Oral Health and Oral Health-Related Quality of Life among Elderly People in Iran.

Background: The study aimed to investigate oral health status and its relationship with oral health-related quality of life in the elderly in Isfahan, Iran, in 2022. Materials and Methods: This cross-sectional study was conducted in Isfahan, with 460 elderly participants. During interviews with the participants, their demographic information, their medical and dental history, oral health-related behaviors, self-perceived oral health, and clinical examinations were collected, and the Geriatric Oral Health Assessment Index (GOHAI) was completed. The final conclusions were made using the Generalized Linear Model (GLM) test. Results: The mean (sd) scores were 45.05 (8.62) for GOHAI, 5.44 (2.96) for self-perceived oral health, and 18.11 (5.76) for DMFT (Decayed, Missing and Filled teeth). Moreover, the number of remaining teeth on average was 11.78 (11.89), 39.56% of the participants did not brush their teeth, 40% of the elderly had complete dentures, and 27.17% had dental insurance. After adjusting and modifying the variables, the GLM test revealed that strong predictors for higher GOHAI scores were the higher levels of education (p < .001), the higher frequency of remaining teeth (p = 0.002), more pleasant self-perceived oral health (p < .001), and dental insurance (p = 0.04). Conclusions: According to the findings, the elderly's oral health-related quality of life in Isfahan was low, which was caused by the following factors: edentulism, few numbers of remaining teeth, high DMFT score, elderly' non-adjustment with dentures and their low quality, inappropriate oral health-related behaviors, lack of complementary insurance for dentistry, and non-using dental services, and low levels of education.

Painless cost control as a central strategy for universal oral health coverage: A critical review with policy guide.

AIM: This study aimed to critically review the methods used to control the significantly increasing costs of dental care. METHODS: Through a comprehensive search of the available literature, the cost control (CC) mechanisms for health services were identified from a healthcare system perspective. The probable applicability of each CC method was evaluated mainly based on its potential contribution to oral health promotion. Each mechanism was then classified and discussed under any of the two headings of financing and service provision. An operational guide was finally presented for policy-making in each of the three main models of healthcare systems, including National Health Services, social/public health insurance and private insurance. RESULTS: From a total of 142 articles/reports retrieved in PubMed, 73 in Scopus and 791 in Google Scholar, 35 were included in the final review after eliminating the duplicates and screening process. Totally ten mechanisms were identified for CC of dental care. Seven were discussed under the financing function, including cost sharing, preauthorization, mixed payment method and an evidence-based approach to benefit package definition, among others. Three further methods were classified under the service provision function, including workforce skill mix with emphasis on primary oral healthcare providers, development of primary healthcare (PHC) network and an appropriate use of tele-dentistry. CONCLUSION: Painless control of dental expenditures requires a smart integration of prevention into the CC plans. The suggested policy guide emphasizes organizational factors; particularly including the development of PHC-based networks with midlevel providers (desirably extended-duty dental hygienists) as the frontline oral healthcare providers.

Oral cancer knowledge among dental patients in Isfahan.

Background: Diagnosis of oral cancer in the early stages is the most effective tool to improve survival and reduce complications caused by the disease. The aim of this study was investigating the dental patients' knowledge of oral cancer in Isfahan. Materials and Methods: This descriptive cross-sectional study was performed on 334 patients referred to dental centers in Isfahan, Shahinshahr, Najafabad, Khomeini Shahr, Harand, and Zarrinshahr cities. Data were collected by a researcher-made 25-item questionnaire. Data analysis was carried out by SPSS (version 26) software using the independent t-test, one-way analysis of variance, and Pearson correlation coefficient (P < 0.05). Results: The patients' mean score of knowledge was 49.3 ± 21.4 in Isfahan city and 53.1 ± 18.4 in the other cities of Isfahan province. There was no significant difference between knowledge of oral cancer and gender, marital status, and residence, but there was a significant difference between employment status and knowledge (P = 0.03). The mean score of knowledge was significantly higher in patients who had a history of oral cancer in relatives than in other patients (P = 0.03). Virtual networks (Telegram, WhatsApp, and Instagram), journals, and books were the most common sources for patients about oral cancers. Conclusion: Dental patients' knowledge of oral cancer in Isfahan province and its cities was moderate, so it is necessary to increase their level of knowledge through more education.

Evaluation of Dentist's Knowledge and Practice About Dental Management of Oral Cancer Patients.

BACKGROUND: Dentists play a key role in and the management of oral cancer treatment complications. This study aimed to evaluate the general and specialist dentists' knowledge and practice regarding the dental management of such patients. METHODS: This cross-sectional analytic study was conducted among 370 general and specialist dentists in Isfahan, Iran 2020. A self-administrative questionnaire was designed and validated. The questionnaire had 18 questions in Knowledge section, 10 questions to measure performance, and 3 questions to evaluate dentist's opinion toward their management ability. The collected data were analyzed by descriptive and analytic tests such as T-Test, Kruskal-Wallis, Mann-Whitney, Chi-square, and Fisher's Exact statistics (P ≤ 0.05). RESULTS: The mean knowledge score was 9.96±2.87 in specialists and 7.59±2.36 in general dentists (out of 18, P < 0.001). There was no statistically significant difference between the mean knowledge based on gender, employment type, work experience of general and specialist, or the number of working days in a week. In addition, there was a significant relationship between the mean knowledge and having patients with oral cancer undergoing radiotherapy or chemotherapy (P = 0.012). CONCLUSION: This study indicated that specialists'knowledge level is higher than general dentists. It was also shown that knowledge directly relates to practice and attitude. Besides, regarding insufficient knowledge of dentists in this field, it is necessary to hold training programs and retraining sessions.

Effectiveness of educational strategies to teach evidence-based dentistry to undergraduate dental students: a systematic review.

OBJECTIVES: Evidence-based dentistry (EBD) training has been widely promoted in dental schools around the world and policymakers ask for suitable strategies to teach EBD within undergraduate dental education. The present study aims to evaluate the effectiveness of these strategies on dental students' knowledge, attitude, and skills. METHODS: PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, and Eric databases were searched using search terms obtained from Medical Subject Headings (MeSH) terms and free text method without time restrictions, up to November 2022. The identified articles were screened based on titles and abstracts for inclusion criteria. Subsequently, relevant articles underwent data extraction. Finally, the risk of bias was assessed through Joanna Briggs Institute critical appraisal checklists. RESULTS: Twelve of 439 studies were included: nine quasi-experimental studies, two cross-sectional, and one randomized controlled trial study. Regarding the overlap among categories, six studies assessed knowledge, seven assessed attitude, and eight focused on skills or performance in EBD. Due to the heterogeneity of the interventions and results of included studies, a meta-analysis was not performed. EBD was mostly taught in small group collaborations. Interventions included lectures, workshops, seminars, small group sessions, journal clubs, online sessions, or a combination of them in various frequencies and duration. CONCLUSIONS: EBD implementation into dental curricula is improving through strategies including designing continuing and frequent dental education courses, establishing collaborative student research groups, utilizing online tools for EBD education, and dividing EBD courses into shorter modules. The systematic review protocol was registered in PROSPERO (ID: CRD42022350238).

Nudging oral habits; application of behavioral economics in oral health promotion: a critical review.

Background: Oral health disorders significantly contribute to the global incidence of chronic diseases. Nudge interventions have demonstrated effectiveness in enhancing people's decision-making and self-management capacities in a cost-efficient manner. As a result, these interventions could be valuable tools for fostering improved oral care habits. This critical review explores potential behavioral nudges applicable to promoting oral health. Methods: A thorough electronic literature search was conducted on Scopus, Embase, and PubMed databases for papers published post-2008. The search focused on empirical evidence concerning the direct and indirect application of Nudge theory in oral health enhancement. In addition, the investigation included the nudge intervention's role in managing common non-communicable disease risk factors (tobacco, alcohol, and sugar) and their use in other health sectors. Results and conclusion: There is a dearth of studies on behavioral economics, particularly those involving reward and reminder techniques. However, various successful nudge interventions have been identified in other sectors that aim to improve health decisions. These include strategies encouraging healthier nutritional choices, tobacco and alcohol cessation, medication compliance, routine physical activity, and regular health check-ups. Such interventions can also have direct or indirect positive impacts on oral health. Implementing these interventions within an oral care framework could promote oral health due to similar underlying cognitive mechanisms. However, different types of nudge interventions have varying degrees of effectiveness. Furthermore, factors such as the method of delivery and the characteristics of the targeted population significantly influence the outcome of the intervention. Hence, it is imperative to conduct extensive studies in diverse socioeconomic settings to fully understand the potentials, limitations, and impacts of nudge interventions in promoting oral health.

Determinants of oral health status: an ecological study in Iran.

OBJECTIVES: The aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level. MATERIALS AND METHODS: The data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05). RESULTS: Mean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01-0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07-0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2-0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 - 0.48) were positively in associated with FT. CONCLUSIONS: The present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors.

General dentists' awareness of orthodontic treatment needs of patients and their referral practices.

Background: Since general dentists (GDs) usually act as the primary referral source for the patients in need of orthodontic treatments, having the proper knowledge and understanding of the accurate diagnosis of clinical situations is very important. The aim of this study was to assess GDs about the identification of orthodontic treatment needs and their referral practices. Materials and Methods: This descriptive and analytical cross-sectional study was carried out in Iran 2020. A questionnaire consisting of three main parts was designed and distributed electronically among GDs. The first section included 11 image and scenario-based questions meant to assess the ability of GDs to correctly diagnose the orthodontic treatment needs of the patients. The next two parts were to assess the dentists' knowledge of the necessity of referral to an orthodontist with 11 questions, and the proper timing of orthodontic treatments with 8 questions. Data were analyzed using SPSS 26, by conducting Mann-Whitney, Kruskal-Wallis, and correlation tests α = 0.05. Results: Among 384 participated dentists, 50.3% (193) were female. The mean score of knowledge was 17.3 ± 3.5 out of 30. The highest percentage of good knowledge (70% of range) was related to the diagnosis of orthodontic problems, while the lowest one belonged to the referring pattern. There was a weak positive correlation between the working experience and the proper timing of referral (R = 0.15, P = 0.004 (. Kruskal-Wallis test also showed a significant difference between the total knowledge scores (P = 0.04) and the knowledge of the proper timing of treatment (P = 0.04) based on the age groups of participants. Eighty-seven percentage (n = 334) reported that they would refer the patients in need of orthodontic treatment. Conclusion: The knowledge level of orthodontic treatment needs among GDs was moderate, thus emphasizing the importance of planning more educational courses for them to improve their knowledge, thus reducing the possible detriments of postponed or inaccurate treatments.

Utilization of dental care among adult populations: a scoping review of applied models.

BACKGROUND: The timely and appropriate utilization of dental health care is essential to the prevention and accurate treatment of oral diseases. Therefore, it is crucial that managers, health professionals and healthcare providers be fully aware of the predictors encouraging the utilization of dental services and reduce social inequalities. In this scoping review, we aimed to analyze the published articles and reports to find out the factors associated with dental services utilization and the comprehensiveness of the applied models among general adult populations. MATERIALS AND METHODS: This scoping study was based on the 5-steps of Arksey and O'Malley framework. Keywords were selected under two main concepts: determinants of dental care utilization and the concept of the applied models. Searches were conducted in some electronic databses including PubMed, Google Scholar and Scopus with variations, and a combination of the keywords under the two main afore-mentioned concepts. All the relevant articles reporting the utilization of dental care and its potential predictors among adult populations were chosen. No restrictions involving terms of study time, location or methodological aspects of oral health utilization were considered. Using tables and charts mapping, we tried to group the studies based on the year of their publication, geographic distribution, the range of included indices and the type of their measurement. Also, a directed content analysis method was used to investigate the comprehensiveness of the studies in regard to considering the determinant factors at different levels suggested by the Andesen model. RESULTS: Fifty-two articles were included in the analysis. Thirty-six (69%) had been published between 2016 and 2020. The United States had conducted the most research in this scope. About 30% of studies had mentioned all three domains of demographics, social structure and beliefs, simultaneously. To evaluate the enabling factors, in 84.61% and 59.61% of studies, the income levels and insurance feature were assessed, respectively. 57.69% of the retrieved studies considered the perceived need features and 38.46% referred to the evaluated ones. The dental services utilization, in terms of the last visit during the "past 12 months", was assessed more commonly. Only 11.54% of studies did evaluate the contextual characteristics and about 71.15% of articles were relatively comprehensive. CONCLUSION: Overall, it seems that in most of the studies, not all of the determinant factors at different levels of the Andersen model have been considered. In order to discover the conceptual linkages and feedback loops of the model, it is essential to conduct more comprehensive research in the future.

Promoting oral and dental healthcare among the elderly in a residential care home in Isfahan: a best practice implementation project.

INTRODUCTION: Oral health is an important aspect of general health, which affects the wellbeing and quality of life of older adults. Residents in aged care facilities often suffer from overall dental neglect and insufficient oral healthcare, leading to moderate-to-high levels of oral diseases. Furthermore, physical or mental health concerns may result in difficulties in maintaining good oral health. OBJECTIVES: This implementation project aims to audit and improve the oral healthcare status of the elderly living in a residential care home in Isfahan, Iran using the JBI evidence summary. METHODS: The methods are preimplementation and postimplementation design using audit and feedback with a situational analysis to guide implementation planning. Seven evidence-based quality indicators were used to measure preintervention compliance with the best practice. Situational analysis was used to identify and target barriers through locally developed practice change strategies following which a repeat audit was conducted at 4 months. Four nursing staff, 11 caregivers, and 38 residents were interviewed for both the baseline and the follow-up audit. RESULTS: Compliance rates improved for all seven criteria except the use of a soft-bristled toothbrush (criterion 6). All eight categories of criterion 2 measuring assessment of oral health improved by at least 10%, with the largest improvements in saliva assessment and gingiva assessment. Criterion 1 (oral health training for caregivers) reached the greatest compliance rate (100%). CONCLUSION: The implemented strategies included improving knowledge and changing the attitudes of the caregivers through organizing educational sessions. These strategies were developed to address process and structural barriers to best practice and were helpful for staff uptake of evidence.

Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran.

INTRODUCTION: The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran. METHODS: This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05). RESULTS: The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4). CONCLUSION: It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.

A model for implementing oral health-promoting school: Integration with dental students' educational curriculum: A protocol study.

BACKGROUND: Schools are ideal setting for children's oral health-promoting programs. It is an integrated model for oral health-promoting schools (OHPS) with the capacities of dental school's curriculum and dental students as workforces. In this protocol, the principle of planning and implementation of the oral health program is described. MATERIALS AND METHODS: Based on the PRECEDE-Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) planning model, a framework for determining the potential predisposing, reinforcing, and enabling factors that could be intervening was diagnosed. To adapt the phases of the planning model for integration of the "OHPS" principles and the dental students' curriculum, the following steps are supposed to be considered: Phases 1-5 which are to assess the baseline data will include the assessment of children oral health status and parents and teachers' knowledge, attitude, and performance. Phase 6 or implementation phase will be allocated to oral health education interventions for students, parents, and teachers, professional screening, prevention, and referral. Phase 7 or the process assessment phase will be to record the number of screened students, the amount of fissure sealant and fluoride provision, and percentage of trained parents and teachers. Phase 8 or the impact assessment phase will assess the students' improvement in knowledge and practice, decayed, missing, and filled teeth scores, teachers and mothers' oral health attitudes and behaviors, and brushing and flossing behaviors. At the last, cost analysis of the program and long-term monitoring of the interventions is suggested. CONCLUSION: In case that the effectiveness of this model is proven, it can be implemented by other dental schools for the primary schools in their regions. Considering the number and distribution of dental schools in the country, this model is executable as targeted population oral health promotion approach in 6-12-year-old schoolchildren.

Competencies of dental public health for undergraduate students and their self-perceived achievements: The case of Iran.

PURPOSE: The aim of this study was to develop Dental Public Health (DPH) competencies and to assess the self-perceived achievements of undergraduate students in regard to these competencies. MATERIALS AND METHODS: In the first phase, by using the mixed method of the RAND-UCLA model, a list of the proposed competencies was developed and validated based on three-round expert consensus using both rating and group discussing method. In the second phase, 120 senior (final-year) dental students were asked to determine their achievements based on the finalised list of competency statements on a 0-10 numerical scale. Descriptive statistical analysis was then performed using SPSS (version 22) to determine the mean score of the items and domains. Some background factors were also tested for any relationship. RESULT: After three rounds of implementing the RAND-UCLA method, 31 statements in 10 domains were developed and validated. The mean total score of the self-reported competency was 176.87 ± 52.4 amongst the recruited dental students with a range of 37 to 304. The highest mean ± sd score (7.7 ± 1.8) was found for the preventive oral health services field, whilst the lowest one (4.5 ± 2.3) was reported for understanding the components and functions of the health system. The average self-reported scores of professional ethics and professionalism, evidence-based practice and oral health determinants were also acceptable amongst them. CONCLUSION: The finalised competencies gained the consensus level of agreement and appropriateness by representatives of all DPH experts in the country. However, according to the dental students' self-reports, they had moderate competencies in most cases. Therefore, content and applied methods of training and evaluation may need to be revised to support students' development. Also, the complementary evaluation method at real work setting is highly suggested.

Knowledge, attitude, and expertise of nurses in intensive care unit regarding oral and dental care in hospitalized patients.

BACKGROUND: The purpose of this study was conducted to evaluate the knowledge, attitude, and practice of intensive care unit (ICU) nurses about oral and dental care in hospitalized patients. MATERIALS AND METHODS: In this descriptive-analytic study, the statistical population included 214 nurses working in the ICU of the affiliated hospitals of Isfahan University in 1394. The level of knowledge, attitude, and practice of ICU nurses was assessed using questionnaires whose justifiability and stability were verified at the beginning of the study with a pilot study. Data were entered into SPSS software and tested by t-test, Spearman, one-way variance, and least significant difference test. The significance level was < 0.05. RESULTS: The data of this study showed that the score of knowledge and performance in male nurses was significantly different from female nurses. There was a significant relationship between nurse's education and their knowledge score (P < 0.001). Furthermore, the performance score of nurses working in different parts was different too (P < 0.001). CONCLUSION: The findings showed that the knowledge and performance of female nurses about oral care were higher than men, but the attitude of the two sexes is almost the same. Nurses with lower educational degree had less knowledge, but their attitude and performance did not differ. The performance score of nurses working in ICU was different, but they had similar knowledge and attitudes.

Effect of sense of coherence on oral health behavior and status: A systematic review and meta-analysis.

The sense of coherence (SOC) is defined as a personal orientation to life. People with higher SOC are better at dealing with stressful situations, psychological stress, and problems and are more able to manage them, leading to better general health. The purpose of this study was to evaluate the effect of SOC on the oral health status of people in different age groups. A systematic search up to May 2019 was carried out in PubMed,Scopus, Psycho info, and Persian sources. Studies were included if they evaluated the relationship between SOC and oral health behaviors (OHBs) or oral health status including dental caries. The Newcastle-Ottawa checklist was used to appraise the selected articles and meta-analysis of included studies were performed using Comprehensive Meta-Analysis software. Value of P < 0.05 was considered to be statistically significant. Odds ratio (OR) was used to measure effect size with 95% confidence interval (CI). The random-effects model was chosen in the presence of heterogenicity. I 2 index and Q index were used to measure the heterogeneity present between the studies. Fifteen articles received the minimum score of criticism. In general, SOC could significantly affect the oral health and OHBs of adults independently of the underlying factors. There was a significant relationship between SOC and tooth decay in adolescents, but this association was poor after adjusting for the underlying factors. In children, only one article revealed an association with OHBs. Meta-analysis revealed that SOC was significantly associated with the caries rate (OR = 0.78, CI 95% = 0.9-0.67, P = 0.001) and tooth brushing frequency (OR = 1.22, CI 95% = 1.1-1.31 and P < 0.001). Sense of coherence appears to be one of the effective factors in predicting oral health behaviors and ultimately oral health, especially in adults. The number of articles available for children and adolescents was not sufficient in this regard.

Knowledge, attitude and practice of dentists toward providing care to the geriatric patients.

BACKGROUND: Tooth loss, systemic diseases and medications add to the complexity of the oral conditions in geriatric popuation, making this age group a special group in need of specific preventive and curative oral health care. Therefore, the dental teams need to be equipped with specific knowledge and skills to provide the appropriate dental care. This study was iaimed to assess the knowledge, attitude, practice and willingness of general dentists to provide dental care to geriatric patients. METHODS: This cross-sectional study was conducted on 231 dentists using a questionnaire including demographic characteristics, knowledge, attitude and practice sections. The availability of the facilities for providing services to the older people in the office was also evaluated. Data were fed into SPSS-22 and analysed using descriptive statistics, t-test, Chi-squared, ANOVA and correlation coefficient tests (α = 0.05). RESULTS: 62.8% of the participants were women and their mean age was 34. 4±8. 1 years. The knowledge mean score was 13.3± 2.9 (out of 30). 86. 5% of the participants had moderate knowledge, and 2.6% displayed good knowledge. The mean score related to the attitudes toward geriatric was 55.8 ± 6. 1 (out of 85), which was not significantly different based on gender. The mean score of practice was 21. 4± 4.3. There was a significantly positive correlation between knowledge and attitude. Dentists with a higher knowledge score had moderately a more positive attitude towards the older people (R = 0.33, p_ value < 0.001). However, over 60% preferred to provide care to the young patients. Significant correlation was observed between their practice and attitude (R = 0. 2, P-value = 0.006). Nearly 30% of the dentists found their knowledge and experience insufficient in treating the older people with complex medical problems. 40% believed that the current dental education in dental schools did not provide adequate training in geriatric dental care. CONCLUSION: Although the dentists in this study had average knowledge and capacity, they mostly displayed a positive attitude towards the old. A high percentage of them were unsatisfied with the sufficiency of geriatric dental education in dental schools.

Professional legislation knowledge of dentists and psychological effects of negligence.

INTRODUCTION: The aim of the present study was to evaluate the extent to which a group of general dentists and specialists had knowledge of the professional laws and psychological effects of negligence on them. MATERIALS AND METHODS: The sample in this cross-sectional study consisted of 400 dentists (General dentists and specialists) in Isfahan city, Iran. Having designed the questionnaire and confirmed its validity and reliability, we published online to be completed by the dentists. The obtained data were analyzed using descriptive statistics, t-test, and ANOVA test. Optimal knowledge was determined to be 75%, and P-value<0.05 was considered to be statistically significant. RESULTS: The majority of the dentists (75%) had poor and very poor knowledge. The mean score of knowledge (range: 0-21, maximum obtainable: 24) was 9.58 ± 4.5. Sixty dentists (15%) reported they had experienced negligence. Further, 278 (69.5%) reported they had somehow experienced the occurrence of malpractice during their practical experience. Legal negligence was more prevalent among the general dentists than specialists (17.8 VS 8%, p < 0.001). Regarding the legal complaint history, a significant difference was observed between the males and females (P = 0.015) and among different categories of work experience years (P = 0.000). Moreover, among those who had a history of a legal complaint, 96.7% showed psychological symptoms, 70% had physical symptoms, and 80% displayed social symptoms related to the stress following legal complaints. CONCLUSION: Findings of this study indicated that refining the knowledge of the rules and regulations of the dental profession should be enhanced by considering appropriate training courses in the curricula and continuous education programs. More than half of the participants considered themselves guilty of negligence in this regard.

Fissure sealant therapy as a portable community-based care in deprived regions: Effectiveness of a clinical trial after 1 year follow-up.

The aim of this study was to evaluate the effectiveness of the fissure sealant therapy in suboptimal setting (as part of a community-based program using the portable equipment and provided by dental students) on the caries status of school children. This pragmatic split-mouth randomised clinical trial was conducted in rural area of Iran. At baseline, 124 patients, including 185 paired teeth with deep pits and fissures of opposite quadrants that were either healthy or at early stages of enamel decay (International Caries Detection and Assessment System [ICDAS] 0-2), were randomly allocated to receive fissure sealant or acted as control. The incidence of new caries (ICDAS code 3-6) and the sealant's retention status after 1-year follow-up were evaluated. Using chi-square test, the relative risk (RR) and the Number Needed to Treat (NNT) to prevent new caries were calculated. After 1 year, 109 patients including 163 paired teeth were available. Sixty-seven (41.4%) and 44 (27.2%) teeth had complete and partial retained sealants respectively. The risk of caries incidence in non-sealed teeth was almost three times more than sealed teeth (RR = 2.88, 95% CI: 1.4-1.97, p = 0.002) and the NNT was 10 (95% CI: 6-26). A significant association was noted between the status of sealant retention after 1 year and the incidence of new caries (p < 0.001). Fissure sealant as part of a community-based program was effective in controlling caries incidence.

Automatic Evaluation of Crown Preparation Using Image Processing Techniques: A Substitute to Faculty Scoring in Dental Education.

BACKGROUND: This study presents a new and innovative experimental method, including software and its prerequisite instruments, to use image processing techniques for crown preparation analysis. METHOD: A platform was designed and constructed to take images from artificial teeth in different angles and directions and to process and analyze them by the proposed method to evaluate the quality and quantity of crown preparation. For each tooth, two series of images were taken from the artificial teeth before and after preparation, and image series were registered by two semi-automated and automated methods to transform them into one coordinate system. Region of interest was segmented by user interaction, and tooth region was segmented by substeps such as transformation to hue, saturation, and value color space, edge detection, morphology operations, and contour extraction. Finally, the amount and angle of crown preparation were computed and compared with standard measures to evaluate the quality of crown preparation. The proposed method was applied to a local dataset collected from Isfahan University of Medical Sciences. RESULTS: Difference between the angle of crown preparation computed by the proposed method and that of the experts showed a mean absolute error of 7.17°. The correlation between the segmented regions by the proposed method and those of the experts was also evaluated by the Intersection over Union (IOU) criterion. The best and worst performances achieved in cases by IOU were 0.94 and 0.76, respectively. Finally, the segmentation results of the proposed method indicated an average IOU of 0.89 in all images. CONCLUSION: Students can use this method as an assessment tool in preclinical tooth preparation to compare their crown work with standard parameters.

Status of geriatric education and meeting the standards of facilities in dental schools.

CONTEXT: Information, specific tendencies, and skills are needed to provide oral care for the elderly population, and these skills should be learned in dental schools. AIMS: The aim of the study was to assess the status of geriatric dentistry education and meeting the standards of facilities in dental schools in Iran. SETTINGS AND DESIGN: In this cross-sectional study, sampling was done by census method, and all the 18 dental schools with a history of ≥6 years of establishment were selected. MATERIALS AND METHODS: A checklist was prepared in two sections, including geriatric dentistry education (existence of specific education module, considered time, specific department, specific faculty members, continuing courses for dentists, relationship with geriatric nursing houses, referral system, and specific clinics) and facilities and was distributed among dental schools. The collected data were input into SPSS (Version 20.0. Armonk, NY: IBM Corp) and analyzed descriptively. RESULTS: After a regular follow-up, 11 dental schools returned the completed checklists. Eight (72%) of them had specific geriatric dentistry education module. Only one (9%) had specific faculty member, continuing educational course, mobile clinic, and regular connection with geriatric nursing houses. None of the dental schools had specific department, specific clinic for delivering care, and a referral system from hospitals to the schools. There were no dental schools with a special transportation system for the elderly and the staff to accompany the patients without attendants. CONCLUSION: The status of geriatric dental education in Iran seems not adequate. Furthermore, dental schools are not equipped with necessary facilities for delivering care to the elderly.