Dentists’ knowledge,attitudes and practices regarding Hepatitis B and C and HIV/AIDS in Sanandaj,Iran

Background

Healthcare workers including physicians, dentists, nurses and laboratory workers are considered to be among the groups at the risk of blood-borne pathogen transmission. Thus, it is necessary to evaluate the Knowledge, Attitude, and Practices (KAP) of dentists regarding infection control and basic principles.

Methods

This cross-sectional study recruited 106 dentists in Sanandaj, Iran. The dentists’ KAP regarding hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV/AIDS were evaluated. Chi-square test, student’s t-test, and one-way ANOVA were used to assess differences between the groups. Data were analyzed in Stata 12.

Results

The results showed that the majority of the subjects in the study population (53.8%) were female. The mean?±?standard deviation (SD) for age and work experience was 39.6?±?9.80 and 10.6?±?8.7?years, respectively. The mean?±?SD for knowledge, attitude and practices of participants was 37.3?±?3.01, 22.9?±?4.80 and 24.07?±?5.06, respectively. The results also indicated that dentists’ higher level of knowledge about HBV, HCV and HIV/AIDS was significantly influenced by work experience (≥10?years; P?<?0.001) and graduation year (after 2006: P?<?0.001). Positive attitude towards HBV, HCV and HIV/AIDS was considerably influenced by age group (<?30?years: P?=?0.021), work experience (≥10?years: P?<?0.001), and workplace (dental office: P?=?0.016).

Conclusions

The results of this study demonstrated a satisfactory level of knowledge and attitude of dentists about HBV, HCV and HIV/AIDS infections, but some gaps were observed, suggesting that higher knowledge level of dentists plays a very important role in forming the attitudes and practices regarding patients with HBV, HCV and HIV/AIDS.

     

Hepatitis C virus infection and its dental implications

In the last two decades dentists and other dental workers have been called attention to the risk of infection with blood-borne pathogens by a few reports. Before Hepatitis B vaccine became available in 1982, dentists and oral surgeons were reported to have a higher prevalence of Hepatitis B Virus (HBV) than other health-care workers and the general population. The first cases of AIDS were recognised in 1981, and in 1988 dentists infected with Human Immunodeficiency Virus was already registered without any other potential risk factor except his occupation. Hepatitis C Virus (HCV), a positive stranded RNA virus was isolated for the first time from a chronically infected chimpanzee by a human VIII factor concentrate. Now HCV is regarded to be the cause of most cases of non-A-non-B hepatitis. Although the risk of HCV infection among health-care workers is lower than it was in the case of HBV infection, there is some evidence of occupational transmission of HCV. The lack of effective vaccine, the proportion of chronic infections, and the limited success of therapy emphasises the importance of the problem for the dentists in practice. In this report the authors surveyed the epidemiology, transmission, and nature of HCV infection, and suggested some possible connection between the virus and certain oral diseases. The authors expounded some general aspects of management of HCV-infected patients in the dental practice and underlined the importance of preventing occupational transmission.     

Knowledge of emergency management of avulsed teeth: a survey of dentists in Beijing,China

Abstract – Objectives: There is a high frequency of dental trauma cases in China, where tooth avulsion is one of the most serious scenarios. The knowledge of how to take care of an avulsion is of great importance to the outcome of such an injury. This knowledge among dentists in Beijing, China has never been tested before. The purpose of this study was to evaluate professional experience and knowledge of emergency management of dentists working in urban and suburban areas of Beijing, China. Material and Methods: A two‐part questionnaire was distributed to 175 urban and 99 suburban dentists in Beijing. The first part contained personal and professional information of the participating dentists. The second part evaluated dentists’ knowledge about the emergency management of avulsed teeth. Data were entered into a SPSS database and analyzed using the chi‐square test and Fisher’s exact test for each question. Results: All dentists had a college or above degree. Almost five times as many urban dentists compared to suburban dentists presented with a Master or PhD degree. The knowledge levels of the participants presenting with correct answer in the respective knowledge areas were; storage medium (15.8%) intra‐canal medication (45.0%), type of splint (45.1%) and splinting period (10.2%). Significantly more urban dentists (50.6%) compared to suburban dentists (34.8%) (P = 0.016), used calcium hydroxide paste as an intracanal medicament, and significantly more urban dentists (51.3%) than suburban dentists (34.1%) chosed a flexible splint (P = 0.008). Conclusion: The results revealed an uneven pattern of knowledge between urban and suburban dentists regarding the emergency management of avulsed teeth. The study highlighted Chinese dentists’ need for continuing education in order to improve current knowledge in emergency management of avulsed teeth.     

四川省口腔医生急救知识水平及影响因素调查

目的 调查四川省口腔医生对急救知识的掌握程度及其影响因素,为口腔临床医生的培训提供建议及参考。方法 设计急救知识调查问卷,内容主要包括口腔医生基本情况、接受培训情况、急救知识知晓情况、门诊遇到的医疗紧急事件及其急救行为、学习急救知识的途径及态度等。用此问卷对四川省城市医疗机构的283名口腔医生进行调查,并对调查结果进行统计学分析。结果 有效问卷245份。1）口腔医生对急救知识的掌握程度普遍较低,工作科室、口腔科以外其他科室经历是口腔医生急救知识水平的影响因素。2）87.3%的口腔医生认为非常有必要学习急救知识,但73.5%的口腔医生在遇到门诊紧急情况时只能找其他医生指导,自己协助或帮不上忙。3）工作经验和医学院专门急救课程是学习急救知识的主要途径。结论 口腔医生应加强急救知识的学习和培训。     

Antibiotic prophylaxis for bacterial endocarditis--a study of knowledge and application of guidelines among dentists and cardiologists

Antibiotic prophylaxis and infective endocarditis is a controversial topic. The compliance with available guidelines among dentists is poor. The dental health education of patients by their cardiologists is inadequate. OBJECTIVE: The objective of this study was to investigate the knowledge and application of available guidelines on antibiotic prophylaxis to prevent infective endocarditis among general dental practitioners and cardiologists. DESIGN: Structured postal questionnaire SUBJECTS AND METHODS: A list of 515 dentists was obtained from a register held by the Postgraduate Medical and Dental Board. A list of 85 cardiologists was obtained from a national register held by the Cardiothoracic Society of Ireland. RESULTS: A 31% response rate was obtained from the cardiologists and 37% from the dentists. The majority of the cardiologists (84%) were in hospital practice and 64% of dentists were in private general practice. Cardiologists showed a preference for the AHA guidelines (50%) and more dentists use the BSAC guidelines (56%). The cardiologists were very familiar with the cardiac conditions that pose a risk for dental patients but weak at educating their patients on the importance of good dental health. The dentists were good at identifying procedures that could place their patients at risk but less informed about which cardiac conditions warranted prophylaxis. Decision-making among the dentists with regard to choice of prophylaxis and appropriate treatment intervals was poor. CONCLUSIONS: The knowledge of and compliance with the available guidelines is poor. Dental health education of at-risk patients by their cardiologists and dentists is inadequate. Further regular education of patients, dentists and medical practitioners is required.     

Using the Maslach Burnout Inventory among dentists: burnout measurement and trends

Abstract – Objectives: To extend our knowledge about the applicability of the Maslach Burnout Inventory (MBI) among dentists and to investigate trends in burnout risk among dental professionals. Methods: The structure of the MBI is examined among two independent, representative samples of dentists (n = 493 and 497, respectively). Moreover, results are compared to those of other independently‐practicing health professionals (i.e., general practitioners and physiotherapists). In addition, the percentage of dentists that are at risk for burnout are compared in samples from 1997, 2000, and 2001. Results: Correlations between the Emotional Exhaustion and Depersonalization subscales among dentists were higher than those found elsewhere. Additionally, a considerable increase in burnout risk was found since 1997. Conclusions: It was confirmed that the MBI can be considered a suitable instrument for use among dentists. It is argued that certain specific aspects of entrepreneur‐like occupations are reflected in deviating responses to the MBI. Given the clear increase in burnout risk found, this topic should remain under investigation among dentists.     

Knowledge, Attitude and use of Fluorides among Dentists in Texas

Aim: The centers for disease control and prevention (CDC) recommendations on fluoride use were published in 2001. This study examines how this information has diffused to practicing dentists and the level of fluoride knowledge and use among Texas dentists. Materials and methods: A questionnaire was sent to dentists who self-identified as being in pediatric (343), dental public health (72), and general practices (980); a 12% sample of registered dentists in Texas. Results: Response rate was 42.9%. About 90% of surveyed dentists reported using fluorides routinely. Only 18.8% reported fluoride varnish as the topical fluoride most often used. About 57% incorrectly identified primary effect of fluoride. 'Makes enamel stronger while tooth is developing prior to eruption' was the most commonly cited wrong answer (44%). Only 5% identified that posteruptive effect exceeds any preeruptive effect. Conclusion: Despite the evidence for fluoride varnish preventing and controlling dental caries being Grade I, its use is still uncommon. Dentists are expected to be knowledgeable about products they use, but this study reflects lack of understanding about fluoride's predominant mode of action. More accurate understanding enables dentists to make informed and appropriate judgment on treatment options and effective use of fluoride based on risk assessment of dental caries. Clinical significance: Lack of knowledge of, or failure of adherence to evidence based guidelines in caries prevention by use of appropriate fluoride regimens may adversely affect caries incidence in the population. Keywords: Dental caries, Fluorides, Evidence-based dentistry, United States, Diffusion of innovation. How to cite this article: Bansal R, Bolin KA, Abdellatif HM, Shulman JD. Knowledge, Attitude and use of Fluorides among Dentists in Texas. J Contemp Dent Pract 2012;13(3):371-375. Source of support: Nil. Conflict of interest: None declared.     

HLA‐C/KIR genotypes in oral lichen planus patients infected or non‐infected with hepatitis C virus

Oral Diseases (2011) 17 , 309–313 Objectives: Oral Lichen Planus (OLP) is associated with hepatitis C virus (HCV) infection and resembles graft‐versus‐host disease (GVHD) both clinically and histologically. The killer cell immunoglobulin‐like receptor (KIR) genes encode a family of receptors expressed on NK and T cells and are supposed to play a significant role in GVHD and HCV infection. The aim of this study was to analyze the association among OLP, HCV infection and variants in KIR gene expression. Methods: A total of 81 patients with OLP (36 HCV+ve and 45 HCV?ve) and 217 healthy controls (HCV?ve) were typed for the presence of eight KIR genes and of HLA‐Cw* alleles by polymerase chain reaction‐sequence specific primer. Results: There were no significant differences in the frequency of the KIR genes and HLA‐C1/C2 group alleles between cases and controls. We only found a significant difference in the frequency of the gene KIR2DL2 between HCV+ve and HCV?ve OLP patients. Conclusions: The present data suggest that OLP is not associated with particular KIR genes or with HLA‐Cw* alleles in patients without HCV infection. Contrarily, the role of the genes in OLP‐HCV+ve patients remains unclear and might warrant further researches.     

National Survey of Korean Dentists' Knowledge and Opinions: Dental Caries Etiology and Prevention

Objectives : Dentists have the potential to influence what their patients know and do regarding dental caries prevention. The practices of dentists and what they tell their patients are influenced, in part, by their own knowledge and opinions. The purposes of this study were to determine the level of knowledge and opinions about caries etiology and prevention among Korean dentists and to describe related factors. Methods : A pretested, 27-item questionnaire was mailed to 2,047 dentists, selected by a stratified random sampling allocated proportionately. A postcard reminder was sent to all dentists after one week. Nonrespondents were sent additional complete mailings after three, seven, and nine weeks. The response rate was 83 percent (n=1,700 dentists). Results : Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that recent graduates and dentists who worked in public health centers were likely to be more knowledgeable about caries etiology and prevention than their counterparts (P<.05). In regression analysis of perceived effectiveness of caries-preventive procedures for children, recent graduates, males, and dentists who worked in public health centers tended to rate caries-preventive procedures more effective than other dentists (P<.05). Dentists who had experience with school-based preventive programs and dentists in rural areas were likely to rate caries-preventive procedures for adults more effective than other dentists (P<.05). Conclusion : Overall, results of this study suggest that the majority of dentists do not know current information concerning etiology and prevention of dental caries, mechanisms of action of fluoride, and effectiveness of preventive procedures for children and adults. Efforts to enhance the level of knowledge and practices of Korean dentists about caries prevention should focus on strategies to educate older graduates and female dentists, especially those in private practice.     

Sample infection control needs assessment survey data from eight countries

Objectives : To compare knowledge, attitudes and practice of standard methods in infection control by dentists in eight countries using a standardised questionnaire. Methods : Self‐administered questionnaires on dental infection control and safety (IC&S) knowledge, attitudes and practice were distributed to a convenience sample of dentists in India, Pakistan, Thailand, Philippines, Taiwan, China, South Korea and the United States of America. Results : Knowledge and practice of infection control among the Asian dentists lagged behind the levels of US dentists. Availability and affordability of equipment and materials were some of the reasons for the practice of infection control and safety. Attitude towards universal/standard precautions in controlling bloodborne pathogens was comparable between groups surveyed. Tested knowledge and practice of infection control was acceptable but the attitude and understanding of universal/standard precautions was ambiguous among both Asian and USA dental practitioners. Education in dental infection control should focus on improving the attitudes of practitioners towards universal precautions. Conclusions : Knowledge and practice of dental IC&S was high among the USA respondents. Immunisation and IC & S should be stressed in Asia. Information obtained through this study could be used to plan and implement policies in improving dental infection control and occupational safety in individual countries.     

Dentists' involvement in identification and reporting of child physical abuse: Jordan as a case study

Objectives.  The objectives of this study were to assess the knowledge, attitude, and experience among Jordanian dentists regarding child abuse, and to explore the factors that affect their hesitation to report any suspected cases.
Materials and methods.  A self-administered structured questionnaire was sent randomly to 500 Jordanian dentists. It investigated dentists' knowledge, attitude, and experience in recognizing and reporting child abuse cases. It also investigated several factors associated with dentists' hesitation to report suspected cases of child physical abuse.
Results.  The response rate was 68%. More dentists were aware of their ethical obligations (80%) than their legal responsibilities (71%) to report child abuse cases. One-third of the dentists knew where to report suspected cases. Although 42% of dentists suspected cases of child abuse, only 20% of them reported these cases. The most frequently cited reasons for hesitation to report such cases were lack of history (76%), uncertainty about diagnosis (73%), and possible consequences on the child (66%). Reporting was significantly associated with suspicion of child abuse cases, as well as the belief of legal responsibilities.
Conclusion.  There was a low reporting rate of child abuse among Jordanian dentists. They lack the adequate knowledge about recognition and reporting issues of suspected cases.     

Oral cancer awareness of physicians and dentists in the Israeli army

Oral cavity squamous cell carcinoma (OSCC) accounts for 2-3% of all body malignancies. The aim of this study was to asses the knowledge and awareness of general practitioners and the dental practitioners in the Israeli army to OSCC. Israeli's defense force's medical corps's dentists and physicians took part in this study. A questionnaire was constructed to obtain information about: Demographics, Knowledge concerning signs, symptoms and risk factors of oral cancer, Attitude on referral and knowledge transfer to patients, Satisfaction and need for farther guidance on the subject. The questionnaire was sent via E mail to all army physicians and dentists. 80% of the dentists and 35% of the physicians replayed. According to our study there is a knowledge gap between physicians and dentists in several areas: Physicians showed less awareness to the disease therefore, are less likely to do regular oral examinations. Physicians had less information about risk factors (especially alcohol) and are less likely to pass information about the risk factors to their patients. Suspicious lesions in the oral cavity were less recognized as such by physicians. This study shows the need to strengthen physicians' knowledge and awareness concerning oral cancer.     

Variation in radiographic interpretation and restorative treatment decisions on approximal caries among dentists in Norway

Of a random sample of dentists in Norway (n = 741), 83% responded to a questionnaire about their use of radiographs in and their opinions and knowledge about the diagnosis of approximal caries. There was great disparity in criteria for initiation of restorative treatment of approximal caries based on radiographic appearance. Two thirds of the dentists would do restorative treatment of lesions confined to enamel, the others would wait until lesions had reached the dentin before treatment was commenced. The criteria for restoration based on radiographic appearance was best correlated with the dentists' opinions about cavity formation. About 20% of the variation in criteria among dentists was explained by the radiographic appearance dentists associated wih the presence of a cavity. The majority of the dentists believed that approximal caries progressed faster than is indicated by progression studies. The interval between recall examinations using radiographs was not consistently shorter for dentists who decided to carry out operative caries treatment at a relatively advanced stage.     

大学生口腔黏膜病知识知晓情况调查及分析

目的:调查大学生口腔黏膜病知识的知晓情况。方法:对331名大学生进行口腔黏膜病知识的问卷调查,并统计学分析。结果:大学生吸烟、饮酒及不健康饮食的现象普遍存在;81.87%的大学生从未通过任何途径了解过口腔黏膜病;各种来源途径中,学校教育和医生讲解最少;各项口腔黏膜病知识知晓率均较低。结论:大学生的口腔黏膜病知识匮乏严重。学校及口腔科医生应积极行动,大力宣传口腔黏膜病知识,为口腔黏膜病的预防打下坚实的基础。     

German general dentists' knowledge of dental trauma

Abstract –  The purpose of this study was to evaluate the knowledge of German general dentists on different scenarios in dental traumatology, as well as to analyse, whether there was any correlation between practitioners' perceptions of their knowledge and their actual expertise. A questionnaire containing questions on demographic data and knowledge was handed out to general dentists at the beginning of different lectures in dental traumatology given by the authors. A total number of 181 questionnaires were evaluated. Sixty-three per cent of the dentists considered their knowledge as being sufficient or comprehensive, while only 37% indicated to have fragmentary knowledge in dental traumatology. Irrespective of the self-assessment, 40% of the questions were answered correctly. Although not statistically significant, there was a trend towards slightly better knowledge for dentists whose graduation was more recent. On the basis of the findings of this study, it can be suggested that the level of knowledge among general dentists in Germany is rather poor on different scenarios regarding dental traumatology and their self-assessment is inaccurate.     

颏部突度改变对面部美学的影响

目的 通过3D图像研究颏部突度改变对面部美学的影响,比较正畸医师、口腔全科医师及普通大众对颏部突度变化的美学认知差异,为临床治疗方法的选择提供定量参考。方法 使用3dMD立体摄影技术,获取志愿者的三维面部图像,使用Geomagic Wrap 2015软件,以2 mm为梯度,使软组织颏前点沿矢状轴前后移动,移动幅度为零子午线前后10 mm。选取正畸医师、口腔全科医师及普通大众3组评价者,以VAS评分对图像进行评价,使用SAS 9.4建立线性混合效应模型,对数据进行方差分析。结果 纳入调查对象243人,其中口腔正畸医师90人,口腔全科医师101人,普通大众52人。研究发现,颏部突度变化对VAS评分有显著影响,软组织颏前点位于零子午线上时评分最高,颏部每后缩2 mm,VAS评分下降0.8910;每前突2 mm,VAS评分下降1.0958,有显著差异（P<0.01）。正畸医师组及普通大众组在颏部后缩超过6 mm、口腔全科医师组在颏部后缩超过4 mm时平均VAS评分低于5,3组人群在颏部前突达到6 mm时平均VAS评分低于5,需要进行治疗。颏部突度变化时,3组人群评分变化无统计学差异,性别及年龄亦无显著影响。结论 颏部突度变化对面部美学有显著影响,软组织颏前点位于零子午线时美学效果最佳,颏部前突达到6 mm或颏部后缩超过6 mm时治疗需求较大。正畸医师、口腔全科医师及普通大众对颏部突度变化的美学认知程度无显著差异。     

What do dentists know about statistics?

Abstract – A multiple choice test with nine statistical questions was sent to a random sample of Danish dentists to assess their knowledge of elementary statistical expressions (SD, SE, P<0.05, P> 0.05 and r). Of 250 dentists, 129 (52%) answered the questions. The test was also completed by 27 (71%) of 38 dental students immediately after the last lecture in statistics. The median number of correct answers was 2.2 among the dentists and 3.4 among the dental students. It is concluded that the statistical knowledge of most dentists, and to a lesser degree also dental students, is so limited that they cannot be expected to be critically against or to draw the right conclusions from those statistical analyses with which they are confronted. Only 35% of the dentists stated that it is very important that this problem be raised.     

What do dentists know about statistics?

A multiple choice test with nine statistical questions was sent to a random sample of Danish dentists to assess their knowledge of elementary statistical expressions (SD, SE, P less than 0.05, P greater than 0.05 and r). Of 250 dentists, 129 (52%) answered the questions. The test was also completed by 27 (71%) of 38 dental students immediately after the last lecture in statistics. The median number of correct answers was 2.2 among the dentists and 3.4 among the dental students. It is concluded that the statistical knowledge of most dentists, and to a lesser degree also dental students, is so limited that they cannot be expected to be critically against or to draw the right conclusions from those statistical analyses with which they are confronted. Only 35% of the dentists stated that it is very important that this problem be raised.     

Sex differences among dentists regarding eating disorders and secondary prevention practices

BACKGROUND: The purpose of this cross-sectional study was to assess sex differences among dentists pertaining to current behaviors and behavioral beliefs with regard to eating disorders. METHODS: The authors collected data via a self-administered paper-and-pencil questionnaire from a randomized sample of 350 practicing male and female dentists. RESULTS: The results showed a low level of practice regarding secondary prevention (that is, measures leading to early diagnosis and prompt intervention) of eating disorders. The authors found statistically significant differences, with more female than male dentists reporting that they assessed patients for oral cues (P < .001), more female dentists reporting that they provided specific dental care instructions (P = .038) and more female dentists referring patients who have oral signs of eating disorders (P = .028). They also found sex differences with regard to mediating factors. Female dentists had greater knowledge of oral manifestations of eating disorders (P = .001), greater knowledge of physical cues of anorexia nervosa (P < .001), greater perception of the severity of anorexia nervosa (P = .007) and greater knowledge of physical cues of bulimia nervosa (P < .001). CONCLUSIONS: Although the dentist may be the first health care provider to assess oral effects of eating disorders, his or her involvement may be influenced in part by sex and sex-related health beliefs. CLINICAL IMPLICATIONS: Female dentists may be more sensitive to oral cues related to women's health issues. Further research is warranted to explore the mediating factors regarding secondary prevention of eating disorders.