Browsing by Author "Kowash, Mawlood"

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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.
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.
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.
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.
How Do Schoolchildren View Other Children Who Have Discolored Teeth?
(2021) Al Khayyal, Moza; Al Halabi, Manal; Hussein, Iyad; Salami, Anas; Hassan Khamis, Amar; Kowash, Mawlood
Objectives: Facial look and expression affect how people are viewed by others. This study aimed to evaluate how schoolchildren in the Emirate of Sharjah, United Arab Emirates view their peers who have discolored teeth. Materials and Methods: A cross-sectional study using randomized cluster sampling of Sharjah public schools was conducted. A previously developed and validated social attribute questionnaire was utilized to determine children’s dental appearancerelated judgments. Children aged 11–14 years were given photographs of subjects either with discolored teeth or without, and they were asked to rate them using six positive and five negative signifiers. The total attribute score (TAS) ranged from 11 (most negative) to 44 (most positive). A linear regression analysis and t-tests were performed to determine the effects of gender and age in mean TAS. Results: TAS was significantly lower among discolored teeth photographs when compared with photographs without teeth discoloration (P = 0.004). TAS was found to be significantly higher with increased age (P = 0.035), but gender had no significant effect. Conclusion: Teeth discoloration resulted in more negative social judgment between Sharjah schoolchildren and their peers.
Knowledge of dental faculty in gulf cooperation council states of multiplechoice questions’ item writing flaws
(2020) Kowash, Mawlood; Hussein, Iyad; Al Halabi, Manal
Abstract: Multiple-Choice Questions provide an objective cost/time effective assessment. Deviation from appropriate question writing structural guidelines will most probably result in commonly ignored multiple-choice questions writing flaws, influencing the ability of the assessment to measure students’ cognitive levels thereby seriously affecting students’ academic performance outcome measures. To gauge the knowledge of multiple-choice question items writing flaws in dental faculty working at colleges in Gulf Cooperation Council (GCC) countries. A cross-sectional short online Survey MonkeyTM multiple-choice questions-based questionnaire was disseminated to dental faculty working in GCC countries during the academic year 2018/2019. The questionnaire included five test incorrect (flawed) multiplechoice questions and one correct control question. The participants were asked to identify flawed multiple-choice question items from the known 14 items writing flaws. Out of a total of 460 faculty, 216 respondents completed the questionnaires, 132 (61.1%) were from Saudi Arabia, while numbers of participants from United Arab Emirates, Kuwait and Oman were 59 (27.3), 14 (6.5%) and 11 (5.1%) respectively. Majority of participants were male (n = 141, 65.9%) compared to 73 females (34.1%). Eighty percent of the participants possessed more than five years of teaching experience. Assistant professors constituted the majority (43.3%) of the academic positions participating in this study. The overall fail rate ranged from 76.3% to 98.1% and almost 2/3rds of the participants were unable to identify one or more of the flawed item(s). No significant association was observed between the demographics (age, region, academic position and specialty) and knowledge except that of participant’s gender (p < 0.009). GCC dental faculty demonstrated below average knowledge of multiple-choice question items writing flaws. Training and workshops are needed to ensure substantial exposure to proper multiple-choice question items construction standards.
Knowledge of Management of Traumatic Dental Injuries of Emergency Department Physicians and Residents in the United Arab Emirates
(2019) Al Halabi, Manal; Hussein, Iyad; Kowash, Mawlood
Purpose: To investigate knowledge of emergency department physicians and residents (ED-Drs) about management of traumatic dental injuries (TDI) in the United Arab Emirates (UAE). Methods: A cross sectional study of ED-Drs was conducted using a questionnaire and a score of TDI knowledge (TDI-K) was created (maximum of six). Statistical analysis was performed using chi-square, Fisher’s exact, Mann-Whitney U, and Kruskal-Wallis tests, and significance was set as P<0.05. Results: One hundred fifty-five physicians participated, with one-third reporting they encountered TDI more than once a week. Sixty percent of ED-Drs had received TDI education, of which a significantly higher proportion (84.4 percent) were Western-trained (P=0.007). Consultants and specialists had the highest knowledge scores (P=0.001). ED-Drs with five to 10 years’ experience scored significantly lower (3.07 }1.65) than those with less than five years of experience (3.86 }1.36) and those with more than 10 years of experience (3.83 }1.36, P=0.034). Only 38.2 percent of general practitioners (GPs) were confident placing sutures intraorally, compared to 80.6 percent of the consultants and specialists and 57.1 percent of the residents. Conclusion: Overall knowledge of TDI and their management among ED-Drs across the UAE is inadequate. GPs had the lowest knowledge and confidence to manage TDI.
Oral health problems in leukaemic paediatric patients in the United Arab Emirates: A retrospective study
(2018-09) Alnuaimi, Eman H; El-Halabi, Manal; Hassan Khamis, Amar; Kowash, Mawlood
Aim: The aim of this study was to estimate the prevalence of oral health problems in leukaemic paediatric patients in the United Arab Emirates (UAE) and correlate it to the phase of chemotherapy. Materials and Methods: Medical records of 120 paediatric leukaemic patients (age below 15 years) in the UAE were reviewed for the occurrence of oral health problems. Records from the three main hospitals that provide cancer therapy were accessed after obtaining the required permissions. Results: The overall prevalence of oral health problems in leukaemic patients in our study is 60%. The most common oral health problem recorded in the patients’ records was oral mucositis and ulceration (52.4%) followed by dental caries and oral candidiasis accounting for 18.3% and 14.2% respectively. Other oral health problems recorded were gingivitis and gingival bleeding, herpetic gingivostomatitis, poor oral hygiene, and facial palsy. The peak occurrence of most oral problems was during phase IV (maintenance). Oral health problems were more common among patients who received treatment and follow-up locally rather than abroad. Statistics: Collected data were analysed using statistical software International Business Machines (IBM) Statistical Package for Social Sciences (SPSS, version 20, Chicago, SPSS Inc). Descriptive statistics were performed to describe the characteristics of the study population. The association between oral health problems and other risk factors was analysed using the Chi-squared test. A P-value of <0.05 was considered statistically significant. Conclusion: This is the first study to describe oral health problems and its correlation to the phase of chemotherapy in leukaemic paediatric patients in the UAE. Oral health problems as a result of leukaemia and its management are both variable and unavoidable. Therefore, oral and dental care is of critical importance in maintaining the overall wellbeing of the patient before, during, and after treatment. This can be achieved by close liaison between the oncology and dental teams.
Oral Health Status among Children with Down Syndrome in Dubai, United Arab Emirates
(2019) Al Halabi, Manal; Hassan Khamis, Amar; Kowash, Mawlood
Objectives: The purpose of this study was to assess the oral health status in Down syndrome (DS) children in Dubai, United Arab Emirates. Materials and Methods: A total of 106 DS children (mean age = 9.3 ± 2.8) and 125 healthy children (mean age = 11.7 ± 4.4) were recruited from both special needs centers and private/public schools in Dubai. A dental examination for decayed‑missing‑filled teeth (DMFT) in deciduous dentition/DMFT in permanent dentition indices, simplified oral hygiene index, calculus index (CI), were carried out. In addition, occlusal, dentofacial, soft‑tissue abnormalities, and erosion were assessed. Statistical analysis was conducted using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA). Results: The mean number of DMFT in DS children was significantly higher than that in healthy children. DS children in the primary dentition group had higher restorative index and Met Need Index scores than the control group. On the other hand, CI was found to be significantly higher among children with DS compared to healthy controls (P < 0.004). DS children had a significantly higher proportion of open bite and other occlusal problems. Class III molar angle malocclusion was significantly higher in DS (66%) compared to controls (11.2%). Erosion was significantly higher among DS children compared to healthy control (34% vs. 15.3%). Conclusions: DS children in Dubai had higher caries rate compared to healthy children. DS group received more restorations and dental treatment compared to the control group. More to add, DS children had significantly more calculus, erosion, and malocclusion problems.
A single-centre investigator-blinded randomised parallel group clinical trial to investigate the effect of probiotic strains Streptococcus salivarius M18 and Lactobacillus acidophilus on gingival health of paediatric patients undergoing treatment with fixed orthodontic appliances: study protocol
(2019) Kaklamanos, Eleftherios G; Nassar, Rania; Al Halabi, Manal; Kowash, Mawlood; Hannawi, Haifa; Hussein, Iyad; Salami, Anas; Hassan Khamis, Amar; Senok, Abiola C
Background: There is limited data on the beneficial effects of probiotics on the gingival health of patients undergoing treatment with fixed orthodontic appliances. This study aims to compare the effect of probiotic tablets combined with regular oral hygiene versus regular oral hygiene alone on gingival status in these patients. The effect of probiotic intake on plaque formation and salivary microbiome composition will be also assessed. Methods and analysis: This is a 3 month single-centre, single blind (clinical and laboratory examiners), parallel group randomised controlled two arm superiority trial. Fifty paediatric patients attending the Postgraduate Orthodontic Clinic at the Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates, who meet the eligibility criteria will be recruited. Block randomisation with 1:1 allocation and concealment of allocation will be carried out. The treatment group will receive probiotic tablets containing Streptococcus salivarius M18 and Lactobacillus acidophilus together with regular oral hygiene versus the control group on regular oral hygiene alone. Clinical examination and collection of saliva formicrobiome assay will be carried out at baseline and end of study. Self-reporting by patients will be used to document acceptability and adverse effects. Statistically significant decrease in gingival bleeding on probing in the treatment group will be classified as primary outcome of treatment success. Statistically significant reduction in Plaque Index, Gingival Index and shift in the composition of the oral microbiome in favour of beneficial bacteria are secondary outcomes indicative of efficacy of probiotic intake. Ethics and dissemination: Ethical approval for the study has been granted by the HBMCDM, MBRU, Institutional Review Board (Reference #: MBRU-IRB-2018–015). Study findings will be disseminated via publication in peerreviewed journal.
A single-centre investigator-blinded randomised parallel-group study protocol to investigate the influence of an acclimatisation appointment on children’s behaviour during N2O/O2 sedation as measured by psychological, behavioural and real-time physiological parameters
(2020) Kowash, Mawlood; Al Halabi, Manal; Hussein, Iyad; Abdo, Mohammad M; Salami, Anas; Hassan Khamis, Amar; Sverrisdottir, Yrsa
Aims and objectives: To describe a study protocol of a randomised control trial (RCT) assessing the effectiveness, in reducing dental anxiety, of an acclimatising nitrous oxide sedation (N2O) session prior to actual dental treatment with N2O. Materials and methods: A single-centre investigator-blinded parallel-group RCT conducted in a postgraduate dental hospital in Dubai, United Arab Emirates (UAE). Anxious children requiring N2O (aged 5–15 years) will be randomly assigned to; a study group: children who will have a preparatory N2O trial experience or; a control group: children who will only have N2O explained to them. Treatment with N2O for both groups will start at the second visit. The following outcomes will be recorded: completion of dental treatment, anxiety scores at baseline and after treatment (using the Modified Child Dental Anxiety Scale faces), behaviour of the child (using Frankl Rating Behaviour Scale) and the acquisition of real-time physiological anxiety-related parameters (using E4® electronic wrist devices). Results: The data will be analysed statistically. Discussion: There is a paucity of research regarding dental N2O acclimatising appointments. This RCT will supplement existing literature. Conclusions: This RCT will report whether prior acclimatising of a child to N2O sedation is effective, or not, in improving dental treatment behaviour.
Sugar content in infant formula: Accuracy of labeling and conformity to guidelines.
(2022-07) Kowash, Mawlood; Hussein, Iyad; Salami, Anas; Al Halabi, Manal; Mohamed Abdo, Mohamed
Background: Infant formulae are a primary source of nutrition during the first years of life, to which sugars are frequently added. This may contribute to adverse dental health problems if consumed excessively when coupled with prolonged and nocturnal feeding habits. Aim: To assess the amount and type of dietary sugars in commercially available infant formulae in the UAE. Design: Sucrose, glucose, and fructose were measured in 71 different brands of commercially available infant formulae for retail sale in the UAE. Analysis was performed using high-performance liquid chromatography with refractive index detection. Sugar values were compared with the reported levels on the nutritional labels. A comparison between findings, product labels, and international standards for infant formulae was performed. Results: Of the 71 samples, 23 had detectable sugar levels, varying between sucrose, glucose, and fructose. Ten samples were found to have sugars contributing to more than 5% of total energy intake ranging between 5.68% and 27.06%. All infant formula packages had carbohydrate levels mentioned on the labels, but very few mentioned the added sugar content. Conclusions: Many infant formula products tested contained sugars that exceeded the standard recommended intake. Tighter regulations that monitor the amount of sugar in infant formulae and guidelines for comprehensive labeling systems are required.
United Arab Emirates dentists perceptions about the management of broken down first permanent molars and their enforced extraction in children: a questionnaire survey
(2019) Dastouri, M.; Kowash, Mawlood; Al Halabi, Manal; Salami, A; Hassan Khamis, Amar; Hussein, Iyad
Purpose: The broken down first permanent molar (BDFPM) is common in children. Enforced extractions of first permanent molars (EExFPMs) guidelines were published in the United Kingdom (UK) in 2014. We aimed to assess the knowledge and practice of dentists in the United Arab Emirates (UAE) of BDFPMs in children in light of the guidelines. Methods: A cross-sectional sample of UAE-based dentists treating children completed a self-administered questionnaire covering; knowledge and practice of the principle of EExFPMs; to whom dentists would refer in case of BDFPMs; knowledge of the ideal age for EExFPMs (8–10 years) and finally actual awareness of the EExFPMs guidelines. Chi-square tests (p<0.05). Results: A total of 199 questionnaires were completed (total return rate was 66.33%). There was no agreement on how to deal with a scenario of BDFPMs. Over 85% majority believed in saving BDFPMs rather than extracting them but 89% would consult/refer to other specialists. Whilst 51% of the participants had never carried out EExFPMs in children, 69% were aware of the EExFPMs concept and 61% knew the ideal timing of a lower FPM extraction. More than 82% were unaware of the actual UK EExFPMs guidelines. Paediatric dentists would consider EExFPMs more than other groups (p=0.007). Conclusion: In the UAE dentist sample surveyed, there was a preference for preserving BDFPMs rather than extracting them in children, despite knowing when the ideal time for extraction was. Training background and specialty were influencing factors. There was a lack of awareness of the actual UK 2014 EExFPMs guidelines.