DT India & South Asia No. 9, 2021

Does soft tissue augmentation hold up long term? Clinical tips from the past decade / News

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DENTALTRIBUNE
The World’s Dental Newspaper · South Asia Edition

Published in India

www.dental-tribune.com

IDS 2021

Materials inventor

Digital tickets for
IDS 2021 now
available

Women in
dentistry: Meet
chemist and
awarded dental
materials inventor
Dr. Sumita Mitra

” Page 03

09/21

Vital skill

Vaccine hesitancy

Why emotional
intelligence in
dentistry is a vital
skill
” Page 04

Worrisome level of
vaccine hesitancy
found among dental
students
” Page 06

” Page 07

Does soft tissue augmentation hold
up long term? Clinical tips from the
past decade

Fig. 3: Harvested Connective
Tissue (CT) graft. An excess of
adipose tissue in the graft
leads to increased shrinkage

By Dr. Neel Bhatavadekar
In this editorial, Dr. Neel
Bhatavadekar briefly outlines
the
long-term
comparison
between two main techniques
for
soft
tissue
grafting:
tunneling vs. envelope flap
and the use of vertical release
incisions vs. without vertical
incisions, and specifically so, in
the Indian patient context.
Introduction
Soft tissue assessment around
teeth or implants has emerged as
one of the most important clinical
considerations for long-term success.
Recently, the Controlled Palatal
Harvest (CPH) technique, published
by our group, has enabled clinicians
to obtain connective tissue graft
thickness of predictable thickness
from the palate. (Bhatavadekar,
Gharpure, 2018)
However, for several dentists
who are perhaps are not
well versed with soft tissue
augmentation,
the
palatal

long-term gains. From a clinical
perspective,
however,
the
tunneling technique often takes
a long time to perform. Thus, the
clinician needs to take a casedependent decision about which
of the techniques would be better
for given case anatomy.
For peri-implant soft tissue,
a zone of keratinized tissue is
known to provide better longharvest of a connective tissue
graft is usually seen as a major
deterrent in proposing this
treatment option to patients. The
advent of allogenic/ xenogenic
soft tissue substitutes has made
this technique less of a hurdle
and effectively enabled a palatefree augmentation approach
in recent times. However, the
choice of the flap and vertical
release incisions has remained a
debatable topic for long.
Characteristics of the Indian
population:
Our
clinical
assessment
demonstrates that we deal with
a unique situation of having
patients with thin biotypes,
both around teeth and around
implants in India. Consequently,
our patients are more prone to
peri-implant and periodontal
gingival recession (Fig 1). If
the biotype and keratinization
are not taken into account at
baseline, it becomes a patient

Fig. 1: Thin tissue biotype
predisposes to mucogingival
problems around implants and
teeth

management problem later to
add soft tissue augmentation to
the list of required procedures.
In my personal opinion, I have
seen about 80% of my implant
cases needing either soft tissue
augmentation, or hard tissue, or
both.
Use of Tunnelling vs.
envelope flap: 6-year results
It is well established that
root coverage with connective

Fig 2.: Baseline and 5 yr post op
photos after root coverage
using a CT graft. Stable long
term soft tissue attachment is
predictable.

tissue grafts is a long-term,
predictable procedure (Fig.2,3).
In our recently published study
(Bhatavadekar et al., IJPRD 2019),
we compared the results between
tunneling and envelope-type
open flaps (combined with a CT
graft) at the 6-year mark. The root
coverage between the two groups
was similar, thus establishing
that the tunnel technique does
not necessarily provide better

Fig. 4: Good soft tissue
maintenance around implants
can be often obtained by soft
tissue augmentation, thus
improving tissue biotype and
keratinization.

term stability (Fig. 4). However,
from a soft tissue augmentation
perspective, either for a tooth or
an implant, the buccal positioning
is critical when assessing the
predictability of the surgical
procedure at baseline. The more
buccal the implant/tooth, the
harder it generally is to graft
around (Fig. 5).

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2

News

09/21

Fig. 5: Buccal positioning of a
tooth/ implant will negatively
impact root coverage, and
needs to be carefully assessed.

Fig. 6: Vertical release incisions
in esthetic zone can often lead
to scar tissue visible even 7
years post-op

Vertical release incisions
in the anterior esthetic zone:
7-year results
We recently compared the
long-term (7 years) results in the
anterior esthetic zone between
2 groups of patients- with and
without vertical release incisions
(Bhatavadekar et al., 2020). At
both the eight months and 7-year
follow-ups, the group without
vertical release demonstrated
statistically
superior
root
coverage and keratinized tissue
zone.
Importantly, we observed that
vertical release incisions left scar
tissue in the anterior esthetic
zone, even though the vertical
incisions were always made at
line angles avoiding areas of root
prominence, which was visible
even at the 7-year mark (Fig. 6).

Conclusion:
Every decision in your clinic
should be based on a multifactorial
evaluation process. Evidencebased decision-making ensures
that most things will work in
your hands, irrespective of your
clinical competency level.
Most surgical techniques will
seem to work in the immediate
aftermath of a procedure. If
utilized wisely, social media is
an important learning tool, but
one often sees anecdotal cases,
often with no follow-up beyond
a few weeks. The astute clinician
will learn to appreciate the
value that long-term follow-up
data provides for one‘s private
practice. Enlisted below are some
clinical tips which I feel may add
value to your soft tissue decision
making:

Dental
newspapers

Clinical take-home points:
1. Monofilament sutures are
greatly preferred over braided
sutures like silk. 5/0 or 6/0 is the
recommended size.
2. Fancy incision designs or
complicated pedicle grafts do
not necessarily provide better
clinical results. Maintaining
tissue and graft vascularity
should be the priority.
3. Tunneling
does
not
necessarily provide better longterm results as compared to
envelope flaps. So choose the flap
technique wisely.
4. The use of TTL (through the
lens) loupes significantly improve
your surgical capabilities and
should be one of the first things
clinicians should invest in.
5. Vertical release incisions
in esthetic areas can leave scar
tissue visible up to 7 years
post-op, as per the results
from our publications. Hence,
judicious use of vertical release
incisions is mandated in high
visibility esthetic zones.
6. If new to soft tissue
augmentation,
start
with
augmentation around teeth
(- it is more forgiving) before
venturing into implant soft
tissue augmentation procedures.
7. Self-document as much as
possible. Learning from one‘s
own mistakes forms a crucial
pillar in progress.

References:
1. Bhatavadekar NB, Gharpure
AS. Controlled Palatal Harvest
Technique(CPH) for Harvesting a
Palatal Subepithelial Connective
Tissue Graft. Compend Contin
Educ Dent. 2018 Feb;39(2):e9-e12.
2. Bhatavadekar
NB,
Gharpure
AS,
Chambrone
L. Long-Term Outcomes of
Coronally Advanced Tunnel
Flap (CATF) and the Envelope
Flap (mCAF) Plus Subepithelial
Connective Tissue Graft (SCTG)
in the Treatment of Multiple
Recession-Type Defects: A 6-Year
Retrospective Analysis. Int J
Periodontics Restorative Dent.
2019 Sep/Oct;39(5):623-630.
3. Bhatavadekar
NB,
Gharpure AS, Chambrone L.
Long-term Evaluation (7-years)
of Coronally Advanced Flap
with (CAF) and without (e-CAF)
Vertical Release Incisions using a
Subepithelial Connective Tissue
Graft in the Treatment of Multiple
Recession-Type Defects. Accepted
Quintessence. 2020. In Press.

Author:

Periodontology at the University
of North Carolina at Chapel Hill,
USA. In addition, he has a Masters
in
Biomedical
Engineering
from the University of Florida
and a Masters in Public Health.
He is the first Diplomate of the
prestigious American Board of
Periodontology to be practicing
in India. He holds adjunct
faculty appointments in the
Department of Periodontology
at the University of Texas Health
Science Center, and at the
University of North Carolina at
Chapel Hill.
He was also the first ITI
(International
Team
for
Implantology) Fellow in India
and a Registered ITI Speaker.
Neel is a reviewer for the Journal
of Periodontology and the Journal
of Clinical Periodontology. He
has also been a KOL for dental
implant and graft companies in
Europe and the US. His clinical
interests are implant dentistry,
mucogingival
surgery,
and
periodontal bioengineering. He
also holds joint US - India dental
licenses and currently practices
in Pune. www.clarusdental.com

Dr. Neel Bhatavadekar BDS,
MS(US) MPH (US), Diplomate,
American Board of Periodontology.
After
graduating
from
Nair Hospital Dental College,
Bombay, he completed Masters in

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Digital tickets for IDS 2021 now
available
By Dental Tribune International
COLOGNE, Germany: As the
39th International Dental Show
(IDS) is rapidly approaching,
the organisers have announced
that registration is now open.
Different from past years,
tickets can only be obtained in a
digital format, which will help
to avoid close contact, a safety
measure owing to the COVID19 pandemic.
IDS is one of the most
prominent global dental industry
platforms. Originally planned for
March, the event will now take
place from 22 to 25 September
and will be comparably smaller
in size to ensure a safe trade
fair experience. According to
organiser Koelnmesse, IDS 2021
will offer the dental industry
a fresh outlook as it slowly
resumes business, and the show
will have around 830 exhibitors

from 56 countries, including
China, Russia, and the US.
Those planning to attend
the event can now purchase
their digital, named-day-only
tickets from the ticket shop on
the IDS website and download
the tickets to a smartphone
in the form of QR codes. As
the organisers explained, the
online tickets will facilitate the
collection of contact data for use
in case of coronavirus infection.
As safety is a major pillar of
IDS 2021, participants will also
be asked to provide recognised
digital proof of vaccination,
COVID-19 recovery, or a SARSCoV-2-negative test result upon
entering the trade fair premises.
Finally, those who are unable to
attend owing to travel or other
restrictions related to COVID-19
are invited to use the free digital
event platform, IDSconnect.

The ticket shop for IDS 2021 is now open, and the participants are invited to reserve their digital-only
tickets in advance. (Image: Rawpixel.com/Shutterstock)

IDSconnect: The new digital event
platform of IDS

Facing the future together: With its digital tool called IDSconnect, the event organisers of Koelnmesse have stepped up their game to make IDS
2021 a successful event online as well as offline. (Video: Koelnmesse)

By Dental Tribune International
COLOGNE, Germany: In
2021, IDS is going hybrid, which
means that more participants
than ever before will attend
the largest trade show in the
dental industry from the
comfort of their homes and not
in person, owing to COVID-19
travel restrictions. To provide

a digital enhancement to the
classic physical event, the free
platform IDSconnect intends
to maintain IDS’s extensive
international reach together
with a successful on-site trade
fair experience.
At a trade fair or in dayto-day commercial business, a
company’s success is based on
three essential building blocks:

inspiration, interaction, and
business. IDSconnect provides
innovative opportunities for you
to reduce the effects of any current
deficit in these crucial elements.
Extensive features enable you to
reach more potential customers
easily, to experience trends
and lectures on-demand, and
to establish valuable contacts—
from anywhere in the world.

The experience starts in
the Lobby, where users find an
overview of all the features as
well as initial recommendations
for relevant contacts, exhibitors
and upcoming scheduled trade
fair items. Features include top
experts on stage presenting on
industry-relevant topics live
from Cologne or streaming
from locations throughout the

world. The IDS Main Stage is the
central platform for the official
event programme of IDS 2021.
This is where to find insight
and motivation in the many
presentations and official side
events. Let yourself be inspired
by the visionary programme.
The area Exhibitors and
Products
represents
the
exhibition hall. From there, users
have access to the booths of the
various exhibitors in so-called
Showrooms in which relevant
information about the exhibitor’s
company, products and services
will be provided. On the Product
Stage, exhibitors will present
product
innovations
and
highlights live to the audience.
Alternatively, these can be
watched later on demand.
At a Virtual Café, visitors,
exhibitors, top decision-makers,
purchasers, industry experts,
and
media
representatives
can come together to chat and
network. In terms of networking,
the Discovery Graph ensures
networking with new contacts
and achieving a direct exchange
of ideas via the communication
centre.

[4] =>

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09/21

Women in dentistry: Meet chemist and
awarded dental materials inventor
Dr. Sumita Mitra

Dr. Sumita Mitra has dedicated more than 30 years to the
development of dental materials. (Image: European Patent Office)

By Franziska Beier,
Dental Tribune International
As the second candidate for
a series portraying outstanding
women in dentistry, Dental
Tribune International (DTI)
interviewed
Dr.
Sumita
Mitra. During her career at
3M, she developed a unique
nanomaterial-based
dental
filler, for which she received the
European Inventor Award 2021.
This material and numerous
other inventions of hers in the
field of dental materials have
been patented. DTI spoke with
Mitra about how a bunch of
grapes inspired her research
efforts, about the greatest
advantages of her developed
material, and about how she
gives back to the next generation
of inventors.

University of Michigan in Ann
Arbor. After a year of postdoctoral work at Case Western Reserve
University in Cleveland in Ohio
I joined the 3M Corporate Research Laboratories in 1978 and
later moved to the 3M Dental
Products Division (now 3M Oral
Care) in 1983. There I held positions of increasing responsibility
and in 1998 was appointed corporate scientist, the highest technical position at 3M. I led the new
materials/products research and
development efforts until my retirement in 2010. From 1999 to
2010, I also served as the industrial director of the Minnesota
Dental Research Center for Biomaterials and Biomechanics at
the School of Dentistry at the
University of Minnesota in Minneapolis. Currently I am a partner at Mitra Chemical Consul-

ric is different from our skin. I learnt that the answer is in the molecules—it is chemistry that is the
central science that defines materials. I was so awestruck by the
subject that I made up my mind
to study chemistry in depth. I
would often visit my father in
his laboratory and peer over his
shoulders as he did his chemistry experiments. After I joined
the 3M company, I got an opportunity to join its Dental Products
Laboratory to develop new polymer matrices for dental composites. I jumped at that prospect and
spent most of my career there,
developing many new materials
technologies, including the development of nanotechnology
for use in dentistry.
You have developed a nanocomposite restorative material
(Filtek Supreme, 3M), that has
already been used for more than
1 billion tooth restorations.
How did you come up with the
idea of using nanotechnology?
Until the late 1990s dentists
wanting to perform natural-looking tooth repairs relied on a
combination of two separate materials. Microfills were esthetically pleasing but too weak to be
used for stress-bearing regions
of the incisal edges and for filling teeth in the posterior region
of the mouth. Less attractive hybrid and microhybrid composites were stronger, but lost their
shine and became rough from
brushing and chewing. This was
both inconvenient and expen“Everyone has the power
to become an innovator”

Fig 1: Dr. Mitra at the 3M Innovation Center in Minneapolis in
Minnesota in the U.S. (Image: European Patent Office)

Dr. Mitra, thank you for
agreeing to this interview.
Could you tell us something
about your background?
I grew up in India and had
my early education there. I did
my BSc at Presidency College in
Kolkata with chemistry honors.
After my MSc in chemistry in
India, I came to the U.S. and obtained a doctorate in organic/polymer chemistry in 1977 from the

ting, an independent consulting
firm, which I co-founded.
Why did you decide to go
into chemistry and how did you
become concerned with dental
materials?
From a very early age I was
fascinated by different materials.
I often wondered what makes
one material different from another—things like why paper is
different from wood, or why fab-

sive for dentists and their patients. So, we wanted to create one
material that would not only be
strong and durable but also have
the long-lasting lustrous beauty
of natural teeth.
I realized that the key problem was that the existing filler
technology used to reinforce dental composites had limitations.
Around that time, nanotechnology was an emerging science.
I hypothesized that developing
nanoparticle technology for use
as dental fillers could allay most
of the problems and afford us a
universal filling material. This is
because nanoparticles are much
smaller in size than the wavelength of light and thus could
provide unique esthetic properties. In addition, nanoparticles

had the potential of providing
mechanically strong materials.
With this idea, and with the help
of a team of 3M scientists, I set
about the task of developing suitable nanofillers and incorporating them into a resin matrix to
generate nanocomposites with
superior characteristics.
Our initial approach was to
make tiny nanoparticles of several sizes, but this approach was
disappointing since it did not

set out to do, with the help of the
excellent team at 3M.
The end result of all that hard
work is the universal filling material 3M Filtek Supreme. Since
the original material was introduced in 2002, several updates
have been made and a family of
Filtek products has been introduced for the benefit of dentists
and their patients.
Would you please explain
how the material works exac-

Fig 2: Together with scientists at 3M, Dr. Mitra invented the nanobased filling material Filtek Supreme. (Image: European Patent Office)

provide all the desirable characteristics, especially the required rheology or handling properties needed by dentists. I realized that this was because we
needed nanoparticles of a wide
size distribution to get packing
efficiency in the composite. It
sounds simple but was not easy
to achieve with the initial nanoparticles.
The decisive idea for the material was inspired by a particular fruit. Could you tell us more
about this?
The breakthrough moment
came as I was looking at a cluster
of grapes in a bowl. If one observes a bunch of grapes, there are
grapes of different sizes, some
small and some large, with the
small ones fitting in between
the gaps created by the large
ones, leading to optimum use of
space. Also, the sizes of the bunches can vary greatly—there can
be clusters of five, 20 or 100 grapes, and so on. If one or two individual grapes are plucked out,
the overall cluster doesn’t change that much. My theory was
that we could first assemble the
nanoparticles into nanoclusters
of wide size distribution and
then combine them with individual nanomeric particles to fill
any voids to provide a synergistic mix that could then be incorporated in a dental resin to create the composite. This is what I

tly and what some of its greatest advantages for dentists and
their patients are?
The 3M Filtek Supreme product is an uncured composite
paste, which comes in a number
of shades that make it possible to
exactly match the patients’ dentition. After using a dental adhesive, the dentist places the composite and shapes it according
to the required anatomy, finally
curing it in place by a short exposure to blue light. The greatest
advantage is that the material is
very versatile and can be used in
all areas of the mouth—anterior,
posterior, and on incisal or molar
surfaces. It is highly esthetic and
has the shine and opalescence
of a natural tooth. It is extre-

Fig 3: Dr. Mitra loves art and
enjoys painting with
watercolors in her free time.
(Image: European Patent Office)

[5] =>

News

mely durable and withstands the
forces of chewing and brushing
without losing its shine for a long
time. Dentists all over the world
have expressed their enthusiasm
and shared examples of their
work, which is very gratifying.
Your material has been patented. Aside from this product,
do you hold any other patents
for dental applications?
I hold 100 U.S. patents, 58 European patents and their corresponding equivalents in other
countries. The majority of my patents are in the area of dental materials.
You have been awarded and
honored many times, including
being inducted into the U.S. National Inventors Hall of Fame in
2018. Only recently, you won
the European Inventor Award
2021—in the category Non-Eu-

09/21

ropean Patent Office countries.
Congratulations! How meaningful are these awards to you?
I feel greatly honored to be
recognized by organizations
like the National Inventors Hall
of Fame, the American Chemical Society and many others, including most recently the European Patent Office for this invention. It is quite humbling to
be included in the same league
as so many well-known inventors whose work has greatly benefited society. This type of recognition validates the importance
of the scientific contributions
of scientists and increases public awareness of the pivotal role
that science and technology play
for the advancement of society.
Another important aspect is that
the award creates role models for
aspiring scientists who pursue
careers in science, technology,
engineering and mathematics

(STEM)-related fields. Furthermore, awards like these give a
voice to science and help in influencing greater funding for scientific research and policymaking.
In your opinion, what are
the essential characteristics that
a person needs in order to start
an innovation?
Basically, it is a combination
of curiosity, exploration and imagination. Of course, you need
a scientific training, but above
all, you have to try new ways of
doing things—a way that is more
convenient and or easier. The
other thing is to have passion
coupled with persistence. The
first attempts may not be successful, but failures should never discourage us. They only show us
that there is another pathway toward achieving a goal.

How do you inspire young
people and what would you tell
the next generation of potential
innovators?
After my retirement, I have
spent many hours volunteering
and teaching at a number of
local organizations, encouraging
STEM education at all levels, primary school to postgraduate. It is
a way for me to give back to society for all the opportunities I
have had.
Everyone has the power to become an innovator. The important thing is to understand that a
solid foundation in STEM-related fields gives young people the
toolset to unleash their creativity
and design better approaches to
improving the well-being of society. I always tell young people,
“Believe in yourself, seek help
when needed, and never give
up.”

Nanorobots will prevent root
canal treatment failures

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PUBLISHER & CHIEF EXECUTIVE
OFFICER
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CHIEF CONTENT OFFICER
Claudia DUSCHEK
DENTAL TRIBUNE SOUTH ASIA
EDITION
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Ruumi J. DARUWALLA
CHIEF EDITOR
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CLINICAL EDITOR
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Nanosized robots will traverse the slender dentinal tubules and target the hard-to-reach bacteria. (Photo:
canva)

By Rajeev Chitguppi,
Dental Tribune South Asia
An indigenously developed
nanorobotic technology will
deploy
nanosized
robots
that will traverse the slender
dentinal tubules and target
the hard-to-reach bacteria,
primarily responsible for the
root canal treatment failures
Many root canal treatment
cases fail due to incomplete
debridement
of
certain
pathogenic bacteria - inaccessible
to instrumentation due to
their deep location inside the
dentinal tubules. Researchers,
including those from the Indian

Institute of Science (IISc),
Bengaluru,
have
developed
nanorobotic technology to solve
this problem. The technology
involves nanosized robots that
will traverse the slender dentinal
tubules and target the hard-toreach bacteria.
What are these nanorobots?
They are spiral silica nanobots
with iron embedded in them.
Less than 300 nanometers in
dimension, they are suspended in
water or water-like biocompatible
medium. Compare their size
with dentinal tubules that are a
few microns wide. There can be
about a billion nanorobots in as

little as 0.5 ml of water. Moreover,
the amount of silica used in the
nanorobots will be so negligible
that it can be considered harmless
for the human body.
How do these nanorobots
work?
The nanorobots are injected
into the root canal, and a rotating
magnetic field is applied. Since
the nanorobots contain magnetic
material, they follow the applied
magnetic field and move into the
dentinal tubule.
Once they reach a colony of
bacteria, such as Enterococcus
faecalis, which are antibiotic-

resistant, the nanorobots deploy
various antibacterial strategies.
Current status
Once this technology clears
the ongoing regulatory tests for
drug compliance, it will enter
animal trials.
Theranautilus, one of the first
nanorobotics companies globally,
will market this nanorobotic
technology. The company has
won this year‘s national award
for technology development and
successful
commercialization
of indigenous technology an award conferred by the
Technology Development Board,
Government of India every year.

Dental Tribune International GmbH
makes every effort to report clinical
information and manufacturers’
product news accurately but
cannot assume responsibility for
the validity of product claims or for
typographical errors. The publisher
also does not assume responsibility
for product names, claims or
statements made by advertisers.
Opinions expressed by authors are
their own and may not reflect those
of Dental Tribune International
GmbH.

[6] =>

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09/21

Why emotional intelligence in dentistry is
a vital skill

Studies have shown that emotionally intelligent people are more
likely to be successful in both their personal and professional lives.
(Image: inimalGraphic/Shutterstock)

By Dental Tribune International
LEIPZIG,
Germany:
Emotional intelligence (EI)
relates to the ways in which
an individual can understand
and manage his or her own
needs as well as recognise and
deal with the needs of others
and the abilities to do this. As
a dental professional, these
are important skills to have
because every activity during
a treatment process requires
connecting emotionally with
patients, and those who can put
their EI into practice effectively
will be more successful in the
long run.
Even
though
dental
professionals work with people
all day, they are not necessarily
the best at doing so and often

lack EI. For example, a study,
titled “Emotional intelligence
among dental undergraduate
students: An indispensable and
ignored aspect in dentistry”,
showed that only 11.55% of
186 undergraduate dentistry
students who were questioned in
a survey had good EI. In a paper
on the topic, author Dr Mohlab
Al-Sammarraie stated that, as
a dentist having many years of
leadership experience, he believes
“that sustainable progress of
the profession depends on the
ability of all dentists to strike a
balance between meeting the
emotional needs of the patients
and adequately performing the
required operational techniques”.
Is trying to increase one’s
knowledge a waste of time?

What
Al-Sammarraie
is referring to here is the
combination of EI and intelligence
quotient (IQ). This relationship
has been extensively established,
and studies have shown that IQ
correlates with cognitive control
abilities. In summary, research
suggests that EI matters more
than technical competence when
it comes to being a successful
manager, that individuals with
better social skills make better
decisions and that the return
of investment on working to
improve EI is far higher than
that for working to increase one’s
knowledge.
This might be a hard pill to
swallow for practitioners who
love to refine their operative
techniques (or whatever their aim
might be) to utmost perfection.
In fact, those technical skills
are worth very little when they
cannot be put into practice
because dentists cannot connect
with their patients emotionally
and continuously encounter
frustrating recurring leadership
and staff problems.
EI is central to success
The good news is that EI can
be learned. EI is described as
the existence of four dominant
behavioural traits called selfawareness, social awareness,
self-management and the ability
to manage relationships. The

following paragraphs investigate
each characteristic and consider
some tips as to how those traits
can be translated into everyday
work life at a dental practice.
1.
Self-awareness
Self-awareness
is
the
foundation for being a good
leader, but it requires selfreflection. Assessing oneself
objectively daily can be a good
way to understand strengths and
weaknesses that were shown in
certain situations throughout the
day. Asking trusted co-workers
to describe oneself can also be a
good source of insight. Another
great tip is to keep a journal
where goals, plans and priorities
can be written down for future
reference.
2.
Social awareness
To be more socially aware and,
essentially, a better leader, it helps
to practise some observational
skills which include learning
to understand what it means to
truly listen to others. In order
to do that, it is essential to pay
attention to other people’s tone
of voice, watch facial expressions
and body language, develop a
feeling for the general mood in
the office, and try to notice the
fine details which can make a
considerable difference.
3.
Self-management
Often before someone has
the capability to concentrate on

others and pay attention to the
seemingly subtle things that
happen in a practice, he or she
needs to gain control of his or
her own workload. Planning
for each workday and coming
to meetings prepared can make
a big difference and provide a
feeling of control. Another great
way to practise self-management
is to set a goal, focus the attention
on this one task, reflect on the
task and then, mindfully, move
on.
4.
Ability
to
manage
relationships
All
these
tips
should
ultimately help to improve
relationships
around
the
workplace because people who
work on themselves develop a
better understanding of what is
going on inside the heads of the
people around them. To deepen
connections with co-workers, it is
important to identify relationship
needs,
manage
boundaries,
appreciate others and schedule
time to build relationships.
Essentially, the reason why EI
is central to one’s success is that
more real-world problems can be
solved with people skills rather
than with pure intelligence.
Luckily, everyday life has many
situations in store where all four
dominant behavioural traits can
be practised.

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[7] =>

7

News

09/21

Worrisome level of vaccine hesitancy
found among dental students

Researchers have found that an alarming number of dental students
either rejected or were hesitant about taking a COVID-19 vaccine,
and that hesitation or disagreement was more likely among dental
students who lived in low- and lower-middle-income countries.
(Image: G.Tbov/Shutterstock)

By Dr. Jeremy Booth,
Dental Tribune International
BRNO, Czech Republic: A
study of the attitudes of dental students around the world
towards COVID-19 vaccines
found that 22.5% were hesitant
and 13.9% rejected the vaccines outright. The researchers
found that acceptancy of vaccines among dental students was
suboptimal owing to a range of
factors, such as socio-economic
contexts, and they called for a
greater focus on infectious disease epidemiology education
within undergraduate dental
curricula.
The
researchers—from
a
number
of
universities
across Europe and from one
in Palestine—liaised with the
scientific committee of the
International Association of
Dental Students (IADS) and
collected data through IADS
member organisations. In total,
6,639 dental students from
22 countries responded to a
questionnaire that aimed to
assess personal acceptance levels
of COVID-19 vaccines and the
factors that influenced these
levels.
The researchers found that
7.4% of the students completely
disagreed with taking a COVID19 vaccine, that 6.5% disagreed
and that 22.5% were hesitant. Of
the respondents, 22.5% expressed
agreement with being vaccinated
and 41.0% totally agreed.
The socio-economic status
of the countries where the
students lived and studied
was found to have a significant
influence on vaccine acceptancy.
Of the respondents in low- and
lower-middle-income countries
(LLMIC), 30.4% were hesitant,
compared with 19.8% in uppermiddleand
high-income
countries (UMHIC).
Vaccine
hesitancy
was
reported by 37.5% of respondents

in low-income countries (LIC),
by 27.8% in lower-middle-income
countries (LMIC), by 25.2% in
upper-middle-income countries
(UMIC) and by 11.1% in highincome countries (HIC). The
lowest percentage of resistance
to COVID-19 vaccines (7.3%) was
reported by respondents in HIC,
and the highest percentage of
resistance (18.6%) was reported
by those in LIC.
Media reports, social media
and trust in governments
influence vaccine hesitancy

percentage of dental students
in LLMIC were influenced
by information provided by
celebrities and religious and
political leaders (21.3%) compared
with those in UMHIC (14.5%).
More students in UMHIC
were found to have confidence in
governments and pharmaceutical
companies (37.9% and 51.0%,
respectively) compared with their
peers in LLMIC (27.1% and 37.0%,
respectively). Dental students in
LLMIC were more likely to agree
with those in their communities
who rejected COVID-19 vaccines
based on religious and cultural
values compared with students
in UMHIC (18.0% versus 10.9%).
Among
respondents
in
LLMIC, 38.1% said that they
considered other methods to be
more effective than vaccination
in preventing the disease,
compared with 22.4% of students
in UMHIC.
More students in UMHIC
were confident that they had
enough information about the
vaccines compared with those in
LLMIC (33.1% versus 27.0%), the
study found.

The researchers stressed the importance of vaccine acceptancy
among dental students as representatives of the global healthcare
student population. (Image: Photographee.eu/Shutterstock)

The researchers assessed
factors that influenced vaccinerelated attitudes among the
respondents as outlined by the
World Health Organization
Strategic Advisory Group of
Experts on Immunization. These
were sources of information
relating to COVID-19 vaccines,
levels of trust in governments
and pharmaceutical companies,
and religious and cultural beliefs.
They also assessed individual
factors, such as confidence in
access to information and belief
that the body’s immune response
would be sufficient to ward off
the disease.
According to the study, more
dental students in LLMIC (42.0%)
were influenced by information
that they received through media
reports and posts on social media
compared with those in UMHIC
(30.4%). Furthermore, a higher

“Mistrust of governments
and
the
pharmaceutical
industry was also found to
have a significant impact
on the attitudes of dental
students towards COVID-19
vaccination”

Dr Huthaifa Abdul Qader,
vice president of science and
research at IADS and one of
the researchers who worked on
the study, explained to Dental
Tribune International (DTI):
“We found that socio-economic
context
was
significantly
associated with dental students’
vaccine hesitancy. The media,
social media and insufficient
knowledge about vaccine safety
were barriers to vaccination.
Mistrust of governments and
the pharmaceutical industry was
also found to have a significant

According to the study, more than 38% of dental students who live in
low- and lower-middle-income countries said that they considered
other methods to be more effective than vaccination in preventing
COVID-19. (Image: Joe McUbed/Shutterstock)

impact on the attitudes of dental
students towards COVID-19
vaccination.”
Call for more epidemiology
training
in
undergraduate
dental curricula
In discussing the findings,
the researchers stressed the
importance of vaccine acceptancy
among dental students. They
wrote: “As representatives of the
healthcare student population,
dental students have a crucial
role in disseminating robust
information
about
COVID19 vaccines’ effectiveness and
safety. This social role is backed
by the prevailing evidence
on healthcare professionals’
impact on shaping public
opinion regarding health issues,
including vaccination.”
Abdul Qader told DTI that
“low levels of perceived risk
of morbidity and mortality of
COVID-19 have led to a fluctuation
of
the
COVID-19
vaccine
acceptance levels within the
dental student community”. He
added that, amid the pandemic,
dental students worldwide have
been placed under pressure to
return to their clinical training
in order to complete their studies.
“This has acutely generated a
sense of indifference towards
COVID-19 vaccination and a
lack of individual accountability
among them,” Abdul Qader said.
The study called for greater
implementation of infectious
disease epidemiology education
within undergraduate curricula.
When asked what the first steps
would be to implementing this,
Abdul Qader said that IADS had
already began collaborating with
institutions and associations
with the aim of raising awareness
about the topic, such as through
on-campus
campaigns.
“This would be the onset of
consolidated efforts to kick
off the required procedures to
integrate educational modules
into dental education. Thus far,

we have presented our study
to the Association for Dental
Education in Europe and are
in talks with the International
Vaccine Institute,” Abdul Qader
explained.
He added: “Several studies
have shown that the rate of
infectious disease has decreased
in high-income countries in
the past 50 years, which has
caused a diminished focus
on their incorporation into
dental education and a surge
of education concerning noncommunicable disease. We have
suggested in our study revival in
“Several studies have
shown that the rate of
infectious
disease
has
decreased in high-income
countries in the past 50
years, which has caused a
diminished focus on their
incorporation into dental
education”

dental curricula of knowledge of
infectious disease and the way
vaccine cascades react in the
human body in order to cultivate
future healthcare professionals
with robust vaccine-pertinent
backgrounds and lower hesitancy
levels.”
The sample group was
representative of students from
dental faculties in all world
regions. The target population
of the study was undergraduate
students; however, those in their
compulsory training year and
those who had graduated in the
12 months prior to the study were
also included. The mean age of
the respondents was around 22
years, and the majority (70.5%)
were female, in the clinical years
of their education (66.8%) and
from UMIC (45.7%).
The study, titled “Global
prevalence and drivers of dental
students’ COVID-19 vaccine
hesitancy”, was published online
on 29 May 2021 in Vaccines.

[8] =>

7 News

7/19

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Does soft tissue augmentation hold up long term? Clinical tips from the past decade / News

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