Effect on undergraduate student self-confidence in using 3D printed primary molars for root canal treatment simulation training.

PURPOSE: The main purpose of this study was to assess the effect of a root canal treatment (RCT) practical simulation-based session using 3D printed primary molars on the self-confidence of fourth-year undergraduate dental students. Our study was also designed to explore student experiences with both manual and rotary RCT procedures and to investigate the association between the self-confidence in undertaking an RCT and the quality of the RCT. METHODS: Student global self-confidence in undertaking an RCT on a healthy, cooperative child aged 4-5 years was evaluated 2 h before, 1 month after, and 11 months after the simulation training session. Once each instrumental procedure had been completed, the students were also asked to score the level of confidence (specific self-confidence) they felt regarding the use of RP and MP. After each training session, the quality of the RCT was radiographically evaluated by two trained, independent investigators. RESULTS: Overall, student global self-confidence in undertaking an RCT increased significantly immediately after the practical session and remained stable for the ensuing eleven months. The students declared a clear preference for RP and were more self-confident in undertaking an RCT after RP than after MP. The proportion of RCTs considered of good quality was the same for the manual (31.5%) and rotary (30.3%) procedures. CONCLUSIONS: Simulation training is a good way to train dental students who are confident in undertaking RCTs. However, confidence is not directly related to competence. Teachers should be encouraged to develop a comprehensive simulation training program, including feedback, debriefing, and repetitions.

An educational intervention about the classification of penicillin allergies: effect on the appropriate choice of antibiotic therapy in pregnant women.

BACKGROUND: Most pregnant women who self-report penicillin allergy are not truly penicillin-allergic and this misunderstanding often leads to administration of inappropriate antibiotic therapy. Decision algorithms have been developed to guide antibiotic selection but major discrepancies have been reported between guidelines and clinical practice. We aimed to optimize the prescription of antibiotics for pregnant women who self-reported penicillin allergy, using an educational intervention about the classification of penicillin allergies that targeted gynecologists, anesthesiologists and midwives. METHODS: This quasi-experimental study assessed the effect of an educational intervention about the classification of penicillin allergy. For six months, a combination of two strategies was used, namely dissemination of printed educational materials and group education. The principal study endpoint was the appropriateness of the antibiotic therapy, defined in advance for each level of allergic risk. RESULTS: The pre-intervention phase included 903 women; one year after its conclusion, the post-intervention phase began and included 892 women. The prevalence of self-reported penicillin allergy was stable over the two periods (6.8% before vs 5.4% after, P=0.24). The clinical classification of penicillin allergies was more often used after the educational intervention (68% vs 100%, P<0.001). The appropriateness of the antibiotic therapy prescribed to self-reported penicillin allergic-women increased significantly between the two periods, from 5/29 (17.2%) to 18/27 (66.7%, P<0.001). CONCLUSION: An educational intervention about penicillin allergy classification was associated with an improvement in the choice of appropriate antibiotic therapy among women who had reported penicillin allergy.

Using e-learning to train dentists in the development of standardised oral health promotion interventions for persons with disability.

BACKGROUND: This study aims to evaluate whether an e-learning curriculum was sufficient to impart the necessary knowledge to dentists to allow them to implement an oral health promotion intervention in an institution for persons with disability. MATERIALS AND METHODS: Participants were asked to complete a 10-module online training course and to implement a standardised intervention in an institution. The outcome measures were as follows: online tracking of progress; multiple choice questionnaires completed at the end of most modules; self-efficacy questionnaire completed before and after online training; completion of training and calibration in the use of a standardised risk assessment form; initiation and full completion of an oral health promotion intervention in an institution; satisfaction of participants with the online training experience; and evaluation of the impact of the intervention by the institution staff. RESULTS: The study sample included 26 dentists. The 10 modules were passed by 24 dentists, and the mean value of the highest overall score recorded in the multiple questionnaires was 88.4% (± 4.0). Twenty participants completed the self-efficacy questionnaire before and after training; the mean values of scores after training were statistically different and higher than those at baseline. Questionnaire regarding satisfaction with the online training experience was completed by 22 participants; all of them stated that they were satisfied with the online training experience. CONCLUSIONS: The results indicate that the online training course helped participants to increase self-efficacy and to provide interventions in institutions. This study could have implications for both undergraduate and postgraduate dental education in France.

[Consumption of fruit juices and fruit drinks: impact on the health of children and teenagers, the dentist's point of view]. / Impact des jus de fruits et des boissons fruitées sur la santé de l'enfant et de l'adolescent: le point de vue du chirurgien dentiste.

OBJECTIVES: The French dietary guidelines published in 2001 recommend daily consumption of 5 portions of fruit or vegetable. Despite this advice, the consumption of fruit in France, especially in the north of France, is low, whereas sale of 100% fruit juices, fruit drinks, and fruit-flavored beverages is increasing. The impact of contemporary changes in beverage patterns on dental caries has received less attention than the impact on childhood obesity. Nevertheless, the cariogenic potential of soft drinks is known. Drinking fruit juices, fruit drinks, or fruit-flavored beverages over a long period of time and continuous sipping could therefore be harmful for the teeth. The aim of this study was to examine the sugar content of such beverages. METHODOLOGY: Four different major supermarkets were visited to select a representative sample of beverages for sale. Fruit juices, nectars, fruit drinks (water and fruit juices) and fruit-flavored waters were included. Lemonades, teas, and drinks containing artificial sweetener were not included. The data were collected in April 2010 by reading nutrition labels. The variables studied were the sugar content (g/100mL), the presence of added sugar, and the percentage of fruit juices. A descriptive analysis of the variables studied was conducted. The mean sugar content of the French population's favorite juices (orange, grapefruit, pineapple, apple, and grape) was compared to the sugar content of a corresponding 100-g portion of fresh fruit. The data were processed using Microsoft Excel. RESULTS: Hundred and eighty-seven different beverages were analyzed: 89 fruit juices, 26 nectars, 51 fruit drinks (sparkling or flat), and 21 fruit-flavored waters. Unlike fruit-flavored waters, nectars and fruit drinks contained fruit juices. Nectars and fruit drinks contained an average of 44.5% (± 10.7%) and 10.5% (± 3.8%) fruit juice, respectively. The sugar content varied from 0 g/100mL to 17.5 g/100mL. The average sugar content was 2.4 (± 2.1) g/100mL, 8.8 (± 2.3) g/100mL, 10.7 (± 1.9) g/100mL, and 10.8 (± 1) g/100mL for fruit-flavored waters, fruit drinks, fruit juices, and nectars, respectively. High sugar content was reported for grape juice, with an average of 15.6 (± 1.9) g/100mL. Nectars, fruit drinks, and 71.4% of fruit-flavored waters contained added sugar. CONCLUSION: These beverages are rich in sugar and labels should better inform consumers on the sugar content. Dental caries is a chronic disease of childhood, which has common risk factors with obesity. General practitioners, dieticians, and dentists must work together to provide preventive guidance: fruit juice intake has to be limited and other beverages restricted to occasional use; fruit juice may contribute to only one portion of the recommended five a day.

Prevalence of symptoms of asthma, rhinitis and eczema in 13- to 14-year-old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III.

Phase I of the International Study of Asthma and Allergies in Childhood has provided valuable information regarding international prevalence patterns and potential risk factors in the development of asthma, allergic rhinoconjunctivitis and eczema. However, in Phase I, only six African countries were involved (Algeria, Tunisia, Morocco, Kenya, South Africa and Ethiopia). Phase III, conducted 5-6 years later, enrolled 22 centres in 16 countries including the majority of the centres involved in Phase I and new centres in Morocco, Tunisia, Democratic Republic of Congo, Togo, Sudan, Cameroon, Gabon, Reunion Island and South Africa. There were considerable variations between the various centres of Africa in the prevalence of the main symptoms of the three conditions: wheeze (4.0-21.5%), allergic rhinoconjunctivitis (7.2-27.3%) and eczema (4.7-23.0%). There was a large variation both between countries and between centres in the same country. Several centres, including Cape Town (20.3%), Polokwane (18.0%), Reunion Island (21.5%), Brazzaville (19.9%), Nairobi (18.0%), Urban Ivory Coast (19.3%) and Conakry (18.6%) showed relatively high asthma symptom prevalences, similar to those in western Europe. There were also a number of centres showing high symptom prevalences for allergic rhinoconjunctivitis (Cape Town, Reunion Island, Brazzaville, Eldoret, Urban Ivory Coast, Conakry, Casablanca, Wilays of Algiers, Sousse and Eldoret) and eczema (Brazzaville, Eldoret, Addis Ababa, Urban Ivory Coast, Conakry, Marrakech and Casablanca).

[Childhood allergies in Reunion Island: is there any difference with metropolitan France?]. / Allergies infantiles à l'île de la Réunion: existe-t-il des différences avec la métropole?

BACKGROUND: The present study had three aims: to estimate for the first time with standardized methodology allowing international comparisons the prevalence and the severity of childhood allergies in Reunion Island, to determine their risk factors and to make a comparison with metropolitan France. METHODS: The same standardized protocol (ISAAC) was used in population-based samples of adolescents recruited in metropolitan France between 1993 and 1994 (n=18555) and in Reunion Island in 2000 (n=2 362). RESULTS: Compared to metropolitans, the adolescents living in Reunion Island suffered significantly more from asthma in the past Year and in life (22 vs 13% and 19 vs 13% respectively). The trend was less clear for allergic rhinitis and eczema since in the case of these manifestations the adolescents reported more symptoms (27 vs 16% et 14 vs 10%, respectively) whereas the metropolitans reported more lifetime diagnostic labels (14 vs 17% et 18 vs 23%, respectively). In Reunion Island, allergies were slightly more severe (1.1 vs 0.8% for severe asthma and 15 vs 2% for eczema). Furthermore, 68% of asthmatics who had severe asthma attacks in the past Year and more than a third of adolescents with severe asthma did not take any asthma medication, which is different from the metropolitan situation. Risk factors for allergies were the same in Reunion Island and in metropolitan France, except the ownership of a pet in the first Year of life, which was not protective against the development of allergies as recently shown in some western countries but was a risk factor. CONCLUSIONS: Asthma and allied diseases are less frequent in metropolitan France than in Reunion Island where management appears to be insufficient. Improvement in prevention and management plans are required in Reunion Island.

[Clinical study and prevalence of fetal alcohol syndrome in medico-social institutions of the Reunion Island]. / Etude clinique et prévalence du syndrome d'alcoolisation foetale pris en charge dans les établissements médicosociaux de l'île de la Réunion.

BACKGROUND: Fetal alcohol syndrome (FAS) is a major problem in the Reunion Island and the Public Health Authorities decided to determine its prevalence in their medico-social centers on 31 December 1996. MATERIAL AND METHODS: A questionnaire was established to identify affected patients in the 20 medico-social centers in charge of 1320 children. Eighty-eight children were selected and 87 could be analyzed. RESULTS: Sixty-four of 87 (76.3%) were FAS and 23 of 87 (23.7%) had closely alcohol-related diseases. The prevalence was between 7.1 and 14.1% and lower than expected from available data. CONCLUSION: The study allowed to precise the social and familial factors predisposing to alcohol addiction during pregnancy. A TV prevention message will be broadcasted after this study.

[Epidemiology of suicide attempts in Reunion Island]. / Epidémiologie des tentatives de suicide à l'Ile de la Réunion.

In order to specify the epidemiological characteristics of attempted suicides on Reunion island, a quantitative study was carried out, using Emergency Room registers of all the hospitals on the island. This enabled collection of 9526 files. The results revealed a high proportion of suicide attempts (335/100,000/year), particularly prevalent in rural areas to the south of the island. There was a tendency towards over representation of women, though less distinct than in Europe, as well as an abnormally frequent use of pesticides or herbicides. Medication and violent means were not used as often as in France. These outcomes, in particular the very high frequency (especially in the rural areas of the south), along with the significance of medico-psychological factors, should be taken into account by anthropologists, linguists, clinical specialists, in order to help determine preventive measures.