Cross-infection and infection control in dentistry: Knowledge, attitude and practice of patients attended dental clinics in King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Knowledge, Attitude, and Practice of Standard Infection Control Precautions Among Medical Students at King Khalid University Hospital

Background Healthcare-associated infection (HAI) risk extends beyond patients to healthcare workers and medical students. However, many HAIs are preventable by adhering to standard infection control precautions (SICPs). This study assesses medical students' knowledge, attitudes, and practices regarding SICPs at the College of Medicine, King Saud University. Methodology A cross-sectional study was undertaken at the College of Medicine, King Saud University, Riyadh, Saudi Arabia, involving interns and medical students from years 1 to 5. The researchers constructed and validated an electronic questionnaire, which was used for data collection from December 2022 to June 2023. The estimated sample size was 371 students and interns, stratified by sex and educational level. The data collected included demographic characteristics, knowledge, attitudes, and practices regarding SICPs. Results Out of 371 participants, approximately a quarter (25.1%) had a good knowledge score, 25.6% had a positive attitude, and 26.7% had good infection control practice. There was an association between good knowledge and male gender; being in clinical years 3, 4, 5, and interns; and attending infection control training (p < 0.05). A significant difference in practice was noted among females (p = 0.002). Conclusions This study showed low-to-moderate knowledge, attitude, and practice toward SICPs. These findings indicate a gap between the recommended guidelines and their implementation in healthcare settings, highlighting the necessity for integrating infection control education throughout the medical curriculum. Further research involving a larger sample from multiple institutions is warranted.

Assessment of infection control in oral radiology during the COVID-19 outbreak: An international collaborative study

Purpose

In the context of COVID-19, studies evaluating the adherence of dentists and dental students to infection control are relevant due to their high occupational exposure and risk, as well as their responsibility for disseminating information and good practices. This study evaluated the adherence of dentists and dental students to infection control in the oral radiology field in the setting of the COVID-19 pandemic on different continents.

Materials and Methods

This cross-sectional observational study involved individuals who performed intraoral radiographic examinations during the COVID-19 pandemic. The Questionnaire on Infection Control in Oral Radiology was administered virtually using a Google Form. Participants from different continents (the Americas, Africa, Europe, Asia, and Oceania) were recruited. Data were subjected to descriptive analysis and simple and multiple binary regression (5%).

Results

There were 582 valid answers, and 68.73% of the participants were from the Americas, 18.90% from Europe, and 12.37% from Asia. The median score for infection control protocols was 94 points for dental students and 104 points for dentists, and participants below the median were considered to have low adherence to infection control in oral radiology. Low access to infection control was found for 53.0% of dentists in the Americas, 34.0% from Europe, and 26.9% from Asia.

Conclusion

The adherence to infection control protocols in oral radiology was low even in the face of the COVID-19 pandemic. The results may help improve the awareness of students and professionals, since oral radiology routines have the potential for transmitting COVID-19.

Factors associated with nurses' attitudes for providing oral care in geriatric care facilities: a cross-sectional study

BACKGROUND

The world's population is getting older. This issue is accompanied by a rise in the number of older people suffering from dementia and disability, for whom oral hygiene care is challenging. Nurses' attitudes toward providing oral care (POC) are critical for the elderly, while few studies have investigated the determinant factors of nurses' attitudes by identifying the current work pressure, resilience and self-efficacy in geriatric care facilities (GCFs). It is of great significance to explore the nurses' attitudes toward POC and associated influencing factors related to psychological aspects including resilience, self-efficacy, and stress from the workplace.

METHODS

Attitudes for Providing Mouth Care (A-PMC) in Chinese version were used in this cross-sectional study with 160 nurses in 2 GCFs. Data were collected using online questionnaires and analyzed by multiple linear regression analysis. Statistically significant values were considered at p < 0.05.

RESULTS

A total of 160 nurses participated in this study, with an average age of 32.86 ± 7.43. The mean score for the A-PMC was 2.81 ± 0.47. The score of A-PMC was negatively correlated with work pressure (r=-0.332, p < 0.01), and positively correlated with resilience (r = 0.735, p < 0.01) and self-efficacy (r = 0.425, p < 0.01) respectively. Multiple linear regression analyses identified that the potential influencing factors of A-PMC were education background, work hours every shift, self-efficacy, work pressure and resilience.

CONCLUSIONS

The study results indicate nurses' attitudes regarding PMC were at a low level, which is influenced by many factors. To improve nurses' attitudes toward PMC and the oral hygiene (OH) of the elderly in GCFs, it is necessary to increase nurses' education and training, establish a reasonable and effective incentive mechanism to improve nurses' work motivation and other intervention measures to reduce work pressure.

Knowledge, Attitude and Practice towards COVID-19 Pandemic among Patients Attending Dental Outpatient Department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India

Background

The 2019 coronavirus disease (COVID-19) is an extremely contagious illness that spreads mostly via the dentistry practice. Patients in need of dental care are at a higher risk of becoming infected with and becoming carriers of the illness.

Aim

To assess the COVID-19-related knowledge, attitude, and practice (KAP) of patients visiting dental outpatient department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India.

Materials and Methods

In this cross-sectional study, patients visiting dental outpatient department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India were included. The questionnaire had four sections including demographic information, knowledge, attitudes, and practice in relation to COVID-19. Along with computation of descriptive statistics, data analysis was performed using unpaired t-test.

Results

A total of 332 people took part in the research. The female respondents were higher in number (53.01%) and the highest percentage of the respondents belongs to the age group 18-40 years (55.72%). Nearly, 98% of respondents were vaccinated. The highest percentage of KAP level was recorded for knowledge (74.95%) followed by that of attitude (50.84%) and practices (37.05%).

Conclusion

While respondents' overall knowledge was high but their enthusiasm for taking preventative measures was low, and their efforts to stem the pandemic were lagging at best. Future campaigns should focus more on reaching out to marginalized populations, such as those with less education or higher poverty rates.

Evaluation of Effective Chloramine-T Concentration to Be Incorporated in Dental Stone for Antimicrobial Activity

Objective The objective of this study was to determine the antimicrobial activity of type III gypsum at three different chloramine-T concentrations and to ascertain the most effective concentration to be added for optimum inhibitory activity against Candida albicans. Method Ten discs of type III gypsum were fabricated for each group. Standard type III gypsum without any disinfectant was used for the control group. For the experimental group, an admixture of chloramine-T and standard dental stone was employed in varying w/w concentrations (0.1%, 0.25%, and 0.5%). Discs were placed in a petri dish containing Sabouraud dextrose agar lawned with Candida albicans culture and incubated for 24 hours. The zone of inhibition created around the discs was measured and evaluated. Result The mean zone of inhibition (mean ± standard deviation) in the control group was 0 mm; 0.70±1.05 mm in group 1 (0.1% w/w concentration), 2.70 ± 2.35 mm in group 2 (0.25% w/w concentration), and 20.80 ± 1.68 mm in group 3 (0.5% w/w concentration). A one-way ANOVA test showed that there was a significant difference in the inhibition zone created around all groups (p < 0.05), with the discs of group 3 yielding the most positive results. Conclusion The addition of 0.5% chloramine-T to type III gypsum showed the most promising result, out of the concentrations tested, as a self-disinfecting dental stone and could be used for further investigations.

A Cross-Sectional, Questionnaire-Based Survey on Air Infection Control among Romanian People

(1) Background: Infection control should be one of the main objectives in the comprehensive medical approach. (2) Methods: A cross-sectional study was conducted from June-July 2022. A questionnaire including 22 questions with multiple answers was applied online to 202 subjects selected at random. The questionnaire collected data on the subjects' knowledge about protective measures against airborne infections. For this study, a descriptive statistic was performed. Pearson's Chi-square test was used for data comparison. (3) Results: Only 61.39% (124) of the subjects consider that protective equipment is mandatory for the dental team, 40.10% (81) know to a very large extent and 44.06% (89) to a large extent that when talking, a respiratory infection can be transmitted. A rather large percentage of the subjects take into account the cost of the protective mask to a very large extent 39.60% (80). Only 30.20% (61) of the subjects would vaccinate to a very large extent and 24.75% (50) to a large extent against micro-organisms transmitted by air p > 0.05. (4) Conclusions: Most people know the aspects related to air decontamination, the priority being the promotion of control methods of airborne infections, and it is necessary to improve the level of knowledge on a large scale within the population.

Child and parent preferences for the appearance of dentists with respect to personal protective equipment in paediatric dentistry

BACKGROUND

Personal protective equipment (PPE) gained particular importance during the COVID-19 pandemic.

AIM

To assess child and parent preferences for dentists' appearance concerning their PPE and to determine the relationship between the child and parent preferences.

DESIGN

A total of 250 children aged 6-12 years and their parents were enrolled in the study. Standardized pictures with different sexes, attires, eye protectors, hair protectors, masks, and gloves were shown to children and their parents separately, and they were asked to choose their preferences. The dental anxiety of the children and their parents was determined using the MCDAS_f and MDAS, respectively. Decayed, missing, and filled tooth (DMFT) indices were employed for the children.

RESULTS

Children and parents preferred a dentist of the same sex as themselves (p < .05). Anxious children preferred cartoon-printed attire, and children with low anxiety mostly preferred white coats (p = .001). Children who preferred colored coats had higher DMFT (p < .001). Statistically significant differences were found in the attire and glove preferences between children and parents (p < .001).

CONCLUSIONS

The production of white and child-friendly fluid-resistant disposable gowns should be considered. PPE with colored or cartoon print was preferred under the influence of factors that could positively affect anxiety.

Impact of the COVID-19 pandemic on dental hygiene students in the Italian region of Emilia-Romagna

BACKGROUND

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new coronavirus detected in China at the end of 2019. Because SARS-CoV-2 is highly infectious due to contamination in the air, there is a high risk of infection in the dental environment which is represents a serious problem for professionals and students (dentistry and dental hygiene). In Italy, since February 23, 2020, the government has suspended all teaching activities of schools and universities.

METHODS

An anonymous questionnaire was administered to the students of the degree courses in Dental Hygiene of the Emilia Romagna Region, one of the most affected regions in Italy. The survey was intended to highlight the practical and emotional consequences of the emergency of COVID-19 on educational activities and in the training of students.

RESULTS

The survey was sent to the 150 students enrolled in the universities of Bologna, Ferrara and Modena and Reggio Emilia; 141 of them completed it (94%). Since the start of the COVID-19 pandemic, several surveys have been proposed to measure the impact of this emergency situation on dental professionals; at present, however, there are still no assessments for dental hygiene degree courses, in particular aimed at assessing the psychological impact on students.

CONCLUSIONS

Students consider the dental hygienist as a risky profession, while the risk taken by patients is considered as low. Given the concern reported the students, it would be useful to address the issue of proper assessment of risk during the university training of dental hygienists.

Knowledge Level on Infection Control among Romanian Undergraduate and Postgraduate Dental Students

Background and Objectives: Infection control practices in dentistry should be continuously evaluated. The aim of the present study was to assess the knowledge of dental students from Iași, Romania about infection control in the dental office. Materials and Methods: Dental students and resident dentists attending the “Grigore T. Popa” University of Medicine and Pharmacy in Iași were randomly selected in accordance with ethical guidelines, and a cross-sectional, questionnaire-based online study was conducted. The questionnaire included 21 items about infection control in dentistry. A descriptive statistical analysis was performed, and the chi-square test was used for data comparison, with a cutoff point of 0.05 for statistical significance. Results: The study sample included 150 subjects (75.3% female and 24.7% male) with a mean age of 25.71 ± 4.54 years. Mode of infection transmission was known by 74% of the subjects, and 76% were aware of standard precautions, with significant differences by the year of study (p = 0.012, r = 0.002). A percentage of 20% of subjects knew the means of transmission of the hepatitis B virus (HBV) (p = 0.032, r = 0.166). Most of the subjects were not vaccinated against HBV (p = 0.002, r = −0.274). Notions of high-level disinfection and sterilization were confused by 19.5% of the subjects. Only 22% of the subjects knew the correct processing of handpieces (p = 0.048, r = −0.071). The sources of information were diverse for 64.66% of the respondents, while 31.33% of them used courses and seminars only. Conclusions: There is a need for improvement in the level of knowledge on infection control for both dental students and residents.

Bibliometric Analyses of Global Scholarly Output in Dentistry Related to COVID-19

Objective

The aim of this study was to evaluate the bibliometric profile of dental scientific production related to coronavirus disease-2019 (COVID-19) in Scopus (2019-2020).

Materials and Methods

This was a descriptive, observational, comparative, and retrospective study. All manuscripts on COVID-19 in dentistry were published between December 2019 and December 2020. The variables were measured objectively through Scopus (SciVal). For the extraction of the manuscripts, the following keywords were used: "Covid-19" and "Dentistry" with its multiple MeSH terms using the Boolean operators "OR" and "AND". On June 14, 2021, 843 manuscripts corresponding to the period January 2019 to December 2020 were downloaded, normalized, and refined through metadata analysis.

Results

The largest number of manuscripts was published in the International Journal of Current Research and Review, Oral Oncology, Oral Diseases, British Dental Journal, and Journal of Dental Education with 54, 50, 49, 48, and 44 manuscripts, respectively. These are the most productive indexed scientific journals on COVID-19. The most productive institutions were Saveetha University, Universidade de São Paulo, and King's College London, with 42, 33, and 27 manuscripts, respectively. In 2019, there were only two scientific publications on COVID-19. In 2020, the largest amount, 228 manuscripts, were published in Q1 journals, followed by 210 manuscripts in Q3 journals, and only 194 manuscripts were published in Q4 journals.

Conclusions

Currently, there is a notable increase in global academic production in Scopus on the impact of COVID-19 in dentistry, whereas Brazil is the only South American country with three highly productive universities.

Rate of compliance with infection control practices while taking dental radiographs in a dental health care center, Saudi Arabia

Background:

Infection control guidelines are aimed at preventing cross-contamination in clinical settings. Radiographs are indispensible part of oral diagnosis and assessing prognosis. Strict adherence to infection control protocol while taking dental radiographs are mandatory.

Aims and Objectives:

To assess the rate of compliance with infection control practices while taking dental radiographs in the dental clinic center of a teaching institution in Saudi Arabia.

Materials and Methods:

An observational study was undertaken for the infection control practices in the dental radiology wing of a university teaching center in Saudi Arabia. Data were collected from dental faculty, dental assistants, and dental students working in dental clinics. Both pretested questionnaire and by direct observation of infection control practices was used for data collection. Chi-Square test for categorical variables and Independent samples t-test for compare mean self-reported infection control practice scores were used. Binary logistics regression was used to identify the factors influencing participant's compliance with infection control practices. P ≤ 0.05 was considered statistically significant.

Results:

129 participants were included in this study, among those 26 were faculty, 19 were dental auxiliaries and 84 were dental students. On direct observation, the overall compliance rate was 79.5%; Dental auxiliaries have the highest compliance rate (94.5%) followed by dental faculty (88.5%) and students (68.6%). Binomial logistic regression predicted that females had 2.94 times more compliance than male counterparts, which is statistically significant.

Conclusion:

Students and faculty need continuing dental education programs for reinforcement on infection control practices.

Knowledge of Patients Regarding Infection Control in Dentistry: Development and Validation of a New Questionnaire

Objectives: Assessment of patients' knowledge regarding infection control in dentistry can help professionals in the development of protocol planning to minimize the risk of disease transmission through dental procedures. The aim of this paper is to assess the knowledge level about infection control of patients presenting to the dental clinic of the School of Dentistry, Tehran University of Medical Sciences in 2020. Materials and Methods: The draft of the questionnaire was designed with eight domains regarding infection control in dentistry including the coronavirus disease-2019 (COVID-19). The content validity of the questionnaire was assessed by six experts and 10 laypersons. The reliability of the questionnaire was assessed by the test-retest method. Two-hundred and forty-four patients (over 20 years of age) were selected based on non-random convenience sampling method, and participated in this study in July 2020. According to the difficulty coefficient, differential coefficient, and the opinion of the experts about the questionnaire filled out by the participants, 24 questions were selected out of 43 for the final version. Results: The intra-rater reliability indices were ≥75% and the scale-content validity indices for relevance, simplicity, and clarity were 87.80%, 93.75% % and 93.33%, respectively. The knowledge score of patients was 76.83%±11.58% which was not correlated with the level of education, age or gender (P>0.05). Conclusion: The knowledge level of patients presenting to the dental clinic of Tehran University of Medical Scineces measured by a valid and reliable researcher-made questionnaire was acceptable about infection control.

Emotional Health Status of Postgraduate Students of Periodontics in India During COVID Health Crisis-A Questionnaire-Based Study

Dental students, especially postgraduate students present a higher risk of getting infected because of their close contact with the patients during this pandemic. The objectives of the study include (a) the reasons for postgraduate students’ altered emotional status during coronavirus (COVID-19) infection. (b) To assess the kind of infection protocols adopted. (c) To assess the impacts of postgraduate students’ emotional status on treating patients with periodontal problems during the COVID-19 lockdown period from March 2020 to December 2020. The emotional status of postgraduate students was assessed in 2 phases that are at the initial phase of COVID infection and lockdown and the second phase when the lockdown was prolonged. Questionnaires were distributed to the Postgraduate students of periodontics all over India to assess their level of awareness of COVID infection, type of infection control measures followed during the pandemic period, as well as the outpatient turnout during the lockdown period. Results of this study stated that more than 80% of students addressed the decline in the number of patients to surgical clinics, 76.3% of postgraduates were worried about themselves and their families due to the pandemic situation. Surprisingly, 74.3% of them even worried about losing their expertize or skills due to a long lockdown period. Dental postgraduates all over India are willing to treat their patients during the period of a pandemic but in strict compliance with infection control guidelines. This study assessed the emotional responses of the postgraduates during the pandemic through the questionnaire and concluded that all the professionals are ready to resume their clinical activities with adequate guidelines provided.

Knowledge, Attitude and Practice of Standard Infection Control Precautions among Health-Care Workers in a University Hospital in Qassim, Saudi Arabia: A Cross-Sectional Survey

Hospital-acquired infections (HAIs) contribute to increased length of hospital stay, higher mortality and higher health-care costs. Prevention and control of HAIs is a critical public health concern. This study assessed the knowledge, attitude, and practice (KAP) of standard infection control precautions among health-care workers (HCWs) in Qassim, Saudi Arabia. A cross-sectional online survey among HCWs was conducted using a structured questionnaire. Predictors of KAP were investigated using multivariate logistic regression analyses and independent sample t-tests. A total of 213 HCWs participated in the survey. The prevalence of good (≥80% correct response) knowledge, attitude, and practice were 67.6%, 61.5%, and 73.2%, respectively. The predictors of good knowledge included the age of the HCWs (>34 years) (adjusted odds ratio: 30.5, p < 0.001), and training (13.3, p < 0.001). More than 6 years of work experience was a significant predictor of having a positive attitude (5.5, p < 0.001). While the predictors of good practice were having >6 years of experience (2.9, p < 0.01), previous exposure to HAIs (2.5, p < 0.05), and training (3.5, p < 0.01). However, being female (0.22, p < 0.001) and older (>34 years) (0.34, p < 0.01) were negatively associated with knowledge. Results indicate that arranging training for HCWs might be useful in improving their knowledge of standard infection control precautions and is also expected to facilitate positive attitude and practice.

Alsalhani A, Alqhtani NR, Bin Nabhan A, Alenzi A, Alrafedah A. COVID-19-Awareness and Practice of Dentists in Saudi Arabia

Dental professionals have a major role in the fight against the spread and transmission of COVID-19. This study aimed to evaluate awareness and practice of dentists in Saudi Arabia regarding COVID-19 and the utilization of infection control methods. A 24-item questionnaire was developed and distributed through social media to 627 dentists working in Saudi Arabia. 177 questionnaires were completed (28.2% response rate). Most dentists were aware about the transmission, incubation time and main clinical symptoms of COVID-19. Almost 83% of the respondents appreciate the risk of droplets, aerosols and airborne particles in transmission of COVID-19 in the dental clinic. Among the common practices of participants are measuring patient’s body temperature before undertaking a dental treatment (88.7%), cleaning the environmental surfaces at the dental clinic after each patient (91.5%) and restriction of dental treatment to emergency cases (82.5%). It seems that practicing dentists in Saudi Arabia are fairly aware about COVID-19. The practices of the surveyed dentists appear to be mostly consistent with the current guidelines and recommendations for infection control of COVID-19 in the dental clinic. Some drawbacks in knowledge and a number of inappropriate practices can be identified and require the attention of health authorities.

Effect of education based on health belief model on observation of standard precautions by dental students in Rafsanjan in 2019

INTRODUCTION

It is vital importance to observe standard precautions (SPs) in dentistry to prevent the transfer and spread of blood-borne diseases in the community. The aim of the present study was to evaluate the effect of educational intervention using health belief model (HBM) on the observation of SPs by dental students in 2019.

MATERIALS AND METHODS

Eighty-seven dental preclinical students were included in the present quasi-experimental study. The students were randomly assigned to two groups, and data were collected using a questionnaire designed based on HBM. Educational intervention was carried out after the pretest analysis in four 60-min sessions. Data were analyzed with independent t-test and paired t-test using SPSS 16 at a significance level of P < 0.05.

RESULTS

After the educational intervention, the mean score of awareness (P = 0.001), perceived susceptibility (P = 0.01), perceived severity (P = 0.02), perceived benefits (P < 0.001), cues to action (P = 0.006), self-efficacy (P = 0.002), and behavior (0.03) in the intervention group was significantly increased.

CONCLUSION

Despite the effect of education on increasing the students' scores in HBM constructs and observation of SPs, the most important barriers to the adoption of precautionary behaviors were deficiencies in protective tools and aids.

Knowledge, Attitudes, and Practices of Dental Patients Toward Cross-Infection and Economic Implications in View of Covid-19: An Online Survey

Aim:

To assess the knowledge, attitude, and practices of the patients regarding cross-infection in dental clinics in view of COVID-19, and its economic implications.

Materials and Methods:

The present study is a cross-sectional online survey done using Google Forms tool which was shared amongst 501 participants via e-mail and various social media platforms. It consisted of 42 structured questions regarding sociodemographics (seven questions), knowledge of COVID-19 (seven questions), practices regarding COVID-19 preventive methods (five questions), knowledge regarding cross-infection in dental clinics (nine questions), attitudes toward infection in dental clinics, and increased cost of treatment due to added disinfection protocols (14 questions). All the associations were tested using the chi-square test and with the P-value set at <.05. The significance level was taken as α = 0.05; therefore, a difference or association with P-value <.05 was considered statistically significant. The linear regression model was used to relate demographics with the knowledge attitude practices items, and Pearson’s correlation coefficient was used to evaluate the correlation between knowledge, attitudes, and practices.

Results:

A total of 478 responses were assessed. 92.2% of the respondents had high knowledge regarding COVID-19, and only 48.1% had a high knowledge score regarding infection control in dental clinics. The respondents exhibited high scores for practice related to COVID-19 (83.9%) and attitude toward infection control in dental clinics (91.9%). Using the Pearson’s correlation coefficient, knowledge attitude practices variables showed a significant correlation amongst each other ( P < .001). Only 60% responded that extra infection control protocols will increase the treatment charges, and approximately 30% responded that they will not pay or were not sure of paying the extra charges. The proportion of respondents who were agreeing about paying the increase cost were independent of age ( P = .226), gender ( P = .328), education ( P = .085), and profession ( P = .121).

Conclusion:

A significant percentage of patients today have a lot of knowledge of COVID-19. Also, they have higher expectations than before from their dental health care providers regarding infection control.

Factors Associated with Infection-Control Behavior of Dental Health-Care Workers During the COVID-19 Pandemic: A Cross-Sectional Study Applying the Theory of Planned Behavior

OBJECTIVE

The objective of this study was to evaluate the usefulness of the extended theory of planned behavior (TPB) in predicting COVID-19-infection prevention and control (IPC) among a sample of dental health-care workers (DHCWs) in Saudi Arabia and to examine their behavioral beliefs, normative beliefs, and control beliefs to better understand their views about COVID-19 IPC.

METHODS

An online cross-sectional survey was administered among DHCWs in Saudi Arabia using convenience sampling. A questionnaire collected data on demographic characteristics and the 43 items from the TPB construct. One-way ANOVA and Independent sample t-tests were used to establish factors associated with TPB-construct scores. Multiple regression analyses with adjusted effects were used to identify significant predictors for intention from attitudes, subjective norms, and perceived behavioral control variables. The significance level was set at 0.05.

RESULTS

A total of 324 study participants completed the questionnaire for a response rate of 40.5%. The majority of respondents were male (59.8%) and aged 25-30 years (32.7%), followed by 31-35 years (31.2%). Only 28.4% reported having participated in IPC activities. With a mean of 41.60±6.26), it was evident that study participants had a favorable attitudes toward COVID-19 IPC. Subjective norms and perceived behavioral control subscale scores were low, with the means of 28.95±5.44) and 34.89±6.49), respectively. The constructs of attitude toward behavior (p<0.001) and subjective norms (p<0.001) significantly predicted the DHCWs' intention to practice COVID-19 IPC behavior, accounting for 44.3% of the variance.

CONCLUSION

The current study suggests that the attitudes and subjective norms of DHCWs significantly predicted their intentions regarding COVID-19 IPC behavior. As such, it is recommended that comprehensive education and training programs on infection control pertaining to COVID-19 be implemented among DHCWs in Saudi Arabia so that their attitudes and behavior toward infection prevention are amplified.

COVID-19 and Infection Control in Dental Clinics; Assessment of Public Knowledge, Attitudes and Practices in Several Regions of Saudi Arabia

Background:

The recent outbreak of the Corona Virus Disease (COVID-19) has affected millions of lives in different countries including the Kingdom of Saudi Arabia. Due to the characteristics of dental practice settings, there is a high risk of infection transmission between patients and dentists.

Objectives:

The aim of this study was to assess the level of public knowledge, attitude and practice regarding COVID-19 and infection control when visiting a dentist.

Methods:

In April 2020, a web-based cross-sectional survey was distributed randomly among the public through social media platforms. A validated anonymous questionnaire was used to assess knowledge about COVID-19 and participants’ attitudes toward extra measures to prevent the spread of infection.

Results:

Among the completed questionnaires (N=521), the mean age of the participants was 36.24 years, 68.3% were women, 87.5% held a university degree, and 81% were from the Makkah region. Most of the participants (99%) obtained a good knowledge score regarding COVID-19. Women were more likely than men to have more knowledge (p<0.05). Nearly all of the participants (99.6%) demonstrated good attitudes towards precautionary measures in dental clinics.

Spearman’s rho test showed a statistically significant correlation between age and attitude score, suggesting that attitude score increased with age (p<0.05). Overall, 73.3% reported that they would maintain good hygiene practices when visiting a dentist during this pandemic.

Conclusion:

Most Saudi residents with a high education level are knowledgeable about COVID-19, hold promising attitudes, and have appropriate practices towards precautionary measures needed while visiting a dental clinic during the virus outbreak.

Patient safety in dental care: an integrative review

Adverse events pose a serious problem for quality of healthcare. Dental practice is eminently invasive and involves close and routine contact with secretions; as such, it is potentially prone to the occurrence of adverse events. Various patient safety studies have been developed in the last two decades, but mostly in the hospital setting due to the organizational complexity, severity of the cases, and diversity and specificity of the procedures. The objective was to identify and explore studies on patient safety in Dentistry. An integrative literature review was performed in MEDLINE via PubMed, Scopus via Portal Capes, and the Regional Portal of the Virtual Health Library, using the terms patient safety and dentistry in English, Spanish, and Portuguese, starting in 2000. The research cycle in patient safety was used, as proposed by the World Health Organization to classify studies. We analyzed 91 articles. The most common adverse events were allergies, infections, diagnostic delay or failure, and technical error. Measures to mitigate the problem highlight the need to improve communications, encourage reporting, and search for tools to assist the management of care. The authors found a lack of studies on implementation and assessment of the impact of proposals for improvement. Dentistry has made progress in patient safety but still needs to transpose the results into practice, where efforts are crucial to prevent adverse events.

Development of a sustainable photocatalytic process for air purification

Nowadays, air pollution has become a global menace being responsible of a significant increase on the morbidity and mortality of human beings. In view of this, sustainable and efficient technologies for air purification are being sought. Air purification by photocatalytic treatment has received a lot of attention due to the unspecific and high oxidation capacity of the catalyst; however still some variables must be optimized to assure practical applications. In this work, visible light active TiO₂-Cu²⁺@perlite and Ag@TiO₂-Cu²⁺/perlite supported materials were fabricated. TiO₂-Cu²⁺ (2 at. %) were synthesized using a sol-gel procedure followed of the impregnation of the support by immersion. For Ag@TiO₂-Cu²⁺, silver deposition was conducted by chemical reduction using sodium citrate and sodium borohydride. The materials (powders and supported materials) were characterized by Scanning Electron Microscopy (SEM) to demonstrate their small size and adherence to the substrate. A prototype of a photocatalytic air purifier was built. The efficacy of the prototype was evaluated for the disinfection of indoor air (dentistry clinics). The photo-catalyst was activated using visible and UVA low-cost high-energy LEDs. The antibacterial activity of the air filter was evaluated. Ag@TiO₂-Cu²⁺ exerts better air disinfection activity at lower doses in comparison to TiO₂-Cu²⁺. Bacterial growth inhibitions up to 99% were achieved for both, Gram-negative and Gram-positive bacteria. The incorporation of Ag and Cu to TiO₂ improves the antibacterial activity of the materials due to enhanced photocatalytic activity and the synergic activity of TiO₂ and dopant elements (Ag, Cu) to inhibit microorganism's growth.

A Survey on Perceived COVID-19 Risk in Dentistry and the Possible Use of Rapid Tests

AIM

The present study was conducted to assess the perceived risk of COVID-19 transmission in dental professionals (DPs), that include dentists and dental auxiliary staffs, and whether rapid tests should be a recommended tool to constrain the transmission of the COVID-19, and who should be bearing their cost (governments, dentists, or patients) through an online survey.

MATERIALS AND METHODS

A sample size of n = 700 was recruited in the study. The study included DPs from all over the world. A randomized selection of samples was done through dental groups present on social networks. An online survey was conducted in April 2020, using the Google Form software to provide questions and collect and elaborate answers. Data were analyzed using the statistical software STATA and presented in terms of percentages.

RESULTS

About 78% of the study participants perceived a very high risk of COVID-19 contamination in dental settings. Nearly 80% of the study participants were willing to be subjected to rapid tests and the same could be performed on patients visiting their dental clinics, which could prevent the spread of the disease. About 55% of the participants had reported that additional costs for the rapid tests should be borne by the governments.

CONCLUSION

The results of the present survey report that DPs do not feel safe and perceive a high risk of COVID-19 contagion and prevention of the disease could be done by performing rapid tests on dentists, dental staff, and patients visiting the dental clinics irrespective of age and gender of the participants.

SIGNIFICANCE

Since all the dentists and allied staff have perceived increased risk for COVID-19 transmission, it is important that preventive measures are implemented through rapid test kits at the earliest.

Perceptions of obstetricians and pediatricians about the risk of COVID-19 for pregnant women and newborns

Objective

To assess the perception of obstetricians and pediatricians about risks of COVID‐19 to pregnant women and possible complications in newborns.

Methods

A structured 27‐item online survey was sent via social media messaging to obstetricians and pediatricians from public, academic, and private sectors in Jordan between March 23–30, 2020. Descriptive statistics were used to represent numbers and percentages of participants’ responses to survey items.

Results

A total of 147 physicians participated (107 obstetricians, 40 pediatricians). Participants were well informed about the symptoms, diagnosis, modes of transmission, and methods of prevention. Participants had variable perceptions about COVID‐19 risk during pregnancy, including potential vertical transmission, preferred route of delivery, and safety of breastfeeding. Most participants felt that pregnant women should be prioritized for testing and medical care provision.

Conclusion

While evidence‐based strategies to reduce the risks of COVID‐19 in pregnant women and newborns are evolving, healthcare providers showed excellent knowledge of the infection and were vigilant regarding its complications for mothers and newborns. To ensure safe pregnancy, physicians must keep informed of developing guidance on best and safest prenatal and perinatal health services. Implementing local hospital policies and adequate training in infection control measures is strongly encouraged.

Physicians are well informed about COVID‐19 transmission and preventive measures. Physicians should follow the developing guidance about the safest prenatal and perinatal health services.

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.

Awareness and Practices of Dental Students and Dentists Regarding Infection Control in Prosthodontic Clinics

Background:

Patient safety is a priority for achieving higher quality health care standards and human error> reduction.

Objective:

The aim of this study was to evaluate the level of appropriate infection control practices in a prosthodontic clinic in Jeddah, Saudi Arabia.

Methods:

This cross-sectional study included 460 dental students and dentists recruited from five centers. Data were collected by self-administered questionnaires> composed of 25 questions. The questionnaires> assessed infection control practices in prosthodontic clinics, including wearable barriers, disinfection measures among patients, disinfection of laboratory submissions, and proper infection control. Other questions assessed sources of knowledge, self-evaluation of knowledge, implementation, and satisfaction with knowledge application.

Results:

Total correct answers for proper practice (16 questions) had a mean of 12.5 with a standard deviation of 2.8. The most commonly practiced procedure was wearing a mask (99.8%) and the least was sterilizing the facebow before its use by the patient (53.7%). Participants from governmental colleges (m = 13.67, SD = 2.17) had significantly higher scores than participants from private colleges (m = 12.35, SD = 2.9),p<0.001. Only 2.8% had never attended a lecture, and only 13.8% had never had hands-on training for infection control. Despite 49.1% evaluating themselves as having very poor to poor knowledge, 90.7% had fair to very good valuation of their infection control implementations, and 87.6% were satisfied with their knowledge and performance levels.

Conclusion:

Dental students and dentists have high levels of adequate infection control practices in the prosthodontic clinic despite the moderate level of their satisfaction with their knowledge.

Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia

The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and the second highest in Europe. An anonymous online survey composed of 40 questions has been sent to dentists practicing in the area of Modena and Reggio Emilia, one of the areas in Italy most affected by COVID-19. The survey was aimed at highlighting the practical and emotional consequences of COVID-19 emergence on daily clinical practice. Specifically, it assessed dentists' behavioral responses, emotions and concerns following the Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20), as well as the dentists' perception of infection likelihood for themselves and patients. Furthermore, the psychological impact of COVID-19 was assessed by means of the Generalized Anxiety Disorder-7 test (GAD-7), that measures the presence and severity of anxiety symptoms. Using local dental associations (ANDI-Associazione Nazionale Dentisti Italiani, CAO-Commissione Albo Odontoiatri) lists, the survey was sent by email to all dentists in the district of Modena and Reggio Emilia (874 practitioners) and was completed by 356 of them (40%). All dental practitioners closed or reduced their activity to urgent procedures, 38.2% prior to and 61.8% after the DM-10M20. All reported a routinely use of the most common protective personal equipment (PPE), but also admitted that the use of PPE had to be modified during COVID-19 pandemic. A high percentage of patients canceled their previous appointments after the DM-10M20. Almost 85% of the dentists reported being worried of contracting the infection during clinical activity. The results of the GAD-7 (General Anxiety Disorder-7) evaluation showed that 9% of respondents reported a severe anxiety. To conclude, the COVID-19 emergency is having a highly negative impact on the activity of dentists practicing in the area of Modena and Reggio Emilia. All respondents reported practice closure or strong activity reduction. The perception of this negative impact was accompanied by feelings of concern (70.2%), anxiety (46.4%) and fear (42.4%). The majority of them (89.6%) reported concerns about their professional future and the hope for economic measures to help dental practitioners.

Dentists' Awareness, Perception, and Attitude Regarding COVID-19 and Infection Control: Cross-Sectional Study Among Jordanian Dentists

Background

Despite the availability of prevention guidelines and recommendations on infection control, many dental practices lack the minimum requirements for infection control.

Objective

This study aimed to assess the level of awareness, perception, and attitude regarding the coronavirus disease (COVID-19) and infection control among Jordanian dentists.

Methods

The study population consisted of dentists who worked in private clinics, hospitals, and health centers in Jordan. An online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire was comprised of a series of questions about dentists’ demographic characteristics; their awareness of the incubation period, the symptoms of the disease, mode of transmission of COVID-19 and infection control measures for preventing COVID-19; and their attitude toward treating patients with COVID-19.

Results

This study included a total of 368 dentists aged 22-73 years (mean 32.9 years, SD 10.6 years). A total of 112 (30.4%) dentists had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in dentistry, and 28 (7.6%) had attended training or lectures regarding COVID-19. A total of 133 (36.1%) dentists reported that the incubation period is 1-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of identifying patients at risk of having COVID-19, were able to correctly report known modes of transmission, and were aware of measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it was necessary to ask patients to sit far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to decrease disease transmission.

Conclusions

Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, and infection controls and measures in dental clinics. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national dental associations to all registered dentists during a crisis, including the COVID-19 pandemic, to make sure that dentists are well informed and aware of best practices and recommended disease management approaches.

An Evaluation of Staff Engagement with Infectious Healthcare Waste Management Policies: A Case Study of Tunisia

This study evaluated the engagement of staff regarding infectious healthcare waste management, in two case-study universities in Tunisia. Using a questionnaire survey, it was found that the most significant reported factors that influenced engagement were the availability of technical sheets and posters, training and education programs, and the age range of the staff. While there was some accordance with the Tunisian Decree application n° 2008–2745 of July 28th, 2008, as well as international guidelines and best practice (e.g. the use of color coded bins, waste management teams, and infection control measures), there were also limitations in the provision of training. This limitation in training and, to a lesser extent, awareness impacted on the beliefs about infectious healthcare waste management of staff and their practices. Recommendations for addressing these issues are suggested.

Management of Instrument Sterilization Workflow in Endodontics: A Systematic Review and Meta-Analysis

Endodontic treatment consists of different working procedures, such as the isolation of the operating field, pulp chamber access, and cleaning and shaping phases with at last the need of a three-dimensional filling of the canals. Each step requires a series of single-use or sterilizable instruments. We have performed a systematic review of different sterilization and disinfection procedures aiming at drawing up a disinfection and sterilization procedure to be used on endodontic instruments. A search on PubMed and Scopus was carried out using the following keywords: “endodontic sterilization,” “endodontic autoclave,” “decontamination dental bur,” “sterilization dental burs,” and “gutta-percha points sterilization.” Eligible articles were included in the qualitative and quantitative analysis. Results of the meta-analysis showed that the most effective method in sterilization is autoclaving. The qualitative analysis showed that the use of single-use or first-use instruments requires presterilization or sterilization procedures, and for reusable tools, attention must be paid to the removal of debris deposited on the blades, not easy to remove manually.

Dentistry during and after COVID-19 Pandemic: Pediatric Considerations

This article is a rumination on the outbreak of the dreaded coronavirus disease-2019 (COVID-19) pandemic which has engulfed both the developed and the developing countries, thereby causing widespread global public health concerns and threats to human lives. Although countries have made varied efforts, the pestilence is escalating due to the high infectivity. It is highly likely that dental professionals in upcoming days will come across COVID-19 patients and SARS-CoV-2 carriers, and hence must ensure a tactful handling of such patients to prevent its nosocomial spread. Despite the avalanche of information that has exploded in relation to this rapidly spreading disease, there is a lack of consolidated information to guide dentists regarding clinical management including precautions to take materials to use and postprocedure care, during and after the COVID-19 pandemic. Available sources of information have been analyzed, while relying on peer-reviewed reports followed by information available from the most respected authoritative sources, such as WHO, Centers for Disease Control and Prevention (CDC), and ADA. This review aims to provide a comprehensive summary from the available literature on COVID-19, its insinuation in dentistry, recommendations that have been published, and the actual in-practice implications, so a plan can be formulated and adapted to the circumstances of each dental practice during the pandemic and the times to follow.

Can probiotic cleaning solutions replace chemical disinfectants in dental clinics?

Objectives:

We aim to assess the antibacterial effectiveness of probiotic cleaning in a dental clinic at the University Dental Hospital Sharjah (UDHS), UAE.

Materials and Methods:

The current cleaning protocol of UDHS was evaluated by the surface swabbing of three dental clinics routinely cleaned using regular chemical disinfectants. Then, a new probiotic cleaning solution containing Bacillus subtilis was applied for 3 weeks in a selected clinic. Bacteria were grown onto selective culture media for colony counting from surfaces cleaned with probiotic solution compared to those obtained from the same surfaces cleaned with the regular chemical solutions. Isolates identity was confirmed by biochemical tests or polymerase chain reaction.

Results:

There was a significant reduction of the bacterial counts of various bacterial species (Staphylococci, Streptococci, and Gram-negative rods) from almost all the surfaces in the dental clinic after the application of the probiotic solution compared to the same surfaces cleaned with the regular chemical solutions. However, the antibiotic resistance rates were not significantly reduced within the short period of 3 weeks of using the new probiotic cleaning product.

Conclusions:

This study demonstrated that the use of probiotic cleaning is effective in reducing microbial growth in dental settings. This approach may be tested further to examine the long-term effect and to evaluate the opportunity of applying this novel biotechnology as part of the infection control routine in dental settings instead of the chemical disinfectants which are known to cause serious health problems. This is the first study testing the application of probiotic-based solution in dental settings.

Antimicrobial PHAs coatings for solid and porous tantalum implants

Biomaterial-associated infections (BAI) are the major cause of failure of indwelling medical devices. The risk of BAI can end dramatically in the surgical removal of the affected device. Therefore, a major effort must be undertaken to guarantee the permanence of the implant. In this regard, we have developed antimicrobial coatings for tantalum (Ta) implants, using polyhydroxyalkanoates (PHAs) as matrices for carrying an active principle. The dip-coating technique was successfully used for covering solid Ta discs. An original PHA emulsion flow process was developed for the coating of porous Ta structures, specially for the inner surfaces. The complete characterization of the biopolymer coatings, their antibacterial properties, toxicity and biointegration were analyzed. Thus, non-toxic, well-biointegrated homogeneous biopolymer coatings were attained, which showed antibacterial properties. By using biodegradable PHAs, the resulting drug delivery system assured the protection of Ta against bacterial infections for a period of time.

Sterilisation in Dentistry: A Review of the Literature

In a small and medium-sized dental facility, the correct management of the sterilisation and presterilisation phases plays a fundamental role in good management of instruments and personnel, in order to ensure conditions that are more efficient with less down time. Nowadays, instrument sterilizers are increasingly efficient in achieving results, both in terms of time and size, and ensure that materials are sterile and ready to be stocked in a reasonable time. A literature search for articles related to revision work was performed using electronic databases such as PubMed, Scopus, and Google Scholar. The following keywords have been entered in the previously mentioned databases: sterilisation instruments; dental autoclave; precleaning; instruments disinfectants. The records obtained were screened by three reviewers, and only relevant articles were read full text. In addition, the timings of dental and sterilisation procedures were measured, and from these, suggestions are made in order to improve the efficiency of instrumentation management (facility used as study subject: University Dental Clinic, University of Foggia) as a function of the health-care interventions. We arrived at the conclusion that without doubt, sterilisation of instruments and products plays a fundamental role, but the efficiency of the sterilisation and presterilisation procedures cannot be separated from managing the personnel in charge by giving them specific and precise tasks.

Knowledge and attitudes towards Zika virus among medical students in King Abdulaziz University, Jeddah, Saudi Arabia

Zika Virus (ZIKV) and its associated consequences remain vital public health challenge of international concerns. The current study was done to assess knowledge and attitudes towards ZIKV and the factors associated with good knowledge among medical students in King Abdulaziz University, Jeddah. A cross-sectional study was conducted among 426 students. They were selected through multistage stratified random sample method, 2016. A validated, confidential, interviewing questionnaire contained 25 knowledge and 10 attitude items was used. Descriptive and inferential statistics were done. Results revealed that Facebook was the commonest source of ZIKV information. About half of the participants correctly identified mosquito bites and vertical route as ZIKV transmission modes. However, smaller percentages recognized the sexual and blood transmission modes. Calculations of knowledge score revealed that 77.5%, 15.0%, and 7.5% of the participants obtained poor, fair, and satisfactory scores, respectively. Age, educational year and attending ZIKV training were significantly associated with good knowledge (p<0.05). Concerning attitudes, about half of the participants agreed that ZIKV could add new burden on healthcare system of the affected countries. Most of participants were interested in learning more about ZIKV, emerging diseases and travel epidemiology. In conclusion, medical students had limited knowledge about ZIKV, and good attitudes towards learning about it. Conduction of ZIKV educational programs, and development of courses about emerging disease epidemiology are required.