Awareness and practice of dentists in gulf cooperation council countries regarding medication-related osteonecrosis of the jaw - A web-based survey.

Background/purpose: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication among dental patients undergoing treatment with antiresorptive medications such as bisphosphonate and denosumab. The present survey investigated the awareness and practice of dentists in the Gulf Cooperation Council (GCC) countries regarding MRONJ. Materials and methods: This questionnaire-based study was conducted among dental practitioners in all six GCC countries. A questionnaire was designed and distributed among all potential participants via different social media platforms. SPSS version 22 was used for data analysis, and P-value <0.05 was considered statistically significant. Results: Overall, 1685 dentists from the six GCC countries participated in the present study. The surveyed dentists revealed relatively fair practices and awareness regarding MRONJ and its prevention, with the majority reported asking their patients about history of anti-osteoporotic medications (67.8%), recording name of the medication (73.1%) and duration of treatment (75.5%). However, the majority of the participants were unconfident about the duration of drug holiday prior to dental surgical interventions (70.6%) and the overall good level of knowledge/practice related to MRONJ was just 50.6%. The regression analysis revealed that previous exposure to MRONJ cases and attending a seminar, course, meeting, or conference about osteonecrosis of the jaw were independent predictors for positive awareness/good practice regarding MRONJ (P < 0.05). Conclusion: The results show inadequate awareness and practices of dentists practicing in GCC countries regarding MRONJ, with significant variations among the countries. Therefore, appropriate interventions such as periodic continuous education courses are required to improve dentists' knowledge and practices regarding MRONJ.

Estrogen, Progesterone and Androgen Receptor in Primary and Recurrent Pleomorphic Salivary Adenomas.

OBJECTIVE: Our study aimed to characterize alteration in the immunohistochemical expression of estrogen, progesterone and androgen receptor in the tumour cells of primary pleomorphic adenomas and recurrent pleomorphic adenomas. METHODS: A retrospective study of data including 30 cases of primary pleomorphic adenomas (PA) without recurrences and 15 cases of recurrent pleomorphic adenomas were examined (RPA). RPA included 8 males and 7 females. Immunohistochemical expression of estrogen, progesterone and androgen receptor was examined in the selected cases. The percentage of slides was semi-quantitatively assessed by two independent observers and scores were given. The statistical analysis included the use of descriptive statistics and proportional frequencies. RESULTS: AR expression was identified in 12 (40. %) out of 30 cases of (PA) pleomorphic adenomas and 7 of 15 cases recurrent pleomorphic adenomas (RPA) (46 %). The results showed that ER and PR expression were negative in PA and RPA. CONCLUSION: Androgen receptors might have role in pathogenesis of PA and RPA. Estrogen and progesterone receptors have no role in development of recurrent pleomorphic salivary adenoma.

Assessment of Knowledge Among the Physicians Regarding Dental Screening Prior to Chemotherapy and Radiotherapy

ABSTRACT Objective: To evaluate the physicians' knowledge regarding the referral for dental screening prior to chemotherapy and radiotherapy. Material and Methods: We conducted a cross-sectional study using simple random sampling among 468 physicians from various specialties with diverse experience levels from different regions in Saudi Arabia. A self-reporting questionnaire was distributed among the physicians, which consisted of questions assessing the physicians' knowledge about oral health and complications in patients prior to chemotherapy and radiotherapy. Statistical analysis was done after the data was collected employing SPSS, and p<0.05 was taken as significant. Results: Residents were more as expected (39.3%), followed by specialists (2.31%). The majority had a practice experience for more than five years (67.8%).The scores for the knowledge assessment showed that 51.3%, nearly half of the participants, had lower scores. The scores were statistically significant (p<0.05). Conclusion: General physicians and specialists should be aware of the dental complications and associated diseases in patients with malignancies and those undergoing chemo and radiotherapy. It is proposed that more awareness should be raised among physicians to rectify this lapse.

Knowledge, awareness, and attitude among dental students regarding oral cancer in Saudi Arabia.

Background: Oral cancer awareness among junior and seniors' dental undergraduate students may have an impact on the early detection and prevention of oral cancer. Aims and Objectives: To assess oral cancer awareness, knowledge and attitude among undergraduate dental students in government and private colleges in Saudi Arabia. Material and Methods: A cross-sectional survey was undertaken to assess oral cancer knowledge, awareness and attitude among undergraduate dental students in government and private colleges in Saudi Arabia. All junior and senior students enrolled during the 2020- 2021 academic year, were eligible to participate (n=189). Results: The study shows that dental Students at private and government colleges in Saudi Arabia are generally knowledgeable regarding Knowledge, awareness, attitude and management of oral cancer. There was no significant difference between knowledge, awareness, attitude, and management of oral cancer between students in either private and government colleges. Results shows that 99 (88.9%) of dental students in government colleges considered human papilloma virus as a risk factor, higher than dental students in private colleges 48 (73.3%). My results indicated that dental students considered (87%) tobacco, and alcohol (83.6%) as main risk to oral cancer, whereas, 100 (53%) identified limited consumption of fruit and vegetables and 124 (65.6%) considered old age as risk factor for oral cancer. Conclusion: The variation in correct answers indicate to need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Revision of knowledge senior students in oral cancer is highly recommended.

Résumé Contexte: La sensibilisation au cancer de la bouche chez les étudiants de premier cycle en médecine dentaire des cycles supérieurs peut avoir un impact sur la détection précoce et la prévention du cancer de la bouche. Objectifs: Évaluer la sensibilisation, les connaissances et l'attitude au cancer de la bouche chez les étudiants en médecine dentaire de premier cycle dans les collèges publics et privés d'Arabie saoudite. Matériel et méthodes: Une enquête transversale a été menée pour évaluer les connaissances, la sensibilisation et l'attitude face au cancer buccal parmi les étudiants en médecine dentaire de premier cycle dans les collèges publics et privés d'Arabie saoudite. Tous les étudiants juniors et seniors inscrits au cours de l'année universitaire 2020-2021 étaient éligibles pour participer (n=189). Résultats: L'étude montre que les étudiants en médecine dentaire des collèges privés et publics d'Arabie saoudite sont généralement bien informés sur les connaissances, la sensibilisation, l'attitude et la gestion du cancer de la bouche. Il n'y avait pas de différence significative entre les connaissances, la sensibilisation, l'attitude et la gestion du cancer de la bouche entre les étudiants des collèges privés et publics. Les résultats montrent que 99 (88,9%) des étudiants en médecine dentaire dans les collèges publics considéraient le virus du papillome humain comme un facteur de risque, plus élevé que les étudiants en médecine dentaire dans les collèges privés 48 (73,3%). Mes résultats ont indiqué que les étudiants en médecine dentaire considéraient (87 %) le tabac et l'alcool (83,6 %) comme le principal risque de cancer buccal, alors que 100 (53 %) ont identifié une consommation limitée de fruits et légumes et 124 (65,6 %) considéraient la vieillesse comme facteur de risque de cancer de la bouche. Conclusion: La variation des réponses correctes indique la nécessité de renforcer le programme d'études dentaires de premier cycle en ce qui concerne l'éducation sur le cancer buccal ; notamment dans sa prévention et sa détection précoce. La révision des connaissances des étudiants seniors en cancer buccal est fortement recommandée. Mots-clés: Étudiants en médecine dentaire, connaissances, cancer de la bouche.

Determinants of COVID-19 Vaccine Acceptance among Dental Professionals: A Multi-Country Survey.

PURPOSE: This study sought to investigate the acceptance rate and associated factors of COVID-19 vaccines among dentists and dental students in seven countries. MATERIAL AND METHODS: A structured questionnaire prepared and guided by the report of the SAGE Working Group on Vaccine Hesitancy was distributed among groups of dentists and dental students in seven countries across four continents. RESULTS: A total of 1527 subjects (850 dentists and 677 dental students) participated in this survey. Although 72.5% of the respondents reported their intention to accept COVID-19 vaccines (dentists: 74.4%, dental students: 70.2%), there was a significant difference in agreement between dentists/dental students across countries; generally, respondents in upper-middle-, and high-income countries (UM-HICs) showed significantly higher acceptance rates compared to those in low- and lower-middle income countries (L-LMICs). Potential predictors of higher vaccine acceptance included being a dentist, being free of comorbidity, being well-informed about COVID-19 vaccines, having better knowledge about COVID-19 complications, having anxiety about COVID-19 infection, having no concerns about the side effects of the produced vaccines and being a resident of an UM-HIC. CONCLUSION: The results of our survey indicate a relatively good acceptance rate of COVID-19 among the surveyed dentists and dental students. However, dentists and dental students in L-LMICs showed significantly lower vaccine acceptance rates and trust in COVID-19 vaccines compared to their counterparts in UM-HICs. Our results provide important information to policymakers, highlighting the need for implementation of country-specific vaccine promotion strategies, with special focus on L-LMICs.

Assessment of Knowledge and Attitude of Dental Students towards HIV and Its Oral Manifestations in Saudi Arabia-A Cross-Sectional Study.

BACKGROUND: It is essential for practicing dentists to have adequate knowledge of HIV/AIDS and its implications in the dental practice. Their attitudes should also be up to the professional expectations. This study aimed to assess knowledge of HIV/AIDS infection and attitudes towards its patients among dental students in Saudi Arabia. METHODS: A questionnaire was prepared and distributed among a sample of dental students in Saudi Arabia. Twenty questions related to knowledge, attitudes, and oral manifestation of HIV were presented. RESULTS: A total of 405 questionnaires were completed (67% response rate). Participants showed low knowledge of safety regarding HIV (39.5%) and 44.2% indicated that they would take an HIV test after needle stick injury. The proportion of correct answers regarding transmission of HIV through saliva, cardiopulmonary resuscitation, and aerosols by hand pieces was 41%, 37.5%, and 26.4%, respectively. Almost 50% of the surveyed dental students expressed unwillingness to treat HIV-positive patients. Poor knowledge was noted regarding oral manifestations of HIV (32.7%). Of the participants, 57.8% indicated that infection control procedures are very important for the treatment of HIV patients and 50.6% believed that a dentist can make a decision to reject the treatment of HIV patients. According to the participating dental students, the three major oral manifestations in HIV patients are hairy leukoplakia (47.4%), oral candidiasis (44.7%), and Kaposi's sarcoma (43.5%). CONCLUSION: Inadequate knowledge and unprofessional attitude towards HIV/AIDS patients were identified among this group of dental students in Saudi Arabia. Dental educators and health care planners in Saudi Arabia should plan to promote the knowledge and attitudes of dental students in Saudi Arabia towards the treatment of HIV patients.

Dentists' Perception of Oral Potentially Malignant Disorders.

OBJECTIVES: Dentists play a major role in the diagnosis of oral potentially malignant disorders (OPMDs) that may lead to malignancy. Their knowledge on OPMDs and the risk factors associated with malignant disease needs to be sufficient. The aim of this study was to assess the level of knowledge, attitudes, and awareness of OPMDs amongst general dentists and dental specialists working in Saudi Arabia. MATERIAL AND METHODS: Questionnaires were distributed to dentists working in Saudi Arabia. A total of 303 dentists participated in the study. The questionnaire included 20 questions on knowledge, attitudes, and awareness of OPMDs. RESULTS: The response rate was 55%. There was no significant difference between general dental practitioners and dental specialists regarding leukoplakia, which is the most common OPMD (P > .05) and in identifying tobacco and alcohol as the main risk factors for malignant transformation of OPMDs into cancer (P > .05). However, there was a significant difference (P < .05) between specialists (75.3%) and general practitioners (52.3%) in the diagnosis of OPMDs. There was a significant difference (P < .05) between specialists (63.5%) and general practitioners (28.0%) in recognising the likelihood of malignant transformation of proliferative verrucous leukoplakia. There was a significant difference between specialists (61.2%) and general practitioners (25.2%, P < .05) in recognising the erosive form or atrophic type of oral lichen planus, considering that it is more likely to undergo malignant transformation. CONCLUSIONS: Dental specialists have better knowledge and awareness than general dentists regarding OPMDs. Improved continuous education programmes on the risk factors and diagnosis of OPMDs should be organised to train dentists.

Study of Lateral Wall Thickness of the Maxillary Sinus in Left and Right Sides for Female and Male: A Cross Sectional Retrospective Study Using Cone Beam Computed Tomography.

BACKGROUND: Dental implants are considered the first option to replace missing teeth. Alveolar bone resorption gradually progresses following tooth extraction leading to loss of vertical bone dimension for implant placement. The lateral window approach is the most commonly used procedure to treat vertical bone loss. OBJECTIVE: The aim of the present study is to evaluate the Lateral Wall Thickness (LWT) of the maxillary sinus and determine the influence of gender and side on maxillary LWT. METHODS: This study involved a cross sectional retrospective study. Cone- beam computed tomography data were collected from 99 patients with a total of 198 maxillary sinuses that met the inclusion criteria. The patient age ranged between 18 to 35 years. On the selected sagittal section, the points of measurement are determined by a perpendicular line at 5 mm from the lowest point of the sinus floor. Measurements were taken at four different areas; first premolar (P1), second premolar (P2), first molar (M1), and second molar (M2). Descriptive statistics were used to calculate mean lateral wall thickness for each tooth, and student's t-test was used to test the effect of gender and side on maxillary LWT. RESULTS: The greatest mean LWT was observed around the left first maxillary molar (2.43±0.82), while the lowest mean LWT was observed around the right second maxillary premolar (1.62±0.61). There was no significant difference in the LWT around any tooth (M1 p=0.56, M2 p=0.92, P1 p=0.14, P2 p=0.19). CONCLUSION: There was no significant difference in both males and females of the lateral wall thickness in the left and right side of maxillary sinus.

Pemphigus Vulgaris in Old Patient.

Pemphigus vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes. The first clinical manifestation is often the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin. The etiological factors of this disease still remain unknown, although the presence of autoantibodies is consistent with an autoimmune disease. A 73-year-old man had bullous lesions on gingiva, oral mucosa first, then scalp, trunk, and face. An oral medicine specialist suspects the lesion in differential diagnosis in the first presentation of oral lesions and follows up the patient, and then these bullous lesions presented on the skin. In this article, a patient had received oral prednisolone (80 mg/kg/day) and azathioprine, then tapered oral prednisolone to 40 mg/day, with a reduction of 5 mg/day every three weeks. The patient shows remission of these lesions, and complication of this treatment includes osteoporosis, hyperglycemia, and hypertension.

Planning the Restorative Dental Treatment at the Time of Coronavirus Pandemic: A Two-arm Strategy.

The high risk of infection with coronavirus forced dental practices to decline/limit oral healthcare services to emergency and urgent conditions. Under this policy, the economic burden on dental professionals and their employees was immense. With the prolonged duration of coronavirus health crisis, it was clear that dentists and associated workers and companies cannot bear the cost of longer suspension of regular dental services. At this point, calls have been made for gradual return to regular dental clinical practice. However, dental health professionals around the world realized that oral care services should be tailored to fit the time of COVID-19 pandemic. An important question to be raised here is regarding planning the dental treatment during the time of coronavirus pandemic. Should a dentist plan the dental treatment in a different way to that at a normal time? This paper aims to propose a simple strategy to plan the restorative dental treatment at the time of coronavirus pandemic. The aim of this strategy is to expand the range of oral care services and minimize the risk of infection with this deadly virus. The role of the shortened dental concept and minimum use of aerosol- /droplet-generating procedures have been emphasized. Keywords: Coronavirus, COVID-19, Dental treatment, Pandemic, Shortened dental arch.

COVID-19-Awareness and Practice of Dentists in Saudi Arabia.

Dental professionals have a major role in the fight against the spread and transmission of COVID-19. This study aimed to evaluate awareness and practice of dentists in Saudi Arabia regarding COVID-19 and the utilization of infection control methods. A 24-item questionnaire was developed and distributed through social media to 627 dentists working in Saudi Arabia. 177 questionnaires were completed (28.2% response rate). Most dentists were aware about the transmission, incubation time and main clinical symptoms of COVID-19. Almost 83% of the respondents appreciate the risk of droplets, aerosols and airborne particles in transmission of COVID-19 in the dental clinic. Among the common practices of participants are measuring patient's body temperature before undertaking a dental treatment (88.7%), cleaning the environmental surfaces at the dental clinic after each patient (91.5%) and restriction of dental treatment to emergency cases (82.5%). It seems that practicing dentists in Saudi Arabia are fairly aware about COVID-19. The practices of the surveyed dentists appear to be mostly consistent with the current guidelines and recommendations for infection control of COVID-19 in the dental clinic. Some drawbacks in knowledge and a number of inappropriate practices can be identified and require the attention of health authorities.

COVID-19 Guidelines to Protect Healthcare Workers at Hospitals and Dental Professionals at Dental Office.

BACKGROUND: Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. This study aimed to address the preventive procedures to protect healthcare workers at hospital to avoid COVID-19, and infection control procedures to protect dental professionals in dental office. METHODS: We conducted a search of published articles from PubMed, google scholar databases using key words such as COVID-19, healthcare worker, infection control, and dental practice. Relevant articles were identified and reviewed. Most published papers were clinical reports and case studies. We have selected some of the current published papers written in English in 2020. RESULTS: Infection control procedures to protect health workers at hospitals, and dental professionals at dental office were summurised and presented. Infection control procedures for healthcare workers at hospitals include Personal protective equipment, Korea filter (KF)94 respirator, goggles, face protector, disposable waterproof long-arm gown, and gloves, and others. Extra-protection procedures should be taken with old and vulnerable healthcare workers. Dental professionals should evaluate patients in advance before starting dental treatment. Aerosols generating procedures should be avoided and personal protective equipment should be used. Dental treatment should be restricted to emergency cases only. CONCLUSION: Old medical staff should be in safer distance to avoid infection, but young physicians and nurses should work at frontline as their immunity is better than their colleagues at old age. Screening patients and measurement of the body temperature are essential measures before dental treatment.

Oral Cancer: Awareness and Knowledge Among Dental Patients in Riyadh.

More than 50 % of oral cancer cases are diagnosed at advanced stages. Public knowledge about oral cancer can help in prevention and early detection of the disease. The aim of the present study was to assess the levels of awareness and knowledge about signs and risk factors of oral cancer among dental patients in Saudi Arabia. A self-administered questionnaire was used to collect information from 1410 randomly selected patients attending dental departments within public hospitals in Riyadh, Saudi Arabia. The collected data were analyzed using SPSS software. The significance level was set at P < 0.05. The study revealed that only 62.4 % were aware of oral cancer. Some 68.2 and 56.5 %, respectively, were able to correctly identify tobacco and alcohol as risk factors. More than two thirds of subjects had no knowledge about any signs of oral cancer. Participants with lower than university education were significantly less aware, and had much less knowledge, of the signs and risk factors of oral cancer. The knowledge regarding oral cancer among Saudi dental patients is alarmingly low. Interventions to improve public knowledge about oral cancer and attitudes towards early diagnosis and treatment are urgently indicated.

Evaluation of p27 Expression in Salivary Gland Neoplasms; A Step Forward in Unveiling the Role of p27.

INTRODUCTION: Salivary gland neoplasms are not uncommon lesions that are seen in the head and neck region. The role of cell cycle regulators as well as that of oncogenes remains unexplored in the pathogenesis of these neoplasms. AIM: Present study was conducted to evaluate the expression of p27 in the three common salivary gland neoplasms. MATERIALS AND METHODS: A total of 34 cases (19 pleomorphic adenoma, 8 mucoepidermoid carcinoma and 7 adenoid cystic carcinoma) were included. The sections were subjected to p27 staining and rated for the expression. RESULTS: Of the total 52.6% of pleomorphic adenoma cases, 25% of mucoepidermoid carcinoma cases and only 14.2% of adenoid cystic carcinoma cases showed strong expression suggesting variable p27 expression in both malignant neoplasms. Normal salivary gland tissue was stained as a positive control for the evaluation. CONCLUSION: The results of the study suggest an important role for p27 in pathogenesis of mucoepidermoid carcinoma as well as adenoid cystic carcinoma while its role in pathogenesis of pleomorphic adenoma remains questionable keeping in view the strong expression of p27 in the same.

Knowledge and Apprehension of Dental Patients about MERS-A Questionnaire Survey.

INTRODUCTION: Middle East Respiratory Syndrome (MERS) is a disease caused by beta corona virus. From April 11(th) to 9(th) June 2014, World Health Organization (WHO) reported a total of 402 laboratory confirmed cases of MERS from KSA, out of which 132 cases were reported from Riyadh alone. AIM: The aim of this study was to assess the knowledge and apprehension of patients about MERS visiting Al Farabi College of Dentistry, Riyadh, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional questionnaire based survey was conducted which consisted of 10 self-prepared questions. A total of 404 patients participated in this study. RESULTS: Three hundred and forty patients had heard about MERS. Nearly a quarter of the patients (25.74%) were apprehensive about undergoing dental treatment because of MERS. A little more than half of the patients (50.99%) knew that camel was a source of Middle East Respiratory Syndrome-Corona virus. Most of the patients (80.72%) were aware of the infection control measures to be followed by dentist and 138 patients claimed they took some precaution when present inside the dental college. CONCLUSION: Majority of the patients had heard about MERS and was aware of the infection control measures. However, some patients were apprehensive about undergoing dental treatment because of MERS. Further steps need to be taken to educate the patient's about transmission of MERS and infection control measures in a dental hospital.

Are dentists involved in the treatment of obesity?

The morbidity and mortality associated with being overweight or obese have been known to the medical profession to be related with an increased risk of associated diseases. This article provides an overview of obesity and addresses possible strategies for the management of this important public health concern. This narrative review sheds light on the problem of obesity and the necessity of professional oral health care to work in partnership with the medical team for managing obesity. In this regard, general dental practitioners should at least reinforce their knowledge regarding obesity and understand their potential role in the treatment and management of obese patients.

Odontogenic Keratocyst in Children: A Review.

OBJECTIVE: Is to highlight the characteristics and management of odontogenic keratocyst in children only. MATERIAL AND METHOD: Computerized search in pubmed between (2005-2015) using specific words such as odontogenic keratocyst in children, odontogenic keratocyst association with Gorlin-Goltz syndrome with abstract written in English only. RESULT: During computerized literature search 77 articles in the years (2005-2015) were found. All these publications were miscellaneous studies including case series and case reports. Only 35 papers were selected which conform to our criteria. Most of the papers indicate that the histological type of keratocyst prevalent in children was parakeratinized variant, and most of the cases occurred in maxilla rather than mandible. CONCLUSION: We recommend that the surgeons who treat keratocysts in children take into consideration the late presentation in addition to the destructive nature and high recurrence rate. General practitioners face difficulty in early detection and referral of children with keratocysts or Gorlin syndrome. Treatment by multidiscplinary team is important if associated with Gorlin's syndrome Postoperative follow up is advised every 6 months.