Assessment of artificial intelligence applications in responding to dental trauma

BACKGROUND

This study assessed the consistency and accuracy of responses provided by two artificial intelligence (AI) applications, ChatGPT and Google Bard (Gemini), to questions related to dental trauma.

MATERIALS AND METHODS

Based on the International Association of Dental Traumatology guidelines, 25 dichotomous (yes/no) questions were posed to ChatGPT and Google Bard over 10 days. The responses were recorded and compared with the correct answers. Statistical analyses, including Fleiss kappa, were conducted to determine the agreement and consistency of the responses.

RESULTS

Analysis of 4500 responses revealed that both applications provided correct answers to 57.5% of the questions. Google Bard demonstrated a moderate level of agreement, with varying rates of incorrect answers and referrals to physicians.

CONCLUSIONS

Although ChatGPT and Google Bard are potential knowledge resources, their consistency and accuracy in responding to dental trauma queries remain limited. Further research involving specially trained AI models in endodontics is warranted to assess their suitability for clinical use.

What is important to medical students' online learning of dental trauma in medical education

Traumatic dental injury (TDI), a topic not normally offered in the medical curriculum is made available through the medical school as an online learning course. Online learning provides an educational pathway for cross-disciplinary learning without any change to the existing curriculum. This research identified important key features that should be included in the design of an online course to provide a positive online learning experience for medical students. Ten important features were identified for medical educators to consider when they develop an online course to introduce dental trauma. These features are (1) prioritising information to TDI, (2) providing specific facts and information to TDI, (3) information must be easily retrieved, (4) providing career-related information, (5) promoting self-confidence, (6) promoting learning of new knowledge, (7) easy-to-understand content materials, (8) establishing a logical sequence of learning, (9) visual illustrations to complement written text and (10) promoting self-directed learning.

Management of traumatic dental injuries: a survey of paediatric emergency department health professionals

OBJECTIVE

To assess paediatric emergency department (PED) health professionals' confidence, experience and awareness in managing traumatic dental injuries (TDIs).

DESIGN

A cross-sectional online survey.

SETTING

PED at Alder Hey Children's Hospital and Birmingham Children's Hospital.

RESULTS

94 ED health professionals responded. One-third of responders (n=26) encounter children with dental trauma daily or weekly. TDI teaching during undergraduate training was received by 13% (n=12) of responders, and 32% (n=30) had never received training. Responders thought they would benefit from online resources and regular teaching on paediatric TDIs, in addition to an easy-to-use decision-making tool to signpost families.ED health professionals' confidence in giving advice to families following a TDI, and in recognising types of TDIs, was notably low; -79 and -76 Net Promotor Score, respectively.Responders' awareness of how to recognise and manage TDIs was varied. Majority were aware of the need to attempt to reimplant an avulsed permanent tooth, and the need to refer a child presenting with a complex permanent tooth injury to the oncall dentist. However, very few responders commented on the importance of follow-up. Responders also raised concerns about the lack of dental services to treat TDIs in children.

CONCLUSIONS

There is a need to enhance dental trauma teaching for all ED health professionals who encounter TDIs to increase their confidence and enable them to triage and advise patients appropriately. Additionally, increased signposting for families to the appropriate service could in turn improve outcomes and experience for children who experience a TDI.

Knowledge and Attitudes of Saudi Medical Students about Emergency Management of Traumatic Dental Injuries

Several studies indicate that physicians lack emergency management knowledge concerning traumatic dental injuries (TDIs), emphasizing the fact that medical students are not taught about this topic. This study aimed to assess the basic knowledge and attitudes of medical students in Saudi Arabia about emergency TDI management. This cross-sectional study recruited a convenience sample of medical students in their clinical years through social networking sites and asked them to answer a pretested internationally accepted questionnaire that included demographic questions, two case scenarios about crown fractures and avulsion of permanent teeth, and self-assessment questions. The data were analyzed statistically using descriptive statistics and the chi-squared test (p < 0.05). A total of 761 medical students responded. Only 5.8% of the students reported receiving information about TDIs in their curriculum. Medical students, mainly those ready to graduate, were more knowledgeable of the emergency management of a crown fractured permanent tooth than an avulsed permanent tooth (p < 0.0001). However, more than half of the students were unable to differentiate between a primary versus permanent fractured tooth and would manage an avulsed primary or permanent tooth similarly. Regarding students' attitudes, less than one-quarter of the students (13.5%) were confident about diagnosing TDIs and/or providing emergency management when required (18.1%). Furthermore, only about one-tenth of the students (9.3%) were satisfied with their self-perceived knowledge, and most (71%) reported needing further education about the topic. Medical students in Saudi Arabia have insufficient knowledge about the emergency management of TDIs. Gaps in students' knowledge of emergency management of avulsion injury were identified in addition to their low confidence level to either diagnose or immediately treat TDIs if required. Students felt dissatisfied with their current knowledge level, this being most prominent among graduating students. There is a need to elaborate the undergraduate medical curriculum in Saudi Arabia to include emergency management of TDIs.

Pediatricians' Knowledge of Emergency Management of Dental Injuries and Use of Mouthguards: A Cross-Sectional Survey

AIM

Dental injuries are one of the most frequent oral health problems in children and adolescents. This study aimed to evaluate Croatian pediatricians' knowledge and practice regarding dental injuries management and the use of mouthguards as means of protection against traumatic injuries.

MATERIALS AND METHODS

A questionnaire-based cross-sectional survey conducted among 186 pediatricians examined their demographic characteristics, knowledge and experience with dental injuries. Student t-test or one-way ANOVA, with Tukey's post-hoc were used to analyze obtained data (p ≤ 0.05).

RESULTS

The overall mean score of knowledge on the management of dental injuries was 3.6 ± 1.53 points. Male pediatricians (p = 0.016), those who witnessed dental injuries (p = 0.003), and those who had more than ten years of pediatric practice (p = 0.027) showed better knowledge. The results of multiple linear regression analysis demonstrated impact between pediatricians' knowledge in the emergency treatment of traumatic dental injuries concerning the level of health care (practice settings) (β = -0.254, p = 0.002) and the number of patients treated by a pediatrician per day (β = -0.187, p = 0.030).

CONCLUSION

Pediatricians have a low level of knowledge regarding the primary care of traumatic dental injuries. An additional course on dental injurie management should be recommended as part of the physician and pediatricians' educational training.

Knowledge and skills of emergency physicians in managing traumatic dental injuries

PURPOSE

Emergency departments are frequently confronted with traumatic dental injuries (TDIs). The prognosis of the injured tooth is related to early dental trauma management. For this reason, physicians must be familiar with the appropriate management of TDI. This study aimed to investigate the knowledge and skills of German emergency physicians regarding TDI.

METHODS

An electronic questionnaire was sent to 438 emergency departments throughout Germany. Four hundred and twenty seven questionnaires were evaluated and included in the analysis. The survey contained questions about physician characteristics and assessed their knowledge and skills of managing dental trauma. For statistical analysis, the Kruskal-Wallis, Mann-Whitney U test or ANOVA test was used as appropriate. Rank correlations were performed with the Spearman's rank correlation.

RESULTS

Out of 427 participants, 256 (59.95%) stated they had no or insufficient knowledge, and 266 (71.12%) stated they had no skills in dental trauma management. Almost 76% of the participants had no previous knowledge of dentistry. Only 7.28% knew the right procedure for replanting an avulsed tooth. Just 26.06% would choose the right medium for temporary tooth storage. Having a dentist in the family (p = 0.0074) or clinical exposure to patients with dental trauma (p = 0.0384) influenced the results of the knowledge score.

CONCLUSION

The knowledge and skills in dental trauma management among German emergency physicians are generally inadequate. Targeted training courses are necessary to ensure early and adequate TDI treatment to reduce the resulting medical and societal costs as much as possible.

Knowledge and attitudes of emergency medicine physicians and nurses regarding emergency management of dentofacial trauma in pediatric patients

OBJECTIVES

Considering that the first visit for dentofacial trauma is generally in emergency departments, the awareness and knowledge of the emergency medicine staff regarding the treatment of dentofacial injuries is very important for the prognosis. The aim of this study was to investigate the knowledge, education, and self-confidence levels of emergency medicine physicians and nurses concerning the diagnosis and treatment of dentofacial traumatic injuries in pediatric patients.

METHODS

This questionnaire-based, cross-sectional study included emergency medicine physicians and emergency medicine nurses. The survey contained questions and three sections on participants' general data, attitudes, basic knowledge, and confidence levels in managing dentofacial trauma.

RESULTS

A total of 407 participants (250 emergency medicine physicians and 157 emergency medicine nurses) were included in this study. There was a significant difference between the groups regarding the correct answers to the questions about trauma management and emergency management of crown fractures and avulsed permanent teeth (p <0.05).

CONCLUSION

Our findings show that there is a lack of information on dentofacial trauma for emergency medicine physicians and nurses. In order to increase knowledge in this area and to improve the diagnosis and management of dentofacial trauma, interdisciplinary seminars, case discussions, and continuing education programs should be held for emergency medicine staff.

Developing a prototype dental trauma e-learning course for medical education

This article aims to demonstrate how an expert feedback process was used to identify emerging issues within a prototype extracurricular course on dental trauma and show how the feedback was addressed prior to piloting the course more widely. Dowse's Design Research Model was adapted for the design and development of a prototype dental trauma e-learning course. This paper will focus on step five, gathering expert feedback and the evaluation process. Four critical features emerged from the feedback that ought to be incorporated into the e-learning course design, namely, 1) keep resources clinically relevant; 2) keep resources simple to learn; 3) make resources easy to understand; and 4) support self-learning. The results demonstrate the value of an expert feedback process for improving a prototype designed to address a major gap in knowledge among medical doctors identified in the literature.

Online dental trauma course for medical education

A literature review identified a knowledge deficit among medical doctors about dental trauma management. To overcome this knowledge gap, a proposal to integrate dental traumatology teaching into the medical curriculum was made to raise medical students' awareness of, and familiarity with managing dental injuries. Despite the challenges of teaching dental trauma, online courses are viewed as a practical learning approach for students to access course material during their busy university schedules. In focusing on the constructivist model, this article details the design and development of the online dental trauma course. It is an example of a learner-led, fully online course. The six steps involved in the course development were as follows: (1) structured order from preclinical to clinical topics; (2) content covering all essential information on TDI diagnosis and management; (3) illustrative materials to support engagement and motivation to complete the course; (4) feedback processes to evaluate the learning process; (5) interactions between peers, educators, and learning materials to help facilitate learning; and (6) content that encompasses mainly visual learning styles. The online dental trauma course has the potential to make important contributions to medical education.

Assessment of the knowledge and attitudes about the management of dental trauma among ear, nose and throat physicians

PURPOSE

Ear, nose and throat physicians (ENTp) encounter dental trauma (DT) when patients refer to the emergency department, as well as during operations such as tonsillectomy and suspension laryngoscopy. This study aimed to investigate the attitudes and knowledge of ENTp about managing DT, and motivation for further education.

METHODS

This study was a cross-sectional observational survey on a sample of ENTp from 15 different private/public hospitals. A questionnaire of 22 questions was divided into three parts: the level of professional experience and the frequency of encountering DT; specific questions on the management of DT; self-assessment of educational approach and level of knowledge regarding DT.

RESULTS

A total of 128 surveys were accomplished and included in the evaluation. A larger percentage (96.9%) of the participants have experienced at least one case in the practice, and one-third (31.3%) have encountered more than ten DT cases. Although the duration of experience significantly affected the total number of correct responses to knowledge and attitudes regarding DT questions (p:0.028), more than half of the participants (44.38%) responded incorrectly to the questions. The majority of participants (97.7%) stated that they had no education on DT, and 90.6% were willing to receive DT training.

CONCLUSIONS

The results of this study emphasize the deficiency of ENTp' knowledge level about the management of DT. In addition, results demonstrated the enthusiasm of ENTp for further training, which can contribute to the requirement of education for providing appropriate management of DT cases.

Acute Vision Loss as an Ophthalmic Complication of Dental Procedures

Introduction: Acute vision loss has been previously described as a complication of dental procedures through a variety of mechanisms. The vision loss is typically transient, although permanent loss has been reported. Physicians, including ophthalmologists, typically lack formal education around dental procedures and may be uninformed about the risks to ocular or periocular structures as well as the types of complications that can arise. We aimed to summarize literature describing the various mechanisms by which dental procedures can lead to vision loss in order to equip physicians (primary care, emergency medicine, and ophthalmologists) with a better understanding of the mechanisms by which dental procedures can lead to acute vision loss. Methods: A literature search (1950 to 2020) identified articles discussing acute vision loss as a complication of dental procedures. Results: Dental procedures can result in a variety of ophthalmological conditions through ischemic, infectious, compressive, and anesthetic-related etiologies. Conclusions: While the majority of vision loss is transient and requires little management, there are vision and life-threatening complications that can arise and would require assessment and appropriate treatment.

Management of Dental Avulsion Injuries: A Survey of Dental Support Staff in Cairns, Australia

Background/Aim: The aim of this study was to assess the knowledge of dental support staff in providing appropriate first-aid advice regarding dental avulsion emergencies. Methods: This study was reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. Dental support staff (includes dental assistants, administrative staff and other non-clinical staff) were contacted and data were collected from 50 private dental clinics across the Greater Cairns Area, Queensland, Australia. These data were collected through an online survey throughout 2020. Descriptive statistics and Pearson’s Chi-squared test was used to analyze the data and any associations between categorical outcomes. Results: This survey yielded a response rate of 34.1% with a margin of error of 10.3%. More than four-tenths of participants (42%) reported that they had received some form of dental avulsion management training previously. All but five participants (92%) denoted that they would immediately replant an avulsed permanent tooth. More than half of all participants would choose to rinse a soiled avulsed tooth with fresh milk (55%) and transport that tooth in fresh milk (65%) should they not be able to replant the tooth at the site. Almost nine in every ten participants (85%) expressed willingness to further their training in this area. Knowledge in replanting avulsed permanent teeth was found to be significantly impacted by gender, age, years of experience and participation in formal avulsion training. Male participants were found to be significantly more likely (p = 0.025) to replant a permanent avulsed tooth than their female counterparts. Participants who were 40 years of age and above were found to be significantly more likely to choose fresh milk to transport avulsed teeth (p = 0.0478). Older participants (p = 0.0021), alongside those who had greater years of experience (p = 0.0112) and those who had undertaken formal avulsion training (p = 0.0106) were all significantly more likely to express greater confidence in their ability to manage dental avulsion injuries. Participants who had previously received some form of education regarding avulsion injury management were also most likely to warrant further education and training in this area (p < 0.0001). Conclusion: This study demonstrated that dental support staff in the Greater Cairns Area seem to have a fair grasp of first-aid knowledge regarding the management of dental avulsion injuries. This result indicates that this knowledge has been picked up through years of experience, rather than a formal education. Despite this, one would expect people who work in the dental industry to be able to provide accurate and appropriate assistance during dental emergencies, hence, further training is warranted to ensure optimum patient outcomes.

Knowledge and Attitudes about Dental Trauma Among the Students of the University of Split

Objectives

Dental trauma among children is a common problem, and everyone who works with them needs to possess appropriate knowledge and skills to provide proper care at the site of the accident. The aim was to evaluate the knowledge of emergency management of dental trauma among students who should be capable of managing such injuries in their future career.

Materials and Methods

A cross-sectional survey regarding dental trauma emergency management was conducted on 679 students from five different studies using a questionnaire. The obtained data were analyzed by the Student t-test or one - way ANOVAusing the Tukey's post-hoc test and multiple linear regression analysis (p<0.05).

Results

The total knowledge score regarding the emergency management of dental trauma among examined student was 4.32±2.25 (max 10). The positive association of the knowledge score was observed with the age of student (β=0.722, p≤0.001). A similar relation was observed depending on whether they received dental injuries training during their academic education (β=2.365, p≤0.001), as well as students’ assessment of the importance of knowledge regarding dental trauma emergency management (β=0.433, p≤0.001).

Conclusions

It can be concluded that the surveyed students have limited knowledge regarding dental injuries and their emergency management procedures. The obtained data emphasized the importance of additional education of all professions that may encounter dental trauma injuries to improve the outcomes of dental trauma treatment.

The prediction levels of emergency clinicians about the outcome of the ambulance patients and outpatients

AIM

The increased number of emergency clinic patients causes the length of stay in the emergency department, low patient satisfaction and dismiss of real emergency patients. In this study, we aimed to determine the prediction levels of emergency clinicians according to working year on the outcome of the ambulance patients and outpatients presented to the emergency department (ED).

MATERIALS & METHODS

This prospective study included patients over 18 years old. The triage of outpatients was made by a senior nurse and patients were divided into three triage categories such as green, yellow and red. Then these patients were evaluated by the emergency physician at the examination areas. Ambulance patients were directly evaluated by the emergency physician. These ambulance patients were noted as yellow or red according to triage categories. The main complaints, triage category, presentation method, vital signs, predicted outcome noted by the clinicians.

RESULTS

The correct prediction levels of hospitalisation (clinic/intensive care unit) were higher in clinicians whose working year is between 6 and 10 years (p < 0.05). There was no significant difference between 6-10 year and >10 year group according to prediction level (p > 0.05). Prediction of dischargement was higher in 0-5 year group than 6-10 year (p < 0.05) and >10 year (p < 0.05) group.

CONCLUSION

Experienced clinicians can make much more accurate prediction on length of stay and the prognosis of the emergency patients so crowded follow-up areas of the emergency room can be planned much more effectively.

Cross-sectional study of the educational background and trauma knowledge of trainees in the "China trauma care training" program

BACKGROUND

Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients, this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training (CTCT) program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.

METHODS

A cross-sectional study was conducted by collecting demographic information, hospital-related information and trauma knowledge of the trainees from 19 regions in China. All participants were assessed by questionnaires collecting the socio-demographic data, the trauma care knowledge levels and the information of the hospitals.

RESULTS

There were 955 males (78.9%) and 256 females (21.1%) enrolled. Among them, 854 were physicians (70.5%), 357 were registered nurses (29.5%). In addition, 64 of them also played an administrative role in the hospitals (5.3%). The score of the trainees who were members of the emergency department staff (72.59 ± 14.13) was the highest among the scores of all the personnel surveyed, followed by those of the trainees from the intensive care unit (ICU) (71.17 ± 12.72), trauma surgery department (67.26 ± 13.81), orthopedics department (70.36 ± 14.48), general surgery department (69.91 ± 14.79) and other departments (69.93 ± 16.91), P = 0.031. The score of the professors (73.09 ± 15.05) was higher than those of the associate professors (72.40 ± 14.71), lecturers (70.07 ± 14.25) and teaching assistants (67.58 ± 15.16), P < 0.0001. The score of the individuals who attended experts' trauma lectures (72.22 ± 14.45) was higher than that of individuals who did not attend the lectures (69.33 ± 15.17), P = 0.001. The mean scores before and after the training were 71.02 ± 14.82 and 84.24 ± 13.77, respectively, P < 0.001. The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training, with a statistically significant difference (P < 0.05).

CONCLUSIONS

The level of trauma knowledge of trauma care providers was associated with their department, professional position and previous participation in related academic conferences. Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals' level of trauma knowledge.

A proposal to introduce dental trauma into medical education: An insight

THE PROBLEM

This proposal aims to tackle the common poor management of traumatic dental injury (TDI) by medical doctors and subsequent poor healthcare outcomes for patients. The literature reports that most medical doctors, in either private practice or hospital emergency departments, lack the knowledge, skills, and confidence needed to adequately assess and manage victims of TDI. This is due to little or no clinical dentistry and dental trauma education being included in their medical studies.

THE GAP IN THE LITERATURE

From a review of the literature, there is a clear lack of learning provision for medical students on the topic of dental anatomy and trauma. In addition, there appears to be no formal university theoretical and clinical training during medical school.

THE PRACTICAL IMPLICATIONS

The introduction of dental trauma into the medical curriculum will provide students with a better understanding of the importance of early management for better patient outcomes. Medical doctors competent in managing emergency dental trauma procedures will be able to provide a higher standard of care that could prevent potentially lifelong negative repercussions for the patient.

Knowledge of Australian primary education providers towards dental avulsion injuries: a cross-sectional study

BACKGROUND/AIM

The aim of this study was to evaluate the knowledge of school professionals regarding the emergency management of dental avulsion.

METHODS

This cross-sectional study utilised a self-administered, pilot-tested questionnaire for school staff from primary schools. Descriptive statistics were used for the analysis - the prevalence and univariate associations between a categorical outcome and the variables under consideration, were evaluated using Pearson's Chi-squared test.

RESULTS

This survey yielded a response rate of 43.5% (n = 313). Approximately 60% of participants held valid first-aid certificates and 23% had received avulsion advice previously. Over 80% of participants expressed an unwillingness to replant an avulsed tooth, and over 90% believed that there should be greater awareness in this area. This unwillingness to replant was influenced by respondents' age (x2 = 8.13 df = 3, P = 0.043) and receiving advice previously (x2 = 13.15, df = 1, P < 0.001). Under-preparedness was related to years of experience (x2 = 15.03, df = 5, P = 0.010), first-aid training (x2 = 6.41, df = 1, P = 0.011) and receiving advice previously (x2 = 43.47, df = 1, P < 0.001). It was also evident that first-aid training positively influenced appropriate dental referral in the management pathway (x2 = 10.49, df = 1, P = 0.001).

CONCLUSION

This study suggests that there is an inadequate level of knowledge on the appropriate management of dental avulsion injuries amongst primary school professionals in Australia.