Browsing by Author "Hussein, Iyad"

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A 24‑month retrospective study of preformed metal crowns: the Hall technique versus the conventional preparation method
(2020) Binladen, H.; Al Halabi, Manal; Kowash, Mawlood; Al Salami, Anas; Hassan Khamis, Amar; Hussein, Iyad
Purpose: Conventional and Hall Technique (HT) Preformed Metal Crowns (PMCs) are used for treatment of carious primary molars. The aim was to evaluate the clinical and radiographic success of conventional and HT PMCs in a postgraduate dental setting. Methods: A retrospective study using patients’ electronic case-notes and radiographic images of carious primary molars treated with either conventional or HT PMCs was conducted to assess clinical and radiographic success/failure. A Kaplan– Meier curve was used to assess PMC survival. Results: 187 PMCs (110 HT and 77 conventional) in 65 children (34 females and 31 males) at 6, 12, 18 and 24 months were assessed. At 24 months, the success rates of conventional and HT PMCs were 97.6% and 93.5%, respectively. Two HT (perforated/abscessed) and four conventional (abscessed) PMCs failures occurred. There was no signifcant diference in success/failure (p=0.362) at 12 months, but the HT was more successful at 24 months (p=0.002) with similar survival times for both methods. Conclusion: HT and conventionally placed PMCs, when placed in a postgraduate paediatric dentistry setting, were clinically and radiographically very successful at 6, 12, 18 and 24 months post operatively with a slightly higher success of the HT at 24 months.
Assessment of paediatric dental guidelines and caries management alternatives in the post COVID‑19 period. A critical review and clinical recommendations
(2020) Al Halabi, Manal; Salami, A; Alnuaimi, Eman H; Kowash, Mawlood; Hussein, Iyad
Purpose: The first aim of this paper is to provide dental professionals caring for children and adolescents during and after the COVID-19 pandemic with a reference to international dental guidelines. The second aim is to suggest minimally invasive treatment alternatives for caries management, minimising the risk of viral cross-infection and ofering a safer clinical environment. Methods: An evidence-based pertinent literature search of diferent electronic databases was performed in addition to leading global dental authorities, royal colleges, and programmes. Results: All guidelines released in response to COVID-19 centred around minimising Aerosol Generating Procedures (AGP) impacting the provision of regular dental treatment of paediatric patients. There was an emphasis on triaging and only treating emergency and urgent cases. Special attention was given to medically compromised children in the guidelines. Detailed guidelines for the dental environment and equipment were given. This paper also summarised the relevant evidence-based guidelines for the use of non-invasive and minimally invasive caries management techniques. Conclusion: Specific recommendations for dental management of paediatric patients during and in the post-COVID-19 era are suggested. Minimisation of AGP procedures, and case-based selection of biological, non-invasive or minimally invasive methods are recommended.
Assessment of Paediatricians Oral Health Knowledge, Behaviour, and Attitude in the United Arab Emirates
(2020) Hussein, Iyad; Kowash, Mawlood; Alsalami, Anas; Al Halabi, Manal
Aim: Paediatricians’ oral health knowledge is essential for early detection of disease, appropriate advice, and proper referral. (erefore, this study aimed to evaluate the knowledge, behaviour, and attitude of paediatricians practicing in the United Arab Emirates (UAE) regarding children’s oral health. Study Design: Cross-sectional survey. Methods: A questionnaire consisting of 16 questions was completed after piloting by a sample of randomly selected registered UAE paediatricians. Scores of knowledge (out of 9), behaviour (out of 4), and attitude (out of 3) were calculated. Statistical analysis was performed using Shapiro–Wilk, Mann–Whitney U, and Kruskal–Wallis tests. Statistical significance was set as P < 0.05. Results: A total of 185 surveys were completed. Nearly half of the paediatricians (95 (51.4%)) identified the appropriate age for child’s first dental visit; while 88 (47.6%) believed that the appropriate age to start brushing was after the eruption of the primary molars (2-3 yrs), and 132 (71.4%) believed that the ideal time to give sugary snacks is in between meals. 123 (66.5%) participants said that they would prescribe antibiotics to treat local dental sepsis without fever. Experienced paediatricians and those trained in Western countries had significantly better knowledge about oral health (P values 0.040 and 0.031 consecutively). (e scores of attitude, behaviour, and knowledge were correlated, and a positive relationship between the scores of knowledge and behaviour was found (r = 0.241, P = 0.001) and between scores of attitude and behaviour (r = 0.197, P = 0.007). Conclusions: The results demonstrated a general lack of knowledge of oral health aspects by UAE paediatricians. Furthermore, continuous education in the subject is recommended.
Assessment of the knowledge of United Arab Emirates dentists of Child Maltreatment, protection and safeguarding
(2018-05) El-Halabi, Manal; Kowash, Mawlood B.; Hassan Khamis, Amar; Hussein, Iyad
Aim: Child safeguarding is society’s responsibility. Dentists are uniquely positioned to recognise Child Abuse and Neglect (CAN) in dental practice and the wider society. The United Arab Emirates (UAE) introduced a child protection law in 2016. We aimed to assess the awareness of UAE dentists of child maltreatment, protection and safeguarding. Study Design: A cross-sectional survey. Methods: We surveyed 381 UAE dentists about the knowledge and practice of CAN and safeguarding issues using a self-administered anonymous questionnaire. Statistical analysis was carried out using Chi-square, t-test, ANOVA and Pearson’s correlation test and statistical significance was set as p <0.05. Results: Over 39 % (n=152) of the responders suspected CAN; male dentists suspected more CAN than females (p=0.015). Orthodontists, paediatric dentists (p<0.001) and female dentists (p=0.001) were more knowledgeable about diagnosing CAN. Paediatric dentists attended more CAN-related postgraduate training (p<0.001) than other specialties. Over 90% (n=346) believed that CAN should be addressed, 58.1% (n=224) and 54.1% (n=206) had CAN undergraduate and postgraduate training respectively but 53.5% (n=204) were unaware of local child protection guidelines. Dentists barriers to child protection reporting were; fear of family violence (59.6%, n=227), lack of knowledge of referral process (60.2%, n=228) and lack of diagnosis certainty (54.9%, n=206). UAE dentists qualified in Western and Asian countries had fewer barriers for child protection reporting (p=0.022) than the Arab and Gulf Cooperation Council qualified dentists. Conclusions: A large minority of UAE dentists suspected CAN. Factors influencing child protection reporting were identified. Dentists’ gender, specialty, and country of qualification affected their knowledge of CAN and practice of safeguarding. Child protection training is recommended.
An Audit on the Quality of Intra-Oral Digital Radiographs Taken in a Postgraduate Paediatric Dentistry Setting
(2017-02-01) Salami, Anas A.; El-Halabi, Manal; Hussein, Iyad; Kowash, Mawlood B.
Abstract: Background: Quality assurance (QA) for radiographs sustains accurate diagnostic information while maintaining radiation doses as low as reasonably achievable (ALARA). Aims: To audit the quality of digital intraoral periapical (IOPAs) and bitewings (BWs) radiographs taken in a postgraduate paediatric dentistry setting. Standards: The National Radiological Protection Board (NRPB) guidance describes three grades of radiograph quality. Excellent (Grade 1 >70% of total exposures), diagnostically acceptable (Grade 2 <20%) and unacceptable (Grade 3 <10%). Methodology: A pilot study was performed on 10 IOPAs and 10 BWs. 50 IOPAs and 50 BWs were reviewed in 2 audit cycles with a 6 month interval (total of 200 X-rays). Results: First Cycle: Of 50 IOPAs: 18 (36%) scored Grade 1, 25 (50%) Grade 2 and 7 (14%) Grade 3. Of 50 BWs: 10 (20%) scored Grade 1, 33 (66%) Grade 2 and 7 (14%) Grade 3. Second Cycle: Of 50 IOPAs: 28 (56%) scored Grade 1, 15 (30%) Grade 2 and 7 (14%) Grade 3. Of 50 BWs: 27 (54%) scored Grade 1, 17 (34%) Grade 2 and 6 (12%) Grade 3. Rejection rate of Grade 3 was analysed in both cycles. A clear improvement in radiograph quality was demonstrated between both cycles, but the standard was not met. Action plan and recommendations: Results were disseminated to all staff and recommendations to improve radiograph quality were made to use film holders and paediatric film sizes. Conclusion: Although a significant improvement was observed in the 2nd cycle, the overall standard of radiographs fell short of the guidelines. Thus, the quality of radiographs requires continuous auditing to reach the gold standard. An audit spiral is planned.
Behavior change due to COVID-19 among dental academics -The theory of planned behavior: Stresses, worries, training, and pandemic severity
(2020) Hussein, Iyad
Objective: COVID-19 pandemic led to major life changes. We assessed the psychological impact of COVID-19 on dental academics globally and on changes in their behaviors. Methods: We invited dental academics to complete a cross-sectional, online survey from March to May 2020. The survey was based on the Theory of Planned Behavior (TPB). The survey collected data on participants’ stress levels (using the Impact of Event Scale), attitude (fears, and worries because of COVID-19 extracted by Principal Component Analysis (PCA), perceived control (resulting from training on public health emergencies), norms (country-level COVID-19 fatality rate), and personal and professional backgrounds. We used multilevel regression models to assess the association between the study outcome variables (frequent handwashing and avoidance of crowded places) and explanatory variables (stress, attitude, perceived control and norms). Results: 1862 academics from 28 countries participated in the survey (response rate = 11.3%). Of those, 53.4% were female, 32.9% were <46 years old and 9.9% had severe stress. PCA extracted three main factors: fear of infection, worries because of professional responsibilities, and worries because of restricted mobility. These factors had significant dosedependent association with stress and were significantly associated with more frequent handwashing by dental academics (B = 0.56, 0.33, and 0.34) and avoiding crowded places (B = 0.55, 0.30, and 0.28). Low country fatality rates were significantly associated with more handwashing (B = -2.82) and avoiding crowded places (B = -6.61). Training on public health emergencies was not significantly associated with behavior change (B = -0.01 and -0.11). Conclusions: COVID-19 had a considerable psychological impact on dental academics. There was a direct, dose-dependent association between change in behaviors and worries but no association between these changes and training on public health emergencies. More change in behaviors was associated with lower country COVID-19 fatality rates. Fears and stresses were associated with greater adoption of preventive measures against the pandemic.
Changes in preschool children’s oral health-related quality of life following restorative dental general anaesthesia
(2020) Alantali, Kholoud; Al Halabi, Manal; Hussein, Iyad; Hassan Khamis, Amar; Kowash, Mawlood
Background: Early childhood caries is the most common childhood disease in preschool children which often requires dental treatment under restorative dental general anaesthesia (RDGA). Aim: To assess the efect of RDGA on preschool children and their families’ oral health-related quality of life (OHRQoL). Methods: A cross-sectional study using a RDGA pre- and post-operative survey to evaluate changes in OHRQoL. Parents completed the Early Childhood Oral Health Impact Scale (ECOHIS) survey before and after their children underwent specialist paediatric RDGA in the United Arab Emirates from 1 March 2017 to 28 February 2018. The ECOHIS and its efect size (ES) served to evaluate children’s OHRQoL status and changes, and the Wilcoxon signed-rank and the Kruskal-Wallis tests were used for statistical analyses. Results: The mean number of decayed, missing and flled teeth (DMFT) of the children (N = 173, mean age 4.6 years) before the treatment was very high (13.8 ± 3.07). Children’s pain and eating problems, and parents feeling upset and guilty, were the most frequently reported impacts at baseline. The ECOHIS scores decreased signifcantly (p <0.001) after RDGA, revealing a large ES for the child (2.19) and family (2.79) sections of the ECOHIS. Conclusions: Preschool children’s RDGA resulted in signifcant improvement in all child and family physical, psychological and social aspects of OHRQoL.
Child maltreatment in Dubai and the Northern United Arab Emirates: dental hygienists and assistants’ knowledge
(2021) Hussein, Iyad; Kowash, Mawlood; Al Halabi, Manal
Purpose: Dental assistants (DAs) and hygienists (DHs) should play an active role in the detection and reporting of child abuse and neglect (CAN). We aimed to investigate CAN knowledge of DAs and DHs in the United Arab Emirates (UAE) and some of the inhibiting factors to the process of CAN reporting. Methods: A cross-sectional study design was utilized. We surveyed 186 DAs and DHs using a previously validated selfadministered anonymous CAN knowledge questionnaire. Statistical analysis was performed using χ2 -square, Fisher’s exact test, t test/Mann–Whitney, and a ROC curve (p <0.05). Results: Among 186 DAs and DHs surveyed, satisfactory knowledge of CAN was demonstrated by 50.5%. DAs scored a signifcantly higher score of knowledge compared to DHs (p=0.03). The most reported CAN referral inhibiting factor was “being afraid to get in trouble with parents”. The recognition of a child with special needs and parents missing multiple appointments as risk factors for CAN was signifcantly higher in the DAs compared to DHs (p=0.04, p=0.024, respectively). Awareness of local laws was related to CAN knowledge in DAs (p=0.012) and DHs (p=0.008). Conclusion: The lack of appropriate knowledge regarding CAN necessitates a clear reporting process and better education for DAs and DHs in the UAE.
Children’s dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital
(2020) AlGharebi, S.; Al Halabi, Manal; Mawlood, K.; Hassan Khamis, Amar; Hussein, Iyad
Purpose: Child dental anxiety (CDA) and uncooperative dental behaviour are common. We aimed to assess the prevalence of CDA (self- and proxy- reported) in the United Arab Emirates (UAE) children related to their dental behaviour. Methods: Data were collected from 312 questionnaires obtained from 156 parent/child (mean age 9.95±2.17 years) pairs attending a postgraduate dental hospital. Demographics, self/proxy- reported CDA scores via a six-question, fve-point Likert scale, of the Modifed CDA Scale-faces version (MCDAS-f: where≥19 was severe CDA) and Frankl Behaviour Rating Scale (FBRS) scores were compared and analysed. Chi-square test, Pearson’s correlation, Kappa- coefcient, one-way ANOVA and independent t test statistical analysis were used (p<0.05). Results: The prevalence of self and proxy severe CDA was 22.4% (n=35) and 33.3% (n=52) respectively, with 9% (n=14) being dentally- uncooperative. In both groups, extractions caused the highest CDA followed by injections and fllings (p<0.001). The mean scores for self-reported/proxy-reported CDA were 15.02 (±4.90)/15.70 (±6.07) respectively. There was a positive linear correlation between self- and proxy- reported CDA scores and a negative linear correlation between self/proxy- reported CDA scores and the FBRS (p<0.001). Self/proxy concordance of severe anxiety/none-to-moderateanxiety was fair (68.6%, kappa=0.23, p=0.003). Both self/FBRS and proxy/FBRS concordance of severe anxiety/noneto-moderate- anxiety/behaviour was fair (78.8%, kappa=0.23, p=0.001) and (71.8%, kappa=0.22, p<0.001) respectively. Conclusions: Considering the limitations of the present study in a UAE child population sample, the prevalence of CDA from extractions, injections and fllings was 22.4% (self- reported) and 33% (proxy reported). There was fair agreement between child- self and parent- proxy- reported CDA. Increased CDA led to uncooperative dental behaviour.
Contemporary dental caries management concepts in paediatric dentistry: A survey of awareness and practice of a group of gulf cooperation council dentists.
(2017-03-08) Hussein, Iyad; El-Halabi, Manal; Kowash, Mawlood B.; Hassan Khamis, Amar
Introduction: Debatable clinically relevant child dental caries management concepts exist; restoring a carious primary molar (RCM), the choice of pulpotomy medicament (PM), the “Hall Technique” (HT), and sealing of dental caries (SDC). Our aim was to assess the knowledge and practice of dentists treating children in the Gulf Cooperation Council (GCC) region of the aforementioned contemporary concepts. Methodology: Paediatric Dentists (PDs) and General Dental Practitioners (GDPs) who treated children completed a questionnaire (N=150) covering: RCM choices; choice of PM; knowledge and practice of HT and acceptance of SDC in primary and permanent teeth. Statistical analysis was conducted using Chi-Square test (p<0.05). Results: For RCM: 76% of those surveyed would remove non-pulpal caries in an asymptomatic lower D and restore with composite (33%), glass ionomer or conventional stainless steel crown (SSC) (17.4%), amalgam (7.4%) and zirconia (0.7%). The remaining 24% would seal caries (HT SSC). For PM: 40.7% chose Ferric Sulphate, followed by Formocresol (36.7%), Mineral Trioxide Aggregate (14%) and Calcium hydroxide (8.7%); For HT: 60.6% had knowledge of HT but 81.5% never used it. For SDC: sealing caries in primary & permanent teeth was rejected by 56.6% & 53.1% respectively. GDPs and PDs choices differed significantly with RCM, HT (knowledge and practice) (p=0.007, 0.003 and 0.003 respectively). Conclusion: Overall the surveyed dentists practicing in the GCC disagreed on RCM, PM with reluctance to accept new concepts like the HT and SDC. PDs choices of RCM differed from GDPs, and their awareness of HT and practice of HT were more favourable.
Correction to: Children’s dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital
(2020) Algharebi, Safeya; Al Halabi, Manal; Kowash, Mawlood B.; Hassan Khamis, Amar; Hussein, Iyad
Correction to: European Archives of Paediatric Dentistry: https ://doi.org/10.1007/s4036 8-020-00517 -x In the original publication of the article the third author’s name “M. Kowash” was submitted as “K. Mawlood” which was left unnoticed in the later stages. The correct name is as published in this erratum and the original article has been corrected. Correction to: https://repository.mbru.ac.ae/handle/1/636
Dentists knowledge of the guidelines of traumatic dental injuries in the United Arab Emirates
(2018-12) El-Halabi, Manal; Hussein, Iyad; Hassan Khamis, Amar; Kowash, Mawlood B.
Aim: This study aimed to assess general dental practitioners’ (GDPs) knowledge within the United Arab Emirates (UAE) regarding the management of traumatic dental injuries (TDIs), and to compare their level of knowledge with that of paediatric dentists (PDs). Methods: Dentists were asked to complete a two-part questionnaire (seven questions covering demographic data and 13 questions about trauma cases scenarios) in electronic and paper format. A total of 296 returned questionnaires were analysed to identify GDPs’ knowledge in managing TDIs, and to compare the score of GDPs’ knowledge with that of PDs’. Results: Out of a total score of 13, the mean knowledge score (MKnS) for GDPs was 4.87±1.82 (only 37.5% of the 13 questions were answered correctly) while the MKnS of paediatric dentists was 5.56±1.47 (with 42.8% correct answers); both scores indicated poor knowledge and the difference was statistically significant (p=0.005). Conclusions: There was poor knowledge of TDIs among the surveyed UAE GDPs as well as the PDs, although PDs scored higher, indicating the need for further training.
An Educational Initiative for Dubai School Nurses and Physical Education Teachers on the Management of Traumatic Dental Injuries
(2019) Kowash, Mawlood; Hussein, Iyad; Al Halabi, Manal
Abstract: The aim of this study was to assess the knowledge of school nurses and physical education teachers (SN and PE teachers) about the emergency management of traumatic dental injuries (TDIs) in schools and to measure the impact of education on their knowledge. A longitudinal prospective study based on a questionnaire survey completed by 68 SN and PE teachers at three time periods (prior to, immediately after, and 3 months-post educational intervention). Pre- and post t-test and repeated measures (analysis of variance) were used to compare the three group means for the same participants (p < .05 was considered significant). Significant improvement in the knowledge score among participants was observed between the initial survey to immediately after the educational session and to 3 months after (p ¼ .047). Significant improvement in the choice of immediately seeking attention after tooth avulsion was observed (p ¼ .001). The initial knowledge deficiency about the emergency management of TDIs among SN and PE teachers was improved and sustained.
The Effect of Chlorhexidine on Bacterial Contamination of Hall Technique Elastomeric Orthodontic Separators and Gingival Health: A Pilot Study
(2023) AlNoman, Nada; Al Halabi, Manal; Kowash, Mawlood; Hassan Khamis, Amar; Salami, Anas; Senok, Abiola; Nassar, Rania; Hussein, Iyad
Objective: To study the effect of chlorhexidine on elastomeric orthodontic separators (EOS) bacterial-colonisation and gingival-health in Hall technique (HT) patients. Material and Methods: Prospective invivo pilot clinical study of EOS bacterial colonisation and primary-molar gingival health assessment in 20 patients (mean age 5.45±1.27 years) requiring bilateral HT crowns (40 teeth). One side received 1-minute 0.12% chlorhexidine-soaked-EOSs (Chx-EOSs), and the other side dry-EOSs (NoChx-EOSs). The EOSs were removed five-days later and underwent a bacterial enumeration technique. Plaque (PI) and Gingival (GI) indices were assessed pre-, five-days and three-months post-treatment. Wilcoxon-Signed-Rank/McNemar-Chi-square statistics were used (p<0.05). Results: Baseline unused/packaged EOSs’ sterility check yielded zero colony-forming-units (CFU) per millilitre, but 100% of the used EOSs became colonised by oral-microorganisms. An overall trend of lower mean CFU count in Chx-EOSs (3.415± 0.78 x105 CFU/ml) compared to NoChx-EOSs (6.157±1.48 x105 CFU/ml) was observed (p=0.009). Both NoChx-EOSs and ChxEOSs insertion sites showed evidence of gingivitis with no difference between PI and GI indices by site over time. Conclusion: There was a lower trend of bacterial colonization in chlorhexidine treated EOSs and an occurrence of gingivitis pre/post HT-treatment regardless of EOS type. The lack of difference in the gingival health may be inconclusive due to this pilot’s low power suggesting the need for robust large scale studies.
Emergency Management of Traumatic Dental Injuries: Knowledge of Dubai School Nurses
(2019-07-15) El-Halabi, Manal; Kowash, Mawlood B.; Hussein, Iyad
Objective: To assess the knowledge of school nurses in Dubai, United Arab Emirates, about the emergency management of Traumatic Dental Injuries (TDIs) at schools. Material and Methods: A cross-sectional questionnaire survey was conducted amongst 68 school nurses (SN) prior to inviting them to an educational workshop on the emergency management of TDIs. The educational workshop covered all the topics in the questionnaire and provided basic necessary information to the SN regarding the emergency management of TDIs. Descriptive statistics were used to describe the characteristics of the sample; the Kolmogorov-Smirnov test was used to test normality for the score of knowledge and Mann-Whitney U test to correlate score of knowledge with different demographical variables (p<0.05). Results: An overall lack of knowledge about the emergency management of TDIs was observed. The overall average for the score of knowledge for all the participants was 10.75 out of a total of 16 correct answers. Female participants had significantly higher scores of knowledge compared to males (p=0.02). None of the other demographic variables were significantly associated with the score of knowledge. Conclusion: More training programs are essential for school nurses to improve their knowledge and awareness for better future handling of traumatic dental injuries.
Enamel defects and caries prevalence in preterm children aged 5-10 years in Dubai
(2019) Alshehhi, Anood; Al Halabi, Manal; Hussein, Iyad; Salami, Anas; Hassan Khamis, Amar; Kowash, Mawlood
Background: Enamel defects (EDs) are commonly reported dental findings in preterm/low birthweight children. EDs potentially increase caries susceptibility. Aim: To assess the prevalence of EDs and dental caries in a group of preterm children (aged 5–10 years) in Dubai, United Arab Emirates (UAE). Methodology: A retrospective cohort study of medical records of 62 preterm children (mean age 8.1 ± 1.54) and 62 full-term children (mean age 8.1 ± 1.73) of both genders born in a UAE children’s hospital were studied. These children were dentally assessed for EDs and caries by a calibrated examiner. Results: EDs were 4.34 times more prevalent among preterm children [odd ratio (OR) = 4.338, CI 95% [2.010–9.366]. The prevalence of EDs in the pre-term group was 58.15%, significantly higher (P < 0.01) than the full-term control group (24.2%). Birth weight, intubation and type of delivery were statistically significant factors contributing to EDs. In the primary dentition, the mean dmft was 4.61 ± 4.30, while in the permanent dentition DMFT was 0.38 ± 0.99. There was a statistically significant difference in permanent teeth caries experience amongst pre-term children compared to the full-term control as measured by DMFT (P = 0.008). Conclusion: EDs and dental caries in permanent dentition in the pre-term group were significantly higher than the full-term group.
Evaluating the Quality of Multiple Choice Question in Paediatric Dentistry Postgraduate Examinations
(2019) Kowash, Mawlood; Hussein, Iyad; Al Halabi, Manal
Objectives: This study aimed to evaluate the quality of multiple-choice question (MCQ) items in two postgraduate paediatric dentistry (PD) examinations by determining item writing flaws (IWFs), difficulty index (DI) and cognitive level. Methods: This study was conducted at Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE. Virtual platform-based summative versions of the general paediatric medicine (GPM) and prevention of oral diseases (POD) examinations administered during the second semester of the 2017–2018 academic year were used. Two PD faculty members independently reviewed each question to assess IWFs, DI and cognitive level. Results: A total of 185 single best answer MCQs with 4–5 options were analysed. Most of the questions (81%) required information recall, with the remainder (19%) requiring higher levels of thinking and data explanation. The most common errors among IWFs were the use of “except” or “not” in the lead-in, tricky or unfocussed stems and opportunities for students to use convergence strategies. There were more IWFs in the GPM than the POD examination, but this was not statistically significant (P = 0.105). The MCQs in the GPM and POD examination were considered easy since the mean DIs (89.1% } 8.9% and 76.5% } 7.9%, respectively) were more than 70%. Conclusion: Training is an essential element of adequate MCQ writing. A general comprehensive review of all program ’s MCQs is needed to emphasise the importance of avoiding IWFs. A faculty development programme is recommended to improve question-writing skills in order to align examinations with programme learning outcomes and enhance the ability to measure student competency through questions requiring higher level thinking.
Fluoride concentration of commercially available infant formulae in the United Arab Emirates
(2019) Kowash, Mawlood; Hussein, Iyad; Al Halabi, Manal
Purpose: To assess fluoride concentration in infant formulae commercially available in the United Arab Emirates (UAE) and compare the measured levels of fluoride to the reported ones on the label. Methods: Twenty-four different infant formula samples collected from retailers in the UAE market were tested for the fluoride content using ion-selective electrode method. Statistical analysis was performed using descriptive statistics and Mann–Whitney test. P < 0.05 was considered significant. Results: The mean fluoride content of baby formula samples collected was 0.19 ppm (range 0–0.4 ppm). All tested samples of formulae were manufactured outside the UAE. Following the daily recommended manufacturer’s preparation guidelines, tested formulae had a range of 0–0.35 mg of fluoride per day, a concentration below the average daily recommended fluoride intake for a 6-month-old infant with an average weight of 7.2–8 kg (0.36–0.42 mg fluoride). Out of the 11 samples where the fluoride content was mentioned on the label, only two were verified to have a somewhat accurate reported concentration when comparing the concentration mentioned on the label with our test results. Out of the 13 samples with no fluoride concentration mentioned on the label, three were found to have no fluoride (Neocate, Isomil, Aptamil), while the remainder (10) contained fluoride with a range of (0.1–0.4 ppm). Conclusions: All the UAE available infant formulae tested had lower than the maximum daily recommended dosage of fluoride. Many labeling inaccuracies were observed. Accurate labeling guidelines are recommended.
Hall technique crowns and children's masseter muscle activity: A surface electromyography pilot study
(2019) Abu Serdaneh, Salsabeel; Al Halabi, Manal; Kowash, Mawlood; Hassan Khamis, Amar; Salami, Anas; Hussein, Iyad
Background: Hall technique crowns (HTCs) alter the occlusion temporarily, potentially affecting jaw muscles, particularly the masseter – the primary jaw-closing muscle. Aim: To assess masseter muscle activity (MMA) in children treated with a unilateral HTC. Design: In 12 children treated with a single HTC, bilateral MMA was recorded with surface electromyography (sEMG) for ten cycles of Rest Position (RP) and Maximum Voluntary Clenching (MVC) over 20 seconds immediately pre-HTC cementation (Pbase), immediately post-HTC cementation (Pimmed), at 2 weeks post-HTC cementation (P2w) and at 6 weeks post-HTC cementation (P6w). t test, ANOVA and post hoc statistics were used (P < .05). Results: As expected, MMA was low at rest and increased during maximal jaw clenching (P < .0001). MMA (mean ± SD) increased significantly y (P < .001) between RP and MVC at: Pbase [from 1.60 μV·s (±0.96) to 5.40(±2.30)]; Pimmed [1.57(±1.15) to 3.75(±1.87)]; P2w [1.39(±0.54) to 5.54(±1.45)] and finally P6w [1.46(±0.56) to 6.45(±2.56)]. Rest MMA at Pbase, Pimmed, P2w and P6w remained unchanged (P = .18) whereas Pbase clench MMA reduced by a third at Pimmed d d (P < .001), returned to and exceeded baseline levels at P2w (P = .822) and P6w (P < .001) respectively. Conclusions: This pilot study showed that Hall technique crowns may affect masseter muscle activity in children. Clench MMA was reduced immediately post-treatment but returned to and later exceeded baseline levels at 2 and 6 weeks, respectively. Rest MMA remained unchanged.
The hall technique in paediatric dentistry: a review of the literature and an “all hall” case report with a-24 month follow up
(2017) Ghaith, Batool; Hussein, Iyad
Aim: This paper highlights a non-invasive treatment option for primary molars, where decay is sealed under preformed stainless steel crowns (SSC). Summary: Restoring the carious primary molar in children using the “Hall Technique (HT)” is an internationally controversial but evidence-based new treatment modality. It started in the United Kingdom (UK) in 2007 where it is now considered the “Gold Standard” for managing the multi-surface asymptomatic carious primary molar. We review the literature and report a two year follow up of a case treated in Dubai, United Arab Emirates (UAE) where we restored all eight carious primary molars in a 3-year-old child by using the Hall Technique. This approach avoided the need for treatment under local analgesia general anesthesia in this very young child. It is relevant to general dental practitioners, with an interest in children’s dentistry in addition to specialists in pediatric dentistry. Key learning points: • SSCs placed using the HT are not suitable for all child patients with caries; • There are selection criteria that should be assessed before considering this technique; • There should be a clear radiolucent band between the carious lesion and pulp of the tooth intended • to be restored with the HT; • There should be no signs or symptoms of pulpal pathosis; • All teeth treated with the HT should be followed up clinically and radiographically following the same protocols as conventional treatments.