Overbite recognition and factors affecting esthetic tolerance among laypeople.

OBJECTIVES: To determine recognition ability and the levels of esthetic tolerance of deep bite and anterior open bite (AOB) among laypeople and investigate the factors affecting levels of tolerance. MATERIALS AND METHODS: Using a questionnaire, laypeople (N = 100) were examined, and overbite was measured. They were tested for whether they recognized deep bite and AOB. Esthetic tolerance thresholds for deep bite and AOB were selected by incremental depiction in grayscale images. Stepwise logistic regression analyses were used to quantify the effect of recognition and other factors (age, sex, education level, occupation, history of orthodontic treatment, interest in orthodontic treatment or retreatment, and overbite presence) affecting the tolerance of overbite problems (α = 0.05). RESULTS: Of the participants, 55% and 94% recognized deep bite and AOB, respectively. Participants with a deep bite were significantly more likely to esthetically tolerate deep bite compared with those without a deep bite (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.29-9.89). Participants who recognized a deep bite problem had significantly lower esthetic tolerance to deep bite compared with participants who did not recognize a deep bite (OR, 0.17; 95% CI, 0.06-0.45). None of the other eight chosen factors significantly affected the tolerance level of AOB (P > .05). CONCLUSIONS: Participants with a deep bite or those who did not recognize a deep bite had significantly higher esthetic tolerance of deep bite than those without or those who recognized the problem (P < .05).

Factors associated with burnout among dentists in public hospitals, southern Thailand.

Background/purpose: Physician burnout is now a public health crisis and dentist is a stressful professional health occupation. The purpose of this cross-sectional study was to determine the level of burnout and related factors among 423 Thai dentists working in public hospitals, southern Thailand. Materials and methods: A self-administered questionnaire was collected through an online platform and included 5 parts: general information, work information, 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS), 23-item Thai Effort-Reward Imbalance Questionnaire (Thai ERIQ), and the Utrecht Work Engagement Scale-9 (UWES-9). The data were analyzed for descriptive statistics - frequency, percentage, mean, standard deviation - and inferential statistics using binary logistic regression. Results: The prevalence of medium to high level of burnout were 45.8%, 44.3%, 4.0% for emotional exhaustion, depersonalization, and low personal accomplishment, respectively. Regarding to the multivariate analysis, the statistically significant factors associated with emotional exhaustion were age, work engagement, workplace relationship, work effort, work reward, grade point average, and workplace consultant. The factors associated with depersonalization were age, work engagement, workplace relationship, work effort, and job reselection. The factors associated with personal accomplishment were age, work engagement, work reward, and level of workplace. Conclusion: In this study, we identified several factors that can be modified to reduce the risk of burnout among dentists in Thailand.

Self-perception of leadership style of dentists: heads of dental departments in community hospitals, Southern Thailand.

INTRODUCTION: Leadership is crucial in all professions and organisations, including the oral health profession. OBJECTIVES: The aims of this analytical cross-sectional study were to evaluate the self-reported leadership behaviours and the factors influencing leadership behaviours among dentists who were heads of dental departments in community hospitals, southern Thailand. MATERIALS AND METHODS: The self-administered questionnaire was composed of four parts: personal data; a 45-item Multifactor Leadership Questionnaire version 5× short (MLQ 5× short); a 34-item organisational climate perception; and a 52-item emotional intelligence screening test. RESULTS: Of 134 dentists, 133 returned the questionnaire, providing a 99.3% response rate. The scores on the transactional component had a mean score of 2.98 (SD = 0.46). The transformational scores ranged with a mean of 2.90 (SD = 0.49). The scores of the passive leadership component had the lowest results, with a mean of 1.21 (SD = 0.57). Afterwards, the highest score for each head of the dental department was examined and compared across the three components. Approximately 60% of the dentists fell on the transactional, 34.6% on the transformational and 2.3% on the passive-avoidant scale. Multiple linear regression showed that the factors influencing the leadership of the dentists included emotional intelligence, the professional position of the dentists and the perception of the organisational climate. CONCLUSIONS: The majority of heads of dental departments had transactional leadership style followed by transformational leadership style, and passive-avoidance was the least common. Emotional intelligence, the professional position and the perception of the organisational climate significantly increased the transformational leadership score.

The periodontal health of lead-exposed children living in a shipyard industrial area.

In a cross-sectional design, 292 schoolchildren living around a shipyard area, known to be contaminated with lead from shipyard industry, were examined to verify the association between lead exposure and periodontal health. The probing pocket depth (PD), bleeding on probing, plaque and calculus, and the presence of Aggregatibacter actinomycetemcomitans (Aa) in subgingival crevices were recorded. Gingival inflammation was the most common (98%) among children in the area. No significant difference in gingival inflammation was observed between high blood lead (PbB) and low PbB children. The prevalence rate of probing PD of ≥5 mm was 14%. The high PbB group showed more deep pockets at tooth 16 (upper right first permanent molar) and tooth 46 (lower right first permanent molar) than the low PbB group. The odds ratios (ORs) for having probing PD ≥5 mm after adjusting for other factors were 3.63 (95% confidence interval (CI), 1.24-10.61; p = 0.02) for tooth 16 and 3.93 (95% CI, 1.18-13.00; p = 0.02) for tooth 46. The presence of Aa was observed in 17% of the children and it significantly increased in high PbB compared with low PbB children at tooth 46 (OR = 5.53, 95% CI: 1.68-18.15; p = 0.005). This study may suggest no association between lead exposure and gingival inflammation, yet there was the involvement of deeper periodontal tissue in lead-exposed children.

Salivary lead in relation to caries, salivary factors and cariogenic bacteria in children.

BACKGROUND: Saliva has been suggested as a useful biomarker of environmental contamination, including exposure to lead. AIMS: The study examined the associations between salivary lead level and the following factors: blood lead level, the number of decayed and filled surfaces (dfs) on deciduous and permanent teeth (DMFS), salivary flow rate, pH, buffer capacity, lactobacilli and mutans streptococci counts. MATERIALS AND METHODS: One hundred and twenty saliva samples of children living in a shipyard area (known to be an area contaminated with lead) were analysed for lead. Clinical oral examination was conducted to define carious lesions in accordance with the criteria of the World Health Organisation. RESULTS: The analysis revealed detectable levels of lead in a range of 0.16-28.52 µg/dl with a mean concentration of 2.26 ± 3.67 µg/dl. No significant differences in salivary lead concentrations were found in relation to gender and age. The salivary lead level significantly correlated with the blood lead level (Rs = 0.18, P = 0.05). There was no association between the salivary lead levels and dfs or DMFS. The results indicated that children with high salivary lead levels did not differ in flow rate, pH, buffer capacity of saliva from those with low lead levels. However, the number of mutans streptococci were reduced in the high salivary lead groups, while the lactobacilli count was not associated with the salivary lead levels. CONCLUSIONS: The current finding suggests that saliva may not have potential to be an appropriate alternative for biological monitoring of lead exposure.

Chemical composition of enamel and dentine in primary teeth in children from Thailand exposed to lead.

Enamel and dentine in teeth of children with high blood levels of lead were analyzed by means of secondary ion mass spectrometry (SIMS) and X-ray micro-analyses (XRMA) and compare with teeth from children with low blood levels of lead. The SIMS analysis revealed detectable levels of Pb in dentine close to the pulp. The XRMA analyses could not detect any lead. There were no differences found in lead level in enamel of high lead level exposed teeth from low level exposed. The results confirm that children with high blood levels of lead have an uptake of lead in dentine close to the pulp.

Microbiology in toothbrush samples from children exposed to lead in southern Thailand.

OBJECTIVE: The purpose of this study was to evaluate the prevalence and level of selected oral bacterial species in association with dental caries in low versus high blood lead (PbB) children. MATERIAL AND METHODS: With an observational cross-sectional design, a sample of 292 children aged 6-11 years from two primary schools around a shipyard, known to be an area contaminated with lead, were examined. The number of decayed and filled surfaces on deciduous teeth (dfs) and the number of decayed, missing, and filled surfaces on permanent teeth (DMFS) were recorded. Microbiological plaque samples were taken from each child with a toothbrush. Enumeration of 17 bacterial species was carried out using the checkerboard DNA-DNA hybridization technique. RESULTS: Overall means (SD) of dfs and DMFS were 13.2 (9.5) and 1.3 (2.3), respectively. Prevalence of excessive count (>or=10(6) cells/sample) was 100% for 4 known cariogenic bacteria and over 95% in another 2 species. With Bonferroni correction for type I error adjustment, there was no significant association between the count of each bacterial species and PbB and caries experience. The checkerboard method is sensitive in bacteria detection, but may not be suitable for differentiating caries risk in the endemic population.

Lead associated caries development in children living in a lead contaminated area, Thailand.

In an observational cross-sectional design, a sample of 292 children aged 6-11 years from two primary schools around a shipyard area, known to be an area contaminated with lead (from the industry), were examined to verify the cariogenicity of lead. The number of decayed and filled surfaces on deciduous teeth (dfs), and the number of decayed, missing, and filled surfaces on permanent teeth (DMFS), the salivary flow rate, pH, buffer capacity, oral hygiene, Lactobacillus spp. and mutans streptococci counts were recorded. The mean (range) of DMFS and dfs were respectively 1.3 (range 0-17) and 13.2 (range 0-45); and the geometric mean blood lead level (PbB) and SD were 7.2 and 1.5 microg/dl. The level of dfs, but not DMFS correlated with the blood lead level (R(s)=0.25, p=0.00 / R(s)=0.09, p=0.14). The odds ratio for DMFS>or=1 and dfs>5 for a doubling of PbB after adjusting for other factors were 1.28 (95%CI, 0.81-2.04; p value=0.35) and 2.39 (95%CI, 1.36-4.20; p value=0.004), respectively. The cariogenicity of lead is evident in deciduous teeth but not in permanent teeth for this age group.

Morphology of enamel in primary teeth from children in Thailand exposed to environmental lead.

Lead is one of the major environmental pollutants and a health risk. Dental hard tissues have a capacity to accumulate lead from the environment. Eighty exfoliated primary teeth were collected from children residing around a shipyard area in southern Thailand, known for its lead contamination. The morphology of the enamel was examined by polarized light microscopy (PLM), microradiography (MRG), and scanning electron microscopy (SEM). The specimens derived from two groups of children, one group with high blood levels of lead (57 teeth) and one group having low blood levels of lead (23 teeth). The enamel irrespective of group appeared normal. However, in a majority of the specimens the enamel surface appeared hypomineralized, which was confirmed in SEM. No morphological changes connected to lead in blood could be found. The hypomineralized surface zone could possibly be attributed to an acid oral environment.