Journal of Dental Medicine

Background and Aims: Trauma to the permanent and deciduous incisors is an undesirable common event in childhood. Proper immediate management of injured teeth is depended on the knowledge of unprofessional people, including teachers, who are usually present at the scene prior to dental treatment. The aim of this study was to assess the knowledge and self-reported practice of primary school teachers on the emergency management of traumatic dental injuries (TDIs) in Arak.

Materials and Methods: In this cross-sectional study, 624 primary school teachers were enrolled in census in Arak. An anonymous questionnaire containing demographic data, the history of previous exposure to traumatic dental injuries, teachers’ knowledge regarding emergency management of TDIs and their practice towards TDIs was used. Questionnaires were distributed among all participants and then were collected on the same day. Descriptive statistics and linear regression were performed to analyze the data.

Results: A total of 292 completed questionnaires (response rate 46.8%) were collected. The mean score of knowledge was 2.65±1.69 out of 10. The mean score of self-reported practice was 3.46±2.04 out of 8. Regarding the demographic variables, knowledge had a significant relationship with the education (P<0.001). No significant relationships were observed between the self-reported practice and demographic variables. The correlation coefficients between the knowledge scores and the practice scores of teachers was 0.2.

Conclusion: This study revealed that insufficient knowledge exists among primary school teachers on emergency management of TDIs. Furthermore, a high percentage of respondents enjoy a significant deficiency regarding favorable practice encountering TDIs.

Background and Aims: Disabled individuals are involved with several oral health problems. The aim of this study was to assess the knowledge and perspective of dentists towards oral health promotion in disabled individuals.
Materials and Methods: Dentists participating in the fifty-fourth International Congress of Iranian Dental Association in 1392 in Tehran were invited. A valid and reliable questionnaire including the information about age, gender, city of practice, the working experience with the disabled was distributed. There were also 13 questions on knowledge and one question about the importance of training in the field of “oral health promotion of the disabled” in this questionnaire. The data were analyzed by linear regression model by SPSS 18 software.
Results: 117 questionnaires were collected and evaluated. The mean age was 35.5 (10.1) years. Among the participants, 53.8% were male and 46.2% were female. Average score of knowledge was 6.5 of the maximum attainable 13. Among the dentists, 60% believed that receiving education on oral health promotion for the disabled is important. Liner regression model which evaluated the effect of confounding factors showed that aging led to reduction in dentists' knowledge of oral health of the disabled. Furthermore, working experience with the disabled led to the increase in knowledge. Dentists who had previously treated a disable individual were more interested in receiving related training.
Conclusion: Knowledge of dentists in the field of oral health promotion of the disabled is not desirable while most dentists recognize the need for training. This issue emphasizes on the need for a broader educational effort.
 

Background and Aims: Cancer is the 3rd cause of death after heart disease and injuries in Iran. Radiotherapy and chemotherapy are the most effective procedures in cancer therapy, but their side effects are still unknown for many patients. The main goal of this study was to evaluate the patients’ knowledge with head and neck cancer regarding the complications of radiotherapy and chemotherapy.
Materials and Methods: This descriptive-analytical research was based on the information extracted from personal questionnaires and files of cancer patients who referred to the centers of Kerman University of Medical Sciences during a 6 months period in 2017. The data were analyzed by chi-square test at the significance level of 0.05.
Results: Our findings showed that most of the patients (76.48%) had low information level. There was no statistically significant association between the knowledge with demographic variables (P>0.05). However, patients with chronic disease had higher level of information. Only 10% of patients had received information by their physicians.
Conclusion: It seems there is not effective education regarding the rated radiotherapy and chemotherapy complications, because their knowledge was not in acceptable level. Considering the importance of this issue, it is necessary to perform educational program to improve patients' ability and skills to cope whit the chemotherapy and radiotherapy complications and their side effects.

Background and Aims: Trauma to primary and permanent teeth caused post-traumatic complications affecting the health of teeth and led to specific problems in treatment. As prognosis of trauma has closed correlation with immediate and correct management after occurrence of the incident and the health educators are the first people in contact with children in this places, their awareness of how to deal with these injuries plays an important role in prevention and treatment. This study aimed to evaluate the knowledge of health educators in confrontation with dental injuries in primary schools of Sanandaj in 2018.
Materials and Methods: In this cross-sectional study, all of fifty-nine health teachers in primary schools of Sanandaj were identified after referring to education centre. The questionnaires were provided to the school health teachers after referring to schools and after completing questionnaires, collected data were analyzed. In order to test the research hypotheses, Multiple regression, Non-parametric tests of spearman correlation coefficient, Mann-Whitney and kruskal-wallis were utilized using SPSS software version 20.
Results: The mean knowledge score of fifty-nine health educators was 14.02±3.41 and knowledge score of females was higher. There was no significant statistical correlation between knowledge score, age,
work experience and education level (P>0.05). In this study, the knowledge score of experienced teachers in confrontation with injured persons and health educators who attended related training courses, was higher than others but this difference was not statistically significant (P>0.05).
Conclusion: The results indicated inadequate knowledge regarding emergency management of dental trauma. Thus strategies to improve the teachers’ knowledge about dental trauma can positively influence their knowledge and attitudes toward emergency management of dental trauma.

Background and Aims: Tooth decay is still one of the most prevalent pediatric diseases. According to the role of general dentists and importance of first dental visit in prevention, the aim of this study was to evaluate dentist’s knowledge and attitude regarding children’s first dental visit in Gorgan, Iran.
Materials and Methods: In this cross-sectional study, 140 general practitioners participated. In order to assess the level of knowledge, a questionnaire including 2 parts was used as the main tool. Data were analyzed using Mann-Whitney, Kruskal-Wallis and Pearson correlation coefficient.
Results: Our findings revealed that the level of knowledge in both sex was equal (P=0.067). There was no significant relationship between the workplace (P=0.68), age (P=0.77), work experience (P=0.84) and the level of knowledge. Interest of practitioners to get the necessary training about examination and treatment of 0-2 year-old children was medium. 51.17% of dentists, admitted the treatment of 8-12 year-old children. 34.5% of dentists revealed that misbehavior of children during treatment was the main reason for unwillingness to accept treating them. 46.9% of dentists, revealed that the most effective result of child’s dental visit at an early age is increasing parents’ knowledge about prevention of carries in primary dentition.
Conclusion: The results showed that general dental practitioners in this study had a good level of knowledge about the first dental visit. Regarding to their little tendency to treat children, it seems necessary to hold workshops and seminars for better desired motivation in this field.

Background and Aims: Considering the role of primary teeth in children's dental health and the importance of parental role on children dental health the purpose of this study was to determine the knowledge and practice of parents of 3-9 year-old children regarding to maintaining primary teeth.
Materials and Methods: This cross-sectional descriptive-analytical study was conducted on the parents referring to Ahwaz dental school in 2017. Using a questionnaire, the participants' demographic characteristics, knowledge and performance regarding maintaining of the primary molars were collected. The percentage of correct responses was considered as the level of knowledge and performance. Analysis of K-square and Spearman and Pearson correlation coefficient and T-test were employed to determine the relationship between the participants' knowledge and performance and their demographic variables. The significance level was P<0.05.
Results: 176 parents completed the questionnaire. The mean parental knowledge score was 57.42±7.45
(range 15-75), and the mean practice score was, 9.42±1.86 (range 4-12). No relationship was found between the parents’ age, sex, knowledge, and performance. The knowledge of parents who had a history of referral to the dentist, fewer children (rs=0.428), higher education (rs=0.490) and higher income (r=0.226) was significantly better (P<0.001). Also practice increases with higher awareness of parents (r=0.549) (P<0.001). The parents’ practice was significantly related to the history of referral to the dentist, and having fewer children (rs=0.320), higher education (rs=0.369), and higher income (r=0.253) (P<0.01).
Conclusion: The findings of this study showed that the knowledge and practice of the parents about primary teeth were moderate. Regarding the important role of primary teeth in children's health, increasing the parents’ knowledge on the maintenance of primary teeth is essential.

Background and Aims: The inferior alveolar nerve block (IANB) is the most frequently used technique for mandibular anesthesia. Due to the many factors which can cause its failure, the aim of this study was to evaluate the efficacy of experience and knowledge in the success rate of IANB technique.
Materials and Methods: : In this study, 115 students of Shiraz Dental school were participated in two groups. One group contained 53 novice students and another group 62 students with one year experience in IANB injection. Each student accomplished injection once and then success or failure of the injection was examined. In order to evaluate the students’ knowledge, each student was asked to fill out a questioner including 6 questions related to the instruction of the injection. Data were then collected, coded, and analyzed by SPSS18 using Chi square with a significant level of 0.05.
Results: The rates of knowledge in novice and experienced group were 71.6% and 86.3%, respectively. The success rates of IANB were 47.1% in novice group and 64.3% in experienced group. The success rates of IANB and knowledge were significantly higher in the experienced group compared with the novice group. (P=0.02 and P=0.01, respectively) There was no significant difference between male and female (P=0.06).
Conclusion: The results showed that knowledge and experience could play an important role in the success rate of IANB technique.

Background and Aims: Pre-cancerous lesions of the oral mucosa as important malformation need acceptable knowledge of dentists. The purpose of this study was to determine the knowledge of Isfahan city general dentists about pre-cancerous lesions of oral cavity.
Materials and Methods: This descriptive cross-sectional study based on validated questioner form was performed in 115 general dentists in Isfahan City in 2019, associated with sex and year of graduation from general dentistry course. The mean score was in the range from 0 to14. Data were recorded in Microsoft Excel and then analyzed by SPSS. In order to compare quantitative variables, independent T–Test, One-Way ANOVA and Mann-Whitney was used. P≤0.05 was considered as significant.
Results: The mean age in the participants of: lower than 5 years, between 5-10 years, and more than 10 years of graduation were 28.6±4.9, 30.6±4.0 and 47.9±10 years old, respectively. In total population, the mean score of knowledge was 5.97±2.79. There was not any significant difference between the mean score of knowledge in women when compared to men (5.96±2.99 versus 5.98±2.6; P=0.58). The mean knowledge score in the participants of: lower than 5 years, between 5-10 years, and more than 10 years, of graduation were as follow: 7.8±2.2 versus 5.8±2.9 versus 4.4±2.1, correspondingly (P≤0.05).
Conclusion: For the early diagnosis of pre-cancerous lesions of the oral cavity, retraining program based on oral cavity pathology courses is recommended for the dentists in Isfahan city.

Background and Aims: A significant percentage of children with dental caries require, hospital dentistry and their parents do not have much information in this regard. The aim of this study was to determine the knowledge, attitude and practice of pediatricians in hospital dentistry in Isfahan Province.
Materials and Methods: This cross-sectional study was performed on 100 pediatricians working in Isfahan. The self-administered questionnaire included demographics of doctors and 19 questions for assessing the knowledge, attitude and practice of pediatric practitioners about hospital dentistry under general anesthesia. Raw data were analyzed by Chi-square test using SPSS software version 23.
Results: 100 pediatricians with an average age of 44.1±5.7 years (57% male) completed the questionnaire. 53% of the pediatricians had a high level of awareness about hospital dentistry and 42% about its related guides. 66% practitioners had a favorable attitude toward general anesthesia and costs, while 71% considered the parents' awareness were poor about hospital dentistry. Only 43% of pediatricians performed oral examinations in their daily visits, and 17% had a referral for hospital dentistry. Male pediatricians aged from 35 to 45 had a higher level of knowledge about hospital dentistry. The attitude and practice of pediatricians did not have a significant relationship with their age. Meanwhile, male pediatricians had better performance in oral and dental examination and referral for hospital dentistry (P=0.15).
Conclusion: From the results of this study, there is a need for a serious improvement in the level of knowledge, attitude, and practice of pediatricians in the field of hospital dentistry.

Background and Aims: Human ergonomics or engineering with proper design and change of work and requirements creates the most productivity based on human physiology. The purpose of this study was to determine the level of awareness of dental students of Isfahan University of Medical Sciences about the basic principles of ergonomics in dentistry.
Materials and Methods: In this descriptive-analytical, sectional study, a questionnaire containing 10 questions was distributed and completed by easy sampling method among 74 final year students of the general doctorate of Isfahan school of dentistry. After collecting the questionnaires, the students were given an educational pamphlet. To evaluate the questionnaires, each correct answer was given a score of one and the wrong answers were given a score of zero. Data were analyzed by T-test, Kai Square, and Mann-Whitney statistical tests using SPSS23 software. P<0.05 was considered as a significant level. P<0.05 was considered as a significant level.
Results: The average score of the knowledge of principles of ergonomics was intermediate (6.23±1.25). Student knowledge was not significantly different based on the student gender (P=0.25) and academic semester (P=0.059). Also, 55% of students had a history of muscle pain that did not have a significant relationship with gender (P=0.258) and average score of the knowledge (P=0.288).
Conclusion: Unfortunately, ergonomics cannot be considered part of the principles of dental education and even later. Musculoskeletal pain is one of the most common complaints of dentists and is a factor in reducing their quality and function. Therefore, it seems that training and evaluation of ergonomic principles in dental education is necessary.

Background and Aims: The increase in life expectancy and decrease in birth rate enhances the elderly population in different societies and consequently, the demand from the health system for providing the treatment needs has been elevated. It has been proposed that dentists must improve their attitude, knowledge, and practice to meet these needs. The present study aimed to assess the knowledge, attitude, and practice of general dentists regarding geriatric oral health.
Materials and Methods: In this descriptive-analytic cross-sectional study, 150 general dentists participating in the annual congress of the Iranian Dental Association in 2018 were selected and completed a valid and reliable self-administered questionnaire including 5 parts about knowledge, attitude and practice regarding old age and oral health of elders. SPSS23 and multiple regression were used for data analysis.
Results: The mean age of dentists was 34.3 (SD: 9.1) and 92 (61.3%) of participants were women. The mean knowledge score about the old age was 16.67 (of maximum: 26, SD: 4.31) and the mean knowledge on the geriatric oral health was 11.01 (of maximum: 18, SD: 2.81). The mean general attitude about elderly was 19.1 (of maximum: 30, SD: 4.26), the mean attitude on geriatric oral health was 13.09 (of maximum: 20, SD: 2.65), and the mean practice about geriatric oral health was 6.5 (of maximum: 10, SD:2.96). Age was significantly associated with knowledge regarding the elderly (P<0.034); i.e. with increase in age lower scores in knowledge were gained.
Conclusion: General dentists participating in the congress of the Iranian Dental Association demonstrated a medium level of knowledge, attitude, and practice regarding the oral health of elders. Proper educational programs should be planned in dental schools to improve dental student's knowledge, attitude and practice about geriatric oral health.

Background and Aims: School teachers have key role in providing the basic health information for their students, and their knowledge, attitude, and practice affect children's oral health through developing of the healthy behaviors. The goal of this study was to evaluate the effectiveness of an oral health education program for primary school teachers on their knowledge, attitude, and practice fields in the framework of oral health promoting schools.
Materials and Methods: This quasi-experimental pre-post study was conducted among five oral health promoting schools in Isfahan city in 2019. A validated and reliable questionnaire including four sections of demographic data, knowledge, attitude, and practice was applied for data collection. The questionnaire contained 24 knowledge, 9 attitudes, and 5 practice questions. It was distributed among 63 enrolled teachers at base line and two months later after two educational-emotional workshops. Before and after data were analyzed by SPSS21 (α=0.05) by related samples Wilcoxon signed rank test and background variables by Kruskall-wallis test.
Results: After the educational intervention, their knowledge score increased significantly from 14.1±3.8 to 18.5±3.7 (P<0.001). About 34% of teachers had a high level of knowledge proficiency at the beginning of the study which eventually rose to 76%. Teachers’ attitude decreased significantly from 34.6±5 to 31.4±4.6 (P<0.001). At the beginning of the study, 89% of them had a positive attitude towards oral health programs which decreased to 84% at the end of the study. In the performance part, 63.5% of the teachers paid attention to the fluoride in their toothpaste which reached 87.3% after the workshop and the teachers' performance score increased from 3.07 to 3.39 after the intervention (P<0.012).
Conclusion: The package of educational intervention for teachers in oral health-promoting schools improved the level of knowledge and practice, but slightly reduced the level of attitude. However, due to the importance of changing attitudes in teachers and the existence of structural and programmatic barriers to integrate the health issues into school education, other models need to be evaluated and compared.

Background and Aims: The objective of this study was to evaluate the knowledge, attitude, and practice of ergonomics during dental treatment among students of Urmia university of medical sciences in 2020.
Materials and Methods: In this descriptive-analytical study, self-administered questionnaires were given to 78 dental students of Urmia University in 2020 and the knowledge, attitude, and practice of every participant were evaluated. Demographic data including sex, age, and University grade were recorded as well. Data were analyzed by SPSS software24 with One Way ANOVA and t-test and the significance level of P<0.05.
Results: 78 students (44 males and 34 female) by Mean Age 23.9±2.12 were included in the study. The difference between the attitudes of different age groups was significant (P=0.006). The age group of 20 to 24 years had a more positive attitude than other age groups. However, the results of this study did not show a significant r elationship between the participants' knowledge and practice with their age (P>0.05).
Conclusion: According to this study, the knowledge, attitude and practice of Urmia dental students were in the desired range. 20-24 year students had significantly higher attitude in comparison to others. Therefore, more endeavors should be taken to improve these parameters in ergonomics.

Background and Aims: The 2019 coronavirus pandemic has resulted in a lot of pressure on health systems around the world. The risk of transmission of infection in dentistry is significantly high. The aim of this study was to evaluate Covid-19 protection knowledge and practice of dentists in Isfahan in clinical environment.
Materials and Methods: In this study which was performed in April 2021 by available sampling method, an online questionnaire was used as a data collection tool. Questions included demographic characteristics, knowledge of proper protective protocols, protection protocols taken against Covid-19, and the prevalence of Covid-19 infection. Descriptive and analytical analyzes were performed using SPSS26 software including frequency distribution tables, graphs, independent t-test, and Pearson and Spearman correlation coefficients.
Results: 310 questionnaires were collected with complete answers. 87.4% of dentists had moderate and high knowledge of proper protective protocols against Covid-19. The mean knowledge score had no significant relationship with the demographic characteristics of age (P=0.59), gender (P=0.31 and r=0.05), work experience (P=0.16 and r=0.07) and degree (0.33=P). In the pandemic period, 87% of dentists treated dental emergencies and 40% delayed the dental treatment for patients with high risk of Covid-19. Dentists used personal protective equipment correctly. Among all the included dentists, 75% used high protection masks, 75% used face shields, 67% used hats, and 60% used sterile gowns in all of their treatment activities. The clinical environment was equipped well to prevent spreading of Covid-19. The results showed that 55.8% of the participants had one or more similar signs/symptoms of Covid-19 and 9% had a positive SARS-CoV-2 test during the last months.
Conclusion: The majorities of dentists had enough knowledge of proper protective protocols against Covid-19 and efficiently used all protections while performing dental procedures.
 

Background and Aims: Oral health is a necessity and part of general health and its importance in childhood is more than ever. The aim of this study was to investigate the knowledge, attitude, and practice of parents in Delfan city-Iran about oral health of their 6-12-year-old children in 2021.
Materials and Methods: The present study was a descriptive-analytical study that was performed on 365 parents of 6-12-year-old children in Delfan city. Convenience sampling was used. The questionnaires included four sections: demographic information, knowledge, attitude and practice about oral health. Data were entered in SPSS23. Independent t-test, analysis of variance and Pearson correlation were used to analyze the data. Significance level was considered 0.05.
Results: The mean age of the subjects was 36.5±7.1. 201 of parents were mothers. Parents' knowledge and attitude were good and their performance was fair. There was a statistically significant relationship between all three variables of knowledge, attitude, and practice (P<0.00). Also, there was a statistically significant relationship between the knowledge and education (P<0.00), mother job (P<0.04), father job (P<0.00), and economic status (P<0.00). There was a statistically significant relationship between the attitude with education (P<0.00), mother job (P<0.04), father job (P<0.01), and economic status (P<0.01), There was a statistically significant relationship between practice and education (P<0.00), mother job (P<0.01), father job (P<0.00), and economic status (P<0.00) of parents.
Conclusion: The results of this study showed that there was a significant relationship between the knowledge, attitude, and practice with education level, job and economic status. Therefore, oral health education for parents with low educational and economic level should be highly considered.

Background and Aims: Considering the prevalence of periodontal disease in Iranian adults and its impact on general health and the role of medical practitioners, the purpose of the present study was to determine physician’s knowledge and attitude towards periodontal health.
Materials and Methods: A cross-sectional study was conducted in Tehran in 2019 and after getting informed consent, a valid and reliable questionnaire was provided to medical practitioners in a continuing education course. Data were analyzed using the SPSS26 software.
Results: In total 170 subjects (response rate=95%) responded. The mean scores of knowledge and attitude towards periodontal health were 4.1 (maximum score of 6) and 51.9 (maximum score of 65), respectively. Work experience (P=0.022) and period of time after graduation (P=0.007) had a positive and significant relationship with participants' knowledge. Also, gender (P=0.012), work experience (P=0.002), period after graduation (P=0.005) and practitioner’s workplace (P=0.001) were significantly associated with their attitudes. The results showed that women had a better attitude towards prevention of gum disease.
Conclusion: In the present study, medical practitioners’ knowledge was good towards description of healthy periodontium and the first sign of periodontal diseas. Also, their attitudes regarding the importance of oral and dental diseases and its impact on social activities were appropriate. The results of the present study showed more emphasis is needed on delivering relevant dental education in medical curriculum.

Background and Aims: Nowadays, the requirement of any policy-making at the national and regional level is to know the level of knowledge of people about oral health and ways to prevent dental caries.  This study examined the habits, actions and economic level of elementary school students in Qazvin city in 2017-2018.  Also, the effects of peer group social network on behaviors related to oral health and obesity was investigated in order to find the way for interventions making it more effective in this social group. Materials and Methods: In this descriptive-analytical study, 145 students participated. They were in the 3nd and 6th grades of elementary school in the academic year of 2017-2018. The questionnaire used in this study had 20 questions and 4 main sections. The main parts of this questionnaire included demographic characteristics, behavior and habits related to oral health, oral health knowledge of students and families, and socio-economic status. Data were collected through clinical examinations and through valid questionnaires and evaluated using SPSS and Excel software. Results: According to the results of Pearson's correlation analysis, a significant correlation was observed between the health knowledge scores of individuals and their friends between both groups of casual and close friends (P<0.01). The correlation between the knowledge of individuals and close friends was significantly stronger (P<0.01). Also, there was a significant relationship between socio-economic status and behaviors related to oral health (P<0.05). There was also a significant positive relationship between the number of times close friends brushing their teeth in a social network (P<0.001). This connection was not observed in the friends’ network. Conclusion: This study determined that close friends can be effective in determining the oral hygiene behaviors of elementary school students.