Clinical Practices and Attitudes of Dental Practitioners in Managing Alveolar Osteitis: A Cross-Sectional Survey in Yemen

Abstract

Background Alveolar osteitis (AO) is a common and challenging complication after tooth extraction, with significant variability in clinical practices despite existing guidelines. This study evaluated the practices and attitudes of dental practitioners regarding AO prevention and management and identified factors associated with evidence-based preventive practices in Sana’a, Yemen. Methods A cross-sectional survey was conducted among 412 dental practitioners using a validated questionnaire. Data on demographic characteristics, preventive and management practices, and attitudes were collected. The composite prevention practice score (PS), evidence-based management score (EBMS), and non-evidence-based practice score (NEPS) demonstrated good reliability (Cronbach’s α = 0.73–0.84). Descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s chi-square test, and multivariable logistic regression were performed. Statistical significance was set at p < 0.05. Results The sample was predominantly young (56.8% aged 24–29 years), male (63.1%), and in early career (47.3% with <5 years’ experience). The mean composite scores were as follows: PS, 4.09 ± 0.63; EBMS, 4.17 ± 0.67; and NEPS, 2.77 ± 0.89. Notably, 17.2% of dental practitioners “always” prescribed routine antibiotic prophylaxis, and 25.5% “always” performed additional curettage. Independent predictors of high prevention practices (defined as PS ≥ median 4.13) included 11–15 years of practice (aOR = 1.87, 95% CI: 1.01–3.46), >20 extractions weekly (aOR = 2.44, 95% CI: 1.10–5.41), frequent surgical extractions (aOR = 1.98, 95% CI: 1.10–3.57), continuing education (aOR = 2.19, 95% CI: 1.32–3.63), positive feasibility attitudes (aOR = 1.55, 95% CI: 1.17–2.06), and greater confidence (aOR = 1.41, 95% CI: 1.07–1.87). Conclusion Dental practitioners in Sana’a, Yemen, demonstrate moderate-to-good adherence to evidence-based AO care, but a minority employ non-evidence-based practices, particularly routine antibiotics and curettage. Continuing education, positive attitudes, and confidence are associated with better practices. Given the cross-sectional design, causal inferences are precluded. These findings support targeted educational interventions, with interventional studies needed to confirm their effectiveness.