Journal of Dental Medicine

Background and Aims: Today, smoking is recognized as a major health problem and an impediment to development in many developing countries. This is the reason of early deaths and disabilities which leads to death of about 4 million people around the globe annually. This study aimed at assessing the awareness and attitude among the students last years dental at Yazd Shahid Sadooghi Medical School in providing consultation for giving up smoking.
Materials and Methods: This study was a descriptive sectional study that evaluated the awareness and attitudes of students last years dental at school of dentistry. Data was collected through standard questionnaires and were analyzed by T test and Pierson correlation coefficient in SPSS18 software.
Results: A total of 110 students participated in this study. Awareness mean's score of female students was 18.38 and male students 17.66. The attitude mean's score of female students was 31.06 and the male students was 32.45. Based on the correlation coefficient of awareness with age (0.112), with the semester (-0.001) and with a GPA (0.76), it was concluded that awareness with increasing age and GPA increased, and with increasing semester decreases. Also, based on the correlation coefficient of attitude with age (0.013), with the academic semester (0.018) and with a GPA (0.008), it was concluded that attitude with increasing age, semester, and GPA was improved.
Conclusion: Despite the relatively good attitude of dental students about smoking cessation counseling, their awareness was poor. Therefore, the need to revise the education programs and steps in the field of training are required.

Background and Aims: Advances of genetic science in genomic techniques have led introducing new diagnostic systems to study the diseases or treatment efficacies. In this science, which named “Personalized Medicine”, human genetic structure is used for evaluation of the diagnosis, treatment, and prevention of disease. Regarding the limited number of studies regarding this issue in Oral & Maxillofacial diseases, this study was aimed to evaluate the benefits and challenges of this new area (Personalized Medicine) in dental treatments.
Materials and Methods: In this study, complete evaluation of abilities and challenges in order to apply the “Personalized Dentistry” in Dental treatments, and also its effect on oral health indexes were done. All the existing related articles were searched with the relevant key words in the scientific data bases of PubMed, Google Scholar, Medline, Scopus, SID and Magiran. Based on the inclusion and exclusion criteria, 5 articles were selected, assessed and summarized.
Results: In the evaluated articles, the benefits of “Personalized Dentistry” in dental treatments as targeted and specialized treatment could result in lower time, energy and cost. In addition, its disadvantage as unknown biologic effective factors and also, the cross effects of some of the above items on each other and the treatment procedures were mentioned.
Conclusion: Regarding the specialized sciences and diagnostic tools for oral & maxillofacial disease, the benefits of “Personalized Dentistry” application can be increased for special treatments of patients. Also, it could reduce the side effects of conventional therapies and thus, could be introduced as an effective step for better dental treatments.

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: Anxiety is a common problem in patients referred to dental clinics that is associated with underlying personality factors. The purpose of this study was to determine the role of personality traits in predicting dental anxiety.
Materials and Methods: In this study, 211 patients (110 men and 101 women) referred to the dental clinics in Tabriz in 2019, were selected by available sampling method. The method of this study is descriptive- correlative. The research instrument was a short-form NEO-personality inventory and a dental anxiety inventory. Data were analyzed by correlation and regression analysis using SPSS22.
Results: The research findings showed that the average age of women and men was 30 and 31 years, respectively. 49% of the clients were single and 51% were married, and the education of most of the clients was undergraduate. Also, Regression analysis showed that dental anxiety had a positive correlation with personality trait of neuroticism (r=-0.49, P<0.01), and it had a negative relationship with extroversion (r=-0.19, P<0.05), agreeableness (r=-0.21, P<0.01), consciences (r=-0.35, P<0.01); and two factors of neuroticism (t=4.71, P<0.01) and conscience (t=2.44, P<0.01), and predicted dental anxiety (P<0.05).
Conclusion: From the results, it can be concluded that anxiety with a sense of danger that was observed in many people in the face of dental interventions, occurred within individuals. By recognizing root factors, it can be partly strengthened by deterrent and suppressor personality factors for anxiety, and thus, taking advantages of the dental services and preventing from avoiding dental treatments.

Background and Aims: Interest and satisfaction of students toward their field of study has important role in knowledge promotion, future activities, and also healthcare of country. This study aimed to evaluate the attitude of dental students toward their field of study and also their future career.
Materials and Methods: This cross-sectional descriptive study was based on a standardized researcher designed questionnaire in 2018. Demographic data was collected and questions were based on the attitude of students toward their field of study and their future. ANOVA and Backward stepwise regression methods were used for statistical analysis. Significance level was determined at 0.05.
Results: In this study 62.2% of responders were female and 37.8% were males. Students chose dentistry under the influence of following matters consecutively: high income, recommendation of people around and self-interest. Girls compared to boys, were significantly influenced more by self-interest and also had more interest compared to boys for working in dentistry (P<0.05). Also, most of students were anxious about the increase in the number of dental students.
Conclusion: Students had positive attitude toward their field of study and their future. They were interested in working in this field but factors such as not having enough familiarity toward this field and also an increase in the number of students in recent years created some worries for them.

Background and Aims: Radiography is one of the most important para-clinical methods in diagnosing and selecting treatment in dentistry. Due to the potential dangers of X-rays for patients, the professional responsibility of the dentist requires that unnecessary radiographs to be avoided. The aim of this study was to investigate the awareness of dentists in Zanjan about the principles of radiation protection in 2019.
Materials and Methods: This cross-sectional study was performed on 107 general dentists and specialists working in Zanjan and the questionnaires were distributed among them. The level of awareness of dentists in 27 questions of radiographic prescribing questionnaire was evaluated and in each of the mentioned questions, their gender, age, work experience, participation in retraining, having X-ray machine in the field of dentistry and type of activity were evaluated. Data were analyzed by Chi-square test, Independent T-test, and ANOVA using SPSS software version 22.
Results: The results showed that the level of knowledge of general dentists about the principles of radiation protection (14.35±3.08) was lower than that of specialized dentists (17.19±2.35). Those who participated in retraining workshops (13.85±2.99) had less knowledge than those who did not (15.97±3.97), which was statistically significant (P<0.05); However, there was no significant difference in the dentists' knowledge about the principles of radiation protection based on gender, age, type of activity, having an X-ray machine at the place of treatment, and history of clinical experience (P≥0.05).
Conclusion: Awareness of dentists at various levels was moderate. Therefore, designing and holding more purposeful retraining courses to maintain and improve the level of awareness of dentists according to the guidelines provided by the authorities, still seems to be necessary.

Background and Aims: Regarding the need for social accountability in dental education, community-based dental courses has been established to improve the oral health of the community and compensate the shortcomings of the health system. Due to the importance of evaluation, the aim of this study was to determine the dental students’ attitudes and believes in the last year of their study towards the community-based dental education.
Materials and Methods: This cross-sectional study was performed on 159 dental students in the sixth year (October and February, 2018) of Isfahan dental school by census. These students took the relevant questionnaire, which was developed by researchers in three sections of “attitudes toward field activities”, “lessons and experiences of field activities during dentistry training” and “barriers and problems of field activities”. Its content and face validity was confirmed. They completed it on their own and after collecting information and descriptive analyzes, the relationship between the gender and entry group with attitude scores was analyzed by Mann-Whitney U test.
Results: Out of a total of 102 questionnaires which were answered (response rate of 64%), half of the students believed in the need to provide dental services in the form of mobile/outreach services for the community. 90% of the students agreed with the combination of field education with routine education in the dental schools. They also considered these services as an opportunity to use their experiences and knowledge to promote oral health in the community. 84% of them believed that their self confidence improved while providing services outside the faculty. In many of the propositions in the field of attitude to provide service in the field, a significant percentage (50 to 60%) did not have an opinion.
Conclusion: There was a good and positive aspects in many areas of attitude toward providing services in social fields as well as attitude towards the lessons learned from community-based dental education. However, we should consider the attitude-emotional aspects of educational objectives in the community-based courses in dental schools.

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.

Conclusion: The trend of publishing scientific articles in Iran in the field of dentistry has been increasing during the selected period. The keywords oral, dental, and pediatric surgery have the most effective and decisive role in the scientific network of dentistry. These keywords provided strong scientific communication amongst the dental scholars in Iran.

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.

Conclusion: According to the results of this study, it seems that dentists should pay more attention to the components of emotion regulation and emotions in order to prevent and reduce job burnout.

Background and Aims: The stress, job satisfaction and depression can affect the performance of dental professionals in various fields. The aim of present study was to examin the level of stress, depression and job satisfaction among different specialized fields of dentistry in Zanjan provinc, Iran.
Materials and Methods: In this cross-sectional study, the depression, anxiety and stress scale questionnaire (DASS-21) and the Herzberg questionnaire were used to assess job satisfaction. The questionnaires were completed on the web, and the relevant link was sent to all specialists in different fields of dentistry in Zanjan province. Finally, 33 people participated in the study. Data were analyzed after appropriate code allocation using independent T-test and U-Mann Whitney tests and SPSS16.
Results: The results showed the mean of stress (24.4), depression (17.48) and anxiety (13.28) among specialists. The mean of stress and anxiety among female dentists was higher than male specialists, but there was no significant difference between these two variables between the two sexes (P>0.05). In terms of job satisfaction, 21.2% were dissatisfied with their job. By gender, 26.6% of female specialists and 16.7% of male specialists were dissatisfied with their jobs.
Conclusion: Despite the general perception that work conditions are suitable for dental specialists, these people suffer from the stresses, anxiety and depression and may not be satisfied with their job. As these conditions can affect the performance of these people in the workplace, it would be necessary to take measures, to identify, and to increase mental health and job satisfaction.

Background and Aims: Due to the review of general dental courses, it was necessary to assess the students' satisfaction with this curriculum. The aim of this study was the assessment level of students’satisfaction with the new educational curriculum of the Ministry of Health at the department of restorative dentistry of Tehran university of medical sciences in 2019-2020.
Materials and Methods: In this descriptive cross-sectional trial,72 sixth year dental students of Tehran University who passed the restorative dentistry courses based on the new curriculum were studied. A questionnaire was developed and for validity content assessment, it was presented to 5 professors and then revised. For reliability approval of the questionnaire, test-retest approach was used. The questionnaire was given to the 30 students of the main pilot group in one session and two-week later and agreement percentage and Kappa index were calculated.  After conducting the "test" process and re-testing, the "questions" were statistically analyzed using STATA software.
Results: The most level of satisfaction regarding to practicality of subjects was found for fundamental of restorative dentistry including principles of amalgam class I cavity preparations and restorations on the dentic (81.94% and 76.39% acceptable respectively) and the principles of amalgam classII cavity restorations on the dentic (72.22%). The least satisfaction levels were obsereved in the first and second theoretical restorative courses including tooth-colored restorations (47.22%), onlays and inlays (47.22%) and tooth-colored classII cavity preparations and restorations (48.61%). The amount (P-value or error of the first type) was reported in all questions>0.001.
Conclusion: Despite the limitation of this study, final-year dental students’ satisfaction of theoretical restorative dentistry courses was medium, while it was high for the fundamental and practical restorative courses of 2017 educational curriculum.

Background and Aims: Studies have shown that dental anxiety may be caused by various factors such as child mood, age, maternal emotional maturity, previous dental anxiety and parenting styles. Therefore, the aim of this study was to investigate the possible relationship between the parenting styles and pediatric dental anxiety and the predictability of this variable through parenting styles.
Materials and Methods: The present study was a cross-sectional correlational study. The study population was children aged 7 to 12 years who had referred to the dental clinics of Tehran in 1400. Sampling from one of the clinics was done randomly. A total of 100 questionnaires of modified child dental anxiety scale and parenting style inventory were given to the children and their parents and 95 of them could have been analyzed. The questionnaires were analyzed using SPSS22 software and Pearson correlation and regression tests.
Results: The results showed that dental anxiety had a negative and significant relationship with authoritative parenting style (r=-0.286, P<0.01) and a positive and significant relationship with authoritarian parenting style (r=0.342, P<0.01). Authoritarian parenting style can be a predictor of dental anxiety.
Conclusion: Knowing the predictors of dental anxiety can help a pediatric dentist analysing who is most prone to dental anxiety. Based on this approach, a relationship based on trust can be established between the dentist and parents to make the necessary recommendations to parents in the office, reduce dental anxiety and improve oral health conditions in children.
 

Background and Aims: For dental students, communication skills are essential to effectively transfer the necessary information to the patient and meet the patient’s needs and expectations. Therefore, this study was conducted to determine the patient communication skills of dental students at Islamic Azad university of Isfahan in 2021.
Materials and Methods: In the present cross-sectional analytical study, an online standardized questionnaire DCCC (Dental consultation communication checklist) was provided to all clinical dental students applying a census sampling method. In total, from 248 clinical dental students, 230 students participated in the study (response rate=92.7%). The questionnaire included five dimensions of introduction, medical history, clinical examination, closure and patient. In order to determine the patient communication skills, its dimensions, and the association between patient communication skills and students’ demographic characteristics, friedman test, analysis of variance, independent t-test and a linear regression model were used for statistical analysis.
Results: The mean score of total communication skills of the students (117.16±15.6) was above average which was obtained from the maximum score of 155. There was a significant difference between the dimensions of communication skills (P<0.001). The highest scores were assigned to the clinical examination, patient, medical history, introduction and closure, respectively. No significant relationship existed between the score of students' communication skills with gender (P=0.08), age (P=0.17), marital status (P=0.19), and educational background in psychology (P=0.07). No significant relationship revealed between the total score of communication skills (P=0.92) and its dimensions (introduction P=0.79, medical history P=0.90, clinical examination P=0.77, closure P=0.35, and patient P=0.85) with the students’ academic year.
Conclusion: The total score of dental students’ communication skills and all its dimensions was above average. However, students reported poorer performance in dimensions of introduction and closure than the other dimensions. Therefore, it is recommended to design and implement educational interventions specially to improve the dimensions of introduction and closure.

Background and Aims: Artificial intelligence (AI) technology is widely used in dentistry in addition to numerous other sectors that impact human life, including medicine. A dentist can use AI technology to analyze patient data, diagnostic processes, and management activities. This study was conducted in Iran to identify the dental applications of AI and prioritize them.
Materials and Methods: In the winter of 2022, this applied research was carried out in two stages using a mixed method. In the qualitative phase, 570 articles from 2011 to 2022 were identified in the databases of PubMed, Web of Science, Scopus and Google Scholar among the studies in the field of dentistry and related to artificial intelligence technology based on keywords and then the applications of artificial intelligence in dentistry were extracted. In the quantitative phase, the identified applications prioritized by a group of experts comprised 13 University faculty members with related research areas using the best-worst method (BWM).
Results: The factors identified in the first stage of research were classified into six categories: implant and surgery, executive management, disease diagnosis, analysis of images, clinical prediction, and orthodontics. According to the experts’ opinion, it was determined that medical photo analysis had the highest coefficient of importance (0.252) followed by orthodontics (0.234), disease diagnosis (0.151), implantology and surgery (0.143), clinical forecasts (0.127), and executive management (0.093).
Conclusion: Dentists can use the capabilities of artificial intelligence in examining patients' teeth and diagnostic tests in dentistry based on the analysis of patient information. Information technology policymakers with the support and reinforcement of knowledge-based companies active in the field of artificial intelligence and joint investment in the field of medicine can be the basis for progress and the development of this technology in the country and the field of treatment.

Background and Aims: One of the concerns of dentists is selecting a suitable brand of stainless steel crowns with maximum dimensional adaptation with primary teeth. The aim of this study was to compare the primary molar crown dimensions with that of two brands of stainless steel crowns (SSCs) in a sample of Iranian children.
Materials and Methods:  In this study, 130 eligible children between 3 and 12 years (66 boys, 64 girls) were selected. After recording the demographic information, the mesiodistal, buccolingual and occluso-gingival dimensions of first (D) and second (E) primary molars were measured on dental casts and compared with the dimensions of KTR (MeiMeiMinBenjing, Benjing, China) and Shinghung (Shinhungcompany, Seoul, South Korea) SSCs. Data were assessed using chi-square test and Pearson correlation coefficient. P<0.05 was considered statistically significant.
Results: In this study, the most dimension matching of the teeth with that of SSCs were observed mesiodistally in upper D and lower D, buccolingualy in the upper D and lower D, and occluso-gingivaly in upper D and lower E. The most cases of mismatch in the mesiodistal dimensions of the teeth with that of SSCs were observed in the lower E and upper D. Also, the most cases of mismatch in the buccolingual dimension were found for upper E and lower E.
Conclusion: Both SSCs brands in this study showed significant dimensional adaptation with the primary teeth in Iranian children. The most dimensional adaptation was between KTR SSCs and maxillary primary molars, and between Shinhung SSCs and mandibular primary molars.

Background and Aims: Dentists are at risk of musculoskeletal disorders due to their job characteristics. The purpose of this study was to compare the posture and musculoskeletal disorders of dentists with high and low work experience.
Materials and Methods: This analytical cross-sectional study research was conducted on 76 dentists in Urmia city. Based on work experience, the samples were divided into two groups: less experienced (less than 15 years) and experienced (15 years and more). The variables of forward head, kyphosis, round shoulder, and musculoskeletal disorders were compared in two groups. Forward head and round shoulder variables were evaluated by photography, kyphosis variable by flexible ruler, and musculoskeletal disorders were evaluated by Nordic questionnaire. Data analysis was done using descriptive statistics and analytical statistics (Kolmogorov-Smirnov test, Leven test, independent t-test and Yeoman-Whitney test).
Results: The independent t-test results showed that the angle of forward head, round shoulder, and kyphosis was higher in the high work-experience group than that of the low work-experience group (P=0.001). In comparing the prevalence of neck disorders, the results were significant such that the experienced group had more neck disorders (P=0.002). However, in examining the difference in the amount of disorders in other parts of the body, the difference between the two groups was not statistically significant (P>0.05).
Conclusion: Experienced dentists had a higher degree of forward head, round shoulder and kyphosis positions. Although, there are musculoskeletal disorders in both groups of dentists with low and high level of experience, neck disorders were more common in high-experienced dentists than that of low-experienced ones.