a previous study that examined the perceived sources of stress among undergraduate dental students at the University of Jordan in the year 2000. Psychological stress was assessed using the General Health Questionnaire (GHQ-12). Perceived sources of stress were evaluated using the Dental Environment Stress questionnaire. In the study, 520 students completed the questionnaires, for a response rate of 74 percent. These students showed a high level of psychological stress, with 70 percent at the cutoff point of a score of more than 3 for the GHQ-12. Women had a higher level of stress than men: 73 percent scored more than 3 on the GHQ-12 vs. 63 percent for men, which was statistically significant at p=0.05. The top perceived sources of stress from the year 2000 were mostly unaltered in our study, despite a substantial increase in the number of students as well as changes in the curriculum. Further research is needed into methods to minimize stress on dental students.

The Arabic version of the modified dental anxiety scale. Psychometrics and normative data for 15-16 year olds.

OBJECTIVE: To prepare an Arabic version of the Modified Dental Anxiety Scale (MDAS) and provide normative information including evidence to support the validity of the measure. METHODS: The MDAS was translated into Arabic and back-translated into English. Data collection took place in Amman, Jordan from March 2009 to March 2010. One thousand and six hundred two 10th grade students took part in the study (15-16 years of age) sampled from 32 schools. Questionnaire consisted not only of the MDAS, but also (i) a single global question on dental anxiety to test concurrent validity, (ii) a question on helplessness in the dental surgery to test construct validity and (iii) demographic profile. RESULTS: The level of missing data was minimal for the translated scale. The internal consistency for this sample using the Arabic MDAS was 0.87 (95% confidence interval was 0.86-0.88). The measure was a one-dimensional scale. The proportion of the sample that was highly dentally anxious was 22% (>/= 19 cut-off score). Expected differences between gender and self-reported dental attendance were observed. There were clear significant relationships as predicted between the Arabic MDAS and (i) a single item measure of dental anxiety and (ii) feeling helpless in the dental chair on a previous occasion. CONCLUSION: The Arabic version of the MDAS can be employed for brief assessment of dental anxiety.

A comparison between a new 2-dimensional digital on-screen tooth measurement method with direct measurements.

OBJECTIVE: To compare the accuracy and reproducibility of tooth measurements using newly developed software that gives 2-dimensional scanned images of dental setups with direct measurements using digital calipers. METHODS: This experimental study was performed at the Dental Laboratories of the Faculty of Dentistry, University of Jordan, Amman, Jordan from September 2010 to December 2010. Ten sets of acrylic teeth (10 upper and 10 lower arches) were used. The mesiodistal width of each individual tooth was measured using a digital caliper (method I), which was considered the gold standard. The teeth were set to create 20 dental setups. The mesiodistal widths of teeth on the created setups were then measured by using a digital caliper (method II). The dental setups were then scanned using a flatbed computer scanner and tooth width measurements were performed using a special computer program (method III). Tooth measurements were divided into 6 groups, and the 3 methods were compared. RESULTS: There was a statistical significant difference between the 3 measurement methods in most of the measured tooth groups. Methods I and II exhibited significant differences for most of tooth groups (ranged from 0.02 to 0.22 mm) while no significant difference was found between methods I and III (ranged from 0.03 to 0.11 mm). CONCLUSION: Tooth width measurement with on-screen 2-dimensional scanned images of dental casts is comparable to measurements obtained using direct digital caliper.