Knowledge, attitudes, and behaviors of dentists regarding child physical abuse in Jeddah, Saudi Arabia

AbstractA large proportion of child physical abuse cases go undocumented and unreported. Dentists can play an important role in identifying and reporting these cases, but little has been reported about this issue in Saudi Arabia. The aims of the study were to (1) assess dentists’ knowledge of child physical abuse, (2) assess dentists’ attitudes towards child physical abuse, and (3) assess the behaviors of dentists in identifying and reporting child physical abuse. A cross-sectional survey of pediatric dentists, pediatric dentistry residents, and dental interns practicing at all of the dental schools in Jeddah, Saudi Arabia was conducted using an anonymous, self-administered questionnaire. The participants in current study demonstrated insufficient knowledge of the signs and symptoms of child physical abuse, actions that should be taken in suspected cases, circumstances in which to report such cases, and the legal authorities to which they should be reported. The attitudes of participants towards detecting and reporting cases were generally positive. Only 11% of the participants had suspected a case of child abuse, and only 3% of them reported it. Lack of knowledge about referral procedures and fear of anger from family members were the main causes of underreporting. In conclusion, this study showed that dentists have insufficient knowledge about child physical abuse but positive attitudes towards their role in detecting and reporting it. This topic should be covered and emphasized in dental schools’ curricula, and healthcare and academic institutes must have a clear protocol to be followed if a case of abuse is suspected

Characteristics of dental fear among Arabic-speaking children: a descriptive study

BACKGROUND: Dental fear has not only been linked to poor dental health in children but also persists across the lifespan, if unaddressed, and can continue to affect oral, systemic, and psychological health. The aim of this study was to assess the factor structure of the Arabic version of the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), and to assess the difference in factor structure between boys and girls. METHODS: Participants were 220 consecutive paediatric dental patients 6–12 years old seeking dental care at the Faculty of Dentistry, King Abdulaziz University, Saudi Arabia. Participants completed the 15-item Arabic version of the CFSS-DS questionnaire at the end of the visit. Internal consistency was assessed using Cronbach’s alpha. Factor analysis (principal components, varimax rotation) was employed to assess the factor structure of the scale. RESULTS: The Cronbach’s alpha was 0.86. Four factors with eigenvalues above 1.00 were identified, which collectively explained 64.45% of the variance. These factors were as follows: Factor 1, ‘fear of usual dental procedures’ consisted of 8 items such as ‘drilling’ and ‘having to open the mouth’, Factor 2, ‘fear of health care personnel and injections’ consisted of three items, Factor 3, ‘fear of strangers’, consisted of 2 items. Factor 4, ‘fear of general medical aspects of treatment’, consisted of 2 items. Notably, four factors of dental fear were found in girls, while five were found in boys. CONCLUSIONS: Four factors of different strength pertaining to dental fear were identified in Arabic-speaking children, indicating a simple structure. Most items loaded high on the factor related to fear of usual dental procedures. The fear-provoking aspects of dental procedures differed in boys and girls. Use of the scale may enable dentists to determine the item/s of dental treatment that a given child finds most fear-provoking and guide the child’s behaviour accordingly. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1472-6831-14-118) contains supplementary material, which is available to authorized users

Birth prevalence of non-syndromic orofacial clefts in Saudi Arabia and the effects of parental consanguinity

Objectives: To describe the characteristics and prevalence of non-syndromic orofacial clefting (NSOFC) and assess the effects of parental consanguinity on NSOFC phenotypes in the 3 main cities of Saudi Arabia. Methods: All infants (114,035) born at 3 referral centers in Riyadh, and 6 hospitals in Jeddah and Madinah between January 2010 and December 2011 were screened. The NSOFC cases (n=133) were identified and data was collected through clinical examination and records, and information on consanguinity through parent interviews. The diagnosis was confirmed by reviewing medical records and contacting the infants’ pediatricians. Control infants (n=233) matched for gender and born in the same hospitals during the same period, were selected. Results: The prevalence of NSOFC was 1.07/1000 births in Riyadh, and 1.17/1000 births overall; cleft lip (CL) was 0.47/1000 births, cleft lip and palate (CLP) was 0.42/1000 births, and cleft palate (CP) was 0.28/1000 births. Cleft palate was significantly associated with consanguinity (p=0.047, odds ratio: 2.5, 95% confidence interval: 1 to 6.46), particularly for first cousin marriages. Conclusion: The birth prevalence of NSOFC in Riyadh alone, and in the 3 main cities of Saudi Arabia were marginally lower than the mean global prevalence. While birth prevalence for CLP was comparable to global figures, the CL:CLP ratio was high, and only CP was significantly associated with consanguinity

Molecular Screening of <i>VAX1</i> Gene Polymorphisms Uncovered the Genetic Heterogeneity of Non-Syndromic Orofacial Cleft in Saudi Arabian Patients

Objective: Nonsyndromic orofacial cleft (NSOFC) including cleft lip with or without cleft palate (CL±P) and cleft palate (CP) are multifactorial developmental disorders with both genetic and environmental etiological factors. In this study we investigated the association between CL±P and CP, and two polymorphisms previously determined using genome-wide association studies, as well as the association between consanguinity and CL±P and CP. Methods: DNA was extracted from saliva specimens from 171 triads consisting of affected individuals and their parents, as well as 189 control triads (matched for age, gender, and location) that were recruited from 11 referral hospitals in Saudi Arabia. Two polymorphisms, rs4752028 and rs7078160, located in the VAX1 gene were genotyped using real-time polymerase chain reaction. A transmission disequilibrium test was carried out using the Family-Based Association Test and PLINK (genetic tool-set) to measure the parent-of-origin effect. Results: Significant differences were found between affected individuals and the control group. In the case of the rs4752028 risk allele in cleft, the phenotypes were: CL±P (fathers: odds ratio [OR] 2.16 [95% CI 1.38–3.4]; mothers: OR 2.39 [95% CI 1.53–3.71]; and infants: OR 2.77 [95% CI 1.77–4.34]) and CP (fathers: OR 2.24 [95% CI 1.15–4.36] and infants: OR 2.43 [95% CI 1.25–4.7]). For CL±P and the rs7078160 risk allele, the phenotypes were: (fathers: OR 1.7 [95% CI 1.05–2.86]; mothers: OR 2.43 [95% CI 1.49–3.97]; and infants: OR 2.34 [95% CI 1.44–3.81]). In terms of consanguinity, we found significant association between consanguinity and the rs4752028 polymorphism minor allele among CL±P compared with controls (p = 0.001). Conclusion: This is the first study to find a relationship between these two loci on 10q25 (rs4752028 and rs7078160) and NSOFC in a population with high levels of consanguinity

In vitro and in vivo effects of parathyroid hormone and human cancer ascites fluid bone resorbing protein

PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact [email protected] and white photographs included.Thesis (D.Sc.D.)--Boston University, Henry M. Goldman School of Graduate Dentistry, 1984 (Oral Biology)Bibliography : leaves 172-198.We have compared the effects of human 1-34 amino terminal fragment of parathyroid hormone (PTH) and a bone resorbing protein (BRP) isolated from human cancer ascites fluid on calcium mobilization, matrix resorption and collagen synthesis. PTH and BRP, as well as lymphocyte derived osteoclast activating factor (OAF), stimulated calcium mobilization from　embryonic chick calvaria after 72 hours in culture. PTH and OAF also stimulated matrix resorption as measured by release of 3H-proline and hydroxyproline.　BRP, in contrast, had no effect on matrix resorption. Both PTH and BRP stimulated synthesis of bone matrix (OAF was not tested).　Indomethacin, an inhibitor of prostaglandin synthesis, had no effect on PTH or BRP stimulated calcium mobilization when added concomitantly with these proteins. However, preincubation of the bones with indomethacin completely inhibited PTH mediated and partially inhibited BRP mediated calcium mobilization. These results suggest that BRP acts to uncouple calcium and matrix resorption and probably acts through a prostaglandin dependent mechanism.　PTH also appears to Stimulate calcium mobilization through a prostaglandin dependent mechanism. We have also examined the effects of BRP and PTH in vivo. PTH, but not BRP, produced acute hypercalcemia in growing chicks. Chronic effects on bone resorption was monitored by labeling bones in growing chicks with tritiated tetracycline and measuring residual radioactivity after chronic administration of either PTH or BHP. Administration of BRP or PTH to chicks twice daily for one week caused significant hypercalcemia when compared to saline injected controls.　BRP increased bone resorption while PTH decreased bone resorption.　Bone calcium, and phosphorus content, expressed on a weight basis, were not different from controls.　However, mice treated with both PTH and BRP were hypocalcemic and bone resorption was inhibited in those animals treated with BRP.　Bone calcium and phosphorus content was also increased.　Molar ca/p ratios were normal in both.　The histological sections from in vitro and in vivo studies showed no difference between groups, although by visual examination of chick bone treated in vivo indicated increased marrow space and thinning of trabeculae

The Use of Pit and Fissure Sealants—A Literature Review

This paper reviews the literature and discusses the latest updates on the use of pit and fissure sealants. It demonstrates the effectiveness of pit and fissure sealants in preventing caries and the management of early carious lesions. It compares the use of different sealant materials and their indications. It describes the application technique for sealants. It also reviews the cost-effectiveness of sealants as a preventive strategy. From this review and after the discussion of recently published studies on pit and fissure sealants, it is evident that sealants are effective in caries prevention and in preventing the progression of incipient lesions. It is therefore recommended that pit and fissure sealant be applied to high-caries-risk children for optimum cost-effectiveness. It is a highly sensitive technique that needs optimum isolation, cleaning of the tooth surface, etching, and the application of a thin bonding layer for maximum benefit. Recall and repair, when needed, are important to maximize the effectiveness of such sealant use

Atraumatic Restorative Treatment and Interim Therapeutic Restoration: A Review of the Literature

This review discusses the techniques and uses of atraumatic restorative treatment (ART) and interim therapeutic restoration (ITR) and states the differences between these two approaches. ART and ITR are similar approaches and are performed using the same material, but they differ in the purpose of their use. ART is used in cases when there are obstacles to reaching dental care units and has been proven to have high success rates in primary and permanent dentitions. ITR is used as a temporary restoration that will be replaced with a more definitive one. ITR is used in cases when the ideal dental treatment cannot be performed. Conventional glass polyalkenoate (ionomer) restorative cement (GIC) is the material of choice that has been used for ART and ITR. This is because of its fluoride release properties, including its ability to bond to enamel and dentine, its pulpal biocompatibility, and its ease of manipulation. High-viscosity glass ionomer performed better than low and medium-viscosity glass ionomer in ART. Combining GIC with conditioner, as well as the use of a chemo-mechanical approach, improved the success rate of ART. Both ATR and ITR are acceptable strategies, with success rates comparable to the traditional treatment methods

Chemistry and Bioactivity of NeoMTA Plus™ versus MTA Angelus® Root Repair Materials

Objectives. To analyse the chemistry and bioactivity of NeoMTA Plus in comparison with the conventional root repair materials. Method and Materials. Unhydrated and hydrated (initial and final sets) materials were analysed by Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD). For bioactivity study, small holes of dentin discs were filled with either materials, immersed in PBS for 15 days, and analysed with FTIR and scanning electron microscope with energy dispersive X-ray (SEM/EDX). The calculation of crystallinity and carbonate/phosphate (CO3/PO4) ratio of surface precipitates (from FTIR) and calcium/phosphate (Ca/P) ratio (from EDX) was statistically analysed using t-test or ANOVA, respectively, at 0.05 significance. Results. Both materials are tricalcium silicate-based that finally react to be calcium silicate hydrate. NeoMTA Plus has relatively high aluminium and sulfur content, with tantalum oxide as an opacifier instead of zirconium oxide in MTA Angelus. NeoMTA Plus showed better apatite formation, higher crystallinity and Ca/P but lower CO3/PO4 ratio than MTA Angelus. SEM showed globular structure with a small particle size in NeoMTA Plus while spherical structure with large particle size in MTA Angelus. Conclusion. Due to fast setting, higher crystallinity, and better bioactivity of NeoMTA Plus, it can be used as a pulp and root repair material

Influence of povidone-iodine on micro-tensile bonding strength to dentin under simulated pulpal pressure

Abstract Background Previous studies had reported that bond strength deteriorate over time following the dentin surface pretreatment with chlorhexidine. Therefore, further investigations are needed to evaluate the effect of other materials such as povidone iodine. The purpose of this study was to investigate the effects of 10% povidone-iodine pretreatment on the resin-dentin micro-tensile bond strength of a single bond adhesive system in permanent teeth over time, and compare it with 2% chlorhexidine. Methods Flat dentin surfaces were prepared in 63 extracted permanent teeth. Teeth were randomly assigned to a 10% povidone-iodine pretreatment, a 2% chlorhexidine pretreatment, or a control group. Composite resin blocks were built up over treated surfaces under pulp pressure simulation. The prepared specimens were assigned to three storage time, 24 h, 1 week, and 2 months. Samples were vertically sectioned to obtain specimens of 0.7 to 1.2 mm2 cross-sectional area. Results No significant reduction of bond strength of povidone iodine group was found among the three storage times (p = 0.477). A significant reduction of bond strength for both chlorhexidine and control groups was found in the three storage times (p <  0.001). Conclusion Povidone iodine pretreatment of etched dentin was effective in reducing the loss of bond strength over time, while the chlorhexidine pretreatment and negative control showed significant deterioration in micro-tensile bond strength over time in permanent teeth

BiodentineTM versus formocresol pulpotomy technique in primary molars: a 12–month randomized controlled clinical trial

Abstract Background The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of BiodentineTM pulpotomies versus formocresol pulpotomies in children vital primary molars. Methods A randomized, split–mouth study design was used with a sample of 37 healthy children aged 4– to 8–year–old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the BiodentineTM pulpotomy group or the formocresol pulpotomy group. Children were followed–up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05. Results At 12 months, the clinical success rates of both BiodentineTM and formocresol groups were 100%, while the radiographic success rates for BiodentineTM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12–month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the BiodentineTM and formocresol groups, respectively. Conclusions Both BiodentineTM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference. Trial registration Registered on NCT03779698. Date of Registration: 18 December 2018