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Introduction: Demanding qualitative dental services calls for hiring competent staff in dental offices. This study was designed to evaluate dental assistants' educational status and ability to perform tasks. Materials & Methods: In this cross-sectional study, 200 dental assistants working in the offices and clinics of Isfahan, Iran during 2020 were selected using random systematic sampling. The researcher-made evaluation tool with a content validity index of 0.77 was used. Tasks were evaluated by 13 items in 6 subscales including communication skills, preparation, radiography, cooperation with dentists, health promotion through prevention and infection control. Moreover, information was requested about the education and training course of the dental assistant. The score of ability was achieved at the range of 0 to 20. The relationship between gender and training course as well as between age and experience level was evaluated with Mann-Whitney test and Spearman correlation. Results: The most frequent major of the study was accounting. The mean total ability score of the dental assistants was 19.1±6.5, ranging from 17.7 to 20. The highest and lowest ability scores were related to the cooperation with dentists and health promotion through prevention, respectively. The mean ability score had a weak relationship with age but had no significant relationship with experience. The mean ability score only in the area of radiography had a significant relationship with the training course and gender (P=0.012). Conclusion: Despite the diversity in the degree and field of study, the ability and task status of the assistants was desirable. In the area of health promotion through prevention, there is a need for training and monitoring its implementation. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effectiveness of the fissure sealant therapy in suboptimal setting (as part of a community‐based program using the portable equipment and provided by dental students) on the caries status of school children. This pragmatic split‐mouth randomised clinical trial was conducted in rural area of Iran. At baseline, 124 patients, including 185 paired teeth with deep pits and fissures of opposite quadrants that were either healthy or at early stages of enamel decay (International Caries Detection and Assessment System [ICDAS] 0–2), were randomly allocated to receive fissure sealant or acted as control. The incidence of new caries (ICDAS code 3–6) and the sealant's retention status after 1‐year follow‐up were evaluated. Using chi‐square test, the relative risk (RR) and the Number Needed to Treat (NNT) to prevent new caries were calculated. After 1 year, 109 patients including 163 paired teeth were available. Sixty‐seven (41.4%) and 44 (27.2%) teeth had complete and partial retained sealants respectively. The risk of caries incidence in non‐sealed teeth was almost three times more than sealed teeth (RR = 2.88, 95% CI: 1.4–1.97, p = 0.002) and the NNT was 10 (95% CI: 6–26). A significant association was noted between the status of sealant retention after 1 year and the incidence of new caries (p < 0.001). Fissure sealant as part of a community‐based program was effective in controlling caries incidence. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the psychometric properties of an oral-health related quality of life (OHRQoL) instrument for application in the population of Iranian adolescents and to assess the discriminate and convergent validity and reliability of the Persian version of the Child Oral Health Impact Profile (COHIP) in a representative sample of this population. Materials and Methods: Using multistage stratified sampling, 597 schoolchildren aged from 13 to 18 years living in the city of Isfahan were recruited to complete the Persian COHIP questionnaire. They were also examined for dental caries and malocclusion by two trained, calibrated examiners. Results: Overall COHIP scores ranged from 15 to 135 (mean ± SD: 103.6 ± 18). Sixty-six percent of the students experienced at least one frequent oral health-related impact over the past three months. The Cronbach alpha coefficient was 0.89 for the overall score. Discriminate validity was supported by the significant difference between COHIP scores in the caries-free group and the others (P = 0.01). In addition, the questionnaire was able to differentiate among the groups by various degrees of need for orthodontic treatment (P < 0.01). Convergent validity was confirmed by significant association between the quality of life scores, the self-perceived health and oral health ratings and the self-perceived treatment need (r = 0.36, 0.57, -0.40). Conclusion: The Persian COHIP demonstrated acceptable psychometric properties for the descriptive purposes. Some discrepancies observed between the clinical data and quality of life status were confirmed by the perceptual identity of such indices influenced by several overt and covert variables. [ABSTRACT FROM AUTHOR]

Background: Various iron-based products are available that are prescribed in iron deficiency. However, inadequate intake of iron due to the discoloration of teeth and perception of beginning caries has been reported. In contrast, other findings indicate cariostatic property for iron. Regarding the dispersion of the results of studies on the effect of iron on the tooth and its importance, this systematic review, reviewed the effect of iron products on dental caries. Methods: To access the articles in this review, which includes Persian and English articles published up to December 2018, keywords were searched based on the outcome of caries, tooth microhardness and dental discoloration on national and international data basis. Both types of in vitro & in vivo studies related to our topic were selected then necessary Information was extracted from each study and appraised by proper checklists. Results: After removing unrelated articles, 34 articles were evaluated qualitatively, which included 30 RCT studies (13 related to caries, 11 related to microhardness and 10 related to discoloration). In decay group 1 study and microhardness group 2 studies received a low risk of bias score. Conclusion: Studies on iron salt combinations reinforce the cariostatic hypothesis, but about the iron drop, because of various configurations and additives cannot be certainty commented. Of course, showing that some iron drops show a cariostatic effect in the presence of a carious diet. In the field of microhardness, the presence of iron in the cariogenic diet decrease changes in microhardness but the acidic diet, we need more in vivo studies. Also about discoloration well-designed studies especially in human beings are required. [ABSTRACT FROM AUTHOR]

Aim: To determine with a cross-sectional study the prevalence of orthodontic treatment need using the Dental Aesthetic Index (DAI). Subjects and Methods: Using a stratified sampling method in private and public schools in Isfahan, Iran, 748 subjects were examined and divided into three age groups: 11 to 14, 14 to 17, and 17 to 20 years (355 females and 393 males, 15.11 ± 2.23 years), including 20 subjects with history of orthodontic treatment. DAI scores were recorded in those without history of orthodontic treatment (n = 728, 340 females and 388 males). The proportions of subjects within sexes needing treatment, as defined by having DAI scores of at least 31, were compared using the chisquare test. The chi-square test was also used to test for any difference for DAI treatment categories in different age groups and also to test for sex dimorphism. Results: The mean DAI score was 26.14 (SD = 7.64) points (95% CI, 26.60 to 26.72). On the whole, 54.5% showed no need or slight need for treatment. In 23.6%, the need for treatment was elective. However, in 11.0%, treatment was highly desirable and 10.9% showed very severe malocclusions and treatment was mandatory. There was a significant difference between sexes with regard to DAI treatment need categories (chi-square = 10.10, df = 3, P < .05). There was no significant difference between different age groups with regard to DAI treatment categories (P > .05). Conclusion: According to our findings, 21.8% of the evaluated Iranian school children in our sample had a DAI score above or equal to 31 points, suggesting highly desirable or mandatory orthodontic treatment need. [ABSTRACT FROM AUTHOR]

Objectives: Indicators of oral health-related quality of life (OHRQoL) in children are widely adopted to evaluate the effects of oral problems. Recently, the scale of oral health outcomes for 5-year-old children (SOHO-5) was developed based on the children's selfreports. This study aimed to evaluate the validity and reliability of the Persian version of the questionnaire in a sample of Iranian children. Materials and Methods: This cross-sectional study was conducted on 160 children from four areas of Isfahan selected via non-random purposive sampling. After forward-backward translation of the questionnaire, content and face validity evaluation, a pilot test was carried out. Children forms were completed by interview, while parents forms were selfadministered. Test-retest reliability was evaluated in 30 subjects. Construct validity, internal consistency and descriptive quality of life score were assessed with SPSS 18. The child-parent agreement was measured with correlation test and paired t-test (a=0.05). Results: The mean (±standard deviation) quality of life scores in children and parents were 2.3±3 and 1.3±1.9, respectively. The most prevalent impacts were difficulty sleeping and eating. The Cronbach's alpha coefficients were 0.82 and 0.67 for the child and parent versions, respectively. Significant correlation of the scores with the oral health rating, pain history and perceived need for treatment confirmed its construct validity (r: 0.4-0.6, P<0.05). The hypothesis of the agreement was not supported (P>0.05). Conclusions: Based on the findings, the Persian version of SOHO-5 has acceptable reliability and validity for use in the pediatric population of Iran while there were some conflicts by parents. [ABSTRACT FROM AUTHOR]

Background: Dentistry practice has become more complex and challenging in the recent years. The clinical decision-making process has experienced many problems due to changing socioeconomic patterns, knowledgeable patients, rapid technological advances, and information explosion. The present study reviewed the status of the attitude toward evidence-based dentistry (EBD) among dental students of Iran Universities. The effect of the educational intervention was also assessed. Materials and Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic review and Meta-Analysis checklist. Search strategy was developed by Medical Subject Headings terms and keywords surfing electronic available databases including Medline/PubMed and Google Scholar and local databases such as Scientific Information Database (SID) and Magiran. Two reviewers read the abstracts of all eligible papers and excluded the duplicates. They extracted the information of the full-text of the studies included in the review and assessed the quality by Joanna Briggs Institute critical appraisal checklist. Results: Ten studies including 8 cross-sectional and 2 interventional studies met the criteria. The assessment of the attitude of 937 dental students from a different region of the country toward EBD showed moderate to acceptable status using 3 different tools. In regard to educational interventions, 2 studies were successful to improve their attitude. Conclusion: Although the researchers presented good scores on the attitude questionnaires, the quality of the study tools, the eligible criteria for recruiting the participants and the method of evaluating the construct of attitude should be investigated in future studies. [ABSTRACT FROM AUTHOR]

Objective: Oral health status particularly maxillofacial disorders in adolescents can affect different aspects of the quality of life. This study aimed to assess the age-related quality of life of students in two age groups of 11-14 years and 14-18 years to evaluate its correlation with orthodontic treatment need in adolescents in Isfahan. Methods: This cross-sectional study was conducted on 11-18 year-old middle school and highschool students. Subjects were selected via two-stage stratified random sampling from 30 schools in different areas of Isfahan city. After examination by two calibrated clinicians, Dental Health Component of Index of Orthodontic Treatment Need (DHC-IOTN) was recorded for all subjects. The Oral Health Related Quality of Life (OHRQoL) was assessed using self-reported Child Perception Questionnaire (CPQ) in 11-14 year-olds and Child Oral Health Impact Profile (COHIP) in 14-18 year-olds. After descriptive analyses, the correlation between the DHC-IOTN and the quality of life score of subjects was assessed using the Spearman's correlation test and the Mann Whitney U test. Results: A total of 1,227 students were evaluated. The mean and standard deviation (SD) was found to be 18.3 (13.7) for CPQ score in 11-14 year olds. For COHIP score it was found to be 103.6 (18) in 14-18 year olds. A total of 22% from the 604 students examined in the first group, and 17% of 570 students in the second group definitely needed orthodontic treatment. Significant differences existed in the mean quality of life score among the three groups requiring orthodontic treatment in the two age groups (p<0.05). The correlation between the malocclusion severity and quality of life subscales was weak. Conclusion: Based on the results, malocclusion significantly affects the dental function and social and emotional domains of quality of life. However, considering the role of confounders, studies with condition-specific formats of the questionnaire are required to assess the correlation of malocclusions with the quality of life after controlling for other factors. [ABSTRACT FROM AUTHOR]

Background: Continuing professional development (CPD) is a life-long learning process for all health-care members including dentists to improve their knowledge and skills in their profession and provide the best quality services. This study aimed to assess the needs, priorities, and obstacles of attending dentists in these programs in Isfahan province, in 2020. Materials and Methods: This descriptive-analytical cross-sectional study was performed on general dentists in Isfahan province. Data were collected through a three-part questionnaire, online and on paper; it included demographic information, prioritization of seven disciplines, and scoring of 33 dental subfields, as well as obstacles limiting participation in the CPD programs. This questionnaire was developed and validated by researchers. Statistical analysis was carried out through Mann–Whitney, Kruskal–Wallis, and Chi-square tests, and a significance level of 0.05 was considered. Results: Of 326 dentists (90.5% response rate) participating in this study, 157 were (48.2%) female, and most of them were in the high work experience group (45.1%). The highest mean scores standard deviation related to the dentist's interest and needs, among the seven dental disciplines, belonged to practice management (6.68 [2.9]), oral and dental reconstruction (6.29 [2.55]), and pediatric dentistry (6.291 [2.87]). On the other hand, lack of time (70.6%), inefficient teaching methods and organization (65%), and irrelevant topics (58.6%) were the most common obstacles limiting dentists in the CPD programs. Conclusion: Based on the results of this study, dentists in Isfahan province reported more interest and need to participate in some fields of CPD courses including practice management, pediatric dentistry, and oral and dental reconstruction. Thus, a system for continuing education based on dentists' needs and preferences is highly suggested. [ABSTRACT FROM AUTHOR]

Background: A comprehensive system of assessing orthodontic need requires the integration of normative clinical measures with patient-based indicators. This study sought to discover weather an oral health-related quality of life measure or Aesthetic Component of Index of Orthodontic Treatment Need (AC-IOTN) could be used as a predictor of orthodontic treatment need. Factors affecting the judgment of patient and dentist about this need are discussed. Materials and Methods: Oral examination on 597 Iranian students between 13 years and 18 years was done to reach the grade of Dental Health Component (DHC). The Child Oral Health Impact Profile (COHIP) and AC-IOTN were recorded. The diagnostic values of subjective tests were assessed. Multiple logistic regressions were applied to investigate the role of variables in the persons' perceptions. Results: Half of the 570 eligible students did not need orthodontic treatment either on professional or self-assessment; 60% of patients with definite need had a distinct impact on their quality of life. The specificity of AC to detect the healthy persons was excellent (0.99) but its sensitivity was low (0.08). COHIP score gave a better sensitivity but its specificity was 50%. Caries experience, quality of life, father's education, and brushing habits were the factors relating to the same judgment of persons and dentists (P < 0.02). Conclusion: Regarding the discrepancies between two assessment methods, present instruments did not meet the predictor's competencies. The patient-based methods could not substitute the professional assessment, but by identification, the persons with higher impacts would benefit the prioritization process. [ABSTRACT FROM AUTHOR]

Background and Aims: Normative need assessments should be substituted or integrated by patient-based outcome measures regarding their shortages in health-oriented approach . This study aimed to assess and compare the ability of an index of oral health-related quality of life measured by Child Oral Health Impact Profile (COHIP) questionnaire and the Aesthetic Component of Index of Orthodontic Treatment Need (AC-IOTN) to identify the normative need to orthodontic treatment using Dental Health Component-IOTN in a sample of the Iranian adolescents. Materials and Methods: Target population of this cross-sectional analytic study was 597 of the 13 to 18 year-old schoolchildren enrolled in middle and high schools of the city of Isfahan, Iran. They completed the COHIP questionnaire and then were examined by two calibrated trained dentists (agreement coefficient:0.9) to record the DHC grading. The students scored their AC in according to the images of the scale. The association between subjective indicators and clinically defined need were evaluated by the correlation analysis and the statistics for the diagnostic validity of tests. Results: Of 568 examined students, 16.7% and 2.1% had definite need according to DHC and AC criteria, respectively. 10% of orthodontic patients had perceived distinct impact on their quality of life. The significant association (P=0.001) between the severity of malocclusion and quality of life was at moderate level by AC (R=0.37), but it was not convincing enough by DHC (R=0.16). The specificity of AC to detect the healthy ones showed to be excellent but its low sensitivity disabled the recognition of patients, precisely. Conclusion: The considered patient-based indices did not meet the competencies to define the orthodontic need in the adolescents, but it could be employed to identify the persons with impaired quality of life and it would probably benefit the process of prioritization. [ABSTRACT FROM AUTHOR]

Objective. To investigate the association between orthodontic treatment need (OTN) and caries experience (CE). Subjects and methods. Using a stratified sampling method, 748 subjects (355 females, 393 males; mean ± standard deviation age 15.11 ± 2.23 years) were examined. The Dental Aesthetic Index (DAI), DMFT, simple (DMFT > 0) and severe CE (DMFT > 8) were recorded. Socio-economic status (SES) was assessed by recording parental education, mother's employment status, and household size. Results. Higher (but not statistically significant) CE was observed in subjects with OTN (DAI > 30). The association between DAI and DMFT scores was not significant (rho = 0.05). Mean DMFT score did not vary significantly between the SES and OTN subgroups. In children with a household size >6 persons ( n = 85), OTN was associated with higher CE and a higher prevalence of severe CE compared with those without OTN. In this group, when DAI treatment need grade increased, severe CE prevalence also increased from 10.8% to 50%. Similarly, in those with OTN and household size >6 persons, the odds of observing subjects with severe CE was 4.6 times higher (95% confidence interval 1.45-14.55) compared to those without OTN. Conclusions. Associations were observed between OTN and CE and also between the prevalence of severe CE and the severity of malocclusion in children with a household size >6 persons. The current findings suggest that the relationship between caries experience and malocclusion should be assessed in a wider context of SES and background factors. [ABSTRACT FROM AUTHOR]

Introduction: Evidence-based dentistry (EBD) is an approach to oral healthcare by combining the best scientific evidence and clinical diagnostics, clinical expertise of the dentist, and the patient's treatment needs and preferences. The aim of the present study is to evaluate the effectiveness of an education program on EBD offered in a community-dentistry course in improving knowledge and attitudes of students in this regard., Study Methods: By a quasi-experimental study design, 64 senior dental students of Islamic Azad University of Khorasgan recruited in a controlled trial. All of the students were randomized as intervention (32) and control (32) groups. A course-based educational program on EBD was randomly assigned to one group. Actual knowledge, self-assessed knowledge, and attitudes, before and after education, were measured in both groups. A questionnaire consisted of 40 items developed by the researcher was used after confirming its validity and reliability. The difference between mean scores at two timelines were measured and compared in three fields by paired t -test and independent t -test analysis via SPSS version 20 software., Results: While the mean scores of actual and self-assessed knowledge and attitude were not significantly different between two groups at the beginning of the program ( P > 0.05), the mean scores of all fields in the intervention group were significantly more than those of the control group after education ( P < 0.001). The effect size of intervention was 86%, 62%, and 57% in three fields, respectively. There was not a significant difference between mean scores of three fields in the control group, after the intervention., Conclusion: Due to the poor knowledge and attitudes of students and improved knowledge and attitudes of the intervention group after education, the education program seems to be effective. Durability of educational impact and evaluating evidence-based performance can be studied in the future., Competing Interests: There are no conflicts of interest.

Objectives: Indicators of oral health-related quality of life (OHRQoL) in children are widely adopted to evaluate the effects of oral problems. Recently, the scale of oral health outcomes for 5-year-old children (SOHO-5) was developed based on the children's self-reports. This study aimed to evaluate the validity and reliability of the Persian version of the questionnaire in a sample of Iranian children., Materials and Methods: This cross-sectional study was conducted on 160 children from four areas of Isfahan selected via non-random purposive sampling. After forward-backward translation of the questionnaire, content and face validity evaluation, a pilot test was carried out. Children forms were completed by interview, while parents forms were self-administered. Test-retest reliability was evaluated in 30 subjects. Construct validity, internal consistency and descriptive quality of life score were assessed with SPSS 18. The child-parent agreement was measured with correlation test and paired t-test (α=0.05)., Results: The mean (±standard deviation) quality of life scores in children and parents were 2.3±3 and 1.3±1.9, respectively. The most prevalent impacts were difficulty sleeping and eating. The Cronbach's alpha coefficients were 0.82 and 0.67 for the child and parent versions, respectively. Significant correlation of the scores with the oral health rating, pain history and perceived need for treatment confirmed its construct validity (r: 0.4-0.6, P<0.05). The hypothesis of the agreement was not supported (P>0.05)., Conclusions: Based on the findings, the Persian version of SOHO-5 has acceptable reliability and validity for use in the pediatric population of Iran while there were some conflicts by parents.

Aim: The aim of this study is to determine the dental caries and oral health behavior status of urban adolescents in Iran. Also it assesses the influence of the socioeconomic background on their oral health outcomes., Methods: A cross-sectional study was conducted in the students living in the city of Isfahan, Iran. 597 adolescents by 13 to 17 years old participated in the study. The asset-based wealth index, household income and parents' educational history were the indicators of socioeconomic status. Data on tooth brushing frequency and smoking experience were collected, and the adolescents were examined for their dental health status. The index of DMFT was recorded by two calibrated examiners considering the criteria of World Health Organization. Bivariate analysis and multivariate regressions were employed to explore the association between dental caries status and socioeconomic variables., Results: The DMFT mean (SD) of the study population was 2.79(2.7) with attributable 50, 4 and 46 percent to D, M and F components and 26% caries- free prevalence. Nearly 19% of the students presented twice daily brushing and 3% of respondents had smoking experience. Dental caries did not show any linear relationship with the social indicators when the DMFT was modeled by the wealth index, parents' educational level and family income adjusted for age and gender. Without adjustment, lower income has increased the chance of untreated tooth decay, 2.5 times among the students., Conclusion: Despite the supporting findings on inequalities in oral health, this study did not show a direct association between socio economic backgrounds of the adolescents with their dental health/disease. The hypothesized balanced risk exposure is considered to justify the results, but it needs to be studied by further comprehensive analysis.