Prevalence and risk indicators of primary dentition malocclusion in Riyadh-Saudi Arabia using a new case definition: A cross-sectional study.

Objectives: To determine the prevalence of primary dentition malocclusion and its linked risk indicators among a group of Saudi preschool children. Methods: A cross-sectional study was carried out on preschool children aged 3 to 5 years residing in Riyadh City, the capital of Saudi Arabia. The study sample included 709 Saudi children of both genders with complete primary dentition. Oral examination was conducted for children to assess the anteroposterior, transverse, and vertical dimensions, arch spacings, and oral habits. Results: The prevalence of malocclusion was 59.1% among the study participants. A deep overbite and increased overjet were found in 26.23 % and 25.11%, respectively. Arch space problems were reported, including missing primate spaces in 24.12%, missing developmental spacing in 27.93%, and crowding in 14.1%. An association between mothers aged 25 years and younger at childbirth was linked with their child's malocclusion in the primary dentition (p-value of 0.03). Conclusion: The prevalence of primary dentition malocclusion among a specific group of Saudi preschool children was significantly high. Increased overbite and overjet were the most prevalent occlusal discrepancies, followed by arch spacing problems. The younger mother's age at childbirth is significantly associated with her child's malocclusion. The study results can serve as a baseline for future investigations.

Clinical Practice Guidelines in an Era of Accountability, Saudi Arabia: A Call for Action.

INTRODUCTION: Clinical Practice Guidelines (CPGs) development and implementation in the Kingdom of Saudi Arabia are suboptimal. The Kingdom's Vision 2030 envisages a transformational change to achieve an effective, integrated, value-based ecosystem focused on patient health. OBJECTIVES: This study aimed to develop a CPG appraisal tool that will support the realization of the Kingdom's Vision 2030 through the development of high-quality and highly implementable CPGs. To maximize its impact, all vital healthcare paradigms, such as systems thinking, value-based healthcare, and information technology, will robustly be incorporated in the tool. METHODS: The Saudi Health Council through its National Center of Evidence-Based Medicine (NCEBM) embarked on a program to develop this appraisal tool. A taskforce of experts was selected based on their experience in evidence-based practice and training. The task force, through a methodology of extensive literature review, deliberation, outside experts' feedback, and Delphi and consensus voting, developed a prototype appraisal tool that was named the Holistic Appraisal Tool for CPGs (HAT-CPG). RESULTS: The HAT-CPG was developed comprising three sections: an initial basic information section, an internal validity section, and an external validity section with a total of 13 section items and 73 reporting elements. CONCLUSION: It is envisaged that the Holistic Appraisal Tool will support CPG developers and users in Saudi Arabia in realizing the objectives for which it was developed.

Obstructive Sleep Apnea Awareness Among Dentists in Saudi Arabia: A Cross-Sectional Study.

OBJECTIVES: This study aims to assess the knowledge and clinical practices among dentists in Saudi Arabia regarding obstructive sleep apnea (OSA). MATERIAL AND METHODS: This cross-sectional study was conducted over a period of 8 months across the whole country. A self-administered questionnaire was used to assess the OSA knowledge and practices. The developed questionnaire was closed-ended questions and consisted of three parts: (1) demographic information such as age, gender, work experience, workplace, and specialty; (2) knowledge of OSA; and (3) OSA management practice. The knowledge score was calculated based on six questions, each of which gives one point when answered correctly. RESULTS: A total of 450 dentists from all over the country were surveyed, with a predominance of females (55.6%) and Saudis (59%). About 56% learned about OSA in their undergraduate study, with theoretical lectures being the main source of information. The overall knowledge score was 3.09, with specialists having a higher score than general practitioners (GPs) (p<0.001) and those who learned about OSA in their post-graduate study having higher scores (p<0.001). Despite this, 58.89% never asked their patients about sleep history, and only 19.11% diagnosed patients with OSA before. Only 7.56% used oral appliances to treat OSA, and only one-quarter referred patients to a physician for a sleep-disordered diagnosis. However, 79.33% were willing to attend a continuing education course on managing OSA patients. CONCLUSION: Our study shows that dentists in Saudi Arabia lack fundamental understanding regarding OSA and their role in screening, diagnosing, and treating patients with OSA, highlighting the need to educate the dental fraternity. Dental GPs and specialists, including orthodontists, must be actively involved in diagnosing and treating this life-threatening health issue.

Poor mental health days is associated with higher odds of poor oral health outcomes in the BRFSS 2020.

BACKGROUND: To test the hypothesis that among individuals in the 2020 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional anonymous health survey in the United States (US), after controlling for confounding, an increasing number of poor mental health (MH) days in the past month is associated with increasing odds of delayed oral health (OH) care utilization and poorer OH outcomes. METHODS: Adjusted logistic regression models were developed with poor MH days as the exposure to examine the association with two dependent variables (DVs): Most recent dental visit longer than one year ago (yes/no), and having lost 6 or more teeth (yes/no). RESULTS: Approximately one third (32%) reported most recent dental visit more than one year ago, and 17% had lost 6 or more teeth. Those in the second quartile of poor MH days had 11% higher odds of delayed dental visit, and those in the highest quartile had 26% higher odds, compared to the reference group. For having lost 6 or more teeth, compared to the reference group, those in the third quartile had 8% higher odds and those in the fourth quartile had 18% higher odds. CONCLUSIONS: Poor MH days is independently associated with odds of poor OH utilization and OH in the US above and beyond diagnosed mental and physical conditions. Policymakers in the US should expand health insurance plans to include dental insurance, and should increase access to MH care, especially for the aging population, and those with chronic conditions.

Periodontal status and whole salivary adipokines after scaling and root planing with and without adjunct antimicrobial photodynamic therapy in obese patients with periodontitis.

OBJECTIVE: Whole-salivary (WS) adiponectin and leptin levels after scaling and root planing (SRP) with and without antimicrobial-photodynamic-therapy (aPDT) in obese and normal-weight individuals with periodontitis remain uninvestigated. This study compared the effect of SRP without and with adjuvant aPDT on periodontal status and WS leptin and adiponectin levels (LAL) in obese patients with periodontitis. METHODS: Groups 1 and 2 entailed obese patients without and with periodontitis. Groups 3 and 4 had normal weight individuals without and with periodontitis. Therapeutically, individuals with periodontitis were categorized into test- (SRP+aPDT) and control- (SRP alone) subgroups. All patients without periodontitis underwent routine dental prophylaxis. Clinical attachment loss (AL), gingival and plaque index (GI and PI), probing depth (PD), missing teeth (MT) and WS LAL were measured at baseline and at three months of follow-up. P<5% were graded statistically significant. RESULTS: At baseline, clinicoradiographic variables were significantly higher among patients in test- and control-groups in groups 1 (P<0.01) and 3 (P<0.01) versus 2 and 4. In group 2 and 3, LL were significantly high at baseline compared with follow-up (P<0.01). There was no difference in periodontal parameters and WS adiponectin and LL in the test and control-groups at of follow-up. No correlation existed between salivary LAL and clinical periodontal parameters (PI, GI, PD and clinical AL). No correlation existed between age, gender and BMI and WS LAL. CONCLUSION: In the short-term, SRP with or without aPDT is ineffective in the treatment of periodontitis in obese patients with periodontitis.

Association between Periodontitis and Genetic Polymorphisms in Interleukins among Patients with Diabetes Mellitus.

There is a perplexity in the association between interleukin (IL) polymorphisms and periodontitis among patients with and without diabetes mellitus (DM). The aim of the present study was to evaluate indexed data regarding the association between periodontitis and genetic polymorphisms in interleukins among patients with and without DM. The addressed question was "Is there an association between periodontitis and polymorphisms in interleukins among patients with and without DM?" Original studies were included. Indexed databases were searched, and the pattern of the present literature review was customized to summaries' the pertinent information. Eight studies were included and processed for data extraction. Two studies showed that polymorphisms in IL-1B genes aggravate periodontitis in patients with type-2 DM, and two studies showed that IL-1B genes either do not or are less likely to contribute towards the progression of periodontitis in patients with type-2 DM. Two studies reported that IL genes do not show cross-susceptibility with periodontitis and type-2 DM. One study reported that the primary factor that governs the occurrence and progression of periodontitis in patients with and without type-2 DM is poor routine oral hygiene maintenance. Seven studies had a high risk of bias. The role of IL gene polymorphisms in the development and progression of periodontitis in patients with and without DM remains controversial.

Knowledge, attitude and use of fluorides among dentists in Texas.

AIM: The centers for disease control and prevention (CDC) recommendations on fluoride use were published in 2001. This study examines how this information has diffused to practicing dentists and the level of fluoride knowledge and use among Texas dentists. MATERIALS AND METHODS: A questionnaire was sent to dentists who self-identified as being in pediatric (343), dental public health (72), and general practices (980); a 12% sample of registered dentists in Texas. RESULTS: Response rate was 42.9%. About 90% of surveyed dentists reported using fluorides routinely. Only 18.8% reported fluoride varnish as the topical fluoride most often used. About 57% incorrectly identified primary effect of fluoride. 'Makes enamel stronger while tooth is developing prior to eruption' was the most commonly cited wrong answer (44%). Only 5% identified that posteruptive effect exceeds any preeruptive effect. CONCLUSION: Despite the evidence for fluoride varnish preventing and controlling dental caries being Grade I, its use is still uncommon. Dentists are expected to be knowledgeable about products they use, but this study reflects lack of understanding about fluoride's predominant mode of action. More accurate understanding enables dentists to make informed and appropriate judgment on treatment options and effective use of fluoride based on risk assessment of dental caries. CLINICAL SIGNIFICANCE: Lack of knowledge of, or failure of adherence to evidence based guidelines in caries prevention by use of appropriate fluoride regimens may adversely affect caries incidence in the population.

Typodont versus live patient: predicting dental students' clinical performance.

In this study, the authors evaluated the accuracy and precision of non-clinical testing for dental students' crown preparation proficiency on a manikin-mounted typodont as a predictor of performance on patients. Eighty-six seniors at Baylor College of Dentistry were evaluated by three calibrated senior faculty members from the general dentistry department. Four areas of interest were evaluated: occlusal reduction; axial reduction; margins, design, and finish line; and operative environment. Standardized grading scales were utilized to evaluate these preparation components. The kappa agreement statistic was used to assess agreement for the areas, which were then compiled to get an overall performance score. A Bland-Altman plot was generated and analyzed for agreement on overall performance between typodont and patient. Results of the analyses showed weak agreement between the two measurements for all four areas of interest with large variation in the differences. When the pairs of overall performance scores were compared, the Bland-Altman plot indicated that the typodont composite score was often larger than the patient composite score, especially for poorer performing students. The authors conclude that students' clinical performance on typodonts is a poor predictor of their clinical performance on patients since the students performed much worse on the clinical crown examination than on the typodont examination.

Age at maximum growth spurt in body height for Saudi school children aged 9-18 years.

OBJECTIVE: To provide growth reference values in body height, to determine the specific age at peak height velocity for Saudi male and female adolescences aged 9-18 years and to evaluate the appropriateness of using the Centers for Disease Control/National Center for Health Statistics (CDC/NCHS) growth standards in body height for the assessment of Saudi adolescents. METHODS: A cross-sectional anthropometric survey was conducted in 1053 Saudi male and female school children living in Riyadh city. The study sample was collected in the year 2000 and data were completed and refined in the year 2002. Standing height measurements were recorded for each subject using standard measuring techniques. The 10th, 25th, 50th, 75th, 90th percentiles for body height were calculated separately for boys and girls in one year intervals. The median reference values were compared with the corresponding values in the CDC/NHCS and with other similar studies on Saudi population. RESULTS: The results revealed that the age at peak height velocity for Saudi boys is 13-14 years and for Saudi girls is 10-11 years. The median value for body height at 18 years old for male and female was comparable with other studies reported in similar ethnic group. CONCLUSION: The use of the CDC/NCHS growth standard for height does not appear appropriate for the assessment of growth of Saudi children aged 9-18 years.