Use of Child Safety Seat and its Determinants in Jeddah, Saudi Arabia: A Cross-sectional Study.

Background: A child safety seat protects children from injury during motor vehicle accidents (MVAs). However, there is a lack of enforcement of regulation regarding its use in Saudi Arabia. Objectives: This study aimed to determine the use of child safety seat and its determinants and barriers in Jeddah, Saudi Arabia. Materials and Methods: This cross-sectional study was based on a structured face-to-face interview across Jeddah among families who drove in cars with children aged ≤5 years. The study used stratified multistage random sampling across the population of the governorate of Jeddah. Results: A total of 675 parents were included, of which 311 (46.1%) reported having a child safety seat in their vehicle, and only 165 (24.4%) reported its regular use. Awareness levels among parents regarding child safety seat use and its benefits, parents' level of education, family size, family income, and the belief in the need for laws governing child safety seat were key determinants of child safety seat use. Poor awareness among parents regarding the utility of child safety seat in reducing child injuries, low education levels among parents, larger families with multiple children, poor affordability, low family income, and a clear lack of laws mandating the use of child safety seat were identified as key barriers. Conclusions: The regular use of child safety seat for children aged ≤5 years is low in even one of the most urban populations of Saudi Arabia. This indicates the need for large-scale awareness drives and stricter implementation of laws enforcing the use of child safety seat in Saudi Arabia.

Comparison of Compliance with Infection Control Practices Among Dental Students in Saudi Arabia Before and During the COVID-19 Pandemic.

BACKGROUND: With the emergence of the COVID-19 pandemic, professional organizations issued new guidelines for infection control standards in dental clinics. The objective of this study was to compare dental students' compliance with those standards before the COVID-19 outbreak and during the pandemic. METHODS: This cross-sectional study entailed observing 622 dental students during their clinical sessions to assess compliance with the infection control protocol. The compliance checklist used was adopted from the Centers for Disease Control and Prevention Infection Control Checklist for Dental Settings. Observations took place during two consecutive years: once in 2019 before the COVID-19 outbreak and once in 2020 during the pandemic. RESULTS: The dental students audited in 2019 were 1.4 times more likely to violate infection control measures compared with those in 2020. The two most common violations in both audits were not wearing eye protection and not following hand hygiene recommendations immediately after they removed their gloves. During both audits, male students violated infection controls significantly less often than female students. CONCLUSION: Dental students' adherence to infection control measures improved during the COVID-19 pandemic compared with before the COVID-19 pandemic. Compliance with personal protective equipment standards was higher than with hand hygiene practices. Our findings have important clinical implications in designing strategies to improve dental students' compliance with infection control standards, particularly hand hygiene practices.

Self-confidence as a predictor of senior dental student academic success.

PURPOSE: Noncognitive indicators, such as personality type and self-confidence, have been used as predictors of achievement. Accordingly, we investigated whether self-confidence in clinical skills predicts academic success among predoctoral senior dental students. METHODS: Two consecutive cohorts (N = 336) of predoctoral senior dental students were invited to rate their self-confidence in clinical procedures twice: at the beginning and at the end of the academic year. Academic performance in clinical assessments was retrieved from scholastic records. Multiple linear regression models were constructed to predict clinical assessment grades using self-confidence scores as a predictor after controlling for possible confounders. RESULTS: Self-confidence scores in clinical procedures were positively correlated with clinical and academic performance. Self-confidence in clinical procedures and grade point averages were consistent predictors of student performance. Additionally, self-confidence had improved at the end of the senior year (p = 0.003). CONCLUSIONS: Self-confidence in clinical procedures was a predictor of future clinical success. Therefore, fostering and nurturing the confidence of students and integrating self-confidence assessment into the curricula at relevant timepoints should be a goal in dental education. Moreover, self-assessment of confidence in clinical skills could be used to guide students and graduates in developing their own personal development plan.

Social determinants of seeking emergency and routine dental care in Saudi Arabia during the COVID-19 pandemic.

BACKGROUND: Between March and June 2020, closing dental clinics during the COVID-19 pandemic except for emergency dental care was recommended. It is documented that health-seeking behaviors change during pandemics. The objective of this study was to examine social determinants associated with decisions to seek dental care in Saudi Arabia during the COVID-19 pandemic. METHODS: A total of 4372 participants were invited to this cross-sectional web-based survey distributed from April 21 to June 20, 2020. The survey included a list of emergency, urgent, and routine dental procedures. Participants were asked if they would seek dental care for these conditions during the pandemic, and what pain severity would make them seek dental treatment. Logistic regression models were performed for predicting variables that explain the decision to go or not to go to the dental clinic during the pandemic for each dental condition. RESULTS: A total of 3443 responded to this survey. The emergency dental situation participants were most willing to go to the dental clinic for was trauma involving facial bones compromising the airway (94.5%). Only 65.8% were willing to seek care for facial cellulitis compromising the airway. On average 35.2% reported seeking teleconsultation as the first step. Eighteen percent of participants were still willing to go to the dental clinic during the pandemic for routine dental procedures. Multiple logistic regression showed that females (Odds Ratio (OR): 1.6, OR 95% CI 1.3, 1.9), people who had never visited a dentist (OR: 1.8, OR 95% CI 1.3, 2.5), and people living in metropolitan regions (OR: 1.8, OR 95%: 1.4, 2.3) had higher odds for not seeking emergency dental care during this pandemic. The pain threshold for seeking dental care during the pandemic was 7 out of 10. Female, those who never visited a dentist, and those from urban regions reported higher pain threshold before seeking dental care (P value < 0.001). CONCLUSION: Social disparities were found in emergency dental care seeking decision-making in Saudi Arabia during the COVID-19 pandemic. It was alarming that some people were afraid to seek dental care for life-threatening dental emergencies as cellulitis during this pandemic. This reflects the importance of increasing public health awareness and governmental regulations.

The Association Between Psychological Symptoms and Self-Reported Temporomandibular Disorders Pain Symptoms in Children and Adolescents.

Background: Several studies have reported an association between temporomandibular disorder pain (TMD-P) and emotional disorders in children and adolescents. However, no studies have reported if self-reported TMD-P in Saudi Arabia is associated with psychosocial symptoms. Therefore, the current study aimed to evaluate the association between self-reported TMD-P with depression, anxiety and somatic problems in children and adolescents in Saudi Arabia. The hypothesis was that there is an association between self-reported TMD-P and psychological symptoms among children and adolescents. Materials and Methods: The included participants were randomly selected boys and girls aged between 10 and 18 years, with a mean (SD) age of 14.0 (2.3) years. Out of 633 children and adolescents that were invited to participate, 509 voluntarily agreed to participate, and 466 completed all questionnaires. The questionnaires included items retrieved from the Youth Self Report (YSR) and Axis II of the Research Diagnostic Criteria for TMD (RDC/TMD) besides demographic data, medical history, and presence of oral parafunctions. To assess the presence of self-reported TMD-Pain, each participant was verbally asked two validated questions regarding the presence of TMD-P and dysfunction (2Q-TMD). Results: Self-reported TMD-P in children and adolescents was significantly associated with anxiety, depression, somatic symptoms, and social problems (P < 0.0001). Further, the frequencies of anxiety, depression, and somatic disorders were more evident among children and adolescents who suffered from TMD-P (P < 0.0001). The odds of reporting TMD-P in children and adolescents was 1.4 times for border line and clinical diagnosis scores for anxiety and withdrawal depression domains, and 2.6 times for the somatic symptoms' domains. However, in the multiple regression model after controlling for possible confounders, only somatic symptoms and social scores were significant. Moreover, self-reported TMD-P was twice as prevalent among girls compared to boys. Conclusion: This study reports a significant association between psychosocial burden and presence of self-reported TMD-Pain, with a stronger impact on girls than boys. There were significantly higher number of participants with self-reported TMD-P reporting a poor oral and general health. In addition, self-reported TMD-P was higher among those with borderline and clinically diagnosed anxiety/depression scores. Based on this finding, the current study supports that an early approach and recognition of children and adolescents with anxiety, depression, somatic symptoms, and TMD problems. This could result in a lesser burden for these children and adolescents both in regard to pain and psychosocial implications with increased quality of life.

Effect of smoking on patient-reported postoperative complications following minor oral surgical procedures.

OBJECTIVE: This study evaluated the effect of smoking on patient-reported postoperative complications after minor oral surgical procedures by comparing the post-extraction symptoms between smokers and nonsmokers. MATERIALS AND METHODS: Patients undergoing minor oral surgical procedures were recruited and followed up prospectively on the first, second, seventh, and twenty-first days after simple dental extractions. RESULTS: A total of 85 patients completed the study. Postoperative pain, measured with a visual analog scale, was consistently higher among smokers than nonsmokers (P < 0.0001). Patient-reported experience of bleeding events was significantly less among nonsmokers (P = 0.009) only on the first postoperative day. Facial swelling was more common in smokers than in nonsmokers (P = 0.04) on the second postoperative day. Postoperative infection was reported more by smokers than nonsmokers (P > 0.05). Trismus did not vary with time according to smoking status. On the 21st postoperative day, there were no statistically significant differences in postoperative complications between the groups. CONCLUSIONS: The patient-reported pain score was consistently higher among smokers. The study's findings suggested that initial differences in patient-reported complications between smokers and nonsmokers undergoing minor oral surgical procedures diminished after a week.

Newly graduated dentists' knowledge of temporomandibular disorders compared to specialists in Saudi Arabia.

BACKGROUND: General dentists are often the first healthcare professionals to see patients with orofacial pain (OFP). OFP conditions associated with the temporomandibular joint are often confused with dentoalveolar disorders, which leads to mismanagement. The objective of this study was to evaluate the level of knowledge of temporomandibular disorders (TMD) among newly graduated dentists compared to OFP specialists in Saudi Arabia. METHODS: This was a descriptive cross-sectional study utilizing an anonymous validated questionnaire assessing professional knowledge regarding TMDs in newly qualified dentists and OFP specialists. The questionnaire interrogated four domains including chronic pain/pain behavior, etiology, diagnosis/classification, and treatment/prognosis. OFP specialists were used as the reference group. RESULTS: A total of 393 dentists participated, a response rate of 67.6% in newly graduated dentists and 77.3% in OFP specialists. The degree of agreement between newly graduated general dentists and OFP specialists was highest for the "chronic pain and pain behavior" domain. The consensus among specialists was highest for the "treatment and prognosis" domain and the least for the "chronic pain and pain behavior" domain. CONCLUSION: Newly graduated general dentists have limited knowledge of TMD in almost all domains compared to specialists. Given that a lack of knowledge of TMD can lead to clinical mismanagement, dental school curricula must address this important knowledge gap.

Prevalence of work-related musculoskeletal disorders and ergonomic practice among dentists in Jeddah, Saudi Arabia.

BACKGROUND: Musculoskeletal disorders (MSD) is the second most common cause of disability. MSD due to the occupation are called work-related musculoskeletal disorders (WMSD) and are common among dentists. OBJECTIVE: Assess the prevalence of self-reported work-related musculoskeletal disorders (WMSD) and to identify associated ergonomic practice among dentists practicing in Jeddah City, Saudi Arabia. METHODS: Dentists practicing in Jeddah were invited to participate in this cross-sectional study using a self-administered survey. The survey consisted of 20 close-ended questions. The survey included questions regarding demographics, dental practice, general health status, exercising, ergonomic practice, musculoskeletal pain location, the severity of pain using a numeric pain rating scale (0-10), interventions sought, and missed work due to WMSD. RESULTS: A sample of 234 dentists participated in this study. Prevalence of WMSD was found to be 70%. The most common location for WMSD pain was in the low back (85%) and neck (84.6%). Female dentists and dentists not exercising regularly had an increased risk of WMSD. The prevalence of CTS was 9%, and its risk increased with age and practicing in the private sector. Among the dental specialties, the least to report WMSD or CTS were maxillofacial surgeons and orthodontists. The reported ergonomic practice reached as low as 24%. CONCLUSION: Work-related musculoskeletal disorders and inadequate ergonomic practices were common. Ergonomics training intervention programs targeting dentists is suggested as a preventive measure for longer and healthier career lives.

The Agreement Rate between Radiographic Interpretation and Histopathologic Diagnosis of Jaw Lesions.

BACKGROUND: To determine the agreement rate between histopathologic diagnosis and radiographic interpretation of jaw lesions. METHODS: Cases with jaw pathologies that have diagnostically adequate histopathologic samples and radiographic examinations were reviewed retrospectively. Two board-certified oral and maxillofacial pathologists (OMFP) independently determined the histopathologic diagnosis, while two board-certified oral and maxillofacial radiologists (OMFR) determined the radiographic interpretations independently. Then the histopathologic diagnosis and the radiographic interpretation were compared for agreement. RESULTS: A total of 104 cases (53% females) were included with a mean age of 31 years. The agreement rate between histopathologic diagnosis and radiographic interpretation was 49%. OMFP required OMFR consultations to reach a diagnosis in 16% of cases. The most commonly encountered lesions were by far odontogenic cysts of inflammatory origin and the agreement for this disease category was 49.1%. However, agreement rates were highest for the disease category of tumors (62.5%). CONCLUSION: The agreement rate between OMFP and OMFR was higher for tumors than cysts. Agreement rates between OMFP and OMFR improved with efficient consultation between the two disciplines.

Coincidence of Fusion and Concrescence in Mandibular Deciduous Incisors: A Case Report.

AIM: The aim of this paper is to report a rare case in which two dental anomalies in primary dentition coexisted-fusion and concrescence in a 4-year-old boy. This highlights the significance of the accurate early diagnosis of these dental anomalies. BACKGROUND: Odontogenic anomalies are frequently encountered in dental practice. These anomalies can occur due to abnormalities during the differentiation stage and lead to abnormalities in the hard tissue formation. Dental anomalies in number and form include fusion, gemination, and concrescence. CASE DESCRIPTION: Primary dentition with fusion between the right central and lateral primary incisors with increased mesiodistal width. Concrescence between the left central and lateral primary incisors with a groove through the incisal edge. Clinical observation along with radiographic evaluation using intraoral periapical (IOPA) radiographs and orthopantomogram (OPG) were used to arrive at a diagnosis. CONCLUSION: Early diagnosis of concrescence will reduce the risk of possible complications associated with any need of extraction later on. Monitoring the patient and long-term follow-up is required to manage the case with coexisting anomalies of true fusion and acquired concrescence. CLINICAL SIGNIFICANCE: A thorough history taking and clinical and radiographic evaluation of fusion and concrescence at an early stage result in an accurate diagnosis. A careful monitoring plan is a key to reduce the risk of possible complications later on.