Pattern of dental needs and advice on Twitter during the COVID-19 pandemic in Saudi Arabia.

AIM: To compare and evaluate the influence of the COVID-19 outbreak on tweets related to dental treatment needs and advice of Saudi Twitter users in 2020 by comparing them to the same time-period in 2019. METHODS: Eight independent searches based on dentistry related keywords: "teeth, mouth and gingiva" were carried out within the timeframe between the 23rd of March and the 21st of June for the years 2020 and 2019. Extracted tweets were analyzed by two calibrated examiners as tweets containing expressed dental needs and tweets for dental advice, while spam tweets were excluded. Descriptive analysis was performed to present the overview of the findings using SPSS. Bivariate analysis was performed with Pearson's Chi Square, Fisher's Exact test and Mann-Whitney U test. Statistical significance was set at p ≤ 0.05. RESULTS: A total of 595 tweets from the year 2019 and 714 tweets from the year 2020 were obtained. Overall, combined dental needs and advice tweets, retweets, likes, and replies were higher in 2020 compared to 2019. Dental needs tweets were higher in 2020 compared to 2019, while dental advice tweets were lower in 2020 compared to 2019. Statistically significant differences were found between 2020 and 2019 with regards to dental needs well as with dental advice (p < 0.05). In addition, statistically significant differences were found between 2019 and 2020 with presence of pain, urgency of the dental need and type of advisor (p < 0.05). CONCLUSION: An obvious impact of the pandemic can be seen in the form of increased self-reported dental needs, pain and urgency among the public in Saudi Arabia. This study highlights the importance of social media, specifically Twitter, in expressing the public needs and utilizing it as a platform for education and advice.

Barriers to Dental Care in Individuals with Special Healthcare Needs in Qatif, Saudi Arabia: A Caregiver's Perspective.

OBJECTIVE: Access to dental care is a key factor influencing oral health outcomes. Individuals with special healthcare needs are at risk of not having access to dental care services which they need to maintain their oral health. This study assessed the magnitude of this problem and identified barriers responsible for the difficulties in accessing dental care in Qatif, Saudi Arabia, as reported by caregivers of individuals with special healthcare needs. METHODS: This cross-sectional study collected data using a self-administered survey questionnaire from caregivers of individuals with special healthcare needs across 11 centers (eight special needs centers and three schools) in Qatif, Eastern Province of Saudi Arabia, between February and April 2019. RESULTS: A total of 186 caregivers participated in the study, 102 (54.8%) of whom reported difficulties in getting access to dental care. The key barriers included lack of time on the part of caregivers (60.8%), unsuitable clinic environment (53.9%), difficulties with transportation (51.9%), medical/health status of the individual with special healthcare needs (51.0%), and geographically distant dental clinics (51.0%). Caregiver demographics (age, gender, and educational level) had no significant influence on the difficulties reported by caregivers in getting access to dental care for individuals with special healthcare needs (p>0.05). CONCLUSION: A large proportion of caregivers in Qatif, Saudi Arabia, experience difficulties with access to dental care services for individuals with special healthcare needs. The most common barriers are physical accessibility of dental facilities (for individuals with special healthcare needs), affordability, and lack of skills and knowledge of dental care providers.

Effect of Remineralizing Agents on Bond Strength of Resin-Composites to Primary Enamel.

Aim: The purpose of this in vitro investigation was to assess the effect of three remineralizing agents (Voco Remin Pro®, Uncle Harry's remineralization kit, Sunshine remineralization gel) on the shear bond strengths of two resin-composites (Tetric® N-Ceram and Filtek™ Z250 Universal Restorative) to enamel of primary molars. Study design: Ninety-six enamel specimens were prepared and randomly distributed to eight groups according to the control, remineralizing agents, and resin composite used. Shear bond strength was measured at a crosshead speed of 0.5 mm/min and the type of bond failure was recorded. Results: The highest shear bond strength (Mean+SD) in MPa was for Tetric® N-Ceram/control [21.06+1.68] while the lowest was for Filtek™ Z250/Sunshine remineralization gel [11.98+1.46]. Tukey HSD Post Hoc Tests showed significant difference between Tetric® N-Ceram/control and all other groups (p=0.0001) except Filtek™ Z250/control. In addition, there was significant difference between Filtek™ Z250/control and all other groups (p=0.0001) except Tetric® N-Ceram/control and Tetric® N-Ceram/Uncle Harry's remineralization kit. Mode of failure was cohesive (9.38%), adhesive (55.21%), and mixed (35.42%). Conclusions: The three tested remineralizing agents affect shear bond strength of the tested resin-composites to enamel of primary teeth. In general, shear bond strength values were acceptable. Mode of failure was mostly adhesive.

A survey of pediatric dentists' caries-related treatment decisions and restorative modalities - A web-based survey.

OBJECTIVE: To identify current practices and the preferred caries-related treatment decisions and restorative modalities of primary teeth among pediatric dental practitioners in Saudi Arabia. MATERIALS AND METHODS: This was a web-based cross-sectional survey conducted among licensed pediatric dental practitioners in Saudi Arabia. Following the retrieval of the email addresses from the Saudi Dental Council, an email explaining the purpose of the study and a link to SurveyMonkey electronic survey consisting of 23 questions was sent to all the members registered under the pediatric dentistry practitioners, starting in September till December 2013. The data obtained was analyzed using descriptive statistics and chi square with and without tabulation processes. The level of significance was set at p < 0.05. RESULTS: A total of 108 [54 (50%) male and 54 (50%) female] pediatric dental practitioners responded to the survey out of 308 targeted individuals for an overall response rate of 35.1%. About 65% of the respondents reported that they have never considered pre-veneered or Zirconia crowns as a restorative option for carious vital anterior primary teeth. About 40% reported doing pulpectomy and restored with composite strip crowns at all times. About 86% of the respondents reported doing pulpotomy and stainless steel crown for restoring carious vital posterior primary teeth whereas 73.8% reported restoring with composite resin. However, 83.1% of the respondents reported that they never used pre-veneered or Zirconia crowns after pulpotomy for restoring carious vital posterior primary teeth. A significantly higher number of male participants reported that they used esthetic pediatric crowns in their practice compared to female participants (p < 0.001). CONCLUSION: The prevalence of use of composite resin to restore primary teeth was higher compared to glass ionomer cements and amalgam whereas a limited use of esthetic pediatric crowns was found among the sample surveyed. Esthetic pediatric crowns were more utilized by male compared to female participants.

Prevalence and Heritability of Early Childhood Caries Among Monozygotic and Dizygotic Twins.

Deciphering the relative importance of genetic and environmental factors, which play a major role in the prevalence of early childhood caries (ECC), can help clinicians with planning a long-term preventive treatment. The objective of the study was to determine the prevalence and heritability of ECC among monozygotic (MZ) and dizygotic (DZ) twins in Chennai, India, in the year 2013. A cross-sectional study was designed to estimate the prevalence of ECC among twins. Zygosity classification for the survey framework was adapted from a highly accurate parental report questionnaire pertaining to the physical similarity between twins. The associated heritability index was estimated. The Decayed, Missing, Filled Surface (DMFS) Index was used as the diagnostic criterion for dental caries. The prevalence of ECC was estimated at 18.7%. The correlation coefficient between the twin pair showed significant correlation. The heritability index for ECC was estimated at 15% higher prevalence of ECC found among children in the age group 25-36 months. The heritability estimate indicated a relatively low genetic influence for early childhood caries among twins. There was no significant difference detected in the concordance rate for the MZ and DZ twins. Further research could be directed toward the prevalence of ECC among higher age group children to explore the role of genetic and environmental factors.

Antimicrobial Efficacy of Salvadora persica Extracts on a Monospecies Biofilm on Orthodontic Brackets In Vitro.

PURPOSE: The oral cavity is a rich ecosystem with a plethora of microorganisms, and different components of fixed orthodontic appliances may contribute to a shift in the balance of oral ecology. The purpose of this study was to investigate the antimicrobial potential of hexane and ethanol extracts of Salvadora persica on a monospecies biofilm model established on orthodontic brackets in vitro. MATERIALS AND METHODS: Streptococcus mutans biofilm was formed on mini diamond orthodontic brackets following three days of anaerobic incubation at 37˚C. The bacterial cell viability of this biofilm was measured after their exposure to saline, hexane extract of S. persica, ethanol extract of S. persica and 0.2% chlorhexidine using 3-(4, 5-dimethylthiazol- 2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulphophenyl)-2H-tetrazolium (MTS) assay. On half of the brackets, the colony forming units (CFU) were counted. Both experiments were performed in triplicate. RESULTS: The absorbance values obtained from the MTS reduction assay after exposure to the different test agents showed a decline in the bacterial cell viability of the S. mutans biofilm as follows: chlorhexidine (+)0.05). The CFU counts of S. mutans obtained from chlorhexidine exposure were lower than from hexane and ethanol extracts. CONCLUSION: S. persica extracts were found to have antimicrobial effects on S. mutans biofilm established in vitro on orthodontic brackets suggestive of its potential use as an oral antimicrobial agent for orthodontic patients.

Career motivations, perceptions of the future of dentistry and preferred dental specialties among saudi dental students.

AIM: The purpose of this study was to determine the career motivations, perceptions of the future of dentistry and preferred postgraduate specialties of Saudi dental students. METHODS: A pretested, self-administered, 16-item questionnaire was distributed to first- through fifth-year dental students at King Saud University in Saudi Arabia. Descriptive statistics were calculated, and the level of significance was set at 5%. RESULTS: Of the 530 potential participants, 329 students (198 male and 131 female respondents) completed the questionnaire. High professional status (71.4%), a secure career (67.8%), a high income (78.1%), flexible working hours (54.4%), a wide range of career options after graduation (59.3%), opportunities for self-employment (69.3%) and good job opportunities abroad (65.3%) were endorsed to a great/considerable extent by the respondents. "It takes time to establish a practice" (62.3%), "Postgraduate education is a necessity" (72.4%) and "The increasing number of dental institutions is a threat to the profession" (59.3%) were endorsed to a great or considerable extent by the respondents. The most popular specialty among the male students was oral maxillofacial surgery (20.1%) and among female students was operative dentistry (23.4%). CONCLUSION: The career motivations of this group of dental students seemed to relate to socioeconomic aspects of dentistry and perceptions of the future of dentistry seemed to relate to the need for postgraduate education.

Oral health survey of 6-12-year-old children with disabilities attending special schools in Chennai, India.

BACKGROUND: The dental literature is replete with reports on the oral health surveys of normal children. Relatively few data exist for the oral conditions of mentally challenged children and adolescents with multiple disabilities in India. AIM: To assess the oral hygiene practices and treatment needs among 6-12-year-old disabled children attending special schools in Chennai, India, between 2007 and 2008. DESIGN: A cross-sectional study data were collected using WHO criteria, a questionnaire (for the parents/guardians) regarding demographic data and oral hygiene practices, medical record review, and clinical examination. RESULTS: Among 402 disabled children, majority of the children brushed their teeth once daily (89.7%) and with assistance from the caregiver (64.4%). The utilisation of the dental services was minimal (extractions 14.4%, oral prophylaxis 1.7%, and restorations 1.7%). There was significant difference between residents and non-residents for the mean dft/DMFT. The periodontal health was comparatively better among the residents of the institutions than the non-residents (P < 0.001). Regression analysis revealed that various variables were significantly associated with dft/DMFT and Community Periodontal Index (CPI). CONCLUSION: This study gives sufficient evidence to suggest that the oral health status of this disabled population was poor and there was an increased unmet dental treatment needs.

Prevalence of oral and systemic manifestations in pediatric HIV cohorts with and without drug therapy.

The prevalence of orofacial and systemic manifestations and their association with drug therapy in pediatric HIV patients is scarce in the literature. The aim of the study was to determine the prevalence of oro-facial and systemic manifestations in HIV sero-positive children with and without highly active antiretroviral therapy (HAART). The study population consisted of 100 pediatric HIV patients (n=47 on HAART and n=53 not on HAART). The majority of the children (n=56) had at least one or more oro-facial manifestation associated with HIV. Oral candidiasis was the most common oral finding present in the HAART (14/33) and non-HAART groups (19/33). Recurrent aphthous ulcers was the only significant oral finding, present more in the HAART group. The percentage of children with upper respiratory tract infection was also more in the HAART group. The other lesions which were found to be significant were seborrheic dermatitis, pulmonary tuberculosis and otitis media. There was no significant difference in the participants' oral findings based on CD4 counts in the HAART and non- HAART groups. The prevalence of oral and systemic manifestations is a persistent feature associated with pediatric HIV, though of moderate intensity in those using HAART and may vary according to individual immune status.