Impact of a virtual learning environment on the conscious prescription of antibiotics among Colombian dentists.

Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists' awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar's tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement.

WebPalestra: a atuação do cirurgião-dentista no atendimento a pacientes com epidermólise bolhosa

O papel do cirurgião-dentista no tratamento da Epidermólise Bolhosa é de extrema importância. Estes pacientes, na sua maioria, fazem ingestão de uma dieta hipercalórica, resultando em altas taxas de cárie, além de alterações orais que requerem certos cuidados durante o atendimento odontológico.

Investigation of Turkish dentists' clinical attitudes and behaviors towards the COVID-19 pandemic: a survey study.

Currently, the whole world is under the threat of the COVID-19 pandemic, and dentists are at high risk. The aim of this study was to investigate what kind of precautions Turkish dentists take in dental clinics during the COVID-19 pandemic. The study population consisted of dentists in Turkey. An online questionnaire (23 questions-57 items) was sent to a sample of Turkish dentists from March 16 to March 20, 2020. The questionnaire comprised a series of questions about dentists' demographic characteristics, their concerns, and the measures taken in dental clinics against COVID-19. This study included a total of 1,958 Turkish dentists. A total of 1,274 (65.1%) were general dentists, and 684 (34.9%) were specialists. Five hundred twenty-two (26.7%) dentists attended an informational meeting on COVID-19. Of these dentists, 69.8% were aware of COVID-19 according to their self-assessed knowledge scores. More than 90% of the dentists were concerned about themselves and their families. Only 12% of the dentists wore an N95 mask. Although Turkish dentists took some precautionary measures, they did not take enough precautions to protect themselves, the dental staff, and other patients from COVID-19. As the number of COVID-19 cases increased, the measures taken slightly increased in dental clinics as well. Dentists are strongly recommended to take maximum precautions in the clinical setting. The guidelines about the COVID-19 pandemic should be sent to all dentists by the regional and national dental associations.

Biological and social aspects of Coronavirus Disease 2019 (COVID-19) related to oral health.

The expansion of coronavirus disease 2019 (COVID-19) throughout the world has alarmed all health professionals. Especially in dentistry, there is a growing concern due to it's high virulence and routes of transmission through saliva aerosols. The virus keeps viable on air for at least 3 hours and on plastic and stainless-steel surfaces up to 72 hours. In this sense, dental offices, both in the public and private sectors, are high-risk settings of cross infection among patients, dentists and health professionals in the clinical environment (including hospital's intensive dental care facilities). This manuscript aims to compile current available evidence on prevention strategies for dental professionals. Besides, we briefly describe promising treatment strategies recognized until this moment. The purpose is to clarify dental practitioners about the virus history and microbiology, besides guiding on how to proceed during emergency consultations based on international documents. Dentists should consider that a substantial number of individuals (including children) who do not show any signs and symptoms of COVID-19 may be infected and can disseminate the virus. Currently, there is no effective treatment and fast diagnosis is still a challenge. All elective dental treatments and non-essential procedures should be postponed, keeping only urgent and emergency visits to the dental office. The use of teledentistry (phone calls, text messages) is a very promising tool to keep contact with the patient without being at risk of infection.

Dentists Survey on Adverse Events During Their Clinical Training.

BACKGROUND: Adverse events (AEs) begin challenging the safe practice of dentistry early when students start treating patients at dental school. We assessed the frequency with which dentists caused common AEs during their undergraduate clinical training. METHODS: A convenience sample of dentists, graduated from more than 34 dental schools in Mexico and other Spanish speaking countries, answered a confidential, self-administered questionnaire with closed-format questions on common AEs they caused and their active errors that could have led to AEs in the teaching clinics. RESULTS: Of 207 participants, 80% had graduated recently. As undergraduates, 79% caused AEs; 38% admitted to causing one adverse event, 41% to causing two or more, and 36% committed active errors that could have hurt patients. No significant associations between AEs and sex or type of school were observed. CONCLUSIONS: The results indicate that dental students caused AEs or committed errors that placed patients at risk, during their clinical training. PRACTICAL IMPLICATIONS: Dental schools must identify challenges to patient safety at their teaching clinics and introduce risk reduction strategies to protect their patients and foster a safety culture in dental education.

Knowledge of human papillomavirus among dental providers: A mixed methods study.

Dental professionals are encouraged by the American Dental Association (ADA) to recommend the HPV vaccine to eligible patients. To better understand their comfort level in following this recommendation, we conducted a mixed methods study of dentists and dental hygienists. A total of 173 providers were surveyed and 8 interviewed. The majority felt they had an important role in preventing HPV-related OPC and that they should educate their patients and encourage HPV vaccination. However, most providers had low knowledge about HPV and expressed a need to obtain more information on the topic. In particular, they desired information about the HPV vaccine, its connection to cancer and where to refer patients for vaccination. They also wanted access to visual aids to help them bring up the topic. This study demonstrates the need to develop and disseminate educational programs for dental providers so they can assist with efforts to raise HPV vaccination rates.

Biological and social aspects of Coronavirus Disease 2019 (COVID-19) related to oral health

Abstract The expansion of coronavirus disease 2019 (COVID-19) throughout the world has alarmed all health professionals. Especially in dentistry, there is a growing concern due to it's high virulence and routes of transmission through saliva aerosols. The virus keeps viable on air for at least 3 hours and on plastic and stainless-steel surfaces up to 72 hours. In this sense, dental offices, both in the public and private sectors, are high-risk settings of cross infection among patients, dentists and health professionals in the clinical environment (including hospital's intensive dental care facilities). This manuscript aims to compile current available evidence on prevention strategies for dental professionals. Besides, we briefly describe promising treatment strategies recognized until this moment. The purpose is to clarify dental practitioners about the virus history and microbiology, besides guiding on how to proceed during emergency consultations based on international documents. Dentists should consider that a substantial number of individuals (including children) who do not show any signs and symptoms of COVID-19 may be infected and can disseminate the virus. Currently, there is no effective treatment and fast diagnosis is still a challenge. All elective dental treatments and non-essential procedures should be postponed, keeping only urgent and emergency visits to the dental office. The use of teledentistry (phone calls, text messages) is a very promising tool to keep contact with the patient without being at risk of infection.

Investigation of Turkish dentists clinical attitudes and behaviors towards the COVID-19 pandemic: a survey study

Abstract Currently, the whole world is under the threat of the COVID-19 pandemic, and dentists are at high risk. The aim of this study was to investigate what kind of precautions Turkish dentists take in dental clinics during the COVID-19 pandemic. The study population consisted of dentists in Turkey. An online questionnaire (23 questions-57 items) was sent to a sample of Turkish dentists from March 16 to March 20, 2020. The questionnaire comprised a series of questions about dentists' demographic characteristics, their concerns, and the measures taken in dental clinics against COVID-19. This study included a total of 1,958 Turkish dentists. A total of 1,274 (65.1%) were general dentists, and 684 (34.9%) were specialists. Five hundred twenty-two (26.7%) dentists attended an informational meeting on COVID-19. Of these dentists, 69.8% were aware of COVID-19 according to their self-assessed knowledge scores. More than 90% of the dentists were concerned about themselves and their families. Only 12% of the dentists wore an N95 mask. Although Turkish dentists took some precautionary measures, they did not take enough precautions to protect themselves, the dental staff, and other patients from COVID-19. As the number of COVID-19 cases increased, the measures taken slightly increased in dental clinics as well. Dentists are strongly recommended to take maximum precautions in the clinical setting. The guidelines about the COVID-19 pandemic should be sent to all dentists by the regional and national dental associations.

Nitrous oxide occupational exposure in conscious sedation procedures in dental ambulatories: a pilot retrospective observational study in an Italian pediatric hospital.

BACKGROUND: Nitrous oxide has a proven clinical efficacy in conscious sedation. At certain environmental concentrations it may pose a health risk to chronically exposed healthcare workers. The present pilot study aims at evaluating the exposure to nitrous oxide of dental ambulatory personnel of a pediatric hospital. METHODS: A descriptive study design was conducted in two phases: a bibliographic analysis on the environmental safety policies and a gas concentration analysis in the dental ambulatories of a pediatric hospital, detected every 6 months from December 2013 to February 2017 according to law provisions. The surveys were carried out using for gas analysis a photoacoustic spectrometer Innova-B&K "Multi-gas monitor model 1312" and Innova-B&K "Multi-sampler model 1309". The biological analysis and monitoring have been carried out on staff urine. RESULTS: The analyses were performed during 11 dental outpatient sessions on pediatric patients. All the patients were submitted to the same dental procedures, conservative care and dental extractions. The pediatric patients were 47 (23 males, 24 females; age range 3-17 years; mean age 6,63, SD ± 2,69) for a mean of 4,27 (SD ± 1,49) per session., The mean environmental concentration of nitrous oxide during the sessions was 24.7 ppm (SD ±16,16). A correlation was found between urinary nitrous oxide concentration of dentists (Pearson's correlation 0.786; p = 0.007) and dental assistants urines (Pearson's correlation 0.918; p < 0.001) and environmental concentrations of nitrous oxide. Weak negative correlations were found between age and sex of patients and environmental concentrations of nitrous oxide. The mean values of the biological monitoring data referring to all the outpatient sessions are lower than the reference values foreseen in accordance to the regulations in force on nitrous oxide concentration. CONCLUSIONS: The mean environmental concentration values recorded in our study are below the limit of 50 ppm considered as a reference point, a value lower than those reported in other similar surveys. The results of the present study provide a contribution to the need to implement technical standards, criteria and system requirements for the dental ambulatories, to date not yet completely defined, and cannot be assimilated to the ones established for the surgical rooms.

Attitudes and knowledge of paediatric dentists' on digital radiography and cone beam computed tomography.

OBJECTIVE: To determine the frequency and reasons of digital radiography and cone-beam computed tomography usage among paediatric dental practitioners, and to assess their knowledge and need for specific education.. METHODS: The cross-sectional study was conducted from January to July 2017 and comprised paediatric dentists present at the European Academy of Paediatric Dentistry Interim Seminar in Turin, Italy, and members of the Turkish Society of Paediatric Dentistry who did not attend the event. Data about sociodemographics and their attitude towards, use of, and knowledge of digital radiography and cone beam computed tomography was collected by means of a 20-item questionnaire that was mailed to all the subjects. SPSS 22 was used to evaluate data. RESULTS: Of the 435 questionnaires distributed, 245(56%) were returned, while 194 (45%) were deemed usable. The mean age of the responding paediatric dentists was 35.84±9.10 (range: 24-67 years) and 126(64.9%) were female. Users of digital radiography identified its advantages, such as lower radiation dose 166(85.7%), ease of image storage 150(77.3%), and the possibility to change image settings and to carry out measurements 106(54.5%). Overall, 70(36%) paediatric dentists had no knowledge of cone beam computed tomography. Dental trauma was cited as the reason for using cone beam computed tomography by 70(61.3%) subjects, dental development issues by 138(71%) and pathology in the jaws by 147(75.8%). CONCLUSIONS: Digital radiography and cone beam computed tomography users are increasing in the world.

Hand hygiene compliance and accuracy in a university dental teaching hospital.

OBJECTIVE: This study aimed to evaluate compliance with guidelines on hand hygiene by examining five handwashing categories in postgraduate year (PGY) dentists at a university teaching hospital and to evaluate the accuracy rates of handwashing. METHODS: Through direct observation, trained PGY dentists were monitored throughout their daily care routine of before contact with patients, before using an instrument, after contact with patients, upon direct exposure to patients' fluids, and while touching the patients' surrounding area. Hand hygiene opportunities were considered complete in each category. A total of 16,597 hand hygiene opportunities across 37 individuals were observed from July to October 2012 and from September to October 2013. RESULTS: The overall handwashing compliance rate was 34.7%. The handwashing compliance rate was higher during work in oral surgery services (92.8%) than during work in general clinical practice (34.2%). The accuracy rate of handwashing was also higher during work in oral surgery services (87.5%) than during work in general clinical practice (51.0%). Similar results were obtained across all five handwashing categories. CONCLUSIONS: Handwashing compliance and accuracy rates are low in PGY dentists. More education and continuous monitoring are suggested to improve handwashing compliance, as well as the correct handwashing procedures for dentists.

Prevention of infective endocarditis during dental extractions among Polish dentists - a contemporary nationwide survey.

INTRODUCTION: Infective endocarditis (IE) is a potentially life-threatening condition. According to current ESC (European Society of Cardiology) guidelines, the use of antibiotic prophylaxis should only be reserved for specific dental procedures with interruption of consistency of the oral mucosa such as extractions and should be reserved for patients with the highest risk of developing IE. The aim of this study was to assess the knowledge of need for IE prophylaxis in de ned clinical settings among Polish dentists. MATERIAL AND METHODS: A specially self-designed internet questionnaire was created concerning the topic of infective endocarditis prophylaxis in specific clinical scenarios for patients undergoing dental extractions during outpatient visits. The survey was made available to the dentists via internet and was active in March 2018. RESULTS: there were 352 Polish dentists who completed the survey. Antibiotic prophylaxis for IE during dental extractions was used in 93% of cases with prior IE, 89% with artificial heart valve, 69% with biological valve, 28% with pacemaker, 54% with coronary stent, 73% with cyanotic heart defect, 58% with diabetes mellitus, 20% after prior myocardial infarction and 54% with heart valve disease. There was a significant relationship between the time of working as a physician (>15 years) and more outdated or improper IE prophylaxis (p = 0.04). CONCLUSIONS: the management of patients for infective endocarditis prophylaxis undergoing dental extractions is suboptimal. Antibiotic therapy is overused in some clinical scenarios and on the other hand underutilized in those recommended by the current ESC guidelines.

The Knowledge Level of Dentists in Turkey About Their Potential Role on the Disaster Victims Identification (DVI) Team.

OBJECTIVE: Although dentists are valuable assets in identification teams during disaster events, forensic dentistry is not used effectively in the identification studies conducted in Turkey, and the importance of dental data is ignored. The aim of this study was to determine the level of knowledge of dentists regarding their duties and responsibilities during major disasters. METHODS: This descriptive study was conducted between December 2015 and June 2016. Registered dentists (n=20.280) of the Turkish Dental Association were invited to complete the organization's online survey. A total of 539 dentists participated in the volunteer workshop. Data were analyzed using SPSS, version 22.0 (IBM Corp, Armonk, NY). The chi-square analysis was used to evaluate the knowledge level of dentists by group regarding disaster victim identification (DVI) - the process and procedure of recovering and identifying victims of major disasters (eg, earthquake, terrorist attack). RESULTS: The dentists included in the study consisted of 320 (59.4%) females and 219 (40.6%) males with a mean age of 37.4±12.6 years. The number of specialists and general dentists were 249 (45.6%) and 297 (54.4%), respectively; 249 (69.71%) dentists who had knowledge about forensic dentistry stated that they received this information during their formal training. The percentage of dentists who were aware of the existence of an organization of a disaster response operation in Turkey was 74.2%, but only 20.5% (n=110) had knowledge about DVI. We found that 92.9% (n=104) of these dentists believed that dentists should be included in the team for the identification of disaster victims. On the other hand, only half (52.3%) of the dentists with knowledge of DVI wanted to work on the identification teams. The majority (99.1%) considered DNA analysis to be the safest method for identification. CONCLUSION: Our findings show that, although dentists know about the identification process, they do not have enough relevant knowledge. (Disaster Med Public Health Preparedness. 2019;13:533-538).

[Results of the assessment procedure for dentists with a foreign degree in the Netherlands]. / Resultaten van de toetsingsprocedure van tandartsen met een buitenlands diploma.

During the period from 1 January 2007 to 1 January 2017, 138 dentists with a foreign dental degree (obtained outside the European Economic Area or Switzerland) who wanted to practice dentistry in the Netherlands have undertaken the assessment procedure to obtain a certificate of professional competence. The procedure comprises a Dutch language proficiency and communications test, followed by tests of competence specific to the dental profession. For 68 dentists (49%), no deficiencies in knowledge or skills were identified. They could register in the BIG-register [for healthcare professionals] for the supervisory period. For 49 (36%), the deficiencies could be eliminated with specific training. In the case of 21 dentists (15%), training was not possible. The number of dentists from this group who were enrolled in the BIG-register in 2017 was determined. On the reference date, 100 dentists (73%) were enrolled. Of the 49 dentists who were permitted to participate in a specific educational programme, 48 had started such a programme: 38 had completed it by 2017, 9 are still actively involved, and 1 stopped the programme. If they complete the programme, the number of dentists who have been enrolled in the BIG-register after [successfully] finishing the assessment procedure could rise to 115 (83%).

Calibration of dentists for Caries Management by Risk Assessment Research in a Practice Based Research Network - CAMBRA PBRN.

BACKGROUND: To prove that Caries Management by Risk Assessment (CAMBRA) can be successfully implemented in dental practices outside of the university setting, dentists in the San Francisco Bay Area (CA) were approached to participate in a Practice Based Research Network (PBRN) study. The overall goal of the CAMBRA-PBRN study was to recruit 30 dentists to perform a two-year study involving approximately 900 patients. Goal of the calibration study was to standardize and calibrate dentists potentially participating in the CAMBRA-PBRN study. METHODS: To minimize inter-examiner variability in data collection, including classification of carious lesions and recording of existing restorations, participating dentists were trained and calibrated in accurate DMFS (decayed, missing, filled surfaces) charting. Dentists were also trained and calibrated to diagnose and differentiate between sound surfaces and non-cavitated caries lesions (International Caries Detection and Assessment - ICDAS scores 1 and 2) for posterior occlusal surfaces. Thirty dentists were calibrated to a single gold standard examiner (BJ) during 6 calibration sessions, between 2011 and 2014. Kappa statistics were used to determine inter-examiner reliability on 13 or more patients, aged 12-63 (average age 38 ± 15 years), per examiner during each session, resulting in 94 patient encounters over the course of all 6 sessions. To participate in the main study, examiners needed to achieve a minimum required kappa of 0.75. During the calibration process, examiners scored between 1036 and 2220 tooth surfaces. RESULTS: The kappa values (unweighted kappa) of the participating dentists compared to the gold standard examiner ranged from 0.75 to 0.90, with an average kappa of 0.84 ± 0.03. 90% of the examiners achieved overall kappa values above 0.8. However, separate reliability for assessment of non-cavitated lesions, as in other studies, was lower (0.55 ± 0.15). Multiple subcategories were evaluated. All dentists reached sufficient reliability values to proceed into the study; nevertheless, one dentist discontinued with the study due to scheduling conflicts. CONCLUSIONS: The high inter-examiner reliability results have shown that dentists who work in primarily non-research based practices can be effectively standardized and calibrated in data collection, based on specific guidelines created to anticipate potential research study scenarios.

Implications of WHO Guideline on Sugars for dental health professionals.

The burden of oral disease is high in populations across the world. This is because of high consumption of free sugars. The WHO Guideline on Sugars Intake for Adults and Children recommended limiting free sugars to no more than 5% energy intake to protect oral health throughout the life-course. The objectives of this paper are to consider the implications of the Guideline for dental health practice and to advocate use of the common risk factor approach when providing dietary advice. As part of a broad range of actions needed to reduce free sugars intake, improved education for dental health professionals and supporting patients to eat less free sugars are key actions for the dental profession. All dental health professionals should have the skills and confidence to provide their patients with healthier eating advice, including how to limit free sugars intake. It is therefore important that dental health professionals receive adequate education in diet and nutrition, and there is a need for dental educational regulating bodies to define the content of the dental curriculum with respect to nutrition. All patients, or their parents or carers, should receive dietary advice to reduce free sugars within the context of a healthy diet for the prevention of all NCDs. Dietary advice should: (i) focus on reducing the amount of free sugars consumed; (ii) be tailored according to the patient's body mass status (eg underweight, overweight, normal weight); (iii) encourage the consumption of fresh fruits and vegetables, nuts, seeds, and wholegrain starch-rich foods; (iv) discourage the consumption of foods high in saturated fat and salt; and (v) discourage the consumption of all drinks containing free sugars. The dental health professional has an opportunity to support patients to reduce their intake of free sugars-such advice and support will have positive impacts beyond the mouth.

Practice Of Endodontic Re-Treatment In Four Cities Of Pakistan.

BACKGROUND: Root canal re-treatment is the procedure of choice when the primary root treatment fails but patient is inclined toward salvage of the tooth. The re-treatment is often a challenging procedure owing to lack to the predictability in the outcomes. Since, there is a no single way of planning and executing such procedure, a study was planned to assess the knowledge, attitude and practice regarding endodontic re-treatment among Pakistani dentists. The effect of clinical experience on the re-treatment planning was also determined. METHODS: A survey was conducted by distributing a questionnaire among 240 dentists practicing in four major cities of Pakistan. Frequency distribution of the gender, experience, designation of the participants etc. was determined. A case scenario was also shared and responses upon decision making were noted. Chi square test was applied to see if re-treatment decision of experienced dentists (>5 years' practice) was significantly different than less experienced dentists. RESULTS: Out of 240 forms, 160 were received (response rate of 66.67%). The most commonly reported reason for endodontic re-treatment was under prepared/ under filled canals. Nearly 40% participants reported doing re-treatment with hand instruments only and 15% did not employ any solvent during re-treatment. There were no significant differences between the less experienced and the more experienced dentists on re-treatment decisions. CONCLUSIONS: Almost half of the dentists reported inappropriate decision making in re-treatment. This shows that in endodontic re-treatment practice in major cities of Pakistan falls short of internationally accepted standards. There is a significant difference in treatment planning done by more experienced dentists compared to ones with <5 years' clinical experience.