The biasing impact of irrelevant contextual information on forensic odontology radiograph matching decisions.

The potential biasing effect of irrelevant context information on the forensic odontology method of radiograph-based identification has never been empirically investigated despite being a recognized problem in other forensic science disciplines. This study examines the effect of irrelevant context information on the probability judgment of match (JOM) of practicing forensic odontologist and dentist participants who were asked to match pairs of dental radiographs supplemented with irrelevant case information. The irrelevant case information contained domain task-irrelevant context information which varied in strength (strong or weak). It suggested either supportive or contradictory bias relative to the actual match status of the radiograph pairs. The dental radiographs consisted of verified match and non-match radiographs pairs sampled and de-identified from actual forensic cases. Changes in accuracy and JOM between supportive and contradictory contexts conditions revealed a contextual bias. Mixed model analysis showed that strong supportive context increased the odds ratio of correct decisions by a factor of 2.4 [1.23, 4.46]; p = 0.0097. Consistent with the biasing effect, the JOM score differences between strong supportive and contradictory irrelevant context information were 1.03 and 0.43 respectively for the non-match and match decisions. The direction of context suggestion (p = 0.0067), the radiograph match status (p = 0.014), and their interactions (p = 0.0061), were all found to impact the participants' decision. The weak context information was not strong enough to have a significant effect on accuracy or JOM scores. This study demonstrates that radiograph match judgment is affected and can be biased by strong irrelevant contextual information.

Pupil diameter differentiates expertise in dental radiography visual search.

Expert behavior is characterized by rapid information processing abilities, dependent on more structured schemata in long-term memory designated for their domain-specific tasks. From this understanding, expertise can effectively reduce cognitive load on a domain-specific task. However, certain tasks could still evoke different gradations of load even for an expert, e.g., when having to detect subtle anomalies in dental radiographs. Our aim was to measure pupil diameter response to anomalies of varying levels of difficulty in expert and student dentists' visual examination of panoramic radiographs. We found that students' pupil diameter dilated significantly from baseline compared to experts, but anomaly difficulty had no effect on pupillary response. In contrast, experts' pupil diameter responded to varying levels of anomaly difficulty, where more difficult anomalies evoked greater pupil dilation from baseline. Experts thus showed proportional pupillary response indicative of increasing cognitive load with increasingly difficult anomalies, whereas students showed pupillary response indicative of higher cognitive load for all anomalies when compared to experts.

Visual Fixation and Scan Patterns of Dentists Viewing Dental Periapical Radiographs: An Eye Tracking Pilot Study.

INTRODUCTION: The visual search patterns of dentists and the areas that attract their attention when interpreting dental periapical radiographs are currently unknown. This research identifies areas and patterns of visual fixation when observing dental periapical radiographs. METHODS: In an observational study using eye tracking technology and a convenience sample of 44 observers, the interpretations of 4 dental periapical radiographs were recorded using Camtasia Software (TechSmith, Okemos, MI) with a gaze tracking "bubble" denoting where within the radiograph the observers' eyes gazed. The recorded observations included the scanning pattern, the area of first fixation, and revisits of areas. Also noted was whether the area of first fixation or revisit was radiopaque, radiolucent, or of normal radiodensity and whether it was a coronal or radicular area. RESULTS: The first fixation is more likely to be an area of high contrast that is either radiopaque or radiolucent compared with areas that were normal or of average gray scale. Significantly more revisits occurred on areas that were radiopaque and located in the radicular area. Of the 4 categorized scanning patterns, tooth by tooth scanning predominated. CONCLUSIONS: When interpreting dental periapical radiographs, significantly more observers initially fixated on areas of the radiograph that were of high contrast (ie, radiopaque or radiolucent) compared with "normal areas." A tooth by tooth scanning pattern was most commonly used.

Attitudes and preferences of parents about being present in the dental operatory.

PURPOSE: To determine if there was an association between the type of dental procedure being performed on children and parental desire to be present in the operatory. METHODS: Parents (N=339) whose children had dental appointments at a university pediatric dental clinic or affiliated practices in Southern Nevada completed a survey. Parents identified attitudes/preferences associated with five commonly conducted pediatric dental procedural scenarios. Data were analyzed using chi-square tests (P=.05). RESULTS: Most respondents (N=339) were female (N=248) and/or Hispanic (N=204), had a household income of less than $50,000 annually (N=251), and a high school education. The primary reason (78 percent) parents wanted to be present during their child's dental treatment was comfort. Most parents wanted to observe exams/X-rays (70 percent), sedation procedures (69 percent), fillings and crowns (66 percent), extractions (64 percent), and physical restraint (61 percent). Only 38 percent of parents would be content with the dentist unilaterally deciding about their presence in the operatory. CONCLUSIONS: Parents in this study expressed a preference to remain with their child during any dental treatment. Practitioners are encouraged to consider their presence customary and establish office policies and protocols that beneficially involve parents in the pediatric patient's care.

Influence of gag reflex on dental attendance, dental anxiety, self-reported temporomandibular disorders and prosthetic restorations.

To assess the influence of gag reflex severity, assessed according to the short form of the patient part of Gagging Problem Assessment Questionnaire (GPA-pa SF), on the dental attendance, dental anxiety, self-reported temporomandibular disorder (TMD) symptoms and presence of prosthetic restorations among patients requiring prosthodontic treatment in Turkey. A total of 505 patients (305 women; mean age: 46·35 years, SD: 28·2 years) undergoing dental examination were administered a questionnaire containing questions regarding their age, gender, education level, dental attendance, TMD symptoms (limitation in jaw opening, muscle pain, pain/sounds in the temporomandibular jaw), the Turkish version of the Modified Dental Anxiety Scale (MDAS) and the GPA-pa SF. Subsequently, any prosthetic restoration was recorded by a dentist. Descriptive statistics, one-way analysis of variance (anova) and the chi-square test were used for statistical analysis. Differences were found between GPA-pa SF scores 0, 1 and 2 for education level (P = 0·001), MDAS scores (P = 0·003), self-reported TMD (P = 0·000) and prosthesis wear (P = 0·000), but not for attendance patterns (P = 0·826). Patients with gag reflex had lower education levels, higher levels of dental anxiety, more self-reported TMD symptoms and fewer fixed or removable prosthetic restorations than patients without gag reflex. Gag reflex has impacts on dental anxiety, self-reported TMD and prosthetic restorations, but not on dental attendance patterns, according to the results of the GPA-pa SF.

Parental knowledge and attitudes towards dental radiography for children.

BACKGROUND: Radiographs are an essential part of most clinical dental examinations and diagnoses. The aim of the study was to assess the knowledge and attitudes of parents towards dental radiographs for their children. METHODS: A 21-item questionnaire, covering parental level of radiation knowledge and socio-demographics was applied. Sliding scales were used to assess attitude towards dental radiographs. RESULTS: There were 1467 questionnaires distributed between five primary schools in the Perth (Western Australia) metropolitan area, with 309 surveys (21%) returned for collection. Most parents displayed a low level of knowledge, but had a positive attitude towards dental radiographs. Parents with children who have previously had dental radiographs perceived dental radiographs as 'good', 'useful' and 'pleasant'. A higher level of education and parents with children who have previously had radiographs were significantly associated with a higher level of knowledge about dental radiography. Parents who had higher scores on questions assessing radiation knowledge were more likely to perceive dental radiographs as 'safe' and 'beneficial'. CONCLUSIONS: Most parents have a positive attitude towards dental radiographs on their children. However, the majority of parents lack knowledge regarding dental radiography, especially regarding the risks involved.

Flemish general dental practitioners' knowledge of dental radiology.

The aim of this study was to assess general dental practitioners' knowledge of dental radiography and radiation protection in order to alert the Belgian authorities and dental professional societies. Prior to attending a postgraduate course on intraoral radiology, general dental practitioners in Flanders, Belgium, were asked to fill in a questionnaire regarding the radiological equipment and the techniques they used for intraoral radiography. The availability and type of dental panoramic equipment were also assessed. A total of 374 questionnaires were available for this study. 15% of the attendants used radiographic equipment that was more than 27 years old and 43% reported equipment that operated with a clockwork timer. 32% and 75% respectively had no idea what the kV or mA settings were on their intraoral equipment. 5% were unaware which cone geometry or geometric technique (paralleling or bisecting angle technique) they were using. 81% claimed to be using a short cone technique. 47% did not know what collimation meant, whereas 40% stated that they were using circular collimation. 38% used digital intraoral image detectors (63% were photostimulable storage phosphorplate (PSPP)), but 16% were not sure about the type of sensor they were using (PSPP or solid-state sensors). 61% also had dental panoramic equipment available, 25% of which was digital (10% charge coupled device (CCD) and 15% PSPP). These results clearly indicate the need for continued education on this subject. The latter is an important signal to Belgian authorities and dental professional societies.

Dental difficulty for adult patients undergoing different dental procedures according to level of dental anxiety.

This study aimed to determine the level of dental anxiety before different dental care procedures. A group of 116 adults presenting for the first time at a French dental hospital were included in the study. These patients completed a French-language version of Corah's Dental Anxiety Scale 1 and used a visual analogue scale to score their perception of the level of difficulty generated by 13 different dental treatments. The acts perceived as the most difficult to face were root canal and restorative treatment without local anaesthesia (LA), followed by oral surgery. There was a positive correlation between DAS score and level of difficulty experienced during dental treatment. Healthy subjects declared difficulty in coping with dental care. Dental procedures may be a factor of co morbidity in terms of the psychological status of dental patients. A classification of dental procedures is given according to the level of difficulty generated.

Evaluation of the use of film holders by undergraduation students

Film holder is used for the Intrabuccal Radiographic Technique (Entrance 453, Ministry of Health, Brazil). This procedure seeks radioprotection, lowering technique mistakes. However, patient's collaboration is necessary to adapt the device. The purpose of this research study is to evaluate the effectiveness of HanShin (Japan), Indusbelo and Imagem (Brazil), and Rinn (USA) X-Ray film positioners as: 1) Technical quality and 2) Comfort (adaptation), correlating to patient's cooperation (Discipline of Integrated Clinical Diagnosis -2000 and 2001-FORP/USP). The methodology applied was: 1st) Protocol of Mistake in Radiographic Technique with film holders and 2nd) Interview Questionnaire to obtain information regarding comfort of the film holders (C=Cooperative; LC= Little Cooperative and NC=Non-Cooperative). During clinical activities each student x-rayed three patients (Apparel of X-Rays 70KVp, 10mA, E Film, Radiographic Processing) and in each patient, a film holder brand was used. As a result of 224 patients' studied, 1179 radiographs were obtained, 255 of those presenting "technique mistakes”, according to the brand of the film holder: 16 percent HanShin, 10 percent Indusbelo, 31 percent Rinn, 33 percent Imagem and 33 percent bisecting line technique (without film holder). Regarding comfort the following results were obtained: HanShin C=95 percent, LC=4 percent and NC=1 percent; Indusbelo C=89 percent, LC=6 percentand NC=5 percent; Imagem C=95 percent, LC=3 percent and NC=2 percent and Rinn C=60 percent, LC=25 percent and NC=15 percent. It was concluded that the brands Hanshin, Imagem and Indusbelo are suitable for dental radiographic exam and that the Rinn brand produces more discomfort, because its size dimensions are not ideal for the size and form pattern of the Dental Arch in the population used in this study.

El posicionador porta películas está indicado en la Técnica Radiográfica Intraoral (Resolución 453, Ministerio de la Salud, Brasil). Este procedimiento permite la radio protección, minimizando el error de técnica; sin embargo, es necesaria la colaboración del paciente para la adaptación del dispositivo. El objetivo de esta investigación-enseñanza fue evaluar la efectividad de los posicionadores de marcas HanShin (Japón), Indusbelo, Imagem (Brasil) y Rinn (USA), en relación a: 1) Calidad Técnica y 2) Confort (adaptación) correlacionándolo con la colaboración del paciente (Disciplina de Diagnóstico Clínico Integrado-2000 y 2001-FORP/USP). Como metodología de investigación se utilizaron: 1ª)Protocolo de Errores de Técnica Radiográfica con Posicionador y 2º) Cuestionario de entrevista para la obtención de las informaciones relativas a la comodidad del posicionador (C=Cooperaba; CP=Cooperaba poco y NC=No cooperaba). Durante las actividades clínicas, cada alumno radiografió a tres pacientes (Aparato de Rayos X, 70kvp, 10mA, Film E, Procesamiento Radiográfico Manual) y en cada paciente se utilizó una marca de posicionador. Como resultado de la atención de 224 pacientes, se obtuvieron 1179 radiografías; de ellas, 255 presentaron “errores de técnica”, debido a la marca del posicionador: 16 por ciento HanShin; 10 por ciento Indusbelo; 31 por ciento Rinn; 33 por ciento Imagem, y Técnica da Bissetriz, sin posicionador, 33 por ciento. En relación al confort, se obtuvieron los siguientes resultados: HanShin C=95 por ciento, CP=4 por ciento y NC=1 por ciento; Indusbelo C=89 por ciento, CP=6 por ciento y NC=5 por ciento; Imagem C=95 por ciento, CP=3 por ciento y NC=2 por ciento y Rinn C=60 por ciento, CP=25 por ciento y NC=15 por ciento. Se concluye que las marcas Hanshin, Imagem e Indusbelo son las indicadas para el examen radiográfico odontológico y que la marca Rinn produce más incomodidad.

A study of behaviour patterns of normal children in a dental situation and its relationship with socioeconomic status, family type and sibling position.

Different psychosocial variables, such as socioeconomic status, family type and sibling position may be considered to be of great significance as it may influence child behaviour pattern in a dental treatment situation. 143 children in the age group of 3-14 years were selected randomly from the out patient department of Pediatric Dentistry, Dental Wing, S. C. B. Medical College, Cuttack with an aim of assessing relationship, if any, between the magnitude of behaviour and the above mentioned psychosocial variables. Behaviour rating was done using Frankl behaviour rating scale. The results of the study reveals no significant relationship between socio economic status, family type and sibling position with child behaviour pattern, but a trend has been observed that children of high socio economic back ground behave more positively, children of a nuclear family exhibit more negative attitude and middle siblings show less negative behaviour than youngest and eldest.

Negative perceptions of dental stimuli and their effects on dental fear.

PURPOSE: About 40% of modern western society are apprehensive about dental visits, 20% are highly fearful, and 5% avoid oral health care completely. This study examined how negative perceptions of dental stimuli contribute to dental fear. METHODS: One-hundred-and-seven people recruited from a dental school clinic and a private practice, participated in the study. Each participant completed measures of general dental anxiety (DAS-R) and negative perception of specific dental stimuli (DFAS). Upon completion of the scales, data were coded and analyzed using Statistical Package for Social Sciences. RESULTS: Data analyses revealed a significant correlation between negative perceptions of common dental stimuli and dental fear (p < .05). Getting an injection, having dental radiographs taken, use of scalers and curets, and the sight of the needle were identified as the dental stimuli evoking the highest negative perceptions by the sample. CONCLUSION: Because exposure to certain stimuli triggers dental fear, it is important to identify anxious oral health care patients, and oral health care providers must be sensitive to their fear. Providing a positive experience will help to lower negative perceptions of oral health care. If particular stimuli produce anxiety and fear, then ways to limit exposure to them is necessary.

RELACION DE LA EDAD CRONOLOGICA DEL NIÑO DE 9 Y 12, CON LA EDAD DENTARIA Y ESQUELÉTICA DETERMINADA MEDIANTE RADIOGRAFIAS INTRAORALES Y CARPIANAS

El estudio radiográfico del carpo para la obtención de la edad esquelética en niños de 9 y 12 años, es el único método adaptado para la odontología. El estudio rediológico dental para la obtención de la edad dentaria realizados en niños de 9 y 12 años, mediante la tabla gráfica de LILIEQUIST y LUNDBERG, observadas las diferentes etapas de calcificación, y asignándole el puntaje correspondiente en las piezas dentarias permanentes, es práctico. La edad esquelética en los niños de 9 años y en ambos sexos en la moyoría de los casos estudiados va paralela a la edad cronológica

Knowledge and adoption of radiographic quality assurance guidelines by general dentists in North Carolina.

OBJECTIVES/STUDY DESIGN: A random survey of equal proportions of urban and rural North Carolina general dentists was conducted to assess their knowledge and adoption of radiographic quality assurance guidelines of the American Dental Association. RESULTS: A total of 159 surveys were returned representing a response rate of 51%. A majority of respondents answered "don't know" to questions dealing with intraoral and panoramic radiography units and darkroom monitoring. Higher levels of knowledge (58% to 77%) and adoption (63% to 86%) of guidelines were seen with film-processing activities. Linear regression demonstrated substantial positive association between knowledge and adoption of guidelines (R = 0.50). Stepwise multiple regression revealed positive associations of the demographic variables of years in practice, urban location, and age with greater knowledge of guidelines (R2 = 0.33, p < 0.05). Urban location was associated with increased likelihood of adoption of guidelines (R2 = 0.09, p < 0.05).