Food intake, oral hygiene and gingival bleeding in pregnancy: does lifestyle make a difference? A cross sectional exploratory study.

OBJECTIVES: To investigate the association between lifestyle factors (food intake, sugary snacks consumption and oral health practices) and gingival bleeding during pregnancy. METHODS: A cross sectional exploratory study was conducted in the Maternity hospital, Dammam, Saudi Arabia. It included pregnant Saudi women selected using a convenience sample. Information was collected concerning participants' background, oral hygiene practices and visits to dentists. They were asked about the amount of food they consumed and their use of sugary snacks. Logistic regression analysis assessed the association between lifestyle factors and gingival bleeding. RESULTS: Responses were obtained from 197 women (92.1% response rate). Most women brushed their teeth but had < the recommended intake in the various food groups. Brushing was associated with lower odd of gingival bleeding (odds ratio= 0.47, 95% confidence interval= 0.23, 0.93) whereas intake of fewer servings than the recommended amounts in all food groups was associated with higher odds (odds ratio = 3.64, 95% confidence interval = 1.12, 11.82). CONCLUSION: Brushing and food intake during pregnancy are associated with gingival bleeding. Pregnant women can potentially improve their oral health by modifying their lifestyle and following healthier practices.

Association of Healthy Eating, Juice Consumption, and Bacterial Counts with Early Childhood Caries.

PURPOSE: To investigate the association of healthy diet, snacking, and bacterial count with early childhood caries in a group of preschool children in Alexandria, Egypt. METHODS: Sixty preschoolers were divided into three groups: (1) caries-free children; (2) children with early childhood caries (ECC); and (3) children with severe early childhood caries (S-ECC). Saliva was cultured to determine bacterial counts. A questionnaire collected information about background, oral health practices, and snacking habits. A 24-hour food recall form assessed dietary intake and was analyzed using the Health Eating Index 2005. RESULTS: Compared to caries-free children, children with ECC and S-ECC had significantly lower odds of drinking juices (odds ratio equals 0.10 and 0.02). Caries-free children had significantly higher Healthy Eating Index values than children with ECC and S-ECC (P=0.003 and P<0.0001). Total streptococci and Streptococcus mutans counts were significantly higher in children with ECC and S-ECC (P<0.0001 for all), whereas Streptococcus sanguis counts were lower (P=0.04 and P=0.01). CONCLUSIONS: Drinking juices was associated with less early childhood caries and severe early childhood caries among preschoolers. Snacking on sweets was associated with more S-ECC. Healthy eating, brushing, and bacterial counts were not significantly associated with ECC or S-ECC in multivariate regression.

e-Assessment in a Limited-Resources Dental School Using an Open-Source Learning Management System.

e-Assessment provides solutions to some problems encountered in dental students' evaluation. The aim of this study was to evaluate the experience of a limited-resources dental school with e-assessment provided through an open-source learning management system (LMS). Data about users' access and types of e-assessment activities at the Faculty of Dentistry, Alexandria University, Egypt, were obtained from the web-based LMS Moodle. A questionnaire developed to assess students' perceptions of the e-assessment was also sent to students registered in two courses (undergraduate and postgraduate) with the same instructor. The results showed that most e-courses at the school had one form of e-assessment (82%) and, of these, 16.7% had summative assessment activities. There were significant differences among departments in the number of e-courses with e-assessment. One-quarter of e-courses with e-assessment used Moodle quizzes. Of 285 students registered in the two courses that included the questionnaire, 170 responded (response rate=59.6%). The responding students positively perceived the impact of e-assessment on learning and its reliability and security, whereas technical issues and related stresses were negatively perceived. This study suggests that e-assessment can be used at minimal cost in dental schools with limited resources and large class sizes with the least demands on faculty members and teaching staff time. For these schools, an open-source LMS such as Moodle provides formative e-assessment not available otherwise and accommodates various question formats and varying levels of instructors' technical skills. These students seemed to have a positive impression of the e-assessment although technical problems and related stresses are issues that need to be addressed.

Predicting academic performance of dental students using perception of educational environment.

Greater emphasis on student-centered education means that students' perception of their educational environment is important. The ultimate proof of this importance is its effect on academic performance. The aim of this study was to assess the predictability of dental students' grades as indicator of academic performance through their perceptions of the educational environment. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was used to assess dental students' perceptions of their educational environment at the University of Dammam, Saudi Arabia, in academic year 2012-13. Aggregate grades in courses were collected at the end of the semester and related to levels of perception of the five DREEM domains using regression analysis. The response rate was 87.1% among all students in Years 2-6. As the number of students perceiving excellence in learning increased, the number of students with A grades increased. Perception of an environment with problems in the atmosphere and social life increased the number of students with D and F grades. There was no relation between any of the DREEM domains and past academic performance as measured by GPA. This study concludes that these students' academic performance was affected by various aspects of perceiving the educational environment. Improved perception of learning increased the number of high achievers, whereas increased perception of problems in atmosphere and social life increased the number of low achievers and failing students.

Comparison of three evidence-based practice learning assessment methods in dental curricula.

Incorporating evidence-based practice (EBP) training in dental curricula is now an accreditation requirement for dental schools, but questions remain about the most effective ways to assess learning outcomes. The purpose of this study was to evaluate and compare three assessment methods for EBP training and to assess their relation to students' overall course grades. Participants in the study were dental students from two classes who received training in appraising randomized controlled trials (RCTs) and systematic reviews in 2013 at the University of Dammam, Saudi Arabia. Repeated measures analysis of variance was used to compare students' scores on appraisal assignments, scores on multiple-choice question (MCQ) exams in which EBP concepts were applied to clinical scenarios, and scores for self-reported efficacy in appraisal. Regression analysis was used to assess the relationship among the three assessment methods, gender, program level, and overall grade. The instructors had acceptable reliability in scoring the assignments (overall intraclass correlation coefficient=0.60). The MCQ exams had acceptable discrimination indices although their reliability was less satisfactory (Cronbach's alpha=0.46). Statistically significant differences were observed among the three methods with MCQ exams having the lowest overall scores. Variation in the overall course grades was explained by scores on the appraisal assignment and MCQ exams (partial eta-squared=0.52 and 0.24, respectively), whereas score on the self-efficacy questionnaire was not significantly associated with overall grade. The results suggest that self-reported efficacy is not a valid method to assess dental students' RCT appraisal skills, whereas instructor-graded appraisal assignments explained a greater portion of variation in grade and had inherent validity and acceptable consistency and MCQ exams had good construct validity but low internal consistency.

Assessment of the Accuracy of Two Dental Screening Methods Used in a School Setting.

PURPOSE: To assess the accuracy of two screening methods used by dentists in the Health Insurance Organisation in Alexandria, Egypt aiming at identifying children who need referral for treatment. MATERIALS AND METHODS: The study included 45 dentists who examined 30 children using exclusively visual screening (VS) and visual screening with tongue blade (VSTB). A benchmark dentist examined the same group of children using mirror and probe (MP). VS and VSTB were compared to MP. Sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV and NPV, respectively) were calculated. The effect of dentist's gender, year of graduation and having postgraduate studies on the accuracy of the two methods was assessed. RESULTS: VS had greater accuracy than VSTB. Both methods had a Sn and Sp>82%. The PPV of both methods was >97%, whereas that of NPV was ≤44%. Males and recent graduates performed better than females and senior dentists when using VS and VSTB methods. CONCLUSIONS: It is questionable whether screening using VS or VSTB can ensure effective referral of children for treatment. Further studies are needed to assess other aspects of screening, including whether referred children actually seek care and whether screening improves children's oral health.

Using peer-assisted learning and role-playing to teach generic skills to dental students: the health care simulation model.

Increasing importance is attached to teaching generic skills to undergraduate students in various disciplines. This article describes an extracurricular, student-led activity for teaching generic skills using the Model United Nations over three months. The activity used the Health Care Simulation Model (HCSM) with peer learning and role-playing to accomplish its objectives. An interview was used to select from undergraduate and postgraduate dental students at Alexandria University, Alexandria, Egypt, to develop a group of staff to act as peer teachers after receiving training (n=77). These peer teachers provided training for 123 undergraduate dental students to serve as delegates who acted as trainees or peer learners. At the end of the training sessions, a conference was held in which the students played the roles of delegates representing officials responsible for health care systems in ten countries. The students reported improvement in generic skills, enjoyed several aspects of the experience, and disliked other aspects of the model to a lesser extent. In multivariate analysis, perceived usefulness of the HCSM was significantly greater for staff than delegates and increased as self-reported improvement in knowledge of health care systems increased. This study suggests that innovative, student-centered educational methods can be effective for teaching generic skills and factual information.

Assessment of the efficacy of second life, a virtual learning environment, in dental education.

This study assessed the efficacy of Second Life (SL) in delivering lectures and demonstrating clinical procedures. Sixteen students in a dental school in Alexandria, Egypt, volunteered to participate in SL to learn about topical fluoride through lectures and YouTube videos demonstrating the application of fluoride gel. This was followed by face to face (F2F) sessions about pits and fissures sealant including lectures and F2F demonstration. Knowledge improvement was assessed by pre- and posttests; practical skills were assessed by a checklist; and percent scores were calculated. The relation between these scores and some background variables was assessed. Students' satisfaction with and perceptions of SL were also assessed. Knowledge improved significantly after both SL and F2F experiences (p<0.0001 for both). There were no significant differences between SL and F2F in knowledge improvement or skills percent scores (p=0.16 and 0.26, respectively). Knowledge improvement was significantly related to previous experience with SL and previous year grade (p=0.02 and 0.007, respectively) but not to gender. Practical skills scores were not related to any of these three variables. Satisfaction with SL experience was high and not affected by any of the three variables, and the experience was perceived positively. This study suggests that SL can complement traditional F2F teaching, especially for underachieving students and in higher education institutions with problems of increasing numbers of students and limited space.

Blogging in a biostatistics and research design graduate dental course: for learning or interaction?

The use of the Internet in health professions education has markedly increased in recent years. There is a need to understand the methods used by students to benefit from Internet-based teaching methods, especially those initially designed to promote social interaction such as blogs. This study describes how students used a blog in a biostatistics and research design graduate dental course. The aims of the blog were to offer exercises to train students for the exam and to enhance interaction among students and between students and instructor. Some features of the blog were modified to suit the course. Posts and comments were counted and classified by type, and their time statistics were analyzed. Students filled out a questionnaire to indicate whether and how exactly they used the blog or reasons for not using it. The relation between final exam scores and different methods of using the blog was assessed. Most of the posts were by the instructor offering exercises and model answers, whereas most of the comments were by students answering the exercises. Students were significantly more satisfied with blog uses related to interaction than with uses related to exercises (9.15+/-1.19, 8.73+/-1.34, P=0.001). The most frequently cited reason for not using the blog was lack of time. The most frequently reported method of using the blog was reading exercises and answers without actively contributing to the blog. Methods of using the blog significantly associated with higher scores in the final exam were actively contributing to the blog by posts or comments and interacting with colleagues. The main advantage of using the blog was promoting interaction between students and instructor, which is essential for the success of online learning in particular and adult learning in general.

Factors affecting postgraduate dental students' performance in a biostatistics and research design course.

Comprehension of biostatistics and principles of research design is important for literature evaluation and evidence-based practice in dentistry as well as for researchers wishing to have their publications accepted by international journals. This study investigated the contribution of several factors to postgraduate dental student performance in a biostatistics and research design course. All of the subjects in this study were dental school graduates currently enrolled in postgraduate programs leading to master's or doctoral degrees. The seven factors selected for study were 1) learning style preferences assessed by the VARK questionnaire, 2) past academic performance at the bachelor's degree level, 3) age, 4) gender, 5) current postgraduate program (master's or Ph.D.), 6) lecture attendance, and 7) performance on a quiz conducted early in the course. Response rate was 64 percent. Using bivariate analysis, a statistically significant relationship was observed between final exam score and the following factors: bachelor's degree grade; having single or multiple learning preferences; having visual, aural, read-write, or kinesthetic learning style preference; percent of lectures attended; and quiz score (P<0.0001, 0.01, 0.02, 0.006, 0.04, 0.03, 0.03, and <0.0001 respectively). In regression analysis, significant predictors of final exam score were bachelor's degree grade, having aural learning preference, and quiz score. The findings suggest that dental educators should direct their attention to students who have difficulties at the beginning of the course and should match the learning preferences of as many students as possible by presenting information in different ways rather than focusing on a single method of delivering the course.

Evaluation of a blog used in a dental terminology course for first-year dental students.

This article reports the findings of a study conducted to evaluate a blog used in a dental terminology course. The blog was established using free online software to provide more learning exercises for students and to collect feedback about course proceedings. The instructor posted exercises such as multiple choice and true/false questions and invited students to publish answers. Students were also encouraged to post comments about difficult parts of the course that needed clarification. Students contributed 149 comments, mostly as answers in response to thirteen posts of exercises over three months. All users of the blog who responded to a questionnaire considered it useful, and most of them expressed the opinion that blogs should be used in other courses. The main reason that students reported for not using the blog was lack of time. Statistically significant differences in examination performance existed between students who used the blog and those who did not. Based on these findings, the blog achieved its purposes, which were to enhance instructor communication with students and provide students with practice exercises to improve their understanding of dental terminology. Further research about the application of blogging and its potential to enhance dental education is needed.