Oral health-related interdisciplinary practices among healthcare professionals in Saudi Arabia: Does integrated care exist?

Background There is a bidirectional relation between oral and general health, therefore collaboration between healthcare providers is needed. This study investigated current interdisciplinary practices (IDP) and the associated factors among healthcare professionals in Saudi Arabia. Methods A cross-sectional study was conducted in the Eastern Saudi Arabia recruiting four groups of health professionals (nurses, physicians, pediatricians and Ear-Nose and Throat (ENT) specialists). A validated, self-administered questionnaire was distributed online and shared through social media platforms. The questionnaire explored predisposing factors (demographics) and facilitating factors (knowledge, attitudes, attendance of oral health training and source of knowledge) associated with IDP. Results A total of 1398 health professionals were recruited. Participants showed fair oral health knowledge (7.1 ± 2.1) and attitudes (22.2 ± 3). Three-fourths (74.6%) reported always providing oral health education (OHE) to their patients, more than half (59.6%) reported always conducting an oral health screening (OHS), two-thirds (66.7%) reported responding to patients’ questions about oral health or conditions and 58.7% reported referring patients to dentists. Pediatricians and physicians had greater odds of IDP compared to other health professionals. Source of oral health knowledge (Ministry of Health (MOH) and formal education) was significantly associated with increased odds of IDP. Participants with good oral health knowledge had greater odds of responding to patients’ oral health question as well as have more referral practices. Conclusion The results reveal a discrepancy between participants' IDP, knowledge, and attitudes. Incorporating dental component to medical curricula, continuous education and training programs targeting health professionals through Ministry of Health should be considered.publishedVersio

Oral health-related interdisciplinary practices among healthcare professionals in Saudi Arabia: Does integrated care exist?

Background: There is a bidirectional relation between oral and general health, therefore collaboration between healthcare providers is needed. This study investigated current interdisciplinary practices (IDP) and the associated factors among healthcare professionals in Saudi Arabia.Methods: A cross-sectional study was conducted in the Eastern Saudi Arabia recruiting four groups of health professionals (nurses, physicians, pediatricians and Ear-Nose and Throat (ENT) specialists). A validated, self-administered questionnaire was distributed online and shared through social media platforms. The questionnaire explored predisposing factors (demographics) and facilitating factors (knowledge, attitudes, attendance of oral health training and source of knowledge) associated with IDP.Results: A total of 1398 health professionals were recruited. Participants showed fair oral health knowledge (7.1 ± 2.1) and attitudes (22.2 ± 3). Three-fourths (74.6%) reported always providing oral health education (OHE) to their patients, more than half (59.6%) reported always conducting an oral health screening (OHS), two-thirds (66.7%) reported responding to patients' questions about oral health or conditions and 58.7% reported referring patients to dentists. Pediatricians and physicians had greater odds of IDP compared to other health professionals. Source of oral health knowledge (Ministry of Health (MOH) and formal education) was significantly associated with increased odds of IDP. Participants with good oral health knowledge had greater odds of responding to patients' oral health question as well as have more referral practices.Conclusion: The results reveal a discrepancy between participants' IDP, knowledge, and attitudes. Incorporating dental component to medical curricula, continuous education and training programs targeting health professionals through Ministry of Health should be considered.</p

Dental Phobia among Pregnant Women: Considerations for Healthcare Professionals

Objective. To report the prevalence of dental phobia and associated factors among pregnant women. Materials and Methods. This cross-sectional study included pregnant women visiting hospitals in Dhahran, Khobar, and Dammam in Saudi Arabia. The Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety and phobia. The score of MDAS ranges from 5 to 25, and a cutoff value of 19 was used to identify participants with dental phobia. Results. The study analyzed data of 825 participants with mean age of 29.08 ± 5.18 years. The prevalence of dental phobia was 16.1%. About 46.9% of the sample believed that dental treatment should be avoided during pregnancy, and the importance of regular dental checkup was recognized by 16.4% of the participants. Dental phobia was associated with the perception of the health of teeth (P 0.004) and gums (P 0.016). Multiple logistic regression showed that being under the age of 30 years (OR 0.63, P 0.019) and updating knowledge about oral health (OR 0.49, P 0.006) were significantly associated with reduced likelihood of dental phobia. However, having bad dental experience (OR 2.13, P 0.001) and being in first trimester of pregnancy (OR 1.57, P 0.033) were significantly associated with increased odds of dental phobia. Conclusions. A considerable proportion of pregnant women reported dental phobia. The bad dental experience was associated with increased dental phobia. However, reduced likelihood of dental phobia was associated with updating oral health knowledge. Healthcare professionals may consider these factors to reduce dental phobia and improve oral health of pregnant women

Influence of Dental Pain and Tooth Sensitivity on the Intention to Quit Smoking among Schoolchildren

Objective. To evaluate the association between oral health problems and sociodemographic factors with the intention to quit smoking and join the tobacco cessation program among schoolchildren. Materials and Methods. This cross-sectional study included a sample of 10–12 grade male students from public high schools in different cities of the Eastern province of Saudi Arabia. Schoolchildren responded to a pilot-tested questionnaire about self-reported oral health problems and the intention to quit smoking. Bivariate and multivariate logistic regression analyses were performed. Results. Out of 587 schoolchildren, 199 were smokers with a smoking prevalence of 33.9%. Significantly higher proportions of smokers than nonsmokers had tooth sensitivity (P = 0.029) and dryness of the mouth (P = 0.001). Most smokers (75.9%) had a family history of smoking, and 51.8% started smoking within the last two years. Tooth sensitivity (56.3%), dental cavities (52.8%), and dental pain (44.7%) were highly prevalent among smokers. About one-third of smokers expressed their intention to quit smoking (38.2%) and join a smoking cessation program (33.7%). Tooth sensitivity (OR = 3.7, P = 0.004) and dental pain (OR = 2.84, P = 0.014) were significantly associated with quitting smoking. In addition, smokers with tooth sensitivity (OR = 3.22, P = 0.007) had higher odds of joining a smoking cessation program than those without tooth sensitivity. The smokers who started smoking within the last two years (OR = 3.97, P = 0.002) were more likely to quit smoking than those who initiated smoking for more than two years. Conclusion. Oral health problems were highly prevalent among smokers. Tooth sensitivity was significantly associated with quitting smoking and joining a cessation program in children. The awareness about the adverse effects of smoking on oral health should be part of regional, national, and global tobacco prevention policies and programs

Possible Future Career Challenges and Associated Factors among Dental Students and Interns

Background. Dental students face a variety of challenges as they enter the dental profession. The study aimed at assessing dental students’ opinions about their perceived future career challenges in the dental profession and the associated factors. Materials and Methods. This cross-sectional study of 637 students representing different public and private dental colleges was conducted in Saudi Arabia. The participants responded to a pretested questionnaire conducted online. Results. There were 59.7% (n = 380) of males and 40.3% (n = 257) of females, and the mean age of the students was 21.80 (±2.14) years. The majority of participants thought that they will have difficulties in establishing their private clinic (63.9%) and finding a government job (>60%). Senior students were more likely to perceive getting a government job (OR = 1.79, P=0.02), securing an admission into specialty program (OR = 2.75, P=0.001), and establishing a private dental clinic (OR = 2.51, P=0.001) as future career challenges than junior students. Similarly, female gender was associated with increased perception of challenges about finding a government job (OR = 1.911, P=0.002), getting an admission into specialty program (OR = 1.5, P=0.038), and establishing a private clinic (OR = 2.02, P=0.001). In addition, low academic score and low level of father’s education were associated with increased odds of perceiving challenges of finding a government job and getting an admission into specialty programs. Conclusions. Establishing a private clinic and getting a government job were the most common career challenges. Senior students, female students, and students with low academic scores had increased likelihood of facing employment and academic-related difficulties

Effect of a Vibration System on Pain Reduction during Injection of Dental Anesthesia in Children: A Randomized Clinical Trial

Background. The ‘‘gate control’’ theory suggests pain can be reduced by simultaneous activation of larger diameter nerve fibers using appropriate coldness, warmth, rubbing, pressure, or vibration. This study investigated the efficacy of a device combining cold and vibration, for needle-related procedural pain in children. Methodology. A total of 51 children aged 5–12 years participated in this randomized controlled clinical trial. Half of the children were in the control group and received maxillary buccal infiltration, by injecting 1.8 ml of 2% lidocaine with 1 : 100,000 adrenaline using topical anesthesia 20% benzocaine gel for 15 seconds, while the other half were in the test group and received the same anesthesia using a commercially available external cold and a vibrating device. A face version of Visual Analogue Scale (VAS) was used as a subjective measure to assess the child’s pain experience. The parents were requested to evaluate the child’s ability to tolerate pain using a behavioral/observational pain scale. Sound, Eyes, and Motor (SEM) scale and Faces, Legs, Activity, Cry, and Consolability (FLACC) scale were used to record the child’s pain as perceived by the external evaluator. T-test or Mann–Whitney U-test was used for scale variables, paired sample T-test or Wilcoxon rank t-test was used for before and after data, and chi-square was used for categorical variable, based on the results of normality test. Results. The results showed a statistically significant reduction in pain after the injection for the test group compared with control using VAS scale (mean = 6.68 (1.09) and 8.42 (0.50); p=0.001) and FLACC scale (mean = 5.92 (1.05) and 8.16 (0.54); p=0.002), but not when using SEM scale (mean 3.22 (0.42) and 4.24 (2.74);p=0.08). Conclusions. Combined external cold and vibrating devices can be an effective alternative in reducing experienced pain and fear in children undergoing infiltration dental anesthesia. This study was registered with clinical trial registry of the United States National Institutes of Health (NIH) at ClinicalTrials.gov (NCT03953001)

Evaluation of Quality of Life among Dental Professionals by Using the WHOQOL-BREF Instrument in Eastern Province of Saudi Arabia

Objective. To evaluate the quality of life (QOL) of dental professionals in the Eastern Province of Saudi Arabia. Methods. This cross-sectional study recruited dental professionals (general dentists, specialists, and consultants) from public and private sectors in the Eastern Province of Saudi Arabia. The World Health Organization’s QOL Assessment-BREF (WHOQOL-BREF) questionnaire was administered among study participants. The questionnaire addresses four domains of QOL which are physical, psychological, social relationships, and environment. Results. There were 313 dental professionals in the study with a mean age of 35.72 (8.58) years. The mean score of QOL in the sample was 63 (13.9) on a 0–100 scale. 75% of the participants rated their QOL as good or very good. Of four domains, the social relationship domain had the highest mean score of QOL (67.04 SD: 23.52) and the physical domain had the lowest score (59.66 SD: 14.69). There were significant differences in the QOL of consultants (66.46 SD: 12.55), specialists (65.42 SD: 12.91), and general dentists (61.06 SD: 14.18) P 0.010. The participants with medical illness had significantly lower QOL (56.91 SD: 12.83) than those without medical illness (63.67 SD: 13.92) P 0.01. There were significant differences in the QOL of participants with 0–10 years since graduation (61.97 SD: 14.71), 11–20 years (61.92 SD: 13.56), and more than 20 years (68.53 SD: 10.71) P 0.009. Conclusion. The qualifications, medical illness, and years since graduation were important determinants of QOL among dental professionals. Measures should be taken to improve QOL of dental professionals which can enhance the quality of patient care

Global Prevalence of Periodontal Disease and Lack of Its Surveillance

Background. Periodontal disease is a public health problem and is strongly associated with systemic diseases; however, its worldwide distribution is not fully understood. Objective. To evaluate global data of periodontal disease: (1) among adolescents, adults, and older population and (2) in low-, middle-, and high-income countries. Methods. This ecological study included data of periodontal disease from the World Health Organization’s data bank which are based on the Community Periodontal Index of Treatment Needs (CPITN code: 0 = no disease; 1 = bleeding on probing; 2 = calculus; 3 = periodontal pocket (PD) 4-5 mm; 4 = PD (6+ mm). Age- and income-related periodontal disease inequalities were evaluated across the globe. Results. Compared with 9.3% of adults and 9.7% of older persons, 21.2% of adolescents had no periodontal disease (P=0.005). Nearly 18.8% of adolescents compared with 8.9% of adults and 5% of older persons had bleeding on probing (P≤0.001). Similarly, 50.3% of adolescents, 44.6% of adults, and 31.9% older persons demonstrated the occurrence of calculus (P=0.01). On the other hand, older persons had the highest prevalence of PD 4-5 mm and PD 6+ mm than adults and adolescents (P≤0.001). The distribution of periodontitis (CPITN code 3 + 4) in adults differed significantly in low- (28.7%), lower-middle- (10%), upper-middle- (42.5%), and high-income countries (43.7%) (P=0.04). However, no significant differences in periodontitis (CPITN code 3 + 4) were observed in adolescents and older persons in low- to high-income countries. Conclusions. Within the limitations of data, this study found that the distribution of periodontal disease increases with age. Periodontitis was the most common in older persons and in population from high-income countries

Oral Health of Children with Autism: The Influence of Parental Attitudes and Willingness in Providing Care

Objectives. Parents play a crucial role in health-related practices of children with autism spectrum disorder (ASD). This study assessed the association between oral health status and oral health practices of children with ASD in relation to their parental attitudes and comfort in providing oral care. Methods. This cross-sectional study included 75 children with ASD attending the special needs schools in Eastern Saudi Arabia from 2015–2018. Parents responded to a self-administered questionnaire assessing their attitudes toward oral health and comfort in providing oral care for children. The clinical examination assessed dental caries (decayed, extracted, and filled: (DMF and def)), gingival disease, and plaque accumulation. The Pearson correlation coefficient was used to assess the relationship between the study variables, while ANOVA followed by post hoc was used to assess the differences. Results. Prevalence of dental caries in primary teeth was 76% and 68% in the permanent dentition with a mean of 0.85 ± 1.9 and 1.03 ± 2.9, respectively. Thirty-one participants had gingival problems, mean gingival index was 1.03 ± 0.88, and mean plaque index was 0.95 ± 0.43. Half of the parents supervised their children’s brushing, which was significantly associated with plaque accumulation (p = 0.004), gingival disease (p < 0.0001), and def (p = 0.02). Parental attitudes and comfort in providing oral health care were not associated with oral health status of ASD children; however, positive parental attitudes were associated with lower sugar consumption (p = 0.043). An inverse correlation was observed between comfort in providing oral health care with gingival and plaque scores r = −0.18 and −0.23, respectively. Conclusions. The data are indicative of poor oral health practices and status among ASD children. Parents’ oral health care practices seem to be reactive rather than proactive. Positive parental attitudes were associated with lower sugar consumption. Greater comfort in providing care was negatively correlated with plaque accumulation and gingival problems

Measuring Empathy among Dental Students and Interns: A Cross-Sectional Study from Dammam, Saudi Arabia

Objective. To evaluate empathy and its related factors among undergraduate dental students and interns enrolled in a public dental college in Dammam, Saudi Arabia. Materials and Methods. This cross-sectional study used the Jefferson Scale of Empathy-Health Profession Students (JSE-HPS) version to determine empathy in 362 dental students and interns in Dammam, Saudi Arabia. The JSE-HPS is a 20-item 7-point Likert scale questionnaire, and its score ranges from 20 to 140 with high values indicating increased empathy. Influences of age, gender, class year, previous year’s grade point average (GPA), educational attainment of parents, and monthly family income on empathy were evaluated. Results. Of 501 enrolled students and interns, 362 returned completed questionnaires, and the response rate of the study was 72%. The sample’s empathy score (JSPE-HPS scale) ranged from 70 to 129 with a mean of 96.75 (±13.76). Most participants believed that empathy is important for effective communication with patients (96.1%) and can improve the provider-patient relationship (95.6%). Females demonstrated a significantly higher mean empathy score (99.98 ± 14.01) than males (92.72 ± 12.35) (P<0.001). Similarly, the participants with high GPA (98.06 ± 13.69) had significantly greater mean empathy scores than those with low GPA (94.84 ± 13.68) (P=0.029). The mean empathy score increased significantly from junior students (3rd and 4th year students) to senior students (5th and 6th year students) and interns (P=0.008). Multiple linear regression analysis showed that class year (B = 2.03, P=0.006) and GPA (B = 8.67, P=0.003) were significant factors associated with empathy. Conclusions. Empathy is important for effective patient communication and improved provider-patient relationship. Female gender, high GPA, and class years were associated with empathy. Empathy should be integrated into dental curricula for effective student learning and positive patient care outcomes