Palestinian women’s oral health status, knowledge, practices, and access to dental care during pregnancy: a cross-sectional study

Abstract Background No data exist about the oral health status, beliefs, and practices of women living in the occupied Palestinian territory generally and in pregnant women in particular. The aim of this study was to investigate pregnant women’s oral health status, beliefs, and practices and the barriers to access to dental care. Methods Pregnant women visiting prenatal programmes at Ministry of Health centres in Jerusalem governorates were screened using the Decayed, Missed and Filled Teeth (DMFT) index to quantify their dental caries experience. A structured interview was also done to assess oral health beliefs and practices, demographic characteristics, and mothers’ stress level and social support. Ethical approval was obtained from Al-Quds University Ethics Committee. Findings 119 pregnant women agreed to participate in this study. 103 (87%) women were housewives with mean age 26 years (SD 5). 30 (25%) women had a household monthly income less than US$380, and 54 (45%) women did not finish their high school education. The sample had a mean DMFT index score of 14 (SD 5). 42 (35%) women had not visited a dentist in the past 3 years, and 61 (51%) women were advised by family and friends not to visit the dentist while pregnant. 96 (81%) women had no dental insurance, and 33 (28%) women considered cost to be a barrier to accessing dental care. 42 (35%) women brushed their teeth sometimes, and 106 (89%) women never flossed their teeth. 29 (24%) women perceived their oral health to be poor, and 65 (55%) women believed that a woman can lose a tooth just because she is pregnant. 60 (50%) women did not know the connection between poor oral health and adverse birth outcomes, and 25 (21%) women believed that cavities in baby teeth do not matter.Partially funded by a L’Oréal/UNESCO “For Women in Science” 2014 Fellowship

Factors related to high dental caries experience in Palestinian pregnant women in the Jerusalem governorate: a cross-sectional study

Beliefs about oral health during pregnancy demographic factors, such as level of education and socioeconomic status, are associated with an increased risk of oral diseases during pregnancy. The aim of this study was to assess the oral health status of pregnant women and the relation to the women’s oral health knowledge, beliefs, behaviour, and access to dental care.This project was partially funded by 2016 International Dental Federation FDI SMILE Award

Dental caries experience and associated risk indicators among Palestinian pregnant women in the Jerusalem area: a crosssectional study

Background: This study described the dental caries experience of Palestinian pregnant women and examined its relationships to their oral health knowledge, beliefs, behavior, and access to dental care. Methods: Pregnant women receiving prenatal care at the Ministry of Health (MOH) centers in the Jerusalem Governorate were invited to participate in this study. Structured interviews were conducted to assess pregnant mothers’ beliefs about oral health care and their oral hygiene practices. Screening for mothers’ dental caries experience was carried out using the Decayed, Missing and Filled Teeth/Surfaces (DMFT/S) index. Univariate, bi-variate and multi-variable analysis were conducted to explain the high level of disease in this population. Results: A total of 152 pregnant women participated in this study. Mean DMFT in this sample was 15.5 ± 4.5 and an average DMFS of 31.8 ± 21. According the World Health Organization (WHO) criteria, 89% of our sample were categorized in the “Extremely High” dental caries experience. Fifty-eight percent of the DMFT scores among this sample were due to untreated dental decay, while 22% of the same DMFT scores demonstrated restorative care received by this sample. Bivariate analysis showed that mothers who completed a degree after high school had lower DMFT scores than mothers who did not (F = 4, n = 152, p = .024). In addition, mothers who believed they could lose a tooth just because they are pregnant had higher DMFT scores (t = − 4, n = 152, p = .037). The final model found that age, level of education, providers’ advice on utilizing dental care during pregnancy, and the belief that a woman can lose a tooth just because she is pregnant explained 22% of the variation in DMFT scores. Conclusions: Women in this study had a high prevalence of dental diseases and knew little about dental care during pregnancy. Faulty beliefs about dental care during pregnancy among women and health care providers were major factors in the high levels of disease.Authors thank Mrs. Raghda Belebesi, the head of the nursing department in the Jerusalem Governorate, and all nurses working in maternal and child health care centers at the Ministry of Health public clinics for their great help and support during this study. Funding Data collection was funded by the 2016 FDI SMILE Award, the Zamalah University Fellowship Program and the L’Oréal-UNESCO “For Women in Science” Fellowship

How Dentistry Survived the Early Months of the COVID-19 Pandemic? The Palestinian Experience

Objectives: Dentists provide care in a proximity with patients and most of dental procedures generate aerosols and droplets. Under these conditions, dentistry had unique challenges to operate safely during the COVID-19 pandemic. This study assessed how Palestinian dentists survived the early months of the COVID-19. Methods: A cross-sectional study targeted dentists in the West Bank area of Palestine using an on line survey during the first two weeks of May, 2020. Questions mainly asked about dentists’ perception of the risks of COVID-19, readiness to reopen their clinics for routine care, and the level of confidence in dealing with suspected COVID-19 patients. Results: 448 dentists completed the survey. Almost 60% believed that they were not ready to re open their practices. Thirteen percent had “no confidence” in dealing with COVID-19 patients, while 64% had “little to moderate” confidence. Confidence was correlated negatively with increased fear of getting infected (ρ=-0.317, p<0.0001) and positively with years of practice (ρ=1.7, p< 0.0001). Dentists who received updated training on infection control or on COVID-19 reported higher levels of confidence (X2 =53.8,p<0.0001, X2=26.8, p<0.0001 respectively). Although 88% preferred not to treat COVID-19 patients, 40% were willing to provide care to them. Almost 75% reported that they were already facing financial hardships and couldn’t survive financially until the end of the current month. Conclusions: Data from this study highlights the fragility of private dental practice in emergency situations. Ethical, health and financial challenges that emerged during COVID-19 require dentists to adapt and be better prepared to face future crises

Oral health status among convenient sample of palestinian adults

The Occupied Palestinian Territories (OPT) is the term used by the UN for those parts of historical Palestine occupied by Israel after the Arab–Israeli war of 1967. (1) Because of the political situation and its consequences, most of the areas in the West Bank has little infrastructure in health, education and social services.(2) Ramallah, a city located in the middle of the West Bank, is considered the commercial and governmental capital of the Palestinian Territories. Palestinians from all over the West Bank seek jobs and business in Ramallah which makes its people very diverse

Infection Control Knowledge, Attitude and Behavior among Undergraduate Dental Students at Al-Quds University

Infection control is one of the most crucial challenges in healthcare settings worldwide and is considered one of the most important causes of morbidity and mortality associated with clinical, diagnostic and therapeutic procedures. At the dental field, the dentists deal with an infective environment while treating patients. Hence strict cross infection protocols are usually taught at dental schools to build the correct habits in dealing with patients and instruments and minimize the risk of cross infection. Al-Quds university dental school applies those strict rules in their out patients dental clinics; however, we don’t know how much of infection control protocols are practiced among students and how much of what they learned, will be practiced in their future clinics. Thus, this study came to evaluate the cross infection knowledge, attitude and practice among undergraduate dental students at Al-Quds University. A cross sectional study based on a self-administered questionnaire consisting of seventeen questions regarding the students’ knowledge of cross infection and blood borne pathogens transmission in dental settings, six questions on attitude and thirteen questions about their practice and behavior. In addition, some demographic questions such as the gender and the academic average were asked. Questions of this survey were modeled after validated published surveys. This questionnaire was administered to 5th year dental students at the mid of their final semester in the DDS program at Al-Quds university Abu-Dis. We will generalize a descriptive study of knowledge and attitude then we’ll do some association using a correlational test to compare the frequencies of knowledge, attitude and practice with a p-value 0.05. Data will be analyzed using SPSS software. Ethical approval will be submitted to AQU Research Ethics Committee

Risk perception and readiness of dental students to treat patients amid COVID-19: Implication for dental education

Dental settings have one of the highest risks of infection transmission (Jamal et al., 2020; Mohebati, Davis, & Fry, 2010). Therefore, the COVID-19 pandemic has presented significant challenge for dental students and infection control measures. Data presented here were extracted from a survey conducted among Palestinian dental students in their clinical study years to evaluate their readiness to return to dental care provision during the COVID-19 pandemic. A total of 305 dental students from Al-Quds University (AQU) and Arab American University (AAU) completed the questionnaire in mid-May 2020. Thirty-four percent of the current sample (n = 103) perceived COVID-19 as very dangerous, and 84.3% (n = 257) believed that COVID-19 is a serious public health issue. Fifty-five percent (n = 168) did not consider themselves prepared for this outbreak, and 66.2% (n = 202) did not think that their outpatient clinics' infection control measures prior to COVID-19 are adequate to receive patients during this pandemic. Eighty-eight percent of the students (n = 269) admitted to fear of transmitting the virus to family and friends. This fear was mainly related to their perception that standard precautions used in dental settings are inadequate and make it unsafe to deal with patients during the current pandemic (χ2 = 50.45, p < .001). Thus, 82% of students (n = 250) preferred to avoid working with COVID-19 suspected patients. This perceptionThe authors would like to thank each anonymously participating dental student of Al-Quds University (Palestine) and Arab American University (Palestine) who contributed to making this work possible

Factors influencing dentists’ willingness to treat Medicaid-enrolled adolescents

Objectives: To identify factors influencing dentists’ willingness to treat Medicaid-enrolled adolescents with intellectual and developmental disabilities in Washington state. Data sources: Primary data were collected by a survey instrument administered in 2017 to general and pediatric dentists who were Medicaid providers (N = 512). Methods: We administered a 40-item survey, which included 20 hypothetical scenarios involving a 12-year-old Medicaid-enrolled adolescent. Based on the characteristics of the potential patient, dentists were asked to rate their willingness to treat (1 = very likely; 5 = very unlikely). We used conjoint analytic techniques to examine the relative importance of six adolescent- and family-level factors (e.g., severity of intellectual and/or developmental disability [IDD], sugar intake, toothbrushing, caregiver beliefs about fluoride, restorative needs, appointment keeping) and state Medicaid reimbursement level (35 percent, 55 percent, 85 percent of usual, customary, and reasonable amount). Analyses focused on data from 178 dentists with complete and varied responses to the scenarios. Results: The mean age of participants was 53.8 ± 10.5 years and 10.7 percent were pediatric dentists. The holdouts correlation statistics indicated excellent fit for the conjoint model (Pearson’s R = 0.99, P < 0.0001; Kendall’s tau = 0.89, P < 0.0001). Reimbursement level and appointment keeping were the most important factors in dentists’ willingness to treat Medicaid-enrolled adolescents (importance scores of 26.7 and 25.7, respectively). Restorative needs, caregiver beliefs about fluoride, and IDD severity were the next most important (importance scores of 15.4, 10.6, and 8.1, respectively). Sugar intake and toothbrushing behaviors were the least important. Conclusions: Reimbursement and appointment keeping were the most important determinants of dentists’ willingness to treat Medicaid-enrolled adolescents with IDD

Factors related to the willingness of Palestinian dentists to treat patients with blood-borne diseases

This study aimed to explore, using groups of simulated patients, the willingness of Palestinian dentists to treat patients with blood-borne diseases. Simulated patients conducted a telephone survey of a random sample of dentists registered with the Palestinian Dental Association. A random system was used to assign dentists to one of two groups, in which simulated patients randomly identified themselves with either human immunodeficiency virus (HIV) or hepatitis B virus (HBV) and asked for a dental appointment. Three-hundred and four dentists (76%) responded to our telephone survey. Sixty-six per cent accepted requests for appointments and 34% declined the appointment requests. Sixty-eight per cent of the dentists declined appointment requests from patients with HIV and 32% declined appointments from patients with HBV. Dentist’s gender, ‘blood-borne disease type’, ‘place of private practice’, ‘country of graduation’ and ‘years since graduation’ were all significant predictors in the final logistic model. More than one-third of our respondents declined appointment requests from patients with blood-borne disease, two-thirds of which were for patients who identified themselves as having HIV. Education and training programmes are needed to improve attitudes of dentists – especially female dentists, older dentists and dentists practising in northern governorates – towards patients with bloodborne diseases.The authors wish to thank Dr. Hussein Al-Rimawi for his statistical advice and Al Quds University dental class of 2008 for their participation in the study as simulated patients

The transition from amalgam to other restorative materials in the U.S. predoctoral pediatric dentistry clinics

Increased concerns about the safety of amalgam restorations in children have resulted in many dental schools emphasizing the teaching of alternative dental materials. This study investigated the current teaching of different dental materials for use in posterior teeth in the United States predoctoral pediatric dentistry programs. In 2011, the authors invited the chairs of the predoctoral pediatric dentistry departments in all accredited dental schools at that time (N = 57) to participate in an internet‐based survey. Descriptive statistics were calculated to describe the frequency of using different restorative materials. Regression models were developed to explore the factors related to the use of dental restorations in predoctoral pediatric clinics. Among the 44 dental schools that responded (77% response rate), 74% used amalgam, and 93% used composite in primary posterior teeth. Glass ionomer was used by 61% of the schools in primary posterior teeth. Placing amalgam in primary posterior teeth was associated with programs that treated more 3–5‐year‐old patients (β = .302, p < .043), whereas the use of glass ionomer was associated with having students serving at off‐site satellite dental clinics (β = .015, p < .012). In general, having departments with chairs who had positive attitudes towards Minimal Invasive Dentistry (MID) used composite (β = .091, p < .0001) and glass ionomer (β = 103, p < .0001) more frequently and were less likely to use amalgam (β = −.077, p < .005) in primary posterior teeth. Although teaching MID concepts in predoctoral pediatric clinics in dental schools is increasing, the use of amalgam in posterior primary and permanent teeth is still widely practiced.This project was funded by NIH/NIDC R T32 Grant DEO 14678‐06