The profession of dentist exposes them during their work to many burdensome and harmful factors. The irrational posture adopted by dentists during their work causes discomfort and disorders of the musculoskeletal system and the peripheral nervous system. The methods and organization of the work of Polish dentists were evaluated from the aspect of ergonomics, with regard to reported by them painful disorders connected with the musculoskeletal system, with the aim of applying proper methods of treatment and prophylaxis. The study showed that dentists worked in conditions which generally produced disorders of the musculoskeletal system. As a result, the long working time in the course of a day was used irrationally from the point of view of ergonomics, which over the years of work consequently increased the number of disorders of the musculoskeletal system. Dentists must make use of various forms of treatment. The effectiveness of prophylaxis concerning the musculoskeletal system were only partly assessed by the respondents through questionnaire. Most dentists are convinced of the effectiveness of physical activity in prophylaxis which they carry out themselves.
Dentistry has much to offer law enforcement in the detection and solution of crime or in civil proceedings. Forensic dental fieldwork requires an interdisciplinary knowledge of dental science. Most often the role of the forensic odontologist is to establish a person's identity. Teeth, with their physiologic variations, pathoses and effects of therapy, record information that remains throughout life and beyond. The teeth may also be used as weapons and, under certain circumstances, may leave information about the identity of the biter. Forensic odontology has an important role in the recognition of abuse among persons of all ages. Dental professionals have a major role to play in keeping accurate dental records and providing all necessary information so that legal authorities may recognize malpractice, negligence, fraud or abuse, and identify unknown humans.
BACKGROUND: Social media has begun to proliferate across medical areas and transformed how medical professionals serve and interact with their patients. It offers a new communication avenue that has the potential to engage patients and, hence, may be used to create value for both medical professionals and patients. In dentistry, even though patients and dentists frequently use social media in their personal lives, little is known about their attitudes and expectations toward using social media for professional interactions. OBJECTIVE: In this paper, we focus on the role of social media in dentistry. Specifically, we explore patients' and dentists' attitudes toward social media usage and their current online behaviors in this context. Furthermore, we examine potential challenges and opportunities regarding dentists' adoption of social media practices. METHODS: This research employed a large-scale online survey of 588 patients and 532 dental professionals. We assessed the attitudes, expectations, and social media behaviors from both patients' and dentists' perspectives. RESULTS: We found that more than 55% (290/532) of dentists in our sample have accounts for their dental practice on various social media platforms. Interestingly, while 73% (374/511) of patients did not expect their dental practice to have a social media presence, and 44% (207/468) thought that establishing a friendship with their dentists is not appropriate, the findings show that 36% (164/460) of patients had searched for their dentists, and 44% (207/470) of them were happy to establish contacts with dentists on social media. Furthermore, the findings highlight that patients were interested in exploring additional information such as online reviews and the qualifications of their dentists on Facebook pages. For dentists, more than half (375/432, 83%) of them in our sample thought that social media marketing is more efficient compared to traditional marketing. CONCLUSIONS: Our findings revealed some key challenges and opportunities to utilize social media in dentistry. For both patients and dentists, the role of social media in dental services remains vague, and both parties still share concerns about connecting with each other on social media platforms. However, there also exists a sizeable number of patients who are already comfortable to connect with their dentists on social media sites such as Facebook. The current findings show that there is an opportunity for dental practices to trade upon a more active social media presence for enhanced patient interaction and engagement.
BACKGROUND: Despite the availability of prevention guidelines and recommendations on infection control, many dental practices lack the minimum requirements for infection control. OBJECTIVE: This study aimed to assess the level of awareness, perception, and attitude regarding the coronavirus disease (COVID-19) and infection control among Jordanian dentists. METHODS: The study population consisted of dentists who worked in private clinics, hospitals, and health centers in Jordan. An online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire was comprised of a series of questions about dentists' demographic characteristics; their awareness of the incubation period, the symptoms of the disease, mode of transmission of COVID-19 and infection control measures for preventing COVID-19; and their attitude toward treating patients with COVID-19. RESULTS: This study included a total of 368 dentists aged 22-73 years (mean 32.9 years, SD 10.6 years). A total of 112 (30.4%) dentists had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in dentistry, and 28 (7.6%) had attended training or lectures regarding COVID-19. A total of 133 (36.1%) dentists reported that the incubation period is 1-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of identifying patients at risk of having COVID-19, were able to correctly report known modes of transmission, and were aware of measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it was necessary to ask patients to sit far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to decrease disease transmission. CONCLUSIONS: Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, and infection controls and measures in dental clinics. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national dental associations to all registered dentists during a crisis, including the COVID-19 pandemic, to make sure that dentists are well informed and aware of best practices and recommended disease management approaches.
Dentists' perceptions about the stressfulness of dental practice, their perceptions about dental anxiety and its management were surveyed in a descriptive study. A mailed questionnaire was completed by 216 randomly selected Danish private dentists. Of these, nearly 60% perceived dentistry as more stressful than other professions. Dentist perceptions of the most intense stressors were (ranked): 1) running behind schedule, 2) causing pain, 3) heavy work load, 4) late patients and 5) anxious patients. Bivariate odds ratio (OR) analyses were undertaken to check for associations of perceived stress and other dentist variables with perceptual outcomes about anxious patients. Signs of dental anxiety were reported to be less often spotted by older (> or = 52 yr) dentists (OR=3.1) who perceived their job stress to be greater than that of other professionals (OR=3.2). Perceived causes of dental anxiety (1st, 2nd or 3rd choices tallied and then ranked) were 1) fear of pain, 2) trauma in dental treatment, 3) general psychological problems, 4) shame about dental status and 5) economic excuses. Dentists who reported that dental anxiety was primarily the result of general psychological problems in patients, usually had solo (OR=2.4) practices older than 18 years (OR=2.6) and reported high perceived stress (OR=2.2). Adjusted odds ratios for these two dentist perception outcomes about anxious patients generally improved strength of associations and confidence intervals. There were no meaningful differences by practice location or perceived public image. Also, there was no significant association between the use of pharmacological strategies for anxiety and the perceived stress of dentists. Nearly all dentists talked with anxious patients as their main treatment strategy. It was concluded that psychosocial aspects of dental practice have meaningful and often adverse associations with dentist perceptions about anxious patients. Some dentists appeared to require more knowledge about dental anxiety and managing their own stress.
In this study, it was hypothesised that dentists with a high burnout risk would experience more health complaints and show more unhealthy behaviour when compared with dentists with a low burnout risk. With a response rate of 75%, a representative group of 709 actively practising dentists responded to a questionnaire containing the Dutch version of the Maslach Burnout Inventory (MBI-NL), a health complaints measure (VOEG), and items on health behaviour. Results showed that dentists with a high burnout risk reported health complaints to a greater extent than dentists with a low burnout risk. They also reported more unhealthy behaviour in some aspects (physical exercise/sporting, increase in alcohol consumption, unhealthy diet), but not in others. It also appeared that one out of ten dentists reported having poor general health, and that three out of ten reported to have poor physical condition. In general, dentists' self-reports appeared favourable in comparison with the Dutch population. It is concluded from this study that among dentists burnout and poor health are strongly related. It is discussed that in order to deal preventively with burnout in dentistry, attention to physical health, including ergonomics, is essential.
BACKGROUND: Musculoskeletal disorders (MSD) represent an important occupational health issue in dentistry. Given the significance of this topic, we considered it necessary to investigate the prevalence and impact of MSD among Australian dentists. METHODS: In 2004, a self-reporting questionnaire was mailed to a random sample of 400 dentists registered with the Queensland Branch of the Australian Dental Association. RESULTS: A total of 285 questionnaires (73.1 per cent) were completed and returned. Of the respondents, 73.3 per cent were male and 26.7 per cent female, with a mean age of 45.2 years (SD = 11.9 years). Most were general dentists (89.1 per cent), with the remainder being specialists (10.9 per cent). Most dentists (87.2 per cent) reported having experienced at least one MSD symptom in the past 12 months. The most prevalent MSD during the previous 12 months were reported at the neck (57.5 per cent), lower back (53.7 per cent) and shoulder (53.3 per cent). MSD which interfered with daily activities during the previous 12 months were reported at the neck (24.6 per cent), the lower back (22.1 per cent) and the shoulders (21.8 per cent). Over one-third (37.5 per cent) of dentists had sought medical advice or treatment for an MSD during the previous 12-month period. Almost 1 in 10 dentists (9.1 per cent) reported taking leave in the previous 12 months because of an MSD. Among those who took sick leave for an MSD, the mean time taken was 11.5 days (SD = 16.0 days). CONCLUSIONS: Overall, this study suggests that MSD represents a major occupational health issue for Queensland dentists, the occurrence of which is similar to reports from other countries. MSD was shown to interfere with daily activities in some cases, while a considerable proportion of dentists had also sought medical attention for their symptoms. Further research is now needed to more carefully elucidate the impact of MSD in this particular occupational group, especially in relation to cessation or reduction of clinical practice, and also to help identify specific risk factors and effective measures for reducing MSD among dentists in Queensland and elsewhere.
BACKGROUND: Understanding the risks associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during oral health care delivery and assessing mitigation strategies for dental offices are critical to improving patient safety and access to oral health care. METHODS: The authors invited licensed US dentists practicing primarily in private practice or public health to participate in a web-based survey in June 2020. Dentists from every US state (n = 2,195) answered questions about COVID-19-associated symptoms, SARS-CoV-2 infection, mental and physical health conditions, and infection control procedures used in their primary dental practices. RESULTS: Most of the dentists (82.2%) were asymptomatic for 1 month before administration of the survey; 16.6% reported being tested for SARS-CoV-2; and 3.7%, 2.7%, and 0% tested positive via respiratory, blood, and salivary samples, respectively. Among those not tested, 0.3% received a probable COVID-19 diagnosis from a physician. In all, 20 of the 2,195 respondents had been infected with SARS-CoV-2; weighted according to age and location to approximate all US dentists, 0.9% (95% confidence interval, 0.5 to 1.5) had confirmed or probable COVID-19. Dentists reported symptoms of depression (8.6%) and anxiety (19.5%). Enhanced infection control procedures were implemented in 99.7% of dentists' primary practices, most commonly disinfection, COVID-19 screening, social distancing, and wearing face masks. Most practicing dentists (72.8%) used personal protective equipment according to interim guidance from the Centers for Disease Control and Prevention. CONCLUSIONS: COVID-19 prevalence and testing positivity rates were low among practicing US dentists. This indicates that the current infection control recommendations may be sufficient to prevent infection in dental settings. PRACTICAL IMPLICATIONS: Dentists have enhanced their infection control practices in response to COVID-19 and may benefit from greater availability of personal protective equipment. ClinicalTrials.gov: NCT04423770.
OBJECTIVES: A cross sectional survey of dentists in the west of Scotland and unmatched controls was conducted to find the effect of chronic exposure to mercury on health and cognitive functioning. METHODS: 180 dentists were asked to complete a questionnaire that included items on handling of amalgam, symptoms experienced, possible influences on psychomotor function, and the 12 item general health questionnaire. Dentists were asked to complete a dental chart of their own mouths and to give samples of urine, hair, and nails for mercury analysis. Environmental measurements of mercury in dentists' surgeries were made and participants undertook a package of computerised psychomotor tests. 180 control subjects underwent a similar procedure, completing a questionnaire, having their amalgam surfaces counted, giving urine, hair, and nail samples and undergoing the psychomotor test package. RESULTS: Dentists had, on average, urinary mercury concentrations over four times that of control subjects, but all but one dentist had urinary mercury below the Health and Safety Executive health guidance value. Dentists were significantly more likely than control subjects to have had disorders of the kidney and memory disturbance. These symptoms were not significantly associated with urinary mercury concentration. Differences were found between the psychomotor performance of dentists and controls after adjusting for age and sex, but there was no significant association between changes in psychomotor response and mercury concentrations in urine, hair, or nails. CONCLUSIONS: Several differences in health and cognitive functioning between dentists and controls were found. These differences could not be directly attributed to their exposure to mercury. However, as similar health effects are known to be associated with mercury exposure, it would be appropriate to consider a system of health surveillance of dental staff with particular emphasis on symptoms associated with mercury toxicity where there is evidence of high levels of exposure to environmental mercury.
This study analyzed a data subset of a national survey of general dentists conducted in 2001 to determine their overall care of children with special health care needs (CSHCN). In the survey, dentists were asked to respond to questions in the following areas: did they provide care for CSHCN (children with cerebral palsy, mental retardation, and those who are medically compromised); what were their perceptions of the training they received in dental school related to CSHCN; what was their interest in additional training for CSHCN; and what factors influenced their willingness to provide care for CSHCN? Only about 10 percent see CSHCN often or very often, and only one in four respondents had hands-on experience with these patients in dental school. Postgraduate education in general practice or advanced general dentistry residency had no effect on willingness to care for CSHCN. Older dentists, those accepting Medicaid for all children, and those practicing in small communities were more likely to see CSHCN. Dentists willing to see CSHCN also were more likely to perform procedures associated with special needs and underserved child populations including pharmacologic management and stainless steel crowns. Dentists with hands-on educational experiences in dental schools with CSHCN were less likely to consider such factors as level of disability and patient behavior as obstacles to care and were more likely to desire additional education in care of CSHCN.
PURPOSE: This study aimed to determine dentists' esthetic preferences of the maxillary anterior teeth as influenced by different proportions. The goal was to link choices to demographic data as to the experience, gender, and training of the dentist. METHOD AND MATERIALS: Computer-manipulated images of the 6 maxillary anterior teeth were generated from a single image and assigned to 5 tooth-height groups (very short, short, normal height, tall, and very tall). For each group, 4 images were generated by manipulating the relative proportion of the central incisors, lateral incisors, and canines according to the proportions 62% (or "golden proportion"), 70%, 80%, and "normal" or not further altered. The images were randomly ordered on a web page that contained a form asking for demographic data and fields asking for a ranking of the images. Dentists were asked via e-mail to visit the web page and complete the survey. The responses were tabulated and analyzed with repeated measures logistic regression with the alpha at 0.05. A subset of North American respondents was chosen for further analysis. RESULTS: A total of 549 valid responses were received and analyzed from dentists in 38 countries. There were statistically significant differences in all groups for the variables of proportion, group (tooth height), and their interaction. The 80% proportion was judged best for the Very Short and Short groups. Three of the choices were almost equally picked for the Normal Height and Tall groups, and the golden proportion was judged best for the Very Tall group. The variables of year of graduation, gender, professional activity, generalist or specialist, or number of patients were not significantly correlated with the choices for the North American respondents. CONCLUSIONS: Dentists preferred the 80 percent proportion when viewing short or very short teeth and the golden proportion when viewing very tall teeth. Golden proportion was worst for normal height or shorter teeth and the 80% proportion for tall or very tall teeth. They picked no clear-cut best for normal height or tall teeth, and their choices could not be predicted based on gender, specialist training, experience, or patient load.
BACKGROUND: The prevalence of musculoskeletal complaints in dentists is high although relatively few studies had focus in this profession. The aim of this study was to investigate the relations between physical, psychosocial, and individual characteristics and different endpoints of musculoskeletal complaints of low back, neck, shoulders and hand/wrist. METHODS: A questionnaire survey was carried out among 430 dentists (response 88%) in Thessaloniki, Greece. Questions include data on physical and psychosocial workload, need for recovery, perceived general health and (i) the occurrence of musculoskeletal complaints in the past 12 months, (ii) chronic complaints during at least 1 month, complaints which led to (iii) sickness absence, and (iv) medical care seeking. In logistic regression analysis odds ratios were estimated for all relevant risk factors. RESULTS: 62% of dentists reported at least one musculoskeletal complaint, 30% chronic complaints, 16% had spells of absence and, 32% sought medical care. Self-reported factors of physical load were associated with the occurrence of back pain (OR = 1.59), shoulder pain (OR = 2.57) and, hand/wrist pain (OR = 3.46). With the exception of hand/wrist complaints, the physical factors were not associated with chronic complaints and musculoskeletal sickness absence. Physical load showed a trend with the number of musculoskeletal complaints with ORs of 2.50, 3.07 and 4.40 for two, three and four musculoskeletal complaints, respectively. No consistent influence of psychosocial factors on complaints, chronicity, sickness absence and medical care seeking was observed. A perceived moderate general health was a significant factor for chronic complaints, comorbidity and medical care seeking where high perceived exertion was significant for absenteeism. Living alone was also related with increased absenteeism due to shoulder pain (OR = 5.01) and hand/wrist (OR = 4.07). CONCLUSIONS: The physical load among dentists seems to put them at risk for the occurrence of musculoskeletal disorders. More than one and severe complaints are related to perceived general health while high perceived exertion and social characteristics are associated with sickness absence. Chronic symptoms seem to determine medical care seeking. Ergonomic interventions may have a greater impact in prevention of hand/wrist complaints. When investigating the influence of work-related risk factors on musculoskeletal health, psychosocial and other personal characteristics should be taken into account.
Antibiotic prescribing practices by dentists: a review Najla Saeed Dar-Odeh1, Osama Abdalla Abu-Hammad1, Mahmoud Khaled Al-Omiri1, Ameen Sameh Khraisat1, Asem Ata Shehabi21Faculty of Dentistry, University of Jordan, Amman, Jordan; 2Faculty of Medicine, University of Jordan, Amman, JordanAbstract: Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, due to a number of factors ranging from inadequate knowledge to social factors. Here we review studies that investigated the pattern of antibiotic use by dentists worldwide. The main defects in the knowledge of antibiotic prescribing are outlined. The main conclusion is that, unfortunately, the prescribing practices of dentists are inadequate and this is manifested by over-prescribing. Recommendations to improve antibiotic prescribing practices are presented in an attempt to curb the increasing incidence of antibiotic resistance and other side effects of antibiotic abuse.Keywords: over-prescribing, antimicrobial resistance, recommended practice, penicillin
Symptoms of the neck, shoulders, arms, and hands of 99 dentists and a reference group of 100 pharmacists were studied by means of a telephone interview. Forty-four percent of the dentists and 26% of the pharmacists reported symptoms of the neck [relative risk (RR) 2.1, 95% confidence interval (95% CI) 1.4-3.1]. Symptoms of the shoulder were reported by 51% of the dentists and 23% of the pharmacists (RR 2.2, 95% CI 1.5-3.3). Musculoskeletal symptoms in the forearm were present almost exclusively in the dentists (12 versus 1%). Numbness and paresthesia were more common among the dentists than among the referents (RR 4.2, 95% CI 2.3-7.7). Unilateral Raynaud's phenomenon in the dominant hand occurred in six dentists and one pharmacist. The high frequency of symptoms from the neck, shoulders, and upper extremities of the dentists was probably related to their difficult work positions with cervical flexion and rotation, abducted arms, and repetitive precision-demanding handgrips.
OBJECTIVES: The aim of this study was to assess school children's feelings and attitudes toward their dentist. METHODS: A questionnaire designed to evaluate children's attitudes and preferences toward dentists was completed by 583 children (289 females, 294 males) with age range 9-12 years attending public schools. RESULTS: 76% of the children who completed the questionnaire reported that they had been to the dentist before. Of the children who had visited the dentist, approximately 64% reported liking their visit, 11% didn't like their visit, and 12% were afraid. 90% of the children preferred their dentist to wear a white coat, while 40% preferred them to wear a mask and protective eye glasses as protective measures during treatment. When asked to choose between two pictures of different clinical settings, 63% of the children indicated that they preferred a decorated dental clinic over a plain clinic. Fear of local anesthesia and tooth extraction were the most common reasons cited for not liking dental treatment. CONCLUSIONS: Children have strong perceptions and preferences regarding their dentists. Data collected for this study can be used by dentists to improve delivery of care.
Hand eczema and contact allergy in Swedish dentists were studied in a multidisciplinary project. The aims of the study were to establish diagnoses, to investigate the occurrence of contact allergy, in particular to (meth)acrylates, and to evaluate certain consequences of hand eczema. A postal questionnaire on skin symptoms, atopy and occupational experience was mailed to 3,500 dentists aged <65 years, and licensed 1965-1995. The response rate was 88%. Among dentists living in 3 major cities, 14.9% (n= 191) reported hand eczema during the previous year. They were invited to a clinical examination, including patch testing with a standard and a dental series. 158/191 (83%) dentists attended, and hand eczema diagnosis was confirmed in 149/158 (94%). Irritant contact dermatitis was diagnosed in 67% and allergic contact dermatitis in 28%. On patch testing, 50% presented at least 1 positive reaction. The most frequent allergens were nickel sulfate, fragrance mix, gold sodium thiosulfate and thiuram mix. 7 (5%) had positive reactions to (meth)acrylates, all to 2-hydroxyethyl methacrylate and 6 also to ethyleneglycol dimethacrylate. 38% had consulted a physician, 4% had been on sick-leave and 1% had changed occupational tasks due to hand eczema. No dentist with allergy to acrylates had been on sick-leave or changed occupation. It is concluded that dentistry is a high-risk occupation for hand eczema, and that irritant contact dermatitis is most common. The prevalence of contact allergy to acrylates was below 1% in the population of responding dentists, and in most cases did not have serious medical, social or occupational consequences.
BACKGROUND: Although the overall rate of antibiotic prescribing has been declining in British Columbia, Canada, the authors conducted a study to explain the increased rate of prescribing by dentists. METHODS: The authors obtained anonymized, line-listed data on outpatient prescriptions from 1996 to 2013 from a centralized, population-based prescription database, including a variable coding prescriber licensing body. Analyses used Anatomical Therapeutic Classification standard codes and defined daily dose (DDD) values. The authors normalized prescribing rates to the population and expressed the rates in DDDs per 1,000 inhabitants per day (DID). The Canadian Dental Association released a webinar that invited correspondence from dentists about the drivers of the trend. RESULTS: From 1996 to 2013, overall antibiotic use declined from 18.24 DID to 15.91 DID, and physician prescribing declined 18.2%, from 17.25 DID to 14.11 DID. However, dental prescribing increased 62.2%, from 0.98 DID to 1.59 DID, and its proportionate contribution increased from 6.7% to 11.3% of antibiotic prescriptions. The rate of prescribing increased the most for dental patients 60 years or older. Communication from dentists in Canada and the United States identified the following explanatory themes: unnecessary prescriptions for periapical abscess and irreversible pulpitis; increased prescribing associated with dental implants and their complications; slow adoption of guidelines calling for less perioperative antibiotic coverage for patients with valvular heart disease and prosthetic joints; emphasis on cosmetic practices reducing the surgical skill set of average dentists; underinsurance practices driving antibiotics to be a substitute for surgery; the aging population; and more dental registrants per capita. CONCLUSIONS: Emerging themes for dental prescribing should be explored further in future studies; however, themes already identified may guide priorities in antibiotic stewardship for continuing dental education sessions. PRACTICAL IMPLICATIONS: Antibiotic prescribing should be reviewed to make sure that we are compliant with guidelines. Most practitioners will find opportunities to prescribe less often and for shorter durations.
To evaluate viral hepatitis as a hazard in general dentistry, we surveyed participants in an annual health-screening program at the 1972 American Dental Association session. Of 1245 practitioners, 0.9 per cent were positive for hepatitis B surface antigen, and 12.7 per cent were antibody positive. Of those who had had clinical hepatitis while studying or practicing dentistry, 43 per cent were seropositive. The frequency of evidence for prior infection with hepatitis B virus increased uniformly with increasing years of professional experience. The proportion of seropositive dentists did not vary with geographic region of the United States, or size of community. Only 10.5 per cent recognized illicit self-injection among patients, and their infection rate was not increased. These data indicate an increased frequency of infection with hepatitis B virus among general dentists, and are compatible with relatively uniform endemicity of subtype/ad strans of that agent in the general population for several decades.
PURPOSE: This study was designed to determine the perceptions of lay people and dental professionals with respect to minor variations in anterior tooth size and alignment and their relation to the surrounding soft tissues. MATERIALS AND METHODS: Smiling photographs were intentionally altered with one of eight common anterior esthetic discrepancies in varying degrees of deviation, including variations in crown length, crown width, incisor crown angulation, midline, open gingival embrasure, gingival margin, incisal plane, and gingiva-to-lip distance. Forty images were randomized in a questionnaire and rated according to attractiveness by three groups: orthodontists, general dentists, and lay people; 300 questionnaires were distributed. RESULTS: The response rate was 88.2% for orthodontists, 51.8% for general dentists, and 60.6% for lay people. The results demonstrated threshold levels of noticeable difference between the varying levels of discrepancy. A maxillary midline deviation of 4 mm was necessary before orthodontists rated it significantly less esthetic than the others. However, general dentists and lay people were unable to detect even a 4-mm midline deviation. All three groups were able to distinguish a 2-mm discrepancy in incisor crown angulation. An incisal plane cant of 1 mm as well as a 3-mm narrowing in maxillary lateral incisor crown width were required by orthodontists and general dentists to be rated significantly less esthetic. Lay people were unable to detect an incisal plane asymmetry until it was 3 mm, or a lateral incisor narrowing until it reached 4 mm. Threshold levels for open gingival embrasure and gingiva-to-lip distance were both at 2 mm for the orthodontic group. Open gingival embrasure became detectable by the general dentists and lay people at 3 mm, whereas gingiva-to-lip distance was classified by these groups as noticeably unattractive at 4 mm. CLINICAL SIGNIFICANCE: The results of this study show that orthodontists, general dentists, and lay people detect specific dental esthetic discrepancies at varying levels of deviation, which may aid the dental professional in making specific treatment recommendations.
An outbreak of novel coronavirus disease (COVID-19) in China has influenced every aspect of life. Healthcare professionals, especially dentists, are exposed to a higher risk of getting infected due to close contact with infected patients. The current study was conducted to assess anxiety and fear of getting infected among dentists while working during the current novel coronavirus diseases (COVID-19) outbreak. In addition, dentists' knowledge about various practice modifications to combat COVID-19 has been evaluated. A cross-sectional study was conducted using an online survey from 10th to 17th March 2020. The well-constructed questionnaire was designed and registered at online website (Kwiksurveys) and validated. A total of 669 participants from 30 different countries across the world responded. After scrutiny, completed questionnaires (n = 650) were included in the study. Statistical analysis was performed using SPSS version 25. Chi-Square and Spearman correlation tests were applied to control confounders and assess the relation of dentists' response with respect to gender and educational level. More than two-thirds of the general dental practitioners (78%) from 30 countries questioned were anxious and scared by the devastating effects of COVID-19. A large number of dentists (90%) were aware of recent changes in the treatment protocols. However, execution of amended treatment protocol was recorded as 61%. The majority of the dentists (76%) were working in the hospital setting out of which 74% were from private, and 20% were from government setups. Individually we received a large number of responses from Pakistan and Saudi Arabia, but collectively more than 50% of the responses were from other parts of the world. Despite having a high standard of knowledge and practice, dental practitioners around the globe are in a state of anxiety and fear while working in their respective fields due to the COVID-19 pandemic impact on humanity. A number of dental practices have either modified their services according to the recommended guidelines to emergency treatment only or closed down practices for an uncertain period.