Aesthetic Dentistry - What You Decided and What I Want: Shade Selection

ABSTRACT Objective: To assess the relationship between patients' and dentists' perceptions of shade selection and its impact on satisfaction with the prosthesis. Material and Methods: A single group pre-post study was conducted at the Prosthodontics department of a teaching hospital in India. One hundred ten participants were selected through a systematic random sampling technique with inclusion and exclusion criteria. Patients' attitudes regarding the aesthetics of their maxillary anterior teeth were recorded using a validated questionnaire. Shades for the intended prosthetic crown selected by the dentist and chosen by the patient were recorded separately, and patient satisfaction with the appearance of the final prosthesis was recorded. We used descriptive statistics followed by Pearson's Chi-square test and a binomial logistic regression model for inferential statistics. Results: 109 participant's data were available for final analysis. Patients choose lighter shades than the dentist's selection, which is statistically significant (p=0.000). 73.4% were satisfied with the final prosthesis, and the binomial logistic regression model identified using patient-selected shade for the final prosthesis was significantly associated with patients' satisfaction with the final prosthesis (OR=3.3, p=0.001). Conclusion: The patient's preference should be considered with the dentist's option when selecting a shade to create good esthetics.

Early Assessment of Impact of Increased Value Added Tax on Smoking Behaviors and Financing among Adult Smokers in Saudi Arabia.

Background: Cigarette smoking has been identified as most perilous risk factor for several health ailments. Increased price may discourage smoking habits. There is limited literature available on impact of price rise on smoking behaviors in Saudi Arabia, which is the fourth largest importer of cigarettes and this study assessed the impact of tax increase (in 2020) on smoking behaviors. Methods: A cross-sectional survey was carried out between July 2021 and December 2021.i.e.one year after new value added tax (VAT) system came into force. Data was collected with 14-item pretested questionnaire from 721 adult smokers in Al-Jouf Region of Saudi Arabia selected through stratified cluster ransom sampling. We measured effects of tax increase on smoking behaviors, its impact on decision to quit and perceived health improvements as outcome variables. Results: Nearly 40% of the respondents said that increased price lead them to smoke less number of cigarettes per day (P=0.000), decreased smoking improved their health in terms of breathing capacity, mood, ability to exercise and sleep in hierarchy. 67.4% of the participants are currently thinking of quitting smoking due to increased prices (P=0.001) and logistic regression models identified reduced smoking due to tax rise (Odds=5.68), improvement in health (Odds=2.94) and excess spending of above 20% (Odds=1.72) significantly associated with intentions to quit smoking. Conclusion: Increased price of cigarettes due to VAT significantly decreased smoking behaviors and has impact on smokers' decision to quit smoking. Future studies needed to assess the long-term effect of increased tax on smoking behaviors and its relapse.

Evaluation of two different approaches of health education (Tailored leaflet vs Video) on referral compliance for prosthetic replacement of missing teeth among the patients at a university dental care center.

BACKGROUND: Prosthodontic replacement of missing teeth is necessary to maintain function, aesthetics and prevent further oral complications. OBJECTIVE: To assess whether health education 'video' increased prosthodontics treatment demand for replacing missing teeth compared to traditional health education (IEC) 'leaflet' among patients visiting a university dental care centre, Saudi Arabia. METHODS: A non-randomized educational intervention was conducted among the patients who had missing teeth. 350 participants were divided equally into two interventions groups- health education leaflet group and health education video group. Two major variants were ascertained; demand for prosthodontic dental care and awareness (knowledge) about importance of replacement of missing teeth. These two variants were studied for the difference in the scores between base line and at the end of the program i.e. after 3 months. Bivariate analysis was done with Chi square test, Mc Nemar Chi-square test and Wilcoxon matched-pairs tests and finally binary logistic regression analysis was done. RESULTS: Final analysis included 324 participants. There was improvement in both knowledge and demand for prosthodontic care in both the groups after health education, but statistically significant improvement in demand for dental care was observed in the health education video group compared to leaflet group (42.9% vs 63.2%). Logistic regression analysis identified that having missing teeth in anterior region of jaw and being into video group were two significant factors associated with increased demand for care. CONCLUSION: Health education video method was found to be effective method compared to leaflets in improving knowledge and demand for replacing missing teeth.

COVID-19 prevalence and infection control practices among dentists in Andhra Pradesh State, India.

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic posed a new challenge not only to public health but also to the health care systems and dentists are one of the highly vulnerable health care professionals for COVID-19 infection. OBJECTIVE: To assess the COVID-19 prevalence, associated factors, and infection control practices among dentists in Andhra Pradesh State, India. METHODS: A cross-sectional web-based questionnaire survey was conducted among dentists in Andhra Pradesh State, India. 21-item pretested questionnaire was used for data collection between January 30, 2021 and February 21, 2021. 3700 dentists from the Andhra Pradesh state were selected from the Dentists Register of India through systematic random sampling method. RESULTS: Out of 3700 dentists invited to participate in this study, responses from 1876 dentists were received with response rate of 51%. Prevalence of 8 among the study population was 9%. Patients were the primary source of infection for 60.5% of the COVID-19 positive study participants. 65.8% of total respondents using full face shield and two-third of them using N95 or equivalent mask while providing dental care. CONCLUSION: This study found a high prevalence rate of COVID-19 among the dentists. Among the associated factors, being into active practice during the pandemic was found to be statistically significant. This study recommend for additional infection control protocols specific to the COVID-19 pandemic.

Evaluating a linkage between obesity and the occurrence of dental caries among school going children in Sakaka, Al Jouf, Kingdom of Saudi Arabia.

Background: Obesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. The aim of this study was to analyze the type of relationship between the dental caries and obesity among school children in Al-Jouf region of Saudi Arabia. Methods: This cross-sectional study was conducted among 400 participants aged 6 to 14 years. The study involved measuring caries (dmft/DMFT), assessing body mass index (BMI), and administering a self-completion questionnaire. An independent t-test, one-way ANOVA, and multivariate logistic regression analyses were performed. Results: Out of 400 participants, 380 agreed to participate in the study. Overall caries prevalence among the participants was 76.1% and mean DMFT and dmft values were 2.8 ± 1.0 and 3.7 ± 1.6. Among the factors associated with mean caries scores, relation between DMFT scores and frequency of consumption of sugar was statistically significant (F = 3.82,0.01). Regression models has identified children with increased BMI values has 3.2 times more risk of getting dental caries in permanent teeth (P = 0.001). Conclusion: There was a positive association between obesity and dental caries in school going Saudi Arabian children. Comprehensive multidisciplinary approach by health professionals is recommended for preventive public health issues related to caries and obesity in teenagers.

Reliability of Educational Content Videos in YouTubeTM about Stainless Steel Crowns.

The purpose of the present study is to evaluate the quality and educational information provided on YouTubeTM about stainless steel crowns (SSC). Videos were searched for on YouTube TM using keywords related to stainless steel crowns in pediatric dentistry in the Google Trends application. A total of 52 videos were available. After exclusion criteria application, 22 videos were selected for the study for analysis. To classify the video content as high or low quality, a scoring system formed of seven parameters was used. For a global evaluation of the video quality, the video information and quality index were applied. Data obtained were analyzed statistically. Only a few videos explained the importance of SSCs. Most of the videos uploaded with a high number of likes were of low quality. Very few videos were of high quality. The content quality and educational quality of videos is poor and incomplete. None of the videos explained the need for the SSC and its benefits in pediatric dentistry.

Rate of Compliance with Infection Control Practices while Taking Dental Radiographs in a Dental Health Care Center, Saudi Arabia.

Background: Infection control guidelines are aimed at preventing cross-contamination in clinical settings. Radiographs are indispensible part of oral diagnosis and assessing prognosis. Strict adherence to infection control protocol while taking dental radiographs are mandatory. Aims and Objectives: To assess the rate of compliance with infection control practices while taking dental radiographs in the dental clinic center of a teaching institution in Saudi Arabia. Materials and Methods: An observational study was undertaken for the infection control practices in the dental radiology wing of a university teaching center in Saudi Arabia. Data were collected from dental faculty, dental assistants, and dental students working in dental clinics. Both pretested questionnaire and by direct observation of infection control practices was used for data collection. Chi-Square test for categorical variables and Independent samples t-test for compare mean self-reported infection control practice scores were used. Binary logistics regression was used to identify the factors influencing participant's compliance with infection control practices. P ≤ 0.05 was considered statistically significant. Results: 129 participants were included in this study, among those 26 were faculty, 19 were dental auxiliaries and 84 were dental students. On direct observation, the overall compliance rate was 79.5%; Dental auxiliaries have the highest compliance rate (94.5%) followed by dental faculty (88.5%) and students (68.6%). Binomial logistic regression predicted that females had 2.94 times more compliance than male counterparts, which is statistically significant. Conclusion: Students and faculty need continuing dental education programs for reinforcement on infection control practices.

Exposure to parental and sibling smoking and future intentions to smoke among 13-15 years old school age children in Saudi Arabia.

INTRODUCTION: prevalence of smoking in school children is alarming in Saudi Arabia and little is well-known about the aspects stimulating such behaviours in secondary school children. The aim of this study was to assess the association between influence of parent/sibling/peer smoking and future intentions to initiate smoke among 13-15 years old school children in Al Ras town, Saudi Arabia. METHODS: a cross sectional survey was conducted in Al Ras city during first quarter of 2019. Data was collected from 492 secondary school children who were selected through multistage stratified cluster sampling. Pretested, self-administered Arabic questionnaire was used to collect data about socio-demographic and prevalence of current smoking behaviours and associated factors. Descriptive statistics was done initially, following by binomial regression to assess the predictors of current smoking and future smoking intentions. RESULTS: the overall prevalence of smoking in respondents was 22.7% and statistically significant difference in smoking prevalence's between boys and girls was observed (40% vs 5.6%). Among the predictors of current smoking, smoking habits in siblings and getting pocket money over 200 Saudi riyals are found to be significant. Siblings smoking (odds ratio: 6.4) and poor academic performance (odds ratio: 3.2) were the two most important factors influencing children's intentions of smoking. CONCLUSION: smoking prevalence in secondary school children of Al Ras was similar to national data. Since, influence of siblings, getting more pocket money and poor academic performance were found to important predictors of children smoking behaviours and attitudes, health education programs should address these factors to be effective.

Effect of probiotic bacteria on oral Candida in head- and neck-radiotherapy patients: A randomized clinical trial.

OBJECTIVE: The aim of the study is to assess the effect of probiotic bacteria on oral Candida counts in cancer patients who are undergoing head- and neck-radiotherapy in a tertiary care center. STUDY DESIGN: The study was a randomized clinical trial including 90 patients who just completed head- and neck-radiotherapy. MATERIALS AND METHODS: Participants were randomly allocated into three equal sized groups, i.e., probiotics group, candid group, and combination groups. Oral rinse samples of the patients were collected before and after the intervention for the identification of Candida. The samples were incubated on Sabouraud's Dextrose Agar with Chloramphenicol at 37°C for 48 h, to assess the counts of colony-forming units/milliliter (CFU/ml) of Candida in saliva, and further on chrome agar plates to identify the Candida spp. Data were analyzed using mixed ANOVA to compare mean CFU/ml of Candida among three groups before and after the intervention. RESULTS: A total of 86 patients were included in the final analysis and there was a statistically significant reduction in mean Candida spp. Counts (CFU/ml) after intervention in all the three groups (P = 0.000) and significant reductions identified in both probiotic and combination therapy groups. Apart from reduction in Candida albicans, significant decrease in Candida glabrata and Candida tropicalis was observed after probiotics usage compared to other groups. CONCLUSIONS: The present study suggests that probiotic bacteria were effective in reducing oral Candida spp which can be recommended alone or in combination with traditional antifungal agents for effective reduction in oral Candida in head- and neck-radiotherapy patients.

Assessment of Caries Spectrum of First Permanent Molars in 7- to 8-Year-Old School Children in Northern Saudi Arabia: A Cross-Sectional Study

Abstract Objective: To estimate caries spectrum in first permanent molars (FPMs) of 7- to 8-year-old children in Saudi Arabia using Caries Assessment Spectrum and Treatment (CAST) index, and examine the correlation between distributions of CAST codes among contralateral and opposite arches. Material and Methods: A cross-sectional survey was conducted of 7- to 8-year-old Saudi school children in Sakaka, Aljouf, Saudi Arabia. A total of 385 children were examined. CAST codes were determined for FPMs, and their distribution was analyzed using Spearman's rank correlation coefficient. Statistical significance was set as p<0.05. Intra-examiner reliability was determined using the unweighted kappa coefficient. Results: The results indicated most of the FPMs were scored as code 3 (enamel lesions) such as upper contralateral FPM 44.40% for right, 53.50% for left, respectively, and lower contralateral molars were 61.30% for right and 64.90% for left, respectively. It was also observed that upper FPMs had scored code 0 (sound teeth) more than that of lower FPMs. Serious morbidity (codes 6 and 7) and mortality (code 8) showed a low prevalence in FPMs. Strong correlations were observed between upper contralateral FPMs (r=0.586) and lower contralateral FPMs (r=0.567, p<0.001). Conclusion: A high prevalence of enamel caries lesions (code 3) was observed in FPMs; in addition, a strong correlation was present between upper contralateral FPMs and between lower contralateral FPMs.

Self-Perceived Preparedness to Work Independently Among Graduating Dental Students in Saudi Arabia: Traditional Versus Integrated Curriculum

Abstract Objective: To investigate the perceived preparedness of graduating dental students to work independently and to compare these perceptions between Traditional and Integrated curriculums of dentistry in Saudi Arabia. Material and Methods: A pretested self-administered questionnaire was filled by 258 dental students from four dental institutions across the country. The questionnaire covered 10 domains consisting of sixty suitable questions. Students were asked to mark their responses at one of five levels of performance for each of the selected skills ranging from 0 (not yet learned) to 4 (can do it confidently). Mean scores for each subscale of the Questionnaire were calculated by individual items and for all comparison, p≤0.05 was considered statistically significant. Results: 253 graduating students were included in the final analysis, out of which 108 belongs to the Integrated curriculum group and 145 from Traditional curriculum. Overall scores of Traditional curriculum students (176 ± 4.8) were more compared to Integrated curriculum students (161 ± 3.2), which are statistically significant. Integrated curriculum students had more self-perceived skill scores in Orthodontics, Conservative/Operative Dentistry & Endodontics, Dental Public Health and Drug & Emergency management group of clinical skills. Overall, perceived preparedness to practice dentistry for all participants is 60.5% and traditional curriculum students expressed more preparedness (68%) than Integrated curriculum (53%). Conclusion: Overall, preparedness to practice independently is unsatisfactory compared to other countries. The Ministry of Education (KSA) should take necessary actions to bridge the gap between training dentists and to be competent practitioners.

Mandible: An Indicator for Sex Determination - A Three-dimensional Cone-Beam Computed Tomography Study.

BACKGROUND: Mandible is considered as one of the stronger bones of skull available for gender identification. Mandibular measurements can be used for the identification of gender either on dry mandible or through panoramic radiography or cone-beam computed tomography (CBCT). AIM: To determine the gender from mandibular measurement using CBCT. MATERIALS AND METHODS: The Morphometric analysis was performed on 200 CBCT scans of the subjects using OnDemand 3D software (Seoul, Korea). Morphometry of mandibular is measured by estimation of the angles formed at different locations on mandible to predict the gender. Statistical analysis was performed; independent samples "t-" test was used to compare the mean values between males and females. Discriminant function analysis was used for gender prediction. RESULTS: The subject's age ranged from 18 to 60 years with an equal number of males and females. The mean angle formed by the intersection of lines from the left and right gonion to menton in males was 129.9 ± 11.9 and it was 126.7 ± 12.6 in females. The mean linear distances from the right gonion to menton in both males and females were 86.8 ± 5.3 and 82.6 ± 6.2, respectively. The mean linear distances from the left gonion to menton were 49.5 ± 5.1 in males and 47.7 ± 3.9 in females. The mean linear distance from the right gonion to left gonion was 47.7 ± 4.4 in males and 46.6 ± 4.2 in females. The Box's M statistics was applied to verify the applicability of mandibular measurements in gender prediction. The values indicate that gender can be predicted using these four variables, which is statistically significant (P = 0.000). The overall prediction accuracy of this model was 67%, with 66.7% in males and 67.3% in females being correctly classified. CONCLUSION: The angle formed by the intersection of lines from the left and right gonion to menton (Gn-M0) helps provide anthropological data, which can be used in dental and medicolegal practices.

Relation between Clinical Oral Dryness Score and Denture Satisfaction among Patients' in a Tertiary Care Centre, India.

INTRODUCTION: Xerostomia is a subjective feeling of dryness commonly seen in elderly populations which impairs the quality of life. Due to loss of lubricating property of saliva the buccal mucosa, tongue and lips tend to stick leading to dry, freckled, ulcerated and sore mucosa which is of major concern to the patient to use complete denture. AIM: The aim of the study was to assess the relation between oral dryness score and denture satisfaction among elderly patients. MATERIALS AND METHODS: A cross-sectional study was conducted in prosthodontics department of a dental institution. Patients wearing dentures for at least six months were invited to participate in study. Visual Analogue Scale (VAS) with scores ranging from 0-100 was used to assess patient's satisfaction and clinical oral dryness score was assessed using the criteria described by Osailan SM et al., with scores ranging from 0-10. Data was analysed with SPSS software (version-20) and Kendall's tau-b correlation was used to determine the relationship between mean denture satisfactions and mean clinical oral dryness scores. RESULTS: A total of 220 participants were included in the study based on inclusion criteria. Mean dryness score of the participants was 1.8±0.6 and mean VAS-score for denture satisfaction was 74.32±21.20 for aesthetics, for chewing ability the mean score was 62.31±19.64 and for phonetics it was 67.82±30.60. Strong negative correlation between VAS-scores and oral dryness scores was observed. CONCLUSION: Clinical oral dryness score is one of the important factors which influence denture satisfaction. Dentist should consider in predicting prognosis.

Gaps in need, demand, and effective demand for dental care utilization among residents of Krishna district, Andhra Pradesh, India.

AIMS: To identify the relation between need, demand, and effective demand for dental services in Andhra Pradesh, India. MATERIALS AND METHODS: This is a cross-sectional study performed among populations residing in the rural and urban areas of Krishna district, Andhra Pradesh, India. Data were collected from 3102 individuals who were selected through multiphase random sampling. Data regarding self-perceived dental need, dental service utilization, and barriers for utilization were collected through s pretested questionnaire followed by type-III clinical examination to assess the normative need of the individuals. Chi-square test was used to compare independent and dependent variables, and further comparison was done with multivariate logistic regression analysis for significant variables. RESULTS: Less than half (40%) of the participants perceived a need for dental care. Among the people who perceived need for care, only 21.4% utilized dental care and 78.6% of them had unmet dental needs. The two main reasons for not seeking dental care was lack of money, i.e., unaffordable dental treatment (48%) and having the perception that they do not have any dental problem (19.4%). CONCLUSIONS: There is an enormous difference between normative need, demand, and actual utilization rates in dental care, and hindrances for effective demand need to be addressed to improve dental care delivery system.

Quality of reporting of randomized controlled trials in ten academic Indian dental journals.

BACKGROUND: Biased results from poorly reported trials can mislead decision-making in health care at all levels, from treatment decisions for the individual patient to formulation of national public health policies. OBJECTIVE: To evaluate the quality of reporting of randomized controlled trials (RCTs) in ten Indian dental journals over the period 2011-2012. MATERIALS AND METHODS: This study included all RCTs published as full-text articles reported in ten Indian dental journals over the period from 2011 to 2012. The relevant trials were identified by searching Medline. Hand searching of the journals was also carried out by three of the authors to check if any potential trial was missing. Each article was assessed against the Consolidated Standards of Reporting Trials criteria tool, as described by Schulz et al. (2010). RESULTS: The mean number of criteria present per article was 12.2 (standard deviation [SD] =2.2) and only 5 of 106 articles got total possible score. Most of the articles (69%) did not mention about justification for sample size calculation, 89% of the articles did not mention about allocation concealment, 86% of the articles did not mention about funding and 63% of the articles did not mention about limitations of the study. CONCLUSION: The quality of reporting of Randomized clinical trials in ten Indian academic journals was poor.

Emotional Intelligence among Dental Undergraduate Students: An Indispensable and Ignored Aspect in Dentistry.

BACKGROUND: Emotional intelligence (EI) is a measure of pure intelligence of cognitive ability that translates psychological knowledge into terms that are useable by people not professionally trained in psychology, like dentists. MATERIALS AND METHODS: A cross-sectional, self-administered, structured questionnaire survey in English was distributed among 186 undergraduate students to assess their EI. It consisted of 30 questions, 5 each to assess the self-awareness, empathy, self-confidence, motivation, social control, and self-competency. All the participants were asked to answer each question, anything between virtually never to virtually always using the rating scale 1-5. RESULTS: The collected data were analyzed using statistical software SPSS version 20 (Chicago, Inc.). The mean, median, and mode for various responses between the groups were compared. Only 11.55% of the participants had good EI with scores above 20 in all domains, while a majority of 54.02% proved to have average EI. A mere 2.05% showed to have very poor EI and 28.84% demonstrated poor EI. CONCLUSIONS: The study showed that only 11.55% had a good EI and a major percentage of the students require immediate intervention to improve their EI.

Dental manpower planning in India: current scenario and future projections for the year 2020.

Dental manpower issues in India are discussed in this article which consists of both qualitative and quantitative research. The output of qualified dentists has increased substantially over last decade and at present there are over 117,825 dentists working in India. Although India has a dentist to population ratio of 1:10,271, the newly graduating dentists find it difficult to survive in the private sector. At present less than approximately 5% graduated dentists are working in the Government sector. If the present situation continues there will be more than one lakh dentists over supply by the year 2020. Continuation of the current situation will lead to wastage of highly trained dental manpower and create a threat to the professional integrity of the dentists. This research highlights the fact that there is an urgent need for an organised national human resource planning system to control the supply and demand of dental manpower, to ensure a uniform distribution of manpower and to give future directions to policy makers.