Students' Perceptions of their Dental Curriculum and Education.

Objective: To evaluate the satisfaction of dental students toward their dental curriculum and education at dental colleges in the central region of Saudi Arabia. Methods: Two forms of the questionnaire were established, a paper version and an electronic internet-based survey (Google online form). Paper versions were distributed to interns graduated from universities in Riyadh. The electronic versions were used to obtain responses from students at dental colleges and universities outside of Riyadh, such as Prince Sattam bin Abdulaziz University (PSAU) and Majmaah University, by emailing the links to the participants who were dental interns that had graduated in the 2018/2019 academic year. Results: A total of 388 interns answered the questionnaire. Overall, 48.4% of the interns were highly satisfied with the Operative Department while regarding Orthodontic Department 16.9% were satisfied while 11.2% were highly satisfied. Regarding the non-clinical satisfaction score, the interns were mostly unsatisfied with their research skills (15.5%). Comparing the interns' satisfaction at different institutions, there was a statistically significant difference in the clinical satisfaction score (P ≤0.01), but there was no difference in the non-clinical satisfaction score (P > 0.05). Conclusion: Dental students need a greater focus and exposure to research skills during their dental school studies. To improve dental students' level of clinical satisfaction, it is more important for them to have early exposure to comprehensive clinical training than specialty-based clinical training.

Evaluation of the Effect of the Loading Time on the Microtensile Bond Strength of Various Restorative Materials Bonded to Silver Diamine Fluoride-Treated Demineralized Dentin.

The aim of this study was to evaluate the effect of immediate versus delayed loading times on the microtensile bond strength (µTBS) of restorative materials, including resin-based composite (RBC), resin-modified glass ionomer cement (RMGIC) and glass ionomer cement (GIC), that were bonded to silver diamine fluoride (SDF)-treated demineralized dentin. Ninety caries-free extracted premolar teeth were assigned to three groups (n = 30) loaded with RBC, RMGIC and GIC restorative materials. Each group was further divided into three subgroups (n = 10): subgroup A (control specimens), immediate loading of the restorative material on sound dentin; subgroup B, demineralized dentin, SDF treatment and immediate loading of the restorative material; and subgroup C, demineralized dentin, SDF treatment and restorative material loading a week later. One-way ANOVA and Tukey's post-hoc tests were performed to compare the µTBS values. The RBC exhibited the highest µTBS, followed by RMGIC and GIC. Multiple comparisons showed an increase in the µTBS in the delayed loading groups irrespective of the restorative material used. The majority of the failure modes were adhesive. Delayed loading of RMGIC for 1 week after SDF application showed significantly higher µTBS than that of immediate loading.

The Effect of Loading Time on Color Stability of Various Restorative Materials Bonded to Silver Diamine Fluoride-Treated Demineralized Dentin.

Aim: To investigate the effect of immediate versus one week later loading time on color stability of resin-based composite (RBC), resin-modified glass ionomer cement (RMGIC) and glass ionomer cement (GIC) restorative materials bonded to silver diamine fluoride (SDF)-treated demineralized dentin. Materials and Methods: Ninety extracted premolars were randomly assigned to the following groups (n = 30 each): group-I (loaded with RBCs), group-II (loaded with RMGIC), and group-III (loaded with GIC). Each group was divided randomly into the following subgroups (n = 10): subgroup-A (control specimens) consisted of sound dentin and the restorative material was immediately loaded; subgroup-B consisted of demineralized dentin, underwent a SDF treatment and the restorative material was immediately loaded; subgroup-C consisted of demineralized dentin, underwent a SDF treatment and the restorative material was loaded 1 week later. The color difference (ΔE) and visual color changes (L*a*b*) of each specimen were calculated using a spectrophotometer. Data were analyzed using one-way ANOVA and post hoc Tukey's tests to compare the ΔE values and a paired t test to compare the mean of L* a* b* coordinates. Results: The highest color stability was observed for GIC, followed by RMGIC, and the lowest color stability was observed for the RBC group. Significant differences within groups were noted in RBC and RMGIC (p < 0.001). Regarding the loading time of the restorative material, in RBCs, a significantly lower ΔE value was observed in the delayed loading group than in the immediate loading group (p = 0.035). In the RMGIC and GIC groups, there were no significant differences. Conclusion: Delaying the loading time of the restorative material for 1 week following the application of SDF resulted in greater color stability than that of immediate loading. The caries arresting potential of SDF was revealed by the dark staining, which could be improved with the subsequent delayed restoration.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia.

OBJECTIVES: To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA). METHODS: Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index more than 15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p less than 0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion. RESULTS: A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA. CONCLUSION: The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Elementary school staff knowledge about management of traumatic dental injuries.

AIM: This study investigated the knowledge of elementary school staff regarding the management of traumatic dental injuries (TDIs) in children. METHODS: The present cross-sectional study analyzed data collected between September 2016 and April 2017. The sample consisted of 2,027 elementary school staff members in Riyadh, Saudi Arabia. A stratified cluster random sampling technique was used to select the required sample. Those who agreed to participate in the study completed a 4-part self-administered questionnaire comprising questions regarding demographic data, knowledge on management of tooth fracture, and avulsion using photographs of TDI cases. RESULTS: The majority of the school staff showed inadequate basic knowledge regarding the importance of saving the broken piece of the tooth and identifying the tooth involved in the trauma (67% and 66.3%, respectively), P<0.05. However, they had a significantly high number of correct responses regarding the immediate management of TDIs for the 2 case scenarios presented in the questionnaire (P<0.05), and the majority (41%) reported normal saline as a suitable storage medium (P<0.01). CONCLUSION: This study revealed a lack of knowledge in certain aspects of TDIs among elementary school staff.

Occurrence of traumatic dental injuries among preschool children with Autism Spectrum Disorder.

OBJECTIVE: To determine the occurrence of traumatic dental injuries (TDIs) among Saudi preschool children with autism spectrum disorder (ASD) and compare it with Saudi preschool children without ASD. METHODS: This study was conducted on a randomly selected sample of three to five year old Saudi preschool children in Riyadh, Saudi Arabia. The sample consisted of two groups; a study group (SG) of 257 ASD children, and a control group (CG) of age- and gender-matched 257 children without ASD. Clinical examinations were performed at selected ASD centers and kindergartens to determine the occurrence of TDIs based on modified World Health Organization (WHO) classification system. RESULTS: Out of 514 children examined, 108 (21.0%) had suffered TDIs. The prevalence of TDIs was significantly higher in the SG (25.7%) children than the CG (16.3%) [p=0.012]. The primary maxillary central incisors were the most commonly affected teeth in both the groups; significantly more in CG (72.9%) than SG (50.1%) [p=0.017]. Enamel fracture was the most frequent type of TDI in both the groups; significantly more in CG (29.2%) than SG (21.1%) [p=0.032]. Luxation injuries and tooth avulsions were significantly higher in the SG than the CG (p=0.028). CONCLUSIONS: The occurrence of TDIs was higher in Saudi preschool children with ASD than in non-ASD children.

Knowledge on management of traumatic dental injuries among Saudi mothers.

OBJECTIVE: This study investigated the knowledge of Saudi mothers regarding the management of traumatic dental injuries (TDIs) in children. MATERIALS AND METHODS: A cross-sectional study using structured questionnaires was employed for mothers chosen by stratified-cluster random sampling technique from primary health care centers in Riyadh, Saudi Arabia, over a period of 12 months (July 2016-June 2017). The questionnaire surveyed mothers' background and knowledge on management of tooth fracture and avulsion using photographs of TDI cases. RESULTS: The sample consisted of 3,367 Saudi mothers. More than half of the mothers (55.3%) gave the correct response, which was to send the child with tooth fracture immediately to the dentist (p<0.01). The majority of mothers (41.6%) gave the correct response for the immediate mode of action, which was to save the avulsed tooth in storage medium and send the child to the dentist immediately (p<0.001). However, they prioritized the immediate management of TDIs, and most reported saline as a suitable storage medium (p<0.001). The mothers expressed a positive interest in further education. CONCLUSION: Educational programs and TDI protocols must be implemented to increase mothers' awareness and improve the prognosis of children with TDIs.

Learning style preferences of dental students at a single institution in Riyadh, Saudi Arabia, evaluated using the VARK questionnaire.

BACKGROUND: Students differ in their preferred methods of acquiring, processing, and recalling new information. The aim of this study was to investigate the learning style preferences of undergraduate dental students and examine the influence of gender, Grade Point Average (GPA), and academic year levels on these preferences. METHODS: The Arabic version of the visual, aural, read/write, and kinesthetic (VARK) questionnaire was administered to 491 students from the first- to the fifth-year academic classes at the College of Dentistry, King Saud University. Descriptive statistics were used to characterize the learning styles of the students, and Chi-square test and Fisher's test were used to compare the learning preferences between genders and among academic years. Significance was set at a p-value of <0.05. RESULTS: A total of 368 dental students completed the questionnaire. The multimodal learning style was preferred by 63.04% of the respondents, with the remaining 36% having a unimodal style preference. The aural (A) and the kinesthetic (K) styles were the most preferred unimodal styles. The most common style overall was the quadmodal (VARK) style with 23.64% having this preference. These differences did not reach statistical significance (p>0.05). Females were more likely to prefer a bimodal learning style over a unimodal style (relative risk =2.37). Students with a GPA of "C" were less likely to have a bimodal or a quadmodal style preference compared to students with a GPA of "A" (relative risk =0.34 and 0.36, respectively). Second-year students were less likely to prefer a bimodal over a unimodal style compared to first-year students (relative risk =0.34). CONCLUSION: The quadmodal VARK style is the preferred learning method chosen by dental students, followed by unimodal aural and kinesthetic styles. Gender was found to influence learning style preferences. Students with a "C" GPA tend to prefer unimodal learning style preferences. The VARK questionnaire is a relatively quick and simple tool to reveal the learning style preferences on an individual or a group level. Dental educators should adjust their delivery methods to approximate the learning preferences of their students. Dental students are encouraged to adapt a multimodal style of learning to improve their academic results.

Occurrence of oral habits among preschool children with Autism Spectrum Disorder.

OBJECTIVE: To determine occurrence of oral habits among Saudi preschool children with autism spectrum disorder (ASD) and compare it with healthy preschool children. METHODS: This study was conducted over a 14-months period in Riyadh, Saudi Arabia. The sample consisted of two groups; a study group (SG) of 150 ASD children, and a control group (CG) of age- and gender-matched 150 healthy children. The parents of the children in both the groups were administered a questionnaire that included questions about the children's demographic information and previous or persistent oral habits. RESULTS: The prevalence of oral habits was higher (87.3%) among the SG children as compared to CG children (49.3%). The most prevalent oral habit among the SG was bruxism (n = 82; 54.7%), followed by object biting (n = 67; 44.7%) and mouth breathing (n = 40; 26.7 %). Among the CG; the most prevalent oral habit was mouth breathing (n = 40; 26.7%) followed by nail biting (n=18; 12%) and object biting (n = 7; 4.7%). The prevalence of bruxism, object biting, thumb sucking and tongue biting was significantly (p<0.05) higher in the SG than the CG. CONCLUSIONS: The prevalence of oral habits was higher in the ASD group children than the healthy children.

Middle East respiratory syndrome in children. Dental considerations.

As of January 2016, 1,633 laboratory-confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection and 587 MERS-related deaths have been reported by the World Health Organization globally. Middle East Respiratory Syndrome Coronavirus  may occur sporadically in communities or may be transmitted within families or hospitals. The number of confirmed MERS-CoV cases among healthcare workers has been increasing. Middle East Respiratory Syndrome Coronavirus may also spread through aerosols generated during various dental treatments, resulting in transmission between patients and dentists. As MERS-CoV cases have also been reported among children, pediatric dentists are at risk of MERS-CoV infection. This review discusses MERS-CoV infection in children and healthcare workers, especially pediatric dentists, and considerations pertaining to pediatric dentistry. Although no cases of MERS-CoV transmission between a patient and a dentist have yet been reported, the risk of MERS-CoV transmission from an infected patient may be high due to the unique work environment of dentists (aerosol generation).

Cone Beam Computed Tomography Evaluation of Inverted Mesiodentes.

A mesiodens is the most common type of supernumerary teeth. The purpose of this report is to present a rare occurrence of non-syndromic impacted inverted mesiodentes in an 8.5-year-old boy who presented with a chief complaint of delayed eruption of his permanent maxillary left central incisor. Occlusal and panoramic radiographs, as well as cone beam computed tomography (CBCT) with a three-dimensional (3-D) reconstruction image, confirmed that one supernumerary tooth had perforated the nasal fossa floor and the other was in close approximation to the to the same site. Surgical removal of both mesiodentes was indicated. Radiographic evidence of complete healing was observed 12 months following surgical removal. The use of CBCT with a 3-D reconstruction image as a tool in diagnosis and evaluation of healing after surgical removal is recommended.

Combined orthodontic and periodontic treatment in a child with Papillon Lefèvre syndrome.

A 9-year-old girl with Papillon-Lefèvre syndrome (PLS) was treated orthodontically 24 months after the start of mechanical and antibiotic therapy in adjunct with periodontal treatment every 6 weeks. After achieving stable periodontal conditions, orthodontic treatment was commenced to correct the teeth position, facial profile, and maxillary protraction. Following the combination therapy and a failure to detect Actinobacillus actinomycetemcomitans from any site in the oral cavity, orthodontic treatment with a fixed appliance was performed aside from creating space for eruption of permanent teeth. We found that combined periodontal and orthodontic treatment of PLS may be successful with a complex interdisciplinary regimen and close follow up. This is a 2-year follow-up case report of a girl with PLS. Orthodontic and periodontic therapy were offered using combined treatments of orthodontic and periodontal with the benefit of prosthodontic consultation, resulting in a treatment plan.