Parental-caregiver perception of child oral-health related quality of life following zirconia crown placement and non-restoration of carious primary anterior teeth.

AIM: Dental caries in preschool children has shown significant impact on children's OHRQoL and family functioning. The aim of this study was to measure parents' perceptions of children's OHRQoL and impact of children's orofacial conditions on the family following management of carious anterior teeth with either zirconia crown placement or non-restorative therapy. MATERIALS AND METHODS: Parents of medically fit children aged from 2 years to 6 years attending specialist paediatric clinics were recruited and a questionnaire that included the Global Oral Health Rating Item, Parent-Caregivers Perception Questionnaire (P-CPQ-8) and Family Impact Scale (FIS-8) was distributed at a recall visit 3-6 months following treatment. Twenty patients were allocated in each of the two groups; zirconia crown and non-restorative therapy. RESULTS: The Global Oral Health Rating item scores were significantly different between groups (p=0.038). Children health effects due to dental status were more among patients treated with zirconia crowns. However, PCPQ and FIS total and individual scores were not significantly different between groups (p>0.05) except that children suffered more food impaction between teeth among patients treated with zirconia crowns (p=0.002). CONCLUSIONS: Parents' perceptions of children's OHRQoL and impact on family were similar when anterior carious teeth were managed with zirconia crown placement or non-restorative therapy.

Undergraduate experience and self-assessed confidence in paediatric dentistry at the University of Jordan Dental School.

INTRODUCTION: The aims of the study were to audit the number and types of clinical procedures completed by the undergraduate dental students in the paediatric dentistry course at the University of Jordan Dental School and to present data on self-reported confidence in a variety of aspects of paediatric dentistry. MATERIALS AND METHODS: A retrospective audit of clinical logbooks for the entire class of 120 dental students in their fifth clinical year was performed. Key clinical procedures performed in the paediatric clinics were recorded including treatment performed on both primary and permanent teeth. Students were requested to complete an anonymous questionnaire to assess confidence related to six activities using a visual analogue scale (VAS). RESULTS: All students performed restorations in primary teeth with the majority providing approximal restorations (91%), pit and fissure restorations (89%) followed by stainless steel crowns (81%). In addition, all students performed a pulpotomy for a primary tooth, extraction of a primary tooth and fissure sealants. Only a quarter of the students treated a traumatised incisor. Students considered themselves most confident (VAS ≥ 7) in performing operative dentistry, examination, diagnosis and treatment planning and providing preventive therapy. They were least confident in the management of dento-alveolar trauma (VAS = 3.8). CONCLUSION: Students at the University of Jordan Dental School were found to have good experience of clinical paediatric operative dentistry with the majority performing pulp therapy, preformed crowns and extractions. Deficiencies have been reported in student exposure to dental trauma, and these are being addressed.

Genotypic and phenotypic characteristics of Cronobacter species, with particular attention to the newly reclassified species Cronobacter helveticus, Cronobacter pulveris, and Cronobacter zurichensis.

In 2013, Enterobacter helveticus, Enterobacter pulveris and Enterobacter turicensis, were reclassified as Cronobacter helveticus, Cronobacter pulveris and Cronobacter zurichensis, respectively. Previously these species had been used as negative controls for some Cronobacter detection assays. This study examined cultural, biochemical and molecular Cronobacter detection and identification assays, with emphasis on the new species. Additionally, 32 Cronobacter genomes were examined for the presence of PCR target genes using the BLAST function of the online Cronobacter PubMLST facility. The results of the cultural methods varied and no single medium was able to correctly detect all Cronobacter spp. Since the supporting databases have not been updated to include the Cronobacter genus, Enterobacter sakazakii was returned for four strains of the newly reclassified species with ID32E and none with API 20E. PCR probes targeting rpoB and ompA could not correctly identify the new Cronobacter spp., due to primer specificity or absent target genes. As neonates have been identified as a high-risk group for infection, international standards require the absence of all Cronobacter species in powdered infant formula. However, many conventional detection methods cannot correctly identify the newly recognized species. Conversely, DNA sequence-based methods can adapt to taxonomic revisions and will likely become more common.

Diversity of the Cronobacter genus as revealed by multilocus sequence typing.

Cronobacter (previously known as Enterobacter sakazakii) is a diverse bacterial genus consisting of seven species: C. sakazakii, C. malonaticus, C. turicensis, C. universalis, C. muytjensii, C. dublinensis, and C. condimenti. In this study, we have used a multilocus sequence typing (MLST) approach employing the alleles of 7 genes (atpD, fusA, glnS, gltB, gyrB, infB, and ppsA; total length, 3,036 bp) to investigate the phylogenetic relationship of 325 Cronobacter species isolates. Strains were chosen on the basis of their species, geographic and temporal distribution, source, and clinical outcome. The earliest strain was isolated from milk powder in 1950, and the earliest clinical strain was isolated in 1953. The existence of seven species was supported by MLST. Intraspecific variation ranged from low diversity in C. sakazakii to extensive diversity within some species, such as C. muytjensii and C. dublinensis, including evidence of gene conversion between species. The predominant species from clinical sources was found to be C. sakazakii. C. sakazakii sequence type 4 (ST4) was the predominant sequence type of cerebral spinal fluid isolates from cases of meningitis.

Knowledge, educational experiences and attitudes towards child abuse amongst Jordanian dentists.

BACKGROUND: Signs of physical abuse often present in the oro-facial region and dentists are in a strategic position to recognise and report suspected cases. The aim of this study was to assess the knowledge, educational experiences and attitudes of Jordanian dentists towards child abuse and to assess their educational needs. METHODS: A cross-sectional survey of a random sample of Jordanian dentists (n=400) was conducted using an anonymous, self-administered structured questionnaire. RESULTS: The response rate was 64%. Thirty-four per cent (n=88) of the respondents reported having formal training in recognising and reporting child abuse, and 42% (n=106) had post-qualification/continuing education training on the topic. Half of the dentists (127/256) suspected a case of child abuse in the past 5 years, but only 12% (31/256) reported their suspicions. The main reasons for not reporting suspicions of abuse were fear from anger of parents (43%), uncertainty about diagnosis (41%) and uncertainty about referral procedures (41%). Those dentists who had formal training in dental school (P=0.0001) and post-qualification courses in child abuse (P=0.006) were significantly more likely to report suspicions. CONCLUSIONS: A significant gap existed between recognising signs of physical child abuse and responding effectively. Improvements in child abuse education and continuing education courses are advised to provide dentists in Jordan with adequate knowledge of indicators of physical child abuse and to inform them on the protocol to follow when suspicions arise.

Prevalence, intensity and identity of bacteraemia following conservative dental procedures in children.

INTRODUCTION: The aim of this study was to investigate the prevalence, intensity and microbial identity of bacteraemia following conservative dental procedures. The procedures were placement of rubber dam, use of the fast drill, use of the slow drill and placement of a matrix band and wedge. METHOD: Two hundred and five children and adolescents undergoing general anaesthesia for dental treatment at the Eastman Dental Hospital were recruited. Each subject was randomly allocated to one of the procedure groups. A baseline blood sample was taken before any dental treatment was carried out. A second blood sample was taken 30 s after a single conservative procedure. The blood samples were processed using lysis filtration. All bacterial isolates were identified using comparative 16 S ribosomal RNA gene sequencing. Oral Streptococcus spp. and coagulase-negative Staphylococcus spp. were further identified by comparative sodA gene sequencing. RESULTS: The prevalence of bacteraemia was significantly greater following placement of rubber dam (P = 0.01) and placement of matrix band and wedge, compared with baseline. The intensity of bacteraemia was significantly greater following placement of rubber dam (P = 0.001) and placement of matrix band and wedge (P = 0.0001). The most frequently isolated bacteria were Streptococcus spp. (56%), Actinomyces spp. (15%) and coagulase-negative Staphylococcus spp. (15%). CONCLUSION: Conservative dental procedures are a significant cause of bacteraemia.

Reasons for choosing dentistry as a career by Arab dental students.

The aim of this study was to determine the reasons for choosing dentistry as a career in an Arab population of undergraduate dental students in Jordan. An anonymous questionnaire was administered to dental students from year 1 to 5 at the Faculty of Dentistry of the University of Jordan in Amman. The questionnaire comprised 31 items and the students were required to rate the importance of each item for selecting dentistry as a career on a 10 point scale. Parametric tests were used to investigate if statistically significant differences existed between scores for different groups. The response rate for the study was 79% (477 out of 604 students recruited). Two hundred and twenty one students (46%) had dentistry as a first choice. Prestige was given a maximum score by 44.4% of the students recruited and a similar number of students, 43.6% gave a maximum score to the factor representing helping people. There were slight differences in the motivation between male and females with males more motivated by financial factors. It was concluded that 'prestige' and 'helping people' were important motivating factors in this group of dental students.

Dental health indices and caries-related microflora in children with severe haemophilia.

The purpose of this work was to investigate the prevalence of dental caries, bacterial dental plaque, gingivitis, enamel defects and caries- related microflora in children with severe haemophilia. Thirty-eight children with severe haemophilia (factor VIII and IX < 2 U dL(-1)) were recruited from Great Ormond Street Hospital for Children and matched for age, gender and ethnicity with healthy control children from the Eastman Dental Institute. Indices were recorded for decayed, missing, and filled teeth and surfaces in both the deciduous dentition (dmfs/dmft) and the permanent dentition (DMFS/DMFT). The plaque and gingivitis scores and developmental enamel defects were also recorded. The caries-related microflora was sampled and cultured for Streptococcus mutans, and Lactobacilli and Candida species. A significantly greater proportion of children with severe haemophilia were caries-free compared with the controls (36.7% vs. 13.3%; P=0.04). Both the DMFS and DMFT were significantly greater in the controls (3.6 and 2.8, respectively) compared with the haemophilia group, (0.8 and 0.7; P=0.007 and P=0.04). The plaque score for the permanent dentition only was significantly greater for the control children (24.2) compared with the haemophilia group, (10.2; P=0.04). The mean number of colony forming units of S. mutans was significantly greater in the control group compared with the haemophilia group (P=0.05). We conclude that children with severe haemophilia have a significantly lower prevalence of dental caries compared with matched, healthy controls.