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Objective: To identify the frequency and types of prescription errors, assess adherence to WHO prescribing indicators, and highlight the gaps in current prescribing practices of Junior dental practitioners in a tertiary care hospital in Karachi, Pakistan. Methods: This cross-sectional study was conducted from January 2021 to March 2021. The study included the prescriptions by house surgeons and junior postgraduate medical trainees for walk-in patients visiting the dental outpatient department. A total of 466 prescriptions were evaluated for WHO core drug prescribing indicators. The prescription error parameters were prepared by studying the WHO practical manual on guide to good prescribing and previous studies. Prescription errors, including errors of omission related to the physician and the patients, along with errors of omission related to the drug, were also noted. The statistical analysis was performed with SPSS version 25. Descriptive analysis was performed for qualitative variables in the study. Results: The average number of drugs per encounter was found to be 3.378 drugs per prescription. The percentage of encounters with antibiotics was 96.99%. Strikingly, only 16.95% of the drugs were prescribed by generic names and 23.55% of drugs belonged to the essential drug list. The majority lacked valuable information related to the prescriber, patient, and drugs. Such as contact details 419 (89.9%), date 261 (56%), medical license number 466 (100%), diagnosis 409 (87.8%), age and address of patient 453 (97.2%), form and route of drug 14 (3%), missing drug strength 69 (14.8%), missing frequency 126 (27%) and duration of treatment 72 (15.4%). Moreover, the wrong drug dosage was prescribed by 89 (19%) prescribers followed by the wrong drug in 52 (11.1%), wrong strength in 43 (9.2%) and wrong form in 9 (1.9%). Out of 1575 medicines prescribed in 466 prescriptions, 426 (27.04%) drug interactions were found and 299 (64%) had illegible handwriting. Conclusion: The study revealed that the prescription writing practices among junior dental practitioners are below optimum standards. The average number of drugs per encounter was high, with a significant percentage of encounters involving antibiotics. However, a low percentage of drugs were prescribed by generic name and from the essential drug list. Numerous prescription errors, both omissions and commissions, were identified, highlighting the need for improved training and adherence to WHO guidelines on good prescribing practices. Implementing targeted educational programs and stricter regulatory measures could enhance the quality of prescriptions and overall patient safety. [ABSTRACT FROM AUTHOR]

Introduction Evidence on smokeless tobacco (ST) cessation interventions is scarce. The South Asian (SA) region that shares more than 90% of the burden of ST use is grossly underrepresented in research on ST cessation. This study aimed to assess the feasibility of delivering and investigating a behavioral support intervention for ST cessation in dental settings in Pakistan. Methods A multicenter, pilot, two-armed parallel-group, individually randomized control trial, with a 1:1 allocation ratio, was conducted at two dental hospitals. Eligibility criteria included being an ST user seeking dental treatment and not currently accessing cessation support. All participants were provided written self-help ST cessation material. The intervention group also received a dentist-delivered, bespoke behavioral support intervention for ST cessation developed for users of SA origin. Participants were followed up telephonically at 3 and 6 months. Self-reported 6-month abstinence was verified by salivary cotinine. Analysis was descriptive, with 95% confidence intervals presented where appropriate. Results One hundred participants were successfully recruited from the selected hospitals. Of these, 78% continued to engage throughout the study duration and provided primary outcome data, whereas 63% completed all hospital visits. The outcome measures were successfully collected. Biochemically verified 6-month abstinence in the intervention and control groups was 10% and 4%. Conclusions It was feasible to deliver and evaluate a dentist-delivered behavioral support intervention for ST cessation in Pakistan. The data suggested that the intervention may improve ST quit rates. The findings of this study will be useful in informing the design of future definitive studies. Implications To our knowledge, this is the first pragmatic pilot trial on ST cessation in dental settings in Pakistan and the first trial on dentist-delivered structured behavioral support intervention for ST cessation. It adds to the scarce, trial evidence based on ST cessation interventions. The findings suggest behavioral support intervention for ST cessation may improve quit rates. The trial was conducted in a country with poor ST control measures, where ST products are not taxed, the products are sold openly to and by minors, and the users are offered negligible cessation support. The findings may, therefore, be generalizable to low–middle-income countries, particularly SA countries, with similar policy backgrounds. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint disorders (TMDs) are a variety of conditions that affect different parts of the temporomandibular joints (TMJ) and can cause orofacial pain and functional impairment. This study aims to investigate dental practitioners' knowledge and management of Temporomandibular Joint Disorders (TMDs), particularly their knowledge of the role physical therapy plays in TMD treatment. Methods: A mixed-methods approach was adopted to provide a comprehensive view of current knowledge, management practices, and attitudes toward collaboration among dental practitioners in treating TMD. Data were collected from a convenience sample of 335 dentists in Karachi using a detailed questionnaire to assess their knowledge of the role of physical therapy in the treatment of TMD. Twenty dentists were chosen for face-to-face, in-depth interviews to explore their experiences and challenges in managing TMDs based on their responses to the administered questionnaire. Results: The cumulative quantitative and qualitative findings of the study revealed a landscape marked by individualized approaches to referral practices and significant gaps in interdisciplinary collaboration. Most practitioners holding a bachelor's degree predominantly used medication (65.2%) and cause-specific treatment (65.3%) for TMD treatment. Thematic analysis of clinical efficacy and practitioner challenges in managing TMD revealed significant issues faced by dental professionals. Conclusions: The study successfully validated a questionnaire to understand dental practitioners' knowledge regarding physical therapy in TMD treatment. The study identified significant gaps in knowledge and a lack of collaboration between dentists and physiotherapists. The limited referral practices highlighted in the study, along with insights from dentist interviews, emphasize the need for improved interdisciplinary approaches to managing TMDs within dental practice. [ABSTRACT FROM AUTHOR]

Background. Preterm birth is a heterogeneous condition with multiple underlying causes, and periodontal diseases are one of them. Approximately 900 000 preterm births are reported in Pakistan each year. Oral infections such as periodontitis during pregnancy are associated with adverse pregnancy outcomes such as low birth weight and preterm births. However, different studies have reported contradictory findings. We conducted a cross-sectional study to assess the association of preterm birth with oral infection in pregnancy. Methods. We conducted a cross-sectional analytical study on 400 postpartum pregnant women in Khyber Teaching Hospital, Peshawar. Only women within the age bracket of 18?40 years were recruited. Data were collected by an interview-based structured questionnaire. The extent and severity index were used to assess the periodontal health of participants. Frequency tables were generated, and the chi-squared test was used to determine associations between different categorical variables. Results. The mean age of the participants was 25.8 ± 4.9 years. Approximately 87.5% of the women had generalized periodontitis. Approximately 68% of mothers had moderate severity of periodontitis. The extent index showed no notable difference between the preterm and full-term birth groups. In contrast, the severity index displayed a statistically significant difference between the preterm and full-term birth groups. Conclusion. The majority of women had generalized periodontitis. The severity index demonstrated a significant association between maternal periodontitis and preterm births. There was no association between the age of mothers and preterm births. Complications in pregnancy were not associated with preterm births. [ABSTRACT FROM AUTHOR]

Introduction Despite evidence on the effectiveness of tobacco cessation interventions in dental settings, the implementation remains low, especially for smokeless tobacco (ST). The purpose of this study was to develop an understanding of the influences governing the implementation of ST cessation support in dental hospitals. Aims and Methods A multicenter qualitative study was conducted at two tertiary-care dental hospitals, in Pakistan. Semi-structured interview guide, guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model, were used to capture the views of dentists (n  = 12) and dental patients (n  = 12), regarding ST cessation support in dental hospitals. Framework approach was used to thematically analyze the data. Results Screening of ST users in routine dental practice was seldom practiced and the cessation support offered was brief advice. Barriers identified by dentists included: Fear of offending and stereotyping patients; lack of knowledge and skills; lack of privacy; lack of belief in the effectiveness of behavioral support; lack of time and workload pressure; ST use amongst dentists; lack of referral systems and; the absence of a mandatory requirement of offering ST cessation support. Facilitators included: Delivering support through junior dentists and the length of interaction between the dentist and the patient. Naswar was the most common ST product used by dental patients. Patients reported receiving negligible cessation support from any healthcare provider. Conclusions A range of influences governing the implementation of ST cessation support in dental hospitals were identified. These findings can inform the implementation of behavioral interventions for ST cessation in dental and other clinical settings, in low and middle-income countries. Implications Smokeless tobacco control considerably lags, in comparison to the control of combustible tobacco. This is the first study that qualitatively explores the implementation of ST cessation support in dental settings in Pakistan. Utilizing the "Capability-Opportunity-Motivation-Behavior" model, it provides an in-depth understanding of the inability of dentists in implementing effective behavioral interventions for ST cessation support in routine dental practice. Highlighting the striking discrepancy between the patient's need for and receptivity towards cessation support and the dentists' concerns over their patients' receptivity towards cessation support, it calls for the need for effective implementation strategies to optimize dentist-led tobacco cessation interventions in low-resource settings. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this study was to validate an Urdu translation of Kleinknecht's Dental Fear Survey (DFS) for use in Pakistan and to explore which items contribute the most to the variance in dental fear scores based on patient perceptions and lived experiences during dental care. Methodology: This mixed-method study was conducted at Dow Dental Hospital from February 2022 to June 2022. For quantitative analysis, a total of 273 participants were enrolled through convenience sampling. After obtaining signed consent, participants were asked to self-report their dental fear. In-depth interviews with 25 patients displaying moderate to high dental fear were conducted to clarify the elements of dental fear scores through the lens of individual perceptions and experiences. Results: The prevalence of moderate dental fear was significantly higher among female participants than males. The mean dental fear score was higher among females (39.47 ± 14.23) as compared to males (30.83 ± 10.50). Most of the female participants reported an increase in breathing rate and heartbeat during dental treatment. The highest mean fear score was reported by participants who underwent oral surgical treatment (42.98 ± 14.21), followed by participants who received restorative care (36.20 ± 12.60). Approaching the dentist's office was the significant factor that contributed the most to the variance in dental fear scores. Four themes were generated through the content analysis of the interviews: physical reactions to dental procedures, perceptions and fears about surgical and restorative procedures, and gender and environmental factors in dental fear and interaction with dentists. Conclusion: The Urdu translation of DFS is a reliable and valid instrument for assessing dental fears in Pakistan based on the findings of this study. Patients perceive surgical and restorative procedures as unpleasant and threatening. It was noted that "the heart beats faster" and "the breathing rate increases." were the top two physiological responses. [ABSTRACT FROM AUTHOR]

Objective: Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan. Methodology: This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists' awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly. Results: The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5–20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists' perceptions, barriers and challenges, knowledge and awareness, and improvement strategies. Conclusion: Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices. [ABSTRACT FROM AUTHOR]

Objective: This study explored the factors influencing the development of empathy in a dentist-patient relationship. Design: An exploratory qualitative study. Place and duration of the study: Khyber Medical University KPK, Pakistan October 2019 to April 2020.was conducted during 2019-2020. Methodology: This exploratory qualitative study was conducted during 2019-2020. It was conducted on 12 dental surgeons, recruited from four major dental clinical specialties. A purposive sampling technique was used. In -depth interviews were conducted through a semi-structured format. The interviews were audio recorded, transcribed verbatim and analyzed, using the thematic analysis framework. Results: Three themes were extracted from the data. 1) Institutionalization of empathy 2) Barriers in the path of empathetic attitude and 3) Cultivating a Culture of empathy for better health care provision. The participants of the study observed tha t the development of empathy in a dentist-patient relationship includes a wide range of factors, ranging from curricular, personal, social, organizational, and cultural. These factors elaborate that empathy is a multidimensional phenomenon with roots deeply entrenched in professional and personal domains. Conclusion: Various factors are involved in developing an empathetic relationship between a dentist and a patient. The content about empathy in our present dental curriculum is very deficient. Contextual academic workload and time constraints affect the execution of empathy. However, empathy is a teachable attribute, hence the factors hampering empathy can be addressed, modified, and re-employed to enhance empathy. [ABSTRACT FROM AUTHOR]

Background: Chest-related diseases and complications encompass a broad spectrum of conditions, and it is imperative that medical professionals across various specialties are well-versed in these issues. While dentistry primarily focuses on oral health, it is equally essential for dental practitioners to have a fundamental understanding of different chest-related diseases and their basic principles. This knowledge enables them to provide comprehensive care to patients, as systemic conditions can manifest oral symptoms and impact overall health. Interdisciplinary collaboration and a holistic approach to healthcare are vital in ensuring the well-being of individuals. Objective: The purpose of the study was to assess the awareness of dental practitioners regarding the management of chest pain. Methodology: The current cross-sectional study was conducted from June 2022 to December 2022 on various dental clinics and dental departments in the hospitals after approval from the institutional review board. A total sample size was 200 participants were included in the study but 178 of the participants responded. The sample size was calculated by using Rao -soft calculator and all the participants were selected through a convenient sampling technique. Data was collected through a well-structured questionnaire and they were insured that privacy and confidentiality will be maintained. All the collected were analyzed through SPSS latest version 24. Results: A total of 178 participants responded out of which 98 (55.05%) of them were male and 80 (44.94%) were female. The mean age of the participants was 32.56 ± 4.6. Overall, 128 (71.91%) of the participants had very good knowledge about the cause of chest pain, while 21.34 % of them had good knowledge, 148 (83.14%) of the participants had very good knowledge regarding the use of nitroglycerin, consequently 143 (80.33 %) very good understanding of the route of administration of nitroglycerin during chest pain, moreover, 139 (78.08%) of the individuals had very good knowledge about the delay in dental surgeries due myocardial infarction. 42.69 % of an average understanding of antithrombotic therapy and 10.11 % had very good knowledge. Conclusion: The present study concluded that the participants had very good knowledge regarding the causes of chest pain and uses of nitroglycerin but in terms of diagnosis, oxygen delivery and proper management as well as antithrombotic therapy they had average knowledge. Therefore, it would be better to arrange a proper session regarding chest pain management in case of emergency cases. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to find the incidence and awareness of endodontic instrument separation and its management among dental house officers, postgraduate trainees, demonstrators, consultants, and general dentists. Methods: This online questionnaire-based cross-sectional study was conducted with the approval of the IRB in private and public dental hospitals and dental clinics in Punjab. The authors developed the survey tool, which comprises 24 closed-ended items regarding demographics, the incidence of file separation, and awareness about its management. The data were analyzed using IBM SPSS version 24. The Chi-Square Test was used to compare percentages of categorical variables. Results: Postgraduate trainees experienced the most instrument separations (43.6%), made the most retrieval attempts (49.2%), and experienced the most secondary errors during retrieval (52.1%) (p<0.001). Around four out of ten respondents always informed the patients (39.6%) and department (41.6%) about errors. Manual files (69.8%), stainless steel files (75.8%), and short files (60.4%) were more frequently separated, and the most frequent cause was older fatigue files (57.7%). Manual files were more frequently broken in public dental institutes (p=0.003). Two-thirds of the file separations (72.5%) occurred during cleaning and shaping in the apical third of molars (65.1%), especially in mesiolingual canal (56.4%). Bypass attempt was the most common in symptomatic teeth (47.7%). Conclusions: Preventive approaches such as limiting file reuse and constructing a glide path can reduce the occurrence of file separation. Operators should be familiar with the number of uses of the instrument before fatigue and should be trained through workshops and refresher courses. [ABSTRACT FROM AUTHOR]

This observational study was conducted to evaluate the clinical signs and symptoms of maxillary sinus tumors and to propose a clinical examination sieve and a unique risk alarm score to be used for timely patient referral and vigilance. The study consisted of 70 patients between 20 to 82 years of age from both sexes. The clinical information gained was collected from the upper dentoalveolar segment, orbit, and nasal sites. Regarding the early clinical sign and symptoms of patients, nasal obstruction was found in 67 patients (95.7%), facial swelling in 69 patients (98.6%), paresthesia in 41 patients (58.6%), and epistaxis in 50 patients (71.4%). Furthermore, in terms of the late signs and symptoms, a palpable mass in buccal sulcus was observed in 65 (92.9%) of the patients, lymphadenopathy in 24 (34.3%), paresthesia in 38 (54.3%), and diplopia in 22 (31.4%). Furthermore, general sign and symptoms like exophthalmos was present in 35 patients (50%), anosmia was observed in 37 patients (52.9%), and oroantral fistula was noted in 37 patients (55.9%). Additionally, 67 (95.7%) of the patients complained of nasal obstruction. Similarly, facial asymmetry was observed in 69 (98.6%) of the patients and double vision was observed in 24 (34.4%). Tumors of the maxillary sinus have a very insidious course of spread and uncertain clinical signs and symptoms. What makes diagnosis worse is the fact that the symptoms of these tumors are so well hidden in the sponge-like nature of the midfacial region that they are easily misinterpreted by patients. Therefore, diagnoses must be made early, dentists must be vigilant, and patients must be fully investigated at the slightest suspicion of a tumor, albeit benign. [ABSTRACT FROM AUTHOR]

BACKGROUND & OBJECTIVE: Brain drain is a term coined for the migration of highly skilled professionals from the country of their origin to more developed countries. As the trend of moving abroad is on a rise, ever since, it is causing a shortage of dental professionals in our country. The objective of our study is to determine the factors that would compel the dentists of Punjab, Pakistan, to move abroad and how to prevent this migration. METHODOLOGY: It was a cross-sectional survey. Data was collected through a self-constructed and validated questionnaire. The study was done in dental colleges in Punjab, and the duration of the study was one year. The questionnaire was distributed both by hand and via digital sources. RESULTS: There were 155(33.4%) participants, who were planning to go abroad for higher education, and 274(59%) had not planned to go out of the country for further studies. Among the study participants, 50(32.3%) participants were planning to move to the United Kingdom, whereas 23(14.8%) participants were planning to go to Australia, 44(28.3%) wanted to move to the US, 10(6.4%) to Canada and the rest 28(18%) had plans to move to any other country. CONCLUSION: The majority of dental graduates wish to go abroad for their post-graduation. The dentists of Punjab were willing to serve their country, provided the economic and political situations improved. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate general dentists' observations of various aesthetic dental procedures among social media users. A cross-sectional study was conducted at the Department of Prosthodontics, Altamash Institute of Dental Medicine, over a duration of six months. Data were collected using a well-structured questionnaire comprising 21 predefined responses. The questionnaire was uploaded and disseminated through Google Surveys by forwarding web page links through emails and WhatsApp. The data collected were analysed through Statistical Package for Social Sciences (SPSS-Version 25). The majority (90.7%) of the dental practitioners surveyed believed that there is an increase in the demand for aesthetic dental procedures and social media is a major contributor to it. Moreover, most of the 377 (81.8%) participants agreed that social media is a beneficial platform enabling them to educate, advertise, and communicate with patients. Concerning popular aesthetic procedures, teeth whitening (54.7%), Hollywood smile (17.1%), dental veneers (11.9%), and Invisalign (10.4%) were the most commonly demanded aesthetic procedures. The patients showed desire for these procedures because they were trending on social media platforms. Almost half of the general dental practitioners used social media to post their content related to aesthetic dentistry and to promote their work. They preferred using before and after pictures (48.6%) for advertising their content related to aesthetic dentistry. Within the limitations of the study, it is concluded that the demand for aesthetic dentistry is rapidly growing, and social media is the main driving force behind this revolution as the general population has direct access to the profiles of celebrities and influencers, who all appear to have 'the perfect smile'. This shift in people's self-image has created a surge in patients seeking cosmetic treatments. [ABSTRACT FROM AUTHOR]

Background: Globally, occupational stress is a common finding among dentists. The present study aimed to assess prevalence of perceived stress among practicing dentists of Karachi, Pakistan, and assess the perceived stress levels according to the professional standing among dental surgeons. Methods: A cross-sectional survey was conducted using a convenience sampling technique in which 200 dentists from Karachi were recruited. A self-constructed questionnaire was used to collect data, including demographic and professional backgrounds. Stress level assessment was performed using the perceived stress scale (PSS). Results: The response rate was 78.5%. In general, a moderate stress level (mean PSS = 18.35 ± 5.417) appeared in the sample size of 157 dentists, and the prevalence of perceived stress was 86%. The level of perceived stress was significantly lower in groups including 40 years old and above (mean diff; p = − 0.197), Rupees 1 lac (100,000) and more of monthly income (mean diff; p = 0.029), 11 and more years of experience (mean diff; p = 0.001) and Assistant Professor/Associate Professor/Professor (mean diff; p = 0.035). Conclusion: All groups representing the senior status of dentists have appeared with lower stress than groups representing the junior status of dentists. Exploratory studies are required to discover an effective coping strategy to deal with occupational stress among the junior dentists of Karachi. [ABSTRACT FROM AUTHOR]

Fabrication of a clinically successful dental prosthesis requires clear and effective communication between dentists and dental technicians. Adequate completion of work authorization by dentists provides a means for increased professional quality assurance and satisfaction in dental prosthesis. The aim of this study was to evaluate the quality of communication between dentists and dental technicians via work authorization for fixed and removable dental prosthesis in Pakistan. This cross-sectional study was conducted for a period of 6 months to assess the quality of communication between dentists and dental technicians. A well-constructed questionnaire regarding work authorization of removable and fixed prostheses was used as a tool to collect data from 453 dentists. A linear regression analysis was performed to evaluate the relationship of the independent and dependent variables. A p value of ≤0.05 was considered statistically significant. It was observed that 92.1% of the dentists leave removable partial denture design to the dental technicians. About 56.5% of the dentists indicated information about base retention of partial dentures in work authorization. The majority of the dentists (56.5%) mentioned the material to be used for the construction of casting partial dentures. Nearly 66% of the dentists indicated the design of margins, and 44.6% of the dentists did not select the shade for fixed prostheses. Nearly 43% of the dentists did not draw the design of restoration, 21.9% chose to draw the design on paper, and 32.2% of the dentists drew the design on the cast. Meanwhile, 76.8% of the participants chose to directly communicate with their dental technicians personally. Nearly 41% of the dentists were satisfied with the restoration design, and 13.5% of the participants were not satisfied with the designs. Poor communication between dentists and technicians was observed, as the majority of the design decisions were left to the dental technicians. Therefore, communication between dentists and dental technicians should be improved by conducting combined workshops for the successful construction of dental prostheses. [ABSTRACT FROM AUTHOR]

Background. Work-related musculoskeletal disorders (WMSDs) have a negative impact on quality of life, and dentists are at risk of WMSDs due to the nature of work being static, repetitious, and for a long duration. The study was aimed at measuring the prevalence and distribution of work-related musculoskeletal disorders and determining the risk factors associated with affliction among Pakistani dentists. Methods. An online cross-sectional survey was conducted using a validated questionnaire consisting of four sections. The first section had questions related to sociodemographic information, the second section had questions that assessed the intensity and frequency of musculoskeletal pain (MSP), third section questions were concerned with the effect of MSP on the respondents' daily life, while the last section contained questions on whether they perceived their work in the dental clinic as a cause of their pain. Chi-square and one-way ANOVA tests were used for the analysis of the data in SPSS-23. Results. A total of 600 completely filled questionnaires were received with a response rate of 76.4%, and about 87% of the dental practitioners had some sort of MSD. The intensity and frequency of WMSDs were statistically significant (p < 0.05) in association with all the sociodemographic characteristics. The lower back area was the most reported site of WMSD pain (51.3%) followed by the neck/upper back (21.3%) and shoulder (17.6%). The site of pain was statistically significant (p < 0.05) in association with all the sociodemographic characteristics except gender (p = 0.11). A majority of participants (95.4%) had sought medical treatment and taken sick leaves (70%) due to WMSDs pain during their life. Participants attributed a number of working years and working posture as the two main reasons behind WMSDs. Conclusion. Considering the high prevalence of WMSDs among dentists, preventive strategies that minimize the occurrence of WMSDs should be adopted by dental professionals. The impact of WMSDs can be reduced by maintaining good posture, taking breaks and rest in between work, doing regular exercise, and improving the work environment. [ABSTRACT FROM AUTHOR]

Objective: To assess the awareness level and need perception of soft skills among general dental practitioners (GDPs), dental residents and specialists. Study Design: Mixed method study Place and Duration of Study: Armed Forces Institute of Dentistry (AFID), Rawalpindi and 28 Military Dental Centre (28 MDC), Lahore Pakistan, from Mar to Sep 2020. Methodology: A mixed method study research design with descriptive and explorative strategies was used to formulate a survey questionnaire and in-depth interviews for participants aged 24-60, medically fit, with a minimum of one year of practical experience, and willing to participate. Results: 136(74.37%) knew the basic concept of soft skills being non-technical skills, as they classified their awareness of soft skills as 'Partially Aware'. Only 9(4.91%) responded as being 'Expert' in this topic. 38(20.76%) were totally 'Unaware'. Regarding the need for teaching soft skills to dental students, 171(93.44%) participants wanted soft skills teaching to begin in the undergraduate years. Conclusion: Participating dental professionals understood the basic concept of soft skills but needed a formal knowledge of what it entails. There is a dire need for the dental professional to have a satisfactory knowledge of soft skills to improve their overall job performance. [ABSTRACT FROM AUTHOR]

BACKGROUND & OBJECTIVE: In Pakistan, there is lack of awareness to maintain oral hygiene and cleaning of oral structures. The current study aims to unveil homemade remedies and self-care methods followed by a majority of the rural population to cure dental pain in Sindh, Pakistan. METHODOLOGY: This cross-sectional descriptive study was conducted at dental OPD of the Secondary Health Care Facility of Sindh, Pakistan, by following a random sample selection approach. Patients from both genders representing oro-dental problems of ages ≥ 5 year were included in the study. Patient's clinical and demographic data was collected, and further descriptive data analysis was done by using Microsoft Excel 2016. RESULTS: A total of 1627 patients fulfilled the inclusion criteria of the study. The highest number of cases (73.81%) were belonging to the age group 15-49 years, affirming that adults are at greater risk of developing toothache and dental pain. Surprisingly, about 78.97% patients had never visited any physician for seeking the clinical services. Similarly, 37.18 % of patients did not use any cleaning substance while 22.12 % patients preferred miswak for cleaning of their teeth. Only 2.95 % of patients visited dentists for proper care. CONCLUSION: Current research report concludes that from all the confirmed toothache cases, 22.13 % of patients sought care from general physicians in parallel with 22.34 % patients were preferring religious spells to manage their dental pain, which further multiplied the disease rate. However, general physicians at primary healthcare settings have limited knowledge and training in managing dental pain. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Pediatric patients have high unmet treatment needs in Pakistan. There are only a handful of pediatric dentists in Pakistan. Thus, the dental services to child patients have to be dependent on general dentists and other dental specialists. The aim of this study was to assess the attitude and practice of the dentists towards clinical pediatric dentistry in Pakistan. METHODOLOGY: A cross-sectional, questionnaire-based study was conducted among the dentists in Pakistan. RESULTS: A total of 372 dentists participated in the study. These included 122 (32.8%) males and 250 (67.2%) females. The majority of the participants (n = 272, 73.1%) were between the ages of 25 to 35 years. As compared to other dentists, a significantly greater number of general dentists (p < 0.008) had received any training in the behavioral management of children. Operative dentists reported practicing more of the various procedures in child patients (pit and fissure sealants, stainless steel crowns, pulpectomies, fluoride varnishes, pulpotomies and restorations), as compared to the other dentists. Even though the operative dentists performed more of these procedures, more than 50% of them still did not frequently perform any of the procedures. A total of 244 (65.6%) dentists wanted to attend pediatric dentistry courses, if available. CONCLUSION: There is a major gap in the needs and availability of pediatric dentistry services. More training needs to be conducted at both the undergraduate and postgraduate levels in pediatric dentistry. [ABSTRACT FROM AUTHOR]

BACKGROUND: Medical professionals, especially dental professionals, have been adversely affected by the pandemic of COVID-19 due to an increased chance of exposure to patients because of close contact during treatments. OBJECTIVES: This study aimed to evaluate knowledge about the disease and assess ways of precautions to be taken during the pandemic. METHODS: A questionnaire was developed and registered at Google Forms. The study population included dental practitioners, working in hospitals and clinics. A total of 495 dental practitioners from 14 different countries across the world responded. Most dentists were aware of the required modifications in the management of patients. The points allotted for each correct/best answer by participants for a group of questions regarding each component (Knowledge, Perceptions, and Practices) were added/summed to generate an overall score for each of the three components. RESULTS: Both univariate and multivariate analysis employed for the evaluation of results. Moreover, the total practice score was significantly associated with gender and sector of practice. Multivariable analysis model using multiple linear regressions was formulated by including those variables which were significant at the univariate stage. Hence, the practice sector was the only variable found to be significantly associated with the total knowledge score (p-value < 0.05). Conclusion: This study, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and infection in dental settings. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The current study is conducted to assess the knowledge and behavior of dentists in Pakistan and various practice modifications adopted in response to current outbreak of COVID-19. METHODOLOGY: Well-constructed online questionnaires were distributed among 300 subjects including dental students (3rd year and 4th year), house surgeons, and dental surgeons of two public hospitals of Punjab, Pakistan. RESULTS: 90% of dentists are afraid of getting the infection and reluctant to continue their dental practice. Most of the dentists 95% are aware of the mode of transmission of disease and follow WHO guidelines but still a large number of dentists are in fear and anxious to perform only emergency dental procedures. CONCLUSION: Most dentists resume their dental practice by following WHO new guidelines related to practice in COVID-19 outbreak but still a significant number of dentists close their dental practice for an indefinite period due to anxiety and fear of being ill or got infected by COVID-19. [ABSTRACT FROM AUTHOR]

Objective: Disturbances in the oral mucosa is a major concern among patients undergoing chemotherapy. One of the most significant barriers in the implementation of oral care is the lack of knowledge. The aim of the study was to assess gingival and periodontal health status of chemotherapy patients before and after the provision of oral hygiene instructions., Methods: A single group, pre-post test was conducted to assess oral health status of patients at the daycare chemotherapy, Aga Khan University Hospital, Karachi, Pakistan. Oral hygiene instructions were given with study models and leaflets. Patients were followed for 6-weeks. Oral health was assessed by using Simplified-Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI). Differences in indices were analyzed in STATA version-15.0 using Generalized Estimating Equation (GEE) and Wilcoxon Signed-rank test., Results: Out of 74, 53 (72%) patients completed study follow-up. Improvement in the OHI-S was found in 14 (26%) patients (p-value < 0.001). GEE showed that age [adjusted OR = 1.10; 95% CI: 1.03-1.11], current chemotherapy cycle [adjusted OR = 1.19; 95% CI: 0.98-1.46], highest education level [Adjusted OR = 1.37; 95% CI: 1.08-12.7] and cancer therapy [Adjusted OR = 0.12; 95% CI: 0.24-0.55] were significantly associated with the change in OHI-S. Wilcoxon signed-rank test showed positive changes in the CPI (p-value < 0.001)., Conclusions: Basic oral hygiene instructional intervention can be effective in improving the oral hygiene of chemotherapy patients. Nurses should also play a key role in providing psychological and nutritional support to patients., (© 2024. The Author(s).)

Background: Article 14 of the WHO 'Framework Convention on Tobacco Control' recommends, that all oral healthcare providers provide support for tobacco cessation, to all patients. Despite evidence on the effectiveness of tobacco cessation interventions in dental settings, implementation remains low in most high-burden countries like Pakistan. A pragmatic pilot trial of a dentist-delivered behavioural support intervention for smokeless tobacco (ST) cessation, was conducted in dental hospitals in Pakistan. This paper presents the findings of the process evaluation of the trial., Methods: A mixed-method process evaluation of a multi-centre randomised control pilot trial of dentist-delivered behavioural support intervention ST cessation was conducted. The intervention included three sessions namely: pre-quit, quit and post-quit sessions. The process evaluation involved: semi-structured interviews with trial participants (n = 26, of which dental patients were n = 13 and participating dentists were n = 13 conducted from June-August 2022); and fidelity assessment of audio recordings of the intervention sessions (n = 29). The framework approach was used to thematically analyse the interview data., Results: Overall the trial procedures were well accepted, however, young patients expressed uneasiness over revealing their ST use status. The intervention was received positively by dentists and patients. Dentists identified some challenges in delivering behavioural support to their patients. Of these, some were related to the contents of the intervention whereas, others were related to the logistics of delivering the intervention in a clinical setting (such as workload and space). Acceptability of the intervention resources was overall low amongst young patients as they did not take the intervention resources home due to fear of their family members finding out about their ST use. The intervention was successful in achieving the intended impact (in those who engaged with the intervention), i.e., change in the patients' ST use behaviour. Giving up ST with the aid of behavioural support also had an unintended negative effect i.e., the use of harmful substances (cannabis, cigarettes) to give up ST use. Patients' satisfaction with their dental treatment seemed to influence the intervention outcome., Conclusion: While there are many variables to consider, but for the participants of this study, behavioural support for abstinence delivered through dentists during routine dental care, appears to be an acceptable and practical approach in helping patients give up ST use, in a country like Pakistan, where negligible support is offered to ST users., (© 2024. The Author(s).)

The current scenario of the COVID-19 pandemic has forced dentists to seek different options for delivering healthcare services other than the in-person direct examination in clinical practice. Teledentistry is one of the options for remote patient care and monitoring. Objective. The present survey was conducted to assess the knowledge and perception of the dentists in Pakistan regarding teledentistry as an emergent supportive tool. Materials and Methods. A self-administered, close-ended, and prevalidated survey questionnaire was used, comprising 21 questions, and distributed electronically via e-mail, WhatsApp, and Facebook Messenger to evaluate the knowledge and perception of dentists regarding teledentistry. The data collected was compiled in a systematic manner and analyzed in terms of frequency (yes/no). Results. Out of a total of 350 dentists, 325 responded to the questionnaire, and it was seen that 62.5% of them did not have knowledge about teledentistry prior to COVID-19. 65.8% of dentists considered the practice of teledentistry in nonpandemic situations in the future. Conclusion. In the present study, it was observed that most of the dental professionals had inadequate knowledge about teledentistry before COVID-19, but the awareness and perception regarding teledentistry were currently satisfactory among the dental professionals in Pakistan. This emerging trend gives a positive hope for the implementation of teledentistry in the healthcare setup of Pakistan in the near future, as it will prove to be beneficial for safe dental practice during times of pandemic and even after. [ABSTRACT FROM AUTHOR]

Background: The objectives of the study were to assess the knowledge, attitude, and practice of dentists towards providing oral health care to pregnant women and to identify barriers and predictors of periodontal and caries related perinatal oral healthcare practices. Methods: A cross-sectional analytical survey was conducted on dentists by using a random sampling technique, and a pre-validated questionnaire was delivered to 350 dentists from May 2018 to October 2018. Data were analyzed by utilizing SPSS software. Frequencies and percentages were recorded for descriptive variables. Binary logistic regression was used to analyze the probability of predicting group membership to the dependent variable using different independent variables determined from contingency tables. Results: Overall response rate was 41%. The mean knowledge score of respondents was 15.86 ± 3.34. The lowest correct responses were noted in the questions related to periodontal health. It was found that the advice to delay dental visits until after pregnancy was eight times more likely to be observed among dentists who lacked the knowledge of importance of oral health during pregnancy (P = 0.04, OR = 8.75). Dentists were more likely to consult obstetricians regarding dental procedures when they fear a risk of labor in the dental practice (P < 0.05, OR = 3.72). Dentists who had the knowledge of periodontal disease association with preterm delivery were about four times more likely to treat periodontal disease during pregnancy (P = 0.01, OR = 3.95). Dentists knowing the association between maternal oral health and childhood decay were more likely to counsel pregnant patients regarding caries prevention (P > 0.05, OR = 3.75). Conclusions: Collectively the results indicated few gaps in knowledge among some dentists and a need to improve existing attitudes towards perinatal oral health. Dentists failing to recognize the importance of perinatal oral health are more likely to be hesitant in treating pregnant patients. Failing to recognize the link between periodontal disease and obstetric complications increases the possibility of hesitance to counsel pregnant patients regarding the same. The appreciation of the evidence for poor perinatal oral health and risk of early childhood caries increases the likelihood of counseling by dentists on caries prevention. [ABSTRACT FROM AUTHOR]

Objective: To compare the consistency of working length control in hand instrumentation and engine-driven rotary files Wave One by comparing their pre and post-instrumentation working lengths. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jun to Dec 2019. Methodology: A total of 90 mandibular first molars were selected. Two groups were drawn with 45 mesio buccal canals each. The First-Group was prepared with manual K-files, whereas the second group had rotary instrumentation using the WaveOne system. Pre and post-preparation working lengths were noted. Results: The mean pre-operative (18.5±1.03mm) and post-operative (18.15±1.09mm) working lengths of manually prepared and WaveOne prepared canals (18.8±3.43mm and 18.7±3.25mm respectively) presented statistically significant loss of post-operative working lengths. The comparison of the two groups gives a statistically significant result in manual preparation, showing a greater loss of working length as compared to canals prepared with WaveOne rotary files. Conclusion: Manual instrumentation causes a greater loss of working length by straightening the canal more than engine-driven WaveOne rotary files postoperatively. [ABSTRACT FROM AUTHOR]

Objective: To investigate the opinions and attitudes of dental practitioners towards intracanal separation of endodontic instruments and to create awareness regarding the management of separated instruments Study Design: Cross-sectional survey Place and Duration of Study: Department of Operative Dentistry Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Mar to Apr 2021. Methodology: An online questionnaire was circulated among 374 dentists of private and public hospitals in Rawalpindi and Islamabad. The questionnaire consisted of close-ended questions related to demographic details, dentists' awareness of instrument separation, the frequency of separated instruments, the causes of separation, the management of separated instruments, and the retrieval strategies if used. Results: Out of 374 study participants, 307(82.1%) of the participants thought that operator-related factors such as improper or overuse of the instrument were considered the most common factors for instrument separation during root canal procedures. 205(54.8%) thought unwinding, defective flutes and shiny areas were the most common factors affecting instrument separation. 241(64.4%) of the instruments are separated during cleaning and shaping. 135(36.1%) K files and 119(31.8%) H files were separated in this survey. Conclusion: Most dentists of Rawalpindi and Islamabad face the problem of endodontic instrument separation during root canal preparation. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate dentist perceptions of attractive smiles in the Pakistani population, considering different dental proportions., Methods: Maxillary casts and digital images were used to create symmetrical representations of anterior teeth. dentists' preferences for good and bad teeth proportions, width/height ratios, and various dental proportions (golden, recurring esthetic dental (RED), golden percentage, Preston, and local/observed) were assessed using one sample and paired t-test. The Chi-square test was used to determine the gender disparities and factors affecting smile attractiveness. A p-value of ≤ 0.05 was taken as significant., Results: The RED proportion emerged as the preferred choice for normal-sized teeth, with specialists and general dentists favoring it over the golden proportion. For tall teeth, the golden proportion was predominantly preferred. The golden percentage received limited preference for aesthetic smile construction., Conclusions: The smiles created using the principles of RED proportion were opted as the most attractive by local dentists. Factors such as tooth arrangement, color, and midline were highlighted as essential considerations in aesthetic smile construction., (© 2024. The Author(s).)

The purpose of the study was to assess the knowledge, attitude, and practices of dentists of twin cities regarding the use of endodontic posts in root canal treated tooth. A questionnaire was created and distributed among dentists of Rawalpindi and Islamabad via social media platforms regarding the use of posts. The results revealed that majority (60%) of the participants used endodontic posts for teeth with adequate ferrule, and believed that the function of endodontic posts is to retain the core material (50.5%). Glass fibre posts were preferred for anterior teeth (87%), whereas metal posts were favoured in posterior teeth (63%). It was concluded that the main function of the endodontic post is to retain the core material. The commonest indication is when there is at least 2mm of ferrule present and the optimal post length is 2/3rd of the root canal.

ABSTRACT The objective of this study was fourfold; 1) To find out the approach of dentists working in the prosthodontics department towards a fractured complete denture, 2)To identify which kind of denture base fracture do dentists mostly encounter in their clinical practice, 3) To find the choice of material preferred by dentists for the repair of complete dentures and 4)To find out whether dentists use any polishing technique after the repair of a fractured denture. A cross-sectional study was conducted in four teaching dental hospitals; Armed Forces Institute Of Dentistry(AFID), Islamic International Dental Hospital, Rawal Dental Hospital, And Watim Dental Hospital in the twin cities of Pakistan from 1st to 20th of August 2021. A questionnaire comprising of seven questions was used and all the clinicians working in theprosthodontic department were targeted. The response rate was 80percent. The collected data were analyzed and interpreted using IBM SPSS version 25. The frequency of categorical variables was calculated. Fischer exact test was used to evaluate the association between variables. The results indicate that a greater percentage of dentists prefer repair of fractured complete dentures instead of refabrication. Separation of a single tooth from the denture base is identified as the most common type of fracture. Heat cure acrylic was the preferred material for the repair of denture bases. The polishing technique was employed by a majority of dentists after the repair of denture bases. This study provided a unique result in contrast to other studies that reported midline as the most common type of denture fracture. [ABSTRACT FROM AUTHOR]

The incidence of tooth loss due to advanced periodontal diseases are on the rise because of the unawareness of basic periodontal treatment needs by the majority of general dentists (GDs) in Pakistan. This cross-sectional study was carried out to evaluate the periodontal knowledge, treatment strategies being used, referral profile and level of confidence of GDs regarding their provision of periodontal care. A pre-validated, self-administered, structured questionnaire-based survey was used, comprising of 16 questions, with a combination of open and closed-ended questions. A total of 300 participants were reached for the data collection. The data were collected and analysed by using SPSS version 26. The response rate was 36.6% (n=110). The results showed that the majority 84 (76%) of the GDs were running their practices for less than 5 years with most of them were males 58 (53%). The majority 88 (80%) of the study participants referred their patients to specialist periodontists. The major (46%) cause of referral was a lack of response to initial periodontal therapy performed by themselves (50%) after basic periodontal examination at their practices. Ninety-nine (90%) participants stated that a visiting periodontist was needed for a private clinical setup. This study concluded that there was an increasing trend of referring patients to periodontists by the GDs. The current knowledge of awareness about diagnosis, treatment strategies, and referral profile of GDs were adequate however, a very low inclination 36 (33%) towards continuing dental education programs on periodontal therapy was expressed which should be addressed. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has affected dentistry in unprecedented ways. This study investigates the perceived effects of the pandemic on operative dentistry procedures and dentistry profession in Pakistan and the factors that determine the behavioral changes among dentists to adapt to the "new normal." A Capability Opportunity Motivation-Behavioral model (COM-B) was utilized to investigate the factors that determine the behavior of dentists in Punjab, Pakistan to adhere to COVID-19 standard operating procedures (SOPs). Using social media, an online questionnaire was sent to operative dentistry professionals in Pakistan, and 312 responses were received. 81.4% of the respondents believed that the COVID-19 pandemic has severely affected the level of care provided to the patients, 66% were extremely worried about the risk of contagion during clinical practices, and more than 75% of the respondents opined that the pandemic has led to an increased emphasis on disinfection and oral hygiene instructions. The multiple regression model suggests that the behavior of Pakistani dentists to adhere to the COVID-19 SOPs is significantly affected by their Capabilities (β = 0.358) and Opportunities (β = 0.494). The study concluded that dentists in Punjab, Pakistan are concerned about the risk of contagion and report a serious concern about consequences such as financial loss and inappropriate care of patients. The current study results can feed the policymaking in Pakistan and other developing countries. Facilities and training to improve dentists' opportunities and capabilities can improve their ability to cope with the COVID-19 challenges., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Manzoor and Alomari.)

Background: Amalgam has been the gold standard for restorations in posterior teeth. Mercury, a major component of dental amalgam, is considered an environmental pollutant. The Minamata Convention on mercury recomends a reduction in the use of mercury-containing products. Since Pakistan is a signatory to the Convention, the same amalgam phase-out limitations are implemented in Pakistan., Aims: To identify and assess the use of amalgam and its waste management by dentists in Pakistan post-Minamata Convention guidelines., Methods: A cross-sectional study was conducted in Lahore among 520 general dental practitioners in 2019., Results: The sample size for the study was calculated as 500; the questionnaire was distributed among 550 dentists. Dental amalgam was used by only 41.6% of the dentists in their practice; 55.0% perceived it to be a health risk. Most of the dentists (76.3%) were unaware of the proper disposal protocols for dental amalgam and 76.5% were unaware of any guidelines regarding amalgam use and disposal., Conclusion: Although there is a gap in knowledge among the dentists regarding amalgam disposal, dentists in Pakistan are reducing their use of dental amalgam in accordance with the guidelines of the Minamata Convention., (Copyright © World Health Organization (WHO) 2022. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)