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

OBJECTIVES

E-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students.

METHODS

This online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P < 0.05.

RESULTS

Most respondents reported regular brushing of their teeth, whereas only 70% used additional oral hygiene aids. Reported frequencies of complaints ranged from as low as 3.3% for tongue inflammation to as high as 53.3% for headache, with significant differences between E-cigarette users and non-users. Compared to non-smokers, E-cigarette users reported significantly higher prevalence of dry mouth (33.1% vs. 23.4%; P < 0.001), black tongue (5.9% vs. 2.8%; P = 0.002), and heart palpitation (26.3%% vs. 22.8%; P = 0.001). Although two-thirds of the sample reported no change in their physiological functions, E-cigarette users reported significant improvement in their physiological functions compared to never smokers or tobacco users.

CONCLUSION

Dental students showed good oral hygiene practices, but E-cigarette users showed a higher prevalence of health complications.

Effect of self-assessment in a removable prosthodontics preclinical course on skills and competence

PURPOSE

Self-assessment is increasingly implemented in medical professions' curricula. In this research, the authors measure the effects of self-assessment within a preclinical removable prosthodontics course among dental students in a private dental school according to the European qualifications framework descriptors.

MATERIALS AND METHODS

Thirty subjects, all fourth-year dental students, were included in this experiment. Fifteen subjects were included in each of the experimental and control groups during one semester. The experimental group subjects used the study roadmap tool in their preclinical tasks. The control group subjects executed the same preclinical tasks under instructor supervision only. All subjects were filmed, and an autonomy score was given to every subject per session. At the end of the semester, cognitive skills development was compared using the Kember et al. questionnaire while practical skills development was compared using a comparison of grades. Two focus groups were undertaken with experimental group subjects. Qualitative and quantitative data were collected and statistically analyzed (p < 0.005).

RESULTS

Subjects from the experimental group showed development in critical thinking, practical skills, autonomy, and taking responsibility, thus development in the competence level.

CONCLUSION

Implementation of self-assessment within preclinical courses may develop skills and competence among dental students, yet more studies are needed.

Happiness among dentists: a multi-scale, multi-national study from 21 countries

OBJECTIVES

The extent to which dentists are happy with their profession and their life has not been well studied. The present study aimed to explore the level of happiness, satisfaction with life and psychological well-being among a sample of dental professionals from 21 countries.

MATERIALS AND METHODS

The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant.

RESULTS

The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P < 0.001; SHS and ABS: r = 0.58, P < 0.001; and SWLS and ABS: r = 0.533, P < 0.001. Country of practice, age, qualification and monthly income were the significant independent predictors of SHS, SWLS and ABS.

CONCLUSION

Country of residence and social characteristics were associated with dentists' responses regarding their feelings and subjective well-being.

Perceived sources of stress amongst dental students: A multicountry study

AIMS

The aim of this study was to explore the perceived sources of stress reported by dental students from fourteen different countries.

METHODS

A total of 3568 dental students were recruited from 14 different dental schools. The dental environmental stress (DES) questionnaire was used including 7 domains. Responses to the DES were scored in 4-point Likert scale. Comparison between students was performed according to the study variables. The top 5 stress-provoking questions were identified amongst dental schools. Data were analysed using SPSS software program. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Logistic regression analysis was also conducted to determine the effect of the studied variables on the stress domains. The level of statistical significance was set at <.05.

RESULTS

Internal consistency of the scale was excellent (0.927). Female students formed the majority of the total student population. The percentage of married students was 4.8%. Numbers of students in pre-clinical and clinical stages were close together. The most stress-provoking domain was "workload" with a score of 2.05 ± 0.56. Female students scored higher stress than male students did in most of the domains. Significant differences were found between participating countries in all stress-provoking domains. Dental students from Egypt scored the highest level of stress whilst dental students from Jordan scored the lowest level of stress.

CONCLUSION

The self-reported stress in the dental environment is still high and the stressors seem to be comparable amongst the participating countries. Effective management programmes are needed to minimise dental environment stress.

Retentive force variations of stud attachments for implant overdentures

Implant overdentures are considered a standard treatment option by many practitioners, especially for edentulous mandibles. Stud attachments have been used extensively in the construction of these overdentures. In this study, the retentive forces of O-ring/ball and Locator overdenture attachments under various conditions in the mouth were investigated through pull-out tests. In dry testing, the retentive forces of the O-ring/ball attachment started higher than those of the Locator attachment but significantly decreased after 50 insertion-removal cycles (P = 0.014). The Locator attachment had no significant change in its retentive force over time (P = 0.328). In wet testing, a saliva substitute was applied to the stud attachments between cycles. The retentive force of the O-ring/ball attachment increased significantly in wet testing compared to dry testing (P < 0.0001). The retentive force of the Locator system during wet testing did not change significantly from that achieved during dry testing for the first 80 cycles, but then it increased to reach the same levels as the O-ring/ball system at 510 cycles (P < 0.05). Within the limitations of the present study, the results suggest that it is advisable to avoid using O-ring/ball attachments as anchors for implant overdentures in a dry mouth environment. In such cases, Locator attachment or metal-to-metal attachment components would be preferable as implant overdenture anchors. In a saliva-irrigated mouth, there is no significant difference between the retentive properties of the O-ring/ball and Locator attachments over 6-9 months' use.

The ala-tragus line as a guide for orientation of the occlusal plane in complete dentures

AIM

The use of the ala-tragus line (ATL) to orient the occlusal plane (OP) is controversial because there is a lack of agreement on the exact points of reference for this line. This study determined the relationship between the natural OP and ATL which was established by using the inferior border of the ala of the nose and (1) the superior border of the tragus (ATL1), (2) the tip (ATL2), and (3) the inferior border of the tragus (ATL3).

MATERIALS AND METHODS

Lateral cephalometric radiographs were taken of each subject by a standard method and tracings were obtained on acetate paper to show the OP and the three ala-tragus lines. The relationship between the OP and each of ATL was measured for each subject. Mean and standard deviation values were then calculated for the relationship. Statistical analysis was performed using repeated measure analysis of variance followed by Bonferroni pairwise comparisons and Student's t-test (α = 0.05).

RESULTS

Significant differences were noted between the three mean angles (p = 0.046). The mean angle (3.275 degrees ± 2.54) formed by OP and ATL2 was significantly the smallest (p < 0.05).

CONCLUSION

The ala-tragus line, extending from the inferior border of the ala of the nose to the tip of the tragus of the ear presented the closest relationship to the natural occlusal plane.

Relationship between the occlusal plane corresponding to the lateral borders of the tongue and ala-tragus line in edentulous patients

AIM

Definitions of the ala-tragus line (ATL) cause confusion, because the exact points of reference for this line do not agree. This study determined the relationship between the prosthetic occlusal plane (OP) corresponding to the lateral borders of the tongue and ATL which was established by using the inferior border of the ala of the nose and (1) the superior border of the tragus (ATL 1), (2) the tip (ATL 2) and (3) the inferior border of the tragus (ATL 3).

MATERIALS AND METHODS

Neutral zone moldings using phonation and autopolymerizing acrylic resin were recorded and leveled with the lateral borders of the tongue. Lateral cephalometric radiographs were taken of each subject by a standard method. Tracings were obtained on acetate paper to show the prosthetic OP and the three ATLs. The relationship between the prosthetic OP and each of ATL was measured for each subject. Mean and standard deviation values were then calculated for the relationship. Statistical analysis was performed using repeated measure analysis of variance followed by Bonferroni pairwise comparisons and Student's t-test (α = 0.05).

RESULTS

Significant difference was found between the three mean angles (p = 0.001). There was no significant difference between the mean angle (5.00° ± 4.38) formed by OP and ATL 2, and the mean angle (4.90° ± 3.50) formed by OP and ATL 3 (p = 1.00) which revealed the smallest.

CONCLUSION

The findings of this study indicated that ATLs, extending from the inferior border of the ala of the nose to (1) the tip of the tragus of the ear, and (2) the inferior border of the tragus presented the closest relationship to the prosthetic OP corresponding to the lateral borders of the tongue.

CLINICAL SIGNIFICANCE

When the ATL is used for orientation of the OP in denture construction, it would seem preferable to define it as running from the inferior border of the ala of the nose to the tip or to the inferior border of the tragus of the ear.

Morphologic comparison of two neutral zone impression techniques: A pilot study

STATEMENT OF PROBLEM

Several studies have compared dentures fabricated using neutral zone and conventional techniques. However, studies comparing swallowing and phonetic techniques for assessing the location and shape of the neutral zone could not be identified in the literature.

PURPOSE

The purpose of this pilot study was to compare the outline form of the phonetic and swallowing neutral zone impression techniques for the same subjects.

MATERIAL AND METHODS

Nine denture wearers with advanced mandibular ridge resorption were included in this study. For each subject 2 trays were prepared in autopolymerizing acrylic resin. One method used phonetics and tissue conditioner to shape the neutral zone; the second method used swallowing and modeling plastic impression compound. The resulting neutral zone impressions were leveled to the same occlusal height by gently grinding the occlusal surface on sandpaper until it corresponded with landmarks (corners of the mouth, two thirds of the height of the retromolar pads, bilaterally) noted on the cast. The impression was inverted onto graph paper, and the contour was outlined with a lead pencil. One impression was made for each subject, for each technique. The buccal contours of both neutral zones coincided at the median line. The maximum distance between the zones was measured in a buccolingual direction in the anterior, premolar, and molar regions bilaterally. When the location of the phonetic neutral zone in relation compared to the swallowing neutral zone was buccally oriented, a plus score was given. When the phonetic neutral zone was lingually located, a minus score was given. When the 2 lines coincided, a score of 0 was given. Measurements were made from direct readings on the graph paper. Statistical analysis was performed using the Sign test (alpha=.05).

RESULTS

Significant differences were noted buccally in the left molar (P =.031) and right molar (P =.003) regions and also in the left and right premolar regions (P =.007), where the swallowing neutral zone was found to be located buccal to the phonetic neutral zone. Significant differences were also noted lingually, in the right premolar region (P =.015), where the swallowing neutral zone was found to be located lingual to the phonetic neutral zone. There was no significant difference between the techniques for the anterior region.

CONCLUSION

Within the limits of this study, the phonetic neutral zone appears to be narrower posteriorly compared to the swallowing neutral zone, thus limiting premolar and molar positioning.