Understanding patient safety in dentistry: evaluating the present and envisioning the future-a narrative review.

BACKGROUND: Patient safety is crucial in dentistry, yet it has received delayed recognition compared with other healthcare fields. This literature review assesses the current state of patient safety in dentistry, investigates the reasons for the delay, and offers recommendations for enhancing patient safety in dental practices, dental schools, and hospitals. METHODS: The review incorporates a thorough analysis of existing literature on patient safety in dentistry. Various sources, including research articles, guidelines and reports, were reviewed to gather insights into patient safety definitions, challenges and best practices specific to dentistry. RESULTS: The review underscores the importance of prioritising patient safety in dentistry at all levels of healthcare. It identifies key definitions and factors contributing to the delayed focus on patient safety in the field. Additionally, it emphasises the significance of establishing a patient safety culture and discusses approaches such as safety plans, incident management systems, blame-free cultures and ethical frameworks to enhance patient safety. CONCLUSION: Patient safety is vital in dentistry to ensure high-quality care and patient well-being. The review emphasises the importance of prioritising patient safety in dental practices, dental schools and hospitals. Through the implementation of recommended strategies and best practices, dental organisations can cultivate a patient safety culture, enhance communication, mitigate risks and continually improve patient safety outcomes. The dissemination of knowledge and the active involvement of all stakeholders are crucial for promoting patient safety and establishing a safe dental healthcare system.

Association of Body Mass Index and Chronology of Tooth Eruption in Children visiting a Dental Hospital in UAE: A Cross-sectional Study.

The objective of this research was to investigate the relationship between body mass index (BMI) and the mean age at which permanent teeth erupt in school-going children. Materials and Method: This cross-sectional study at RAK College of Dental Sciences, UAE, involved 89 children aged 6-14 years. Erupted teeth in the mouth were included. Statistical analysis, including t-tests, ANOVA, and Kruskal-Wallis, was conducted using SPSS version 29, with a significance threshold set at p < 0.05. Results: Out of 89 children (41 girls and 48 boys) in the study, 56.17 % had normal weight, 20.22 % were overweight, 17.97 % were underweight, and 5.6 % were obese. Female children generally experienced earlier permanent tooth eruption than males. Additionally, there was an observed trend of earlier tooth eruption with increasing weight or BMI. Underweight children notably displayed a delayed mean age of tooth eruption. Conclusion: This study demonstrates a notable correlation between BMI and the mean age at which permanent teeth erupt in school-going children aged 6 to 14 years who visited our dental hospital. To establish a more precise understanding of the connection between BMI and dental development, we recommend conducting further longitudinal studies involving multiple centers. Clinical Significance: Monitoring a child's BMI is crucial for assessing dental health and planning tailored treatment for those aged 6 to 14. Understanding the BMI's connection to permanent tooth eruption timing allows dental professionals to identify trends in early or delayed development. This enables them to customize treatment strategies, promoting a precise and personalized approach for better oral health outcomes in this age group.

Tracing of Microbes in Prepared Cavity Following Different Minimally Invasive Caries Removal Protocols.

AIMS: The conventional caries removal technique has been replaced with minimally invasive (MI) techniques to preserve healthy natural teeth and to provide durable dental restorations. Each of these MI caries removal protocols is reported to be favorable in dealing with different caries conditions. The current study aimed to trace the residual bacteria that may remain in a prepared cavity following a visual-tactile (VT), caries detection dye (CDD), and chemo-mechanical caries removal (CMCR) protocol. MATERIALS AND METHODS: A total of 29 extracted human molar teeth with visible caries lesions were randomly divided into three groups. The cavity preparation and caries removal of each group was accomplished following one of the MI caries removal protocols. Swab samples (one from each specimen) were taken and inoculated onto a blood agar plate and incubated for 48 hours. The growth of the bacterial colony was observed under a microscope and the specific genome of the bacteria was identified by polymerase chain reaction (PCR) test. RESULTS: The maximum number of traceable bacteria was observed following the chemo-mechanical caries removal group followed by the caries detection dye group and the least in the visual-tactile group. The PCR test revealed the presence of Streptococcus mutans in all the observed colonies; however, Streptococcus sobrinus was absent completely. The Chi-square test reveals a statistically insignificant (p = 0.646) difference among the tested groups. CONCLUSION: All of the MI caries removal protocols used in this study showed a trace of microbes in certain teeth. The cavity prepared following a visual tactile protocol showed the least amount of traceable bacteria in the prepared cavity. CLINICAL SIGNIFICANCE: Cavity that is prepared following individual MI protocol has a risk of leaving microbes in it.

Association between Salivary Cortisol Levels, Dental Anxiety, and Dental Caries in Children: A Cross-Sectional Study.

AIM: This study aimed to investigate the relationship between dental caries, dental anxiety, and salivary cortisol levels in children visiting pediatric dental clinics and their implications on pediatric oral health. MATERIALS AND METHODS: A cross-sectional study was conducted at a dental university in the UAE. A total of 60 children, aged 4-12 years, were included. Salivary cortisol levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. Dental caries status was evaluated, and dental anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Statistical analyses, including Mann-Whitney U test and Pearson's correlation coefficient, were performed to determine significant differences and associations. RESULTS: The study group showed significantly higher salivary cortisol levels compared to the control group (p < 0.0001). A strong positive correlation was found between salivary cortisol levels and dental caries status (p < 0.001). However, no significant difference in dental anxiety levels was observed between the study and control groups (p = 0.85). A strong positive correlation was found between dental anxiety levels and dental caries status (p < 0.001). CONCLUSION: The findings indicate a significant association between salivary cortisol levels and dental caries, suggesting that higher cortisol levels are associated with active caries. Dental anxiety levels were positively correlated with dental caries. Understanding the relationship between these variables can contribute to better oral health strategies and interventions for children, emphasizing the importance of managing dental anxiety and stress in pediatric dental care. CLINICAL SIGNIFICANCE: This study highlights the potential of salivary cortisol as a biomarker for assessing stress and its impact on oral health in children. By addressing dental anxiety and stress, dental professionals can provide child-friendly dental care, enhance preventive measures, and improve oral health outcomes in pediatric patients.

Prevalence of Dental Caries in Children Visiting a Dental College and Hospital in the United Arab Emirates: A Cross-sectional Study.

AIM: The purpose of this study was to examine the prevalence of dental caries in school children visiting a dental college and hospital and investigate the associated risk factors. MATERIALS AND METHODS: Eighty children were recruited in this study between the ages of 6-12 years. The caries prevalence of decayed, missing, filled teeth (DMFT) was recorded using an evaluation form. A structured questionnaire was used to understand the associated risk factors. RESULTS: The caries prevalence in the population was found to be at 91.25%. There was a strong negative correlation between age and dental caries and the results were statistically significant with p-value being less than 0.0001. The duration of bottle and breastfeeding, frequency of teeth brushing, adult supervision during brushing, consumption frequency of sweets, and the frequency or timing of children's dental visits were found to be positively associated with dental caries and these results were statistically significant with p-value being less than 0.05. CONCLUSION: A high prevalence of dental caries was observed among the population visiting the dental college and hospital. Encouraging dental health education, including promoting the significance of good oral hygiene practices, is crucial. CLINICAL SIGNIFICANCE: The study emphasizes the rising prevalence of dental caries and underscores the need for dental health education and the promotion of good oral hygiene practices to prevent complications and reduce their prevalence.

Knowledge and Practice of Immediate Dentures among the Dentists in Private Clinics in Khartoum State: A Descriptive Cross-sectional Study.

AIM OF THE STUDY: To assess the awareness and practice of Immediate Dentures among the dentists who work in the private clinics in Khartoum state, Sudan Materials and methods: A descriptive cross-sectional questionnaire-based study was conducted among the dental medical officers, registrars, specialists, and consultants who are working in private clinics and centers in Khartoum state and registered the private medical institutions in Sudan. The sample population was 664, using the stratified sampling technique and simple randomization within the stratum, 265 dentists were asked to participate in the study voluntarily A self-administered questionnaire consisted of 32 closed questions and 3 sections, section (1) involved the participant's data, section (2) contained the participant's knowledge, and section (3) the participant's practice was distributed. The participant's knowledge and practice scores were calculated as percentages achieved by dividing the number of accurate answers of the participants by the total number of questions and categorized as Good (66.6-100%), Average (33.3-66.6%), and Poor (less than 33.3%) Data was collected and analyzed using a statistical package of Social Science (SPSS) computer software version 22. Chi-square was used for statistical analysis Results: The response rate was 100%, with nearly equal distribution between males (135, 50.9%) and females (130, 49.1%). The age range is 24-39 years, with a mean of 31.65 ± 7.52 years. The majority of the participants (172, 64.9%) were freshly graduated and young practitioners, with the majority of them having experience ranging from 1 to 6 years. The result of the study revealed that 65.7% of the respondents have average knowledge about immediate denture while 8.7% expressed poor knowledge and only 25.7% had excellent knowledge On the other hand, the majority of the participants (200,75.5%) have never constructed an immediate denture, while only 21.1% have a history of constructing 1-5 immediate dentures, 3% constructed more than 5-10 immediate dentures and only 0.4% constructed more than 10 immediate dentures The lack of knowledge and experience was the main barrier preventing the use of immediate dentures, and the mainstream of the participants (118, 44.5%), evaluated their knowledge about the immediate denture as poor Using the Chi-square test, the correlation between the participants' knowledge and their gender, years of experience, and qualification was found not significant (p -values of 0.46, 027, and 0.66, respectively) while a significant correlation was found between the participants' self-evaluation of their knowledge and their knowledge score with a p-value of 0.000* Conclusion: Within the limitations of this study, the dental practitioners have average knowledge about the immediate denture, but the practice of the immediate denture is still very limited and requires enhancement Clinical significance: Immediate dentures have a significant role in maintaining the patient's esthetics, phonetics, masticatory efficiency, self-esteem, and quality of life. Hence, the knowledge and practice of the different dentists about the immediate denture are of great importance to improve the standard of care provided for the patient Keywords: Dentists, Immediate denture, Knowledge, Practice.

Endodontic Procedural Errors and Associated Factors among Undergraduate Dental Students: A Cross-sectional Study.

AIMS AND BACKGROUND: To assess the procedural errors committed by undergraduate students at RAK College of Dental Sciences, during root canal treatments and the factors associated with these errors. MATERIALS AND METHODS: In this cross-sectional study, 180 self-administered questionnaires were distributed, each comprising 26 questions, among 4th and 5th-year students. Participants were requested to report their endodontic mishaps based on feedback from their supervisors. The questionnaire assessed the frequency and types of procedural errors, considering patient, operator, and tooth-related factors. Data were collected tabulated and analyzed using the Chi-square test. RESULTS: A total of 124 root canal-treated teeth exhibiting iatrogenic errors done by students were assessed. Out of which, 53% were performed by 5th-year students, and 69% were conducted by female operators. About 62% of errors occurred in the upper teeth and 68% in the posterior teeth. The most prevalent errors during the rubber dam isolation step were soft tissue trauma (21%) and isolation leakage (20%), significantly associated with limited mouth opening, excessive salivation, and tooth malalignment (p < 0.05). Apical blockage (15%) emerged as the most frequent error during instrumentation phase, showing a significant association with canal dimension and curvature (p < 0.05). For access cavity and obturation phases, under-extended cavity (9%), and under-extended filling (11%) were the most reported errors, respectively. CONCLUSION: Tooth isolation emerges as a particularly challenging aspect for dental students, particularly when dealing with patients exhibiting limited mouth opening and excessive salivation. CLINICAL SIGNIFICANCE: Clinical instructors should caution the undergraduates about the heightened risk of endodontic procedural errors when dealing with patients exhibiting limited mouth opening, excessive salivation, tooth misalignment, and narrow canals. Addressing these challenges is crucial for enhancing the proficiency of undergraduate students in performing successful root canal treatments. How to cite this article: Elsayed MA, Islam MS, Saleh DR, et al. Endodontic Procedural Errors and Associated Factors among Undergraduate Dental Students: A Cross-sectional Study. J Contemp Dent Pract 2023;24(12):998-1007.

Comparative Evaluation of Remineralizing Effect of Novamin and Tricalcium Phosphate on Artificial Caries: An in vitro Study.

AIM: The aim of the present study was to compare the remineralizing efficacy of novamin and tricalcium phosphate (TCP). MATERIALS AND METHODS: Nail varnish was coated to a total of 30 sound human premolars except for 5 mm × 5 mm window. Baseline microhardness was measured for all test samples. Artificial carious lesions were created for all teeth by subjecting them to demineralization process. Then microhardness of demineralized lesion was measured. Later artificial caries teeth were equally divided into two groups to treat with remineralization solution for 10 days; group I: novamin and group II: TCP. After 10 days of pH cycling, microhardness was measured. The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) statistical software from Chicago SPSS Inc., version 21 and using analysis of variance (ANOVA) post hoc multiple comparisons test for intergroup and significant difference at p < 0.05. RESULTS: In the present study, group I indicated a higher value for remineralization compared with group II (p < 0.05). CONCLUSION: The present study showed that both novamin and TCP were effective in remineralizing the carious lesions. CLINICAL SIGNIFICANCE: This study evaluates the remineralizing potential of novamin and TCP on initial carious lesions.

Use of different oral hygiene strategies in children with cerebral palsy: A comparative study.

BACKGROUND: Cerebral palsy (CP) is described as a group of conditions usually occurring in childhood, where children have motor dysfunction and are unable to adequately master the necessary techniques of plaque control, which ultimately leads to dental caries and periodontal problems. AIMS: The objective of this study was to educate the parents/caretakers/institution staff and children with CP about the different preventive home care measures and to evaluate the oral hygiene and gingival health status of these children before and after the institution of different preventive home care measures. MATERIALS AND METHODS: A total of 64 individuals with CP, aged between 6 and 18 years, were examined for their oral hygiene and gingival health status, after which the parents/caretakers received a health education program. The children were then randomly divided into four groups. Each group was administered a specific preventive home care measure (mechanical and chemotherapeutic) to be followed for a period of 6 weeks, and the oral hygiene and the gingival health status were recorded at the end of 1 week, 2 weeks, and 6 weeks. The data were then subjected to statistical analysis. RESULTS: In the sample of 64 children diagnosed with CP, the mean OHI(S) score among the groups of children who were given different preventive home care measures was compared at baseline, 1 week, 2 weeks, and 6 weeks. Group 4 showed a marked reduction in the OHI(S) score measured from baseline to 6 weeks, when compared to the other three groups which wa statistically very highly significant (P < 0.001) The mean MGI score was compared at baseline, 1 week, 2 weeks, and 6 weeks home, Group 4 showed a marked reduction in the MGI score measured from baseline to 6 weeks, when compared to the other three groups. When the mean MGI score was compared from baseline to 6 weeks, there was a gradual decrease in the MGI score, which was statistically highly significant between baseline and 1 week (P < 0.05) and statistically very highly significant between 1 and 2 weeks (P < 0.001). However, this improvement was not statistically significant between 2 and 6 weeks (P > 0.05). CONCLUSION: A combined mechanical and chemotherapeutic measure is highly recommended to maintain the oral hygiene and gingival health of these special children because of their difficulties and their limited abilities to control dental plaque.

Peripheral fibroma obstructing the eruption pathway.

Reactive hyperplasias comprise a group of fibrous connective tissue lesions that commonly occur in oral mucosa secondary to injury. Peripheral fibroma is also a type of reactive hyperplasia. Peripheral fibroma is a reactive hyperplastic mass that occurs on the gingiva and is derived from connective tissue of the submucosa or periodontal ligament. It may occur at any age, although it does have a predilection for young adults. Females develop these lesions more commonly than do males. Here, we are presenting a case report of a child who is 6 years old and presented to us with a swelling in the lower anterior region which was providing discomfort to the child and also was obstructing the eruption pathway of the permanent central incisor in the region. The lesion was surgically excised.

Crouzon's syndrome: A review of literature and case report.

Crouzon's syndrome is an autosomal dominant disorder with complete penetrance and variable expressivity. Described by a French neurosurgeon in 1912, it is a rare genetic disorder. Crouzon's syndrome is caused by mutation in the fibroblast growth factor receptor 2 (FGFR2) gene. Normally, the sutures in the human skull fuse after the complete growth of the brain, but if any of these sutures close early then it may interfere with the growth of the brain. The disease is characterized by premature synostosis of coronal and sagittal sutures which begins in the first year of life. Case report of a 7 year old boy is presented with characteristic features of Crouzon's syndrome with mental retardation. The clinical, radiographic features along with the complete oral rehabilitation done under general anesthesia and preventive procedures done are described.

Sleep disordered breathing in children--a review and the role of a pediatric dentist.

Among the many factors important in children's development is sleep. Sleep disorders can impair children's sleep and lead to negative consequences. The most common sleep disordered breathing (SDB) in children is obstructive sleep apnea (OSA). One of the main causes of childhood SDB is enlargement of the tonsil tissues and, in most cases, their removal serves as an ultimate treatment of SDB. However, it remains unclear what proportion of children with enlarged tonsil tissue suffer from SDB. Dentists are becoming increasingly aware of the issue of SDB as they are sometimes involved in treatment of this condition using oral appliances. Moreover, as dentists often look into children's mouths, they can play an active role in identifying those with enlarged tonsils and referring them for sleep assessment. This review focuses on the diagnosis and treatment of SDB and also on the utility of oral appliances in the management of this disorder.

Total antioxidant capacity of saliva in children with HIV.

UNLABELLED: Several recent reports have indicated high levels of reactive oxygen species, causing oxidative stress, in the pathogenesis of HIV infection. Oxidative stress may lead to enhanced HIV replication in infected cells and may also aggravate the immunodeficiency by reduction of cellular immunity and possibly by increased programmed cell death of lymphocytes. Saliva can constitute a first line of defense against free radical mediated oxidative stress. The use of saliva as a diagnostic fluid has become somewhat of a translational research success story. Technologies are now available enabling saliva to be used to diagnose disease and predict disease progression. PURPOSE: The antioxidant capacity of saliva was investigated in 68 children who were divided into two groups. 34 children who were investigated were diagnosed as having HIV infection and the other group consisted of children who reported to the department and served as healthy controls. Total antioxidant capacity of saliva was evaluated by spectrophotometric assay. CONCLUSIONS: The results indicated that the total antioxidant capacity (TAC) of saliva decreased in children with HIV infection. TAC was seen to increase with the age of the children.

Total antioxidant capacity of saliva and its relation with early childhood caries and rampant caries.

Dental caries is an infectious and communicable disease and multiple factors influence the initiation and progression of the disease. Recently it has been claimed that oxidative stress may play an important role in the onset and the development of several inflammatory oral pathologies and dental caries may also be included. Saliva could constitute a first line of defense against free radical- mediated oxidative stress. This is the reason why antioxidant capacity of saliva has led to increasing interest and hence the need for this study. The antioxidant capacity of saliva was investigated in 100 children who were divided into four groups. Two of which comprised the study and control groups of children with ECC (below 71 months of age) and the other two groups comprised of the study and control groups of the children with rampant caries [(RC) (6-12 yrs)]. Unstimulated saliva samples were collected from all the groups. Total antioxidant capacity of saliva was evaluated by spectrophotometric assay. The results indicated that the total antioxidant capacity (TAC) of saliva increased in children with caries. TAC also increased with the age of the children.