Hall technique versus conventional preformed metal crowns: can paediatric dentists tell the difference on radiographs?

PURPOSE

Hall technique (HT) preformed metal crowns (PMCs) are allegedly oversized compared to conventional (C) PMCs. To investigate paediatric dentists' (PDs) perception of HT-PMCs and perception/ability to identify HT or C-PMCs on bitewings radiographs.

METHODS

An online cross-sectional questionnaire including ten bitewings (five of each of HT/CPMCs) was sent to PDs across the globe. A PMC type score (from '10') was calculated. T test, Pearson's and Fischer's Chi-square, and Odd Ratios (OR) (p < 0.05).

RESULTS

A total of 476 PDs from around the world responded. Most (97%) used PMCs in their practice. Most (98.7%) knew of, and 79% used HT-PMCs. A clear opinion shift, towards supporting HT, over time was noted (OR 11.154 [95% confidence interval (CI) 6.006-20.715]. A majority (67%) thought that HT/C-PMCs were similar radiographically. Only five PMCs were identified correctly [mean score 4.9 (± 1.73)]. A minority who thought that HT/C-PMCs were dissimilar scored higher than those who thought they were similar (5.31 ± 1.22; 4.68 ± 1.9, respectively, p < 0.00001). Nobody identified all ten PMCs. HT-PMCs were 4.63 times more identifiable than C-PMCs [(OR 24.857 CI 15.059-41.028) and (OR 5.361 CI 3.089-9.304)] for HT-PMCs and CP-MCs, respectively (p < 0.0001).

CONCLUSIONS

PDs identified the PMC type in half of the bitewings. They perceived no clear radiographic difference between HT-PMCs and C-PMCs, but their chance of recognizing HT-PMCs was five times higher than C-PMCs. HT-PMC support was high.

Sugar content in infant formula: Accuracy of labeling and conformity to guidelines

BACKGROUND

Infant formulae are a primary source of nutrition during the first years of life, to which sugars are frequently added. This may contribute to adverse dental health problems if consumed excessively when coupled with prolonged and nocturnal feeding habits.

AIM

To assess the amount and type of dietary sugars in commercially available infant formulae in the UAE.

DESIGN

Sucrose, glucose, and fructose were measured in 71 different brands of commercially available infant formulae for retail sale in the UAE. Analysis was performed using high-performance liquid chromatography with refractive index detection. Sugar values were compared with the reported levels on the nutritional labels. A comparison between findings, product labels, and international standards for infant formulae was performed.

RESULTS

Of the 71 samples, 23 had detectable sugar levels, varying between sucrose, glucose, and fructose. Ten samples were found to have sugars contributing to more than 5% of total energy intake ranging between 5.68% and 27.06%. All infant formula packages had carbohydrate levels mentioned on the labels, but very few mentioned the added sugar content.

CONCLUSIONS

Many infant formula products tested contained sugars that exceeded the standard recommended intake. Tighter regulations that monitor the amount of sugar in infant formulae and guidelines for comprehensive labeling systems are required.

Characteristics of Pediatric Dental Treatment Provided under General Anesthesia in Dubai, United Arab Emirates: A Retrospective Analysis

Background

Dental general anesthesia (DGA) is a widely utilized technique in pediatric dentistry and is indicated for a variety of cases such as very young children and children with special healthcare needs (SHCN). In the United Arab Emirates (UAE), there is a paucity of studies relating to this subject.

Objective

To analyze the characteristics of DGA treatment in special healthcare needs and healthy children in the only postgraduate dental hospital in Dubai, UAE.

Materials and Methods

A retrospective analysis was conducted on the electronic records of all Dubai Dental Hospital (DDH) pediatric patients who underwent DGA in the period between January 1^st, 2016, and 29^th of February 2020.

Results

The study population consisted of 98 children. A total of 26 children had a medical condition and were categorized as SHCN. The most common justification for DGA was dental caries and a lack of cooperation due to young age. SHCN patients received significantly more preventive measures and significantly fewer pulp therapies than healthy patients.

Conclusion

We found that the services provided under DGA for healthy pediatric patients differ from those provided to SHCN patients. Frequently missing recall appointments following DGA increased the likelihood of the need for further restorative dental treatment. These results highlight the importance of robust prevention and follow-up programs for children treated under GA.

What is the effect of preterm birth on permanent tooth crown dimensions? A systematic review and meta-analysis

BACKGROUND

The permanent tooth formation process may be disrupted in preterm infants with potential discrepancies in size and subsequent occlusal disturbances.

OBJECTIVE

To systematically analyse and quantitively synthesize the available evidence regarding the impact of preterm birth on permanent tooth crown dimensions.

SEARCH METHODS

Unrestricted searches in 6 databases and manual searching of the reference lists in relevant studies were performed up to March 2021 (Medline via PubMed, CENTRAL, Cochrane Database of Systematic Reviews, Scopus, Web of Science, ProQuest Dissertations and Theses Global).

SELECTION CRITERIA

Observational studies investigating permanent tooth crown dimensions in preterm and control full-term born individuals.

DATA COLLECTION AND ANALYSIS

Following study retrieval and selection, relevant data were extracted, and the Newcastle-Ottawa scale was used to assess the selection, comparability, and outcome domains. Exploratory synthesis and meta-regression were carried out using the random effects model.

RESULTS

Three studies were located from the initially retrieved records and the assessments with the Newcastle-Ottawa scale identified issues regarding the selection and comparability domains. Overall, the mesiodistal and the buccolingual dimensions of the permanent teeth in both dental arches tended to be smaller in children born prematurely than full term children. Subgroup analyses showed statistically significant differences for the extremely preterm to control group comparisons for the incisors and the first molars. Meta-regression showed a modificatory effect of gestational age and racial background but not of birth weight and gender on tooth size. The quality of available evidence was rated at best as moderate.

CONCLUSIONS

Premature birth could potentially be associated with reduced tooth-crown dimensions in some permanent teeth especially in children born extremely preterm. Although the results from these observational studies should be approached with caution until more information becomes available, the possible clinical implications in terms of diagnosis and treatment planning should be considered.

REGISTRATION

PROSPERO (CRD42020182243).

How Do Schoolchildren View Other Children Who Have Discolored Teeth?

Objectives:

Facial look and expression affect how people are viewed by others. This study aimed to evaluate how schoolchildren in the Emirate of Sharjah, United Arab Emirates view their peers who have discolored teeth.

Materials and Methods:

A cross-sectional study using randomized cluster sampling of Sharjah public schools was conducted. A previously developed and validated social attribute questionnaire was utilized to determine children’s dental appearance-related judgments. Children aged 11–14 years were given photographs of subjects either with discolored teeth or without, and they were asked to rate them using six positive and five negative signifiers. The total attribute score (TAS) ranged from 11 (most negative) to 44 (most positive). A linear regression analysis and t-tests were performed to determine the effects of gender and age in mean TAS.

Results:

TAS was significantly lower among discolored teeth photographs when compared with photographs without teeth discoloration (P = 0.004). TAS was found to be significantly higher with increased age (P = 0.035), but gender had no significant effect.

Conclusion:

Teeth discoloration resulted in more negative social judgment between Sharjah schoolchildren and their peers.

A 24-month retrospective study of preformed metal crowns: the Hall technique versus the conventional preparation method

PURPOSE

Conventional and Hall Technique (HT) Preformed Metal Crowns (PMCs) are used for treatment of carious primary molars. The aim was to evaluate the clinical and radiographic success of conventional and HT PMCs in a postgraduate dental setting.

METHODS

A retrospective study using patients' electronic case-notes and radiographic images of carious primary molars treated with either conventional or HT PMCs was conducted to assess clinical and radiographic success/failure. A Kaplan-Meier curve was used to assess PMC survival.

RESULTS

187 PMCs (110 HT and 77 conventional) in 65 children (34 females and 31 males) at 6, 12, 18 and 24 months were assessed. At 24 months, the success rates of conventional and HT PMCs were 97.6% and 93.5%, respectively. Two HT (perforated/abscessed) and four conventional (abscessed) PMCs failures occurred. There was no significant difference in success/failure (p = 0.362) at 12 months, but the HT was more successful at 24 months (p = 0.002) with similar survival times for both methods.

CONCLUSION

HT and conventionally placed PMCs, when placed in a postgraduate paediatric dentistry setting, were clinically and radiographically very successful at 6, 12, 18 and 24 months post operatively with a slightly higher success of the HT at 24 months.

Children's dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital

PURPOSE

Child dental anxiety (CDA) and uncooperative dental behaviour are common. We aimed to assess the prevalence of CDA (self- and proxy- reported) in the United Arab Emirates (UAE) children related to their dental behaviour.

METHODS

Data were collected from 312 questionnaires obtained from 156 parent/child (mean age 9.95 ± 2.17 years) pairs attending a postgraduate dental hospital. Demographics, self/proxy- reported CDA scores via a six-question, five-point Likert scale, of the Modified CDA Scale-faces version (MCDAS-f: where ≥ 19 was severe CDA) and Frankl Behaviour Rating Scale (FBRS) scores were compared and analysed. Chi-square test, Pearson's correlation, Kappa- coefficient, one-way ANOVA and independent t test statistical analysis were used (p < 0.05).

RESULTS

The prevalence of self and proxy severe CDA was 22.4% (n = 35) and 33.3% (n = 52) respectively, with 9% (n = 14) being dentally- uncooperative. In both groups, extractions caused the highest CDA followed by injections and fillings (p < 0.001). The mean scores for self-reported/proxy-reported CDA were 15.02 (± 4.90)/15.70 (± 6.07) respectively. There was a positive linear correlation between self- and proxy- reported CDA scores and a negative linear correlation between self/proxy- reported CDA scores and the FBRS (p < 0.001). Self/proxy concordance of severe anxiety/none-to-moderate- anxiety was fair (68.6%, kappa = 0.23, p = 0.003). Both self/FBRS and proxy/FBRS concordance of severe anxiety/none-to-moderate- anxiety/behaviour was fair (78.8%, kappa = 0.23, p = 0.001) and (71.8%, kappa = 0.22, p < 0.001) respectively.

CONCLUSIONS

Considering the limitations of the present study in a UAE child population sample, the prevalence of CDA from extractions, injections and fillings was 22.4% (self- reported) and 33% (proxy reported). There was fair agreement between child- self and parent- proxy- reported CDA. Increased CDA led to uncooperative dental behaviour.

Knowledge of dental faculty in gulf cooperation council states of multiple-choice questions' item writing flaws

Multiple-Choice Questions provide an objective cost/time effective assessment. Deviation from appropriate question writing structural guidelines will most probably result in commonly ignored multiple-choice questions writing flaws, influencing the ability of the assessment to measure students' cognitive levels thereby seriously affecting students' academic performance outcome measures. To gauge the knowledge of multiple-choice question items writing flaws in dental faculty working at colleges in Gulf Cooperation Council (GCC) countries. A cross-sectional short online Survey Monkey^TM multiple-choice questions-based questionnaire was disseminated to dental faculty working in GCC countries during the academic year 2018/2019. The questionnaire included five test incorrect (flawed) multiple-choice questions and one correct control question. The participants were asked to identify flawed multiple-choice question items from the known 14 items writing flaws. Out of a total of 460 faculty, 216 respondents completed the questionnaires, 132 (61.1%) were from Saudi Arabia, while numbers of participants from United Arab Emirates, Kuwait and Oman were 59 (27.3), 14 (6.5%) and 11 (5.1%) respectively. Majority of participants were male (n = 141, 65.9%) compared to 73 females (34.1%). Eighty percent of the participants possessed more than five years of teaching experience. Assistant professors constituted the majority (43.3%) of the academic positions participating in this study. The overall fail rate ranged from 76.3% to 98.1% and almost 2/3^rds of the participants were unable to identify one or more of the flawed item(s). No significant association was observed between the demographics (age, region, academic position and specialty) and knowledge except that of participant's gender (p < 0.009). GCC dental faculty demonstrated below average knowledge of multiple-choice question items writing flaws. Training and workshops are needed to ensure substantial exposure to proper multiple-choice question items construction standards.

Enamel defects and caries prevalence in preterm children aged 5-10 years in Dubai

Background: Enamel defects (EDs) are commonly reported dental findings in preterm/low birthweight children. EDs potentially increase caries susceptibility.Aim: To assess the prevalence of EDs and dental caries in a group of preterm children (aged 5-10 years) in Dubai, United Arab Emirates (UAE).Methodology: A retrospective cohort study of medical records of 62 preterm children (mean age 8.1 ± 1.54) and 62 full-term children (mean age 8.1 ± 1.73) of both genders born in a UAE children's hospital were studied. These children were dentally assessed for EDs and caries by a calibrated examiner.Results: EDs were 4.34 times more prevalent among preterm children [odd ratio (OR) = 4.338, CI 95% [2.010-9.366]. The prevalence of EDs in the pre-term group was 58.15%, significantly higher (P < 0.01) than the full-term control group (24.2%). Birth weight, intubation and type of delivery were statistically significant factors contributing to EDs. In the primary dentition, the mean dmft was 4.61 ± 4.30, while in the permanent dentition DMFT was 0.38 ± 0.99. There was a statistically significant difference in permanent teeth caries experience amongst pre-term children compared to the full-term control as measured by DMFT (P = 0.008).Conclusion: EDs and dental caries in permanent dentition in the pre-term group were significantly higher than the full-term group.

Hall technique crowns and children's masseter muscle activity: A surface electromyography pilot study

BACKGROUND

Hall technique crowns (HTCs) alter the occlusion temporarily, potentially affecting jaw muscles, particularly the masseter - the primary jaw-closing muscle.

AIM

To assess masseter muscle activity (MMA) in children treated with a unilateral HTC.

DESIGN

In 12 children treated with a single HTC, bilateral MMA was recorded with surface electromyography (sEMG) for ten cycles of Rest Position (RP) and Maximum Voluntary Clenching (MVC) over 20 seconds immediately pre-HTC cementation (P_base ), immediately post-HTC cementation (P_immed ), at 2 weeks post-HTC cementation (P_2w ) and at 6 weeks post-HTC cementation (P_6w ). t test, ANOVA and post hoc statistics were used (P < .05).

RESULTS

As expected, MMA was low at rest and increased during maximal jaw clenching (P < .0001). MMA (mean ± SD) increased significantly (P < .001) between RP and MVC at: P_base [from 1.60 μV·s (±0.96) to 5.40(±2.30)]; P_immed [1.57(±1.15) to 3.75(±1.87)]; P_2w [1.39(±0.54) to 5.54(±1.45)] and finally P_6w [1.46(±0.56) to 6.45(±2.56)]. Rest MMA at P_base , P_immed , P_2w and P_6w remained unchanged (P = .18) whereas P_base clench MMA reduced by a third at P_immed (P < .001), returned to and exceeded baseline levels at P_2w (P = .822) and P_6w (P < .001), respectively.

CONCLUSIONS

This pilot study showed that Hall technique crowns may affect masseter muscle activity in children. Clench MMA was reduced immediately post-treatment but returned to and later exceeded baseline levels at 2 and 6 weeks, respectively. Rest MMA remained unchanged.

Oral health problems in leukaemic paediatric patients in the United Arab Emirates: a retrospective study

AIM

The aim of this study was to estimate the prevalence of oral health problems in leukaemic paediatric patients in the United Arab Emirates (UAE) and correlate it to the phase of chemotherapy.

MATERIALS AND METHODS

Medical records of 120 paediatric leukaemic patients (age below 15 years) in the UAE were reviewed for the occurrence of oral health problems. Records from the three main hospitals that provide cancer therapy were accessed after obtaining the required permissions.

RESULTS

The overall prevalence of oral health problems in leukaemic patients in our study is 60%. The most common oral health problem recorded in the patients&#x26;#x2019; records was oral mucositis and ulceration (52.4%) followed by dental caries and oral candidiasis accounting for 18.3% and 14.2% respectively. Other oral health problems recorded were gingivitis and gingival bleeding, herpetic gingivostomatitis, poor oral hygiene, and facial palsy. The peak occurrence of most oral problems was during phase IV (maintenance). Oral health problems were more common among patients who received treatment and follow-up locally rather than abroad.

STATISTICS

Collected data were analysed using statistical software International Business Machines (IBM) Statistical Package for Social Sciences (SPSS, version 20, Chicago, SPSS Inc). Descriptive statistics were performed to describe the characteristics of the study population. The association between oral health problems and other risk factors was analysed using the Chi-squared test. A P-value of &#x26;#x3C;0.05 was considered statistically significant.

CONCLUSION

This is the first study to describe oral health problems and its correlation to the phase of chemotherapy in leukaemic paediatric patients in the UAE. Oral health problems as a result of leukaemia and its management are both variable and unavoidable. Therefore, oral and dental care is of critical importance in maintaining the overall wellbeing of the patient before, during, and after treatment. This can be achieved by close liaison between the oncology and dental teams.

Dentists' knowledge of the guidelines of traumatic dental injuries in the United Arab Emirates

AIM

This study aimed to assess general dental practitioners' (GDPs) knowledge within the United Arab Emirates (UAE) regarding the management of traumatic dental injuries (TDIs), and to compare their level of knowledge with that of paediatric dentists (PDs).

METHODS

Dentists were asked to complete a two-part questionnaire (seven questions covering demographic data and 13 questions about trauma cases scenarios) in electronic and paper format. A total of 296 returned questionnaires were analysed to identify GDPs' knowledge in managing TDIs, and to compare the score of GDPs' knowledge with that of PDs'.

RESULTS

Out of a total score of 13, the mean knowledge score (MKnS) for GDPs was 4.87±1.82 (only 37.5% of the 13 questions were answered correctly) while the MKnS of paediatric dentists was 5.56±1.47 (with 42.8% correct answers); both scores indicated poor knowledge and the difference was statistically significant (p=0.005).

CONCLUSION

There was poor knowledge of TDIs among the surveyed UAE GDPs as well as the PDs, although PDs scored higher, indicating the need for further training.

Evaluating the Quality of Multiple Choice Question in Paediatric Dentistry Postgraduate Examinations

Objectives

This study aimed to evaluate the quality of multiple choice question (MCQ) items in two postgraduate paediatric dentistry (PD) examinations by determining item writing flaws (IWFs), difficulty index (DI) and cognitive level.

Methods

This study was conducted at Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE. Virtual platform-based summative versions of the general paediatric medicine (GPM) and prevention of oral diseases (POD) examinations administered during the second semester of the 2017–2018 academic year were used. Two PD faculty members independently reviewed each question to assess IWFs, DI and cognitive level.

Results

A total of 185 single best answer MCQs with 4–5 options were analysed. Most of the questions (81%) required information recall, with the remainder (19%) requiring higher levels of thinking and data explanation. The most common errors among IWFs were the use of “except” or “not” in the lead-in, tricky or unfocussed stems and opportunities for students to use convergence strategies. There were more IWFs in the GPM than the POD examination, but this was not statistically significant (P = 0.105). The MCQs in the GPM and POD examination were considered easy since the mean DIs (89.1% ± 8.9% and 76.5% ± 7.9%, respectively) were more than 70%.

Conclusion

Training is an essential element of adequate MCQ writing. A general comprehensive review of all programme’s MCQs is needed to emphasise the importance of avoiding IWFs. A faculty development programme is recommended to improve question-writing skills in order to align examinations with programme learning outcomes and enhance the ability to measure student competency through questions requiring higher level thinking.

A single-centre investigator-blinded randomised parallel group clinical trial to investigate the effect of probiotic strains Streptococcus salivarius M18 and Lactobacillus acidophilus on gingival health of paediatric patients undergoing treatment with fixed orthodontic appliances: study protocol

BACKGROUND

There is limited data on the beneficial effects of probiotics on the gingival health of patients undergoing treatment with fixed orthodontic appliances. This study aims to compare the effect of probiotic tablets combined with regular oral hygiene versus regular oral hygiene alone on gingival status in these patients. The effect of probiotic intake on plaque formation and salivary microbiome composition will be also assessed.

METHODS AND ANALYSIS

This is a 3 month single-centre, single blind (clinical and laboratory examiners), parallel group randomised controlled two arm superiority trial. Fifty paediatric patients attending the Postgraduate Orthodontic Clinic at the Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates, who meet the eligibility criteria will be recruited. Block randomisation with 1:1 allocation and concealment of allocation will be carried out. The treatment group will receive probiotic tablets containing Streptococcus salivarius M18 and Lactobacillus acidophilus together with regular oral hygiene versus the control group on regular oral hygiene alone. Clinical examination and collection of saliva for microbiome assay will be carried out at baseline and end of study. Self-reporting by patients will be used to document acceptability and adverse effects. Statistically significant decrease in gingival bleeding on probing in the treatment group will be classified as primary outcome of treatment success. Statistically significant reduction in Plaque Index, Gingival Index and shift in the composition of the oral microbiome in favour of beneficial bacteria are secondary outcomes indicative of efficacy of probiotic intake.

ETHICS AND DISSEMINATION

Ethical approval for the study has been granted by the HBMCDM, MBRU, Institutional Review Board (Reference #: MBRU-IRB-2018-015). Study findings will be disseminated via publication in peer-reviewed journal.

TRIAL REGISTRATION NUMBER

ISRCTN95085398.

A study protocol of a single-center investigator-blinded randomized parallel group study to investigate the effect of an acclimatization visit on children's behavior during inhalational sedation in a United Arab Emirates pediatric dentistry postgraduate setting as measured by the levels of salivary Alpha Amylase and Cortisol

INTRODUCTION

Inhalation sedation is a proven safe method for reducing children's dental anxiety and has been used worldwide for decades. There is controversy regarding the use of acclimatization or familiarization visits for dental sedation treatment pathways for children. This may increase acceptance to the treatment based on desensitization and acclimatization principles underpinning many behavior management techniques. This study aims to identify whether, an inhalation sedation acclimatization visit is effective in reducing the stress level in anxious children as measured by salivary Alpha Amylase and Cortisol levels.

METHODS

The study is a single-center, single blinded, parallel group 2 arm clinical trial. Children in need of inhalation sedation aged 5 to 15 years from September 2019 through March 2020 attending the Postgraduate Pediatric Clinic at the Hamdan Bin Mohammed College of Dental Medicine, in Dubai, will be allocated randomly and equally to either:At the initial visit a salivary sample will be collected at the beginning of the visit and the sedation need score will be recorded using the pediatric indicator of sedation need. Treatment for both groups will commence at the second visit. Salivary samples will be collected 15 minutes before the start of the treatment and 15 minutes after the conclusion of the treatment. The following outcomes will be recorded: completion of dental treatment, anxiety scores at baseline and after treatment using Frankl rating behavior scale and physiological anxiety related changes will be recorded using salivary Alpha Amylase and Cortisol levels. Mean changes of physiologic anxiety levels and corresponding 95% confidence intervals will be determined to compare the 2 treatments (sedation with familiarization and sedation without familiarization).

DISCUSSION

This is will be the first study to measure the effect of the acclimatization visit of nitrous oxide inhalation sedation on the level of physiological anxiety and the behavior of the pediatric patients during treatment.

Oral Health Status among Children with Down Syndrome in Dubai, United Arab Emirates

Objectives:

The purpose of this study was to assess the oral health status in Down syndrome (DS) children in Dubai, United Arab Emirates.

Materials and Methods:

A total of 106 DS children (mean age = 9.3 ± 2.8) and 125 healthy children (mean age = 11.7 ± 4.4) were recruited from both special needs centers and private/public schools in Dubai. A dental examination for decayed-missing-filled teeth (DMFT) in deciduous dentition/DMFT in permanent dentition indices, simplified oral hygiene index, calculus index (CI), were carried out. In addition, occlusal, dentofacial, soft-tissue abnormalities, and erosion were assessed. Statistical analysis was conducted using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA).

Results:

The mean number of DMFT in DS children was significantly higher than that in healthy children. DS children in the primary dentition group had higher restorative index and Met Need Index scores than the control group. On the other hand, CI was found to be significantly higher among children with DS compared to healthy controls (P < 0.004). DS children had a significantly higher proportion of open bite and other occlusal problems. Class III molar angle malocclusion was significantly higher in DS (66%) compared to controls (11.2%). Erosion was significantly higher among DS children compared to healthy control (34% vs. 15.3%).

Conclusions:

DS children in Dubai had higher caries rate compared to healthy children. DS group received more restorations and dental treatment compared to the control group. More to add, DS children had significantly more calculus, erosion, and malocclusion problems.

Knowledge of Management of Traumatic Dental Injuries of Emergency Department Physicians and Residents in the United Arab Emirates

Purpose: To investigate knowledge of emergency department physicians and residents (ED-Drs) about management of traumatic dental injuries (TDI) in the United Arab Emirates (UAE).<br/> Methods: A cross sectional study of ED-Drs was conducted using a questionnaire and a score of TDI knowledge (TDI-K) was created (maximum of six). Statistical analysis was performed using chi-square, Fisher's exact, Mann-Whitney U, and Kruskal-Wallis tests, and significance was set as P <0.05.<br/> Results: One hundred fifty-five physicians participated, with one-third reporting they encountered TDI more than once a week. Sixty percent of ED-Drs had received TDI education, of which a significantly higher proportion (84.4 percent) were Western-trained (P =0.007). Consultants and specialists had the highest knowledge scores (P =0.001). ED-Drs with five to 10 years' experience scored significantly lower (3.07±1.65) than those with less than five years of experience (3.86±1.36) and those with more than 10 years of experience (3.83±1.36, P=0.034). Only 38.2 percent of general practitioners (GPs) were confident placing sutures intraorally, compared to 80.6 percent of the consultants and specialists and 57.1 percent of the residents.<br/> Conclusion: Overall knowledge of TDI and their management among ED-Drs across the UAE is inadequate. GPs had the lowest knowledge and confidence to manage TDI. (J Dent Child 2019;86(1):24-31)<br/> Received December 11, 2018; Last Revision January 11, 2019; Accepted January 11, 2019.

The Prevalence and Severity of Molar Incisor Hypomineralization and Molar Hypomineralization in Dubai, UAE

Purpose: The purpose of this study was to evaluate the prevalence and severity of molar incisor hypomineralization (MIH) among schoolchildren in Dubai, UAE.Methods: A randomized cluster sample of 342 eight to 12-year-old schoolchildren had their permanent first molars and incisors evaluated for prevalence and severity of MIH using the European Academy of Paediatric Dentistry criteria.Results: The prevalence of MIH in Dubai was found to be 27.2 percent and was significantly higher in girls (32.6%) compared to boys (18.1%;P=0.002). The prevalence of molar hypomineralization (MH) was higher than MIH: of the 27.2 percent diagnosed children, 65.6 percent had only MH while 34.4 percent had MIH. MH prevalence in maxillary molars was 20.8 percent, significantly higher than 14.6 percent in mandibular molars (P≤0.005). Almost nine percent of maxillary incisors were affected by MIH compared to 0.9 percent of mandibular incisors (P≤0.001). The presence of demarcated opacities was significantly higher in females than males (P =0.002). Fifty-three percent of the children with MIH had mild defects, 17 percent had moderate defects, and 30 percent had severe defects.Conclusions: Despite the high prevalence of MIH in schoolchildren in Dubai, the severity was mild. The prevalence of MIH and MH was significantly related to sex and location of tooth in the oral cavity.

A systematic review and meta-analysis of primary teeth caries studies in Gulf Cooperation Council States

OBJECTIVES

The aim of the study was to evaluate the prevalence and severity of dental caries in pre-school children in the Gulf Cooperation Council (GCC) area.

METHODS

A search of literature was conducted to identify articles of dental caries in primary dentitions published during the period from January 1st, 1992 to June 30th, 2016. PubMed, Google Scholar search, and hand searching of journals was conducted to identify relevant articles. The search strategy employed both dental subject headings and free-text terms.

RESULTS

Out of a total of 193 studies that fit the initial inclusion criteria, 159 studies were further excluded. Only 34 studies were included in the systematic review and meta-analyses. The overall mean dmft in the primary teeth was 5.14 with prevalence of 80.9% in the GCC area. A high level of heterogeneity in the selected studies was found as demonstrated by Q-value of 2538.501 (df = 21) and I2 value of 99.17%. However, the funnel plots showed symmetrical shape at the bottom in both dmft and prevalence studies indicating absence of publication bias, which was also confirmed by insignificant result of Egger's regression statistical test (Egger's test P = 0.179-0.358).

CONCLUSION

Caries in the primary dentition in the GCC States was high both in terms of mean dmft (5.14) and prevalence (80.95%).

An Educational Initiative for Dubai School Nurses and Physical Education Teachers on the Management of Traumatic Dental Injuries

The aim of this study was to assess the knowledge of school nurses and physical education teachers (SN and PE teachers) about the emergency management of traumatic dental injuries (TDIs) in schools and to measure the impact of education on their knowledge. A longitudinal prospective study based on a questionnaire survey completed by 68 SN and PE teachers at three time periods (prior to, immediately after, and 3 months-post-educational intervention). Pre- and post t-test and repeated measures (analysis of variance) were used to compare the three group means for the same participants (p < .05 was considered significant). Significant improvement in the knowledge score among participants was observed between the initial survey to immediately after the educational session and to 3 months after (p = .047). Significant improvement in the choice of immediately seeking attention after tooth avulsion was observed (p = .001). The initial knowledge deficiency about the emergency management of TDIs among SN and PE teachers was improved and sustained.

Oral health challenges facing Dubai children with Autism Spectrum Disorder at home and in accessing oral health care

AIM

To investigate the challenges faced by Autism Spectrum Disorder (ASD) children and their families in Dubai from three different perspectives of dental care: oral care at home, oral care at the dentist and access to oral care, and to compare the results to their normally developing peers.

MATERIALS AND METHODS

A case-control comparative study of 84 ASD and 53 healthy children attending special needs centres and schools in Dubai including siblings of the autistic children. Data collection was by a survey questionnaire completed by parents or guardians.

RESULTS

More parents of ASD children compared to parents of healthy children reported difficulties across almost all oral care variables explored. The majority of ASD children's parents (83.3%) reported that their children need assistance in brushing their teeth compared with 15.4% of the healthy controls (p-value < 0.001). The ASD children's uncooperative behaviour increased during dental visits and significantly more parents (37%) rated their child's experience as negative compared with 9.5% among the parents of control children (p-value=0.006). The autistic children had visited a dentist mostly for extractions.

CONCLUSION

This study indicates that autistic children in Dubai experience more challenges and barriers to oral care than their typically developing healthy peers.

Assessment of the knowledge of United Arab Emirates dentists of Child Maltreatment, protection and safeguarding

AIM

Child safeguarding is society's responsibility. Dentists are uniquely positioned to recognise Child Abuse and Neglect (CAN) in dental practice and the wider society. The United Arab Emirates (UAE) introduced a child protection law in 2016. We aimed to assess the awareness of UAE dentists of child maltreatment, protection and safeguarding. Study Design A cross-sectional survey.

MATERIALS AND METHODS

We surveyed 381 UAE dentists about the knowledge and practice of CAN and safeguarding issues using a self-administered anonymous questionnaire. Statistical analysis was carried out using Chi-square, t-test, ANOVA and Pearson's correlation test and statistical significance was set as p <0.05.

RESULTS

Over 39 % (n=152) of the responders suspected CAN; male dentists suspected more CAN than females (p=0.015). Orthodontists, paediatric dentists (p<0.001) and female dentists (p=0.001) were more knowledgeable about diagnosing CAN. Paediatric dentists attended more CAN-related postgraduate training (p<0.001) than other specialties. Over 90% (n=346) believed that CAN should be addressed, 58.1% (n=224) and 54.1% (n=206) had CAN undergraduate and postgraduate training respectively but 53.5% (n=204) were unaware of local child protection guidelines. Dentists barriers to child protection reporting were; fear of family violence (59.6%, n=227), lack of knowledge of referral process (60.2%, n=228) and lack of diagnosis certainty (54.9%, n=206). UAE dentists qualified in Western and Asian countries had fewer barriers for child protection reporting (p=0.022) than the Arab and Gulf Cooperation Council qualified dentists.

CONCLUSIONS

A large minority of UAE dentists suspected CAN. Factors influencing child protection reporting were identified. Dentists' gender, specialty, and country of qualification affected their knowledge of CAN and practice of safeguarding. Child protection training is recommended.

Oral Health Knowledge, Attitude, and Practices of Sharjah Mothers of Preschool Children, United Arab Emirates

Objective:

The improvement of children's oral health, a world global health target, is essential to general health and quality of life. Hence, the aim of this study was to assess the knowledge, attitude, and practices of mothers toward their children's oral health in Sharjah, United Arab Emirates (UAE).

Materials and Methods:

A cross-sectional interview-based study was conducted among 383 mothers of preschool children (average age 3.49 [+1.63 years]) attending Sharjah Dental Center, UAE. Statistical analysis was performed using SPSS software for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA).

Results:

Adequate knowledge was found among 58.2% of mothers, 99% exhibited excellent attitude, and only 20% followed good practices toward their children's oral health. Poor knowledge and practice of mothers were significantly associated with mothers' occupation and education. Employed mothers had a significantly higher score of knowledge. Mothers with secondary education and university qualifications had significantly higher scores of practice compared with mothers with primary education.

Conclusions:

Although mothers had better than average knowledge and excellent attitude toward their children's oral health issues; most of them carried out improper practices. Mothers’ educational and employment backgrounds were significant influencing factors.

Oral manifestations and dentofacial anomalies in β-thalassemia major children in Dubai (UAE)

AIMS

The purpose of this study was to identify special oral and dentofacial manifestations of β-thalassemia major (ΒTM) in Emarati children in Dubai (UAE).

MATERIALS AND METHODS

A total of 38 (ΒTM) and 76 healthy Emirati children were recruited. An oral examination was conducted to determine dmft/DMFT indices, Simplified Oral Hygiene Index, occlusal anomalies, dentofacial, and soft-tissue abnormalities.

RESULTS

ΒTM children had significantly higher DMFT compared to the healthy controls (p-value, 0.017). The Met Need Index (MNI) and the Restorative Index (RI) were lower in the ΒTM group but without statistical significance. Calculus Index (CI) was found to be significantly higher in ΒTM children (p-value, 0.002). The proportion of gingivitis was significantly lower in the ΒTM group (p-value, 0.009). ΒTM children had significantly higher proportion of retained primary teeth (p-value, 0.001) and gingival pigmentation compared with healthy controls (p-value, 0.001). BTM children did not have any statistically significant difference in the Angle molar classiication compared to the control. Interestigly, a significantly higher proportion of transverse cross bite was found in the control subjects compared to the BTM group (p-value, 0.004).

CONCLUSIONS

Significantly higher DMFT, retained primary teeth, gingival pigmentation, and CI was found in the BTM group compared to the controls while significantly lower gingivitis index and transverse cross bite was seen in the BTM group.

Oral Health Status among Children with Cerebral Palsy in Dubai, United Arab Emirates

Objectives:

The purpose of this study was to assess the oral health status of children with cerebral palsy (CP) in Dubai, United Arab Emirates (UAE).

Materials and Methods:

Eighty-four CP and 125 healthy children were recruited from special needs centers and private/public schools in Dubai. A dental examination for decayed-missing-filled teeth in primary dentition (dmft)/Decayed-Missing-Filled teeth in permanent dentition (DMFT) indices, simplified oral hygiene index, calculus index (CI), and oral debris index was conducted. In addition, assessments of occlusal, dentofacial, soft tissue anomalies and erosion were conducted. Statistical analysis was conducted using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA).

Results:

DMFT/dmft scores were comparable in both groups. CI was significantly higher among children with CP. CP patients had a significantly higher proportion of anterior open bite, anterior spacing, Class II molar Angle malocclusion, trauma, high-arched palate, tongue thrust, lymphadenopathy, angular cheilitis, macroglossia, drooling, and erosion as compared to controls.

Conclusions:

The study highlighted peculiar characteristics and needs for the CP patients in Dubai, UAE.

A Systematic Review and Meta-analysis of School Children's Caries Studies in Gulf Cooperation Council States

OBJECTIVES

The aim of the present study was to evaluate the prevalence and severity of dental caries school children in the Gulf Cooperation Council (GCC) area, to help the development of systematic approaches for preventive oral care programs in the GCC states and to provide sound information for oral health promotion and public health care.

MATERIALS AND METHODS

A comprehensive search to identify both published and unpublished articles concerning relevant studies of dental caries in children aged 6-16 years for their permanent teeth published from 1992 to 2016 with no language and time limit was performed. The search strategies employed electronic databases and incorporated both dental subject headings and free-text term.

RESULTS

The overall mean decayed, missing and filled teeth in the permanent teeth was 2.57, and the prevalence was 64.7% in the GCC area.

CONCLUSIONS

Most of the studies were conducted in the Kingdom of Saudi Arabia. The results may not be a true reflection, and other countries in GCC are urged to study the prevalence and severity of caries in their children population.