Oral health knowledge and attitudes of community health workers in East Azerbaijan, Iran

Statement of the Problem: Prevention is the key factor in acquiring dental and oral health. Community health workers, as a part of health care networks in Iran, play an important role in delivering primary care and their knowledge and attitude directly affect the population whom they interact with in their service scope

Purpose: The aim of this research was to evaluate the knowledge and attitude level of community health workers regarding oral health

Materials and Method: This descriptive analytical study was carried out on 1170 community health workers who were employed in health offices in East Azerbaijan to evaluate their knowledge and attitude level about oral health. Data were acquired through filled out questionnaires and were analyzed by SPSS software

Results: There was no significant statistical relationship between knowledge and gender [p= 0.063], level of education [p= 0.08] and the period spent from the last continuing education course [p= 0.148].However, by increasing age [p= 0.016], work experience [p=0.083] and number of attended continuing education courses [p= 0.023], the knowledge scores were reduced. No statistically significant relationships were found between attitude and any of research variables

Conclusion: The level of knowledge and attitude of community health workers in East Azerbaijan regarding oral health was good. There was a reverse relationship between age, work experience, and frequency of participation in continuing education courses and knowledge scores which emphasizes the necessity of continuous training and revising the method of training in education of community health workers and other staffs of health care system

Subepithelial connective tissue graft with and without the use of plasma rich in growth factors for treating root exposure

PURPOSE: The aim of this study was to evaluate the clinical efficiency of the subepithelial connective tissue graft (SCTG) with and without plasma rich in growth factor (PRGF) in the treatment of gingival recessions. METHODS: Twenty bilateral buccal gingival Miller's Class I and II recessions were selected. Ten of the recessions were treated with SCTG and PRGF (test group). The rest ten of the recessions were treated with SCTG (control group). The clinical parameters including recession depth (RD), percentage of root coverage (RC), mucogingival junction (MGJ) position, clinical attachment level (CAL), and probing depth (PD) were measured at the baseline, and 1 and 3 months later. The data were analyzed using the Wilcoxon signed rank and Mann-Whitney U tests. RESULTS: After 3 months, both groups showed a significant improvement in all of the mentioned criteria except PD. Although the amount of improvement was better in the SCTG+PRGF group than the SCTG only group, this difference was not statistically significant. The mean RC was 70.85+/-12.57 in the test group and 75.83+/-24.68 in the control group. CONCLUSIONS: Both SCTG+PRGF and SCTG only result in favorable clinical outcomes, but the added benefit of PRGF is not evident.

Comparison of pain intensity of anterior middle superior alveolar injection with infiltration anesthetic technique in maxillary periodontal surgery

PURPOSE: The aim of the present clinical trial was to compare pain during injection of anterior middle superior alveolar (AMSA) technique with that of infiltration injection technique in the maxilla in periodontal flap surgeries of patients referring to the Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences. METHODS: Twenty subjects with an age range of 20 to 40 years were selected for the present study. One side of the maxilla was randomly selected as the test side and the other as the control side using a flip of a coin. AMSA technique was used on the test side and infiltration technique was used on the control side for anesthesia. On both sides 2% lidocaine containing 1:80,000 epinephrine was used for anesthesia. The operator obtained the visual analogue scale for each patient immediately after the injection and immediately after surgery. Data was analyzed using descriptive statistical methods (frequency percentages, means and standard deviations) and Wilcoxon's test using SPSS ver. 13 (SPSS Inc.). Statistical significance was defined at P<0.05. RESULTS: There were no statistically significant differences in pain during injection between the two techniques (P=0.856). There were statistically significant differences in postoperative pain between the two injection techniques (P=0.024). CONCLUSIONS: Postoperative pain in AMSA injection technique was less than that in the infiltration technique. Therefore, the AMSA technique is preferable in the periodontal surgeries for the anesthesia of palatal tissues given the fact that it has other advantages, too.

Comparison of pain intensity of anterior middle superior alveolar injection with infiltration anesthetic technique in maxillary periodontal surgery

PURPOSE: The aim of the present clinical trial was to compare pain during injection of anterior middle superior alveolar (AMSA) technique with that of infiltration injection technique in the maxilla in periodontal flap surgeries of patients referring to the Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences. METHODS: Twenty subjects with an age range of 20 to 40 years were selected for the present study. One side of the maxilla was randomly selected as the test side and the other as the control side using a flip of a coin. AMSA technique was used on the test side and infiltration technique was used on the control side for anesthesia. On both sides 2% lidocaine containing 1:80,000 epinephrine was used for anesthesia. The operator obtained the visual analogue scale for each patient immediately after the injection and immediately after surgery. Data was analyzed using descriptive statistical methods (frequency percentages, means and standard deviations) and Wilcoxon's test using SPSS ver. 13 (SPSS Inc.). Statistical significance was defined at P<0.05. RESULTS: There were no statistically significant differences in pain during injection between the two techniques (P=0.856). There were statistically significant differences in postoperative pain between the two injection techniques (P=0.024). CONCLUSIONS: Postoperative pain in AMSA injection technique was less than that in the infiltration technique. Therefore, the AMSA technique is preferable in the periodontal surgeries for the anesthesia of palatal tissues given the fact that it has other advantages, too.

Clinical comparison of treatment response patterns following non-surgical periodontal therapy in non-smokers and passive smokers with chronic periodontitis

Smoking is a risk factor for periodontal disease. It has been documented that smoking impairs response to periodontal therapy. The aim of this study was clinical comparison of treatment response patterns following non-surgical periodontal therapy in non-smokers [NS] and passive smokers [PS] with chronic periodontitis. Eighty adult patients [40 NS and 40 PS] with mild to moderate periodontitis were treated with full-mouth subgingival scaling and root planing. Clinical parameters evaluated included probing depth, clinical attachment level, bleeding on probing, and plaque index, collected at baseline, and at 3- and 6-month intervals.. In comparison with the baseline data, both groups showed statistically significant improvements in all the parameters after 3 and 6 months. Full-mouth plaque and bleeding scores at 6 months did not demonstrate any significant differences between the two groups [P = 0.36 and P = 0.69, respectively]. However, the inter-group differences after 6 months were statistically significant with regard to probing depth and clinical attachment level measurements [P = 0.001]. Results demonstrated that response to non-surgical periodontal therapy in non-smokers is better than that in passive smokers

Endocarditis prophylaxis in cardiac patients: knowledge among general dental practitioners in Tabriz

Dental procedures injuring oral tissues may induce bacterial release to blood stream that can cause infective endocarditis in susceptible patients. The aim of this study was to determine the level of knowledge of general dental practitioners [GDPs] in Tabriz, Northwest of Iran, regarding endocarditis prophylaxis in cardiac patients receiving dental treatments. This was a cross-sectional, descriptive, analytical study that included 150 GDPs. All practitioners were given a self-administered questionnaire which consisted of three parts assessing their knowledge of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis. Statistical analysis of data was carried out using independent t-test, one-way ANOVA and chi-square test. The level of knowledge among GDPs in three areas of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis were 63.7%, 66.8% and 47.7%, respectively. Their overall level of knowledge regarding endocarditis prophylaxis was 59%. Association of the level of knowledge with age and practice period was statistically significant [P < 0.05]. However, the level of knowledge was not significantly associated with gender or university of graduation in either of three areas evaluated [P > 0.05]. According to our results, the knowledge of endocarditis prophylaxis among GDPs in Tabriz was in a moderate level. Regarding the importance of endocarditis prophylaxis in susceptible patients, it should be more emphasized in the curriculum of dental schools and continuing dental education programs

Assessment of intra-and inter-examiner reproducibility of probing depth measurements with a manual periodontal probe

The main purpose of this study was to assess intra- and inter-examiner reproducibility of probing depth measurements with a manual periodontal probe. In this study, 32 dental students in Tabriz Faculty of Dentistry with normal periodontium were evaluated. Each tooth of the upper right quadrants, except the third molars, was examined. Probing depths were measured in 6 surfaces of each tooth [mesiofacial, midfacial, distofacial, mesiolingual, midlingual and distolingual]. Each patient was examined by two examiners [two periodontists] in two sessions with an interval of 7-10 days. A total of 218 teeth and 1295 surfaces were examined. Intra-examiner measurements showed no statistically significant differences, while the differences of inter-examiner measurements were statistically significant. Intra-examiner reproducibility was more than the inter-examiner one. Measurements for anterior region, facial and mid-facial/mid-lingual surfaces were more reproducible than posterior, lingual and proximal surfaces. Probing depth measurements with a conventional probe have an appropriate reproducibility in clinical settings, although variations between examiners may affect the reproducibility, especially when great accuracy is required

[ evaluation of oral hygiene instruction in reduction of plaque index]

The main etiologic factor for periodontal disease is bacterial plaque elimination of the plaque by plaque control procedures, is one of the main treatment modalities of periodontal disease. In this respect, the most important problem in plaque control is oral hygiene instruction. The aim of this study is to evaluate the efficiency of oral hygiene instructions in periodontics department of Tabriz dental faculty on reduction of plaque index from 1999-2001 in admitted patients. The charts of 161 patients were studied randomly and the information about variables such as age, occupation, sex of educator and level of educator's knowledge were registered. Then the information were statistically analyzed, using SPSS program. In accordance with other studies, oral hygiene instruction caused significant reduction in plaque index. In addition, reduction of plaque index was greater in females than in males but there was not a significant relationship between reduction of plaque index and age, occupation and level of educator's knowledge. There was a significant relationship between plaque reduction and sex of educator and patient. The reduction of plaque index in females when the student was male was 45% and 38% when the educator was female. The reduction of plaque index in male patients when the educator was male, was 40% and 34% when the educator was female. It seems that instructions taught for dental students in motivating the patients to maintain therapy and perform oral hygiene were inefficient and a change in oral hygiene instructions is recommended