| 1. |
- Al-Khotani, Amal A, et al.
(författare)
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Professional knowledge among Swedish and Saudi healthcare practitioners regarding oro-facial pain in children and adolescents
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Oro-facial pain (OFP) and temporomandibular disorders (TMD) in children and adolescents are a growing problem. To meet patients' healthcare needs, professionals must perform their work intuitively and with quality. Therefore, a high degree of professional knowledge is necessary. To investigate the professional knowledge regarding OFP/TMD in children and adolescents among Swedish and Saudi Arabian dental and medical specialists compared with Swedish OFP specialists. One questionnaire including the four domains Chronic pain and behaviour; Aetiology; Diagnosis and classification; Treatment and prognosis was distributed to 383 potential participants, that is physicians and dentists in Sweden and Saudi Arabia. The Swedish OFP/TMD specialists were used as a reference group. The response rates from Sweden and Saudi Arabia were 49% and 86%, respectively. The degree of agreement was highest in the domain Chronic pain and behaviour, especially for the Swedish groups. Regarding the other three domains, the agreement was modest to poor. In general, Swedish groups showed a higher agreement with Swedish OFP/TMD specialists than Saudi Arabian groups. This study shows that professional knowledge regarding OFP/TMD in children and adolescents is limited among Swedish and Saudi Arabian dental and medical professionals compared to Swedish OFP/TMD specialists. In Swedish groups, the professional knowledge is more accurate than in the corresponding Saudi Arabian. With these results in mind, and the frequent prevalence of OFP/TMD in children and adolescents, one can draw the conclusion that there is a need for modern medical education regarding OFP/TMD among both physicians and dentists, especially in Saudi Arabia.
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| 2. |
- Al-Khotani, Amal
(författare)
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Orofacial pain and jaw function in children and adolescents : epidemiology, biopsychosocial implications and caregivers' approach
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Relying on practitioner knowledge of the diagnosis and treatment of orofacial pain (OFP) and temporomandibular disorders (TMD) in children and adolescents tends to be insufficient for effective dental practice. To improve overall performance, it is crucial to discuss topics related to practitioner competency, including professional knowledge and its associated perspectives. In light of the prevalence of OFP/TMD, insufficient knowledge in this area might result in under-treatment of children with these conditions. This thesis consists of four studies. Studies I and II aimed to examine professional knowledge among Swedish and Saudi Arabian practitioners regarding several aspects of OFP/TMD in children and adolescents. Further, the studies investigated whether there is a need to improve education and practices in this field, especially in Saudi Arabia. Studies III & IV investigated the prevalence of OFP/TMD in the general population of Jeddah in Saudi Arabia by determining the number of children and adolescents with diagnoses of TMD in 2014. Further, III & IV aimed to examine which biopsychosocial perspectives possibly affect the incidence of TMD. In studies I and II, we sent a questionnaire comprised of four domains on OFP/TMD knowledge to 383 dental and medical practitioners (general practicing and specialists) in Sweden and Saudi Arabia. The questionnaire used an 11-point modified Likert scale (0-10) as the response format and all responses were compared to those of the reference group, Swedish specialists in OFP/TMD. We added 10 questions to the questionnaire that allowed the participants to assess their own knowledge. Studies III & IV included 456 children and adolescents (aged 10–18 years), selected from schools (boys and girls separately) in the five major regions of the city of Jeddah, Saudi Arabia. Both schools and school-classes were randomly selected. The children’s examinations followed the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD [Axis I & II]). However, for Axis II of the RDC/TMD, we replaced the Symptom Checklist-90-Revised (SCL-90-R) with the Youth Self Report (YSR). All children and adolescents underwent screening for TMD. The main findings from Studies I and II indicate limitations in almost all domains of professional knowledge among the dental and medical practitioners in both countries with regard to OFP/TMD. Agreement between the Swedish general practitioners and the reference group, however, was higher than between the Saudi Arabian practitioners and the reference group. Highest agreement occurred between Swedish specialists in oral and maxillofacial surgery and the reference group. On the other hand, there were significant associations in self-assessment of professional knowledge among almost all Swedish groups in all domains except for Chronic pain and Pain behavior. In the Saudi Arabian group, however, there was only a significant association in the Diagnosis and classification domain. The main finding from Studies III & IV was a prevalence of diagnosed TMD in children and adolescents among the Saudi Arabian general population of 27.2%. The studies also found indications of a significant association between a TMD diagnosis and self-reported OFP and/or headache that occurs once a week or more. The same studies reported that aggressive behaviors, depression, anxiety, stomachache, sleeplessness, feeling tired and dizzy, and eye problems are significantly associated with a painful TMD diagnosis compared to children and adolescents with a non-painful TMD diagnosis. Taking all these studies together, the thesis concludes that there are gaps in professional knowledge of OFP/TMD among both medical and dental practitioners in Sweden and Saudi Arabia. Nevertheless, both professional knowledge and selfassessment ability seem to be higher among Swedish practitioners than Saudi Arabian. This difference suggests improving and modernizing educational methods in undergraduate and postgraduate studies in Saudi Arabia. It also suggests improving the OFP/TMD curriculum in Sweden, especially regarding Chronic pain and pain behavior. Moreover, the results from the present thesis found indications of a high prevalence of TMD among children and adolescents in Saudi Arabia. The prevalence in Saudi Arabia is also high when compared to counterpart studies in Brazil, Germany, and China using the same methodology. No certain conclusions can be drawn from a single study in one country, despite the high prevalence of TMD found, so future studies in other countries are warranted. Similar to many studies, the current results showed a significant association between painful TMD conditions and biopsychosocial factors when compared to pain-free TMD conditions. These findings indicate a need to improve OFP/TMD education in Saudi Arabia and suggest the need for an accredited OFP/TMD specialty in Saudi Arabia.
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| 3. |
- Al-Khotani, Amal, et al.
(författare)
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Study on self-assessment regarding knowledge of temporomandibular disorders in children/adolescents by Swedish and Saudi Arabian dentists
- 2015
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 73:7, s. 522-529
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To estimate the degree of self-assessed knowledge among dentists in Sweden and Saudi Arabia regarding temporomandibular disorders (TMD) in children and adolescents using a summative form of assessment and further to investigate the possible factors that may influence the self-assessed knowledge. MATERIALS AND METHODS: A questionnaire survey covering four domains (Etiology; Diagnosis and classification; Chronic pain and pain behavior; Treatment and prognosis) regarding TMD knowledge was used. Out of 250 questionnaires (125 in each country) a total of 65 (52%) were returned in Sweden and 104 (83%) in Saudi Arabia. RESULTS: Self-assessed individual knowledge was significantly associated to the level of actual knowledge among the Swedish groups in the domains Etiology; Diagnosis and classification and Treatment and prognosis (p < 0.05). However, in the Saudi Arabian groups a corresponding significant association was only found in the domain Diagnosis and classification (p < 0.05). CONCLUSIONS: This study showed that there is a difference in the accuracy of self-assessment of own knowledge between the dentists in Sweden and Saudi Arabia. The Swedish dentists have a better ability to assess their level of knowledge compared to Saudi Arabian dentists regarding TMD in children and adolescents. This difference could be related to several factors such as motivation, positive feedback, reflection, psychomotor, and interpersonal skills, which all are more dominant in the Swedish educational tradition.
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| 4. |
- Ekberg, EwaCarin, et al.
(författare)
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Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations : Comprehensive and short-form adaptations for adolescents.
- 2023
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 50:11, s. 1167-1180
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed.OBJECTIVE: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings.METHODS: International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents.RESULTS: The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers, and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents, and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents.CONCLUSION: The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.
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| 5. |
- Nilsson, Ing-Marie, et al.
(författare)
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Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations : Comprehensive and short-form adaptations for children
- 2023
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 50:2, s. 99-112
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed.OBJECTIVE: To present comprehensive and short-form adaptations of Axis I and II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings.METHODS: Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children.RESULTS: The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire, and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, and (ii) adding anxiety and depression assessments that have been validated in children, and (iii) adding three constructs (stress, catastrophizing, and sleep disorders) to assess psychosocial functioning in children.CONCLUSION: The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.
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| 6. |
- Rongo, Roberto, et al.
(författare)
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Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II
- 2022
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Ingår i: Journal of Oral Rehabilitation. - : WILEY. - 1365-2842 .- 0305-182X. ; 49:5, s. 541-552
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Tidskriftsartikel (refereegranskat)abstract
- Background Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. Objectives To develop a new standardised instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments. Methods A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2 and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophising, sleep problems and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritise the suggested instruments from most to least recommended. Results The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophising, stress and resilience. Conclusion Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.
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