Effect of Dietary Simulating Solvents on the CAD-CAM Provisional Restorative Materials' Microhardness and Color Stability Properties: An in vitro Study.

Purpose: This in vitro study investigated the effects of dietary solvents on the microhardness and color stability of CAD/CAM provisional restorations compared to conventional materials. Methods: Disc-shaped specimens (n=200) were fabricated from self-cured acrylic resin, two 3D-printing resins (FormLabs, NextDent), and a milled material (TelioCAD). Randomization assigned specimens (n=10/group) to immersion solutions: artificial saliva, citric acid, heptane, coffee, and tea. Microhardness and color stability were evaluated. One-way and three-way ANOVA with Tukey's post hoc test analyzed the data. Results: Dietary solvents significantly reduced the surface microhardness of all tested materials (p<0.05). Unpolished surfaces exhibited greater color changes compared to polished ones (p<0.05) across all materials. Coffee and tea induced the most substantial reductions in hardness and the most significant color alterations (p<0.05), whereas saliva and citric acid had minimal effects. Conclusion: Milled provisional restorations exhibited superior hardness and color stability. Dietary solvents significantly affected material properties over time, highlighting the importance of material selection for clinical applications.

Epidemiology and Management of Poisoning Cases in the Emergency Room: A Cross-Sectional Study in Saudi Arabia.

Introduction Acute poisoning, arising from exposure to toxic substances, is a critical healthcare challenge. In the United States, it's one of the primary causes of morbidity and mortality. European institutions report that about 1% of all emergency department admissions relate to poisoning, a statistic that becomes alarming given the life-threatening implications. While there's an underreporting of these cases, the actual figure could be much higher. Acute poisoning has resulted in over a million morbidity cases with a 20% mortality rate. Most concerning is the World Health Organization's data indicating that over 90% of accidental poisoning deaths occur in low to middle-income countries. Methods This was a cross-sectional study conducted over a 12-month period in three major hospitals in Saudi Arabia. The study population comprised of 1470 patients who presented to emergency departments with suspected acute poisoning. Medical records were retrospectively reviewed, capturing data on patient demographics, nature and type of poisoning, initial management, and outcomes. Data were analyzed using SPSS software version 28.0 (IBM Corp., Armok, NY). Descriptive statistics were used to summarize the data, while Chi-square tests were employed to determine associations between demographic factors and the nature of poisoning. Furthermore, the Pearson correlation was used to evaluate the link between referrals to specialized centers and patient outcomes. Results Out of the 1470 participants, a significant majority were males, constituting 77.1%. The dominant age group was between 18-24 years, representing 71.4% of the sample. A substantial 88.6% had visited the emergency room due to medical complications stemming from poisoning. When queried about their understanding of acute poisoning, 60.0% were able to correctly define the term. However, a concerning 54.3% reported they had never received any formal training or been part of awareness programs regarding poisoning. There was a marked association (p < 0.001) between demographics and the nature of toxin exposure. Delving deeper into the specifics of poisoning incidents, medications were identified as the primary culprits in 8.6% of the cases, followed by household chemicals at 5.7%. Crucially, a vast majority, 82.9%, were of the opinion that with the right education and precautions in place, the incidence of poisoning cases could be substantially reduced. Conclusion Acute poisoning is a pressing concern in Saudi Arabia, with a significant proportion of the population unaware or inadequately trained to handle such emergencies. This study underscores the importance of awareness campaigns, formal education, and specialized training to prevent and effectively manage poisoning cases in emergency settings. Moreover, the strong association between certain demographics and toxin exposures suggests that targeted interventions might be necessary for specific groups.

Predictors and Outcomes of Falls in Older Adults Presenting to the Emergency Room in Saudi Arabia: A Cross-Sectional Analysis.

INTRODUCTION: Saudi Arabia is witnessing a demographic shift characterized by a rising elderly population. Cases of fall in this demographic have emerged as a significant health concern, especially in emergency room (ER) settings. Despite this, there is limited research on the causes and outcomes of such incidents. This study intends to bridge the gap in understanding the factors leading to falls in elderly patients presenting to ERs and the subsequent outcomes. Such understanding is pivotal for the formulation of effective prevention strategies and enhanced healthcare services for the elderly. METHODS: To achieve the study's objectives, we employed SPSS software for Windows, version 28.0 (IBM Corp., Armonk, NY) for data analysis. We collected demographic information, including age, gender, education, employment status, and location, to measure patient satisfaction with the quality and responsiveness of emergency care, using Likert scale responses via electronic survey conducted as a cross-sectional study from January 2023 to August 2023, summarizing it using descriptive statistics. We analyzed categorical variables by frequencies and percentages. Chi-square tests were utilized to examine differences in distribution across categories for fall factors, and a p-value below 0.05 was deemed significant. Through logistic regression, we pinpointed the predictors of falls among older adults, showcasing the strength and direction of these relationships. Adjusted odds ratios with 95% confidence intervals were documented. A perception survey was also conducted to evaluate ER patient satisfaction. RESULTS: Our results shed light on various aspects of fall prevention and emergency care. There was a pronounced representation in age groups of 18-24 and 25-34 years, indicating the need for interventions tailored to different age groups. Patterns were identified where subjects engaged in limited physical activity and consumed alcohol infrequently. Mobility and balance problems were commonly found, stressing the need to address these issues. Chronic conditions such as hypertension and diabetes correlated with fall incidents. Additionally, sociodemographic factors like gender, education, and employment status played a role in influencing the risk of falls. Although age and location seemed to have a less pronounced effect, there exists an opportunity to enhance communication and patient participation in emergency care for improved experiences. CONCLUSION: The findings from our study provide crucial insights into the prevention of falls and enhancement of emergency care for Saudi Arabia's elderly population. By revealing the intricate relationships between sociodemographic attributes, health indicators, chronic ailments, and incidents of falls, we emphasize the need for well-rounded interventions. There is a pressing requirement for comprehensive fall prevention initiatives tailored to specific risk groups. Additionally, improving ER services is integral to ensuring the safety and well-being of older adults. This research can serve as a foundational resource for healthcare professionals and policymakers to devise robust strategies to reduce fall-related injuries and elevate the quality of emergency care outcomes.

Toward esthetically and biomechanically reliable anterior resin composite restorations: Current clinical experiences among dental practitioners in Saudi Arabia.

Background: Esthetic anterior composite restorations are very challenging. They constitute a main part of the clinical practice of restoring teeth with resin composites. Distinctive variations in composite material selection and technique of application in anterior teeth exist when compared to the practice of restoring posterior teeth with resin composites. In a continuation of a previous assessment of class II resin composite practice,  a cross-sectional survey study was performed to determine the awareness of general dental practitioners in Saudi Arabia about resin composite restorations in anterior teeth and to provide evidence-based recommendations to improve their practice. Methods: A total of 500 dental practitioners from different provinces in Saudi Arabia were invited to participate in an online questionnaire which comprised four domains and included a total of sixteen questions addressing aspects regarding the selection of resin composites, cavity configuration, etching protocol, light-curing technique, liner application, application of poly-chromatic composite, as well as finishing and polishing procedures. Chi square testing and descriptive statistics were used to analyze the attained data. Results: From 250 respondents, the greatest participation was from the Eastern and Middle provinces of Saudi Arabia. Female dentists participated less than males. There was no general agreement between participants regarding the resin composite material or the employed technique of application in restoring anterior tooth defects. Respondents indicated that discoloration and hypersensitivity were the most common reasons for patient's dissatisfaction with resin composites in anterior teeth. Conclusions: Dental practitioners are highly encouraged to improve their clinical practice of restoring anterior teeth using resin composites with the focus upon continuous education programs, online webinars, and workshops.

Analyses of Experimental Dental Adhesives Based on Zirconia/Silver Phosphate Nanoparticles.

This study aimed to evaluate the incorporation of zirconia/silver phosphate nanoparticles to develop experimental dental adhesives and to measure their physical and mechanical properties. The nanoparticles were synthesized by the sonication method, and the phase purity, morphological pattern, and antibacterial properties with Staphylococcus aureus and Pseudomonas aeruginosa were assessed. The silanized nanoparticles were incorporated (0, 0.15, 0.25, and 0.5 wt.%) into the photoactivated dimethacrylate resins. The degree of conversion (DC) was assessed, followed by the micro-hardness and flexural strength/modulus test. Long-term color stability was investigated. The bond strength with the dentin surface was conducted on days 1 and 30. The transmission electron microscopy and X-ray diffractogram confirmed the nano-structure and phase purity of the particles. The nanoparticles showed antibacterial activities against both strains and inhibited biofilm formation. The DC range of the experimental groups was 55-66%. The micro-hardness and flexural strength increased with the concentration of nanoparticles in the resin. The 0.5 wt.% group showed significantly high micro-hardness values, whereas a non-significant difference was observed between the experimental groups for flexural strength. The bond strength was higher on day 1 than on day 30, and a significant difference was observed between the two periods. At day 30, the 0.5 wt.% showed significantly higher values compared to other groups. Long-term color stability was observed for all the samples. The experimental adhesives showed promising results and potential to be used for clinical applications. However, further investigations such as antibacterial, penetration depth, and cytocompatibility are required.

Fragment Reattachment: A 4-Year Case Report of Uncomplicated Dental Fractures.

Two fractured maxillary central incisors were restored via the crown fragment reattachment technique with adhesive systems and composite resin material. A long-term successful outcome was achieved after 4 years of follow-up. The patient presented with fractured maxillary central incisors, and a comprehensive intraoral and radiographic examination revealed that both teeth had extended crown fractures with no pulpal exposure (Class II, Ellis and Davey). The tooth fragments were thoroughly cleaned and inspected before being repositioned. Both fragments were in excellent condition with almost no pieces missing. Therefore, the proposed treatment was fragment reattachment. After verifying the repositioning and adaptation of the fractured fragments, a flowable composite was used to perform the reattachment procedure under rubber dam isolation. With modern dental adhesives, the reattachment of tooth fragments in good condition is considered a more conservative option for restoring tooth morphology, esthetics, and function. Although one tooth showed signs of irreversible pulpitis and required root canal treatment 2 weeks after the restoration, the clinical and radiographic evaluations at the 4-year follow-up visits confirmed the success of the restorative treatment. The restorations showed good functional and esthetic outcomes after 4 years of follow-up.

Inorganic Compounds as Remineralizing Fillers in Dental Restorative Materials: Narrative Review.

Secondary caries is one of the leading causes of resin-based dental restoration failure. It is initiated at the interface of an existing restoration and the restored tooth surface. It is mainly caused by an imbalance between two processes of mineral loss (demineralization) and mineral gain (remineralization). A plethora of evidence has explored incorporating several bioactive compounds into resin-based materials to prevent bacterial biofilm attachment and the onset of the disease. In this review, the most recent advances in the design of remineralizing compounds and their functionalization to different resin-based materials' formulations were overviewed. Inorganic compounds, such as nano-sized amorphous calcium phosphate (NACP), calcium fluoride (CaF2), bioactive glass (BAG), hydroxyapatite (HA), fluorapatite (FA), and boron nitride (BN), displayed promising results concerning remineralization, and direct and indirect impact on biofilm growth. The effects of these compounds varied based on these compounds' structure, the incorporated amount or percentage, and the intended clinical application. The remineralizing effects were presented as direct effects, such as an increase in the mineral content of the dental tissue, or indirect effects, such as an increase in the pH around the material. In some of the reported investigations, inorganic remineralizing compounds were combined with other bioactive agents, such as quaternary ammonium compounds (QACs), to maximize the remineralization outcomes and the antibacterial action against the cariogenic biofilms. The reviewed literature was mainly based on laboratory studies, highlighting the need to shift more toward testing the performance of these remineralizing compounds in clinical settings.

A bibliometric analysis of minimally invasive dentistry: A review of the literature from 1994 to 2021.

STATEMENT OF PROBLEM: Minimally invasive dentistry is a technique for the maximal preservation of healthy tooth structures and has been a focus of attention in dental research. However, a detailed bibliometric analysis focusing on research related to minimally invasive dentistry is lacking. PURPOSE: The purpose of this bibliometric analysis was to analyze leading countries and organizations and to identify the preferred journals, the most productive authors, and the most commonly used keywords in the field of minimally invasive dentistry. MATERIAL AND METHODS: The search was performed by using the Scopus database, and publications pertinent to the field of minimally invasive dentistry from 1994 to 2021 were identified. A bibliometric analysis with reference to citations and documents, authors, journals, and keywords was performed. A total of 391 articles published in Scopus indexed journals between 1994 and January 2021 were analyzed by using a software program. RESULTS: A continuing yet steady increase in research publications was identified, with a substantial increase in publications since 2013. The United States and Germany were the countries that published the most articles (98 and 46, respectively), articles that received 1877 and 806 citations, respectively. Cardiff University, UK, was the most productive organization that received 212 citations. The most highly cited articles were from the Q1 category. Blum from King's College London was the highest-cited author in this field. CONCLUSIONS: Considerable advancement has been made in minimally invasive dentistry, as demonstrated by the increase in the number of publications linked with collaboration among various authors, nations, and institutes. This citation analysis gives a perspective on the progress of research in the field of minimally invasive dentistry and allows identification of the most significant and pertinent research areas.

Methanol poisoning outbreak in Saudi Arabia: a case series.

BACKGROUND: Outbreaks of methanol poisoning have been described in the medical literature in different regions around the world. Even though in Saudi Arabia a few outbreaks of methanol poisoning have occurred, they remain undocumented. Herein, we describe several cases of methanol poisoning in Saudi Arabia with the goal of increasing awareness about the dangers of methanol poisoning among healthcare staff. CASE PRESENTATION: Nine middle-aged Saudi patients (five men aged 24, 26, 27, 36, and 49 years and four females aged 19, 20, 24, and 25 years) were admitted to our emergency department after alcohol consumption. All patients presented with severe metabolic acidosis and some visual impairment. Treatment was initiated based on the clinical suspicion of methanol intoxication because of laboratory test limitations and time constraints. Patients showed improvement and favorable hospital outcomes after aggressive empirical treatment. CONCLUSIONS: Many social and cultural factors influence the lack of reporting of methanol poisoning cases in Saudi Arabia. We believe it is important to document these outbreaks to increase the knowledge among healthcare providers and promote public health awareness. A high index of suspicion and the development of local public health networks to monitor, survey, follow-up, and facilitate data exchange can help healthcare providers recognize and aggressively treat affected individuals. Early empiric and aggressive management can greatly decrease morbidity and mortality despite challenges and limited resources.

Bioactive Inorganic Materials for Dental Applications: A Narrative Review.

Over time, much attention has been given to the use of bioceramics for biomedical applications; however, the recent trend has been gaining traction to apply these materials for dental restorations. The bioceramics (mainly bioactive) are exceptionally biocompatible and possess excellent bioactive and biological properties due to their similar chemical composition to human hard tissues. However, concern has been noticed related to their mechanical properties. All dental materials based on bioactive materials must be biocompatible, long-lasting, mechanically strong enough to bear the masticatory and functional load, wear-resistant, easily manipulated, and implanted. This review article presents the basic structure, properties, and dental applications of different bioactive materials i.e., amorphous calcium phosphate, hydroxyapatite, tri-calcium phosphate, mono-calcium phosphate, calcium silicate, and bioactive glass. The advantageous properties and limitations of these materials are also discussed. In the end, future directions and proposals are given to improve the physical and mechanical properties of bioactive materials-based dental materials.

The Antifungal and Antibiofilm Activities of Caffeine against Candida albicans on Polymethyl Methacrylate Denture Base Material.

BACKGROUND: In this study, the effect of pure caffeine was established against Candida albicans (C. albicans) using different microbiological techniques. METHODS: Broth microdilution and colony forming units (CFUs) assays were used to detect the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC). The Live/Dead fluorescent dyes were implemented to determine the yeast viability. Polymethyl methacrylate acrylic resin (PMMA) discs were prepared to evaluate caffeine's effects against adherent C. albicans using microplate reader, CFUs, and scanning electron microscope (SEM). RESULTS: caffeine's MIC was detected around 30 mg/mL, while the MFC was considered at 60 mg/mL. In an agar-well diffusion test, the inhibition zones were wider in caffeine groups. The Live/Dead viability test verified caffeine's antifungal effects. The optical density of the adherent C. albicans on PMMA discs were lower at 620 nm or 410 nm in caffeine groups. CFU count was also reduced by caffeine treatments. SEM revealed the lower adherent C. albicans count in caffeine groups. The effect of caffeine was dose-dependent at which the 60 mg/mL dose demonstrated the most prominent effect. CONCLUSION: The study reinforced caffeine's antifungal and antibiofilm properties and suggested it as an additive, or even an alternative, disinfectant solution for fungal biofilms on denture surfaces.

Toward a Clinically Reliable Class II Resin Composite Restoration: A Cross-Sectional Study into the Current Clinical Practice among Dentists in Saudi Arabia.

Objective: The aim of this study was to evaluate the current clinical practice of general dentists in Saudi Arabia in restoring class II cavities using direct resin composites and to set evidence-based practice recommendations of concern. Methods: An online survey formed of 20 questions and classified into four domains was developed. 500 dentists in 5 Saudi provinces were invited to join the survey anonymously and voluntarily using poster announcements and e-mail invitations. Descriptive statistics were used to analyze participants' responses. Results: 343 responses were received. Dentists in Saudi Arabia vary in their clinical practices and techniques of insertion of resin composite in class II cavities. 67% of participants use cotton rolls for isolating the field while 32% use rubber dam isolation. 33% and 28% of respondents use circumferential matrix (Tofflemire) and AutoMatrix, respectively. Fracture, followed by recurrent caries and open proximal contacts, was the received main reason of failure of class II direct resin composite restorations. Conclusion: Diversity of class II resin composite practices exists among dentists in Saudi Arabia. For ensuring optimum quality outcomes and high standards of restorative dentistry healthcare, several dentists in Saudi Arabia need to reconsider their clinical practice and modify their clinical procedures of direct class II resin composites. Several evidence-based practice guidelines are recommended to dentists in this article to improve their practice and enhance the clinical reliability and longevity of class II direct resin composite restorations.

The Characteristics of Syncope-Related Emergency Department Visits: Resource Utilization and Admission Rate Patterns in Emergency Departments.

Background and objective Decision-making about syncope patients presenting to the emergency department (ED) is challenging since physicians must balance the minimal risks of life-threatening conditions with the unessential use of expensive imaging or unnecessary hospitalizations. This study aimed to determine the characteristics of ED visits, resource utilization, and admission rate patterns related to syncope in the United States (US) during the period 2005-2015. Methods Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) on ED visits during the 11-year period from 2005 to 2015 were retrieved. ED visits for syncope were identified and compared against non-syncope ED visits. The demographic and clinical characteristics of patients, as well data on resource allocation and admission trends were captured and described for the syncope and the non-syncope groups. Results Syncope accounted for 1.11% of the total ED visits during the study period from 2005 to 2015. The incidence of syncope-related ED visits was higher among elderly females, whites, and non-Hispanics. The trend of admission rates showed a decline from about 30% in 2005-2010 to less than 20% in 2014 and 2015. Advanced imaging (CT or MRI) was ordered for 34% of syncope patients. Conclusion The percentage of syncope-related ED visits remained stable during the study period, but the admission rates declined while the use of advanced imaging in syncope-related ED visits remained substantially high despite the advances in research and availability of clinical guidelines. Future research is needed to rationalize healthcare utilization in syncope-related ED visits and precisely identify the high-risk population.

Oral manifestations associated with Novel Coronavirus Disease - 2019 (COVID-19): A questionnaire based hypothetical study.

Background: Since the Coronavirus disease 2019 (COVID-19) outbreak in 2019, the virus has evolved drastically, presenting with sets of mutations that influence its properties, including transmissibility and antigenicity. The oral mucosa is postulated as probable portal entry and several oral manifestations have been identified, which places dental professionals in a position to recognize probable COVID-19 patients depending on oral signs and symptoms in the initial phases of the disease itself. As co-existing with COVID-19 seems to be a new reality, greater understanding is required regarding early oral signs and symptoms which can be predictors for timely intervention and prevention of complications in COVID-19 patients. The objective of the study is to identify the distinguishing oral signs and symptoms among COVID-19 patients and to establish possible correlation between severity of COVID-19 infection and oral symptoms. Methods: This study recruited 179 ambulatory, non-hospitalized COVID-19 patients from the Kingdom of Saudi Arabia's Eastern Province's designated hotels for COVID-19 and home isolated patients from the same region using a convenience sample method. Data was collected by qualified and experienced investigators, including two physicians and three dentists, using a validated comprehensive questionnaire through telephonic interviews with the participants. The X 2 was used to assess the categorical variables, and odd's ratio was calculated to determine the strength of the association between general symptoms and oral manifestations. Results: Oral and nasopharyngeal lesions or conditions like loss of smell and taste, xerostomia, sore throat, and burning sensation were predictors of COVID-19-related systemic symptoms such as cough, fatigue, fever, and nasal congestion were identified to be statistically significant (p<0.05). Conclusions: The study reveals the occurrence of olfactory or taste dysfunction, dry mouth, sore throat, and burning sensation along with COVID-19 generic symptoms, should be considered as suggestive yet not conclusive indicators of COVID-19.

Novel calcium phosphate ion-rechargeable and antibacterial adhesive to inhibit dental caries.

OBJECTIVES: This study aimed to develop an antibacterial and calcium (Ca) and phosphate (P) rechargeable adhesive and investigate the effects of dimethylaminododecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP) on dentin bonding, biofilm response, and repeated Ca and P ion recharge and re-release capability for the first time. MATERIALS AND METHODS: Pyromellitic glycerol dimethacrylate (PMGDM), ethoxylated bisphenol A dimethacrylate (EBPADMA), 2-hydroxyethyl methacrylate (HEMA), and bisphenol A glycidyl dimethacrylate (BisGMA) formed the adhesive (PEHB). Three groups were tested: (1) Scotchbond (SBMP, 3 M) control, (2) PEHB + 30% NACP, and (3) PEHB + 30% NACP + 5% DMAHDM. Specimens were tested for dentin shear bond strength, and Ca and P ion release, recharge, and re-release. Biofilm lactic acid production and colony-forming units (CFU) on resins were analyzed. RESULTS: The four groups had similar dentin shear bond strengths (p > 0.1). Adhesive with DMAHDM showed significant decrease in metabolic activity, lactic acid production, and biofilm CFU (p < 0.05). The adhesives containing NACP released high levels of Ca and P ions initially and after being recharged. CONCLUSION: This study developed the first Ca and P ion-rechargeable and antibacterial adhesive, achieving strong antibacterial activity and Ca and P ion recharge and re-release for long-term remineralization. CLINICAL RELEVANCE: Considering the restoration-tooth bonded interface being the weak link and recurrent caries at the margins being the primary reason for restoration failures, this novel calcium phosphate-rechargeable and antibacterial adhesive is promising for a wide range of tooth-restoration applications to inhibit caries.

Effect of Ageing Process and Brushing on Color Stability and Surface Roughness of Treated White Spot Lesions: An in vitro Analysis.

PURPOSE: To evaluate the effect of ageing process and brushing on the color stability and surface roughness of white spot lesions treated with resin infiltration or remineralization. PATIENTS AND METHODS: Artificial white spot lesions were created on the facial surface of extracted bovine teeth. Specimens were divided into three main groups based on treatment received: resin infiltration (Icon), MI Paste Plus (MI) or no treatment (control). Specimens underwent pH cycling for 7 days, followed by brushing with toothbrush simulator. Specimens were then immersed in three different solutions (water, cranberry juice, or coffee) for 7 days. Surface roughness (SR) and color stability (CS) assessments were performed at baseline and after each test. One-way and two-way ANOVA were used to calculate the statistical comparisons between the groups and significance considered at P <0.05. RESULTS: Icon group had the least color change after pH cycling, while MI showed the least color change after brushing test. Immersion in coffee produced the highest color change in all groups, followed by cranberry juice. Icon group had the best color stability when immersed in cranberry juice or coffee. Control and the MI treated specimens showed gradual increase of SR after pH cycling and brushing test, while Icon group had improved surface properties. Brushing test alone produced less color change in comparison with immersion in cranberry juice and coffee; however, brushing increased SR. CONCLUSION: Icon treatment showed superior color stability and surface roughness, compared to the control and the MI treated teeth. Brushing had less influence on color change compared to the immersion in cranberry juice or coffee.

Dental Fear and Patient Preference for Emergency Dental Treatment Among Adults in COVID-19 Quarantine Centers in Dammam, Saudi Arabia.

PURPOSE: Dental fear is associated with the avoidance of dental visits and negative oral health outcomes. It is important to assess distribution of dental fear and preference for emergency dental treatment among adult population during COVID-19. Therefore, the purpose of this study was to evaluate dental fear and emergency dental treatment among adults in COVID-19 quarantine centers in Greater Dammam, Saudi Arabia. MATERIALS AND METHODS: Male and female adults (N=606) in quarantine centers for COVID-19 participated in this cross-sectional study (June-July 2020). Dental Fear Survey was used to collect data on dental fear. The participants also provided their responses about emergency dental treatment/dental attendance patterns in addition to demographic information. RESULTS: The mean DFS score of the sample was 39.08 ± 19.47, and 23.1% of the participants were a little fearful and 22.6% were highly fearful. About 36.8% reported that they would prefer to visit a dental office in case of dental emergency mostly for dental pain and fractured tooth during the COVID-19 pandemic. Only 10.4% of the participants reported visiting a dentist in less than 3 months, 35.8% in less than 6 months, 52.5% between 6 and 12 months and more, and 1.3% never visited the dentist. DFS scores significantly differed among participants who visited the dentist in less than 3 months (31.86 ± 14.57), less than 6 months (37.70 ± 18.57), between 6 and 12 months and more (40.78 ± 20.23), and never visited the dentist (65.75 ± 14.74) (P < 0.001). The timing of last dental visit (P < 0.001), female gender (P 0.039), and dental pain (P < 0.001) were the significant predictors of dental fear. CONCLUSION: Dental fear was common among adults with a predilection for the female gender. Increased dental fear was significantly related to dental pain and reduced dental attendance. Only one-third of adults were willing to perform emergency dental visits.

Optical coherence tomography's current clinical medical and dental applications: a review.

Optical coherence tomography (OCT) is a non-invasive investigative technique that is used to obtain high-resolution three-dimensional (3D) images of biological structures. This method is useful in diagnosing diseases of specific organs like the eye, where a direct biopsy cannot be conducted. Since its inception, significant advancements have been made in its technology. Apart from its initial application in ophthalmology for retinal imaging, substantial technological innovations in OCT brought by the research community have enabled its utilization beyond its original scope and allowed its application in many new clinical areas. This review presents a summary of the clinical applications of OCT in the field of medicine (ophthalmology, cardiology, otology, and dermatology) and dentistry (tissue imaging, detection of caries, analysis of dental polymer composite restorations, imaging of root canals, and diagnosis of oral cancer). In addition, potential advantages and disadvantages of OCT are also discussed.

Resource utilisation among patients with syncope presenting to the emergency department.

BACKGROUND: Syncope is a common problem encountered in the emergency department (ED) and a significant source of ED resource utilisation, including advanced imaging modalities. Current guidelines do not recommend routine Computed Tomography (CT) imaging of the head for patients seen in the ED due to syncope. OBJECTIVE: In this study, we investigate resource allocation in the ED for syncope-related visits, including advanced imaging modalities using a large national database. OUTCOMES ANALYSIS: Data from the CDC's National Hospital Ambulatory Medical Care Survey (NHAMCS) for years 2008-2017 were compiled and analysed. Intrinsic survey and constructed variables were utilised to identify and investigate all syncope-related ED visits in the United States during the study period that met study criteria. Appropriate bivariate and multivariate statistical analyses were applied in order to identify and compare the resource utilisation, demographics, and ED visit dynamics of syncope and non-syncope-related ED visits. RESULTS: During the study period, there were over 15 million ED visits for syncope. A high percentage of syncope visits received head CT compared with non-syncope visits (34% vs. 4.5%, P > .001). When investigated by age-grouping utilisation of head CT ranged from 26.5 (95% CI 18.9-27.5) for ages 18-40 to as high as 40.2% (95% CI 33.8-47.1) for ages 80 and higher. Compared with non-syncope ED visits, syncope-related ED visits were older and more likely to have Medicare or private insurance. CONCLUSION: Syncope continues to be a large and growing share of visits to US EDs. Despite well-supported, evidence-based recommendations that do not recommend routine utilisation of head CT in syncope-related ED visits, these data suggest that emergency physicians routinely over-utilise this modality. More specific guidelines may be required to help reduce the use of imaging studies for patients who present to the ED with syncope.

Knowledge of dentists, dental auxiliaries, and students regarding the COVID-19 pandemic in Saudi Arabia: a cross-sectional survey.

BACKGROUND: This study aimed to assess the knowledge of dental professionals in Saudi Arabia regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19). METHODS: A questionnaire was developed to assess various dental professionals from both governmental and private sectors through online and social media outlets. RESULTS: A total of 1,033 questionnaires were collected (273 dental students, 193 dental auxiliary personnel, 544 dentists). In all, 63.4% of the respondents worked in hospitals. Of all the respondents, 44.9%, 33.4%, and 21.7% worked in governmental clinics, academia, and the private sector, respectively. Overall knowledge of the incubation period and route of transmission of SARS-CoV-2 was consistent across all dental professions. Knowledge of hand-soap cleaning time was significantly different among dental professionals (p < 0.001). Dental professionals displayed significant disagreement on the survival of SARS-CoV-2 outside the host (p < 0.001). Furthermore, 75.1% of the respondents were reluctant to treat a suspected COVID-19 patient, and 92% of the participants believed that the mode of transmission was droplet inhalation. Fever, coughing, and shortness of breath were identified as the most common symptoms of COVID-19. Most standard methods of prevention in the dental office were selected by at least 50% of the participants. CONCLUSIONS: Dental professionals seem to be consistent regarding their knowledge of the incubation period of SARS-CoV-2. However, knowledge of viral survivability and recommended hand-soap washing time was significantly variable among the professionals. A high degree of apprehension toward suspected COVID-19 patients existed among all dental professionals. Pandemic-awareness campaigns are essential among healthcare providers.