Knowledge, beliefs, attitude, and practices of E-cigarette use among dental students: A multinational survey.

BACKGROUND: E-cigarette use is a trend worldwide nowadays with mounting evidence on associated morbidities and mortality. Dentists can modify the smoking behaviors of their patients. This study aimed to explore the knowledge, beliefs, attitude, and practice of E-cigarette use among dental students. MATERIALS AND METHODS: This multinational, cross-sectional, questionnaire-based study recruited undergraduate dental students from 20 dental schools in 11 countries. The outcome variable was current smoking status (non-smoker, E-cigarette user only, tobacco cigarette smoker only, dual user). The explanatory variables were country of residence, sex, age, marital status, and educational level. Multiple linear regression analysis was performed to explore the explanatory variables associated with E-cigarette smoking. RESULTS: Of the 5697 study participants, 5156 (90.8%) had heard about E-cigarette, and social media was the most reported source of information for 33.2% of the participants. For the 5676 current users of E-cigarette and/or tobacco smoking, 4.5% use E-cigarette, and 4.6% were dual users. There were significant associations between knowledge and country (P< 0.05), educational level (B = 0.12; 95% CI: 0.02, 0.21; P = 0.016) and smoking status (P< 0.05). The country of residence (P< 0.05) and smoking status (P< 0.05) were the only statistically significant factors associated with current smoking status. Similarly, there were statistically significant associations between attitude and country (P< 0.05 for one country only compared to the reference) and history of previous E-cigarette exposure (B = -0.52; 95% CI: -0.91, -0.13; P = 0.009). Also, the practice of E-cigarettes was significantly associated with country (P< 0.05 for two countries only compared to the reference) and gender (B = -0.33; 95% CI: -0.52, -0.13; P = 0.001). CONCLUSION: The knowledge of dental students about E-cigarette was unsatisfactory, yet their beliefs and attitudes were acceptable. Topics about E-cigarette should be implemented in the dental curriculum.

Oral health practices and self-reported adverse effects of E-cigarette use among dental students in 11 countries: an online survey.

OBJECTIVES: E-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students. METHODS: This online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P < 0.05. RESULTS: Most respondents reported regular brushing of their teeth, whereas only 70% used additional oral hygiene aids. Reported frequencies of complaints ranged from as low as 3.3% for tongue inflammation to as high as 53.3% for headache, with significant differences between E-cigarette users and non-users. Compared to non-smokers, E-cigarette users reported significantly higher prevalence of dry mouth (33.1% vs. 23.4%; P < 0.001), black tongue (5.9% vs. 2.8%; P = 0.002), and heart palpitation (26.3%% vs. 22.8%; P = 0.001). Although two-thirds of the sample reported no change in their physiological functions, E-cigarette users reported significant improvement in their physiological functions compared to never smokers or tobacco users. CONCLUSION: Dental students showed good oral hygiene practices, but E-cigarette users showed a higher prevalence of health complications.

Optical properties of CAD-CAM monolithic systems compared: three multi-layered zirconia and one lithium disilicate system.

OBJECTIVE: this in vitro investigation aims to evaluate and compare optical properties of three types of esthetic CAD-CAM monolithic multi-layered zirconia materials with a control (conventional lithium disilicate, IPS e. max CAD). METHODS: Four monolithic CAD-CAM ceramic materials were investigated: Ceramill Zolid® FX Multilayer (ZF), IPS e. max® ZirCAD MT Multi (ZM), Katana® STML (KS) and one lithium disilicate glass-ceramics as a control (IPS e. max® CAD LT; LC). A total of 72 (15 × 15 × 1 mm) samples were CAD CAM fabricated and sintered based on sample-size power calculations, and each material comprised 18 samples. The translucency and opalescence parameters with the contrast ratio were evaluated with a dental spectrophotometer over the backgrounds of black and white. The data were analyzed by ANOVA, then Bonferroni post hoc comparison test was made between groups. The statistical significance was set at p < 0.05. RESULTS: Zirconia materials revealed lower optical properties than the lithium disilicate control LC (P < 0.05). TP values ranged from 14.174 to 20.439. No differences were detected between the zirconia products in terms of TP and CR (P = 1.000). OP values ranged from 5.068 to 10.097. The lowest OP values were found statistically significant for ZF followed by KS and ZM (P = 1.000). LC had the highest TP and OP values, as well as the lowest CR (p < 0.05). CONCLUSIONS: The optical properties of monolithic zirconia systems tested here are still lower than those of lithium disilicate glass-ceramics. The only difference observed between the monolithic CAD CAM zirconia materials, was for the low opalescence parameter for the ZF. CLINICAL SIGNIFICANCE: Multi-layered monolithic zirconia systems have better esthetics by shade layers resembling natural tooth color gradients. CAD-CAM technology allowed for in-office milling and shaping of restorations using these systems. This study reports on their optical properties affecting human vision/perception of natural tooth shade to conclude about their use in the esthetic zones.