Measuring the efficiency of "fee for service" clinics in the faculty of dentistry, alexandria university, using data envelopment analysis

The [fee for service] clinics in the Faculty of Dentistry, Alexandria University were established in 1998 to provide oral health care services to the community at reasonable fees. The present study was conducted to evaluate the efficiency of these clinics [five clinics after exclusion of the orthodontics clinic whose output in terms of income and number of services far surpassed the others]. Data envelopment analysis was used to evaluate the efficiency of the clinics in two models to examine the robustness of the technique to various model specifications. The analyses were also performed across nine windows by dividing the performance of each clinic in every year into two. This was done to test stability across time [window analyses]. The efficiency scores were plotted for the two models in the form of frontier plot and they were regressed on the outputs and inputs used to determine the factors that had the greatest effect on the scores. The two models identified the same units as the most efficient [Operative and Pediatric dentistry]. The same clinics were also identified across time in the window analysis which suggests the stability of the technique across different specifications and across time. The factors that most affected the efficiency of the clinics were income generated, number of procedures and experience of dentists. The efficiency of the clinics as a whole needed improvement and this can be done by increasing the income they gencrat, increasing the number of procedures provided to patients, decreasing the number of dentists employed or employing junior dentists

Risk indicators for severe periodontitis in adult population

The aim of this study was to identify the risk indicators and develop a predictive model for severe periodontitis among the study population. The study included 280 dentate subjects [87 males, and 93 females], whose mean age was 33.9 +/- 11.0. They were randomly selected from the Outpatient Dental Clinic of the Faculty of Dentistry, Alexandria University. A Personal interview was performed to obtain information regarding several independent variables which included: so-ciodemographic factors, subjectively reported oral health status, toothbrushing behavior, history of general diseases and smoking habits. The clinical parameters selected as possible indicators of periodontal disease included assessment of plaque and gingivitis according to Silness and Lb'e index, as well as assessments of calculus and bleeding in response to probing as dichotomous variables. The Ramfjord's technique for the indirect measurement of loss of periodontal attachment was used to as- sess the periodontal condition of the individuals. Subjects with severe periodontitis were defined as those having loss of attachment > 3 mm in the top 20% of the sample. The results showed that although a wide range of sociodemographic, general health and clinically determined oral health variables were significantly associated with severe periodontitis in univariate analysis, however, this relation disappeared in multivariate analysis. The only variables that had profound and consistent effect across the multivariate analysis were calculus, gingival indices, and smoking [2- versus 4+ cigarettes/day] [OR = 5.89, 3.36, 2.71, respectively]. Age, although included in the predictive model, proved to be rather weaker [OR = 1.06] compared to the previously mentioned variables. To conclude, although the predictive variables outlined in this study are few, yet it is possible to develop an acceptable predictive model for severe periodontitis. Therefore, these indicators are worthy for longitudinal examination to determine if they are true risk factors

effects of cigarette smoking on the periodontal condition in an adult population

The aim of this study was to investigate the relationship between smoking and the periodontal condition in an adult population. In this case-control study, 280 dental patients were selected from those who attended the Dental Clinic in the Faculty of Dentistry in Alexandria. Their age ranged between 18 to 60 years and they were all medically fit. The subjects were classified as periodontitis positive [cases] if they possessed at least one site with probing depth > 4 mm and attachment loss of > 2 mm. Otherwise, patients were allocated in the control group. Smoking status was expressed in terms of consumption, i.e. the number of cigarettes consumed per day and duration [number of years of smoking]. The clinical examination included evaluating the plaque and gingival condition by Sil-ness and Loe index. Calculus and bleeding were recorded as dichotomous variables. While the loss of attachment was calculated by measuring the distance from the cementoenamel junction to gingival margin and subtracting the value from the probing depth measurement. The results proved that smokers had higher levels of plaque, more site which bled in response to probing, and a greater mean probing depth and attachment loss than never smokers. Smokers had 2.44 times greater risk of having periodontal disease compared to non-smokers [OR = 0.41]. A dose-response relationship was revealed in the present study between both the amount of cigarette smoking, smoking duration and periodontal disease. In the whole sample, those who never smoked had significantly less odds [OR = 0.41] than those who smoked [OR = 2.44]. Nearly a two-fold increase in the odds of periodontitis was noticed in persons who smoked [1 - 10 or 11 - 20 cigarettes] versus those who did not [OR = 2.15, 1.93, respectively]. Also, those who smoked for more than 10 years had significantly higher odds of periodontitis than those who smoked for a shorter period [OR = 6.83 versus 0.76]. In conclusion, the present study clearly indicates an association between chronic smoking and periodontal diseases, both in terms of pocketing and attachment loss. It also provides evidence in favor of the assumption that smoking has a causative role in periodontitis which is based on the finding of the dose-response relation between smoking and periodontitis. It is recommended that dentists acquire smoking intervention skills to provide community education for preventing periodontal diseases

Caries prevalence, severity and contributing factors related to dental fluorosis among preparatory school children in alexandria governorate

The aim of the present study was to determine the prevalence, severity of dental fluorosis and to identify the contributing factors to fluorosis among preparatory school children in Alexandria Gov-ernorate. To meet this aim, a cross-sectional sample was selected using a stratified sampling with proportional allocation technique. A total number of 1007 children, aged 12 to 13 years old, were randomly selected from 27 preparatory schools in all of Alexandria districts [urban and rural - private and public schools], and they were equally divided into males [505] and females [502] A questionnaire was used to collect fluoride exposure data. Only students who returned the questionnaire and their parents' consent were clinically examined on the next day for dental fluorosis, which was recorded by Dean's [1942] index. One hundred samples of drinking tap water for residents [since birth] were analyzed to measure the fluoride concentration For further confirmation of the fluoride analysis, 12 water samples were collected from all Alexandria water stations The results showed that the water fluoride level in Alexandria ranged from 0.30 to 0.90 mg/L, the highest water fluoride concentration was in Borg El-Arab district, which was attributed to presence of agricultural waste products that drained in the main water stream just before the water supply station Although this fluoride concentration in drinking tap water is considered optimal, however there is a trend towards increase in the prevalence of dental fluorosis [60.0% to 85.7%], particularly in Borg El-Arab district [85.7%], also in rural children [92.4%] than urban children [69.9%] and public schools [72.1%] than private [64.6%]. The most prevalent form of dental fluorosis was the very mild form. Fluorosis was proved to be more prevalent in maxillary than mandibular teeth and premolars were the teeth most affected. The multiple regression analysis proved that the most significant contributing factor for dental fluorosis was fluoridated toothpaste if used in large size on toothbrush's head and particularly if the child started brushing teeth with fluoridated toothpaste at an early age Also, fluoride supple-ments intake in the first 8 years of life and frequency of eating fish per week increased the probability of the child to have different degrees of dental fluorosis. The results suggested that fluorosis prevalence is increasing but can be put under control by monitoring fluoride level in drinking water and controlling hidden sources of fluoride intake by labeling juices and beverages, aboundenting the practice of dietary fluoride supplementation, and close parent supervision on the dispersion of fluoridated toothpastes by children

focus group assessment of a community out reach dental health education program

Community outreach extra mural programs are increasingly used in dental education to achieve several outcomes such as providing services for the underserved, preparing students to practice in the real world and to decrease the costs of maintaining clinical education. The Dental Public Health Department in the Faculty of Dentistry, Alexandria University introduced a pilot school-based community outreach dental health education program to investigate the possibility of using this approach in education. This study explores the attitudes and impressions of fourth year students towards this outreach program using focus groups assessment, which is a data collection technique used in qualitative research to explore perceptions and attitudes of participants. Content analysis and framework analysis were used for data analysis. Findings of the focus groups proved that students had a favorable impression of the program. Positive outcomes were gained by the program such as increased confidence, awareness of the denlist role as a community educator and improved communication skills. Areas identified by the focus groups that need to be addressed in future planning of such programs are: need for curriculum change, improving student supervision, credit points awarded for the procedures performed in these programs , defining the nature of the relationship between the extra mural site and the educational institution in addition to financial support of these programs. The outreach program proved to be a successful experience as perceived by the students. Plans for such programs need to address the issues identified in the study and to involve stake holders so that community outreach programs can be a part of the curriculum

comparative study between the occlusal wear of glass ionomer cement [ketac fill] and resin fissure salant [prisma shield]

This study was carried out to compare between the wear of resin sealant and glass ionomer cement for sealing fissures of lower mandibular molars. Sixteen patients were used in this study. Resin sealant was applied to one quadrant and glass ionomer cement to the opposite quadrant. Rubber base impression is taken one day and after 6 months and poured in hard stone. Wear was evaluated using Abbe vertical microscope. The results proved that glass ionomer cement had higher wear rate than resin sealant, also no caries was found around any of the sealed teeth