Assessing Patients' Preferences for Preventive Dental Care: A Discrete Choice Experiment.

Background It is crucial to recognize patients' behavioral responses to improve oral healthcare delivery. A discrete choice experiment (DCE) is typically used to measure service user preferences. The purpose of this study was to examine the preferences of the Saudi population regarding primary dental care using a DCE. Materials and methods An online DCE survey was distributed among adults aged 18 years and older living in Saudi Arabia. An orthogonal design was used to reduce the number of combinations while maintaining the main effects that reflect patient preferences. Respondents were presented with a reduced set of 10 cards (tasks), and each of the cards had two concepts (offers). Descriptive statistics were used to summarize the sample characteristics. The coefficients were calculated based on discrete choice results on the Qualtrics platform. Results A total of 532 participants completed the survey. Among patients seeking a preventive dental visit, the ability to get an appointment was rated the most important influence on their decision with a relative importance of 41%, followed by the dental care provider (29%) and the dental clinic in relation to the sector and the fees (20%). The least important attribute was the waiting time in minutes, with a relative importance of 10%. Conclusion The study findings revealed that patients make trade-offs when deciding to receive primary dental care. Policymakers can use the study's findings to inform their decisions concerning dental clinic services. The study results suggest that it is possible to improve access to primary dental care by improving the accessibility of appointments.

Dental Students' Perceptions Regarding Bioterrorism; a Cross-Sectional Study.

Introduction: During the COVID-19 outbreak, dental professionals have demonstrated their importance in combating mass casualty incidents. This study aimed to understand dental students' perceptions of their potential roles in a bioterrorism attack. Methods: This cross-sectional study used a self-administered anonymous questionnaire, which was sent to all dental students and interns at King Abdulaziz University, Saudi Arabia. Bivariate and multiple linear regression analyses were conducted to assess dental students' willingness to provide care during a bioterrorism attack, knowledge regarding bioterrorism and total number of roles a dentist should play during an attack. Results: This study included 472 dental students and interns. The mean knowledge score regarding bioterrorism was 3.3 ± 1.9 out of 5. A large majority of the respondents (83.8%) were willing to provide care during a bioterrorism attack. Students with a cumulative grade point average (GPA) of 4.5-5 were more likely to indicate that a dental professional should take on more roles during a bioterrorism attack than those with a GPA of 2.5-2.99. Fourth- and fifth-year dental students had lower knowledge scores regarding bioterrorism than dental interns (B: -0.71; SE: 0.30; 95% CI: -1.3--0.1 and B: -0.68; SE: 0.30; 95% CI: -1.3- -0.1, respectively). Conclusion: Despite the fact that dental curricula do not cover topics related to bioterrorism, most students would be willing to provide care under bioterrorism conditions. There is wide agreement among the students regarding the need to add bioterrorism-related educations to dental curricula.

The association between adverse childhood experiences and oral health: A systematic review.

OBJECTIVE: It is well established that adverse childhood experiences (ACEs) negatively affect health and are associated with health-risk behaviors. This study aimed to provide a systematic review of the studies that examine the relationship between ACE exposure and oral health among adults aged 18 years and older. METHODS: The following electronic databases were searched in January 2022: MEDLINE, Cochrane, Web of Science, CINAHL via EBSCOhost, ProQuest, ScienceDirect, and Google Scholar. Data were extracted independently by two reviewers. The quality of the studies was assessed using the Newcastle-Ottawa Scale. RESULTS: Among the 292 articles identified, four met the eligibility criteria. All included studies were cross-sectional and of satisfactory quality. The dental outcomes included: last dental visit, last dental cleaning, number of filled teeth, number of extracted teeth, and number of remaining teeth. The studies showed that exposure to ACE was negatively associated with oral health. The relationship between ACE score and oral health outcome measures was found to be directly proportional. CONCLUSION: There is an association between ACE and poor oral health. Moreover, the association was proven to have a dose-response relationship. Given that the studies in the literature were cross-sectional, causality cannot be determined with certainty, therefore interpretation of the results should be cautious. Longitudinal follow-up studies are needed to understand how ACEs contribute to oral diseases later in life.

Factors affecting the acceptance of teledentistry determined using the technology acceptance model: A cross-sectional study.

Objective: The aim of this pilot study is to identify the main predictors and barriers that influence user intention to adopt teledentistry services among the Saudi population. Methods: A total of 426 respondents completed a questionnaire. Our study used the technology acceptance model to predict how users will adopt teledentistry. An analysis of the factors that influence patient users' intention to utilize teledentistry was conducted using partial least square structural equation modeling. Results: Among the factors that influenced the intention to use teledentistry services, social influence positively affected the intention (ß = 0.18, t = 2.19, p-value = 0.03), whereas perceived risk negatively affected it (ß = -0.21, t = 2.69, p-value =0.01). Conclusion: The perception of risk was a major barrier to the adoption of teledentistry services, while social influence was a significant positive predictor. Using the findings of the study, policymakers and health service providers can gain a better understanding of the factors influencing the implementation of teledentistry.

Response to commentary: See Original Article here.

This letter is a response to commentary by Dr. Smith on 'Examining the association between cancer history in early life and dental care utilization'. We provided additional information and clarification regarding our analysis and results in response to Dr. Smith's questions and comments. Despite the limitations and weaknesses of our study, we still believe that it provides important information and further research questions.

Dental Students' Perception of Integrating E-learning During COVID-19: A Cross-Sectional Study in a Saudi University.

Purpose: The aim of this study was to assess dental students' perceptions and overall experiences regarding e-learning at King Abdulaziz University, Jeddah, Saudi Arabia, during the COVID-19 pandemic. Methods: This cross-sectional study was carried out from November 2020 through March 2021. A pre-structured, self-administered questionnaire was emailed to undergraduate dental students (second year through sixth year and dental interns). The final sample included 296 undergraduate dental students and interns. Univariate analysis was done to report the sample characteristics. Chi-square and Fisher exact with Monte Carlo were conducted to evaluate the preference of students regarding e-learning across characteristics of the study sample. Results: The majority of students preferred to integrate e-learning into traditional classroom lectures, although 51.7% did not favor it for clinical subjects. More than half of the sample believed that e-learning allowed excellent interactivity with the instructors. A higher percentage of second-year students preferred traditional learning (71%) than students in other years who preferred a combination of both traditional and online learning (P-value < 0.001). The mode of learning is not associated with marital status, though 36.4% of married students prefer e-learning (P-value = 0.4). Most dental students considered e-learning a positive experience. Conclusion: There were significant differences in the mode of learning preference between the preclinical and clinical years. Continuous monitoring of learners' needs, challenges, and outcomes is crucial to effectively evaluate e-learning in dental education.

Examining the association between cancer history in early life and dental care utilization.

OBJECTIVES: This study aims to examine associations between cancer history in early life (diagnosed at 20 years of age or younger) and utilization of dental care. METHODS: We analysed data of 10,185 participants, aged ≥20 years, from the National Health and Nutrition Examination Survey cycles 2015-2018. The main predictor was self-reported past history of any type of cancer diagnosed at 20 years of age or younger (yes/no). The outcome variables were having a dental visit within the past year, treatment or preventative visit, urgent need for care, and unmet dental need. Covariates included gender, age, race, marital status, education, and income. Bivariate and multiple logistic regression were conducted, accounting for the complex sampling design. RESULTS: There was no difference between early life cancer survivors in regards to dental visit within the past year (OR: 0.7; 95% CI: 0.3-1.6), visit for dental treatment (OR: 0.6; 95% CI: 0.3-1.6), urgent need for care (OR: 0.8; 95% CI: 0.3-2.0), or unmet dental need (OR: 0.6; 95% CI: 0.2-1.6) compared to cancer-free participants. CONCLUSIONS: Cancer history in early life doesn't impact dental care visits, type of last dental visit, dental care recommendation, or unmet dental need. Future cohort studies are needed to confirm this association.

The association between the supplemental nutrition assistance programme participation and dental caries among U.S. adults.

INTRODUCTION: The Supplemental Nutrition Assistance Programme (SNAP) is a federal programme aimed to alleviate hunger and improve food insecurity. The impact of SNAP participation on overall health has been studied. However, little is known about the effects of SNAP participation on oral health. We aimed to investigate the association between participating in SNAP and dental caries and to explore the role of food insecurity as a moderator in this relationship. METHODS: We obtained data from the National Health and Nutrition Examination Survey (NHANES) cycles 2011-2012 and 2013-2014.The primary outcome was untreated dental caries (none vs. one or more). Self-reported SNAP participation status in the past 12 months was the predictor, and food security was the moderator. Food security was measured as overall food security status (full food secure/ food insecure) and household-level food security (full, marginal, low and very low). Bivariate and multiple logistic regression analyses were conducted to evaluate the relationship between SNAP and dental caries, and whether food insecurity moderates this relationship. Statistical analysis was carried out in September 2020. RESULTS: Our results suggested that after adjusting for potential confounders, SNAP participants were more likely to have untreated dental caries than non-SNAP participants (odds ratio: 1.6; 95% CI: 1.2-2.0). Food security status did not alter the relationship between SNAP participation and untreated dental caries. CONCLUSIONS: Food security status did not alter the relationship between SNAP participation and untreated dental caries. SNAP participation was associated with untreated dental caries among U.S. adults, and this was not affected by their food security status.

Women's awareness regarding the use of dental imaging during pregnancy.

BACKGROUND: There is often anxiety among pregnant women about dental imaging during pregnancy. This may hinder some women from seeking dental treatment during pregnancy and consequently, may negatively affect the oral health of the mother and fetus. This study was conducted to assess women's awareness regarding the use of dental imaging during pregnancy. METHODS: In this cross-sectional study, the electronic distribution of structured questionnaires was done via social media. The self-administered questionnaires contained questions related to women's knowledge regarding the radiation protection measures during dental imaging, the safest period for dental imaging, the type of radiographs that can be acquired during pregnancy, and the possibility of radiation-induced malignancy and fetal malformation as a result of dental imaging. RESULTS: In total, 410 completed questionnaires were received and analyzed. More than half of the participants were 30-49 years of age. The majority of the participants (91%) demonstrated poor knowledge concerning dental imaging. Only 4% reported that pregnant women can have dental imaging during any trimester. The majority believed that panoramic images and cone-beam computed tomography should not be acquired during pregnancy. The majority also believed there is a high risk of congenital malformation due to dental imaging and were unsure about the oncogenic risks. CONCLUSIONS: Our study suggests that there is insufficient knowledge about dental imaging safety during pregnancy. This misconception may have a direct impact on the attitude toward seeking dental care. Therefore, community awareness initiatives aimed at informing our society about radiation exposure, safety, and required protection measures are critical.

The association between food insecurity, diet quality, and untreated caries among US children.

BACKGROUND: The aim of this study was to examine the association between food insecurity and untreated caries among US children and the potential role of diet quality as a mediator in this relationship. METHODS: The authors analyzed data for 4,822 children aged 5 through 17 years from the National Health and Nutrition Examination Survey cycles from 2011 through 2014. The authors measured food security as household-level food security status (full, marginal, low, very low) and overall food security status (full food secure, food insecure). They measured diet quality using the Healthy Eating Index. The primary outcome measure was untreated caries (none, ≥ 1). The authors used multiple logistic regression analysis to evaluate the relationships among food insecurity, diet quality, and untreated caries. They conducted mediation analysis using the Baron and Kenny approach. RESULTS: Food-insecure children were more likely to have untreated caries compared with their fully food-secure counterparts, after controlling for confounding variables (odds ratio [OR], 1.38; 95% [CI, 1.11 to 1.72). Specifically, children from marginal and very low food-secure households had significantly higher odds of untreated caries (OR, 1.48; 95% CI, 1.10 to 2.01) compared with children from fully food-secure households (OR, 1.59; 95% CI, 1.12 to 2.26). Diet quality was not significantly associated with untreated caries. CONCLUSIONS: Food insecurity was negatively associated with untreated caries among US children. Diet quality was not associated with untreated caries. PRACTICAL IMPLICATIONS: Social factors such as food insecurity should be taken into consideration when dental clinicians perform caries risk assessment because caries risk is shown to be associated with overall health and dental health.

The association between food insecurity and dental caries among U.S. adults: Data from the National Health and Nutrition Examination survey.

OBJECTIVES: The purpose of this study was to examine the association between food insecurity and untreated dental caries using a nationally representative sample of US adults. METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) cycles 2011-2012 and 2013-2014 on adults aged 18 years and older were analysed (n = 10 723). Primary predictors were overall food security (food-secure/ food-insecure) and household food security (full, marginal, low and very low). The main outcome was any untreated dental caries (none/ ≥ one). Multiple logistic regression analyses were done to estimate the adjusted odds ratio after controlling for confounders. RESULTS: Food-insecure adults were more likely to have untreated dental caries than food-secure adults after adjusting for potential confounders (OR: 1.2; 95% CI: 0.9-1.5). Adults from households with marginal (OR:1.4; 95% CI:1.5-2.2), low (OR:1.3, 95% CI:1.3-2.0) and very low food security (OR:1.3; 95% CI:0.9-1.5) had higher odds of untreated caries than adults from households with full food security. Following age stratification, marginal, low and very low food-secure adults had higher prevalence of untreated dental caries than full food-secure adults across all age groups. CONCLUSIONS: Our findings suggest that food-insecure adults had higher odds of untreated dental caries than food-secure adults. These findings highlight the importance of assessing food insecurity as a risk factor for dental caries. Longitudinal cohort studies are recommended to determine causal mechanisms.