Managing dental caries in children in Saudi Arabia

This paper describes oral health among children in Saudi Arabia, the dental health system in the country, and some possible solutions and recommendations to improve the oral health status.     

A systematic review of population-based dental caries studies among children in Saudi Arabia

ObjectiveDental caries critically impacts the health and development of children. Understanding caries experience is an important task for Saudi Arabian policymakers to identify intervention targets and improve oral health. The purpose of this review is to analyze current data to assess the nationwide prevalence and severity of caries in children, to identify gaps in baseline information, and to determine areas for future research.MethodsA search of published and unpublished studies in PubMed, Google, and local Saudi medical and dental journals was conducted for the three keywords “dental,” “caries,” and “Saudi Arabia.” The inclusion criteria required that the articles were population-based studies that assessed the prevalence of dental caries in healthy children attending regular schools using a cross-sectional study design of a random sample.Results/discussionThe review was comprised of one unpublished thesis and 27 published surveys of childhood caries in Saudi Arabia. The earliest study was published in 1988 and the most recent was published in 2010. There is a lack of representative data on the prevalence of dental caries among the whole Saudi Arabian population. The national prevalence of dental caries and its severity in children in Saudi Arabia was estimated to be approximately 80% for the primary dentition with a mean dmft of 5.0 and approximately 70% for children’s permanent dentition with a mean DMFT score of 3.5. The current estimates indicate that the World Health Organization (WHO) 2000 goals are still unmet for Saudi Arabian children.ConclusionChildhood dental caries is a serious dental public health problem that warrants the immediate attention of the government and the dental profession officials in Saudi Arabia. Baseline data on oral health and a good understanding of dental caries determinants are necessary for setting appropriate oral health goals. Without the ability to describe the current situation, it is not possible to identify whether progress is being made toward these goals. A roadmap with a clear starting point, destination, and pathway is a desperately needed tool to improve the oral health of Saudi Arabian children.     

Periodontal disease prevalence and dental needs among schoolchildren in Saudi Arabia

Abstract The study population consisted of 1174 intermediate Saudi schoolchildren; 601 girls and 573 boys, aged 13, 14 and 15 years. Periodontal disease was assessed by the method recommended by WHO and data were computerized by using IBM 3033, SAS package. Boys had significantly higher debris, calculus deposits and intense gingivitis counts than girls by sex and age. But for advanced periodontal involvement, the result shows no significant differences by sex and age. There was a position correlation between debris, calculus and periodontal diseases There was a highly significant difference between girls and boys. The results of this study suggest the need for an oral health program for the entire community.     

Dental fluorosis prevalence in Saudi Arabia

AimIn order to improve the understanding of dental fluorosis prevalence in Saudi Arabia and have a good idea of the quality of the studies that have been conducted, a systematic review was conducted to evaluate the prevalence of dental fluorosis among people who live in Saudi Arabia.MethodsOnline databases EMBASE and MEDLINE and the Cochrane Library were searched, without any restriction regarding age. In addition, there were no study design filters applied to the search engine. Study selection and data extraction were conducted in duplicate. Studies were included if they were conducted in Saudi Arabia on any population (adults and children) and collected dental fluorosis data. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies. A narrative synthesis was conducted.ResultsSeven cross-sectional studies were identified. Areas of weakness in study design/conduct were low response rates, and identification and handling of confounding factors. Statistical pooling of data was not appropriate due to substantial heterogeneity, due in part to variation in sample size, variation of water fluoridation concentration, index used, targeted population and age group. Seven studies present dental fluorosis at any level. The proportion of dental fluorosis prevalence at any level ranged from 0.00 to 0.91. Six studies explored the prevalence of dental fluorosis of aesthetic-only level of concern. The proportion of dental fluorosis in this category ranged from 0.07 to 0.76.ConclusionThe proportion of dental fluorosis at any level ranged from 0.00 to 0.91 and fluorosis at aesthetics level ranged from 0.07 to 0.76. However, current data does not provide a complete assessment of dental fluorosis across Saudi Arabia. Existing studies are limited in terms of the population covered. The included studies had methodological flaws.     

Role of community pharmacists in providing oral health advice in the Eastern province of Saudi Arabia

Objective

To determine the frequency of patients seeking oral health advice and willingness of community pharmacists to provide oral health information in the Eastern Province of Saudi Arabia.

Association between body mass index and dental caries in the Kingdom of Saudi Arabia: Systematic review

ObjectiveThe Kingdom of Saudi Arabia (KSA) has one of the highest prevalence of both obesity and dental caries. To date, there has not been any documented evidence linking these two factors. Therefore, the objective was to conduct a systematic review of published studies that have analysed the association between body mass index and dental caries in the KSA for both children and adults.MethodsA systematic database search [PubMed, EMBASE, Web of Science, CINAHL and Cochrane Library] was conducted following the PRISMA guidelines. The inclusion criteria were observational studies, with no limit on the publication date. Search terms included: dental caries, obesity, overweight, body mass index, BMI ‘AND’ Saudi Arabia. The independent variable was body mass index (BMI), and the primary outcome measure was dental caries prevalence and severity.ResultsFrom 951 search results, 935 citations were identified and excluded. Of the 16 potentially eligible studies, two citations were excluded, because the studies did not meet the inclusion criteria. This left fourteen studies meeting the criteria to be included in this systematic review. Ten studies outlined children, and four studies assessed adults. For children, two studies resulted in a positive association between high BMI and caries, six studies resulted in a negative association, and two studies had a non-significant association. For adults, two studies resulted in a positive association between high BMI and dental caries, and two studies had a non-significant association. These were rated as having low to moderate risk of bias.ConclusionAs a result of this equivocal outcome within the systematic review, body mass index and dental caries present as a complex association. Further long-term studies are required to translate the findings into clinical practice.     

A survey of root canal treatment of molar teeth by general dental practitioners in private practice in Saudi Arabia

The purpose of this study was to evaluate the practice and depth of knowledge of root canal treatment by general dental practitioners working in private dental centers in different cities within the Kingdom of Saudi Arabia. A questionnaire was distributed to 400 general dental practitioners. Completed questionnaires were analyzed in term of simple summary statistics. A total of 252 (63%) practitioners responded. The majority of the respondents were Syrians (59%) and Egyptians (32%). Ninety-one per cent of the respondents indicated that they performed root canal treatment. Amongst those who carried out root canal treatment, only seven practitioners (3%) used rubber dam for isolation. More than half of the respondents (55%) used saline to irrigate canals during treatment. Forty-six per cent of practitioners used formocresol as an inter appointment medicament. The standardized and step-back preparation techniques were the method of choice for the majority of the respondents (91%). Ninety-seven per cent of the practitioners used stainless steel hand instruments to prepare root canals and the majority (92%) used gutta-percha for obturation. Seventy-four per cent of the respondent used cold lateral condensation. The average number of radiographs routinely taken for root canal treatment was four. Ninety-three per cent indicated that they usually completed a root canal treatment of molar teeth in three or more visits. Eighty-eight per cent of the practitioners preferred waiting for 1 or 2 weeks to restore the teeth permanently. Results of this study confirm that many general dental practitioners are not following quality guidelines for endodontic treatment.     

Need for dental care drives utilisation of dental services among children in Saudi Arabia

Objectives: This study used Andersen’s predisposing, enabling and need behavioural model to predict factors that influence utilisation of oral health services for children in Saudi Arabia. Methods: The model was tested in a random sample of parents of third- and eighth-grade children in Jeddah (n = 1,668) using the access to care questionnaire adapted from the Basic Screening Survey. Predisposing (sex, parent education, nationality); enabling (school type, family income, government financial support, health insurance); and need for dental care (examined or perceived) were modelled to assess children’s use of dental services. Univariate and multivariate logistic regression models were conducted. Significant findings were reported at P ≤ 0.05. Results: About 84% of parents responded to our questionnaire (n = 1,397). One in four children have never visited a dentist. Our findings indicate that need and predisposing factors explained oral health services’ use among younger children, whereas need, predisposing and enabling factors predicted use of services among older children. Perceived barriers to dental care for children who never went to a dentist and for those who needed dental care and could not get it included oral health illiteracy (82.3%, 49.7%), dentist-related (19.9%, 42.1%), financial (22.8%, 37.1%) and transportation (9.8%, 20.8%), respectively. Conclusions: The need for dental care, predominantly for illness-related dental care, drives utilisation of dental health services among children in Saudi Arabia. Enhancing oral health literacy and mitigating organisational and financial barriers to dental care for families will increase children’s access to quality oral healthcare, and promote better oral health practices and outcomes.Key words: Utilisation, oral health services, oral health literacy, children, Basic Screening Survey, Saudi Arabia     

Women in dentistry: A perspective on major universities in Saudi Arabia. Part 1: Historical background

As the works of females have been present in many fields of our lives, the history mentions little trace of these facts. The field of dentistry was among these professions. This paper will review the presence of dental practice by women world wide and will present a review of dentistry in Saudi Arabia.     

Assessment of knowledge and attitude toward stem cells and their implications in dentistry among recent graduates of dental schools in Saudi Arabia

Background

To evaluate the knowledge and attitude level of recent dental graduates in Saudi Arabia toward stem cells and their potential therapeutic applications.

社区口腔健康教育对居民口腔菌斑控制的影响

目的 探讨社区口腔健康教育对居民口腔菌斑控制的影响.方法 对237例在社区健康服务中心口腔科就诊的患者,在实施个性化口腔健康教育前后,就口腔健康知识、态度、行为等进行问卷调查,检查口腔菌斑控制情况,并对结果进行统计学分析.结果 237例社区居民患者在实施口腔健康教育前各项口腔健康知识知晓率均在68％以下,且在态度上不够重视,口腔保健行为不规范.经个性化的社区口腔健康教育后,237例患者的口腔健康知识知晓率、口腔保健态度和行为均有明显改善,差异有统计学意义(P＞0.05).237例患者实施口腔健康教育1年后的菌斑指数为1.61±0.21,明显低于实施教育前的2.12±0.31,差异有统计学意义(P＜0.05).结论 个性化社区口腔健康教育模式能够明显提高社区居民的口腔健康知识知晓率、改善其口腔保健态度和行为,改善口腔菌斑控制情况,具有较大的推广价值.     

The assessment of dental caries for public health purposes

ABSTRACT – The results of an evaluation of the W.H.O. recommendations for the assessment of dental caries confirmed that the method and the criteria are satisfactory. Attention is drawn to the limitations of df and DMF indices for predicting requirements for dental treatment, and the efficacy of a simple system for collecting information on requirements for care is described.     

An assessment of the dental public health infrastructure in the United States

OBJECTIVES: The National Institute of Dental and Craniofacial Research commissioned an assessment of the dental public health infrastructure in the United States as a first step toward ensuring its adequacy. This study examined several elements of the U.S. dental public health infrastructure in government, education, workforce, and regulatory issues, focused primarily at the state level. METHODS: Data were drawn from a wide range of sources, including original surveys, analysis of existing databases, and compilation of publicly available information. RESULTS: In 2002, 72.5% of states had a full-time dental director and 65% of state dental programs had total budgets of 1 million dollars or less. Among U.S. dental schools, 68% had a dental public health academic unit. Twelve and a half percent of dental schools and 64.3% of dental hygiene programs had no faculty member with a public health degree. Among schools of public health, 15% offered a graduate degree in a dental public health concentration area, and 60% had no faculty member with a dental or dental hygiene degree. There were 141 active diplomates of the American Board of Dental Public Health as of February 2001; 15% worked for state, county, or local governments. In May 2003, there were 640 U.S. members of the American Association of Public Health Dentistry with few members in most states. In 2002, 544 American Dental Association members reported their specialty as Dental Public Health, which ranged from 0 in five states to 41 in California. Just two states had a public health dentist on their dental licensing boards. CONCLUSIONS: Findings suggest the U.S. dental public health workforce is small, most state programs have scant funding, the field has minimal presence in academia, and dental public health has little role in the regulation of dentistry and dental hygiene. Successful efforts to enhance the many aspects of the U.S. dental public health infrastructure will require substantial collaboration among many diverse partners.     

Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia

MATERIAL AND METHODS: Dental examinations were carried out on 354 boys aged 5-6 years, and 862 boys aged 12-14 years, attending 40 schools in Riyadh. The prevalence of dental erosion was assessed using diagnostic criteria similar to those employed in the 1993 UK National Survey of Child Dental Health. RESULTS: Pronounced dental erosion (into dentine or dentine and pulp) was observed in 34% of 5-6 year olds and 26% of 12-14 year olds. Information on food and drink consumed and dietary habits was obtained by means of a questionnaire. Parents reported that 65% of 5-6 year old boys took a drink to bed. Water was the commonest drink consumed (37%) followed by carbonated soft drinks (21%). One third of parents reported that their son had something to eat in bed or during the night and 60% of this was sweet food or confectionery. Seventy per cent of 12-14 year old boys reported consuming drinks at night; these were mainly water (30%), carbonated soft drinks (27%) and tea or coffee, with sugar (18%). Forty-six per cent of the 12-14 year olds reported that they ate in bed at least once a week and 54% of this was sweet food or confectionery. When the dental examination and questionnaire results were correlated, a statistically significant relationship was found between the number of primary maxillary incisors with pronounced erosion of their palatal surfaces and the consumption of carbonated soft drinks at night (P=0.015). A significant relationship was also found between the number of permanent maxillary incisors with pronounced erosion on their palatal surfaces and the frequency of drinks at night (P=0.020), as well as the duration of drinks retained in the mouth (P=0.038). CONCLUSION: It is concluded that dental erosion is more common in the primary and permanent dentitions of Saudi Arabian boys compared with results for similar age groups from the United Kingdom.     

Public awareness of forensic odontology and willingness to enroll in a prospective dental registry: A survey conducted in Saudi Arabia

BackgroundThe establishment of a national dental registry provides a great opportunity for the healthcare and criminal investigation systems. Its feasibility would rely mainly upon public knowledge and a willingness to contribute dental profiles. The aim of this study was to evaluate the level of awareness among the Saudi public of forensic odontology and to evaluate their willingness to participate in a prospective national dental registry.MethodsA cross-sectional survey based on a self-administered survey questionnaire was conducted in 2018 at the Al-Janadriyah National Festival in Riyadh, Saudi Arabia. Visitors were questioned about their demographic data and responded to 20 knowledge statements using the alternatives “correct”, “incorrect”, or “don’t know”. Their perception towards registries was assessed using 15 statements and a 5-point Likert scale. The percentage mean score (PMS) of knowledge, the mean positive response rate (MPRR) of participant perception, and their willingness to participate in a prospective dental registry were assessed with respect to their demographic characteristics.ResultsComplete surveys were received from 812 study participants (85.5% response rate). The PMS ± standard deviation of knowledge was 39.8 ± 22.5 and the MPRR of perception was 64.7 ± 25.5. More than two-thirds of the responders (n = 548, 67.5%) indicated a willingness to register in a future national dental registry. Differences in knowledge were identified with regard to sex, marital status, education, and occupation, while differences in perception and willingness to enroll were influenced by sex. After adjustment for possible confounders, female participants and employed participants were 1.7 times (95% confidence interval [CI] = 1.2–2.4) and 1.6 times [95% CI = 1.1–2.5] more likely to enroll in the proposed registry (P = 0.004 and P = 0.03, respectively). Higher knowledge and perception scores were associated with more willingness to enroll in the national dental registry (adjusted [adj.] P = 0.03 and adj. P < 0.001, respectively).ConclusionsA future national dental registry in Saudi Arabia is expected to be well-received by the public. An improvement in the public’s knowledge regarding the importance of forensic dentistry is expected to encourage their active enrollment in such a registry. Although women and employed participants were more willing to enroll, it is too early to predict the rates of participation, given the fact that nationwide marketing surveys have yet to be launched.     

Impact of international collaboration on dentistry related papers published in Kingdom of Saudi Arabia

ObjectiveThis bibliographic analysis was designed to review all dental publications in the Kingdom of Saudi Arabia (KSA) and evaluate the effect of international collaboration on the impact of published articles.MethodsThe Web of Science (WOS) database was used to extract all related published articles in the KSA from 1982 to 2021. The keywords were connected using Boolean Operators to download related articles. Downloaded articles were screened according to the following inclusion criteria: collaboration journal category, journal discipline, number of citations, number of authors, and impact factor. After applying the inclusion criteria and excluding single-author articles, 5,689 documents were included in the final analysis. The chi-square test and two-independent samples t-test were used to determine the statistical significance between the variables.ResultsA significantly higher proportion of articles with international collaboration (51.4%) were published in dental journals than those published nationally (43.3%) or within the institutional level (41.8%) (P < 0.0001). In addition, the average number of citations (9.28 ± 23.8) ranged from 0 to 749, received by an article and the impact factor of the journal in which the article was published, significantly higher in the case of internationally collaborative work compared with national or within institutional collaboration (P < 0.0001).ConclusionInternational collaboration positively affected the impact factor, number of citations, and quartile rank of published articles. Moreover, the number of co-authors in different countries contributes to the international collaboration effect.