Comparison of Self-Reported Empathy Levels among Dental Undergraduate Students in Northern India: A Questionnaire-Based Cross-Sectional Study.

CONTEXT: Empathy is one of the fundamentals of communication relevant within the practice of dentistry, and the research is limited in this field. AIMS: The present study was conducted to assess the self-reported empathy levels among dental undergraduate students in Lucknow city of Northern India. SETTINGS AND DESIGN: A descriptive cross-sectional study was conducted among three dental colleges of Lucknow city during July 2019-September 2019. SUBJECTS AND METHODS: E-survey link was circulated among 790 students through e-mails. It has two parts. The first part included sociodemographic information, wherein the second part, the empathy level of students was assessed using the Jefferson Scale of Physician Empathy-Health Profession Students Version Questionnaire. The possible score range is 20-140: the higher the mean score, the higher the self-reported empathy level. STATISTICAL ANALYSIS USED: The data collected were analyzed using SPSS software version 24. Chi-square test was used to test gender distribution differences among different years. One-way analysis of variance including post hoc tests was used to compare the differences between study variables. RESULTS: The mean ± standard deviation empathy score was 92.55 ± 11.85, 91.85 ± 12.23, 93.25 ± 11.24, 93.37 ± 12.31, and 88.34 ± 12.01 among the first-year, second-year, third-year, final-year, and interns' students, respectively, with a statistically significant difference. CONCLUSION: It can be concluded from the results of the present study that the mean empathy score was highest among final-year students which is suggestive of the impact of education in behavioral sciences.

Perception of undergraduates enrolled in health science courses from Asmara Eritrea towards Hepatitis B.

INTRODUCTION: Hepatitis B (HB) is one of the highly infectious and the most common cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. It is transmitted through blood and body fluids. Most healthcare related personnel are at very high susceptibility towards this infection from the infected patients. AIMS: To evaluate the knowledge and practice towards the hepatitis disease and its cross-infection among dental and medical undergraduate students for the first time ever from Eritrea. SETTINGS AND DESIGN: It is a cross-sectional survey conducted in the only institute offering undergraduate courses in the field of health sciences. MATERIALS AND METHODS: A total of 115 medical and 50 dental undergraduate students from a health science institute situated in Asmara Eritrea filled the form and submitted for evaluation. The questionnaire consisted of the demographic variables such as college of study, year of course, age, gender, apart from questions regarding the knowledge, attitude, and practice towards hepatitis and its transfusion. All the data was transferred to excel and applied statistical test using SPSS software. STATISTICAL ANALYSIS USED: Chi-square test was to test the association between the knowledge and practice variable within the stream of study. RESULTS: The overall knowledge of the undergraduate students was found to be very high when assessed through this survey although practice scores were not satisfactory. When asked, "Do you think you can be affected by Hepatitis?", in regular practice 33 individual gave incorrect answers. CONCLUSION: There is no doubt that the overall knowledge of the undergraduate students is found to be very high but practice scores and awareness towards chances of cross-infection is poor which requires further sessions of education and practice-based courses to be planned for the students.

Empathy among dental students: A systematic review of literature.

BACKGROUND: Empathy is just as relevant within dentistry, although research is limited in this field and very less is available in the current literature. The demonstration of empathy by dentists has been correlated with decreased dental fear. The authors systematically reviewed the literature to investigate empathy levels among dental students. METHODS: A systematic review of the literature was undertaken concerning dental students' empathy, published from November 2016 to June 2018, using manual methods and the PubMed, PMC, PsycINFO, and other databases. Articles not in English and not concerned with dentistry were excluded, and intervention studies intended to enhance empathy, opinion articles, and reviews or reports of nonoriginal research were excluded. Eligible studies were those published from January 1, 2005, to May 31, 2017, in English language. A total of 34 full-text articles were obtained and assessed. Of these 34 papers, only seven publications were considered to have met the inclusion criteria and were directly related to the aim of literature search. RESULTS: Only seven articles that provided data and evidence describing empathy among dental students were included. Four studies reported that the difference in mean empathy level across the year of study was statistically significant (P < 0.05), and one reported that there was no significant difference in empathy scores between the year levels of study. Three articles reported that males had higher mean empathy score than females, whereas vice versa was found in the remaining four articles. CONCLUSION: This article demonstrates that there is only a limited evidence to provide the understanding of empathy among dental students. The results indicated that as patient exposure increases, the empathy level decreases among dental students. Furthermore, it is observed that education in behavioral sciences may be effective in increasing self-reported empathy, and further training may be necessary to maintain high levels.

A 1-year appraisal of pit and fissure sealants following disinfection with and without chlorhexidine solution: An in vivo randomized trial.

OBJECTIVE: The objective of this study is to evaluate the effect of chlorhexidine on the outcome of pit and fissure sealant (PFS) in permanent molars. METHODS: A double-blind randomized controlled trial using split-mouth design was conducted for a period of 1 year. The clinical trial registry was done in the Indian Council of Medical Research, and the clinical trial number obtained was CTRI/2016/08/007222. The age group of participants involved in the trial was 7-14 years. Maxillary or mandibular permanent molar which satisfies the criteria for application of PFS was included in the trial. Based on the eligibility criteria and considering the unknown observer/instrumentation errors, the sample size is 33 for each group. Simple randomization of treatment allocation was carried out using computer-generated random number for treatment assignment of the right molar tooth. The left molar received the alternative treatment. The outcomes of PFS were evaluated by a lone proficient assessor by means of the mouth mirrors and probes following the US public health service criteria. RESULTS: A 6-month evaluation for the PFS with and without chlorhexidine showed 77.27% and 89.39% retention, respectively. PFS without chlorhexidine suffered a greater loss of surface texture and marginal discoloration in comparison to PFS with chlorhexidine at 3-, 6-, and 12-month intervals, but it was statistically insignificant. CONCLUSION: The present study showed improvement in outcome of PFS when an additional step of chlorhexidine is added although the results were statistically nonsignificant.

Route of Drug Abuse and its Impact on Oral Health-Related Quality of Life among Drug Addicts.

BACKGROUND: Various studies have tested quality of life (QOL) among drug addicts, however very few have reported any association between oral health-related quality of life (OHRQOL) and mode of drug administration among drug addicts. Hence, the present study was conducted aiming to evaluate the impact of mode of administration of drugs on OHRQOL among drug addicts. METHODS: Data was collected using respondent-driven sampling (RDS) method among 313 male drug addicts in Sri Ganganagar, Rajasthan, India, using self-administered questionnaires on oral hygiene aids and drug addiction history. OHRQOL was recorded using Oral Health Impact Profile (OHIP-14) questionnaire. The chi-square test, t-test, and Kruskal-Wallis test were used for statistical analysis. FINDINGS: In this study, 56.2% of the drug addicts reported practicing oral hygiene aids. The main drugs abused were heroin, cocaine, and amphetamines as 51.4%, 35.1%, and 13.4%, respectively. Most of the drug addicts were employed (82.4%) and studied up to primary education (46.3%). The highest mean values of community periodontal index (CPI) and decayed, missing, filled surface (DMFS) were found among the cocaine addicts and amphetamine abusers with rates of 3.11 ± 0.98 and 6.69 ± 8.52, respectively. Poor OHRQOL was observed among addicts who consumed drugs in inhalation since a long time irrespective of the type of the drug, but among them heroin addicted subjects had the poorest OHRQOL. CONCLUSION: OHRQOL was poor among the drug addicts in comparison to general population. Preventive strategies on oral health and other health promotion programs for this vulnerable group can be unified.

OBJECTIVE AND SUBJECTIVE EVALUATION OF ADOLESCENT'S ORTHODONTIC TREATMENT NEEDS AND THEIR IMPACT ON SELF-ESTEEM. / AVALIAÇÃO OBJETIVA E SUBJETIVA DA NECESSIDADE DE TRATAMENTO ORTODÔNTICO DO ADOLESCENTE E SEU IMPACTO SOBRE A AUTOESTIMA.

OBJECTIVE: To investigate the presence of association between objective and subjective evaluation of orthodontic treatment needs in adolescents and their impact on their self-esteem. METHODS: Cross-sectional study with adolescents aged 10-17 years old in Sri Ganganagar city, Rajasthan, India. The objective index of orthodontic treatment need (IOTN) dental health component (DHC) and the subjective aesthetic component (AC) were used to determine the normative and the self-perception need for orthodontic treatment, respectively. The selected students were further examined for dental trauma, tooth loss, and dental caries. Rosenberg Self-Esteem Scale was applied for self-esteem level determination. Linear regression analysis was executed to test the individual association of different independent clinical variables with self-esteem scores. RESULTS: Among 1,140 studied adolescents, the prevalence of dental normative orthodontic treatment need was in 56.9% of individuals, whereas 53.3% of individuals considered themselves as needy for the treatment. Multivariate analyses revealed that out of all dental disorders, DHC followed by AC of IOTN had maximum impact on the self-esteem of the adolescence. CONCLUSIONS: Dissatisfaction with dental appearance is a strong predictor for low self-esteem in adolescence.

OBJETIVO: Verificar a presença de associação entre a avaliação objetiva e subjetiva da necessidade de tratamento ortodôntico em adolescentes e seu impacto na autoestima. MÉTODOS: Estudo transversal com adolescentes de 10 a 17 anos da cidade de Sri Ganganagar, Rajastão, Índia. Foi utilizado o Índice de Ortodontia de Saúde Dental (IOTN) para avaliar de modo objetivo a necessidade de tratamento (DHC) e o componente estético desse índice (AC) para a avaliação subjetiva. Os estudantes selecionados foram também avaliados quanto a traumatismos dentários, perda dentária e cárie dentária. Aplicou-se a escala de autoestima de Rosenberg para determinar o nível de autoestima dos estudantes. Os dados foram analisados por regressão linear múltipla, testando a associação individual das diferentes variáveis clínicas independentemente da autoestima dos adolescentes, de acordo com o escore da escala de Rosenberg. RESULTADOS: Entre 1.140 adolescentes estudados, a prevalência da necessidade de tratamento ortodôntico avaliado de modo objetivo pelo IOTN-DHC ocorreu em 56,9% dos indivíduos. A avaliação subjetiva do adolescente (IOTN-AC) revelou prevalência de necessidade de tratamento de 53,3%. A análise multivariada mostrou que, além de todos os problemas dentários, o componente objetivo (IOTN-DHC), seguido do componente estético subjetivo (IOTN-AC), teve maior impacto na autoestima dos estudantes analisados. CONCLUSÕES: A insatisfação com a aparência dental é um forte preditor de baixa autoestima na adolescência.

Traumatic Dental Injuries Prevalence and their Impact on Self-esteem among Adolescents in India: A Comparative Study.

INTRODUCTION: Adolescents are mostly injured during sport activities, traffic accidents and some forms of violence which may lead to traumatic injuries. Traumatic injuries not only pose a health risk worldwide but are also regarded among serious social problems. Poor oral health has been related to poor social relationships that affect the ability to learn and grow which may lead to reduced self-esteem. AIM: This study was conducted to compare self-esteem of adolescents with and without anterior Traumatic Dental Injury (TDI). MATERIALS AND METHODS: A population based comparative study was conducted among 10 to 17 years old adolescents from November 2014 to January 2016. The study sample comprised of 424 controls and 212 cases with 2:1 control-to-case ratio that were selected by four examiners along with a gold standard examiner. TDI was recorded using Ellis classification and self-esteem was recorded using Rosenberg's Self-Esteem Scale (RSES). For comparing self-esteem of cases and controls according to RSES questions, t-test is used. Odds ratio (OR) was utilized to assess and compare the self-esteem according to high and low esteem in cases and controls. RESULTS: Ellis Class I, Ellis Class II and Ellis Class III fractures were observed in 53.3%, 33.49% and 13.20% of cases, respectively. The maxillary arch was the most affected (72.48%) and on the hierarchy of causes, this study found that on most occasions dental injuries were caused by sports (40.09%). The total mean score of RSES in cases (23.16) and in controls (24.43) was also statistically significant (p<0.001). CONCLUSION: Improving oral health in schools may contribute considerably to increase the self-esteem of adolescents in a positive direction and help them in becoming socially competent adults.

Impact of Dental Disorders and its Influence on Self Esteem Levels among Adolescents.

INTRODUCTION: Self esteem is more of a psychological concept therefore, even the common dental disorders like dental trauma, tooth loss and untreated carious lesions may affect the self esteem thus influencing the quality of life. AIM: This study aims to assess the impact of dental disorders among the adolescents on their self esteem level. MATERIALS AND METHODS: The present cross-sectional study was conducted among 10 to 17 years adolescents. In order to obtain a representative sample, multistage sampling technique was used and sample was selected based on Probability Proportional to Enrolment size (PPE). Oral health assessment was carried out using WHO type III examination and self esteem was estimated using the Rosenberg Self Esteem Scale score (RSES). The descriptive and inferential analysis of the data was done by using IBM SPSS software. Logistic and linear regression analysis was executed to test the individual association of different independent clinical variables with self esteem. RESULTS: Total sample of 1140 adolescents with mean age of 14.95 ±2.08 and RSES of 27.09 ±3.12 were considered. Stepwise multiple linear regression analysis was applied and best predictors in relation to RSES in the descending order were Dental Health Component (DHC), Aesthetic Component (AC), dental decay {(aesthetic zone), (masticatory zone)}, tooth loss {(aesthetic zone), (masticatory zone)} and anterior fracture of tooth. CONCLUSION: It was found that various dental disorders like malocclusion, anterior traumatic tooth, tooth loss and untreated decay causes a profound impact on aesthetics and psychosocial behaviour of adolescents, thus affecting their self esteem.

AVALIAÇÃO OBJETIVA E SUBJETIVA DA NECESSIDADE DE TRATAMENTO ORTODÔNTICO DO ADOLESCENTE E SEU IMPACTO SOBRE A AUTOESTIMA / OBJECTIVE AND SUBJECTIVE EVALUATION OF ADOLESCENT'S ORTHODONTIC TREATMENT NEEDS AND THEIR IMPACT ON SELF-ESTEEM

RESUMO Objetivo: Verificar a presença de associação entre a avaliação objetiva e subjetiva da necessidade de tratamento ortodôntico em adolescentes e seu impacto na autoestima. Métodos: Estudo transversal com adolescentes de 10 a 17 anos da cidade de Sri Ganganagar, Rajastão, Índia. Foi utilizado o Índice de Ortodontia de Saúde Dental (IOTN) para avaliar de modo objetivo a necessidade de tratamento (DHC) e o componente estético desse índice (AC) para a avaliação subjetiva. Os estudantes selecionados foram também avaliados quanto a traumatismos dentários, perda dentária e cárie dentária. Aplicou-se a escala de autoestima de Rosenberg para determinar o nível de autoestima dos estudantes. Os dados foram analisados por regressão linear múltipla, testando a associação individual das diferentes variáveis clínicas independentemente da autoestima dos adolescentes, de acordo com o escore da escala de Rosenberg. Resultados: Entre 1.140 adolescentes estudados, a prevalência da necessidade de tratamento ortodôntico avaliado de modo objetivo pelo IOTN-DHC ocorreu em 56,9% dos indivíduos. A avaliação subjetiva do adolescente (IOTN-AC) revelou prevalência de necessidade de tratamento de 53,3%. A análise multivariada mostrou que, além de todos os problemas dentários, o componente objetivo (IOTN-DHC), seguido do componente estético subjetivo (IOTN-AC), teve maior impacto na autoestima dos estudantes analisados. Conclusões: A insatisfação com a aparência dental é um forte preditor de baixa autoestima na adolescência.

ABSTRACT Objective: To investigate the presence of association between objective and subjective evaluation of orthodontic treatment needs in adolescents and their impact on their self-esteem. Methods: Cross-sectional study with adolescents aged 10-17 years old in Sri Ganganagar city, Rajasthan, India. The objective index of orthodontic treatment need (IOTN) dental health component (DHC) and the subjective aesthetic component (AC) were used to determine the normative and the self-perception need for orthodontic treatment, respectively. The selected students were further examined for dental trauma, tooth loss, and dental caries. Rosenberg Self-Esteem Scale was applied for self-esteem level determination. Linear regression analysis was executed to test the individual association of different independent clinical variables with self-esteem scores. Results: Among 1,140 studied adolescents, the prevalence of dental normative orthodontic treatment need was in 56.9% of individuals, whereas 53.3% of individuals considered themselves as needy for the treatment. Multivariate analyses revealed that out of all dental disorders, DHC followed by AC of IOTN had maximum impact on the self-esteem of the adolescence. Conclusions: Dissatisfaction with dental appearance is a strong predictor for low self-esteem in adolescence.

Exploring the missing link - Empathy among dental students: An institutional cross-sectional survey.

BACKGROUND: Empathy plays an important role in healthy dentist and patient relationship. Hence, the aim of the study is to (a) to measure the self-reported empathy levels among dental undergraduate and postgraduate students. (b) To review the trend of changes in empathy level with experience, age, and gender among dental undergraduate and postgraduate students. MATERIALS AND METHODS: This cross-sectional, questionnaire-based study was carried out in two private dental institutions situated in Sri Ganganagar, India, with a sample size of 978. Data were obtained from the 1st to final year (BDS), interns, and postgraduate students from January to March 2015. An empathy level of students was assessed by the Jefferson Scale of Physician Empathy - Health Profession Students Version Questionnaire. An exploratory factor analysis using Kaiser's criteria was undertaken to appraise the construct validity and dimensionality. Based on the results of the factor analysis, three factors were selected; labeled as perspective taking, compassionate care, and standing in patient's shoes. RESULTS: The majority of the students was female in a equivalent  ratio of 1338:618. There were significant differences in empathy scores by gender and age (P < 0.01). The lowest and highest mean empathy scores were found in postgraduate (mean = 108.77, standard deviation [SD] =9.12) and 1st year (mean = 117.23, SD = 14.19) dental students, respectively. CONCLUSION: Dental educators should consider the likely decline in empathy among students as early as possible and adopt communication teaching strategies to promote the development of empathy and reduce the risk of further decline.

Impact of sociodemographic attributes and dental caries on quality of life of intellectual disabled children using ECOHIS.

OBJECTIVES: To assess the impact of oral health outcomes on Oral Health-Related Quality of Life (OHRQoL) among intellectual disabled children and their families. METHODOLOGY: OHRQoL based study was conducted among 150 intellectual disabled children students in the North West part of the country, Rajasthan, India. Guardians were asked to complete questionnaire on socioeconomic status and the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the children's OHRQoL. Clinical assessment included dental caries and OHI-S INDEX. Univariate regression analysis was fitted to assess covariates for the prevalence of impacts on OHRQoL. RESULTS: 54% of the caregivers reported that their child had an impact on at least one ECOHIS item. Negative impacts were more prevalent on items related to difficulty in eating some foods, difficulty in pronouncing any words and missed preschool, day-care or school. The univariate Poisson regression analysis showed that dental caries was significantly associated with the outcome. The prevalence of any impact on OHRQoL was approximately 1.32 and 2.84 times higher for children with low and higher severity of dental caries respectively when compared with those who were free of caries. CONCLUSION: Patient-oriented outcomes like OHRQoL will enhance our understanding of the relationship between oral health and general health and demonstrate to clinical researchers and practitioners that improving the quality of patient's well-being go beyond simply treating dental disease and disorders.