Prevalence of periodontitis in Saudi Arabia: A systematic review and meta-analysis

Objective

The aim of this systematic review was to assess the prevalence of periodontal disease among Saudi Arabian adults based on studies conducted from 1992 to 2023.

Methods

The study protocol was registered in PROSPERO. Three databases (MEDLINE, EMBASE and Cochrane library) and the Saudi Dental Journal were searched for published literature up to June 2023 using prespecified search strategy. Quality of included studies was checked using the risk of bias in population-based prevalence studies tool.

Results

The systematic review included 15 studies that assessed the prevalence of periodontal disease in Saudi Arabia. Most of the studies used non-confident case definitions. The pooled estimate of periodontal disease prevalence in Saudi Arabia based on the data of 14 which included 6,596 individuals is 51% (95% CI: 35.99, 73.05).

Conclusion

Periodontal disease is a significant public health issue in Saudi Arabia, with a substantial prevalence among the included participants. Nevertheless, the existing studies exhibit methodological disparities and regional limitations. Therefore, while the results shed light on the pressing nature of periodontal disease in Saudi Arabia, further comprehensive research is imperative. A more accurate estimate, coupled with effective strategies, can be achieved through broader, multidisciplinary collaborations and the prioritization of a national oral health survey in Saudi Arabia.

Exploring health advice by dental professionals in USA: A secondary data analysis of NHANES (2015-2018)

OBJECTIVES

To examine socioeconomic and ethnic variations in the provision of health advice by dental professionals.

METHODS

Data were from the National Health and Examination Survey (NHANES) (2015-2018). Socioeconomic position (Poverty-income ratio and education) and ethnicity were the main exposures. The outcome variable of interest was whether participants received health advice regarding the "benefits of quitting cigarettes," "benefits of monitoring blood sugar levels," and "importance of oral cancer screening". Logistic regression analysis was used to examine the relationship between socioeconomic factors/ethnicity, and health advice after adjusting for covariates.

RESULTS

The analysis included a total of 5524 people aged eighteen and above who had complete data. Black and Hispanic individuals had higher odds of receiving advice on smoking (OR = 1.49, 95% CI: 1.04-2.12 and OR = 1.48, 95% CI: 1.05-2.07, respectively) and glucose monitoring (OR = 3.00, 95% CI: 2.03-4.43 and OR = 3.14, 95% CI: 2.04-4.82, respectively), but no significant difference for cancer screening advice.Higher poverty-income ratios (PIR) were associated with lower odds of receiving smoking advice (OR = 0.91, 95% CI: 0.84-0.98), but no significant associations were observed for glucose monitoring or cancer screening advice. The study's findings reveal a social gradient in the provision of cancer advice, with individuals having higher education levels, particularly university education (OR = 1.69, 95% CI: 1.24-2.31), showing significantly higher odds of receiving cancer screening advice CONCLUSION: The study highlights significant variations in health advice provision in dental settings, with education level, ethnicity, and smoking status playing prominent roles, emphasizing the need for targeted interventions to promote equity and cultural competence in delivering health advice in dental settings.

PRACTICE IMPLICATION

The results emphasize the importance of strong policies and ongoing education for dental professionals to ensure optimal treatment and prevention.

Validity of self-reported number of teeth among Saudi older adults: A public health perspective

Objectives

This study aimed to evaluate the agreement between self-reported and clinically measured numbers of teeth in older adults from Almadinah Almunawwarah, KSA, and to identify factors associated with self-reporting accuracy.

Methods

This study included 337 older adults (≥60 years). Participants completed a survey assessing sociodemographic characteristics, self-rated oral and general health, and the self-reported number of teeth. Clinical examination was conducted using the 2013 criteria published by the World Health Organization. Bland-Altman plots and correlation coefficients were used to assess the agreement between self-reported and clinically measured teeth.

Results

The mean age of the study participants was 67.1 (SD = 6.5) years, and the majority were males (71.2%). The self-reported teeth count was higher than the clinically measured number, and only 47.7% (n = 161) of the sample showed complete agreement between the two measures. The mean difference between the self-reported and clinically recorded number of teeth was 0.41 teeth, and almost two-thirds of the study participants reported their number of teeth within an error margin of two teeth (p < 0.001). Both Spearman's and Pearson's correlation methods revealed a significant positive correlation between the two measures. Specifically, the Spearman's rho was 0.91, while Pearson's r coefficient was 0.96.

Conclusion

Among Saudi older adults, the self-reported number of teeth correlated with the clinically measured numbers of teeth. This suggests that self-reports can be a reliable and cost-effective method for assessing oral health in large-scale surveys, potentially guiding health policies and interventions for older adults.

Is Parental Rating of Child's Oral Health Associated with Caries Experience in Children? A Cross-Sectional Study

Aim

The Parents' view to the oral health of their children is a significant factor that can impact oral health practices and behaviors. The aim of this research was to investigate how parental assessment of their child's oral health associates with caries experience in children receiving dental treatment at the hospital of Taibah University Dental College.

Materials and Methods

This cross-sectional study enrolled 127 children who underwent dental treatment at Taibah University Dental College and Hospital during 2020-2021. Dental caries experience was assessed using the dmft/DMFT index, and parental rating of oral health was obtained through a questionnaire. Three logistic regression models were used to assess the correlation between dental caries experience and parental rating of oral health while controlling for sociodemographic and behavioral factors.

Results

Most parents rated the oral health of their child as good (60.4%), followed by excellent (18.8%) and very good (15.6%). The mean dmft/DMFT score was 3.47 ± 3.46, with 43.8% of children having high/very high dental caries experience. Logistic regression analysis showed that children whose parents rated their oral health as poor were more likely to have high/very high dental caries experience compared to those rated as excellent/very good/good/fair (adjusted odds ratio = 4.45, 95% confidence interval 1.23-16.07).

Conclusion

This study suggests a link between parental assessment of their child's oral health and an elevated prevalence of dental caries in children. The study found that children whose parents rated their oral health as suboptimal had higher odds of having high dental caries experience. These findings emphasize the significance of parental perception of their child's oral health and suggest a necessity for customized interventions to enhance parental knowledge and practices concerning children's oral health.

The Association between Electronic Health Literacy and Oral Health Outcomes among Dental Patients in Saudi Arabia: A Cross-Sectional Study

OBJECTIVE

This cross-sectional study aimed to investigate the association between electronic health (eHealth) literacy and oral health outcomes, including the number of teeth and brushing frequency.

METHODS

A total of 478 participants were included in the study and assessed for their eHealth literacy levels. Demographic variables, including age, gender, income, and education, were collected. The participants' number of teeth and brushing frequency were also recorded. Multiple regression analyses were performed to examine the relationship between eHealth literacy and oral health outcomes, adjusting for sociodemographic variables.

RESULTS

The study sample consisted of both males (66.5%) and females (33.5%), with a mean age of 31.95 years. Among the participants, 16.95% were classified as having inadequate eHealth literacy, 24.06% had problematic eHealth literacy, and the majority (59.00%) demonstrated sufficient eHealth literacy. There was a significant association between eHealth literacy and oral health outcomes. Individuals with problematic eHealth literacy had a higher likelihood of having a greater number of teeth (RR = 1.12, 95% CI: 1.05-1.20, p < 0.001) compared to those with inadequate eHealth literacy. Similarly, individuals with sufficient eHealth literacy showed a higher likelihood of having more teeth (RR = 1.14, 95% CI: 1.07-1.21, p < 0.001) compared to the inadequate eHealth literacy group controlling for age, gender, income, and education. Individuals with problematic eHealth literacy exhibited a tendency towards lower odds of irregular brushing (OR = 0.39, 95% CI: 0.15-1.02, p = 0.054), although this result was marginally significant. In contrast, individuals with sufficient eHealth literacy had significantly lower odds of irregular brushing frequency (OR = 0.24, 95% CI: 0.10-0.62, p = 0.003) compared to the inadequate eHealth literacy group.

CONCLUSION

The findings suggest a positive association between eHealth literacy and oral health outcomes. Improving eHealth literacy may have implications for promoting better oral health behaviors and outcomes.

Development, validation and performance of laboratory frailty indices: A scoping review

INTRODUCTION

Frailty is a syndrome characterised by decline in functional ability and increasing vulnerability to disease and associated with adverse outcomes. Several established methods exist for assessing frailty. This scoping review aims to characterise the development and validation of frailty indices based on laboratory test results (FI-Lab) and to assess their utility.

METHODS

Studies were included in the review if they included data concerning the development and/or testing an FI-Lab using the deficit accumulation method. Studies were identified using PubMed/MEDLINE, Embase (Elsevier), OpenGrey and Google Scholar from 2010 to 2021. Two reviewers independently screened all abstracts, and those that met the inclusion criteria were reviewed in detail. Data extracted included details about the study characteristics, number, type and coding of laboratory variables included, validation, and outcomes. A narrative synthesis of the available evidence was adopted.

RESULTS

The search yielded 915 articles, of which 29 studies were included. In general, 89% of studies were conducted after 2016 and 51% in a hospital-based setting. The number of variables included in FI-Labs ranged from 13 to 77, and 51% included some non-laboratory variables in their indices, with pulse and blood pressure being the most frequent. The validity of FI-Lab was demonstrated through change with age, correlation with established frailty indices and association with adverse health outcomes. The most frequent outcome studied was mortality (79% of the studies), with FI-Lab associated with increased mortality in all but one. Other outcomes studied included self-reported health, institutionalisation, and activities of daily living. The effect of combining the FI-Lab with a non-laboratory-based FI was assessed in 7 studies with a marginal increase in predictive ability.

CONCLUSION

Frailty indices constructed based on the assessment of laboratory variables, appear to be a valid measure of frailty and robust to the choice of variables included.

Burnout assessment among academic dental staff during COVID-19: Data from Arab countries

Purpose/objective

This study aimed to identify factors that were associated with high burnout and investigate the prevalence of burnout among academic dental staff during the COVID‐19 pandemic.

Method

A cross‐sectional online survey was carried out among academic dentists who are working in multiple dental schools in Arab countries. The Copenhagen Burnout Inventory was used to assess participants’ work‐related burnout. Logistic regression was used to assess the factors that increase the risk of burnout among academic dentists.

Results

Of the 254 participants who took part in the study, 141 were males (55.5%). The average age of the participants in the study was 42.1 years (standard deviation = 10.0). The prevalence of burnout among participants was 44.9% (n = 114). Using a fully adjusted logistic regression model, age (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01–1.09, p = 0.008) and gender (OR = 0.54, 95% CI: 0.31–0.94, p = 0.03) were significant variables associated with high overall burnout. Female individuals had a substantially reduced risk of experiencing high personal burnout than male participants (OR = 0.56, 95% CI: 0.32–0.98, p = 0.043) in the personal burnout subdomain. While in the patient's burnout subdomain, age (OR = 1.04, 95% CI: 1.00–1.08, p = 0.048), type of speciality (OR = 2.44, 95% CI: 1.02–5.83, p = 0.044), and teaching place (OR = 2.49, 95% CI: 1.21–5.11, p = 0.013) were associated with higher burnout.

Conclusion

This study concluded that gender and age are characteristics that increase the risk of higher burnout among academic dentists during the COVID‐19 pandemic.

The Impact of COVID-19 Lockdown on Injuries in Saudi Arabia: Results From a Level-I Trauma Center

Background: The COVID-19 pandemic has placed an enormous strain on global health. Due to precautionary measures, the epidemiology of health conditions may have been affected. Saudi Arabia imposed a lockdown order on March 25, 2020. This study investigated the impact of the pandemic lockdown on injuries in a level-I trauma center in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: This retrospective study identified all injured patients seeking emergency care during the lockdown period (March 25-June 21, 2020) and a similar period in two previous year (March 25-June 21) 2018 and 2019. The collected data included patients' demographics, injury types, mechanisms, and health outcomes. Results: Two hundred sixty nine injured patients sought emergency care during the lockdown, while 626 and 696 patients were treated in the same period of 2018 and 2019, respectively. There was a significant reduction in motor vehicle crashes (OR: 0.47; 95% CI: 0.31-0.73) and burns (OR: 0.24; 95% CI: 0.08-0.66), coupled with a significant increase in assault injuries (OR: 2.20; 95% CI: 1.30-3.74) in the lockdown period compared to 2019. Apart from the intensive care unit (ICU) admission and hospital length of stay, there were no differences between the two periods in the health outcomes. ICU admission was significantly reduced by 57% during the lockdown period (OR: 0.43; 95% CI: 0.22-0.83). Mechanisms of injuries were not significant predictors of deaths or ICU admission or both in the lockdown period. Conclusion: The COVID-19 lockdown had a clear impact on the volume and mechanisms of injuries. The findings highlight that injury risk factors are modifiable and emphasize the importance of public health measures for preventing injuries and the significance of maintaining trauma services capacity during pandemics.

Association between Oral Health and Frailty among Older Adults in Madinah, Saudi Arabia: A Cross-Sectional Study

OBJECTIVES

This study aimed to examine the association between normative and subjective oral health indicators and frailty assessed by Frailty Phenotype (FP) and frailty index (FI) among older Saudi adults.

DESIGN

cross-sectional study.

SETTING

community and hospital-based.

PARTICIPANTS

participants were 356 community-dwelling older adults attending dental clinics and social centres at Madinah, Saudi Arabia.

METHODS

Frailty was measured with the frailty phenotype and a 34-item FI. Oral health included the following measures: self-rated oral health, number of teeth, and functional dentition. Covariates included sociodemographic factors and nutritional status. Logistic regression and negative binomial regression models were constructed to test the association between oral health indicators, FP, and FI, respectively. The first model was adjusted for demographic and socioeconomic factors, the second model was additionally adjusted for nutritional status.

RESULTS

The number of teeth, functional dentition and self-rated oral health showed significant associations with frailty after adjusting for demographic and socioeconomic variables for both FP and FI. Adjusting for nutritional status attenuated the associations.

CONCLUSION

This study has shown significant associations between oral health indicators namely number of teeth, functional dentition and self-rated oral health, and both FP and FI among Saudi older adults. Nutritional status appeared to mediate the association between oral health and frailty implicating inability to eat in this relationship.

Self-rated oral health and frailty index among older Americans

OBJECTIVE

To assess the association between self-rated oral health and frailty index among older American adults aged 60 years and over.

MATERIALS AND METHODS

Data from the National Health and Nutrition and Examination Survey from 2011 to 2014 were used. Self-rated oral health was assessed based on a single question "rate the health of your teeth and gum". A frailty index of 49-items covering multiple systems was created. Age, gender, ethnicity, poverty-income ratio, education, poor nutritional intake and smoking were used as covariates. Weighted negative binomial regression was used to test the association between self-rated oral health and frailty index adjusting for the covariates.

RESULTS

A dose response relationship was observed between self-rated oral health and frailty index. The rate ratios (RR) of frailty index were 1.03 (95% CI 0.95-1.13), 1.15 (95% CI 1.05-1.25), 1.30 (95% CI 1.17-1.45) and 1.41(95% CI 1.28-1.54) for participants who rated their oral health very good, good, fair or poor, respectively, compared with those who rated their oral health excellent after adjusting for covariates.

CONCLUSION

Poorer self-rated oral health is associated with higher rates of frailty index. This highlights the importance of oral health as a predictor of frailty and the adequacy of using self-rated oral health in health surveys and clinical practices when conducting a comprehensive clinical oral examination is not feasible.

Association Between Oral Health and Frailty Among American Older Adults

OBJECTIVE

We examined the association between tooth loss, periodontal diseases, and frailty among older American adults.

DESIGNS, SETTINGS, AND PARTICIPANTS

Data from the National Health and Nutrition Examination Surveys (NHANES) 2011-2014 was used. We included 2368 community-dwelling adults aged 60 years and older. Frailty was measured with the 49-item frailty index. Oral health indicators included number of teeth and periodontal disease. A composite nutritional intake variable based on 13 micronutrients from the dietary assessment was created. Negative binomial regression was used to test the association between oral health and frailty. The first model was adjusted for age and gender, the second model was additionally adjusted for nutritional intake, and the third model was additionally adjusted for other covariates.

RESULTS

For each additional tooth, the rate ratio (RR) for frailty was 0.99 [95% confidence interval (CI) 0.98-0.99] in the fully adjusted model. Similarly, participants with moderate-severe periodontitis had 1.08 RR (95% CI 1.02-1.14) for frailty index compared with participants with no periodontitis after adjusting for age, gender, and poor nutritional intake. The association lost significance in the fully adjusted model.

CONCLUSIONS AND IMPLICATIONS

Oral health is associated with the frailty index, and nutritional intake appears to have a modest effect on the association. Periodontal disease has a weaker association with frailty compared with number of teeth. The findings highlight the importance of maintaining good oral health at older age and incorporating oral health indicators in routine geriatric assessments. Future research should investigate the role of potential mediating factors in this association.

Is there socioeconomic inequality in periodontal disease among adults with optimal behaviours

OBJECTIVE

To examine if socioeconomic inequalities exist in periodontal disease among adult with optimal oral health behaviours.

MATERIALS AND METHODS

Data were from the Adult Dental Health Survey 2009, a national survey of England, Wales and Northern Ireland. Overall, 4738 participants aged 35 years and older were included in the analysis. Periodontal disease indicated by pocket depth or loss of attachment ≥4 mm, and gingival bleeding were used as periodontal outcomes. Education and deprivation indicated socioeconomic position. Behavioural factors were dental visits, toothbrushing and smoking. The subset of adults with and without optimal health related behaviours included 2916 and 1822 participants, respectively. The associations between periodontal disease and socioeconomic position were tested adjusting for demographic and behavioural factors. Additional models stratifying the sample to those with and without optimal behaviour subgroup were constructed.

RESULTS

Education and deprivation were significantly associated with periodontal disease in the partially adjusted models. In the analysis of those with optimal behaviours, only deprivation and highest level of education showed significant association with periodontitis (PD), but not with gingival bleeding. Among those without optimal behaviours, all socioeconomic factors were associated with all outcomes except deprivation and PD.

CONCLUSIONS

Oral health behaviours marginally contributed to inequalities in gingival bleeding and periodontal disease. Socioeconomic inequalities were attenuated among those with optimal behaviours and persisted among those without optimal behaviours. Behaviours appeared to be an effect modifier for the relationship between periodontal outcomes and socioeconomic factors.