Treating patients with herpes simplex virus infections: dental and dental hygiene students' knowledge, attitudes, and professional behavior

Dental and dental hygiene students frequently interact with patients with herpes simplex virus (HSV) infections, often simply referred to as cold sores. The objectives of this study were to assess dental and dental hygiene students' knowledge, attitudes, and professional behavior concerning the treatment of patients with HSV infections and to investigate the relationships among knowledge, attitudes, and professional behavior. Questionnaire data were collected from 337 dental and seventy-three dental hygiene students at regularly scheduled classes. Dental and dental hygiene students did not differ in their overall knowledge concerning HSV infections. Dental hygiene students were more apprehensive about treating patients with these infections, but used more appropriate professional behavior compared to dental students. Dental students' knowledge and appropriateness of professional behavior increased over the course of their education. Overall, it was found that an increase in student knowledge was associated with increased apprehension related to treating these patients. However, the more apprehensive they were, the more they engaged in appropriate professional behavior. Educating future health care providers about the treatment of patients with infectious and communicable diseases can potentially increase the students' apprehension/negative attitudes concerning providing care, while at the same time increasing appropriate professional behavior during their education. Addressing students' apprehensions might be a crucial moderator that will determine whether they will provide the best possible care for these patients in their future professional lives.     

Effect of an educational course at an Iranian dental school on students' knowledge of and attitudes about HIV/AIDS

This study investigated the effects of an educational program designed to improve the knowledge and attitudes of senior dental students in an Iranian dental school about caring for patients with HIV/AIDS. As part of an extramural program in community dentistry, a new educational program about HIV/AIDS was developed at Tehran University of Medical Sciences in 2009. The program consisted of two days' observation at the Consultation Center for Behavioral Diseases and a one-day workshop on infection control. A control group was selected from dental students at Shahid Beheshti University of Medical Sciences. Before and after the intervention, students in both the intervention and control groups completed a questionnaire concerning their knowledge of and attitudes about HIV/AIDS. Students in the intervention group also expressed their opinions in a post-test questionnaire. An independent sample t-test was used for statistical analysis. In the control group, the means of students' knowledge and attitude scores did not differ significantly from pre-test to post-test. In the intervention group, however, the means of both knowledge and attitude scores on the post-test were significantly higher than on the pre-test (p=0.001 and p=0.009, respectively). In the intervention group, more than 96 percent of the students reported that they would completely follow infection control principles in future practice. This study concludes that the educational program improved the students' knowledge of and attitudes about HIV/AIDS and will have a positive effect on their future practice.     

Education about treating patients with HIV infections/AIDS: the student perspective

This study investigated dental and dental hygiene students' a) perceptions of their education about treating patients with HIV infections/AIDS, b) knowledge of universal precautions, c) attitudes towards treating these patients and patients perceived to be at risk for HIV infections, and d) evaluations of potential curricular activities such as discussion groups with HIV-infected patients. Data were collected with self-administered questionnaires from 315 dental and 89 dental hygiene students. On average, dental students reported having learned about this topic in fever courses than dental hygiene students. However, dental students answered significantly more knowledge questions about universal precautions correctly than did dental hygiene students. This knowledge increased over the program course. Male students had significantly stronger negative attitudes towards patients at risk for or with HIV infections/AIDS than female students. Overall, dental and dental hygiene students responded positively to the suggested methods for including more material about patients with HIV infections/AIDS such as case studies, discussion groups, and closely supervised clinical experiences. This study shows that dental and dental hygiene students are interested in learning more about treating patients with HIV infections/AIDS. It also adds information to previous research on factors involved in the dental healthcare providers' decisions to treat patients at risk for or with HIV infections/AIDS. The implications of these findings for curriculum development efforts are discussed.     

Iranian dental students' knowledge of hepatitis B virus infection and its control practices

With more than two billion infected people, from whom 350 to 400 million suffer from chronic infection, hepatitis B virus (HBV) is still a major health problem worldwide. As dental treatment puts both dentists and patients at a higher risk of HBV infection, dentists can play an important role in preventing HBV transmission in dental settings. This study was performed to evaluate dental students' awareness and practice regarding HBV-related issues and to compare the results obtained from different academic years. One hundred and forty-two questionnaires consisting of questions on students' knowledge of HBV and preventive measures against this virus were completed by third- to sixth-year dental students of Tehran University of Medical Sciences (TUMS), Tehran, Iran. Overall, a relatively good level of knowledge was observed amongst this population. However, students' answers to practice questions were less satisfying. It is noteworthy that in some cases students of higher academic years showed less awareness. This finding highlights the necessity of continued infection control education. TUMS students must complete an infection control workshop before they start their clinical education. The authors propose that such training at the beginning of each academic year would be worthwhile.     

A Survey of Final-Year Dental, Medical and Nursing Students: Occupational Injuries and Infection Control

BACKGROUD: This study investigated nonsterile occupational injuries and infection control practices reported by final-year dental, medical and nursing undergraduates. Data from an anonymous, self-administered questionnaire were analyzed using ANOVA and chi-square tests. Nonsterile occupational injuries in the previous year were reported by 82% of dental, 57% of medical and 27% of nursing respondents, including one hepatitis B virus (HBV) and one human immunodeficiency virus (HIV) exposure. Although students received appropriate management for known HIV and HBV exposure, 48% of dental, 77% of medical and 59% of nursing students reporting injuries also reported no postexposure follow-up. Dental students were more aware of postexposure protocols (p < 0.001) and also reported more frequent use of gloves (p < 0.05), masks (p < 0.001) and protective eyewear (p < 0.001) than other students. Students who reported 2-handed recapping of needles had twice the number of percutaneous injuries (mean = 1.9/year) than those who avoided recapping or recapped with one hand using a device or scoop technique (p < 0.05). All dental, and 99% and 95% of medical and nursing students, respectively, reported HBV immunization; however, 6% of dental students had inadequate response (i.e., titre of antibodies to HBV surface antigen [anti-HBs].10 mIU/mL) and 13% of dental, 24% of medical and 41% of nursing students did not know whether their postimmunization anti-HBs titre was adequate. The majority of students reported occupational injuries that increase risk of exposure to pathogens. Educational interventions are required to improve postexposure follow-up, handling of sharps, use of barriers and HBV postimmunization serology.     

Knowledge and attitudes towards HIV/AIDS among dental students of Jazan University,Kingdom Saudi Arabia

Objectives

To evaluate the knowledge and attitudes of dental students at Jazan University, Saudi Arabia; compare the differences in HIV/AIDS related knowledge and attitudes between the genders and years of study.

Infection control attitudes and perceptions among dental students in Latin America: implications for dental education

Latin American dental schools are at diverse stages in the continuum of implementation of infection control (IC) programmes that comply with evidence-based recommendations. Poor IC training may result in low compliance and negative attitudes against patients infected with blood borne pathogens (BBP). OBJECTIVE: To evaluate students' knowledge on IC and attitudes toward occupational BBP risks, in six dental schools in Latin America. METHODS: This survey was administered to convenience samples of dental students at one school in Costa Rica; four schools in Mexico, and one in Venezuela. The questionnaire included Likert-type scale evaluations of agreement with statements. Study variables included knowledge about and confidence in recommended IC procedures, degree of concern about HIV and HBV transmission in dental settings, and attitudes toward patients infected with BBP. Possible associations between variables were analysed using Pearson's Chi square and Kruskal Wallis tests. RESULTS: Substantial numbers of students had incomplete knowledge and often lacked confidence on IC and procedures; believed that HIV and HBV could be transmitted during clinical procedures; felt worried about occupational exposure to BBP, and held prejudices towards HIV and HBV infected individuals. CONCLUSIONS: Educational efforts are needed to enhance IC teaching and compliance. Diverse educational resources and international networks for research collaboration are available from organisations specialised in IC, hopefully paving the way to harmonising regional standards.     

Oral Hygiene and dental student's knowledge, attitude and behaviour in managing HIV/AIDS patients

Abstract:  The human immunodeficiency virus (AIDS) and the acquired immunodeficiency syndrome (AIDS) have profoundly affected every aspect of the public health sector. The possibility of HIV transmission in the oral health care setting is very rare. Nonetheless, the oral health care environment has become a helpful setting for early detection, as most lesions of HIV infection present orally during the first stages of the disease. Willingness to treat patients with HIV/AIDS appears to be related to knowledge of the disease process, its oral manifestations and modes of transmission, thus influencing health workers' attitudes and behaviour towards management of HIV/AIDS patients. This study assessed the level of management of HIV/AIDS patients amongst dental and oral hygiene students at the University of the Western Cape Dental faculty. Student's knowledge of HIV/AIDS, their behaviour and attitude in treating HIV/AIDS patients, the precautionary measures practiced and their perceptions of curriculum preparation on HIV/AIDS were assessed. Data were collected by means of a self- administered questionnaire. The results indicated that students' knowledge on HIV/AIDS generally increased as they progressed throughout their curriculum but their utilization of all barrier techniques for infection control and clinical protocol, lacked consistency and compliance. Given the fact that the possibility of transmission of HIV/AIDS does exist within the dental setting, it is important that supervisors reinforce universal precautions. Clinical application of these precautions has a direct impact on the spread of the disease.     

Increasing acceptance of hepatitis B vaccine by dental personnel but reluctance to accept hepatitis B carrier patients

Dental personnel in London were surveyed for their uptake of hepatitis B vaccine and willingness to provide dental care to carriers of hepatitis B virus (HBV). Most respondents were aware of current recommendations about vaccination, and three fourths of dentists had been vaccinated against HBV. However, only half of dental ancillary staff members had been vaccinated against HBV. Three fourths of the London dentists surveyed, despite their immunity against HBV, were unwilling to treat HBV carriers.     

Students' comfort level in treating vulnerable populations and future willingness to treat: results prior to extramural participation

This study analyzed senior dental students' perceptions prior to extramural rotations for comfort and future willingness to treat patients with special needs and other vulnerable groups. The sample included 690 University of Iowa senior dental students who graduated from 1992 through 2004. These students completed a questionnaire concerning twelve vulnerable population groups. Logistic regression models were performed, using student comfort and future willingness to treat each group as the dependent variable. There was a wide percentage of range of comfort with these groups, yet there was no individual group that more than 60 percent of these students were willing to treat in their future practices. Generally, prior experience with the group had a positive impact on comfort level. When gender was included in the regression models, male students were more likely to express comfort. In all instances except one, experience had a positive influence on perceived future willingness to treat the associated group. However, younger graduates had a greater willingness to treat. When controlling for other variables within the future willingness to treat models, comfort was statistically significant only for HIV+/AIDS and non-English speaking groups. This study provides insight about comfort with and perceived future willingness to treat special needs and other vulnerable patient groups.     

Knowledge and attitudes towards HIV/AIDS amongst Kuwait university dental students

The HIV and AIDS have emerged as complex health threats to the world population. As future dentists, it is pertinent that the dental students have sufficient knowledge and a positive approach towards the disease. Accordingly, the aim of this study was to assess the HIV/AIDS related knowledge and attitudes amongst clinical dental students at Kuwait University. A cross‐sectional survey was conducted amongst the clinical dental students using a structured questionnaire with 60 questions to examine their knowledge under various categories and 13 questions to examine their attitudes towards the disease. The survey revealed that almost 58% of the respondents demonstrated a high level of knowledge (mean score: 45.23 ± 4.35 SD). Majority of the students (63.6%) expressed negative attitude (mean score: 5.36 ± 2.56 SD). The mean knowledge score of the fifth year dental students was significantly higher (P = 0.022) than that of the final year dental students regarding the knowledge of virus and disease process. However, no significant difference was observed with respect to other knowledge categories. Despite their high level of knowledge, the majority displayed a negative attitude towards HIV/AIDS. Hence, the findings imply that there is a need to address, more clearly, the students’ misconceptions and attitudes towards the disease.     

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 blood‐borne diseases.     

Knowledge and attitudes about HIV/AIDS of dental students from Kuwait and Sri Lanka

Several studies regarding knowledge and attitudes of dental students towards HIV/AIDS have been reported from various countries. However, to the best of our knowledge, an international comparison between countries with diverse cultural and educational backgrounds has not been reported in the literature. The aim of this study was to compare the knowledge and attitudes towards HIV/AIDS of dental students of Kuwait University (KU), Kuwait and the University of Peradeniya (UP), Sri Lanka, the only dental schools in the respective countries. A cross-sectional survey was conducted among a total of 258 dental students, representing the clinical years of both universities, using a similar structured questionnaire with sixty questions to examine their knowledge of various aspects of HIV/AIDS and thirteen questions to examine their attitudes towards the disease. The mean knowledge and attitude scores were calculated and compared between students from the two universities using t-test with SPSS 17.0. A total of 215 questionnaires were completed and returned, giving a total response rate of 83.3 percent. The KU students were significantly more knowledgeable (p=0.018) regarding HIV/AIDS than the UP students. However, the UP students demonstrated a more highly significant positive attitude (p<0.001) towards the disease than those in KU. This information might help to define strategies to improve the quality of education in these countries.     

中国口腔医学各专业实习生对乙型肝炎病毒感染知、信、行情况调查

目的 调查及比较中国口腔医学不同专业实习生对于乙型肝炎病毒(HBV)感染的知识、态度、行为(KAB).方法 对232名进入临床实习阶段的口腔实习生进行问卷调查,采用数据描述及双变量分析的方法得出KAB与不同专业及性别之间的关系.结果 在各专业口腔实习生中,超过80％的调查对象具有“较高”或者“高”的知识等级,其中修复科实习生的知识得分高于口腔内科(P=0.035)和口腔外科(P=0.019 87).口腔内科实习生的态度与是否接触HBV感染患者有关(P=0.006),口腔外科亦然(P=0.047).超过60％的实习生接受过至少3次的乙肝疫苗接种,特别是正畸科实习生(约80％);34％的口腔内科实习生表示“总是”或者“经常”检查抗体滴度,但66％的正畸科实习生表示“很少”或者“从不”;正畸科实习生比口腔内科的针头扎伤率低(P=0.044),与口腔外科相比,有相对较低的趋势(P=0.053);100％的正畸科实习生“总是”使用工作服.此外,口腔内科实习生相比于口腔外科(P=2.31e-6),修复科(P=1.704e-7)及正畸科(P=1.3es)实习生来说,行为得分更高,女性学生的行为得分显著高于男性学生(p=2.584e-s).结论 修复科实习生应掌握更多关于HBV传播的知识,正畸科实习生应提升疫苗注射率及检查抗体滴度,口腔内科实习生应更注重理论与实践结合,口腔外科实习生可提升自我效能及保持积极态度.     

Dental education and care for underserved patients: an analysis of students' intentions and alumni behavior

The U.S. surgeon general's report on oral health stressed the importance of providing dental care to underserved patients. The objectives of this study were to explore a) dental students' intentions and dentists' behavior concerning treating underserved patients, b) their perceptions of their education concerning these patients, and c) the relationship between dental education and their attitudes and behavior. Data were collected from 328 dental students (response rate: 77.5 percent) and 234 alumni (response rate: 43.7 percent). Only 67.4 percent of the students and 38 percent of the alumni indicated that their education had prepared them well to treat patients from different socioeconomic backgrounds; 71.3 percent of students and 55.2 percent of alumni responded that they had been well educated to treat patients from different ethnic/racial groups. The findings showed a positive relationship between the degree of curriculum focus on the importance of treating patients from all aspects of society and students' and alumni intentions to provide inclusive patient care to patients from diverse backgrounds. The more students agreed that their dental education had prepared them well to treat patients from different ethnic backgrounds, the more likely they were to report that they intended to treat these patients (r=.12; p=.033). In a similar manner, the more the alumni agreed that their dental education had prepared them well to treat patients in different communities, the more likely they were to treat patients from different socioeconomic backgrounds (r=.18; p=.009). In conclusion, these findings showed that access to oral health care for underserved patients could potentially be increased if dental students were more overtly educated about the importance of treating patients from all segments of society.     

Managing the care of patients infected with bloodborne diseases

BACKGROUND: The emergence of the bloodborne pathogens HIV, the cause of AIDS; hepatitis B virus, or HBV; and hepatitis C virus, or HCV, has been a milestone in the history of the dental profession. In the early 1980s, new cases of AIDS increased dramatically, and fear of acquiring this disease compelled clinicians to modify the delivery of medical and dental care to allay fears of transmission on the part of both patients and health care workers. Arguably, the AIDS pandemic has been the most significant factor in the evolution and delivery of modern medical and dental care in the last century. OVERVIEW: To help ally fears and remove barriers to caring for the HIV population, the Centers for Disease Control and Prevention, or CDC, introduced the concept of universal precautions in 1983. This was followed by the Occupational Safety and Health Administration's Bloodborne Pathogens Standard in 1991. Specific to the dental profession was the development of the principles of infection control in dentistry recommended by the CDC (1993); the American Dental Association (1995) and the Organization for Safety & Asepsis Procedures (1997). While initially difficult for some clinicians to acknowledge, these recommendations now are universally accepted throughout the profession, and provision of oral health care to patients infected with bloodborne disease is becoming commonplace. Compliance with recommended infection control practices remains an important component of dental practice. But it must be accompanied by an understanding of infectious and bloodborne diseases and the medical/dental management of the care of infected dental patients. CONCLUSIONS AND PRACTICE IMPLICATIONS: The emergence of the bloodborne pathogens and the increasing number of infected patients who seek oral health care compel clinicians to have a thorough knowledge about bloodborne diseases and the medical/dental management of the care of patients presenting with HIV, HBV or HCV infection.     

Knowledge, attitudes, and practice regarding infection control measures among dental students in Central India

A questionnaire study was conducted among 245 dental students from Bhopal city, Central India, to determine their level of knowledge, attitudes, and practice regarding infection control measures and if any correlation exists among the knowledge, attitudes, and practice scores. The self-administered questionnaire consisted of three parts: knowledge, attitudes, and practice. Analysis of Variance (ANOVA) was used to compare mean of knowledge, attitudes, and practice scores and Kendall's test to compute the correlation between knowledge, attitudes, and practice scores. A p value of ≤0.05 was considered significant for all statistical analyses. We found that 61.2 percent of the dental students had not been vaccinated with hepatitis B. Use of face mask, gloves, eyewear, and protective clothing as standard infection control measures was practiced only by two students. Mean knowledge, attitude, and practice scores were 3.75 (1.01), 3.40 (0.75), and 3.35 (1.04), respectively. Significant linear correlation was seen between attitude and practice scores (r=0.20, p≤0.01). The level of knowledge and practice of infection control measures was poor among dental students. The attitude towards infection control measures was positive, but a greater compliance was needed. We recommend rigorous training on infection control measures prior to graduation and mandatory hepatitis B immunization of students before exposure to clinical practice.     

Medicaid patients in dental school clinics: do personal and professional experiences matter?

The purpose of this study was to explore dental and dental hygiene students' and faculty members' personal experiences with Medicaid prior to coming to dental school as well as their professional/educational experiences with patients on Medicaid during their dental/dental hygiene education and how these experiences relate to their professional attitudes and behavior concerning treating patients on Medicaid. Survey data were collected from 317 dental students, fifty-five dental hygiene students, and fifty-seven clinical faculty members at the University of Michigan. The results showed that while responding students' confidence concerning treating Medicaid patients increased over the course of their education, their intention to treat these patients actually decreased. The more personal experiences with Medicaid these students had before dental school, the more they enjoyed treating Medicaid patients, the more confident they were when treating these patients, and the more likely they were to treat these patients in the future. The more professional experiences these students had during dental school, the more they enjoyed treating Medicaid patients, and the more confident they were when treating these patients, but the less likely they were to treat them in the future. In conclusion, experiences with Medicaid before dental school as well as professional experiences during dental education correlated with later professional attitudes and behaviors. The implications of these findings for dental education are explored.     

Hepatitis: still a concern?

Although some forms of viral hepatitis were identified more than 50 years ago, hepatitis continues to have an impact on the practice of dentistry. Possible transmission in the dental setting, management of the chronically ill, and legal issues related to treatment of infectious patients combine to emphasize that hepatitis is still an important issue for dental health care workers. Currently, 7 viral forms are recognized. Those with predominantly enteral modes of transmission-including HAV, HEV, and HFV-are of minor concern in the dental environment. HBV, the most infectious blood-borne pathogen, has been largely controlled in this country by vaccination and the use of universal precautions. HDV is an incomplete virus that has HBV infection as a prerequisite. HCV is of great concern today for several reasons. A high percentage of HCV infections results in chronic disease. Most cases remain asymptomatic for an extended period of time, and many have no identifiable risk factors. Currently, no vaccination is available for HCV. Patients infected with HCV present a management challenge, because they may ultimately develop serious liver dysfunction. In fact, HCV infection is presently the most common reason for liver transplantation. By understanding the various forms of viral hepatitis and following recommended infection control and vaccination protocols, the dental healthcare worker can treat infected patients in a manner that is safe for both patients and dental health care workers.     

Cross-sectional comparison of dental students' knowledge and attitudes before geriatric training: 1984-1999

The existence of negative attitudes toward aging and a lack of factual information has been voiced in the dental and other health professions. With increasing numbers of elderly in society, intergenerational social contact is more likely to occur and has the potential to reduce negative attitudes and increase knowledge about aging. The purposes of this study were to determine if the level of intergenerational social contact of dental students in one dental school had changed over the last fifteen years and whether any such changes were related to shifts in students' baseline knowledge about aging and attitudes toward elderly patients. Dental students (n=269) representing three different cohorts were surveyed about intergenerational contact, knowledge about aging, and attitudes toward elderly patients prior to receiving any geriatric training. Overall, findings revealed little evidence of increasing intergenerational social contact, an actual decrease in knowledge, an increased negative bias in knowledge, and unchanged attitudes toward elderly patients over the past fifteen years. Recent students were more likely to have had grandparents living in the family home, to have slightly less correct factual knowledge, and to be more negatively biased in their incorrect factual knowledge than earlier students. There were no differences in attitudes toward elderly patients among cohorts. We concluded that additional research is needed to confirm or refute our trends on a national scope. Should these trends be confirmed, dental educators would be alerted to the continuing necessity of countering the students' potential negative biases as well as a lack of basic knowledge about aging.