CONTEXT: To investigate the antibiotic prescribing training received by dental students, clinical experience in treating child patients, awareness of antibiotic prescribing guidelines, preparedness in antibiotic prescribing, and compliance with antibiotic prescribing guidelines for the management of dental infections in children.
METHODS: This was a cross-sectional study involving final year dental students from Malaysian and Asian dental schools. A self-administered questionnaire consisting of five clinical case scenarios was e-mailed to all final year students at selected dental schools. Students' responses were compared for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association. Compliance in each scenario was tested for association with their preparedness in antibiotic prescribing, previous training on antibiotic prescribing and awareness of antibiotic prescribing guidelines using Chi-square test. Data collected were analyzed using SPSS statistics version 20.
RESULTS: A total of 108 completed responses were received. About 74 (69%) students were from Malaysian dental schools. The compliance rate with prescribing guidelines ranged from 15.7% to 43.5%. Those attending Malaysian dental schools (47.3%) and those who had treated child patient more often (46.3%) were more likely (P < 0.05) to be aware of the guidelines. Those who had received antibiotic prescribing training (21.3%) were more likely to think they were well prepared in antibiotic prescribing (P < 0.05).
CONCLUSIONS: Final year dental students had low awareness and compliance with antibiotic prescribing guidelines. Further research is needed to investigate how compliance with the guidelines may be enhanced.
This study was to evaluate the microbial contamination level in direct water supply at the Polyclinic, Faculty of Dentistry, USIM, Malaysia. Water samples were collected randomly from water supplied via the cup filler outlet of 20 dental units and 20 side water taps at Level 16 and 17 of Polyclinic, Faculty of Dentistry, USIM. All the samples were placed and spread evenly on the surface of prepared agar media (the nutrient agar) using the spread technique. Each sample consists of 0.5 mL water. The microbial count was done using a magnifying glass and the total number of bacteria concentration was reported as colony forming unit in 1 mL of water (cfu/mL). In this study water from an aquarium was used as positive control with 220 cfu/mL, while the distilled water taken from the CSSD was used as negative control with no colony of microorganism. The study demonstrated that there were low contamination before the treatment that was beginning of the session in water supplied via the cup filler outlet and side water tap from the sink with 2 cfu/mL. However, two cup fillers water and one side water taps from Polyclinic level 17 showed a slightly higher bacterial colonies with 4 cfu/mL and 6 cfu/mL of microbes. At the end of the session, result showed that higher bacterial count from Polyclinic level 17 than Polyclinic level 16 with the highest reading of 40 cfu/mL. The findings were considered low and the water was safe for the dental procedures. The quality of water supplied at the Faculty of Dentistry, USIM was within the limits recommended by the American Dental Association, i.e. bacterial loads of not more than 200 cfu/mL for dental procedures.
Water from the dental unit waterlines (DUWLs) is known to contaminate with microbial from the biofilm that formed in the tubing system. The water quality from DUWLs is important to patients and dental health care professionals as they could be infected either directly from the contaminated water or aerosol that is generated during dental procedures. Suppliers claimed that dental units supplied to the hospital can only use a specific disinfectant which is uneconomic compared with the others. The aims of this study were to evaluate and compare the efficacy of different disinfectant on the water quality of DUWLs. Four disinfectants (Calbenium, A-dec ICX tablet, Dentel 5, Metassys) and distil water were evaluated. 350 mL water sample was collected separately, from the outlet of high-speed handpiece, scaler, 3-ways syringe and cup filler into a sterile thiosulfate bag on the 1st, 2nd, 4th, 8th, 12th and 24th weeks of the study. The samples were tested on the following day for total viable count (TVC). There is significant difference in the efficacies of the different disinfectants. Only one disinfectant consistently produces water quality within the recommended level of American Dental Association (ADA). Within the limitation of this study, it was found that there is alternative disinfectant that can reduce the TVC to the level recommended by ADA. However, the water qualities produced with these disinfectants were not consistent although they did not cause any technical problem to the dental units during the period of study.
Abstract Water quality in the dental unit waterlines (DUWLs) is important to the patients and dental health care personnel as they are at risk of being infected with opportunistic pathogens such as Pseudomonas or Legionella species. In this study, a total of 86 samples were collected from DUWLs of 19 dental units in 11 Malaysian Armed Forces dental centres (MAFDC). 350 ml water sample was collected in sterile thiosulphite bags from the outlets of 3–way syringe, high speed handpiece, scaler, cup filler, independent water reservoir or the tap of the same surgery respectively. Samples were transported to the laboratory within 24 hours and kept in the refrigerator at 40C. 100ml of each sample was filtered through a 0.45 μm polycarbonate membrane filter. The filter was then inoculated onto plate count agar and incubated at 370 C for 24 hours, after which the formed colonies were enumerated. Another separate 100ml of water sample was poured onto buffered charcoal yeast extract agar and cetrimide agar to culture Legionnella and Pseudomonas respectively. Identification of these bacteria were confirmed by polymerase chain reaction and sequencing. Pseudomonas aeruginosa was detected in 9.5% of the samples but Legionnella was not detected in any of the samples. 77% of the samples met American Dental Association (ADA) recommendation of less than 200 cfu/ml. The result of this study showed that it is difficult if not impossible to eliminate biofilm from the DUWLs. Regular monitor of water quality from DUWL is required to maximise the health of the dental patients and dental health care personnel.