Assessment of attributes for choosing a dental center in Trujillo, Peru: patients versus dentists / Valoración de los atributos para la elección de un centro odontológico en Trujillo, Perú: pacientes versus odontólogos

Objective: To determine the difference between patients and dentists regarding the assessment of attributes for choosing a dental center in Trujillo, Peru. Materials and Methods: A comparative cross-sectional observational study was conducted involving a sample of 162 dentists and 162 patients from the Trujillo province in Peru. The data was collected through a virtual questionnaire, validated by experts, and assessed for reliability. Statistical analysis was performed using the U-Mann Whitney and Spearman correlation tests, with a significance level set at 5%. Results: Patients, in comparison to dentists, demonstrated a greater preference for selecting a dental center where the practitioner is a recognized specialist (p<0.001). Similarly, patients showed a preference for centers offering expedited appointments, advanced technology, and equipment, providing affordable and flexible payment options, free consultations, and having convenient parking and comfortable facilities (p<0.05). Conversely, dentists perceived that the most valued attribute by patients is the recommendation of the dentist (p=0.031). Conclusions: When choosing a dental center, patients primarily value attributes related to both the professional responsible for care and administrative management. Conversely, dentists consider the main factor influencing a patient's choice of dental center to be recommendations of the dentist. Valoración de los atributos para la elección de un centro odontológico en Trujillo, Perú: pacientes versus odontólogos

Objetivo: Determinar la diferencia entre pacientes y odontólogos con respecto a la valoración de atributos para la elección de un centro odontológico en Trujillo. Materiales y Métodos: Se realizó un estudio observacional transversal comparativo con una muestra de 162 odontólogos y 162 pacientes de la provincia Trujillo (Perú). La data fue recogida a través de un cuestionario virtual, sometido a validación por expertos y prueba de confiabilidad. El análisis estadístico se realizó mediante las pruebas U-Mann Whitney y correlación de Spearman, considerando un nivel de significancia del 5%. Resultado: Los pacientes, con respecto a los odontólogos, mostraron mayor valoración para la elección del centro odontológico cuando el profesional es especialista y reconocido (p<0.001); así mismo, cuando se le brindan citas rápidas, se usa tecnología y equipamiento adecuados, se brindan facilidades de pago con precios bajos y consultas gratuitas, y el centro cuenta con estacionamiento y espacios cómodos (p<0.05). Por su parte, los odontólogos consideran que el atributo más valorado por los pacientes es que el profesional sea recomendado (p=0.031). Conclusión: Para la elección del centro odontológico, los pacientes valoraron en mayor medida los atributos relacionados al profesional responsable de la atención y la gestión administrativa. Por otro lado, los odontólogos consideraron preferentemente que el atributo principal para la elección del centro odontológico por parte del paciente es que el odontólogo haya sido recomendado.

The Role of the Dental Surgeon in the Pediatric Intensive Care Unit / O Papel do Cirurgião-Dentista na Unidade de Terapia Intensiva Pediátrica

Dentistry plays a significant role in the supportive care of hospitalized children in Pediatric Intensive Care Units (PICUs) as these patients arrive in this environment with altered immune systems and compromised oral health. This paper aims to present an integrative literature review on the role of dentists in the hospital setting, particularly in the PICU, and discuss the challenges encountered in this environment. A free search was conducted on the electronic platforms PubMed, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Sciences (Lilacs), and Virtual Health Library (BVS) from January to February 2023, with no defined publication period and including all types of studies. Health Science descriptors (DeCS/MeSH) were used in English and Portuguese, applying Boolean operators. According to the data collected, among the conditions requiring admission to the PICU, respiratory disorders, heart and kidney failure, neurological disorders, severe metabolic diseases, infections, injuries, traumas, near-drowning incidents, and post-operative care after complex surgeries stand out. Dental care in this environment reduce hospitalization time, costs, and improve the quality of life of pediatric patients. However, the integration of these professionals into the PICU is still limited. Dentists in the hospital setting optimize multidisciplinary work through protocol-based measures derived from studies conducted in adult patients in intensive care units. Due to the lack of robust evidence related to oral care practices in pediatric intensive care settings, further research is mandatory. (AU)

A Odontologia tem um papel importante na assistência de crianças hospitalizadas nas Unidades de Terapia Intensiva Pediátricas (UTIP), pois esses pacientes chegam neste ambiente com o sistema imunológico alterado e a saúde bucal comprometida. Apresentar uma revisão integrativa da literatura sobre o papel do cirurgião-dentista no hospital, em especial, na UTIP, além de discutir os desafios encontrados nesse ambiente. Uma busca foi conduzida nas plataformas eletrônicas PubMed, Scientific Eletronic Library Online (SciElo), Latin American and Caribbean Literature in Sciences (Lilacs) e Biblioteca Virtual da Saúde (BVS), entre janeiro a fevereiro/2023, sem período definido de publicação e sob a inclusão de todos os tipos de estudos. Os descritores em Ciências da saúde (DeCS/MeSH) foram utilizados em inglês e português, sob aplicação dos operadoress booleanos. Segundo dados coletados, dentre as condições que necessitam de internação na UTIP, destaca-se as alterações respiratórias, insuficiência cardíaca e renal, alterações do sistema nervoso, doenças metabólicas graves, infecções, ferimentos, traumatismos, quase afogamentos e pós-operatório de cirurgias complexas. O cirurgião-dentista neste ambiente reduz o tempo de internação, os custos e aumenta a qualidade de vida dos pacientes pediátricos. Todavia, ainda é escassa a inserção deste profissional em UTIP. O cirurgião-dentista em ambiente hospitalar otimiza o trabalho multidisciplinar através de medidas baseadas em protocolos obtidos a partir de estudos em pacientes adultos em unidades de terapia intensivas. Devido a falta de evidências robustas relacionadas à prática de cuidados bucais no ambiente de cuidados intensivos pediátricos, a realização de pesquisas futuras torna-se mandatória. (AU)

Consumo nacional de antimicrobianos prescritos por cirurgiões-dentistas / National consumption of antimicrobials prescribed by dentists

O cirurgião-dentista (CD) é o profissional habilitado para prescrever agentes antimicrobianos destinados à profilaxia ou ao tratamento de infecções bacterianas. No Brasil, a comercialização demanda a retenção de receita e é notificada no Sistema Nacional de Gerenciamento de Produtos Controlados (SNGPC). O objetivo desse estudo foi analisar o consumo de antimicrobianos prescritos por CDs, a partir dos dados disponibilizados pelo SNGPC entre 2015 e 2021. Amoxicilina, azitromicina, amoxicilina-ácido clavulânico, cefalexina, metronidazol, eritromicina, clindamicina, ciprofloxacino, ampicilina e tetraciclina foram os mais vendidos e os cinco primeiros contaram por 92% de todas as comercializações. Os estados com maior comercialização foram São Paulo e Minas Gerais, com Rio Grande do Sul e Rio de Janeiro alternando entre as terceira e quarta posições. A menor comercialização ocorreu nas regiões norte e nordeste, em especial no Acre, Amapá, Roraima e Piauí. Ainda que não seja possível conhecer o motivo da prescrição, pois a indicação clínica não é informada no SNGPC, o estudo traz um panorama nacional sobre a prescrição de antimicrobianos por CDs. Observa-se que o maior consumo se deu nas regiões de maior índice de desenvolvimento humano, o que pode refletir o maior acesso dos habitantes à assistência odontológica.

The dentist is the professional qualified to prescribe antimicrobial agents intended for the prophylaxis or treatment of bacterial infections. In Brazil, sales require prescription retention and are notified in the National Controlled Products Management System (SNGPC). The objective of this study was to analyze the consumption of antimicrobials prescribed by dentists, based on data provided by the SNGPC between 2015 and 2021. Amoxicillin, azithromycin, amoxicillin-clavulanic acid, cephalexin, metronidazole, erythromycin, clindamycin, ciprofloxacin, ampicillin and tetracycline were the top sellers and the top five accounted for 92% of all sales. The states with the highest sales were São Paulo and Minas Gerais, with Rio Grande do Sul and Rio de Janeiro alternating between third and fourth positions. The lowest sales occurred in the North and Northeast regions, especially in Acre, Amapá, Roraima and Piauí. Although it is not possible to know the reason for the prescription, as the clinical indication is not reported in the SNGPC, the study provides a national overview on the prescription of antimicrobials by dentists. It is observed that the highest consumption occurred in regions with the highest human development index, which may reflect greater access to dental care.

Revisión de Literatura sobre la migración de odontólogos. Sus implicancias para Latinoamérica y el Caribe

La migración internacional de odontólogos es un fenómeno en aumento, pero poco estudiado. Objetivo: Reconocer el abordaje en la literatura científica del fenómeno de migración de odontólogos en diferentes regiones del mundo. Método: Se realizó una revisión sistemática exploratoria en bases de datos de Pubmed, Medline, Scopus, Lilacs y Web of Science en español e inglés. Se analizaron objetivos, metodologías, problemas, temas, principales hallazgos y las discusiones. Resultados 25 estudios seleccionados utilizaron abordajes cualitativos, cuantitativos y mixtos. Se enfocaron en América del norte, Europa, Oceanía y Asia orientados a mejorar políticas migratorias, y ajustar demanda - oferta. Los temas abordados fueron: flujo migratorio, datos demográficos, evaluación y cualificación; aspectos de la experiencia migratoria; y condiciones políticas de la migración. Se trató la migración sur-norte o entre países centrales, pero no la migración sur-sur, ni en Latinoamérica. Se identifica que la migración de odontólogos tiene repercusiones en los sistemas de salud, equidad de la atención; debilidades en la regulación, sistemas de información y evaluación y cualificación de los migrantes; los motivos de migración pueden ser personales, profesionales y sociopolíticos; las condiciones de trabajo, adaptación cultural y experiencias de la migración dependen del proceso y condiciones migratorias, personales y profesionales. Conclusión: Es necesario realizar investigaciones de la migración sur-sur, mejorar la información sobre la migración en los países de salida. Los países de la periferia deben articular sus esfuerzos con los países receptores para entender mejor el fenómeno, no producir inequidades y garantizar un mejor flujo y satisfacción laboral de los odontólogos migrantes.

A migração internacional de dentistas é um fenômeno crescente, mas pouco estudado. Objetivo: Reconhecer a abordagem na literatura científica do fenômeno da migração de dentistas em diferentes regiões do mundo. Método: Foi realizada uma revisão sistemática exploratória nas bases de dados Pubmed, Medline, Scopus, Lilacs e Web of Science em espanhol e inglês. Foram analisados ​​objetivos, metodologias, problemas, temas, principais achados e discussões. Resultados 25 estudos selecionados utilizaram abordagens qualitativas, quantitativas e mistas. Centraram-se na América do Norte, Europa, Oceânia e Ásia, com o objetivo de melhorar as políticas de migração e ajustar a procura-oferta. Os temas abordados foram: fluxo migratório, dados demográficos, avaliação e qualificação; aspectos da experiência migratória; e condições políticas da migração. A migração Sul-Norte ou entre países centrais foi discutida, mas não a migração Sul-Sul, nem na América Latina. Identifica-se que a migração de dentistas repercute nos sistemas de saúde, na equidade do atendimento; fragilidades na regulação, nos sistemas de informação e na avaliação e qualificação dos migrantes; As razões da migração podem ser pessoais, profissionais e sociopolíticas; As condições de trabalho, a adaptação cultural e as experiências migratórias dependem do processo e das condições migratórias pessoais e profissionais. Conclusão É necessário realizar pesquisas sobre a migração sul-sul, melhorar a informação sobre a migração nos países de partida. Os países periféricos devem articular os seus esforços com os países receptores para melhor compreender o fenómeno, não produzir desigualdades e garantir um melhor fluxo e satisfação profissional dos dentistas migrantes.

The international migration of dentists is a growing but little studied phenomenon. Objective: Recognize the approach in scientific literature to the phenomenon of migration of dentists in different regions of the world. Method: An exploratory systematic review was carried out in PubMed, Medline, Scopus, Lilacs and Web of Science databases in Spanish and English. Objectives, methodologies, problems, themes, main findings and discussions were analyzed. Results 25 selected studies used qualitative, quantitative and mixed approaches. They focused on North America, Europe, Oceania and Asia aimed at improving migration policies and adjusting demand-supply. The topics addressed were: migratory flow, demographic data, evaluation and qualification; aspects of the migratory experience; and political conditions of migration. South-North migration or between central countries was discussed, but not south-south migration, nor in Latin America. It is identified that the migration of dentists has repercussions on health systems, equity of care; weaknesses in regulation, information systems and evaluation and qualification of migrants; The reasons for migration can be personal, professional and sociopolitical; Working conditions, cultural adaptation, and migration experiences depend on the personal and professional migratory process and conditions. Conclusion: It is necessary to carry out research on south-south migration, improve information on migration in the countries of departure. Periphery countries must articulate their efforts with destination countries to better understand the phenomenon, not produce inequalities and guarantee a better flow and job satisfaction of migrant dentists.

Profil vaccinal des chirurgiens-dentistes de la région de Dakar (Sénégal) / Vaccination profile of dental surgeons in Dakar Region (Senegal)

Introduction : Plusieurs mesures de contrôle dont la vaccination du personnel soignant ont été élaborées pour empêcher la propagation des infections. Longtemps négligée, la vaccination connaît aujourd'hui un regain d'intérêt notamment avec la pandémie du Covid 19. L'objectif de cette étude était de décrire le profil vaccinal des chirurgiens-dentistes de la région de Dakar. Méthodes : Il s'agissait d'une étude descriptive, transversale, effectuée de Mars 2017 à Mars 2018 auprès des chirurgiens-dentistes de la région de Dakar. Tous les chirurgiens-dentistes consentants, inscrits aux tableaux de l'Ordre National des Chirurgiens-Dentistes du Sénégal et exerçant dans la région de Dakar ont été inclus dans cette étude. L'étude a utilisé un questionnaire auto-administré comportant des items sur les données socioprofessionnelles, le statut vaccinal ainsi que les vaccins effectués. Résultats et Discussion : Au total, 176 chirurgiens- dentistes ont été contactés, 150 parmi eux ont accepté de participer à l'enquête, soit un taux de participation de 85,2%. L'échantillon comprenait 89 hommes soit 59% et 61 femmes soit 41%. Le nombre d'année d'expérience moyenne des praticiens était de 11 ans ± 8,6. Dans la région de Dakar, 70,7% des chirurgiens-dentistes interrogés sont vaccinés contre 29,3% de chirurgiens-dentistes qui ne le sont pas. Le profil vaccinal montre une fréquence plus élevée de la vaccination contre l'hépatite B soit 65,3%. Seulement 32,7% des chirurgiens-dentistes interrogés affirment être vaccinés contre la tuberculose tandis que 42,7% déclarent l'être contre le tétanos. Conclusion : Cette étude a révélé une couverture vaccinale faible et disparate des chirurgiens-dentistes de Dakar.

Introduction: Several control measures, including vaccination of healthcare personnel, have been developed to prevent the spread of infections. Long neglected, vaccination is now experiencing a renewed interest, especially with the COVID-19 pandemic. The objective of this study was to describe the vaccination profile of dentists in the Dakar region. Methods: This was a descriptive, cross-sectional study conducted from March 2017 to March 2018 among dentists in the Dakar region. All consenting dentists, registered with the National Order of Dentists of Senegal and practicing in the Dakar region, were included in this study. The study used a self-administered questionnaire containing items on sociodemographic data, vaccination status, and administered vaccines. Results and Discussion: A total of 176 dentists were contacted, of whom 150 agreed to participate in the survey, resulting in a participation rate of 85.2%. The sample included 89 men (59%) and 61 women (41%). The average years of experience of the practitioners was 11 years ± 8.6. In the Dakar region, 70.7% of the dentists surveyed are vaccinated, while 29.3% are not. The vaccination profile shows a higher frequency of vaccination against hepatitis B at 65.3%. Only 32.7% of the surveyed dentists claim tobe vaccinated against tuberculosis, while 42.7% declare vaccination against tetanus. Conclusion: This study revealed low and disparate vaccination coverage among dentists in Dakar.

Dental students' empathy levels and opinions about attributes for "good dentist": a cohort study

Empathy is fundamental to the physician-patient relationship and influences the clinical outcomes. The aim of this study was to determine the dental students' empathy levels and to compare their opinions on attributes of a "good dentist". This cohort research was included 79 dental students volunteering to participate in the study at a public university. The data were collected by the Dökmen's Empathic Tendency Scale (ETS) and Empathic Skill Scale (ESS). In this study, from the orientation day to the end of the third-year, the dental students' ETS mean scores (respectively 69.59 and 68.34) and ESS mean scores (respectively 142.53 and 140.00) showed a decline. At the end of the third-year, starting clinical rotations and taking patient responsibility may lead to decrease the empathy levels of students. The findings of our study show that female students have higher empathy tendency and skill scores compared to male students (p<0.001). In the ranking of the attributes required to be a good dentist, empathy was ranked 4th by the first-year students, while final-years students placed empathy in second rank (p<0.05). According to these results, it is possible to claim that the dentist candidates realized that being empathetic is necessary to be a good dentist.

La empatía es fundamental para la relación médico-paciente e influye en los resultados clínicos. El objetivo de este estudio de cohorte -que incluyó a 79 estudiantes de odontología de una universidad pública que se ofrecieron como voluntarios- fue determinar los niveles de empatía de los estudiantes de odontología y comparar sus opiniones sobre los atributos de un "buen dentista". Los datos se recogieron mediante las Escalas de Tendencia Empática (ETE) y Habilidad Empática (EHE) de Dökmen. Desde el día de orientación hasta el final del tercer año, los puntajes medios ETE de los estudiantes de odontología (69.59 y 68.34, respectivamente) y los puntajes medios de EHE (142.53 y 140.00, respectivamente) mostraron una disminución. Según la literatura, al final del tercer grado, iniciar rotaciones clínicas y asumir la responsabilidad del paciente puede llevar a disminuir los niveles de empatía de los estudiantes. Los hallazgos de nuestro estudio muestran que las estudiantes tienen una mayor tendencia a la empatía y puntajes de habilidad en comparación con los estudiantes (p<0.001). En el ranking de los atributos requeridos para ser un buen dentista, la empatía ocupó el cuarto puesto en estudiantes de primer año, mientras que los de último año colocaron la empatía en segundo lugar (p<0.05). De acuerdo con estos resultados, es posible afirmar que los candidatos a dentistas se dieron cuenta de que ser empáticos es necesario para ser un buen dentista.

A empatia é fundamental na relação médico-paciente e influencia os resultados clínicos. O objetivo deste estudo foi determinar os níveis de empatia de estudantes de odontologia e comparar suas opiniões sobre os atributos de um "bom dentista". Esta pesquisa de coorte contou com 79 estudantes de odontologia voluntários para participar do estudo em uma universidade pública. Os dados foram coletados pela Escala de Tendência Empática (ETE) de Dökmen e Escala de Habilidades Empáticas (EHE). Neste estudo, desde o dia da orientação até o final do terceiro ano, os escores médios do ETE dos alunos de odontologia (respectivamente 69,59 e 68,34) e os escores médios do EHE (respectivamente 142,53 e 140,00) apresentaram declínio. No final da terceira série, iniciar os rodízios clínicos e assumir a responsabilidade do paciente pode levar à diminuição dos níveis de empatia dos alunos. Os achados do nosso estudo mostram que os alunos do sexo feminino apresentam maior tendência à empatia e pontuações de habilidades em comparação aos alunos do sexo masculino (p<0,001). No ranking dos atributos necessários para ser um bom dentista, a empatia foi classificada em 4º lugar pelos alunos do primeiro ano, enquanto os alunos do último año colocaram a empatia em segundo lugar (p<0,05). De acordo com esses resultados, é possível afirmar que os candidatos a dentista perceberam que ser empático é necessário para ser um bom dentista.

Knowledge, attitudes, and experiences of a group of turkish dentists regarding child abuse / Conocimientos, actitudes y experiencias de un grupo de dentistas turcos en relación con el abuso infantil

Child abuse is a universal problem with critical lifelong effects. This study aimed to evaluate knowledge, attitudes, experiences of dentists regarding child abuse and to increase relevant awareness of them. A self-administered questionnaire with 48 questions about dentists' personal and educational information and their level of knowledge, attitudes, experiences on child abuse was implemented. Out of targeted 305 participants, 183 (60.0%) returned completely filled out questionnaires. Majority of participants knew signs and symptoms of child abuse. Of the participants, more than half were well-informed on what to do, however, one quarter had no knowledge about where to report in case of child abuse. In identifying child abuse, 39.3% of the participants found themselves inadequate. The most commonly stated reason for low rate of reporting was hesitancy to identify the case as abuse, and all participants needed more training. Only 12 (6.6%) participants suspected a case of child abuse. Dentists who had children and were long-time experienced and generalist did not have sufficient knowledge about legal obligations, signs and symptoms of child abuse (p<0.05). Arrangements and training programs to increase knowledge, awareness, and responsibility levels of dentists about child abuse appear to be a critically important topic.

El abuso infantil es un problema universal con efectos críticos de por vida. Este estudio tuvo como objetivo evaluar el conocimiento, las actitudes y las experiencias de los dentistas con respecto el abuso infantil y aumentar la conciencia relevante sobre ellos. Se implementó un cuestionario autoadministrado con 48 preguntas sobre información personal y educativa de los odontólogos y su nivel de conocimientos, actitudes, experiencias sobre el abuso infantil. De los 305 participantes seleccionados, 183 (60.0%) devolvieron los cuestionarios completos. La mayoría de los participantes conocían los signos y síntomas del abuso infantil. De los participantes, más de la mitad estaban bien informados sobre qué hacer, sin embargo, una cuarta parte no sabía dónde denunciar en caso de abuso infantil. Al identificar el abuso infantil, el 39.3% de los participantes se encontraron inadecuados. La razón más común para la baja tasa de informes fue la vacilación para identificar el caso como abuso, y todos los participantes necesitaban más capacitación. Solo 12 (6.6%) participantes sospecharon un caso de abuso infantil. Los odontólogos que tenían hijos y eran de larga experiencia y generalistas no tenían suficiente conocimiento sobre las obligaciones legales, signos y síntomas de abuso infantil (p<0,05). Los arreglos y los programas de capacitación para aumentar los niveles de conocimiento, conciencia y responsabilidad de los dentistas sobre el abuso infantil parecen ser un tema de importancia crítica.

Influencing factors and prediction model of neck pain in dentists / 环境与职业医学

Background Dentists are a high-risk population of work-related musculoskeletal disorders (WMSDs), where the body part with the highest prevalence is the neck. Objective To analyze potential influencing factors of neck pain among dentists, and explore a prediction model of neck pain in dentists. Methods Dentists from different hospitals in Fuzhou were selected as study subjects by stratified cluster sampling according to hospital characteristics (dental hospitals, general hospitals, and dental clinics). The basic information, presentation of WMSDs, and its influencing factors were investigated by using the Chinese version of Musculoskeletal Disorders Questionnaire and the Subjective Workload Assessment Technique. A total of 655 questionnaires were collected, of which 603 were valid, with an effective rate of 92.1%. Multiple logistic regression was used to analyze potential influencing factors of neck pain in dentists. A prediction model of neck pain of dentists was constructed by using neural network model, and the prediction efficiency of the model was evaluated. Results The neck was the body part with the highest prevalence (43.8%, 264/603) of WMSDs among dentists. The results of multiple logistic regression analysis showed that female (OR=2.709, 95%CI: 1.852-3.962, P <0.001), working age of 10-<20 years (versus <10 years, OR=3.836, 95%CI: 2.471-5.957, P<0.001), keeping head up or down for a long time (OR=8.492, 95%CI: 2.203-32.731, P=0.002), holding head sideways for a long time (OR=2.210, 95%CI: 1.376-3.550, P<0.001), maintaining the same sitting spot for a long time (OR=4.336, 95%CI: 2.192-8.579, P<0.001), and psychological load value ≥70 (versus <40, OR=1.901, 95%CI: 1.038-3.480, P=0.037) increased the risk of neck pain in dentists. Sufficient operating space (OR=0.507, 95%CI: 0.302-0.850, P=0.010) and doing some exercise during work break (OR=0.670, 95%CI: 0.453-0.991, P=0.045) reduced the risk of reporting neck pain among dentists. A neural network prediction model of dentists' neck pain was constructed with 1 hidden layer and 6 hidden layer neurons. The percentage of correct prediction of training set was 89.6%, and the percentage of correct prediction of test set was 83.9%. The order of importance of the independent variables included in the model were working age, holding head sideways for a long time, psychological load, etc. The result of neural network model of neck pain among dentists showed that the area under the curve of receiver operator characteristic (ROC) was 0.940 (95%CI: 0.922-0.958, P<0.001). When the maximum diagnostic value was determined by the ROC curve, the sensitivity was 84.8%, the specificity was 91.2%, and the Youden Index was 0.760. Conclusion Neck pain of dentists is affected by many factors, such as individual factors (gender and working age), ergonomic factors (keeping various postures and operations for a long time, operating space, etc.), psychological factors (different levels of psychological load) and so on. The neural network model can be used as a prediction tool to explore the risk of reporting neck pain among dentists.

A medicalização na prática de dentistas no SUS: um olhar qualitativo para os sentidos da prática / Dentistry medicalization at SUS: a qualitative practice-based perspective

Resumo Este artigo explora sentidos e significados do trabalho odontológico no SUS, no contexto da relação profissional-paciente. Pesquisa qualitativa com 20 cirurgiões-dentistas que atuavam em um município paulista de médio porte, abordada por meio de três grupos focais, com a pergunta disparadora "Qual é o sentido ou significado do seu trabalho, aqui na prefeitura, para você?". O material foi áudio-gravado, transcrito na íntegra e analisado pelo método de análise de conteúdo temática. Procedemos a realização de leitura flutuante, categorização e discussão dos achados junto aos pares de pesquisadores para validação final. Como resultados, aponta-se a construção das categorias 1) Estranheza às necessidades percebidas pelos pacientes e a consequente medicalização da vida, e 2) Poder e consumo como significados da prática. O trabalho do cirurgião dentista, nesse contexto, evidenciou as diferenças entre as necessidades percebidas pelo paciente e aquelas que o dentista considera. Além disso, revelou o poder que emana da assimetria entre paciente e profissional como dificultador da produção de autonomia do paciente. Tais significações parecem trazer sofrimento para esses profissionais no seu trabalho. Concluiu-se que há necessidade de reflexão sobre o trabalho em saúde como forma de se evitar sofrimento, e que a prática desses dentistas é carregada de sentidos e significados.

Abstract This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in São Paulo, divided into three focus groups and asked the guiding question "What sense or meaning do you attribute to your work here in the city?" Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients' needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients' needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients' autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.

Contribución de la ética convergente en la enseñanza de la odontología / Contribution of convergent ethics in the teaching of dentistry

Objetivo: refexionar sobre la aplicación de la ética convergente en la práctica odontológica de pregrado para comprender las tensiones entre los principios cardinales que pueden suscitarse en la relación estudiante-paciente. Métodos: se exponen los fundamentos teóricos de la ética convergente y se relacionan las tensiones bio(éticas) que propone con un ejemplo en la práctica formativa estudiante-paciente de odontología. Resultados: se desarrolló una articulación de la ética convergente con un caso práctico en odontología. Conclusión: la ética convergente puede brindar un punto de partida para aplicar el análisis bioético en la práctica clínica odontológica, por parte del estudiante.

Objective: To refect on the application of convergent ethics in undergraduate dental practice to understand the tensions between the cardinal principles that can arise in the student-patient relationship. Methods: The theoretical foundations of convergent ethics are exposed and the bio(ethical) tensions proposed in convergent ethics are related to an example of their application in the dental student-patient training practice. Results: An articulation of convergent ethics was developed with a practical case in dentistry. Conclusion: Convergent ethics can provide a starting point to apply bioethical analysis in the clinical practice of dental students.

Dentist During Covid: A Bitter Sweet Victory

Introduction: During the second wave of COVID pandemic, due to the increase in number of admissions, we were posted in the COVID ward for a period of 15 days. Description: This communication presents a brief about my experience in the ward and the duties performed. Conclusion: Looking through silver linings, this experience can help reorient the education in the field of oral pathology for the future.

Assessment of Biological Risk among Dentists during the COVID-19 Pandemic—A Cross-Sectional Study

Background: The health and life of a healthcare worker are repeatedly under threat due to the rising number of epidemics and pandemics. The COVID?19 pandemic is said to be fatal in people with a risky biological, demographic profile and working environment. This study is the first of its kind carried out on the dentist population from India, who were most affected during the COVID?19 pandemic. Aims and Objective: The present study aims to assess the biological risk of dentists based on the objective risk stratification (ORS) tool developed by Strain et al. Materials and Methods: This was a cross?sectional study of dentists in government dental colleges of Kerala using the online form of the ORS tool consisting of questions which included certain demographic characteristics and comorbid conditions of the individual. An additional question was added to the tool, to categorise the work of the dentist depending on the exposure to aerosol (non?aerosol, minimal aerosol and aerosol). Results: Out of the 74 dentists, 48.6% reported high aerosol and 31% with minimal aerosol. The median score of the study participants was 2 (ranging from 1 to 12). Using the ORS tool, 16.2% had medium risk and only 2.7% had high risk. When the ORS tool was stratified with the aerosol generation, 5.4% had minimal and 6.7% had significant with medium?risk scores. Also, 2.7% with a high?risk score had minimal aerosol generation. Conclusion: Identifying the high?risk category to allocate duties accordingly and decrease the morbidity and mortality among dentists has to be kept a top priority in the event of a pandemic.

Percepção e atitude do cirurgião-dentista diante do atendimento emergencial a mulheres em situação de violência: uma revisão de escopo / Dentists' perceptions and attitudes towards emergency care for women in situations of violence: a scope review

Resumo Avaliar por meio de uma revisão de escopo estudos que abordam a percepção e atitude do cirurgião-dentista diante do atendimento a mulheres em situação de violência. Utilizando os descritores women violence, dentist attendence ou dentist care, foram identificados 473 artigos, sendo incluídos 13, ao final da seleção. Embora a necessidade de capacitação tenha sido predominante, ela não é suficiente. Existe uma fragilidade em se compreender a violência como problema de saúde, de entender o papel do profissional na solução desse problema, os fatores que podem contribuir com seu crescimento ou seu controle. Os resultados revelaram que o cirurgião-dentista apresentou maior dificuldade do que os outros profissionais no enfrentamento e exigem um amplo aprendizado. O reconhecimento dos referidos casos pelo cirurgião-dentista exige a incorporação de medidas educativas que provoquem mudanças culturais, desconstrução de normas de gênero e a desnaturalização desse fenômeno social.

Abstract The purpose of this study was to evaluate, through a scope review, studies that address the perceptions and attitudes of dentists regarding the care of women in situations of violence. Using the descriptors women violence, dentist attendance or dentist care, 473 articles were identified, of which 13 were included at the end of the selection process. Although the need for training was predominant, it was not sufficient. There is a weakness in understanding violence as a health problem, in understanding the role of the professional in solving this problem, and the factors that can contribute to its growth or its control. The results revealed that the dentist had greater difficulty than other professionals in coping with the issue and required extensive training. The recognition of these cases of abuse by the dentist requires the incorporation of educational measures that cause cultural changes, deconstruction of gender norms and the denaturalization of this social phenomenon.

Characterization of allergic manifestations in dental professionals / Caracterización de manifestaciones alérgicas de profesionales en Odontología

Abstract The aim was to determine the prevalence and types of the allergies present among dental professionals in Costa Rica. We performed a cross-sectional study on 664 dentists who completed a self-reported questionnaire. A descriptive cross-sectional study with inferential analysis was carried out. Dentists reported allergies prior to studying dentistry in 39% of cases, 36% reported chronic illnesses, and 61% of the dentists reported first-degree relatives with some type of allergic reaction. Different allergies had a similar prevalence among the dental professionals (ranging between 19%-26%), all allergic manifestations occurred within the first 120 minutes after exposure. The average time of exposure to dentistry-related environments was 16 years (95% CI) among all the dentists surveyed. There is a positive correlation between the presence of a chronic illness and the predisposition to develop allergic reactions among dentists. In addition, there is a directly proportional relationship between age, time of exposure to dental environments, and the risk of developing allergic conditions to dental materials. The main adverse reactions reported due to exposure to dental materials, medicines and/or food were gastrointestinal, skin, and respiratory problems.

Resumen El objetivo del estudio fue determinar la prevalencia y tipo de alergias presentes entre los odontólogos en Costa Rica. Se realizó un estudio transversal descriptivo en 664 dentistas que completaron un cuestionario, utilizando análisis inferencial para el procesamiento de los resultados. Los odontólogos reportaron alergias previo a estudiar odontología en un 39% de los casos, el 36% informó enfermedades crónicas y el 61% de los dentistas mencionó tener familiares en primer grado que habían presentado algún tipo de reacción alérgica. Diferentes tipos de alergias tuvieron una prevalencia similar entre los odontólogos (oscilando entre el 19% y el 26%), todas las manifestaciones alérgicas ocurrieron dentro de los primeros 120 minutos después de la exposición al alergeno. El tiempo medio de exposición a entornos relacionados con la odontología fue de 16 años (IC del 95%) entre todos los dentistas encuestados. Existe una correlación positiva entre la presencia de una enfermedad crónica y la predisposición a desarrollar reacciones alérgicas entre los dentistas. Además, existe una relación directamente proporcional entre edad, tiempo de exposición a entornos dentales, y el riesgo de desarrollar reacciones alérgicas a los materiales dentales. Las principales reacciones adversas notificadas posterior a la exposición a materiales dentales, medicamentos y/o alimentos fueron problemas gastrointestinales, cutáneos y respiratorios.

Conocimiento, percepción y actitudes de las medidas de prevención relacionadas al COVID-19 entre los odontólogos de distintos distritos de Lima, Perú de mayor y menor número de contagiados / Knowledge, perception and attitudes of prevention measures related to COVID-19 among dentists from different districts of Lima, Peru with the highest and lowest number of infected

Resumen Objetivo: Determinar si existen diferencias entre conocimientos, percepción y actitudes de las medidas de prevención relacionadas al COVID-19 entre los odontólogos de los distintos distritos de Lima, Perú de mayor y menor número de contagiados. Métodos: El tamaño de muestra fue un total de 117 odontólogos pertenecientes a los distritos de mayor número de contagiados y 125 de los distritos de menor número de contagiados. Estos distritos de ambos extremos se basaron en las tasas de contagio que presentaron en agosto del 2020 según el Ministerio de Salud. Se utilizó un cuestionario como instrumento que constó de 33 preguntas cerradas de opción múltiple y se distribuyó vía redes sociales. Para el análisis univariado, se obtuvo la estadística descriptiva donde se calcularon las medidas de frecuencia absoluta y relativa para las variables dependientes, independientes y covariables. Para el análisis bivariado, se realizó la comparación entre las variables conocimiento, percepción y actitudes con los odontólogos de los distritos con mayor y menor número de contagiados mediante la prueba Chicuadrado. Resultados: Los odontólogos de los distritos de mayor número de contagiados presentan mayores conocimientos sobre los principales síntomas, vías de transmisión y medidas de prevención frente a la COVID-19 a comparación de los odontólogos de los distritos de menor número de contagiados. Además, los de mayor número de contagiados perciben a la COVID-19 como muy peligroso, mientras que los de menor número de contagiados lo perciben moderadamente peligroso y muy peligroso en proporciones iguales. Por último, con respecto a la actitud, los de mayor número de contagiados no atienden a un paciente sospechoso y lo derivan a un centro de salud, mientras que los de menor número de contagiados sí los atienden y los derivan a un centro de salud. Conclusión: Se encontraron diferencias entre conocimientos, percepción y actitudes de las medidas de prevención relacionadas al COVID-19 entre los odontólogos de los distintos distritos de Lima, Perú de mayor y menor número de contagiados.

Knowledge, perception and attitudes of prevention measures related to COVID-19 among dentists from different districts of Lima, Peru with the highest and lowest number of infected Abstract Objective: To determine if there are differences between knowledge, perception and attitudes of the prevention measures related to COVID-19 among the dentists of the different districts of Lima, Peru with the highest and lowest number of infection cases. Methods: The sample size was 265 dentists, of which 117 were from the districts with the greatest impact and 148 from the districts with the least impact. These districts of both extremes were based on the contagion rates that they presented in August 2020 according to the Ministry of Health. A questionnaire was used as an instrument and it was distributed via social networks. For the univariate analysis, the descriptive statistics were obtained where the absolute and relative frequency measures were calculated for the dependent, independent and covariate variables. For the bivariate analysis, a comparison was made between the variable's knowledge, perception and attitudes with the dentists of the districts with the highest and lowest number of infected using the Chi-square test. Results: The dentists of the districts with the highest impact have greater knowledge about the main symptoms, transmission routes and prevention measures against COVID-19 compared to the dentists of the districts with the least impact. In addition, those with the greatest impact perceive COVID-19 as very dangerous, while those with the least impact perceive it as moderately dangerous and very dangerous in equal proportions. Finally, with regard to attitude, those with the greatest impact do not care for a suspicious patient and refer him to a health center, while those with the least impact do care for them and refer them to a health center. Conclusión: Finally, differences were found between knowledge, perception and attitudes of the prevention measures related to COVID-19 among the dentists of the different districts of Lima, Peru with the highest and lowest number of infected people.

El odontólogo, custodio de la función masticatoria / The dentist, guardian of masticatory function

La masticación tiene como objetivo la adecuada preparación de los alimentos para su deglución y digestión. Cualquier alteración en el sistema estomatognático puede deteriorar la masticación. El odontó- logo es el profesional responsable de mantener y/o restaurar la función masticatoria. La evaluación de la función masticatoria puede hacerse de forma subjetiva utilizando cuestionarios para medir la percepción del paciente sobre su capacidad masticatoria o de forma objetiva analizando la fuerza oclusal, la actividad electromiográfica de los músculos mas- ticadores, la trayectoria de la mandíbula al masticar o la capacidad de trituración de los alimentos. Estos métodos se utilizan en proyectos de investigación, pero en la clínica ¿evaluamos si existe alguna alteración al masticar y al finalizar el tratamiento si cumplimos con el objetivo de restaurar la función masticatoria? ¿Realmente nos preocupamos por mantener y/o restaurar la función masticatoria? Por lo general no, ni en los consultorios, ni en las clínicas universitarias. Es esencial que nos concienticemos de nuestra responsabilidad y para ello es necesario que se le dé mayor peso curricular a la función masticatoria y cómo evaluarla. Seamos realmente custodios de la función masticatoria de nuestros pacientes (AU)

The goal of chewing is to properly prepare food for swallowing and digestion. Any problem in the stomatognathic system can deteriorate chewing. The professional responsible of maintaining and/or restoring masticatory function is the dentist. Masticatory function can be evaluated subjectively through questionnaires to measure the patient's perception of his/her masticatory capacity or objectively analyzing occlusal force, the electromyographic activity of the masticatory muscles, the movements of the mandible during chewing or the individual's capacity to breakdown food. These methods are used in research projects but, do we examine if there is any problem during chewing and if we are achieving our goal of restoring masticatory function at the end of the treatment in our offices? Do we really focus on maintaining and/or restoring masticatory function? Not truly, not in our offices or university clinics. It is imperative that we acknowledge our responsibility but for that it is essential that masticatory function and how to evaluate it is given more weight in the curriculum. Let us be genuine guardians of the masticatory function of our patients (AU)

Assessment of anxiety levels in children aged 4–9 years about the pediatric dentists donning a personal protective equipment during treatment in the COVID-19 pandemic

Background: Managing anxiety in children during the pandemic will be a concern for many pediatric dentists. Aim: The aim of this study was to assess the anxiety levels in children aged between 4 and 9 years about the pediatric dentists donning a personal protective equipment (PPE) for dental treatment during the COVID-19 pandemic era in Bengaluru. Materials and Methods: The study was done in two parts with a sample size of 100 each. The first part was a questionnaire-based survey addressed to the pediatric dentists practicing in Bengaluru. The second part of the study was clinical assessment of dental anxiety at three time intervals (T1, T2, and T3) using the animated emoji scale. Results: The study revealed that 87% use preprocedural behavior management post-COVID. Majority of the dentists donned the PPE before conditioning the child (59%) and 41% wore the PPE after conditioning the child. The mean anxiety level in the study children showed an increase in anxiety level at T2 of 3.58 (P < 0.001 ± 1.32) in children aged 4–6 years when compared to T1 and T3 of 3.27 (P < 0.001 ± 1.64) and 3.07 (P < 0.001 ± 1.32), respectively. Conclusion: Children aged between 4 and 6 years showed increased levels of anxiety compared to the 7–9-year age group to the pediatric dentists donning a PPE during treatment in the COVID-19 pandemic. Pediatric dentists also showed a satisfactory knowledge regarding disinfection and fumigation procedures.

The funding system of American dentist scientist and its enlightenment / 中华医学科研管理杂志

Objective:To provide reference for the cultivation of stomatologist scientists in China by comparison and learning from the development of dental scientist training funding system in the United States.Methods:The development, training funding system and evaluation system of dental scientists in the United States were analyzed through literature review, and compared with the training of dental scientists in Chinese context.Results:The training of American dental scientists started early, and the funding system covered the whole process of dental students' learning and career choice; tailored measurements were adopted to deal with challenges and difficulties during the training process. On the other hand, the training of stomatologist scientists in China started late, the methods are diverse but uneven. In this paper, it is proposed to enhance the training by strengthening the construction of the training and funding system of stomatologist scientists, encouraging the collaboration between professional societies and colleges and universities, establishing specific funds and balancing the weight of clinical and scientific research in the teaching system.Conclusions:The funding system for the training of dental scientists in the United States can be used as a reference for optimizing the training of dental scientists in China.

Percepção de cirurgiões-dentistas em serviços de emergência odontológica: o atendimento a mulheres vítimas de violência interpessoal / Perception of dentists in services of dental emergency: the service to women victims of interpersonal violence

INTRODUÇÃO: A violência configura-se como um fenômeno que vem tomando proporções alarmantes no mundo, sendo considerada internacionalmente como problema de saúde pública e de violação dos direitos humanos das mulheres. A literatura evidencia que dentre os profissionais de saúde, o cirurgião-dentista (CD) apresenta boa chance de identificar os casos de mulheres em situação de violência, uma vez que o exame odontológico envolve a avaliação da cavidade oral e estruturas adjacentes, e o trauma maxilofacial é uma das principais lesões observadas em atendimentos desses casos. Considerando o papel do atendimento em saúde, no reconhecimento e cuidado nesses casos,é de fundamental importância a realização de pesquisas que permitam a ampliação do conhecimento sobre esse fenômeno, sobretudo com relação à atuação do CD. OBJETIVO:Avaliar a percepção e atitude do cirurgião-dentista diante do atendimento a mulheres em situação de violência interpessoal, que apresentaram trauma maxilofacial. MÉTODOS: Estudo qualitativo, realizado por meio de uma revisão de escopo a fim de mapear o que temsido produzido na literatura sobre o cuidado prestado pelo CD, nos serviços emergenciais de saúde, quando do atendimento às mulheres em situação de violência. RESULTADOS:Dos 48 estudos retidos, foram incluídos treze, publicados entre os anos de 2001 e 2018. Dos 13 artigos incluídos, sete foram estudos transversais, dois estudos qualitativos, três revisões de literatura e uma discussão teórica. Seis artigos têm como população os CDs, exclusivamente. Os outros avaliam profissionais de saúde, incluindo os CD. Os resultadosrevelaram que o CD é imprescindível no enfrentamento da violência contra mulher, por sero profissional de saúde que mais tem condições de identificar os referidos casos uma vez que sua área de atuação, cabeça e pescoço, são aquelas em que os sinais de violência estãomais presentes. Entretanto a percepção e atitude do CD diante do atendimento a mulheres em situação de violência interpessoal são falhas e estes profissionais ainda não estão preparados e qualificados para lidar com a problemática. Como parte final do estudo, foi construído um Guia Profissional Orientador para atendimento a mulheres em situação de violência interpessoal. O guia teve como base teórica a revisão de escopo. CONCLUSÕES: O reconhecimento dos casos de mulheres em situação de violência peloCD exige a incorporação de medidas educativas que provoquem mudanças culturais que envolvem o desenvolvimento de ações que visem à desconstrução dos estereótipos, a transformação das normas de gênero e desnaturalização desse fenômeno social peloprofissional CD.

INTRODUCTION: Violence is a phenomenon that has been taking alarming proportions in the world, being internationally considered a public health problem and a violation of women's human rights. The literature shows that among health professionals, the dental surgeon (DC) has a good chance of identifying cases of women in situations of violence, since the dental examination involves the evaluation of the oral cavity and adjacent structures, and trauma maxillofacial is one of the main injuries observed in these cases. Considering the role of healthcare, in the recognition and care in these cases, it is of fundamental importance to carry out research that allows the expansion of knowledge about this phenomenon, especially in relationto the performance of the CD. OBJECTIVE: To evaluate the dentist's perception and attitude towards the care of women in situations of interpersonal violence, who presented maxillofacialtrauma. METHODS: Qualitative study, carried out through a scope review in order to map what has been produced in the literature on the care provided by the CD, in emergency health services, when caring for women in situations of violence. RESULTS: Of the 48 studies retained, thirteen were included, published between 2001 and 2018. Of the 13 articles included,seven were cross-sectional studies, two were qualitative studies, three were literature reviews and a theoretical discussion. Six articles have CDs as their population exclusively. The others evaluate health professionals, including the DCs. The results revealed that the CD is essential in the fight against violence against women, as it is the health professional who is most able toidentify these cases, since their area of activity, head and neck, are those in which the signs of violence are more present. However, the perception and attitude of the CD regarding the care of women in situations of interpersonal violence are flaws and these professionals are still not prepared and qualified to deal with the problem. As a final part of the study, a Professional Guiding Guide was created to assist women in situations of interpersonal violence. The guide was theoretically based on the scope review. CONCLUSIONS: The recognition of cases of women in situations of violence by the CD requires the incorporation of educational measuresthat provoke cultural changes that involve the development of actions aimed at the deconstruction of stereotypes, the transformation of gender norms and the denaturalization of this social phenomenon by the professional CD.

The referral pattern of patients to periodontists by general dentists / O padrão de encaminhamento de pacientes para periodontistas por clínicos gerais

Objetivo: O sucesso da terapia periodontal requer um relacionamento adequado entre o clínico geral e o periodontista. O objetivo deste estudo foi determinar, por meio de um questionário, o padrão de encaminhamento de pacientes por dentistas clínicos gerais a periodontistas em Yazd, Irã. Material e Métodos: Este estudo transversal descritivo foi realizado na forma de uma pesquisa incluindo 145 dentistas licenciados em Yazd. Foi elaborado um questionário composto por sete questões com subquestões. Resultados: 89% dos cirurgiões-dentistas encaminham o paciente ao periodontista. A recessão gengival foi o motivo mais frequente de encaminhamento (69,7%), enquanto o sangramento gengival foi o menos frequente (13,1%). Em termos de procedimentos cirúrgicos, os procedimentos mais frequentes para encaminhamentos foram terapias de periimplantite e aumento de rebordo. O encaminhamento realizado por dentistas do gênero feminino foi de 95,9% e pelo gênero masculino foi de 81,7%. O número de pacientes encaminhados por dentistas que atuavam simultaneamente em clínicas privadas e públicas foi maior do que aqueles que atuavam apenas em clínicas privadas ou públicas. O maior percentual de encaminhamento foi no grupo de cirurgiões-dentistas com menos de 5 anos de experiência, com ligeira diferença daqueles com mais de 10 anos de experiência. Apenas 26,1% dos entrevistados relataram ter participado de programas de reciclagem. Conclusão: É necessário que os dentistas gerais considerem os sinais primários da doença periodontal e encaminhem os pacientes mais graves em estágios iniciais para fornecer um resultado ideal a longo prazo para os pacientes.(AU)

Objective: The successful periodontal therapy needs a proper relationship between general dentist and periodontist. The aim of this study was to determine the referral pattern of patients to periodontists by general dentists in Yazd, Iran, by means of a questionnaire. Material and Methods: This descriptive cross-sectional study was carried out in the form of a survey among 145 licensed general dental practitioners in Yazd, Iran. A questionnaire comprising of seven questions with sub-questions was prepared. Results: 89% of dentists have referred patient to periodontist. Gingival recession was the most frequent reason for referring (69.7%) and the least was gingival bleeding (13.1%). The most frequent surgical procedure for what patients have been referred were peri-implantitis therapy and ridge augmentation. Referral status to periodontist for female dentists was 95.9% and for male dentists was 81.7%. The number of referred patients form the dentists who were practicing simultaneously at both private and public clinics was higher than those who were practicing only at private or public clinics. The most referral percentage was in the group of dentists with less than 5 years of experience with a slight difference from those with more than 10 years of experience. Only 26.1% of the respondents have participated in retraining programs. Conclusion: There is a need for general dentists to consider the primary signs of periodontal disease and necessity of referring the patients in early stages more serious, to provide an optimal long-term outcome for patients. (AU)