Validity and reliability of a teledentistry survey among dental practitioners in Saudi Arabia.

Background: The perception of teledentistry use among dental practitioners in various contexts was assessed using the Teledentistry Survey (the TDS-24). However, this survey's psychometric analyses have not yet been analysed. This present study aims to examine the validity and reliability of the TDS-24 in a sample of dental practitioners in Saudi Arabia. Methods: A self-administered questionnaire, including sociodemographic characteristics and the TDS, was distributed as a cross-sectional survey to 800 current dental practitioners in Saudi Arabia recruited via convenience and snowball sampling. The construct validity and reliability of the TDS were assessed using exploratory factor analysis (EFA) and Cronbach's alpha. Results: The EFA of the survey yielded 20 items supporting a four-factor structure as follows: factor I (10 items), factor II (four items), factor III (three items) and factor IV (three items). The overall Cronbach's alpha was 0.85, while it was 0.86 for the first factor, 0.70 for the second factor, 0.52 for the third factor and 0.57 for the fourth factor. Conclusions: The TDS-20, after excluding four items, revealed four factors with adequate psychometric properties, making it a valid and reliable tool in assessing teledentistry perceptions among dental practitioners in this study sample.

The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis.

BACKGROUND: A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes. MATERIALS AND METHODS: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software. RESULTS: A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001). CONCLUSIONS: The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.

Differentiating Characteristics and Responses to Treatment of New-Onset Heart Failure With Preserved and Reduced Ejection Fraction in Ambulatory Patients.

Background: Differences in clinical presentation and therapy outcomes between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) have been reported but described mainly among hospitalized patients. Because the population of outpatients with heart failure (HF) is increasing, we sought to discriminate the clinical presentation and responses to medical therapy in ambulatory patients with new-onset HFpEF vs. HFrEF. Methods: We retrospectively included all patients with new-onset HF treated at a single HF clinic in the past 4 years. Clinical data and electrocardiography (ECG) and echocardiography findings were recorded. Patients were followed up once weekly, and treatment response was evaluated according to symptoms resolution within 30 days. Univariate and multivariate regression analyses were performed. Results: A total of 146 patients were diagnosed with new-onset HF: 68 with HFpEF and 78 with HFrEF. The patients with HFrEF were older than those with HFpEF (66.9 vs. 62 years, respectively, P = 0.008). Patients with HFrEF were more likely to have coronary artery disease, atrial fibrillation, or valvular heart disease than those with HFpEF (P < 0.05 for all). Patients with HFrEF rather than HFpEF were more likely to present with New York Heart Association class 3 - 4 dyspnea, orthopnea, paroxysmal nocturnal dyspnea or low cardiac output (P < 0.007 for all). Patients with HFpEF were more likely than those with HFpEF to have normal ECG at presentation (P < 0.001), and left bundle branch block (LBBB) was observed only in patients with HFrEF (P < 0.001). Resolution of symptoms within 30 days occurred in 75% of patients with HFpEF and 40% of patients with HFrEF (P < 0.001). Conclusions: Ambulatory patients with new-onset HFrEF were older, and had higher incidence of structural heart disease, in comparison to those with new-onset HFpEF. Patients presenting with HFrEF had more severe functional symptoms than those with HFpEF. Patients with HFpEF were more likely than those with HFpEF to have normal ECG at the time of presentation, and LBBB was strongly associated with HFrEF. Outpatients with HFrEF rather than HFpEF were less likely to respond to treatment.

Forecasting Head and Neck Cancer Trends in GCC Countries: Implications for Public Health Policy and Strategy.

Purpose: The data available on the incidence and mortality rates of head and neck cancer types (HNCs) in the Gulf Cooperation Council countries (GCC) have relied on global trends and covered only certain cancer sites, types or certain age groups. This study aimed to assess the incidence and mortality rates of head and neck cancer (HNCs) within the Gulf Cooperation Council (GCC) countries, providing insights into their geographic variability in 2020. Methods: Prediction of the magnitude of the disease to 2040 was explored based on demographic projections. Estimates of incidence and mortality and the population projections were extracted from the Global Cancer Observatory (GLOBOCAN) database and the United Nations Department of Economic and Social Affairs respectively for the time frame 2020 to 2040. Additionally, we analyzed the distribution of cases and deaths by age and sex for both time periods. Results: The analysis indicates varying patterns in HNC rates across GCC countries in 2020, with Oman and Saudi Arabia carrying the highest burden. Projections for 2040 reveal a substantial increase in new HNC cases and related deaths, particularly in Qatar, UAE, and Bahrain. Furthermore, incidence rates are predicted to rise significantly for individuals aged 50 and older, while remaining relatively stable for those under 50. With regards to sex, males generally exhibit higher rates, except in Qatar. Conclusion: HNC burden is anticipated to rise significantly in the GCC, with variations per age, sex and geographical location. By 2040, a 2-3-fold increase in HNCs in the GCC is anticipated, emphasizing the need for focused public health strategies to address this rising health challenge.

Utilization of Antibiotics for Hospitalized Patients with Severe Coronavirus Disease 2019 in Al-Madinah Al-Munawara, Saudi Arabia: A Retrospective Study.

Background: Most patients admitted to intensive care units (ICUs) with severe Corona Virus Disease 2019 (COVID-19) pneumonia receive antibacterial antibiotics with little evidence of bacterial infections. Objective: This study was designed to review the profiles of patients with severe COVID-19 pneumonia requiring intensive care, the rate of bacterial coinfection, the antibiotics used, and their relation to patient outcomes (death or recovery). Methods: This was a retrospective study that reviewed the medical records of all patients with confirmed COVID-19 (n = 120) severe pneumonia admitted directly from the emergency room to the intensive care unit, at a public hospital during the period from May 2020 to April 2021. The data collected included patients' demographic and laboratory data, comorbidities, antibiotic treatment, and their outcome. Descriptive statistics, bivariate inferential analysis tests (chi-square and unpaired T-Tests) and multivariable binary logistic regression were performed. Results: The mean age of the patients was 56.8 ± 16.5 years old, and among them, 74 (62.7%) were males. Of the included patients, 92 (77.0%) had comorbidities, 76 (63.3%) required mechanical ventilation and 30 (25%) died. All patients received empirical antibiotics for suspected bacterial coinfection. The most common antibiotics used were azithromycin (n = 97, 8%) and imipenem (n = 83, 9%). Ninety patients (75%) were on two empirical antibiotics. Early positive cultures for pathogens were found only in four patients (3.3%), whereas 36 (30%) patients had positive cultures 5-10 days after admission. The most frequently isolated pathogens were Acinetobacter baumannii (n = 16) and coagulase-negative Staphylococci (n = 14). In bivariate analysis empirical treatment with azithromycin resulted in a significantly lower mortality rate (p = 0.023), meanwhile mechanical ventilation, days of stay in intensive care unit, morbidities (e.g., lung disease), linezolid and, vancomycin use associated with mortality (p< 0.05). The adjusted logistic regression, controlling for age and gender, revealed that azithromycin antibiotic was more likely protective from mortality (OR= 0.22, 95%CI 0.06-0.85, p=0.028. However, patients with lung diseases and under mechanical ventilation were 35.21 and 19.57 more likely to die (95%CI =2.84-436.70, p=0.006; 95%CI=2.66-143.85, p=0.003, respectively). Conclusion: Bacterial coinfection with severe COVID-19 pneumonia requiring intensive care was unlikely. The benefit of Azithromycin over other antibiotics could be attributed to its anti-inflammatory properties rather than its antibacterial effect.

Curcumin mouthwashes versus chlorhexidine in controlling plaque and gingivitis: A systematic review and meta-analysis.

OBJECTIVES: The purpose of the present systematic review and meta-analysis was to assess the available evidence regarding the efficacy of curcumin mouthwashes on plaque and gingivitis. METHODS: A comprehensive online search of multiple databases (PubMed, Scopus, Web of Science, and Google Scholar) was performed to identify all relevant studies published up to August 2020, using the following keywords: curcumin, turmeric, gingivitis, periodontal health, and plaque control. All clinical trials that compared the efficacy of curcumin mouthwash with chlorhexidine in controlling dental plaque and gingivitis were included. Data were analysed using Review Manager (RevMan) 5.3 software. The risk of bias was evaluated by two independent reviewers using the Cochrane assessment tool. RESULTS: Six randomized clinical trials (comprising 320 subjects) fulfilled the eligibility criteria. Five studies showed a high risk of bias and only one study showed a low risk of bias. The pooled data of the six included studies revealed comparable efficacy of curcumin and chlorhexidine in reducing dental plaque (I2  = 91%; standardized mean difference [SMD]: 0.27, 95% CI: -0.53, 1.07, p = 0. 51) and gingival inflammation (I2  = 40%; SMD: -0.13, 95% CI: -0.35, 0.09, p = 0.24), with no statistically significant differences between the two groups. CONCLUSION: The results suggest that curcumin mouthwashes have promising anti-plaque and anti-gingivitis properties. Further clinical trials with adequate sample sizes and standardized methodologies are required to discern the efficacy of curcumin mouthwash in reducing plaque and gingivitis.

Xerostomia, Salivary Flow, and Oral Health Status Among Saudi Diabetic Patients: A Comparative Cross-Sectional Study.

PURPOSE: Diabetes mellitus (DM) is associated with numerous oral complications, including frequent oral infections, periodontal diseases, hyposalivation, and xerostomia. The present study aimed to investigate salivary flow rate, xerostomia, and oral health status among a group of Saudi diabetic patients as compared to healthy controls. PATIENTS AND METHODS: This comparative cross-sectional study involved 50 diabetic patients (aged between 15 and 70 years) and 53 age- and gender-matched healthy controls. Data collection was carried out using a structured questionnaire and clinical examination of oral health status, which included salivary flow rates, saliva pH, tooth loss, plaque accumulation, and gingival health. Independent t-tests, one-way analysis of variance (ANOVA), and chi-square tests were performed to compare between groups. RESULTS: The results revealed a statistically significant lower salivary flow (0.33 ± 0.16 vs 0.59 ± 0.54; p = 0.002) and lower saliva pH (6.36 ± 0.49 vs 6.58 ± 0.39; p = 0.014) in diabetic patients than in the control group. A higher proportion of diabetic subjects (60%) self-reported having xerostomia compared to controls (52%), but the findings were statistically non-significant. Additionally, the results revealed slightly poorer oral health and greater tooth loss among DM patients, although the results did not attain a significant difference (P > 0.05). CONCLUSION: The findings of the present study demonstrate poor oral health and a high prevalence of xerostomia among Saudi diabetic patients. Oral health education should therefore be promoted in this group of patients.

Trend Analysis of Head and Neck Neoplasms between 2012-2018 in Patients Residing in Al-Madinah, Saudi Arabia: A Retrospective Study.

OBJECTIVES: This study sought to present a view of head and neck neoplasms (HNN) prevalence with specific focus on sociodemographic determinants in Al-Madinah Province, Saudi Arabia. MATERIALS AND METHODS: This was a hospital-based retrospective study based on retrieval of histopathological data for a period of 6 years between 2012 and 2018. Data was collected from the archives of the Oral and Maxillofacial Pathology Laboratory at King Fahad Hospital (the only referral center for biopsy services) in Al-Madinah City. STATISTICAL ANALYSIS: An independent t-test and/or nonparametric (Mann-Whitney U test, chi-squared test) tests were used to determine the differences between groups. Statistical significance was set at the p-value < 0.05. RESULTS: Out of 96 patients, a total of 58 patients had valid biopsy data with preoperative diagnosis. Over three quarters of the cases (n = 44) were benign with only 24% were malignant. Males were more likely to be diagnosed with a benign tumor than females (54.5 vs. 45.6%, respectively), and malignancy was also more common in males (64.3 vs. 24.1). A significant difference was found in relation to mean age of older patients who were more likely to be diagnosed with malignant tumors (p = 0.001). CONCLUSIONS: The findings suggest that most of biopsied HNN cases are benign neoplasms. Age is a significant risk factor for head and neck malignancy in this region. Delays in diagnosis of HNN need to be explored.

Comparative Study of Attitudes towards Communication Skills Learning between Medical and Dental Students in Saudi Arabia.

Background: Communication skills (CS) learning is a core skill in medical and dental education. The comparison of attitudes towards CS between dental and medical students based on the taught curriculum (problem-based learning vs. traditional teaching) in Saudi Arabia awaits investigation. Aims: (1) To assess the attitudes of both undergraduate dental and medical students towards communication skills (CS) learning and (2) to compare the attitudes towards CS between Medical and Dental students in relation to sociodemographic and education-related characteristics. Methods and Materials: A cross-sectional study, using an online survey, invited 260 conveniently sampled Taibah university medical and dental undergraduate students. The survey collected data on sociodemographic characteristics, education-related factors, and CS using Communication Skills Attitude Scale (CSAS) that assess positive and negative attitudes (PAS, NAS). Data analysis included descriptive statistics and the Mann-Whitney U test. Results: Of the distributed questionnaire 91% responded (145 dental and 91 medical students). There were, overall, non-significant scores' differences between medical and dental students on PAS (Medicine Median 51 vs. Dentistry Median 50, p = 0.059) and NAS (Medicine Median 32 vs. Dentistry Median 32, p = 0.596). Older medical students, those at clinical levels and those who reported they need to improve their communication skills and student whose parents were not doctors, tended to score statistically significantly (p = 0.032, 0.017, 0.034, and 0.004, respectively) on PAS compared with dental students; on the other hand, medical students with doctor parents scored significantly high in NAS compared to dental students (p = 0.015). Conclusion: Demographic and education-related characteristics underpinned medical student positive attitude towards CS compared to dental students. Although medical and dental students showed no differences in self-rating their attitudes towards (CS). Different factors influence medical and dental students' attitudes towards CS learning.

Undergraduate Dental Students' Acceptance of Treatment by Dental Student Peers: A Cross-Sectional Study.

OBJECTIVE: To enumerate students who accepted/would accept treatment by dental student peers (DSP), describe characteristics of DSP and explore factors associated with determining DSP treatment. METHODS: A 17-item online survey was distributed to students of all levels (383) at Taibah University Dental College and Hospital during the academic year 2019-2020. The survey comprised three sections: section one asked questions about the students' demographics and socioeconomics (family income), section two focused on the acceptance of treatment by DSP, characteristics of DSP, and section three asked about factors influencing acceptance of treatment by DSP. The collected data underwent descriptive, bivariate and logistic regression analyses. RESULTS: Of 383 students, 222 (58%) completed the survey; 72 (32%) were at an intern level and 150 (68%) at other levels. Those who had accepted/would accept treatment by DSP comprised 88% of respondents. Performance (85.4%) and quality of treatment (85.5%) were important characteristics of DSP. The multivariable analysis revealed that increase in score rates of confidence in DSP was significantly associated with acceptance of treatment, odds ratio (OR)=1.89, 95% CI: (1.48-2.43), p<0.001. Similarly, students who had a better understanding of patients' management were more likely to accept treatment by DSP (OR=2.70, 95% CI: 1.05-6.96, p=0.039). CONCLUSION: A high percentage of students had accepted/would accept treatment by DSP. These findings also suggest that students who have confidence in DSP and those who understand patient management would accept oral health care by DSP.

The association between Epstein-Barr virus and oral lichen planus: A systematic review and meta-analysis.

BACKGROUND: Oral lichen planus (OLP) is a relatively common inflammatory disease, with unclear etiology. A number of studies have linked Epstein-Barr virus (EBV) with OLP. The present systematic review and meta-analysis aimed to evaluate the available evidence regarding the potential association between EBV and OLP. METHODS: Online databases (PubMed, Scopus, Web of Science, ProQuest, and Google Scholar) were searched from date of inception till May 2020. Studies were included if they met the following criteria: 1) observational studies that assessed the relationship between EBV and OLP, 2) the study comprised OLP patients and control subjects, 3) diagnosis of OLP was confirmed histopathologically, and 4) articles were in English. Studies without control groups, experimental studies, case reports, and reviews were excluded. The fixed-effects model was performed for meta-analyses using RevMan 5.3 software. RESULTS: A total of 10 studies comprising 386 OLP cases and 304 controls were included. Of these, only 8 studies were eligible for the meta-analysis. The results of the quality assessment showed that only 2 studies were of high quality, while the remaining studies were of moderate quality. The results of the pooled eight studies revealed a significant positive association between EBV and OLP (OR = 4.41, 95% CI: [2.74, 7.11], P < .0001). CONCLUSION: The results of the present systematic review suggest that EBV infection is statistically associated with increased risk of OLP. However, these results are preliminary, and high-quality, large-scale studies are warranted to further explore the potential role of EBV in the pathogenesis of OLP.

Dental Students' Perceptions before and after Attending a Centre for Children with Special Needs: A Qualitative Study on Situated Learning.

Objectives: To develop an in-depth understanding of the perceptions and experiences of senior dental students before and after fieldwork visits to a centre for children with special needs. Methods: A qualitative study utilised open-ended questions and involved 39 fifth-year dental students. A thematic analysis of the collected responses was undertaken, and a hierarchy of themes and subthemes were developed. Results: Analysis of the pre-visit responses revealed three main themes and a number of subthemes: 'negative expectations', 'positive expectations', and 'pain expectations'. Similarly, four main themes with a number of subthemes emerged from the post-visit responses: 'positive perceptions', 'negative perceptions', 'oral problems observed', and 'recommendations'. Conclusions: Within the study limits, different perspectives were extracted. Prior to the fieldwork visit, students expressed their lack of self-confidence and inadequate preparation. Following the situated learning visit experience, students' perceptions of managing special needs children was positively influenced. Students were happy to be exposed to such an experience, but hoped for better organisation and specialised supervision in the future.

The association between number of teeth and physical function limitation among older adults in the USA.

AIM: To examine the association between the number of teeth and physical function limitation (PFL), as an indicator of frailty, among older adults in the USA. BACKGROUND: Physical function limitation is common among the elderly and potentially associated with oral health, particularly the number of extracted teeth. MATERIALS AND METHODS: Data from the Behavioral Risk Factor Surveillance System 2014 (BRFSS, 2014), a cross-sectional national interview survey of US population, were analyzed. The number of participating older adults aged 65 and over was 158 962. The association between PFL, outcome and number of extracted teeth, demographic data, socio-economic status, smoking, general health, comorbidity conditions and body mass index (BMI) was assessed using logistic regression analyses. RESULTS: The prevalence of PFL was 28%. In the fully adjusted model, the number of extracted teeth had a significant association with PFL: edentulous older adults had higher odds for PFL, (odds ratio [OR]:1.36; 95%CI: 1.22, 1.52). Similarly, those who lost 6 teeth or more but not all were likely to have PFL (OR 1.35: 95% CI: 1.23, 1.48). CONCLUSIONS: There was a significant association between the number of extracted teeth and PFL among US older adults aged 65 and more, based on the data from BRFSS 2014. The findings indicate that losing teeth may be a potential risk for PFL.

Effectiveness of WhatsApp as a Part of a Hybrid Learning Environment: An Opportunity for Post-COVID-19 Pandemic Pedagogy.

AIM AND OBJECTIVE: This study sought to examine the effectiveness of hybrid learning utilizing WhatsApp as an adjunct to traditional learning in delivering knowledge to and supporting the learning of undergraduate dental students and investigate learner perceptions of WhatsApp use in educational contexts. MATERIALS AND METHODS: The 3-month prospective analytical interventional study sampled 85 undergraduate students from the Department of Preventive Dental Sciences. A WhatsApp group was created, information was sent to the male and female groups, and a written assignment was used as a performance benchmark of knowledge acquisition and application. Perceptions of e-learning through WhatsApp were assessed using a previously validated and published questionnaire. Collected data underwent descriptive and bivariate analyses (unpaired t-test). RESULTS: The average assignment scores of the 85 hybrid learners were statistically significantly higher than those of traditional learners from the previous academic year (34 ± 1 vs 26 ± 3; p < 0.05, respectively). Meanwhile, 57 hybrid learners completed the survey, and 73% agreed/strongly agreed that introducing a new method of teaching via WhatsApp was useful, 70% reported that a professional and comfortable learning environment was created, and 70% felt that group distractions were handled appropriately. The top advantages of learning through WhatsApp were availability/immediacy (94.7%) and being simple to operate (91.2%). Males (40.4%) were significantly more likely to report a sense of belonging to the group than females (33.3%, p = 0.01). Respondents agreed that high expectations of teacher availability (71.9%) and some students making no effort (52.6%) were challenges. Message flooding (45.6%) and time-consuming nature of WhatsApp (36.8%) were identified as technical challenges. CONCLUSION: The findings showed significant improvements in student performance using the hybrid learning tool, as reflected in assignment scores. Positive perceptions of hybrid learning and improved academic performance indicate that WhatsApp is a convenient new teaching tool. CLINICAL SIGNIFICANCE: The results of this study may be applicable to other clinical dental disciplines.

The impact of protective psychosocial factors on khat chewing among male medical and dental future health-care providers in Yemen.

BACKGROUND/PURPOSE: Khat chewing, a green leaf with amphetamine effects, is a public health concern. Yet, it is prevalent and evident, in the khat belt region, among male students in health faculties. This study aimed to examine whether psychosocial factors have a protective impact on khat chewing among male dental and medical students. MATERIALS AND METHODS: A cross-sectional study included all students (1457) in second year and above at a Yemeni university. A self-administered questionnaire was used to obtain sociodemographic data and to assess students' psychosocial characteristics namely, depression, resilience and social support (perceived or received [living with or away from family]). Data analysis included descriptive statistics and multivariable logistic regression modelling. RESULTS: The response rate was 61% (male = 334, female = 547) and the responding students' mean ±â€¯SD age was 22.95 ±â€¯1.56 years. Of the respondents 185 (21% [95%CI = 18%-24%]) were current khat chewers (7 [4%] females and 178 [96%] males respectively). In the adjusted model, among male students living away from family was significantly associated with khat chewing (adjusted odd ratio [AOR] = 3.15,95%CI = 1.96-5.07, p < 0.001) and perceived social support was inversely significantly related to khat chewing (AOR = 0.98; 95%CI = 0.96-1.00; p = 0.019). CONCLUSION: Within the limitation of the study of a single institute, social support whether received (living with family) or perceived appeared to be a protective factor from khat chewing among male medical and dental students. Social support should be enhanced and targeted to discourage khat chewing during the preparation of this future health care force.

Loxoprofen Sodium Versus Diclofenac Potassium for Post-Dental Extraction Pain Relief: A Randomized, Triple-Blind, Clinical Trial.

One of the most common post-operative complications of tooth extraction is pain. Oral analgesics, namely loxoprofen sodium and diclofenac potassium, are often prescribed; however, the efficacy of these drugs irrespective of gender and type of extraction has not been tested. Therefore, this study aimed to compare the efficacy of these two drugs in post-dental extraction pain relief among male and female patients in cases of simple and surgical tooth extraction. A single-center, triple-blind, randomized clinical trial was conducted among 100 male and female patients who underwent tooth extraction at Taibah University Dental College and Hospital in Al-Madinah, Saudi Arabia. The patients reported their pain post-operatively after 6 hours and every 12 h for 3 days using the Verbal Descriptor Scale (e.g., "no pain", "mild pain"). Descriptive statistics and chi-square tests were run to analyze the data. An equal number of patients received either the drug loxoprofen sodium or diclofenac potassium and completed the study follow-up. Patients allocated to the diclofenac potassium drug group after 36 h were statistically significantly in their reporting of "no pain" and "mild pain" compared to patients allocated to the loxoprofen sodium group (86% vs. 66%, respectively; p = 0.019), irrespective of gender or type of tooth extraction. However, both groups demonstrated comparable (p > 0.05) post-operative pain relief over the other aforementioned allocated time intervals. In conclusion, the diclofenac potassium group had slightly better control over post-operative pain than the group receiving loxoprofen sodium.

Self-Perception Of Malocclusion And Barriers To Orthodontic Care: A Cross-Sectional Study In Al-Madinah, Saudi Arabia.

PURPOSE: This study was conducted to assess adult levels of knowledge, awareness of malocclusion and barriers to the uptake of orthodontic care alongside the associated factors (sex and gender). METHODS: A convenience sample aged 18 years and above, residing in Al-Madinah Al-Munawwarah, Saudi Arabia, was recruited. A self-administrated validated questionnaire was used to collect the data, and data descriptive and inferential statistical analysis were performed. RESULTS: Of the 700 distributed questionnaires, 554 usable were returned (response rate = 79%). The mean±SD age of participants was 26.40 (±7.87) years and 55.2% were females. Over 60% of the participants reported high oral health knowledge with respect to the alignment of teeth being important for esthetics and neglected malocclusion had consequences, eg, caries. Likewise, high percentages were having knowledge that thumb sucking (80%) contributed to malocclusion although early extraction of primary teeth and genetics was reported by just 52% and 40%, respectively. Awareness of the importance of teeth alignment was reported by 81.6%; however, 37.7% were only advised for orthodontic treatment. Notably, most of the aforementioned knowledge and awareness was statistically significantly higher among females compared to counterpart males (p < 0.05). As for barriers, high orthodontic treatment fees were the barrier for 80% of the total participants irrespective of age and gender. Females were statistically significantly more likely to report barriers for orthodontic care, eg, accessibility and length of treatment (p < 0.05). CONCLUSION: The majority of the participants scored high levels of knowledge and awareness of oral health-specific conditions in relation to malocclusion. Although females were significantly knowledgeable and aware of malocclusion compared to males, social and orthodontic treatment factors were perceived as barriers to uptake of orthodontic care.

Dentists' attitudes towards chairside medical conditions screening in a dental setting in Saudi Arabia: an exploratory cross-sectional Study.

BACKGROUND: Screening for medical conditions (MCs) of public health importance is a first step in disease prevention and control. Prior studies in the United States found oral health care providers (OHCPS) embrace screening for increased risk of medical conditions in the dental setting. Our objectives were to assess Saudi Arabian (SA) dentist's attitudes, willingness and perceived barriers towards implementing screening for MCs into their dental practices. METHODS: A self-administered, 5-point Likert Scale (1 = very important/willing to 5 = very unimportant/unwilling) questionnaire was given to a convenience sample of 190 practicing dentists. Friedman nonparametric analysis of variance was used to compare responses within each question. RESULTS: Of the 143 responding dentists the mean age was 31 years; 102 (71%) were men. The majority felt it was important for a dentist to screen for cardiovascular disease (98.6%), hypertension (97.9%), diabetes (97.9%), human immunodeficiency virus (HIV) (97.9%), and hepatitis C virus (98.6%). Respondents were willing to refer a patient to a physician (97.9%); send samples to an outside laboratory (96.1%); conduct screening that yields immediate results (96.2%); and discuss results immediately with the patient (93.7%). Respondents were willing to measure/collect blood pressure (67.2%); weight and height (63.7%); and finger stick blood (54.6%). The whole responding dentists (100%) reported time as an important barrier. Respondents were significantly more willing to refer a patient for consultation than send samples to an outside laboratory (mean ranks: 2.32, 2.81, P < 0.001); significantly more willing to measure blood pressure than take oral fluids for salivary diagnostics (mean ranks 2.22, 2.75, p = 0.003). Insurance was significantly (P < 0.05) less important barrier than time, cost, patients' willingness or liability (mean ranks 3.56, 2.63, 3.00, 2.79, 3.02, respectively). CONCLUSIONS: The majority of dentists in this study reported positive attitudes towards and willingness to perform medical screenings in their practice. Time was an important factor.

Socio-Demographic Variation, Perceived Oral Impairment and Oral Impact on Daily Performance among Children in Saudi Arabia.

Background: This study aimed to describe the oral impact (estimate, severity, frequency) on daily performance (e.g., eating, speaking) and identify the potential perceived oral impairment(s) and socio-behavioral factors associated with oral impact, namely presence or absence of oral impact, among children aged 9-12 years old in Al-Madinah Al-Munawwarah, Saudi Arabia. Methods: A cross-sectional convenience sample of 186 children aged 9-12 years old was recruited. Sociodemographic characteristics, oral health-related behaviors, and perceived oral impairments (e.g., caries, toothache) were obtained from participants. The validated Arabic Child Oral Impact on Daily Performance (C-OIDP) inventory was used to assess oral impacts. Sample descriptive statistics and multivariable logistic regressions modeling the association between C-OIDP and explanatory variables were performed. Results: The mean (±SD) age of the children was 10.29 ± 1.24 years, 66.4% were from public schools, and 52% were females. At least one C-OIDP was reported by 78% of the participants. The mean C-OIDP score was 2.27 ± 1.99. Toothache was reported as a perceived impairment for almost all oral impacts and was the strongest predictor of C-OIDP. Low father income was negatively associated with C-OIDP (odds ratio (OR) = 0.24, 95% confidence interval (CI) = 0.10-0.62). Females had significantly higher odds of reporting C-OIDP than males. Conclusions: In this convenience sample, a high percentage of children aged 9-12 years old reported C-OIDP, which was linked to oral impairment and socio-demographic factors. Further studies, however, are required to explore the clinical, behavioral, and sociodemographic factors in relationship to C-OIDP among Saudi children in a representative sample.

Revisited maxillary sinus pneumatization narrative of observation in Al-Madinah Al-Munawwarah, Saudi Arabia: A retrospective cross-sectional study.

OBJECTIVES: Maxillary sinus pneumatization (MSP), is linked worldwide to number of factors. MSP measurements and assessment alongside potential correlates in Al-Madinah Al-Munawwarah, Saudi Arabia (SA) awaits identification. MATERIALS AND METHODS: A retrospective cross-sectional study was conducted at Taibah University Dental-College and Hospital, Al-Madinah Al-Munawwarah; SA. The analysis included 700 female patients digital Orthopantomogram (OPG), of which 535 (76%) OPGs were usable. MSP was established according to the distance between the maxillary sinus floor and posterior teeth apices number 15, 16, 17, 18, 25, 26, 27 and 28. MSP categorized as followed: Sever MSP (Category I), Moderate MSP (Category II) and No MSP/normal (Category III). Descriptive statistics, and inferential analysis were carried out. RESULTS: Mean age of the patients was 30.11 (±10.26) and 290 (54.5%) were Saudi nationals. Severe pneumatization (category I) was prominent in the right and left first and second molars, 16, 26, 17, 27 (66%, 64%, 63% and 62%, respectively). A statistically significant difference (P < 0.0005) was observed between pneumatization categories in all sites. Furthermore, the impact of young age on levels of MSP was statistically significant (P < 0.05) on most teeth. However, nationality was non-significantly (P > 0.05) associated with MSP levels. CONCLUSION: High percentages of female patients showed bilateral sever MSP in the upper molar area, specifically, young age group. CLINICAL SIGNIFICANCE: The oro-antral communication during extraction and surgical cases of female patients' maxillary teeth is possible. This should be considered during dentists' daily practice in this geographic area of SA.