Reliability and validity of the Turkish version of the shorter form of the gagging problem assessment questionnaire

Summary  The aim of this study was to evaluate the reliability and validity of the Turkish version of the shorter form of the gagging problem assessment questionnaire. Forty-three patients with gagging problems and 89 patients who showed no signs of gagging during dental examination were included in the study. The patients completed the patient portion of the gagging problem assessment questionnaire, as well as the modified dental anxiety scale, dental fear scale and Spielberger trait anxiety scale for comparison. Two experienced dentists subsequently completed the dentist portion of the gagging problem assessment questionnaire by performing clinical examinations with a dental mirror. The results indicate that patients with gagging problems had significantly higher mean scores than the control group ( P  <   0·001). The internal consistency of the questionnaire was found to be adequate, and good intra- and inter-observer reliability was present. Patients with a gagging reflex had significantly higher anxiety scores, indicating the validity of the questionnaire. The Turkish translation of the shorter form of the gagging problem assessment questionnaire was found to be reliable and valid for distinguishing among patients with and without a gagging reflex.     

Influence of gag reflex on removable prosthetic restoration tolerance according to the patient section of the short form of the Gagging Problem Assessment Questionnaire

PURPOSE

To assess removable prosthetic restoration tolerance according to the patient section of the short form of the Gagging Problem Assessment Questionnaire (GPA-pa SF) and the influence of gender, education level and prosthesis type and denture-related mucosal irritation on the GPA-pa SF scores before treatment and over a period of two months after prosthesis insertion.

MATERIALS AND METHODS

130 participants who required removable prosthesis were surveyed with a standard form that included questions regarding age, gender, education level, dental attendance, and prosthetic restoration type. Participants answered the GPA-pa SF before restoration (T0) and 1 day (T1), 2 days (T2), 15 days (T3), 1 month (T4), and 2 months (T5) after prosthesis insertion.

RESULTS

Of the 130 participants, 110 participants completed the prosthetic restoration procedure, but only 93 of these were able to use the prosthesis over the two-month period. The mean GPA-pa SF score obtained at T0 was higher than the scores obtained at the other periods in the total of the sample. Significant difference was present between mean scores obtained at T0-T1 and T2-T3 than scores obtained at other periods (P<.05). Female participants and participants with denture-related mucosal irritation had higher GPA-pa SF scores at all time points analysed. Significant difference was present between mean GPA-pa SF scores obtained at T2-T3 than scores obtained at other periods for females and participants with denture-related mucosal irritation (P<.05). Education level and prosthesis type did not significantly influence the GPA-pa SF score at any time point analysed (P>.05).

CONCLUSION

GPA-pa SF scores were higher before the restoration procedure began, and decreased over time with the use of prosthesis. Gender and denture-related mucosal irritation affected the GPA-pa SF scores.     

A needs assessment survey of dental public health graduate education in Saudi Arabia

Objectives

The Faculty of Dentistry at King Abdulaziz University (KAU) is planning to develop a master’s program in dental public health (DPH). To develop a curriculum for this program, a needs assessment was conducted in order to identify the level of DPH expertise that currently exists in Saudi Arabia, to identify gaps in knowledge, and to explore current perceptions regarding this type of program.

Methods

A competency-based survey instrument was administered to private and government affiliated dental practitioners in Jeddah, Saudi Arabia. Participants’ knowledge, attitudes, and competencies in DPH were assessed. In addition, questions were submitted that addressed preferred strategies of teaching, curriculum delivery methods, course content, and prerequisites for DPH. These data were combined with data previously collected from dentists holding academic positions at KAU (n = 146) and were analyzed using Statistical Analysis System version 9.3 software. Mean values and frequencies were calculated for the study variables. Proportional odds ratios and 95% confidence intervals were estimated to assess differences in educational preferences and DPH competencies according to age, gender, and qualification.

Results

Most of the participants (95%) reported a need for a DPH graduate program. The respondents had a basic knowledge of DPH and moderate experience in DPH competencies. A variety of preferred educational strategies and methods were identified and differences in educational preferences according to age, gender, and qualification of the respondents were identified. The responses obtained also acknowledged skills and competencies that the participants considered most important for a DPH practice and that would be important for students accepted into a DPH graduate program.

Conclusions

This needs assessment survey represents a preliminary step in establishing a DPH graduate program that addresses current gaps in knowledge and in the practice of public health dentistry. This survey also provided valuable feedback regarding the development of course content for a graduate education program in DPH.     

Patient-reported outcome measures compared to professional dental assessments of monolithic ZrO2 implant fixed dental prostheses in complete digital workflows: A double-blind crossover randomized controlled trial

Purpose

This double-blind randomized controlled trial analyzed patient-reported outcome measures in terms of subjective patient satisfaction compared to objective dental evaluation of prosthetic treatment with 3-unit monolithic zirconium dioxide implant fixed dental prostheses (iFDPs) in 3 digital workflows.

Material and methods

Twenty patients were restored with 3 iFDPs each on Straumann TL-implants with 2 completely digital workflows using different intraoral optical scanning systems with model-free fabrication of the restoration (Trios 3/3Shape [Test-1]; Virtuo Vivo/Straumann [Test-2]), and mixed analog-digital workflow with conventional impressions and digitized gypsum casts (Impregum/3M Espe [Control]). The order of impression-taking and the prosthetic try-in were randomly allocated. Sixty iFDPs were compared for patient satisfaction and dental evaluation using ANOVA.

Results

For iFDP evaluation, patients generally provided more favorable ratings than dental experts, regardless of the workflow. ANOVA revealed no significant difference for overall satisfaction when comparing Test-1, Test-2, or Control, either for patients (f-ratio: 0.13; p = 0.876) or dentist (f-ratio: 1.55: p = 0.221). Secondary, patients clearly favored the digital impression workflows over the conventional approach (f-ratio: 14.57; p < 0.001). Overall, the 3Shape workflow (Test-1) received the highest scores for all analyses.

Conclusions

The different digital workflows demonstrated minor influence on the subjective and objective evaluation of the monolithic zirconium dioxide iFDPs in nonesthetic regions; however, the dentist may significantly increase patient satisfaction by choosing intraoral scanning instead of conventional impressions. The dentist has to consider individual patients’ needs to fulfill their expectations for a personalized solution.     

Caries management decision: Influence of dentist and patient factors in the provision of dental services

Objectives

Little is known about how dentists implement caries management and provide restorative dental services in everyday practice. This study explored whether or not recent concepts in caries management were implemented in practice by private practitioners. The influence of patient and practitioner characteristics on the provision of restorative dental services was also investigated through multidimensional analyses.

Methods

A sample of French general private dental practitioners was asked to record the characteristics of 35 preventive or restorative treatments made on vital permanent teeth. The data collection form was designed to explore dentists’ attitudes towards caries management and their use of minimally invasive therapies.

Results

Twenty-six practitioners recorded the characteristics of 921 treatments performed on 457 patients. Results indicate that participants rarely performed non-invasive treatments. They used an inappropriate detection tool, as most of decisions to treat were based on visual inspection frequently associated with probing. Multidimensional analysis showed that dentists provided different restorative treatments depending on patient characteristics, with minimally invasive, esthetic restorations preferentially performed for healthy, young and well-insured patients. Restorative treatments and detection tools also varied markedly among practitioners. These variations in service patterns were not related to a specific patient profile in each dental practice.

Conclusions

Results indicate that recent concepts in caries management have not yet been adopted in everyday practice. Patient and dentist characteristics influence the provision of restorative dental services. Decision-making in caries management not only depends on pathophysiology but also seems to be influenced by many other factors.     

An assessment of the dental public health infrastructure in the United States

OBJECTIVES: The National Institute of Dental and Craniofacial Research commissioned an assessment of the dental public health infrastructure in the United States as a first step toward ensuring its adequacy. This study examined several elements of the U.S. dental public health infrastructure in government, education, workforce, and regulatory issues, focused primarily at the state level. METHODS: Data were drawn from a wide range of sources, including original surveys, analysis of existing databases, and compilation of publicly available information. RESULTS: In 2002, 72.5% of states had a full-time dental director and 65% of state dental programs had total budgets of 1 million dollars or less. Among U.S. dental schools, 68% had a dental public health academic unit. Twelve and a half percent of dental schools and 64.3% of dental hygiene programs had no faculty member with a public health degree. Among schools of public health, 15% offered a graduate degree in a dental public health concentration area, and 60% had no faculty member with a dental or dental hygiene degree. There were 141 active diplomates of the American Board of Dental Public Health as of February 2001; 15% worked for state, county, or local governments. In May 2003, there were 640 U.S. members of the American Association of Public Health Dentistry with few members in most states. In 2002, 544 American Dental Association members reported their specialty as Dental Public Health, which ranged from 0 in five states to 41 in California. Just two states had a public health dentist on their dental licensing boards. CONCLUSIONS: Findings suggest the U.S. dental public health workforce is small, most state programs have scant funding, the field has minimal presence in academia, and dental public health has little role in the regulation of dentistry and dental hygiene. Successful efforts to enhance the many aspects of the U.S. dental public health infrastructure will require substantial collaboration among many diverse partners.     

A radiographic assessment of the prevalence of pulp stones in a group of Turkish dental patients

Aim  To determine the prevalence of pulp stones in a group of patients using radiographs, and to assess any associations with age, gender, systemic diseases, tooth type, jaw, caries, restorations, impacted third molars and dental anomalies including dens invaginatus, taurodontism, dens evaginatus and microdontia.
Methodology  A total of 519 patients were selected randomly amongst patients referred to Oral Diagnosis and Radiology Department, Faculty of Dentistry, Ankara University. After clinical inspection, full-mouth periapical radiographs were obtained. An oral radiologist examined the radiographs to identify pulp stones. Frequency distribution of teeth with pulp stones was calculated and statistical analysis was performed with chi-square test.
Results  Of the patients, 313 (60%) were female and 206 (40%) were male. Sixty (12%) had one or more teeth that contained pulp stones. Amongst the 13 474 teeth examined radiographically, 627 (5%) had pulp stones. There was no significant association between pulp stone occurrence and gender or systemic diseases. As age increased, the prevalence of pulp stones increased ( P  < 0.01). Molars had statistically more pulp stones than premolars and incisors ( P  < 0.001). Frequencies in both maxillary and mandibular jaw were similar. There was no association between pulp stones and impacted third molars, caries, restorations or dental anomalies.
Conclusions  The prevalence of pulp stones increased with age and was significantly higher in molar teeth than premolars and incisors. There was no significant association between pulp stones and gender, systemic diseases, impacted third molars, condition of the crown and dental anomalies.     

Prevalence of dental caries among workers in the sweets industry in Israel

The purpose of the present study was to assemble data on the prevalence of dental caries among workers in the sweets industry. Three confectionaries were selected for the study. Most employees consented to be examined and were included in the study. The participants were distributed into two main groups: production line workers (228 participants) and non-production line workers (195 participants). The control group consisted of a group of production line workers from five textile industrial establishments; 812 in all. The results indicate that the mean DMFT values recorded for the sweets industry workers were significantly higher than those recorded for the control group. Significantly higher mean DMFT values recorded in the production line workers, as compared with the non-production line workers, in the confectionary industry were assumed to be attributed to a higher consumption of sweets and closer exposure to sugar dust. Mean DMFT values were found to increase significantly in relation to the duration of exposure to the effect of carbohydrates in both groups of workers in the sweets industry.     

The value of a questionnaire in assessing the acquisition and retention of basic science knowledge by dental students

This cross-sectional study aimed to assess and compare, by performances in a questionnaire, the level of knowledge of basic medical sciences in 6th-form school pupils studying science subjects as entrance requirements to University and in 2nd, 3rd and 4th-year undergraduate dental students. A 40-part multiple response, true/false questionnaire, testing recall of factual knowledge in anatomy, biochemistry, physiology and oral biology, was used as the method of assessment. The results suggested that this simple format was an acceptable and useful method of assessment of the knowledge level of the study groups. The difference in scores of knowledge, expected to be higher in 2nd-year students compared to 6th form groups, was greatest in anatomy and oral biology, less in biochemistry and, unexpectedly, was not apparent in physiology. A difference in performance on the knowledge questionnaire was observed between 4th and 2nd year dental students, attributable primarily to decreased scores for 4th year dental students in biochemistry and, to a lesser extent, anatomy. The results obtained with this standardised test of factual knowledge recall may be of value to teachers compiling medical sciences courses for dental undergraduates and to those planning and evaluating new curricula with a less didactic approach.     

Factors affecting the amount of long-term restorative dental treatment provided to 100 patients by 20 dentists in 3 Adelaide private practices

Apart from the effects of the frequency of patient attendance for dental examination, and of a change of dentist, little is known of those factors which may influence the amount of treatment provided in dental practice. The present study investigated during 1992 the effects of seven factors on the amount of treatment provided for 100 adult patients treated by 20 male dentists over many years in three selected Adelaide private practices. The amounts of particular types of restorative treatments provided were significantly related to patient age, gender and frequency of attendance, and to practice location, change of dentist and number of changes of dentist, and to the experience or time since graduation of the dentist. These factors were of special significance for the number of crowns provided, most of which were placed in older patients by more experienced dentists. But, there was no evidence of increased numbers of direct placement restorations being received by patients who attended more frequently or who changed their dentists.     

The validity of different display monitors in the assessment of dental implant site dimensions in cone beam computed tomography images

Abstract

Objective. To determine if the differing contrast resolution of various LCD monitors affects the reliability or accuracy of measurements of proposed implant sites. Materials and methods. Edentulous areas of human dry skulls were marked with radiopaque markers in order to standardize the plane of the transverse cross-sections of the ridges and path of measurements. The skulls were imaged by a CBCT device and the images stored in proprietary format on the workstation. The data sets were then transferred, with the proprietary reformatting software, to two different laptops using CDs. Transverse cross-sectional images of the ridges were reformatted on all three computers and ridge dimensions were recorded using the linear measurement tool of the proprietary software. Ridge dimensions were recorded directly from the three different monitors by two observers and compared to measurements recorded directly from the bone. The measurement errors and intra- and inter-examiner reliability were calculated for each monitor and compared with each other. Results. Intra- and inter-examiner reliability scores for the measurements recorded from all three devices were very high and ranged between 0.993–0.999. The mean of the absolute errors was 0.55 mm for the workstation, 0.61 mm for laptop 1 and 0.68 mm for laptop 2. The absolute errors were statistically significant for all three monitors (p-value < 0.001), but there was no statistically significant difference between the absolute errors obtained from the three monitors. Conclusions. No differences in the reliability or accuracy of measurements of implant site dimensions were obtained using color LCD monitors with different contrast resolution capabilities.     

Evaluation of Dimensional Accuracy of Panoramic Cross‐Sectional Tomography,Its Ability to Identify the Inferior Alveolar Canal,and Its Impact on Estimation of Appropriate Implant Dimensions in the Mandibular Posterior Region

Objectives: To evaluate the dimensional accuracy of panoramic cross‐sectional tomography, its impact on implant size estimation and its ability in identifying the inferior alveolar canal in the mandibular posterior region. Material and Methods: Eight partially edentulous mandibles with 18 edentulous sites were obtained. Orthopantomograms and tomograms were made and the mandible's outline and the position of mandibular canals on tomograms were traced on a clear acetate paper. Horizontal and vertical magnification factors were calculated. The mandibular height, distance between mandibular canal and alveolar crest, maximum bucco‐lingual width, distance between buccal cortex and mandibular canal, and cortical thickness at the inferior border of the mandible were measured. Potential implant sites were identified and implant sizes were estimated. Location and visibility of mandibular canals were also evaluated. The mandibles were sectioned at each site and all the above mentioned parameters were assessed which served as gold standard. Results: Mean horizontal and vertical magnification factors were 1.47 ± 0.048 and 1.53 ± 0.038. Total height and maximum bucco‐lingual width were underestimated by 1.88% and 1.59%. Crest to canal distance, cortical thickness at the inferior border of the mandible and buccal cortex to mandibular canal were overestimated by 0.59%, 5.16%, and 3.64%. Implant sizes were estimated for 11 sites and changes were recorded at 2 sites between record 1 and record 2. However, there was no disagreement between record 2 and record 3. Of the canals, 61.11% were located lingually and the visibility of mandibular canals was poor in 44.44% of cases. Conclusions: The tomograms were found to be accurate for the measurements in both horizontal and vertical planes and reliable for implant size estimation, taking into consideration proper magnification factors. They were also found to be useful in assessing the location of mandibular canal but were not very effective in discerning it.     

Attitudes of final year dental students to the use of rubber dam

Aim  To investigate the attitudes of final year dental students in Wales and Ireland to the use of rubber dam.
Methods  A pre-piloted questionnaire was distributed to final year dental students in Cardiff and Cork Dental Schools in January 2008. Information sought included attitudes to, and the current and anticipated use of, rubber dam for a variety of operative and endodontic treatments.
Results  Of 93 questionnaires distributed, 87 were completed and returned (response rate = 94%; Cardiff: 89%, n  = 51; Cork: 100%, n  = 36). Rubber dam was routinely used by 98% of respondents ( n  = 85) on adult patients, but only 32% of respondents ( n  = 28) had used rubber dam on child patients ( P  < 0.05). Rubber dam was never used by 75% of respondents ( n  = 65) when placing posterior amalgam restorations, and by 21% of respondents ( n  = 18) when placing anterior composite restorations. Rubber dam was used by 98% of the respondents ( n  = 85) when performing root canal treatments. Sixty-two per cent of respondents ( n  = 54) believed their use of rubber dam would decrease once leaving the dental school.
Conclusion  Whilst dental students believe that rubber dam is relevant to clinical dentistry, there are negative perceptions associated with its use amongst dental students. More than half of those questioned predicted their use of rubber dam would decrease once in independent practice. Greater emphasis should be placed on the advantages of using rubber dam in clinical dentistry whilst at dental school.     

A 5‐year prospective clinical study of Astra Tech dental implants supporting fixed bridges or overdentures in the edentulous mandible

In a 5‐year prospective clinical study, 1.55 endosseous implants were installed in the mandible anterior to the mental foramina in 33 edentulous patients (13 males and 20 females). Usually 6 implants were installed for fixed prostheses (FP). 13 patients with 77 implants, and 4 implants for overdentures (OD) with a Dolder bar, 20 patients with 78 implants. At the time of abutment connection 1 implant in 2 patients was found to be loose and removed. However, in both these patients overdentures were successfully placed on the remaining 3 implants. Narrow‐beam radiography was used for radiological evaluation. The mean (SD) total marginal bone loss in 5 years was 0.48 (0.38) mm (0.36 (0.22) mm in the FP group and 0.56 (0.45) mm in the OD group). Very few complications were reported during the 5 years, most of them being related to the superstructures. The overall cumulative implant survival rate was 98.7%(100% in the FP group and 97.4% in the OD group). The survival rate of the superstructures was 100%. The present study has demonstrated that Astra Tech implants offer reliable and predictable medium‐term support for fixed prostheses and overdentures in the edentulous mandible.