Faculty Publications (HBMCDM)

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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.
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.
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
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.
Non syndromic familial hypodontia - a case series
(2018) Binladen, Halah; Amal, Mahmoud; Neeta, Chandwani; Al Halabi, Manal
Aim: The aim of this case report is to discuss the features of non-syndromic familial hypodontia, which was noted in three siblings who had an unremarkable medical history. Summary: Congenital absence of teeth is a common dental anomaly referring to teeth that fail to erupt in the oral cavity and remain invisible in radiographs. Congenital tooth agenesis is defined by the number of missing teeth, excluding the third molars; hypodontia refers to the absence of less than six teeth, while oligodontia is the absence of six or more teeth. Tooth agenesis can occur as part of a genetic syndrome such as the cleft lip and palate, ectodermal dysplasia and Trisomy 21 (syndromic hypodontia) or an isolated trait (nonsyndromic hypodontia). Non-syndromic hypodontia is the most common form and can be familial or sporadic. The most supported etiological theory suggests that tooth agenesis may be due to a combination of genetic and environmental factors, which lead to disturbances in the tooth germ during the initial formation stages. This case series reports bilateral agenesis of the maxillary canines in siblings, which is quite rare in occurrence. The management of these anomalies involves a multidisciplinary approach in order to restore esthetics and function. An early diagnosis can lead to effective treatment planning and satisfactory results. Key learning points: The clinical manifestations as well as the short and long term management of this condition are discussed.
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.
Self-reported adaptability among postgraduate dental learners and their instructors: Accelerated change induced by COVID-19
(2022-07) Amir-Rad, Fatemeh; Al Halabi, Manal; Baqain, Zaid; OtakiI, Farah; ZaryI, Nabil
Abstract: It is forecasted that the skills and competencies necessary for post-pandemic success in higher education need to be founded upon adaptability, coping, and Self- Regulated Learning (SRL). It is worth investigating how stakeholders perceived their adaptability and coping with the accelerated change accompanying Coronavirus Disease of 2019 (COVID-19). Accordingly, the purpose of this study was to assess the self-reported adaptability of postgraduate dental learners and their instructors in the context of abrupt transition to distance learning induced by the pandemic. This study utilized a convergent mixed methods study design. The quantitative and qualitative data were concurrently collected from instructors and learners, using a tailor-made survey of items measured with a Likert-type scale, complemented with open-ended questions. The collected datasets were independently analyzed. Descriptive and inferential analysis were conducted using the quantitative data. Qualitatively, the researchers underwent a multi-staged thematic analysis. The generated information was then integrated using a joint model analysis. The percentage of the total average of self-reported adaptability for both groups of stakeholders was 81.15%. The instructors, with a mean of satisfaction of 17.94 (±1.76), rated their adaptability significantly higher than the learners, with a mean of satisfaction of 15.66 (±2.77) (p = 0.002). The thematic analysis resulted in two interrelated themes: Self and Environment. Within the Self theme, three subthemes surfaced: Cognitions, Emotions, and Behaviors. As for the Environment theme, it encapsulated two subthemes: Enablers and Impediments. The stakeholders perceived themselves to have adapted well to the transition, and SRL appeared as a cornerstone in the adaptation to the accelerated change accompanying COVID-19. There appeared to be an interplay between the cognitions, emotions, and behaviors on the level of the self as part of the adaptation process. Also, building upon existent models of SRL, this study uncovered that the stakeholders considered the environment to play a crucial role in their adaptation process. This highlights the importance of developing a climate that remains, despite external pressures, conducive to attaining learning and teaching goals. It is also crucial for university-level mental health promotion activities to proactively foster, among learners and instructors, adaptability, building ‘academic resilience’.
Simulation-based education for selected communication skills: exploring the perception of post-graduate dental students
(2021) Mascarenhas, Sharon; Al Halabi, Manal; Otaki, Farah; Davis, Dave
Purpose: The role of simulation-based education (SBE) in enhancing communication has been established in the literature. To ensure achieving desired outcomes from SBE initiative, the individual learners, their experiences, and environments need to be considered. This study aimed at exploring the perception of post-graduate dental students regarding their participation in SBE sessions, around selected communication skills, designed in alignment with the assumptions of adult learning theory and steps of Kolb’s experiential learning cycle. Methods: This study utilized a qualitative design. Six focus-group sessions were conducted following the SBE sessions. The generated data was inductively investigated using a multi-staged participant-focused approach to thematic analysis, based upon constructivist epistemology. NVivo was utilized to facilitate text Fragments’ coding and categorization. Results: Forty-three post-graduate dental students participated. The analysis resulted in 16 categories spread across five sequential phases of the SBE experience. The “input” theme referred to the resources needed for the SBE process, and included three categories: facilities, personnel, and teaching materials. The second theme included steps of SBE “process”: pre-brief, simulation, and debrief. The third, fourth, and fifth themes constituted the short- and longer-term results of the SBE intervention. The participants reported instant benefits on confidence in their expertise in communicating with patients and their guardians. Additionally, perceived effects on the empathy and professionalism were reported. Conclusion: SBE, that is based upon adult and experiential learning theories, and developed after thorough consideration of the individual learners, and their experiences and learning environments, holds potential in enhancing communication skills among post-graduate dental students.

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