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This study aimed to estimate dental caries’ prevalence and potential risk factors among schoolchildren aged 8–12 in Damascus, Syria. The study was cross-sectional and conducted between February 2023 and April 2024, the target population was 1,052 children selected using multi-stage cluster sampling. Dental caries were determined using the DMFT/dmft index, while additional information on sociodemographic status, and attitude towards oral hygiene practices, were collected via a structured questionnaire. Data analyses were conducted using the Statistical Package for Social Sciences (SPSS). The overall prevalence of dental caries was 90.8%. Males had a slightly higher prevalence (91.9%) than girls (89.8%). Children aged [10–12] years showed the highest caries prevalence (91.7%). The mean DMFT/dmft score was 2.07 ± 1.91/3.74 ± 2.25, respectively. Caries prevalence was significantly associated with the type of school attended, family size, socioeconomic status, and parental education. Additionally, the frequency of tooth brushing, dental flossing, and irregular dental visits were significantly linked to higher caries incidence. It was found that caries experience remains high in the children in Damascus, with many associated factors including their sociodemographic factors and oral behaviors. We confirm that visiting the dentist regularly, using dental floss, and brushing regularly decreased the prevalence of dental caries among children.

This study was undertaken to determine the prevalence of molar incisor hypomineralization (MIH) in Syrian children and to provide information about clinical patterns and severity of MIH lesions. A sample of 1138 children aged 8–11 years was recruited for this cross-sectional study. The diagnosis of MIH was made using the criteria of the European Academy of Paediatric Dentistry (EAPD) and the MIH/HPSMs short charting form was used to score the index teeth. The results showed that the prevalence of MIH in Syrian children was 39.9%. Demarcated opacities were the most prevalent pattern of MIH defects on Permanent first molars (PFMs) and permanent incisors (PIs). Spearman rank correlation showed that the mean number of PIs and HPSMs with MIH increased when the number of affected PFMs was increased ( P  < 0.001). Chi-square test resulted that girls showed a higher number of severe PFMs than boys did with a statistically significant difference (x 2  = 133.1, P  < 0.05). Moreover, Chi-square test showed that the number of severe PFMs is higher than the number of severe PIs with a statistically significant difference (x 2  = 54.9, P  < 0.05). In addition, the mean dmft/DMFT index in children with MIH was found to be significantly higher than children without MIH ( P  < 0.05). The findings emphasize the need for early identification and management of MIH in children to prevent adverse effects on their oral health.

Background Evaluation tools for training programs vary, necessitating a standardized tool for assessing surgical clinical training quality to enhance program effectiveness, pinpoint improvement areas, and ensure resident readiness for independent practice. We present a new tool designed to provide a reliable and consistent framework for evaluating the effectiveness of surgical clinical training. Methods The Surgical Clinical Training Measurement (SCTM) was developed using the modified Delphi method to evaluate ten variables, including core competencies specific to surgical training. It employs a 5-point Likert scale, with scores ranging from 40 to 200. General surgery residents completed the SCTM twice to evaluate training levels. Results were categorized based on score ranges. Statistical analysis via SPSS included descriptive statistics, group comparisons, internal consistency assessments, correlations, and reliability tests to evaluate the SCTM scores, demographic characteristics, and language versions. ANOVA, Chi-Square, Cohen Kappa, and Spearman’s rho tests were employed for data analysis. Results 74 general surgery residents at Aleppo University Hospital have participated in this study. The SCTM scores indicated a mean total score of 131.42, with most residents falling into the good satisfactory category. Analysis showed no significant differences in total scores across specialty years, but post-hoc tests revealed differences between specific years. The SCTM demonstrated strong reliability, with a Kappa value of 0.884 indicating high agreement between English and Arabic versions ( p  < 0.05). Test-retest reliability was also high ( r  = 0.964, p  < 0.01). Internal consistency was excellent across various domains, reinforcing its validity in surgical education. The analysis of variables showed different levels of reliability and mean scores among the various factors. The Pre-Operative Clinical variable had the highest performance, while the Evidence-Based Quality Clinical Training variable indicated the most potential for improvement. The strong positive correlations between various domains of SCTM emphasize the interconnected nature of skill development, with proficiency in patient care closely linked to competency in other areas such as Medical Knowledge, Practice-based Learning and Improvement, and Evidence-Based Quality Clinical Training. Conclusion SCTM offers a standardized and cohesive method for evaluating the quality of surgical clinical training. It’s a valuable resource for program directors, educators, and residents to assess and enhance training programs, and identify specific areas for improvement. Additional research is required to validate the SCTM in different settings and explore its applicability in other fields. Clinical trial number Not applicable.

The study aimed to investigate parental satisfaction and acceptance of silver diamine fluoride (SDF) treatment for permanent molars affected by molar incisor hypomineralisation (MIH). This study was conducted in the pediatric dental department at Damascus University, Syria. This study was performed at the period from Jan 2023 to April 2023. In this cross-sectional study, a validated questionnaire employing a 5-point Likert scale was used to evaluate esthetics, ease of application, pain perception, and taste acceptability. Participants included 100 parents or guardians of children aged 6–9 years who had received SDF treatment in the past year. The findings of this study revealed high satisfaction levels (77.5%) with the treatment. Parents expressed contentment with the appearance of their child's molars after SDF application (58% agreed or strongly agreed) and found the application process easy and pain-free (100% agreed or strongly agreed). However, taste acceptability posed a challenge, with over half of the parents (53%) finding it unacceptable. Regression analysis underscored the significant impact of esthetics, ease of application, pain perception, and taste on parental satisfaction. Moreover, parents with higher education levels (graduate or postgraduate) exhibited higher acceptance rates compared to those with lower education levels (63.1% vs. 33.6%). Notably, parental gender and age did not significantly influence SDF treatment acceptance. This study provides critical insights into parental satisfaction and acceptance of SDF treatment for MIH-affected permanent molars. Despite concerns about tooth discoloration, the high satisfaction levels suggest that SDF holds promise as an effective treatment option. Parental education significantly influenced acceptance rates. This research highlights the importance of considering parental perspectives and tailoring communication strategies in pediatric dentistry, ultimately contributing to improved care for young patients with MIH.

This study aimed to compare parental satisfaction between two pediatric dental anesthesia techniques, computerized intraosseous anesthesia (CIA) and inferior alveolar nerve block (IANB). This study was designed as a split-mouth randomized controlled clinical trial. A total of 52 parents of children undergoing dental treatment were enrolled in the study. Each participant received both CIA and IANB anesthesia, with the order of administration randomized. Parental satisfaction was evaluated using the parental satisfaction of dental local anesthetic techniques scale (PSLAS). Statistical analysis revealed that parental satisfaction regarding CIA was higher than that for IANB with a significant difference ( P ˂ 0.05). However, there was no difference regarding the age, gender or the education level of the parents. ( P  > 0.05). This study provides insights into parental satisfaction with pediatric dental anesthesia techniques and highlights the influence of socioeconomic factors on anesthesia decision-making. Within the limitations of this trial, it was concluded that CIA was significantly superior to IANB in overall parental satisfaction. However, parental satisfaction values were lower in CIA group regarding costs and concern from complications. In addition, it was concluded that there was no difference in satisfaction levels regarding the gender, age and education level of the parents.

This study aimed to investigate the association between facial action units and pain levels in Syrian children, focusing on both genuine and fake pain expressions. A total of 300 Syrian children aged 6–9 years participated in the study. Pain levels were assessed using the validated Face, Legs, Activity, Cry, Consolability scale, and facial expressions were analyzed using the Facial Action Coding System. The children were asked to mimic their feelings after receiving a dental injection to elicit fake pain expressions. Statistical analysis, including multinomial logistic regression and chi-square tests, was conducted to determine the Action Units (AUs) associated with each pain level and to compare the differences between real and fake pain expressions. The results revealed significant associations between specific AUs and pain levels. For real pain expressions, the most activated AUs across different pain levels with positive coefficient values of correlation ( P -value < 0.01) were analyzed. In contrast, for fake pain expressions, AU12 and AU38 were consistently observed to be the most activated. These findings suggest that certain AUs are uniquely associated with fake pain expressions, distinct from those observed in real pain expressions. Furthermore, there were no significant differences between boys and girls in terms of their genuine and fake pain expressions, indicating a similar pattern of AU activation ( P -value > 0.05). It was concluded that AUs 4, 6, 41, and 46 were associated with mild pain, and AUs 4, 6, 41, 46, and 11 were associated with moderate pain cases. In severe pain, AUs 4, 6, 7, 9, 11, and 43 were associated. In fake pain feelings, AU43, AU38, and AU12 were the most activated with no difference between boys and girls.

Aim This study was undertaken to compare direct composite resin restorations (DCRR) and indirect composite resin restorations (ICRR) for treating permanent first molars affected by MIH in terms of clinical performance. Materials and methods This was a controlled, randomized, clinical split-mouth study. The studied sample consisted of 40 asymptomatic first permanent hypomineralised mandibular molars in 20 children aged between 7–11 years, these cases were divided randomly into two groups: Group 1 (experimental): 20 first permanent mandibular molars were restored with ICRR, and Group 2 (control): 20 first permanent mandibular molars that were restored with DCRR. The cavity was prepared using a diamond bur on a high-speed handpiece, and the prepared cavity was wiped with cotton moistened with sodium hypochlorite. The composite was applied directly with a total-etch bonding system. In the ICRR group, an impression for the prepared cavity was taken using a silicon-based material, and the restoration was adhesive with self-adhesive resin cement. The child’s satisfaction with each of the two application techniques was assessed through the scale FACES. Restorations were evaluated during follow-up periods (3, 6, and 12 months) according to Modified USHPH criteria. Results The clinical success rate was 90% in the ICRR group versus 85% in the DCRR group after 12 months of follow-up without statistically significant differences ( P  = 0.218). Children were significantly more satisfied ( P  = 0.0351) with ICRR than DCRR. Conclusions Both DCRR and ICRR can be considered effective restorations with acceptable clinical performance in the restoration of hypomineralised first permanent molars with an advantage of ICRR in terms of child acceptance of the restoration application technique.

Background The early recognition of technology together with great ability to use computers and smart systems have promoted researchers to investigate the possibilities of utilizing technology for improving health care in children. The aim of this study was to compare between the traditional educational leaflets and E-applications in improving oral health knowledge, oral hygiene and gingival health in schoolchildren of Damascus city, Syria. Methods A clustered randomized controlled trial at two public primary schools was performed. About 220 schoolchildren aged 10–11 years were included in this study and grouped into two clusters. Children in Leaflet cluster received oral health education through leaflets, while children in E-learning cluster received oral health education through an E-learning program. A questionnaire was designed to register information related to oral health knowledge and to record Plaque and Gingival indices. Questionnaire administration and clinical assessment were undertaken at baseline, 6 and at 12 weeks of oral health education. Data was analysed using one way repeated measures ANOVA, post hoc Bonferroni test and independent samples t-test. Results Leaflet cluster (107 participants) had statistically significant better oral health knowledge than E-learning cluster (104 participants) at 6 weeks ( P  < 0.05) and at 12 weeks ( P  < 0.05) (Leaflet cluster:100 participants, E-learning cluster:100 participants). The mean knowledge gain compared to baseline was higher in Leaflet cluster than in E-learning cluster. A significant reduction in the PI means at 6 weeks and 12 weeks was observed in both clusters ( P  < 0.05) when compared to baseline. Children in Leaflet cluster had significantly less plaque than those in E-learning cluster at 6 weeks ( P  < 0.05) and at 12 weeks ( P  < 0.05). Similarly, a significant reduction in the GI means at 6 weeks and 12 weeks was observed in both clusters when compared to baseline ( P  < 0.05). Children in Leaflet cluster had statistically significant better gingival health than E-learning cluster at 6 weeks ( P  < 0.05) and 12 weeks ( P  < 0.05). Conclusions Traditional educational leaflets are an effective tool in the improvement of both oral health knowledge as well as clinical indices of oral hygiene and care among Syrian children. Leaflets can be used in school-based oral health education for a positive outcome. Trial registration Australian New Zealand Clinical Trials Registry ( ACTRN12618000395235 ), Date registered: 16/03/2018, retrospectively registered.

Objective Oral health educators should have the required knowledge, skills and attitude in order to meet the increased needs of the Ministry of Education in Syria as well as to perform their duties in promoting oral health in children appropriately during the COVID-19 pandemic. Therefore, this study was undertaken to identify core competencies required for oral health educators in elementary schools during the COVID-19 pandemic. Qualitative exploratory study was undertaken. A focus group which consisted of 5 Medical Education postgraduates and 3 oral health educators’ training team members were invited to formulate a preliminary list of basic competencies. Delphi technique was also adopted through inviting 12 experts in oral health education to evaluate and formulate a final list of elementary schools’ oral health educators’ competencies during the COVID-19 pandemic. Results A competency framework was developed. Fifty-five competencies were identified including 35 in cognitive domain, 12 skills and 8 attitude competencies. A list of essential competencies has been identified. These competencies should be addressed in training programs targeting oral health educators, which can consequently produce competent educators who can successfully promote and provide health care to all schoolchildren during the COVID-19 pandemic.

Background Health professionals should have certain degree of empathy to eliminate the pain and suffering of their patients. There is a need to design a scale, which can assess empathy among health professionals and is relevant to community and culture. Therefore, this study was undertaken to measure the empathy among Syrian health professionals and students of health professions using a newly designed Syrian Empathy Scale that is relevant to community during Syrian crisis. Methods A cross-sectional observational study was undertaken. A total of 214 participants (118 males and 96 females) responded to the Syrian Empathy Scale SES from Medical ( n  = 62), Dental ( n  = 152). They were 59 undergraduates, 116 postgraduates and 39 general practitioners. The SES was designed as a tool that includes 20 items in a 7-point Likert-type scale with overall score ranges from 20 to 140. Group comparisons of the empathy scores were conducted using t -test and analysis of variance (ANOVA). A factor analysis was performed. Bartlett’s test of the sphericity and the KMO measure of sampling adequacy were also determined. Cronbach’s alpha was calculated. Results A significant difference was found between males and females in the SES mean score. The ANOVA analysis showed that the SES empathy scores of dentists were higher than the SES empathy scores in medical doctors with no significant difference. The SES empathy score of undergraduates was significantly higher than postgraduates and practitioners. Findings of KMO indicated sampling adequacy (KMO = 0.824 > 0.7) and the value of Bartlett’s test of the sphericity (1255.65, df = 190, P- value< 0.001) proved that the factor analysis is meaningful and acceptable. The results of varimax rotation proved that five main factors were retained. Conclusion Findings of this study support the reliability of the newly designed Syrian Empathy Scale for measuring empathy in the field of health care. The SES can be suggested for assessing empathy in different health educational programs. However, future works are still essential to support the validity of the scale as well as to ascertain the role of empathy in improving health care.