Knowledge about tooth avulsion and its management among dental assistants in Riyadh, Saudi Arabia

Development and validation of a questionnaire to assess commonality knowledge of traumatic dental injuries and management of emergencies

BACKGROUND

Dental trauma represents a significant public health problem, causing a burden for both individuals and society. The aim of this study is to systematically develop and validate a questionnaire on 'traumatic dental injuries and management of emergencies' (TIME) for assessing the knowledge, attitude and practice (KAP) for a commonality.

METHODS

The scale development phases included conceptual framework, systematic development of an item pool, refinement of the item pool by Focus-group discussion (n = 23), validity-testing using Content Validity Index (n = 5), translation and back-translation, Cognitive interviewing (n = 30,45), and reliability testing (n = 40). The conceptual framework was built based on six broad constructs, such as broken teeth, knocked-out (avulsion) teeth, pushed/moved-in and loosened teeth (luxation injuries), soft tissue injuries, follow-up and management, and prevention and protection.

RESULTS

Reviews of existing questionnaires significantly helped to generate an initial pool of 68 items (refined to 51 items). Lawshe's content validity was 0.92. High test-retest reliability was demonstrated (kappa value = 0.98). The questionnaire showed a high level of reliability (Cronbach's alpha = 0.86) with great internal consistency.

CONCLUSION

TIME is the first validated scale for recording knowledge, attitude and practices on traumatic dental injuries and management of emergencies for non-dental professionals. The 51-tem tool will allow dentists to evaluate KAP of commonality. KAP measured across the globe would have a significant impact on planning awareness programs by dentists and dental associations.

Management of Dental Avulsion Injuries: A Survey of Dental Support Staff in Cairns, Australia

Background/Aim: The aim of this study was to assess the knowledge of dental support staff in providing appropriate first-aid advice regarding dental avulsion emergencies. Methods: This study was reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. Dental support staff (includes dental assistants, administrative staff and other non-clinical staff) were contacted and data were collected from 50 private dental clinics across the Greater Cairns Area, Queensland, Australia. These data were collected through an online survey throughout 2020. Descriptive statistics and Pearson’s Chi-squared test was used to analyze the data and any associations between categorical outcomes. Results: This survey yielded a response rate of 34.1% with a margin of error of 10.3%. More than four-tenths of participants (42%) reported that they had received some form of dental avulsion management training previously. All but five participants (92%) denoted that they would immediately replant an avulsed permanent tooth. More than half of all participants would choose to rinse a soiled avulsed tooth with fresh milk (55%) and transport that tooth in fresh milk (65%) should they not be able to replant the tooth at the site. Almost nine in every ten participants (85%) expressed willingness to further their training in this area. Knowledge in replanting avulsed permanent teeth was found to be significantly impacted by gender, age, years of experience and participation in formal avulsion training. Male participants were found to be significantly more likely (p = 0.025) to replant a permanent avulsed tooth than their female counterparts. Participants who were 40 years of age and above were found to be significantly more likely to choose fresh milk to transport avulsed teeth (p = 0.0478). Older participants (p = 0.0021), alongside those who had greater years of experience (p = 0.0112) and those who had undertaken formal avulsion training (p = 0.0106) were all significantly more likely to express greater confidence in their ability to manage dental avulsion injuries. Participants who had previously received some form of education regarding avulsion injury management were also most likely to warrant further education and training in this area (p < 0.0001). Conclusion: This study demonstrated that dental support staff in the Greater Cairns Area seem to have a fair grasp of first-aid knowledge regarding the management of dental avulsion injuries. This result indicates that this knowledge has been picked up through years of experience, rather than a formal education. Despite this, one would expect people who work in the dental industry to be able to provide accurate and appropriate assistance during dental emergencies, hence, further training is warranted to ensure optimum patient outcomes.

Global status of knowledge for prevention and emergency management of traumatic dental injuries in dental professionals: Systematic review and meta-analysis

BACKGROUND

Dental professionals are the primary care providers for traumatic dental injuries (TDI). The dental traumatology literature has a number of studies evaluating the knowledge of dental professionals from different parts of the world but its global status is unknown. Hence, the aim of this systematic review was to assess the global status of knowledge for the prevention and emergency management of TDI in dental professionals and to provide recommendations for future research.

MATERIALS AND METHODS

The protocol was designed as per the PRISMA guidelines and registered in PROSPERO (CRD42020192381). A broad-based search using text words and MeSH terms was performed in established databases as per a pre-defined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity and reliability were excluded. Data extraction was performed, risk of bias assessment was done using the Joanna Briggs Institute's critical appraisal tool, and a meta-analysis was performed.

RESULTS

Sixteen studies, which had been published between 2008 and 2020, were included for qualitative synthesis. Most of them were cross-sectional, used convenience sampling and evaluated knowledge for avulsion. Previous dental trauma training was undertaken by <50% of the participants of five studies, <50% knew about the correct approach in management of complicated crown fractures in three studies and ≤60% in four studies knew the critical time for replantation. There was insufficient level of knowledge in >50% of the included studies. High risk of bias was found in three studies.

CONCLUSION

The knowledge level in several areas of the world was unknown. The studies lacked uniformity in methods and well-designed questionnaires and they revealed insufficient levels of knowledge among dental professionals.

Assessment of Knowledge and Attitudes of School Teachers Regarding Emergency Management of an Avulsed Permanent Tooth of Southern Region of Saudi Arabia

AIM

An avulsion is defined as one of the most common dental injuries where the tooth is displaced completely from its socket, followed by trauma. The most important time in managing the avulsed tooth is the first few minutes and as children spend their most of waking time in school so the teacher is considering their immediate caregiver. Hence, this study was done to carry out the knowledge and attitude of school teachers regarding emergency management of avulsed permanent tooth in schools located in the southern region of Saudi Arabia.

MATERIALS AND METHODS

The study was conducted at Najran School of Saudi Arabia. All teachers who are willing to participate in the study were involved. A questionnaire was made after reviewing several studies and was administered through emails to 318 teachers. The questionnaire consists of part I regarding demographic questions and part II information related to knowledge, action taken, education, and their way of managing the avulsed tooth at accident place. Statistics analysis was done using SPSS version 16.

RESULTS

Fifty percent of the participants know about the tooth avulsion. Fifty percent of the teachers who get information from the school health dental program get the tooth back to the dentist. There is a significant association found between the source of information and choice of treatment. Fifty-nine percent of the participants do not know about the management of tooth avulsion. And workshop plan then 89% was interested to attend the training.

CONCLUSION

The present study revealed that knowledge regarding the management of avulsed tooth is low among the school teachers. There is a strong need for a school health dental program for the management of avulsed teeth among the school teachers.

HOW TO CITE THIS ARTICLE

Khan SDAA, Assiry AA, Al Yami SMH, et al. Assessment of Knowledge and Attitudes of School Teachers Regarding Emergency Management of an Avulsed Permanent Tooth of Southern Region of Saudi Arabia. Int J Clin Pediatr Dent 2020;13(6):644-649.

Clinical-based Scenario Questionnaire About Dentists’ Awareness of Tooth Avulsion Management in Riyadh City

Aim:

To evaluate the knowledge of general dentists in Riyadh city regarding tooth avulsion using a questionnaire that contained case-based questions.

Materials and Methods:

Case-based questionnaires were distributed amongst 128 dentists. The questionnaire contained 5 items on demographic data and 10 items on clinical cases. Participants selected the most appropriate answer on the basis of the American were analyzed using the Statistical Package for the Social Sciences (SPSS, version 22, IBM Corp., New York).

Results:

The survey was completed with 74 percent males and 26 percent females. Most participants had freshly graduated and had not experienced any accident involving tooth avulsion. The overall mean score was 5.13 (standard deviation = 1.73). There were no significant differences in scores among the demographic categories.

Conclusion:

Freshly graduated dentists in Riyadh city demonstrated a moderate level of knowledge on management of avulsed teeth. Close adherence to AAE guidelines for traumatic dental injuries could result in further improvement.

Poly lactic-co-glycolic acid scaffold loaded with plasmid DNA encoding fibroblast growth factor-2 promotes periodontal ligament regeneration of replanted teeth

OBJECTIVE

This study investigated the effects of poly lactic-co-glycolic acid (PLGA) loaded with plasmid DNA encoding fibroblast growth factor-2 (pFGF-2) on human periodontal ligament cells (hPDLCs) in vitro and evaluated the ability of the PLGA/pFGF-2 scaffold to promote periodontal ligament (PDL) regeneration in a beagle dog teeth avulsion animal model.

BACKGROUND

Growth factor and scaffold play important roles in PDL regeneration. PLGA is a kind of biodegradable and biocompatible polymer that can be used as a carrier to deliver growth factors or genes. FGF-2 can induce potent proliferative responses, promote cell migration and regulate the production of extracellular matrix. Therefore, a gene-activated matrix composed of scaffold and genes is supposed to be a superior approach for promoting tissue regeneration.

METHODS

In this study, PLGA and PLGA/pFGF-2 scaffolds were fabricated using electrospinning. The characterization of scaffolds was shown by scanning electron microscope (SEM) and transmission electron microscope (TEM). dsDNA HS was used to test the plasmid release of PLGA/pFGF-2 scaffold. The viability and proliferation of hPDLCs on the two kinds of scaffolds were evaluated by the CCK-8 assay, and the expression of collagen I and scleraxis were analysed by RT-qPCR. The roots of avulsed teeth were covered by the two types of scaffolds and replanted into the alveolar pockets in beagles. Haematoxylin-eosin and Masson staining were used to evaluate the effects of PLGA/pFGF-2 scaffold on promoting PDL regeneration.

RESULTS

The smooth and uniform fibres can be observed in both scaffolds, and the plasmids were randomly distributed in the PLGA/pFGF-2 scaffold. dsDNA HS analysis demonstrated that the PLGA/pFGF-2 scaffold released up to 123 ng pFGF-2 over 21 days in a sustained manner without any obvious burst release. The PLGA/pFGF-2 scaffold promoted the proliferation of hPDLCs and increased the expression levels of collagen I and scleraxis compared with PLGA scaffold. Animal experiments showed that more regular PDL-like tissues and less root surface resorption occurred in the PLGA/pFGF-2 scaffold group compared with the PLGA scaffold group.

CONCLUSIONS

The PLGA/pFGF-2 scaffold promoted hPDLCs proliferation and facilitated periodontal ligament-related differentiation. The PLGA/pFGF-2 scaffold possesses excellent biological characteristics and could be used as a promising biomaterial for improving the treatment prognosis of replanted tooth.

Assessment of schoolteachers' knowledge about management of traumatic dental injuries in Al-Madinah city, Saudi Arabia

Objective:

This study aimed to assess the knowledge of primary and intermediate schoolteachers about the management of TDIs in Al-Madinah city, Saudi Arabia.

Materials and Methods:

A previously validated, self-administered, anonymous, close-ended structured questionnaire was administered to schoolteachers in 13 different schools. It included two parts: basic demographic information (part one) and questions regarding the management of dental traumatic injuries (part two).

Results:

A total of 178 schoolteachers voluntarily completely filled in the questionnaire. Nearly 28.1% of the teachers acquired a first-aid training program and 6.2% only learned about dental injury management in first-aid training. Concerning the knowledge about the management of dental traumatic injuries, 55.1% of teachers realized the appropriate time for treatment of dental traumatic injuries. A few percentage of teachers selected correct answers for the suitable storage medium. The most commonly selected storage media were found to be cold milk, physiological saline, and patient's saliva at 14.6%, 6.7%, and 2.2%, respectively.

Conclusion:

The knowledge among primary and intermediate schoolteachers in the management of dental traumatic injuries is unsatisfactory.

Emergency management of dental trauma: a survey of public knowledge, awareness, and attitudes in Al-Madinah Al-Munawwarah

Background

Dental trauma is one of the most commonly encountered dental emergencies. The prognosis is determined by the appropriate intervention and immediate management of the traumatized teeth. Thus, public awareness is a leading determinant of treatment success. The purpose of this study was to assess the knowledge, attitudes, and awareness of Al-Madinah Al-Munawwarah residents regarding the management of dental trauma.

Methods

This cross-sectional observational study was conducted between December 2016 and January 2018. A two-part self-administered questionnaire comprising 13 closed-ended questions was used. Part one contained questions to elicit demographic data that included information related to the participants' sources of dental trauma. Part two assessed their knowledge and attitudes regarding the most common types of dental trauma. The data were analyzed with IBM SPSS Statistics for Windows, Version 22.0 software.

Results

A total of 598 participants were included in this study. The results indicated that 64% of the participants knew where to go to receive treatment for dental trauma, and 74% were aware of the differences in the management of the primary and permanent teeth after trauma. A majority (83%) did not have any information about these issues; however, 83% were interested in learning about the appropriate management of dental trauma.

Conclusion

The study participants were found to have low levels of knowledge. A majority had never received information about the management of dental trauma or avulsed teeth. Education programs are necessary for promoting positive attitudes by increasing the knowledge about dental trauma management.

Elementary school staff knowledge about management of traumatic dental injuries

Aim

This study investigated the knowledge of elementary school staff regarding the management of traumatic dental injuries (TDIs) in children.

Methods

The present cross-sectional study analyzed data collected between September 2016 and April 2017. The sample consisted of 2,027 elementary school staff members in Riyadh, Saudi Arabia. A stratified cluster random sampling technique was used to select the required sample. Those who agreed to participate in the study completed a 4-part self-administered questionnaire comprising questions regarding demographic data, knowledge on management of tooth fracture, and avulsion using photographs of TDI cases.

Results

The majority of the school staff showed inadequate basic knowledge regarding the importance of saving the broken piece of the tooth and identifying the tooth involved in the trauma (67% and 66.3%, respectively), P<0.05. However, they had a significantly high number of correct responses regarding the immediate management of TDIs for the 2 case scenarios presented in the questionnaire (P<0.05), and the majority (41%) reported normal saline as a suitable storage medium (P<0.01).

Conclusion

This study revealed a lack of knowledge in certain aspects of TDIs among elementary school staff.

Knowledge on management of traumatic dental injuries among Saudi mothers

Objective

This study investigated the knowledge of Saudi mothers regarding the management of traumatic dental injuries (TDIs) in children.

Materials and methods

A cross-sectional study using structured questionnaires was employed for mothers chosen by stratified-cluster random sampling technique from primary health care centers in Riyadh, Saudi Arabia, over a period of 12 months (July 2016-June 2017). The questionnaire surveyed mothers' background and knowledge on management of tooth fracture and avulsion using photographs of TDI cases.

Results

The sample consisted of 3,367 Saudi mothers. More than half of the mothers (55.3%) gave the correct response, which was to send the child with tooth fracture immediately to the dentist (p<0.01). The majority of mothers (41.6%) gave the correct response for the immediate mode of action, which was to save the avulsed tooth in storage medium and send the child to the dentist immediately (p<0.001). However, they prioritized the immediate management of TDIs, and most reported saline as a suitable storage medium (p<0.001). The mothers expressed a positive interest in further education.

Conclusion

Educational programs and TDI protocols must be implemented to increase mothers' awareness and improve the prognosis of children with TDIs.

The Status of Knowledge Related to the Emergency Management of Avulsed Tooth amongst the Medical Practitioners of Nagpur, Central India

INTRODUCTION

Tooth avulsion is a frequently reported traumatic injury amongst young children and whenever it occurs, the parents or teachers of those children often seek the help of Medical Practitioners to provide the first line of treatment. Therefore, the general physician's knowledge regarding the same is an important issue to be taken into consideration.

AIM

To assess the knowledge, attitude and practice of general medical practitioners of Nagpur city of Central India regarding emergency management of avulsed tooth and highlight the importance of avulsed tooth education in schools and medical colleges in order to increase the knowledge of the same among teachers, parents and general physicians.

MATERIALS AND METHODS

A cross-sectional survey was carried out amongst 1045 medical doctors after a comprehensive search made in Google database using the keywords "Medical", "doctors" "Nagpur". Data regarding the emergency management of avulsed tooth was collected using a self administered close ended questionnaire.

RESULTS

A total of 1045 medical practitioners (718 males, 327 females) voluntarily participated in this survey. It was observed that 56.8% of the medical practitioners had no prior knowledge of management of an avulsed tooth. A 81.6% of practitioners were unaware of transport medium for an avulsed tooth whereas, more than half practitioners (64.7%) were naive about an ideal time for replantation of an avulsed tooth. A little more than one third of the practitioners (26.5%) were unacquainted about the method of holding an avulsed tooth.

CONCLUSION

Regardless of the level of education, the general medical practitioners of Nagpur lack most of the knowledge required for the emergency management of an avulsed teeth. Keeping the in mind the present scenario, it was recommended that education regarding avulsed tooth should be incorporated in school and medical curriculum to increase awareness among parents, teachers and medical practitioners. Also, it is the responsibility of the dentist to make the society aware of this situation.

Knowledge about permanent tooth avulsion and its management among dentists in Riyadh, Saudi Arabia

Background

There is a lack of adequate information on dentists’ knowledge about tooth avulsion and its management in Saudi Arabia. The aim of this study was to evaluate the level of knowledge about permanent tooth avulsion and its management among dentists working in Riyadh, Saudi Arabia.

Methods

A total of 550 dentists were contacted to request their participation in this 19-item questionnaire survey over a three-month period starting in January 2015 using convenience sampling methodology. A questionnaire consisting of demographic items and multiple-choice questions regarding knowledge of avulsion and its management was used. The level of knowledge was assessed using a scoring system that assigned one point for each correct answer and zero points for wrong answers, with a maximum possible score of ten points. An independent t-test was used to compare the level of knowledge (mean score) based on particular variables, such as sex, nationality, type of practice, current employment, working hours and whether the respondents had attended a continuing dental education (CDE) programme on avulsion management. The level of significance was set at P< 0.05.

Results

A total of 470 completed questionnaires were collected with data suitable for statistical analysis. The majority of the respondents were Saudi (n = 331; 72.1 %) and general practitioners (n = 278; 59.3 %). Most of the participants correctly responded to the knowledge-based questions, except the questions regarding the best storage medium (milk: 24.1 %) and the duration of follow-up by clinical and radiographic examination (5 years: 15.6 %). The mean knowledge score was 5.94 ± 1.57. Gender (P = 0.001), current employment (P = 0.045) and working hours per day (P = 0.020) had a significant effect on the mean knowledge score.

Conclusions

The surveyed dentists were found to have a moderate knowledge of avulsion and its management, although a relative lack of knowledge was observed regarding the duration of follow-up after replantation.