Dental care satisfaction among adult population in Isfahan, Iran and its influencing factors

BACKGROUND AND AIM: The aim of this study was to assess the level of dental care satisfaction among Iranian adult population and to identify socio-demographic factors and factors related to dental service that affect satisfaction. METHODS: A self-administrated valid and reliable 21-item questionnaire was designed and distributed among 1360 adult population living in Isfahan, Iran, using multi-stage proportional cluster sampling. It consisted of 5 main sections including demographic questions, perceived oral health status, oral health behaviors, barriers in receiving the demanded care and some 5-point Likert scale questions to assess the satisfaction level. Chi-square and analysis of variance were used to compare variables. People were classified as satisfied/dissatisfied based on their total score with score of 26 as the cut-off point. A logistic regression model was used to identify the factors affecting the level of satisfaction and to estimate their effect size. RESULTS: The mean age of participants was 31.2 ± 11.3 and they mostly reported to have dental visits during the last year. The mean satisfaction score was 3.34 out of 5 (53% were satisfied) and the least and the most satisfaction was in regard to waiting time and the convenience to access, respectively. Logistic regression showed that participants in lower age group [odds ratio (OR) = 0.7], those who reported their oral health status as poor (OR = 0.8) and those who had to spend more time to reach dental care setting (OR = 0.6) and those who had to wait more (OR = 0.5) were less satisfied. CONCLUSION: About 53% of participants were satisfied which was much lower than percentage of satisfied people in developed countries and the level of satisfaction was associated with socio-demographic, behavioral and also dental service. KEYWORDS: Patient Satisfaction; Dental Care; Adult; Ira

Stewardship of the Oral Health System in the Australia Capital Territory (ACT)

The study had two main aims: firstly to use the standards developed as part of DrTahani's PhD in order to evaluate the stewardship of the oral health system in the ACT; and secondly, to see if the standards, initially developed for the task of evaluating oral health stewardship in a middle income nation (Iran), had face validity and use value in the evaluation of the oral health system in a high income province (the ACT). The present report mostly focusses on the first aim

Orofacial Pathological Lesions in Children and Adolescents: A 25-year survey in Iran

Statement of the Problem: Oral pathological conditions presented in children are various and often different from those of adults. There is considerable variation in the prevalence of these lesions among different regions of the world. Purpose: The aim of this study was to assess the frequency and clinical-pathological features of oral lesions diagnosed in children and adolescents throughout 25 years in an oral pathology department. Materials and Method: This cross-sectional study was conducted in the Department of Oral and Maxillofacial Pathology at Dental School of Isfahan University of Medical Sciences. All the medical reports and biopsy files of the patients aged <18 years that were diagnosed during January 1990 and December 2015 were retrieved. The data regarding histopathologic diagnosis, site of lesions, and date of diagnosis and demographic characteristics of patients were elicited. The lesions were categorized based on their origin and age group of the patients. Descriptive statistics were used as appropriate. The critical level of significance was set at p< 0.05. Results: 1267 lesions were recorded. The mean age of the samples was 12.5±3.9. Of lesions, (408, 49.3%) were in posterior area. The most common lesions were odontogenic cysts (416, 32.9%) and reactive lesions (317, 25.1%) and the least common lesions were allergic and immunologic disorders (2, 0.2%). In age groups of 7-12 and 13-18 years, odontogenic cysts [(208, 38.1%), (198, 31.4%)] and reactive lesions [(143, 26.3%), (147, 23.3%)] were the most common lesions, respectively. During the 25 years of survey, the prevalence of pulp and periapical disease increased (p <0.001), that of bone pathology decreased (p< 0.05) and trend of other lesions did not significantly change over this time. Conclusion: The most frequent lesions were odontogenic cysts and reactive lesions. The prevalence of lesions was not changed dramatically during the 25 year. The frequency of oral lesions in Isfahan province (in Iran) is different from other regions in the world and even, to some extent, different from other regions in Iran, which is in agreement with the hypothesis of geographical distribution of these lesions

Health Technology Assessment of CEM Pulpotomy in Permanent Molars with Irreversible Pulpitis

Introduction: Teeth with irreversible pulpitis usually undergo root canal therapy (RCT). This treatment modality is often considered disadvantageous as it removes vital pulp tissue and weakens the tooth structure. A relatively new concept has risen which suggests vital pulp therapy (VPT) for irreversible pulpitis. VPT with calcium enriched mixture (VPT/CEM) has demonstrated favorable treatment outcomes when treating permanent molars with irreversible pulpitis. This study aims to compare patient related factors, safety and organizational consideration as parts of health technology assessment (HTA) of the new VPT/CEM biotechnology when compared with RCT. Materials and Methods: Patient related factors were assessed by looking at short- and long-term clinical success; safety related factors were evaluated by a specialist committee and discussion board involved in formulating healthcare policies. Organizational evaluation was performed and the social implications were assessed by estimating the costs, availability, accessibility and acceptability. The impact of VPT/CEM biotechnology was assessed by investigating the incidence of irreversible pulpitis and the effect of this treatment on reducing the burden of disease. Results: VPT/CEM biotechnology was deemed feasible and acceptable like RCT; however, it was more successful, accessible, affordable, available and also safer than RCT. Conclusion: When considering socioeconomic implications on oral health status and oral health-related quality of life of VPT/CEM, the novel biotechnology can be more effective and more efficient than RCT in mature permanent molars with irreversible pulpitis

Effect of Camellia sinensis plant on decreasing the level of halitosis: A systematic review

Tea is the second most consumed beverage. Polyphenolic catechins of green tea have a number of beneficial effects in oral cavity. This study aims to evaluate the clinical effects of green tea on halitosis through a systematic review of available literature. All available randomized, clinical trials – with a relevant subject that met the inclusion criteria – were included by searching PubMed, Cochrane, ProQuest, and Google Scholar, and Scopus databases. To score the selected articles, 27 items of CONSORT 2010 checklist were considered. Each article was reviewed by all the authors. Searching the PubMed database yielded 42 articles, 2 of which met the inclusion criteria. None of the 12 articles were obtained through Cochrane library, and 85 articles retrieved from ProQuest database met the inclusion criteria. Three hundred and five articles were obtained from Google Scholar, three of which fulfilled the inclusion criteria. Two articles were omitted because they were duplicated, and the rest were excluded. Searching the Scopus database yielded 270 articles, 2 of which met the inclusion criteria, but they were also duplicated. Finally, two studies were selected according to the inclusion criteria of the study. In both of the included articles, the early effect of green tea use was statistically significant in comparison with baseline. One of the studies showed the long-term effect of green tea mouthwash. Green tea can reduce halitosis through rinsing and antimicrobial effect

Students’ Perspectives in pre-clinical and during the clinical courses in Dental School of Isfahan University of Medical Sciences in year 2016

Introduction: Studies have shown that educational environments play an important role in the success, happiness and motivation of the students. The aim of this study was to investigate the perspective of dental students regarding their learning environment in the dental school of Isfahan University of Medical Sciences. Methods: In this descriptive cross-sectional study, all dental students studying in 2016 were selected (229 pre-clinical students and 383 clinical education students). The students' perspectives about their learning environment were examined in seven domains through the DSLES (Dental Student Learning Environment survey) questionnaire with 48 questions. Validity and reliability of this research tool have already been confirmed by Mojtahedzadeh et al. The collected data were analyzed using descriptive statistics, ANOVA, Chi Square and T-test. Results: 336 out of 612 questionnaires were completed and analyzed. The findings showed that positive attitude toward dentistry was seen in 87% of students (n=287). The highest score and the lowest score were in the field of organization and supportiveness. The mean scores obtained for the fields of flexibility, emotional environment, meaningful experience and breadth of interest were 1.9 ± 0.5, 2.1 ± 0.4, 2.0 ± 0.4 and 2.1 ± 0.6, respectively. The scores of flexibility (P <0.01), student-student interaction (P <0.002), breadth of interest (P <0.01) and the total mean (P <0.002) in Pre-clinical were higher significantly. There was a significant correlation between meaningful experience and GPA (p=0.04). Conclusion: According to the results, it is suggested that more attention be paid to flexibility in the content of the curriculum and communicational ways between the students and heads of the faculty to answer their concerns

Oral health status and oral health related quality of life among independent elderly attending municipal public centers

Background and Aims: With the growth of elderly population, attention to their oral health status has become increasingly important. Most of the available studies have been conducted among dependent elders who usually have different oral health statuses and needs. Therefore, the aim of this study was to determine the oral health status of independent elderly attending municipal public centers and parks in Isfahan in 2020. Materials and Methods: This is a descriptive-analytical cross-sectional study conducted among 195 elderly people attending Isfahan municipal centers in 2020. The oral health status and the oral health related quality of life (QOL) of elderly were evaluated using Geriatric Oral Health Assessment Index (GOHAI) and clinical examinations. The obtained data were analyzed using descriptive statistics (mean and standard deviation), correlation, independent T-test, Chi-squared and ANOVA using SPSS22 (α=0.05). Results: 69% of the participants (n=133) were male and the mean age was 68.9± 3.5. Almost 20% of elderly (n=39) did not have any of their natural teeth. 63% (n=123) suffered from at least two chronic diseases and 38.5% (n=75) had a functional occlusion. The mean score of quality of life (QOL) of elderly and their DMFT was 51.7±6.4 and 20.5±6.3, respectively. A significant and negative relationship was found between the DMFT and GOHAI (P<0.001, r=-0.36). QOL scores were significantly higher in participants with dentures than those without dentures (P<0.001). There was a significant relationship between the frequency of brushing and the mean of DMFT (P<0.001). In people who did not brush, the DMFT score was higher than those who brushed at least once a day or even sometimes a week. Conclusion: The results indicated that the oral health status of elderly was weak and it would reflect the need for more attention to taking more measures to both prevent the oral problems and to promote oral health

Satisfaction of Dental Students and Faculty Members with the Educational Outputs of Community-Based Dental Education Using Mobile Units in Religious Site

Introduction: Promoting public health through the facilities of religious sites has become a popular solution for different fields of medicine around the world. However, these programs have been less developed in Iran’s dentistry. The purpose of this study was to introduce a novel method of providing dental care using portable units in a religious site and to evaluate the satisfaction of students and faculty members with the educational outputs of the program. Methods: In This descriptive study, mobile dental units were first moved to the auditorium of a religious site (Zeinabieh) to provide dental care to the deprived patients of that area. All the senior dental students (N=75) were selected through census method. While examining the patients and providing the comprehensive treatment plan according to patient priority, they provided some necessary dental care during two weeks. After one semester, the program was evaluated through measuring the satisfaction of 30 students and five supervisor professors (selected randomly) by using a researcher-made 10-item questionnaire whose validity and reliability were confirmed. Data were analyzed using descriptive statistics. Results: The total mean score was 3.1±0.5. Sixty percent of the students believed that the effects of the program were high or very high on increasing their ability in restorative and preventive clinical treatments and efficient communication with patients. The lowest satisfaction level was related to improved skills in root canal treatment. Conclusion: Students’ satisfaction with the program was high in improving ability to provide preventive and dental care services and in communicating with patients

Determinants of oral health status: an ecological study in Iran

Abstract Objectives The aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level. Materials and methods The data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05). Results Mean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01–0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07–0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2–0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 − 0.48) were positively in associated with FT. Conclusions The present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors

Nudging oral habits; application of behavioral economics in oral health promotion: a critical review

Background: Oral health disorders significantly contribute to the global incidence of chronic diseases. Nudge interventions have demonstrated effectiveness in enhancing people’s decision-making and self-management capacities in a cost-efficient manner. As a result, these interventions could be  valuable tools for fostering improved oral care habits. This critical review explores potential behavioral nudges applicable to promoting oral health. Methods: A thorough electronic literature search was conducted on Scopus, Embase, and PubMed databases for papers published post-2008. The search focused on empirical evidence concerning the direct and indirect application of Nudge theory in oral health enhancement. In addition, the investigation included the nudge intervention’s role in managing common non-communicable disease risk factors (tobacco, alcohol, and sugar) and their use in other health sectors. Results and conclusion: There is a dearth of studies on behavioral economics, particularly those involving reward and reminder techniques. However, various successful nudge interventions have been identified in other sectors that aim to improve health decisions. These include strategies encouraging healthier nutritional choices, tobacco and alcohol cessation, medication compliance, routine physical activity, and regular health check-ups. Such interventions can also have direct or indirect positive impacts on oral health. Implementing these interventions within an oral care framework could promote oral health due to similar underlying cognitive mechanisms. However, different types of nudge interventions have varying degrees of effectiveness. Furthermore, factors such as the method of delivery and the characteristics of the targeted population significantly influence the outcome of the intervention. Hence, it is imperative to conduct extensive studies in diverse socioeconomic settings to fully understand the potentials, limitations, and impacts of nudge interventions in promoting oral health