Prevalence of dental caries in primary and permanent teeth and its relation with tooth brushing habits among schoolchildren in Eastern Saudi Arabia‬‬‬‬‬‬‬‬

A Systematic Review and Meta-Analysis of the Prevalence of Dental Caries in the Permanent Teeth of Arab Children

Despite the global prevalence of dental caries, there is a paucity of comprehensive data on the extent of this issue among children in the Arab region. This systematic review and meta-analysis aimed to evaluate the prevalence of dental caries and the associated Decayed, Missing, and Filled Teeth (DMFT) indices in permanent teeth among children from 4 to under 18 years of age in the Arab region. A comprehensive review of various studies was conducted. Studies were searched across eight different electronic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. The random effects (RE) model was used for analysis, allowing variation in effect sizes across studies.The RE model suggested a high caries prevalence rate of 72.62% (with a 95% confidence interval of 65.3%-78.89%), suggesting a large burden of dental caries in this population pertaining to permanent teeth. The I 2 score was 99.0%, showing high heterogeneity among the investigations. The mean DMFT score was found to be 1.675 (with a 95% confidence interval of 0.5519-2.7980), indicating of substantial dental health concerns. Surprisingly, the I 2 value for DMFT scores was 0.0%, demonstrating no detected heterogeneity among the trials. The study highlights a high prevalence of dental caries and significant DMFT scores among children in the Arab region, signaling an urgent public health concern. The lack of heterogeneity in DMFT scores across studies, despite high caries prevalence, suggests potential limitations in the DMFT indices' ability to capture the full severity of dental caries. Further research is needed to refine these tools and fully understand the burden of dental caries in this population.

Prevalence and Demographic Insights in Public Dental Clinics in Jazan, Saudi Arabia

BACKGROUND In Saudi Arabia, particularly the Jazan region, a high prevalence of caries is reported among children, while adult data remain limited. This study aimed to assess the sex, age, and prevalence distribution of dental caries among adults in the Jazan region, Saudi Arabia. MATERIAL AND METHODS A cross-sectional study assessed dental caries among walk-in patients from 4 dental centers in Jazan region, using the WHO Oral Health Assessment Form (2013). Seven trained dentists conducted examinations, ensuring interrater reliability (Cronbach alpha=0.7). Sociodemographic data and Decayed, Missing, and Filled Permanent Teeth (DMFT) scores were collected and analyzed by tooth type, dental arches, and sides of arches. Data were analyzed using STATA/SE 15.1, using descriptive statistics, ANOVA, and t tests. Statistical significance was set at P≤0.05. RESULTS Of 312 participants, 94.6% were women. Caries prevalence was highest in the 26-30 year age group (24.4%), and overall was 94.6%. Maxillary arch had higher caries prevalence (91.3%) than mandibular arch (84.9%), with molars most affected. DMFT scores were lowest in the 19-25 age group (9.33±5.23) and highest in 36-40 group (13.42±4.94). Participants over 50 years showed significant tooth loss (6.09±5.51). There was a significant difference and association between the presence of caries and arch type with age groups (P=0.005, P=0.002 with ANOVA). CONCLUSIONS Widespread prevalence of dental caries in the Jazan region was found, affecting diverse demographics. Findings stress the need for preventive care, early intervention, and tailored treatments to address age-specific and sex-related differences, to improve overall oral health outcomes.

Distal and Proximal Influences on Self-Reported Oral Pain and Self-Rated Oral Health Status in Saudi Arabia: Retrospective Study Using a 2017 Nationwide Database

BACKGROUND

Oral health significantly influences overall well-being, health care costs, and quality of life. In Saudi Arabia, the burden of oral diseases, such as dental caries and periodontal disease, has increased over recent decades, driven by various lifestyle changes.

OBJECTIVE

To explore the associations between proximal (direct) and distal (indirect) influences that affect oral pain (OP) and self-rated oral health (SROH) status in the Kingdom of Saudi Arabia (KSA) using an adapted conceptual framework.

METHODS

This retrospective cross-sectional study used data from a national health survey conducted in KSA in 2017. The sample included adults (N=29,274), adolescents (N=9910), and children (N=11,653). Sociodemographic data, health characteristics, and access to oral health services were considered distal influences, while frequency and type of dental visits, tooth brushing frequency, smoking, and consumption of sweets and soft drinks were considered proximal influences. Path analysis modeling was used to estimate the direct, indirect, and total effects of proximal and distal influences on OP and SROH status.

RESULTS

The mean age of adult respondents was 42.2 years; adolescents, 20.4 years; and children, 10.58 years. Despite OP reports from 39% of children, 48.5% of adolescents, and 47.1% of adults, over 87% across all groups rated their oral health as good, very good, or excellent. A higher frequency of tooth brushing showed a strong inverse relationship with OP and a positive correlation with SROH (P<.001). Frequent dental visits were positively associated with OP and negatively with SROH (P<.001). Sweet consumption increased OP in adolescents (β=0.033, P=.007) and negatively affected SROH in children (β=-0.086, P<.001), adolescents (β=-0.079, P<.001), and adults (β=-0.068, P<.001). Soft drink consumption, however, was associated with lower OP in adolescents (β=-0.034, P=.005) and improved SROH in adolescents (β=0.063, P<.001) and adults (β=0.068, P<.001). Smoking increased OP in adults (β=0.030, P<.001). Distal influences like higher education were directly linked to better SROH (β=0.046, P=.003) and less OP (indirectly through tooth brushing, β=-0.004, P<.001). For children, high household income correlated with less OP (β=-0.030, P=.02), but indirectly increased OP through other pathways (β=0.024, P=.003). Lack of access was associated with negative oral health measures (P<.001).

CONCLUSIONS

Among the KSA population, OP and SROH were directly influenced by many proximal and distal influences that had direct, indirect, or combined influences on OP and SROH status.

Obesity and dental caries in Saudi Arabia: a correlated study

BACKGROUND

Obesity and dental caries are two major global public health concerns. There have been conflicting reports about the relationship between obesity and dental caries. This study intends to examine the link between obesity and dental caries across the five regions of Saudi Arabia.

METHODS

The study involved 380 participants, which was a cross-sectional survey, with an age range of 6 to 14. We distributed a self-reported questionnaire to assess the participants body mass index (BMI) and caries (dmft/DMFT). In this study, descriptive analysis, student t-test, one-way analysis of variance (ANOVA), and multiple linear regression analysis were used.

RESULTS

The study comprised 380 respondents, consisting of females (60.8%) and males (39.2%), with a mean age of 9.1 years and mean BMI of 26.3. The prevalence of caries among the study respondents was 66.6% (Table 2), and this prevalence was higher among females (67.5%), those who consumed sugar more than six times (77.5%), those who brushed their teeth once per day (80.3%), those who used no dental floss (68.4%), those who did not use mouthwash or rinse (68.4%), and those in the east and center regions (100%). The obese possess a statistically significant (P < 0.05) higher mean dmft/DMFT (dmft = 8.00 and DMFT = 6.00). Furthermore, BMI had a negative influence on the DMFT score (b = -0.01, P = 0.776), which was not statistically significant.

CONCLUSION

Participants categorized as obese demonstrated a notably higher mean dmft/DMFT in comparison to their non-obese counterparts. Although BMI showed a negative impact on the DMFT score, this association did not reach statistical significance.

Prevalence of dental carries among school-going children aged 7-13 years in Kabul City

BACKGROUND

Dental caries is a major, multifactorial oral condition that causes the demineralization of tooth enamel and impacts approximately half of the world's child population. This study aimed to determine the prevalence of dental caries among school-going children aged 7 to 13 years in Kabul city.

METHODS

This descriptive cross-sectional study was conducted with 491 students aged 7 to 13 years in Kabul during the first half of 2019. A multistage cluster sampling method was used, in which educational zones, schools, and classes were selected. The data were collected using pre-structured questionnaires through face-to-face interviews and oral examinations of students using dental probes and mouth mirrors while adhering to infection control protocols. The collected data were analyzed using Statistical Package for Social Science version 21.0, and a p-value < 0.005 was considered as statistically significant.

RESULTS

The average age of the study participants was 9.9 ± 1.8 years. Boys made up approximately 45% of the participants, while 54.8% were girls. The overall prevalence of dental caries was 78.8%, with 62.1% in deciduous teeth and 42.8% in permanent teeth. Among students who did not brush their teeth, the prevalence of dental caries was 84.8%, compared to 81.7% for those who brushed once daily, 78.7% for those brushing twice daily, and 67.4% for those brushing three times daily (p = 0.022). About 10% of students had dental calculus, with a prevalence of 17.0% among those aged eleven and older, 10.0% among students aged nine to ten years, and 5.9% among students aged eight and younger (p = 0.006). Poor oral hygiene affected nearly one-third of the students, with 34.2% among boys and 30.9% among girls. Poor oral hygiene was more prevalent in students aged eight and younger (38.8%) compared to those aged eleven and older (25.9%) (p = 0.023).

CONCLUSIONS

The prevalence of dental caries among students aged 7 to 13 years in Kabul schools was similar to that in most developing countries. The prevalence of dental calculus was greater among students aged eleven years and older. Over 99% of the students surveyed had not undergone any dental treatment.

Caries prevalence among children at public and private primary schools in Riyadh: a retrospective study

Dental caries is a global oral health issue, especially critical in children, affecting their growth, nutrition, and education due to school absences or distractions from dental pain. The aim of the study was to investigate the correlation between school types (indicative of socioeconomic conditions) and dental caries prevalence among primary school children in Riyadh, alongside assessing the overall caries prevalence among schoolchildren in Riyadh. Retrospective study on 28,343 first and fourth-grade students from 960 public and private schools in Riyadh, using data from the Saudi Ministry of Health (Feb-April 2019). Utilized the DMFT/dmft index for assessment and collected demographic data. Most of the schools were public (76.1%), private national (17.1%), and private international (6.8%). Overall, the mean DMFT index for permanent teeth and the dmft index for primary teeth were 1.78 and 1.94, respectively. 58% of school children had no dental caries, 25% had mild caries, and 17% had moderate to severe caries. Public school children showed a higher caries prevalence than private schools. Oral disease rates were higher in girls than in boys, and grade four students had a higher prevalence than grade one students. Saudi Arabia, a developing nation, faces challenges in addressing oral health, especially in public schools. Targeted initiatives are crucial for awareness, preventive measures, and meeting oral health needs.

SEQUEL: Prevalence of dental caries in Saudi Arabia: A systematic review and Meta-analysis

This meta-analysis investigated the prevalence of dental caries throughout the Kingdom of Saudi Arabia (KSA) between 2011 and 2023 as a follow-up to a previously published review in 2013 by Khan et al. and aimed to provide an update on the current status of caries prevalence in the KSA. A literature search was conducted, and thirty-three articles were included in the final analysis. To determine the prevalence of caries in primary teeth, the 2- to 12-year-old Saudi population was included in the search, and an age range of 6-18 years was used for permanent teeth. The prevalence of caries in the primary and permanent dentition was analyzed separately. As the included studies for the primary and permanent teeth had insignificant heterogeneity, fixed-effect models and forest plots were used to evaluate caries prevalence in both dentitions. In the primary dentition, the mean decayed-missing-filled teeth (dmft) index was 4.14 (95 % confidence interval (CI): 3.11-5.18), with an average prevalence of 75.43 %. For the permanent teeth, the mean DMFT (uppercase used for permanent dentition) was 1.28 (95 % CI: 0.93-1.64), with an average prevalence of 67.7 %. The average dmft/DMFT scores decreased in both primary and permanent teeth compared to the previous meta-analysis by Khan et al., suggesting a beneficial effect of preventative measures on caries prevalence. Continuing these measures is necessary to maintain the downward trend of caries prevalence in the KSA.

Dental decay in children and the link to weight status: A cross-sectional analysis of national school health data

Recent national reports have indicated an increasing trend of dental decay among school-aged children. National school-based data are required to guide decision-making to ensure effective public health efforts to manage dental decay. This study aimed to assess the prevalence of dental decay among school-age children in Saudi Arabia and explore the possible link between dental decay and weight status. This was a cross-sectional analysis of a national sample including 1,134,317 Saudi children in the 1st, 4th, 7th, and 10th grades who participated in a national school screening program. Data for weight, height, body mass index (BMI), dental decay prevalence, and decayed, missing, and filled teeth (DMFT) index were analysed. An independent t-test, one-way analysis of variance, and chi-square test were used to compare the means, while Pearson's r correlation and multiple linear regression were used to examine the relationships between the study variables. The prevalence of dental decay was 24.20%, and dental decay was the highest among female students (26.5%), students in primary school (25.9%), students living in the eastern region (35.2%), in the administrative capital (27.6%), and in rural areas (23.4%). Dental decay was the highest among students who were underweight. Female sex and living in rural areas significantly predicted higher DMFT while being overweight/obese significantly predicted lower DMFT. Dental decay is highly prevalent among underweight students, female students, and students living in rural areas and the eastern regions of Saudi Arabia. To reduce the prevalence of dental decay and related health disparities, dental health screening programs should be designed to detect dental decay early among children at high risk due to abnormal BMIs and sociodemographic factors. In addition, dental health screening and management programs should utilize standardized dental decay assessment methods and ethnically representative growth charts.

Prevalence and severity of dental caries in school children in Saudi Arabia: A nationwide cross-sectional study

Aim

This nationwide study assessed the prevalence and severity of dental caries in 6-, 12-, and 15-year-old school children across Saudi Arabia. This study examined differences between genders and among regions regarding the mean values of decayed, missing, and filled teeth (dmft/DMFT), the care index (CI), and the significant caries index (SiC index).

Materials and methods

Data from 19,870 participants, 10,435 males and 9435 females, were collected using stratified multistage cluster random sampling. The survey team divided Saudi Arabia into five regions (northern, eastern, western, southern, and middle). To represent each respective region, a large city, two random towns (peri-urban), and four random rural areas were selected for surveying. Lastly, the sampling technique was applied by choosing random schools and random classes within the selected schools. Dental caries were assessed using the dmft/DMFT score, CI, and the top 30% and 10% of the sample dmft/DMFT scores (SiC30 and SiC10, respectively).

Results

The overall prevalence of caries was 65.6%, with 72.1 occurring in primary teeth and 61.7% in permanent teeth. The percentages of individuals with missing teeth and filled teeth were 9.0% and 20.5%, respectively. The mean dmft was 3.93 ± 3.60, while the mean DMFT was 2.42 ± 2.52; most of the DMFT components were significantly higher in females than males, while the dmft components were higher in males. The northern region had the highest and worst DMFT/dmft ratios of the five regions. The mean SiC30 and SiC10 values were significantly higher than the overall average DMFT/dmft values (P < 0.001).

Conclusion

Dental caries remain a public health challenge among school children in Saudi Arabia. The SiC and CI analysis indicated that caries management had a high overall efficacy, but that certain groups of the population may need targeted management in the future.

Comparative Evaluation of Preformed Stainless Steel Crown's Crazing at Different Autoclave Cycles

Aim

The study aimed to assess and compare the crazing of preformed stainless steel (SS) crowns at various autoclave cycles.

Materials and methods

Around 15 SS crowns were subjected to zero (unsterilized), one, three, five, and seven autoclave cycles at 121°C, 15 psi for 20 minutes. After each autoclave cycle, the mesial surface of each crown from occlusal to cervical portions was examined under a 40× stereomicroscope. Crazing was evaluated using Wickersham's criteria.

Results

One autoclave cycle does not produce any cracks, whereas the higher the number of autoclave cycles, the higher the cracks, which affects the prognosis of the SS crown treatment.

Conclusion

Surface alterations of SS crowns after different autoclave cycles were significant. So, preformed SS crowns should be discarded after sterilizing once or twice during clinical practice.

How to cite this article

Sowkarthicaa P, Mathian VM, Gawthaman M, et al. Comparative Evaluation of Preformed Stainless Steel Crown's Crazing at Different Autoclave Cycles. Int J Clin Pediatr Dent 2023;16(S-1):S77-S80.

An Analysis of Gender Differences and Assessment of Oral Health Status among the General Population Residing in Kanyakumari District: A Pathfinding Scientific Study

Aim

The aim of this study is to assess the prevalence oral health status among the general population residing in Kanyakumari district, Tamil Nadu, India.

Materials and Method

A descriptive cross-sectional study was conducted among the general public of index age groups to analyze the oral health status in the Kanyakumari district. A total number of 400 samples were selected and were equally divided among urban (200 samples) and rural areas (200 samples). The samples were further divided randomly based on the index age groups 5, 12, 15, 35-44, and 65-74 years using the multistage random sampling method. The data regarding oral health status was recorded using the World Health Organization's (WHO's) Oral Health Assessment Form 2013 and 1997. Collected data were tabulated and analyzed using descriptive statistics and the Chi-squared test.

Results

The prevalence of periodontal diseases (88.75%) was found to be highest in Kanyakumari district, followed by dental caries (63.7%) and malocclusion (63.1%). There was a statistically significant difference found between oral health status and index age groups.

Conclusion

Oral disorders such as dental caries, periodontitis, and dental fluorosis are more prevalent among the Kanyakumari district population. Oral health policies should be targeted to the populations in the Tamil Nadu region.

Prevalence of Dental Caries in Children Visiting a Dental College and Hospital in the United Arab Emirates: A Cross-sectional Study

AIM

The purpose of this study was to examine the prevalence of dental caries in school children visiting a dental college and hospital and investigate the associated risk factors.

MATERIALS AND METHODS

Eighty children were recruited in this study between the ages of 6-12 years. The caries prevalence of decayed, missing, filled teeth (DMFT) was recorded using an evaluation form. A structured questionnaire was used to understand the associated risk factors.

RESULTS

The caries prevalence in the population was found to be at 91.25%. There was a strong negative correlation between age and dental caries and the results were statistically significant with p-value being less than 0.0001. The duration of bottle and breastfeeding, frequency of teeth brushing, adult supervision during brushing, consumption frequency of sweets, and the frequency or timing of children's dental visits were found to be positively associated with dental caries and these results were statistically significant with p-value being less than 0.05.

CONCLUSION

A high prevalence of dental caries was observed among the population visiting the dental college and hospital. Encouraging dental health education, including promoting the significance of good oral hygiene practices, is crucial.

CLINICAL SIGNIFICANCE

The study emphasizes the rising prevalence of dental caries and underscores the need for dental health education and the promotion of good oral hygiene practices to prevent complications and reduce their prevalence.

Association between different behavioral factors and dental caries among children attending the dental clinics in a sample from Saudi Arabia

BACKGROUND

This study aimed to assess the association between different behavioral factors and the prevalence of dental caries among children attending the dental clinic in a sample from the Hail and Tabuk regions, Saudi Arabia.

METHOD

A cross-sectional study design was employed to determine the burden of dental caries in teeth and key associated factors among 6-12-year-old children who attended different dental clinics. The data was recruited from Hail and Tabuk districts, Saudi Arabia. The study included only Saudi nationals, whose parents could fill out the self-administered questionnaire and provide informed consent for their child's dental examination at clinics. Children underwent a simple dental examination based on the World Health Organization diagnostic criteria for oral health surveys. The Decayed, Missed, Filled Tooth (DMFT) index developed by the World Health Organization (WHO) was utilized to assess dental caries. Descriptive statistics were performed to describe categorical variables. The mean DMFT was compared between girls' and boys' and the children from Hail and Tabuk regions using the Mann-Whitney U-test. The chi-square test was used to examine the association between different behavioral factors and the prevalence of dental caries.

RESULTS

Of the total 399 children examined, 203 (50.9%) were boys, whilst 196 (49.1%) were girls. The prevalence of dental caries was correlated with the cleaning tool, parental educational level, dental visits, and sugar consumption (p < 0.05). However, brushing frequency failed to demonstrate a correlation with the prevalence of dental caries (p > 0.05). The total mean DMFT for the studied sample was 7.81 (SD ± 1.9). Caries' experience was made up mainly of decayed teeth. Decayed teeth made up an average of 3.30 (SD ± 1.07). The total mean of missing and filling teeth was 2.51 (SD ± 0.99) and 1.99 (SD ± 1.26) respectively. There was no statistically significant difference in the mean DMFT and gender or between Hail and Tabuk (p < 0.05).

CONCLUSION

Saudi Arabia continues to have a high prevalence of dental caries compared to the global norm.

Influence of Tooth Brushing and Previous Dental Visits on Dental Caries Status among Saudi Arabian Children

OBJECTIVE

To evaluate the dental caries status and its association with tooth brushing frequency and previous dental visits among Arabian children.

METHODS

Arabian school children attend a specialty pediatric dental clinic at Majmaah University, Saudi Arabia. Only children of Saudi origin with primary dentition were included in the study, and only one examiner was involved in the assessment and data collection. The parents of children completed a questionnaire to investigate possible explanatory variables for caries status, including tooth brushing frequency and previous dental visits. Dental caries were diagnosed according to the criteria recommended by the World Health Organization (2013). The comparison performed was based on sex, age, tooth brushing frequency, and previous dental visits. The descriptive statistics were carried out using SPSS (version 21.0) with a p-value of <0.05 significance.

RESULTS

The study involved 268 Saudi children with a mean age of 4.6 ± 1.1 years. The caries prevalence was 78.8%, and the mean dmft was 5.82 ± 4.48, while the overall mean scores for decayed, missing, and filled were 3.903 ± 3.69, 1.18 ± 1.69, and 0.73 ± 1.35, respectively. The mean dmft scores for the <3 years, 3.1-6 years, and >6 years old children were found to be 1.74, 6.58, and 4.58, respectively. Among the children, the females reported higher dmf scores (7.51 ± 4.18) compared to males (4.97 ± 4.39) with a statistically significant difference (p < 0.001). Fifty percent of the children had tooth brushing habits of once daily, followed by never (22.4%), twice daily (15.7%), and rarely (11.2%) brushed their teeth. Statistically significant correlations were found between the children's dental caries status, age, and dental visits, while sex and tooth brushing did not find a correlation.

CONCLUSION

The prevalence of dental caries among Arabian preschool children was higher. Mandibular second molars were commonly affected by dental caries, while mandibular central incisors were less frequently affected. The child's age and frequency of dental checkups were positively related to the prevalence of dental caries.

Epidemiology of dental caries in permanent dentition: evidence from a population-based survey in Egypt

BACKGROUND

In recognition of the risk factors common between oral diseases and various chronic conditions and the intersection between oral health and some sustainable development goals, the current cross-sectional study was designed to quantify the burden of dental caries and identify factors associated with its occurrence in permanent teeth.

METHODS

Using data from Egypt's population-based survey (2013-2014), two individual-level outcomes; past caries experience (DMFT > 0) and presence of untreated carious lesions (DT > 0) were assessed using the WHO basic methods for oral health surveys. Information on potential explanatory variables including sociodemographic characteristics, exposure to fluoridated water, dental attendance, and dental anxiety was gathered using a structured questionnaire. Stratified multistage cluster random sampling was used to recruit survey participants. Multivariable logistic regression was performed to identify significant potential risk factors for caries in the permanent dentition of Egyptians.

FINDINGS

A total of 9,457 participants were included of which 70.3% had at least one untreated carious lesion. After adjusting for all covariates, analphabetic Egyptians were found to have significantly higher odds of caries experience in permanent dentition DMFT > 0 (OR 1.54, 95% CI [1.20-1.98]), DT > 0 (OR 1.62, 95% CI [1.32-2.00]). Males, however, had significantly lower caries risk DMFT > 0 (OR 0.75, 95% CI [0.67-0.85]), DT > 0 (OR 0.81, 95% CI [0.73-0.89]) when compared to females. Regarding age, mean DMFT scores were significantly lower in age groups (6-15 years) (OR 0.03, 95% CI [0.014; 0.082]), (16- 20 years) (OR 0.09, 95% CI [0.037; 0.23]), and (21-35 years) (OR 0.22, 95% CI [0.09; 0.53]) than among people ≥ 60 years.

CONCLUSION

Addressing individual-level caries risk factors should be complemented by addressing upstream factors to reduce burden of untreated dental caries among Egyptians.

Prevalence of class I caries in the second mandibular primary molar in 3-6-year-old children

Dental caries is the disease of the oral cavity with serious oral health concern. It affects 50% of the schoolchildren worldwide. The consequences affect quality of life and may lead to socioeconomic crisis. The study was undertaken with the aim to understand the prevalence of class I caries in the second mandibular primary molar in 3-6-year-old children. The data were collected from the institutional patient records between September 2020 and February 2021. Of 6828 children, 100 children with class I caries in the mandibular second molar were included in the study. Data analysis was performed to find the association. On analyzing the correlation between age and prevalence of class I caries, all the age groups (i.e., 3-6 years) have almost equal prevalence of class I caries in both left and right second mandibular primary molars. On analyzing the correlation between gender and prevalence of class I caries, male children constitute about 56% of overall prevalence. About 43% of female children constitute class I caries. From the present study, it shows that there is high prevalence of class I caries in the second mandibular primary molar in children of 3-6 years of age. Knowledge on caries pattern on individual teeth and risk factors will help control and reduce dental caries.

Oral Health Needs and Barriers among Children in Saudi Arabia

(1) Background: Understanding oral health needs and barriers is important to overcome the oral disease burden, especially after the COVID-19 pandemic. The aim of this study was to assess oral health needs and barriers among Saudi children after the COVID-19 pandemic wave started. (2) Methods: Parents of healthy children aged 3-11 years from five regions of Saudi Arabia were surveyed using an electronically administered validated questionnaire from Febuary-2021 to July-2021. Oral lesions/manifestations during the last 12 months reported by parents included tooth discoloration, ulcers, abscess, swelling of the gingiva, halitosis, gingival bleeding, dry mouth, pain while eating, difficulty in speaking or eating, burning sensation, and white spots. Barriers were assessed according to the WHO Oral Health Questionnaire. (3) Results: Children experiencing toothaches were reported by 1098 (72.4%) respondents. When reported, oral manifestations and lesions were associated with a higher inability to visit a dentist (p < 0.001). Barriers to dental care were more frequent among parents with lower education (p < 0.001; adjusted-odds ratio (AOR), 1.815) and a greater number of children (p < 0.001; AOR, 1.197). (4) Conclusion: Parents reported a high frequency of unmet oral health needs. Education could play an important role in improving oral health care in children and as a predictor of public health concerns.

Analysis of Trends in Demographic Distribution of Dental Workforce in the Kingdom of Saudi Arabia

Dental professionals are playing an imperative role in the healthcare system. It is important to distribute the dental workforce across the country. Therefore, this study aimed at analyzing the recent distribution of the dental workforce in the Kingdom of Saudi Arabia (KSA) and determining the current dentist-to-population ratio in the KSA. This is a cross-sectional study focused on the dental workforces working in the KSA between 2015 and 2020. Complete data of dentists working in the KSA with different professional ranks were obtained. The data were stratified by gender, professional rank (Saudi and non-Saudi), area of working (13 provinces in the KSA), and sector of working (public and private). A complete list of all dental universities was obtained to identify the increasing number of dental institutes at this current moment. In addition, the dentist-to-population ratio was also evaluated based on the current inhabitant in the KSA and the total dental surgeons. There are a total of 27181 dental surgeons and 8022 dental auxiliaries registered in different specialties as of 2020. Saudi citizens are holding the majority of the posts in both dentist and dental auxiliary categories. The percentage of males and female is slightly higher in dentists and dental auxiliaries, respectively. It also indicated that where most of the dental personnel work in the private sector, dental auxiliaries work in the public sector. Moreover, the highest number of dental workforces is identified in the Riyadh region among all the 13 provinces. Based on the databases, the current dentist-to-population ratio is 1 : 1288.16. In conclusion, the number of dental professionals is ample; however, rural areas lack specialists. Saudi dentists are progressively replacing foreign dentists in different professional ranks working in the KSA.

Prevalence of Caries among School Children in Saudi Arabia: A Meta-Analysis

Introduction

Children's dental health has become the primary concern, because of the increase in the prevalence of caries amongst school children in Saudi Arabia. Therefore, a meta-analysis was conducted to assess the prevalence and severity of dental caries among school children in Saudi Arabia.

Method

A systematic search of Scopus, ISI Web of Science, EMBASE, Saudi digital library, Google Scholar, and MEDLINE via Ovid for cross-sectional studies with healthy participants between 5and -15 years. Two authors independently extracted the prevalence of caries. With 95% confidence intervals (CIs) using a random-effects model, we calculated caries prevalence.

Results

Dental caries prevalence data were extracted from 18 cross-sectional studies (n = 56,327 children). The pooled estimate for the caries prevalence among 5-7 years' children was 84% (95% CI: 0.81-0.87%; I2 = 91%) while among 12-15 years' children was 72% (95% CI: 0.63-0.79; I 2 = 96.2%). Discussion. In this systematic review, the summary estimate of the prevalence of dental caries among children of 5-7 years and 12-15 years were 84% and 72%, respectively. Further research is required to identify approaches for preventing and treating dental caries in schoolchildren.

Oral healthcare-seeking behavior during the COVID-19 lockdown period: A cross-sectional study from Eastern Saudi Arabia

Objective

Methods

Results

Conclusion

Correlation between BMI and Oral Health Status (DMFT, PI, mSBI, and Salivary 1,5-AG) among the Pediatric Population in Saudi Arabia: A Clinico-Biochemical Study

The study aimed to investigate the association of varying body mass index (BMI) with oral health status among children aged 5−14 years and correlate the concentration of salivary levels of 1,5-AG with varying BMI, dental caries, and periodontal disease. This cross-sectional study was conducted on subjects aged 5 to 14 years. The children were recruited from the Pediatric Dental Clinic, College of Dentistry, Majmaah University, by convenient sampling method. Sociodemographic details and clinical parameters, including body mass index (BMI), DMFT/def (deciduous decayed tooth (d), deciduous extracted tooth (e), deciduous filled tooth (f), permanent tooth decayed (D), permanent missing tooth (M), and permanent filled tooth (F)), plaque index (PI), and modified sulcular bleeding index (mSBI), were evaluated. Salivary 1,5-anhydroglucitol (1,5-AG) was analyzed using an enzyme-linked immunosorbent assay (ELISA) for all the subjects. Statistical analyses performed using SPSS v. 27 (IBM Statistics, Chicago, IL, USA) and the Kruskal−Wallis and chi-square tests were used for comparisons. The Spearman rank correlation coefficient was used to examine the association between the study subjects’ independent variables, BMI, and caries activity. The mean def score, PI, and mSBI scores were higher in obese children. PI score, mSBI score, and salivary concentrations of 1,5-AG between the BMI categories were statistically significant (p < 0.001). The study emphasizes promoting preventive oral health regimes, health awareness campaigns, and nutritional educational programs among the pediatric population.

Profiles of sugar fermenting bacteria of the oral cavity among children with dental caries attending stomatology services at Ruhengeri referral hospital in Musanze District, Northern Rwanda

BACKGROUND

Dental caries remains a public health threat of concern among children. About 2.3 billion people are affected by dental caries, of which 530 million are children globally.

OBJECTIVE

This study was carried out to identify sugar fermenting bacteria in the oral cavity and their antibiotic susceptibility pattern, assess the association with sugar fermenter bacteria and dental caries and evaluate dental caries outcomes among children.

MATERIALS AND METHODS

This was a cross-sectional study conducted between October 2021 and February 2022 at Ruhengeri Referral Hospital. About 136 oral swab samples were collected from children with and without dental caries at 1:1 ratio. The samples were put in Stuart sterile container and transported to INES-clinical microbiology laboratory for microbial identification. Logistic regression analysis of demographic characteristics was performed to study the relationship between demographic variables and dental caries. Chi-square test was performed for the association between variables.

RESULTS

About 67.6% were male, while children of age 7-9 years (64.7%) dominated the age groups. Lactobacilli spp (15.29%) and Streptococcus mutans (12.94%) were the most predominant microorganisms observed in the oral cavity among children with dental caries. The S. mutans (x² = 27.03, P < 0.00001, 95% confidence interval [CI]=0.2901-0.5785), S. aureus (x² = 34.59, P < 0.00001, 95% CI = 0.3541-0.6292), Enterobacter aerogenes (x² = 13.5, P = 0.000239, 95% CI = 0.151-0.4622), Serratia marcescens (x² = 11.64, P = 0.00645, 95% CI = 0.1275-0.4418) and Klebsiella pneumonia (x² = 13.51, P = 0.000237, 95% CI = 0.1511-0.4623) were significantly associated with dental caries. Teeth loss (x² = 51.04, P < 0.00001, 95% CI = 0.4757-0.7205), teeth pain (x² = 5.05, P = 0.0246, 95% CI = 0.0249-0.33499), and infection (x² = 4.73, P = 0.02964, 95% CI = 0.0186-0.3441) were dental outcomes associated with tooth decay. Ciprofloxacin, clindamycin, and amoxicillin were the most sensitive antibiotics, while vancomycin and chloramphenicol were the most resistant.

CONCLUSION

Sugar consumption favours the growth of sugar fermenter bacteria that cause dental caries among children. Dental caries is associated with adverse oral health outcomes among children. Oral health education is recommended for children. Parents are advised to reduce the consumption of sugary food for their children for oral health safety.

Evaluating a linkage between obesity and the occurrence of dental caries among school going children in Sakaka, Al Jouf, Kingdom of Saudi Arabia

Background

Obesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. The aim of this study was to analyze the type of relationship between the dental caries and obesity among school children in Al-Jouf region of Saudi Arabia.

Methods

This cross-sectional study was conducted among 400 participants aged 6 to 14 years. The study involved measuring caries (dmft/DMFT), assessing body mass index (BMI), and administering a self-completion questionnaire. An independent t-test, one-way ANOVA, and multivariate logistic regression analyses were performed.

Results

Out of 400 participants, 380 agreed to participate in the study. Overall caries prevalence among the participants was 76.1% and mean DMFT and dmft values were 2.8 ± 1.0 and 3.7 ± 1.6. Among the factors associated with mean caries scores, relation between DMFT scores and frequency of consumption of sugar was statistically significant (F = 3.82,0.01). Regression models has identified children with increased BMI values has 3.2 times more risk of getting dental caries in permanent teeth (P = 0.001).

Conclusion

There was a positive association between obesity and dental caries in school going Saudi Arabian children. Comprehensive multidisciplinary approach by health professionals is recommended for preventive public health issues related to caries and obesity in teenagers.

Bibliometric Analysis of the Current Landscape of Global Scientific Production on the Development of Vaccines against Dental Caries

Objective. To perform a bibliometric analysis of the scientific research on the development of vaccines against dental caries. Methods. An extraction of the scientific production published on the development of vaccines against dental caries between 2011 and 2020 was carried out from the Scopus database. Microsoft Excel was used for the elaboration of tables and SciVal for the bibliometric analysis of the data, which were divided into indicators of production, impact, and collaboration. Finally, VOSviewer was used for co-occurrence analysis of keywords and collaborative networks. Results. 106 studies were retrieved from the Scopus database, which were conducted on the development of dental caries vaccines within the years 2011–2020. Wuhan University, in China, was the university with the highest scientific production on the subject, with 4 publications. Regarding the most productive journals, the first place was occupied by the Journal of Dental Research with 7 publications. Regarding the most productive journals, the first place was occupied by the Journal of Dental Research with 7 publications. The highest percentage of the documents analyzed was in quartile 1 journals and in the national collaboration pattern. Conclusion. Most of the manuscripts regarding the development of vaccines against dental caries were published in China and in Q1 quartile journals. In addition, Yan Huimin, Yang Jingyi, Zhou Dihan, Yang Yi, Li Yuhong and Fan Mingwen were found to top the list of most productive authors. The Journal of Dental Research was also identified as the most productive and cited journal.

Does the Behavior of Pediatric Patients towards Dental Treatment Influence the Pattern of Adjacent (Sound, Decayed, and Filled) Proximal Surfaces in Primary Molars?

This retrospective study aimed to investigate the influence of patient behavior toward dental treatment on the presence of adjacent (sound, decayed, or filled) proximal surfaces in the primary molars. The study included a records review of 2226 pediatric patients. Records were eligible if the patients were in primary or mixed dentition, and if they included a complete set of bitewings and periapical intraoral radiographs of all their primary molars. Four calibrated reviewers used intraoral radiographs to record the sound, decayed, and filled proximal distal surfaces of the first primary molars and the mesial surfaces of the second primary molars. Demographical variables were reported from patients’ medical records including gender, age, medical history, nationality, and patient behavior. Patients’ behaviors were evaluated using Frankl’s Behavior Rating Scale. The Pearson correlation was used to test the association between the sound, decayed, and filled distal surfaces of the first primary molars and the mesial surface of the second primary molar. High correlations of ≥0.6 were further tested in simple and multiple linear regression models to test the influence of patients’ behaviors on these correlations after adjusting for demographical factors. All tests were performed at 5% significance level A. A total of 1194 records met the inclusion criteria and were analyzed. There was a high positive correlation between the sound, decayed, and filled distal surfaces of the first primary molar and similar surfaces on the mesial of the second primary molars (0.66, 0.61, and 0.60, respectively). Compared to cooperative patients, the adjusted estimate of the mean decayed mesial surface of the second primary molar increased significantly for non-cooperative patients by 0.1 (95% CI = 0.16–0.53). On the contrary, the adjusted estimate of the mean sound mesial surfaces of the second primary molars decreased significantly by 0.09 for non-cooperative patients, compared to those who were cooperative (95% CI = −0.52–−0.15). Patient cooperation did not significantly influence the mean of the filled mesial surfaces of the second primary molars (adjusted B = 0.01, 95% CI = −0.05–0.09). Educating parents and clinicians about the influence of children’s behaviors on oral health is highly encouraged to improve treatment outcomes and reduce the progression of dental caries. The implementation of specific behavior management techniques is also important to reduce dental fear and anxiety.

Caries prevalence and severity in association with sociodemographic characteristics of 9-to-12-year-old school children in Al-Madinah, Saudi Arabia

Aim

This study was conducted to estimate the prevalence and severity of dental caries in 9-to-12-year-old schoolchildren in Al-Madinah, Saudi Arabia (SA); to compare its expression by mean of decayed, missing and filled teeth (dmft/DMFT) and the Significant Caries Index (SiC Index); to examine the association between caries experience and sociodemographic factors; and to determine whether schoolchildren in Al-Madinah are at greater risk for high levels of dental caries.

Materials and methods

Data of 1,000 schoolchildren aged 9–12 years old from a cross-sectional oral health survey in Al-Madinah, SA was obtained and analysed. Dental caries was measured using dmft/DMFT and the SiC Index which was computed into two groups: highest 30% DMFT scores (SiC³⁰) and highest 10% DMFT scores (SiC¹⁰). Sociodemographic variables included age, gender, nationality, school type (public or private) and family income. Descriptive and inferential were calculated to estimate caries prevalence and severity and its association with sociodemographic factors.

Results

Caries prevalence in primary or permanent teeth was 85.1%, with untreated caries of 76.1%. The mean dmft was 2.66 ± 2.63 while the mean DMFT was 1.43 ± 1.73. Caries severity was significantly higher among males, Saudis, those from low-income families and those from public schools (p < 0.05). The mean values of SiC³⁰ (3.52 ± 1.57) and SiC¹⁰ (4.98 ± 1.77) were considerably higher than the overall average DMFT value.

Conclusion

Dental caries persists as a public health challenge among schoolchildren in Al-Madinah, SA, with a very high prevalence and severity among schoolchildren. The use of the SiC Index highlighted the subgroups with more severe caries experience.

Global Burden and Inequality of Dental Caries, 1990 to 2019

Previous studies on the global burden of caries primarily focused on simple descriptive statistics. We aimed to characterize the burden, trends, and inequalities of untreated caries of permanent and deciduous teeth from 1990 to 2019 at the global, regional, and national levels through an array of analytic approaches. Estimates of caries burden were extracted from the Global Burden of Disease Study 2019. Decomposition analysis was performed to examine the contribution of demographic and epidemiologic factors to the evolving number of prevalent caries cases. In portfolio analysis, the caries epidemiologic profile of each country was categorized by terciles of age-standardized prevalence in 2019 and average annual percentage change from 1990 to 2019. Sociodemographic attribution analysis was performed to reveal the scale of inequality in burden of caries. Age-standardized prevalence of caries in permanent and deciduous teeth decreased 3.6% (95% uncertainty interval, 2.6% to 4.5%) and 3.0% (1.3% to 4.9%), respectively. Population growth was the key driver of the changes in the number of caries cases, especially in sub-Saharan Africa (percentage contribution: 126.6%, permanent teeth; 103.0%, deciduous teeth). Caries prevalence in the permanent dentition was lower in more developed countries, whereas a reverse trend was noted in the deciduous dentition, except for the highest sociodemographic quintile where caries prevalence was the lowest. Globally, 64.6 million (95% CI, 64.4 to 64.9 million) and 62.9 million (62.8 to 63.1 million) prevalent cases of caries in permanent and deciduous teeth were attributable to sociodemographic inequality in 2019. This amounted to 3.2% (3.2% to 3.2%) and 12.1% (12.1% to 12.1%) of the global number of prevalent cases of caries in permanent and deciduous teeth. Burden of dental caries remains a global public health challenge. A systemwide reform of the global oral health care system is needed to tackle the causes of the burden and inequality of dental caries.

The Effect of Parental Education and Socioeconomic Status on Dental Caries among Saudi Children

Parental attitudes toward the importance of oral hygiene have an impact on the formation of their children’s oral habits and the prevalence of oral diseases. Our aim was to assess the association between parents’ education and socioeconomic status and their children’s oral health. A cross-sectional study was conducted between the years of 2018 and 2020 in the eastern province of Saudi Arabia among primary school children. Two pre-calibrated dentists performed the clinical examination of the children, and a self-administered validated questionnaire was obtained from their parents. Clinical examination was performed on 589 children with an age range of 3 to 14 years, where 47% were males and 53% were females, 70% with dental caries. Both parents with higher education and a high monthly income were significantly associated with lower prevalence of decayed teeth in their children, respectively. Mother’s education, age, gender and application of sealant were found significantly associated with the high prevalence of caries. High prevalence of tooth decay was reported among school children in the eastern province of Saudi Arabia. A high educational level of parents and high income were correlated with a lower prevalence of decayed teeth, similarly to the situation in the case of presence of medical insurance.

Exome array identifies functional exonic biomarkers for pediatric dental caries

BACKGROUND

Pediatric dental caries is common among Arab children, however we are still searching for possible genes and molecular mechanisms that influence caries development.

AIM

To identity genetic predispositions of dental caries among Saudi children with high DMFT (Decayed, Missing, and Filled Teeth).

DESIGN

This case-control study analysed putative functional exonic-variants (n = 243,345) to study the molecular genetics of pediatric caries with high dmft index, 8.75 ± 4.16 on Arab-ancestry subjects with primary dentition (n = 111; 76 cases, dmft>5 and 35 controls, dmft = 0).

RESULTS

Pediatric caries is significantly associated with single nucleotide polymorphisms (SNP) in the GRIN2B-rs4764039C (p-value = 2.03 × 10^-08) and CFH-rs1065489G (p-value = 8.26 × 10^-08) genes, even after Bonferroni correction. Irregular tooth brushing habits (p = 0.0404) and irregular dental visits (p = 0.0050) are significantly associated with caries. Functional enrichment analysis of significant genes is associated with calcium-activated chloride channel, Staphylococcus aureus infection, and N-linked glycosylation.

CONCLUSION

Genetic predispositions are found to be significantly associated with the high prevalence of pediatric caries, which is a disorder of multigene-environment interaction. The significant functional exonic variants identified can be biomarkers for the early diagnosis of pediatric dental caries in Arabs.

The silent epidemic of common oral diseases among the Arab population: An emerging health problem

Oral diseases are often ignored in public health policy within the Arab world, despite being a prevalent public health problem exerting a significant continuous increasing socioeconomic cost. This review paper explored the current status of the common oral diseases (dental caries, periodontal disease, oral cancer, and oro-facial trauma) in the Arab world through a literature search of the PubMed, Scopus, Google Scholar, and Google databases between 1998 and 2021. The literature available revealed sufficient evidence to support that oral diseases are highly prevalent in Arab nations. Collective, multi-sectorial action to reduce and eliminate oral diseases among the Arab population has become an urgent need.

Dental caries in Saudi Arabia: A systematic review

OBJECTIVES

In KSA, numerous studies are conducted to measure the prevalence of dental caries. However, the prevalence of dental caries varies in KSA. This systematic review aims to improve the understanding of the prevalence of dental caries among adults and children residing in KSA.

METHODS

Online databases of MEDLINE, EMBASE, and the Cochrane Library were searched. The Saudi Dental Journal was hand-searched. Study selection and data extraction were conducted in duplicate. The studies on dental caries in the Saudi population were included. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the selected studies. Finally, a narrative synthesis was conducted.

RESULTS

Forty-nine cross-sectional studies were identified. Areas of weakness in study design/conduct were low response rates, reliable outcome measurement, and identification and handling of confounding factors. Statistical pooling of data was not appropriate due to substantial heterogeneity, also in part to a variation in geographical location and the target population. Twenty-nine studies presented data for primary dentition. The proportion of dental caries among primary teeth ranged from 0.21 to 1.00. Eighteen studies presented data for permanent dentition. The proportion of dental caries across permanent teeth ranged from 0.05 to 0.99.

CONCLUSIONS

In general, the methodological quality of the included studies was poor. Dental caries proportion level ranged from 0.05 to 0.99 in permanent teeth, and 0.21 to 1.00 across primary teeth. The available data does not provide a complete assessment of dental caries across KSA. Existing studies are limited in terms of the populations studied for dental caries.

Prevalence of Missing First Permanent Molars in a Selected Population in a University Dental Clinic Setting: A Retrospective Radiographic Study

Aim and objective

This study aimed to determine the prevalence of missing first permanent molars (FPMs) in the 7–29-year-old selected population of Al Ahsa, Saudi Arabia.

Materials and methods

This study retrospectively analyzed 398 panoramic radiographs of patients aged from 7 to 29 years old for missing FPM. Patients were divided into two age-groups: 7–15 and 16–29 years old. Study variables including gender, age, missing FPM, dental arch, and right or left sides of the arch were recorded. The data were statistically analyzed using Chi-square tests.

Results

Of the total study sample, 23.1% of patients had only one missing FPM, 13.3% of patients had two, and 2.8% of them had three missing FPM teeth. No patient had four missing FPM teeth. A total of 60.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (17.4%) and the left mandibular quadrant showed a higher rate of missing FPM (21.9%). No statistically significant association was seen between the missing FPM and the gender or age-group (p > 0.05).

Conclusion

The high prevalence rates of missing FPM in the study population warrants attention. Further prospective studies are needed to comprehensively evaluate the effect of early loss of the FPM on space changes in the arch and subsequent reduction in complex orthodontic treatment needs.

How to cite this article

Almugla YM. Prevalence of Missing First Permanent Molars in a Selected Population in a University Dental Clinic Setting: A Retrospective Radiographic Study. Int J Clin Pediatr Dent 2021;14(2):269–272.

Association of oral hygiene practices with the outcome of untreated dental caries and its clinical consequences in pre- and primary school children: A cross-sectional study in a northern province of Saudi Arabia

Objectives

To assess the association amongst oral hygiene practices, untreated dental caries (UDC) and clinical consequences of UDC in pre‐ and primary school children aged 3–5 and 6–7 years.

Materials and methods

A total of 250 subjects were recruited. The demographic and oral hygiene data were collected using a closed‐ended questionnaire. The UDC was measured using the ‘d/D' component of the decayed, missing, filled teeth (dmft/DMFT) index, and its clinical consequences were recorded using the ‘p/P' component of the pulpal involvement, ulceration, fistula and abscess (pufa/PUFA) index. The data were analyzed by multiple logistic regression.

Results

Overall, 94.2% and 56.5% of the participants had one or more UDC and pulp involvement (p ≥ 1), respectively in 3–5‐year‐old age group. In the 6‐7‐year‐ age group the prevalence of UDC was 26.7% and the pulp involvement was 11.6%. Children who brushed with their fingers were 4.7 times more likely to have UDC (crude odds ratio [COR] = 4.71; 95% CI: 1.21–18.40). Twice‐daily brushing resulted in a 39% (p = 0.732) lower likelihood of having UDC compared with once‐daily brushing (COR = 0.61; 95% CI: 0.04, 10.09). Children with irregular brushing frequency were 3.2 times more likely to have pulpal involvement (COR = 3.21; 95% CI: 1.74–5.93).

Conclusion

Finger brushing, irregular frequency of brushing and lack of parental supervision whilst brushing were associated with UDC and its consequences.

Comparison of Fissure Sealant Chair Time and Patients' Preference Using Three Different Isolation Techniques

This randomized clinical trial aimed to evaluate the patient’s preference and chair time needed during pit and fissure sealant placement under three isolation techniques (Isolite system, rubber dam isolation, and cotton roll isolation). Participants, aged 6–15 years and requiring four sealants on the first or second permanent molars, attending the pediatric dental clinics at King Saud University in Saudi Arabia were enrolled according to the inclusion criteria. Each participant received sealants on three random first or second permanent molars using three isolation techniques. The time required for sealant placement was recorded for each technique. Following sealant placement, an interview-based questionnaire was administered to the participants to evaluate their preference regarding the isolation techniques. Forty-eight children (23 male and 25 female) with a mean age of 8.58 ± 1.93 years participated in this study. The mean chair times were 248.14, 255.89, and 243.29 s for the Isolite system, rubber dam isolation, and cotton roll isolation, respectively. Approximately 79% of participants considered cotton roll isolation to be the most comfortable, whereas approximately 71% were significantly less likely to use rubber dam isolation again. In conclusion, there were no significant differences in sealant placement time among the three isolation techniques. However, cotton roll isolation was the technique that was most preferred by the participants.

Parental Acceptance for the Use of Silver Diamine Fluoride on Their Special Health Care-Needs Child's Primary and Permanent Teeth

Purpose

The effectiveness and simplicity of the procedure and the low expense are the main advantages of silver diamine fluoride (SDF). It is useful for controlling caries in challenging patients such as those with special health care needs (SHCN). First aim of this study was to assess parents’ acceptance towards using SDF in SHCN children in their primary and permanent teeth. Second aim was to determine the factors that influence parents’ decisions toward dental treatment options.

Patients and Methods

This descriptive cross-sectional study included the parents of SHCN children aged 12 years old and younger who were actively seen in pediatric dentistry clinic at King Fahad Medical City (KFMC) and were receiving dental treatment. A previously developed and tested questionnaire was used. The surveyors received training about the questionnaire and participants’ consent was obtained before enrolling in the survey. The statistical significance level was set at P<0.05.

Results

Two hundred twelve participants completed the study questionnaire. Parents had a higher acceptance of SDF use regardless of the tooth location and type when their child had a positive history of pain and/or inflammation (P=0.019). In addition, parents had higher acceptance of SDF staining in primary teeth compared to permanent teeth (P=0.006). Moreover, the acceptance of SDF staining was higher in posterior teeth compared to anterior teeth in both primary and permanent dentition (P<0.001).

Conclusion

Parental acceptance of SDF was higher for primary compared to permanent teeth and posterior compared to anterior teeth in both dentitions, as well as for those with a positive history of dental pain and/or inflammation.

Infant Oral Healthcare and Anticipatory Guidance Practices among Dentists in a Pediatric Care Shortage Area

Objectives

To assess dentists' practices and barriers towards infant oral healthcare (IOH) and anticipatory guidance (AG) in eastern Saudi Arabia.

Methods

A regional, cross-sectional survey was distributed to 340 (323 general dentists (GPs) and 17 pediatric dentists (PDs)) working in a governmental setting in eastern Saudi Arabia. A 23 close-ended, pilot-tested questionnaire was developed. The questionnaire asked about dentists' IOH and AG practices. A five-point Likert scale question assessed barriers interfering with AG practices. Descriptive and multivariate logistic regressions were used.

Results

Participation rate was 98.5% (335/340). Only 18% of GPs indicated performing IOH exams, while 100% of PDs do. About 90% of GPs would see children on a first visit when they are ≥3 years old, whereas 60% of PDs reported seeing one-year-old children. Older practitioners and those performing AG were more likely to perform IOH (OR = 1.8, CI = 1.06-3.1, and OR = 3.84, CI = 1.93-7.65, resp.). The majority of respondents (94%) felt their training did not prepare them to practice AG. "Parents bringing their children for the first time for emergency or existing conditions" was cited by 99% of respondents as a barrier to performing AG.

Conclusion

Increasing the awareness of GPs and parents about the importance of IOH and AG is crucial in improving children's oral health. Collaboration with pediatricians for early referral of children is equally important in increasing the awareness on prevention principles.

Assessment of Brushing Techniques in School Children and Its Association with Dental Caries, Omdurman, 2019

Background

Dental caries are a common infectious disease of childhood. It is a highly prevalent disease among children.

Aim

The goal of this study was to assess the different brushing techniques used by school children and to identify if there is an association between brushing techniques and dental caries.

Materials and Methods

A descriptive cross-sectional study was carried out among 396 school children (9-12 years old) chosen by convenience sampling technique from schools located in Omdurman locality, Sudan. After consent was taken, students were asked in an interview-based questionnaire about their brushing habits. Consequently, they were examined in an upright position using a sterile mouth mirror and a probe. The examination was carried out by a single examiner to investigate the presence of dental caries. The diagnosis was done based on the World Health Organization diagnostic criteria 2013. The data were analyzed through descriptive statistics and comparison between values using the chi-square test with a P value <0.05.

Results

The present study found that the prevalence of dental caries is 70.9%. The combined brushing technique was the most used technique (42.9%). There was no statistical significance between brushing techniques and dental caries (P value ≤0.330). There was a statistical significance between the periodic change of the toothbrush and dental caries (P value ≤0.001). There was statistical significance between the level of education of the mother (P value ≤0.001) and father (P value ≤0.012) to the brushing technique used by the child as well.

Conclusion

Due to a lack of awareness consequent of lower socioeconomic status, only a few percentage of the Sudanese population knows how to implement the correct oral hygiene practices to combat dental caries. It is important to design a specific public health program that particularly targets families of low socioeconomic status, which represents the majority. Dental caries persist as a widespread condition in Sudan as a result of a deficit in these kinds of programs.

Association Between Dental Caries and Obesity among Children with Special Health Care Needs

PURPOSE

Obesity and dental caries constitute an important public health problem worldwide. Special-needs children are at higher risk of developing dental caries and obesity because of their physical, neurological, or behavioural impairment or due to side effects of the medications they take. The present study was conducted to assess the association between dental caries and obesity among children with special health care needs in Taif City, Saudi Arabia.

MATERIALS AND METHODS

A descriptive cross-sectional study was conducted among 400 (220 girls and 180 boys) special-needs children. Body mass index (BMI) was determined by using height and weight measurements. Dental caries was recorded according to World Health Organization criteria. The association between caries and obesity was assessed using multivariable logistic regression analysis.

RESULTS

289 (72.3%) children presented with caries with mean dmft and DMFT of 3.9 ± 2.7 and 4.8 ± 2.3, respectively. Regression analysis showed specials needs children were at a greater risk of having dental caries: 1.69 times (CI: 0.18-2.62, p < 0.05) greater with obesity; 2.01 (CI: 0.18-3.09, p < 0.05) times greater with sugar consumption; 2.21 times (CI: 1.27-4.12, p < 0.001) greater with cerebral palsy; and 2.27 (CI: 1.29-5.12, p < 0.001) times greater with intellectual disability.

CONCLUSION

The present study showed a positive association between dental caries and obesity among children of special health care needs. Hence, a focused approach towards the common risk factors is essential to prevent both obesity and dental caries in special-needs children.

Are anxiety and the presence of siblings risk factors for dental neglect and oral health status in children?

OBJECTIVE

Neglect has a negative effect on all aspects of a child's overall health. Dental neglect is the intentional failure of parents or caregivers to take precautions and ensure the necessary dental treatment, and is closely related to dental caries and anxiety. We aimed to determine whether the presence of siblings causes dental neglect, and whether there is a relationship between dental neglect and anxiety.

METHODS

The cross-sectional study included 100 children and their parents. The children's oral health status was evaluated using the DMFT/dmft and PUFA/pufa indices. In addition, the parents completed the Dental Neglect Scale and a questionnaire, while the Modified Child Dental Anxiety Scale was administered to the children to assess their dental anxiety.

RESULTS

Multivariate linear regression analysis showed that the number of children in the family was statistically significantly associated with DMFT/dmft (β=2.963; P<0.001), PUFA/pufa (β=1.271; P=0.005), and dental neglect scores (β=5.449; P<0.001). The PUFA/pufa scores were statistically higher among children who had visited a dentist before (β=1.181; P=0.043).

CONCLUSIONS

The high level of dental anxiety and neglect in children with more than one sibling indicates that families should be more aware of the importance of oral health.

An in-vitro evaluation of fluoride content and enamel remineralization potential of two toothpastes containing different bioactive glasses

BACKGROUND

Many novel biomaterials have been incorporated in toothpastes to promote remineralization of tooth structure.

OBJECTIVES

This study was carried out to compare the discrepancies between declared and actual total fluoride (TF) or total soluble fluoride (TSF) concentration of two modern toothpastes containing bioactive glasses; these were also assessed for their remineralization potential.

MATERIALS AND METHODS

The TF and TSF concentration were assessed using a fluoride ion selective electrode. Enamel remineralization was evaluated through micro-hardness analysis. Eighteen enamel blocks were divided into three groups: 1 (n = 6; control), 2 (n = 6; Novamin® toothpaste), and 3 (n = 6; BiominF® toothpaste). The specimens were demineralized by 6 wt% citric acid (pH = 2.2). Subsequently, the specimens in group 1 were kept in artificial saliva (AS), while the specimens in groups 2 and 3 were stored in AS + Novamin® and AS + Biomin®, respectively.

RESULTS

Both Novamin® or BiominF® showed less TF concentration than their label claims. BiominF® had more TF and TSF compared to Novamin® (p < 0.05). The BiominF® toothpaste presented higher micro-hardness values on remineralization.

CONCLUSION

BiominF® toothpaste demonstrated more fluoride content and greater potential to promote remineralization of demineralized human enamel compared to Novamin®.

Relationship between Obesity and Dental Caries in Saudi Male Adolescents

Introduction

Obesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. Therefore, the study aimed to investigate the association between obesity and dental caries among male adolescents.

Materials and Methods

This cross-sectional study included a sample of 258 male students' aged 12 to 15 years from schools in Dammam/Al-Khobar, Saudi Arabia. The study involved measuring caries prevalence and DMFT estimates, assessing body mass index (BMI), and administering a self-completion questionnaire. Independent samples Student's t-test, one-way ANOVA test, Pearson's correlation test, and bivariate and multivariate logistic regression analyses were performed.

Results

Caries prevalence of the sample was 79.8%, and the mean score of DMFT was 3.55 ± 2.94. The mean BMI of participants was 23.42 ± 6.82 and 18% were obese (BMI > 30). The obese participants had a higher mean DMFT score (4.46 ± 3.54) than nonobese participants (3.35 ± 2.77) (P=0.021). Similarly, the mean untreated caries was higher in obese (4.17 ± 3.22) than in nonobese participants (3.01 ± 2.66) (P=0.010). In the logistic regression analysis, after controlling for father's education, family history of obesity, meals per day, fast food per week, and physical activity in the final model, the participants with high caries experience (DMFT = 5-15) were 2.21 times more likely to have obesity than those with low caries experience (DMFT = 0-4) (P=0.04). No/school education of father (odds ratio 3.54, P=0.011), family history of obesity (odds ratio 3.27, P=0.002), and not performing physical activity (odds ratio 4.37, P=0.002) were significantly associated with an increased likelihood of obesity.

Conclusion

The prevalence of caries and obesity was high in male adolescents in Saudi Arabia. Obesity was significantly associated with untreated caries and caries experience. Children with high caries experience were more likely to have obesity than children with low caries experience. Preventive programs and policies should address public health issues related to caries and obesity in male teenagers.

Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and meta-analysis

BACKGROUND

Early childhood caries (ECC) is a type of dental caries in the teeth of infants and children that is represented as one of the most prevalent dental problems in this period. Various studies have reported different types of prevalence of dental caries in primary and permanent teeth in children worldwide. However, there has been no comprehensive study to summarize the results of these studies in general, so this study aimed to determine the prevalence of dental caries in primary and permanent teeth in children in different continents of the world during a systematic review and meta-analysis.

METHODS

In this review study, articles were extracted by searching in the national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between 1995 and December 2019. Random effects model was used for analysis and heterogeneity of studies was evaluated by using the I2 index. Data were analyzed by using the Comprehensive Meta-Analysis (Version 2) software.

FINDINGS

In this study, a total of 164 articles (81 articles on the prevalence of dental caries in primary teeth and 83 articles on the prevalence of dental caries in permanent teeth) were entered the meta-analysis. The prevalence of dental caries in primary teeth in children in the world with a sample size of 80,405 was 46.2% (95% CI: 41.6-50.8%), and the prevalence of dental caries in permanent teeth in children in the world with a sample size of 1,454,871 was 53.8% (95% CI: 50-57.5%). Regarding the heterogeneity on the basis of meta-regression analysis, there was a significant difference in the prevalence of dental caries in primary and permanent teeth in children in different continents of the world. With increasing the sample size and the year of study, dental caries in primary teeth increased and in permanent teeth decreased.

CONCLUSION

The results of this study showed that the prevalence of primary and permanent dental caries in children in the world was found to be high. Therefore, appropriate strategies should be implemented to improve the aforementioned situation and to troubleshoot and monitor at all levels by providing feedback to hospitals.

First Permanent Molar Caries and Oral Health Practices in Saudi Male Teenagers: Inequalities by Socioeconomic Position

OBJECTIVES

Caries remains a problem in high-risk groups aggravated by socioeconomic inequalities. The study aimed to investigate (1) oral health practices associated with caries in the 1^st permanent molars in Saudi male teenagers and (2) the impact of socioeconomic position (SEP) on caries control using these practices.

METHODS

A cross-sectional study targeted 1137 male teenagers in intermediate schools in Khobar and Dammam, Saudi Arabia, in 2016. Caries was examined using the World Health Organization criteria and plaque was assessed using the plaque index of Loe and Silness. A questionnaire assessed SEP (parental education, employment, and home ownership) and oral health practices (using fluoridated toothpaste twice daily, regular dental visits for check-ups, and avoiding daily sugary snacks). Regression models analysed the association of these factors with caries presence and the mean number of decayed 1^st permanent molars. Stratification was used to assess differences between SEP levels.

RESULTS

The response rate was 81.7%. Caries prevalence and mean (SD) number of decayed 1^st permanent molars were 50.4% and 1.08 (1.31). The use of fluoride toothpaste was associated with lower odds of caries and fewer decayed molars (OR = 0.50 and regression coefficient = -0.35). Differences in the relationship between caries and toothpaste were observed by SEP levels with stronger associations in less advantaged groups.

CONCLUSIONS

Brushing twice daily using fluoride toothpaste was associated with less caries in Saudi male teenagers with stronger association observed in groups with lower SEP. The use of fluoride toothpaste helps in reducing health inequalities associated with SEP.

Magnitude of Dental Caries and Its Associated Factors Among Governmental Primary School Children in Debre Berhan Town, North-East Ethiopia

Background

In Ethiopia, oral health prevention and treatment have gotten low attention in the government, and the existing dental services are privately owned and thus expensive. Hence, this study aimed to assess the prevalence of dental caries and its associated factors among governmental primary school children in Debre Berhan town, Ethiopia, 2019.

Methods

An institutional-based cross-sectional study was conducted from January 30 to February 14/2019. A total of 417 primary school children were selected using computer-generated simple random sampling and interviewed using structured and pretested questionnaires. Data were coded, entered, and cleaned using Epi-data version 3.1 and export to SPSS version 22 for analysis. Binary logistic regression analysis was employed to test the association between dependent and independent variables. P-value less than 0.05 was taken as significant association. Finally, the result of this study was present by text, tables, and graphs.

Results

Out of the 396 study participants, 135 (34.1%) had dental caries. Of these, more than half, 95 (59.37%) had the pre-molar decayed. Two hundred eighty-five (72.0%) of them were cleaned their teeth. The Independent predictors of dental caries were drinking sugared tea [AOR= 2.034, 95% CI: (1.223–3.385)] and food particle on their teeth [AOR= 6.709, 95% CI: (3.475–12.954)], which had shown a significant association with dental caries.

Conclusion

The over magnitude of dental caries was relatively high and found to be a public health problem. Drinking sugar tea, presence of food particles, or dental plaque were significantly associated with dental caries. In contrast, merchant occupation reduced the chance of dental caries. Giving health education to minimize drinking sugar tea and cleaning their teeth after consumption of sugar tea should be given attention.

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

OBJECTIVE

The 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.

METHODS

A 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.

RESULTS

From 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.

CONCLUSION

As 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.

Oral health and socio-economic status among children during Syrian crisis: a cross-sectional study

BACKGROUND

The Syrian crisis has started eight years ago and has, directly and indirectly, affected all the aspects of the Syrians lives. A lot of new war-related factors contributed to change the socio-economic status, the demographical distribution and the ability to access the public health services. Moreover, the crisis created the biggest displacement crisis both inside and outside Syria. Therefore, it is important to study the prevalence of dental caries and oral health in these specific circumstances in order to build a database to assess and compare future results of preventive programs and to assess health and social needs of the communities affected by war or crisis. The aim of this research is to Study the level of oral health among children during the Syrian crisis, as well as the relation between oral health and socioeconomic status (SES).

METHODS

A cross-sectional study to assess the oral health of children in Damascus city by using DMFT index and other dental indices. The data were collected from ten randomly selected schools covering all the areas of Damascus city, and the final sample size was 811 children.

RESULTS

DMFT index was used to assess the oral health of the children. The average number was (3.36) among all children; 14% of the sample size had a good oral health, while 86% had at least one decayed, missed, or filled tooth. There was also a strong association between SES of the child and the oral health represented as DMFT Index (P = 0.03), Pearson's correlation test displayed an inverse association between the SES and oral health (P = - 0.074).

CONCLUSION

This study highlights the impact of the Syrian crisis on the SES of the Syrian children and their oral health. Bad oral health has been recorded and it has a significant relation with the SES of the children.