Objective Physicians often need uptodate, reliable and with easy access information for clinical decisions evidence based medicine (EBM) databases can be a suitable approach to meet this need. The aim of this study was to assess the knowledge, use and factors affecting the acceptance of EBM and its databases by Iranian medical residents using UTAUT model. Method The present research is an applied survey, the population of which consisted of 192 medical residents of Shahid Beheshti University of Medical Sciences (SBUMS) in Iran. A questionnaire was used for collecting data and SPSS software was used for data analysis. Results The results show that the total average score of assistants (range = 1–5), 2.99 and 2.73 scores were respectively obtained for the awareness and use of EBM databases. The study of factors affecting the acceptance using UTAUT showed that item "performance expectancy" with an average of 3.02 is the most important factor in the acceptance of EBM databases by medical residents and items "effort expectancy", "facilitating conditions" and "social influence" are in their next ranks with an average score of 2.54, 2.45 and 2.14, respectively. Conclusion The findings of this study showed that the majority of medical residents do not have sufficient awareness and knowledge about concepts of EBM and still not comprehend the necessity of using EBM databases. Therefore, planning for accepting and teaching Evidence based medicine and databases is essential.

Acceptance of evidence based medicine (EBM) databases by Iranian medical residents using unified theory of acceptance and use of technology (UTAUT)

Background The authors’ objective in this systematic review was to investigate the barriers involved in the application of evidence-based dentistry principles, as reported by dentists. The authors registered the protocol in the PROSPERO database. Types of Studies Reviewed Eligible studies included qualitative and quantitative approaches, constituting information about barriers, collected through interviews, questionnaires, or conversation sessions. The authors searched databases and reference lists of preselected studies. After the selection process, the authors evaluated the included studies for potential risk of bias and collected either qualitative or quantitative data. Results After the selection process, the authors included 35 studies, of which 16 were reported in this article. The authors synthesized and classified the barriers in 4 categories: self-related, evidence-related, context-related, and patient-related barriers. Shortage of time and financial constraints were the barriers most frequently studied. However, the quantification of these barriers, as well as others, was not possible because of the variability of the results and methodological issues of the included studies. Conclusions and Practical Implications The authors suggest the development of valid questionnaires and their use in representative samples to quantify the effects of specific barriers. The authors encourage practitioners to participate in educational programs focused on training in evidence-based dentistry abilities, in addition to seeking accessible and synthesized formats of reliable scientific knowledge.

Barriers involved in the application of evidence-based dentistry principles: A systematic review

The objective of this study was to evaluate the combined risk of oral problems in the oral health–related quality of life (OHRQoL) of adolescents aged 15 to 19 years in Sao Paulo state (Brazil) in the year of 2015. Data from the Sao Paulo State Oral Health Survey (SBSP-15) and the contextual characteristics of the cities of Sao Paulo state, evaluated in the year 2015 were accessed. Correlations were made between contextual factors (i.e., coverage of the family health team, average supervised tooth brushing, number of first dental appointments, and average income), individual sociodemographic variables (i.e., ethnicity, gender, and schooling) and dental problems (dental pain, caries, overjet, open bite, indication for endodontic and exodontic treatment, gingival bleeding, and dental trauma). These variables were correlated with the quality of life of the adolescents using the Oral Impacts on Daily Performance (OIDP) index. Multilevel Poisson regressions were performed to calculate the rate ratio (RR) with 95% confidence interval (CI). According to the bivariate analysis, the presence of low (RR, 1.62; 95% CI 1.07–2.46) and very intense (RR, 2.53, 95% CI 1.92–3.34) dental pain, indication for endodontic (RR, 1.31; 95% CI 1.05–1.63) or for exodontic (RR, 1.31; 95% CI 1.06–1.63) treatment, and gingival bleeding (RR, 1.41; 95% CI 1.11–1.80) reduced the quality of life of adolescents. All domains of OIDP scores were associated between healthy and unhealthy individuals (p < 0.001) increasing mean scores with combined oral health problems. Higher impact on quality of life was associated with simultaneous presence of dental pain, gingival bleeding, and indication for exodontic treatment (RR, 6.03; 95% CI, 4.02–9.04) in the adolescents. Individual and contextual factors and the various dental problems are independently associated with the quality of life of Brazilian adolescents aged 15 to 19 years, especially when they are associated with the perception of intense dental pain, gingival bleeding, and indication for exodontic treatment, with up to six times greater impact on OIDP. The study highlighted the importance for an integral treatment in adolescents, considering that the associated risk of several dental diseases can progressively affect the quality of life of this population.

Analysis of the combined risk of oral problems in the oral health-related quality of life of Brazilian adolescents: multilevel approach

Background/aims Traumatic dental injuries (TDIs) stand out as one of the major public health problems worldwide, characterized by a high prevalence in children and adolescents. However, their association with the 15-19 years age group has not been fully described. The aim of this study was to evaluate TDIs in a population of Brazilian adolescents. Methods An association study was performed with 5558 adolescents attending the Sao Paulo State Oral Health Survey (SBSP-15). Individual predisposing variables (gender, age, schooling, ethnic, overjet, and molar relationship); contextual predisposing (city size and Municipal Human Development Index); individual enabling (per capita income and type of service used); contextual enabling (number of dentists, family health team coverage, and family median income); individual need (satisfaction and perception regarding treatment) and contextual needs (average supervised brushing, number of visits, and dental extractions per city), as well as health behaviors were analyzed. Andersen's behavioral model was used for the data analysis. A multilevel logistic regression with fixed effects was performed to calculate the odds ratio (OR), with 95% confidence interval (CI). Results The prevalence of TDIs in adolescents was 1.42% (95% CI: 0.94-2.13). Individual and contextual factors of need, predisposing factors, facilitators, and health behaviors were associated with TDIs. In the adjusted analysis, gender (OR = 0.32, 95% CI: 0.18-0.53), mean family income (OR = 2.52, 95% CI: 1.35-4.69), number of dental visits (OR = 0.40, 95% CI: 0.19-0.84), and time of last visit (OR = 2.64, 95% CI: 1.46-4.77) remained significant concerning trauma. Conclusion At least one variable of the individual and contextual predisposing, enabling, and need factors (except for individual enabling variables) were associated with dental trauma in Brazilian adolescents aged 15-19 years. This information may help with the planning of preventive actions and dental treatment, especially in mid-sized and large cities.

Individual and contextual factors associated with traumatic dental injuries in a population of Brazilian adolescents

Azadirachta indica (A. Juss), also known as the neem tree, has been used for millennia as a traditional remedy for a multitude of human ailments. Also recognized around the world as a broad-spectrum pesticide and fertilizer, neem has applications in agriculture and beyond. Currently, the extensive antimicrobial activities of A. indica are being explored through research in the fields of dentistry, food safety, bacteriology, mycology, virology, and parasitology. Herein, some of the most recent studies that demonstrate the potential of neem as a previously untapped source of novel therapeutics are summarized as they relate to the aforementioned research topics. Additionally, the capacity of neem extracts and compounds to act against drug-resistant and biofilm-forming organisms, both of which represent large groups of pathogens for which there are limited treatment options, are highlighted. Updated information on the phytochemistry and safety of neem-derived products are discussed as well. Although there is a growing body of exciting evidence that supports the use of A. indica as an antimicrobial, additional studies are clearly needed to determine the specific mechanisms of action, clinical efficacy, and in vivo safety of neem as a treatment for human pathogens of interest. Moreover, the various ongoing studies and the diverse properties of neem discussed herein may serve as a guide for the discovery of new antimicrobials that may exist in other herbal panaceas across the globe.

https://www.frontiersin.org/articles/10.3389/fphar.2022.891535/pdf

The Antimicrobial Potential of the Neem Tree Azadirachta indica

INTRODUCTION: Evidence based dental practice is said to be the recent best approach to provide treatments or interventions, methodically proven to be safe and sound, efficient and cost effective. So, for providing quality dental care, clinical expertise, research evidence and patient's preferences all should be given equal importance. AIM: To assess the awareness, attitude & barriers of evidence-based dental practice (EBDP) amongst dentists of Bhopal city. MATERIALS AND METHODS: The target population of this cross-sectional study involves dentists of Bhopal city. Two hundred fifty private dentists of Bhopal were selected using convenience sampling technique. Data was collected using a self-administered questionnaire containing 15 questions for assessing Knowledge, attitude, practice & barriers in Evidence based practice. Chi-square, t-test & one-way ANOVA were applied for data analysis and p<0.05 was considered statistically significant. RESULTS: The study revealed that dental practitioners had low knowledge about evidence based dental practices but they showed positive attitude towards adopting it in their future practice. There exist certain barriers in practice of evidence based dentistry. CONCLUSION: Including evidence based dental practice teaching in dental curriculum may prove to be a significant step in effective and efficient dental care delivery to the patients. Barriers in evidence based practice needs to be identified & eliminated.

Awareness, Attitude and Barriers Towards Evidence Based Dental Practice Amongst Practicing Dentists of Bhopal City.

Background: There is increasing interest to develop antimicrobial aids from alternative sources such as medicinal plants for the treatment of infectious diseases. Neem and clove are known to have antimicrobial properties. Aim: The study aimed at detecting the antibacterial and antifungal activity of neem and clove extract against Streptococcus mutans and Candida albicans. Materials and Methods: Strains of S. mutans and C. albicans and selective media for growing micro-organisms were procured. Antimicrobial activity was assessed using two methods, by determining the minimum inhibitory concentration (MIC) using the broth dilution method and determining the zone of inhibition using well diffusion method on mitis salivarius bacitracin selective for S. mutans and Saboraud's dextrose agar plates for C. albicans. One way ANOVA with post hoc analysis was done to compare the antimicrobial activity of extracts and 0.2% chlorhexidine. Results: MIC of neem extract was found to be 4.2 mg/ml and 5.0 mg/ml against S. mutans and C. albicans, respectively. While for cloves, it was 5.5 mg/ml for both. Neem had the highest antibacterial activity with a mean zone of inhibition of 11.4 mm followed by chlorhexidine and cloves whereas antifungal activity was highest for chlorhexidine (14.4 mm) followed by neem and clove. Conclusion: The result of the study established that both plant extracts possess antimicrobial activity against common microbes present in the oral cavity.

Assessment of Antimicrobial Effectiveness of Neem and Clove Extract Against Streptococcus mutans and Candida albicans: An In vitro Study.

Aims and Objectives: Traumatic dental injuries (TDIs) of the permanent anterior teeth among the schoolchildren are quite prevalent but often the neglected problem. The objective of the present study was to assess the prevalence of the TDIs of the permanent anterior teeth among 11-15 years schoolchildren attending government and private schools of Bhopal city. Methodology: Descriptive cross-sectional study was conducted among 1518, 11-15 years old schoolchildren of Bhopal city. Andreasen’s epidemiological classification (2004) for assessing the TDIs, Angle’s classification with Dewey’s modification for assessing the occlusal relationship, and the World Health Organization Basic Oral Health Survey (1997) guidelines for measuring the overjet were used. Data were tabulated and statistically analyzed using and Chi-square, Mantel–Haenszel common odds ratio (OR), and binary logistic regression for adjusted OR. Results: The prevalence of TDIs was 10.7%. Falls (56.4%) were the most common cause of TDIs, mainly at home (54.6%). Boys were more affected than girls. There was no statistically significant association between TDIs and socioeconomic status. The adjusted results revealed that TDIs were significantly associated with overjet (OR = 5.5, 95% confidence interval [CI]: 3.66-8.23) and lip coverage (OR = 1.78, 95% CI: 1.28-2.48). Conclusion: Overall the study results showed lower but significance prevalence of TDIs of permanent anterior teeth compares to previous studies, but there was considerable negligence in seeking care for these injuries.

https://journals.sagepub.com/doi/pdf/10.1177/2229411220160206

Prevalence, Risk Factors, and Treatment Needs of Traumatic Dental Injuries of Anterior Teeth among 11-15 Year Old Children Attending Government and Private Schools of Bhopal City, India

Introduction: Dental quackery has become one of the most unethical practices misleading majority of the Indian population. It has become prevalent to such a grass-roots level that curbing this menace is becoming very difficult. This mockery of dental practice imparts unethical dental care to the innocent people and results in complications, which sometimes lead to death of the individual. Objectives: To estimate the prevalence of visits to dental quacks, and to describe the factors influencing these visits. Materials and Methods: A cross-sectional study was conducted for a period of 3 months in Bhopal, Madhya Pradesh. Study participants were recruited from one of the satellite centres of a private dental institution. Information regarding visits to dental quacks, reasons for the visit and self-rated oral health was obtained from the participants using structured questionnaires and face-to-face interviews. The obtained data were analysed using chi-square test and logistic regression analysis. P < 0.05 was considered statistically significant. Results: Out of 314 people who visited the centre during the study period, 280 (92%) agreed to participate in the study. The prevalence of the visits to dental quacks was 42.1%. The participants who visited quacks were older and less educated. The reason for preferring a quack to a dentist was primarily because of the referrals provided by the family members and peers. The most common reason for visiting a quack was toothache (66.1%), and tooth extraction was the most common treatment received (33.8%). Conclusion: Age and level of education significantly influenced the visits to dental quacks and are the two major factors influencing such visits.

Vaibhav Bansal

Papers

Awareness, Attitude and Barriers Towards Evidence Based Dental Practice Amongst Practicing Dentists of Bhopal City.

Assessment of Antimicrobial Effectiveness of Neem and Clove Extract Against Streptococcus mutans and Candida albicans: An In vitro Study.

Prevalence, Risk Factors, and Treatment Needs of Traumatic Dental Injuries of Anterior Teeth among 11-15 Year Old Children Attending Government and Private Schools of Bhopal City, India

Perceptions Regarding Treatment by Dental Quacks and Self-Rated Oral Health Among the Residents of Bhopal City, Central India