Assessing Tele-Oral Medicine in Saudi Arabia: A Cross-Sectional Study on Specialists' Experiences and Effectiveness in Oral Healthcare.

INTRODUCTION: Teledentistry is an emerging tool to exchange medical information and clinical images to facilitate the diagnosis, prevention, and treatment of oral diseases and patient assurance and education. Considering the shortage of oral medicine specialists in Saudi Arabia, this study aims to assess the experiences of dental specialists with tele-oral medicine and its potential applicability in addressing this shortage. MATERIALS AND METHODS: This was a pilot, cross-sectional study conducted among specialists in the field of oral medicine from January 2020 to March 2020. A total of 16 preselected cases with oral lesions, including clinical history and images, were developed, validated, and shared via email with study participants. Each case included questions on differential diagnosis, provisional diagnosis, and management. The responses were recorded, analyzed, and presented as means and percentages. RESULTS: A total of 49 subjects participated in this study and more than half were under 40 years of age and two-thirds were women. A total of 23 participants had prior experience with tele-oral medicine, mainly via WhatsApp (95.7%), and these cases were received from patients, their families, friends, or other dentists. For all study cases, the correct diagnosis score ranged between 73.50 and 100%, and correct management ranged between 51 and 98%. CONCLUSIONS: Tele-oral medicine is an effective tool that may play an important role in patient management in rural regions with a shortage of oral medicine services. Further studies with larger sample sizes and in collaboration with international centers are warranted to confirm these findings.

The Effectiveness of Oral Health Education Among Non-dental Healthcare Professionals in Jeddah, Saudi Arabia: A Quasi-experimental Study.

OBJECTIVES: The purpose of the study was to evaluate the level of oral health knowledge and practices among non-dental health professionals and to evaluate the effectiveness of oral health education provided to them. METHOD: A convenience sample was recruited from non-dental healthcare professionals in Jeddah, Saudi Arabia. A self-administered questionnaire was distributed to participants to evaluate their oral health knowledge and behavior. Then, oral health educational material (a video) that was specifically developed for the study was sent to all participants to educate them about some oral health information related to adult oral health, oral signs of some systemic diseases, and the oral side effects of some medications. Two weeks later, the same questionnaire was sent to these participants to assess the effectiveness of the oral health education provided to them. RESULT: The pre-intervention questionnaire results revealed a lack of oral health knowledge and inadequate oral health practices among the participants. After the intervention, the level of knowledge improved significantly from 6.4±2.2 to 10.4±3.8 out of 16 (p <0.001). CONCLUSION: The oral health education intervention used in the current study was effective in improving oral health knowledge among non-dental healthcare professionals.

Social Anxiety and Orthognathic Surgery Effect on Oral Health-Related Quality of Life.

OBJECTIVES: This study aimed to investigate the impact of patients' social anxiety on oral health-related quality of life (OHRQoL) in the context of orthognathic surgery. METHODS: The study involved a cohort of 70 patients who were tasked with completing a comprehensive questionnaire aimed at assessing various facets of their OHRQoL at distinct stages of treatment: pre-surgery, within one month post surgery, and more than one month post surgery. Statistical analyses were conducted in the form of t-test. RESULTS: Out of the 70 participants, 27 were male (38.57%) and 43 were female (61.43%). The sample distribution comprised 30 (43%) subjects in the pre-surgical stage, two (3%) at one month post surgery, and 38 (54%) more than one month post surgery. In relation to the t-test results, we found variations in the significance of the results for each question, with multiple results showing patients who reported experiencing discomfort significantly outnumbering those who did not (p < 0.05). CONCLUSION: Social anxiety and orthognathic surgery both demonstrate significant influences on OHRQoL. Subsequent research should delve into specific areas where patients experience the greatest impact.

Awareness of Nutrition Facts Labeling and Its Relation to Oral Health Practices and Caries Experience Among Adult Patients.

AIM: To investigate the relationship between the usage of nutrition facts labels (NFL) and oral and dietary practices and the decayed, missing, and filled teeth (DMFT) score. METHODS: A self-administered questionnaire was distributed to a convenient sample of 150 adult dental patients attending the King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. Electronic dental records were accessed to record each patient's DMFT score. RESULTS: Only 38% (N=57) of the participants read the NFL on their food. A statistically significant association was found between patients' DMFT scores and the NFL reading. Participants who said they read NFLs had lower mean DMFT scores than those who said they did not (8.4 vs. 10.5). CONCLUSIONS: The results of this study demonstrate that there is low usage of NFL among participants. A significant association was noted between the reading of the NFL and caries experience as measured using the DMFT index.

Genotoxicity and cytotoxicity of cone beam computed tomography in children.

BACKGROUND: Dental radiographs are essential tools for diagnosis. However, there are significant concerns about the dangerous effect of radiation especially on children. The aim of this study was to evaluate genotoxicity and cytotoxicity in the exfoliated cells of buccal mucosa of children subjected to Cone Beam Computed Tomography (CBCT). METHODS: The study included 18 healthy children aged (9-12 years) who were exposed to CBCT. All CBCT scans were performed with the i-CAT CBCT. Exfoliated buccal cells were scraped from the left and right cheek immediately before the exposure, after 10 ± 2 days, and after 1 month. Cells were stained using Feulgen/fast green stain and examined under light microscopy. Genotoxicity (Micronuclei) and cytotoxicity (condensed chromatin, karyorrhexis, pyknosis, and karyolysis) were scored. Statistical analysis was performed using the McNemar test, Wilcoxon Signed-Rank test, and Mann-Whitney U test at a significance level of p < 0.05. RESULTS: There were statistically significant differences in the mean percentages of micronuclei, condensed chromatin, karyorrhexis, pyknosis, and karyolysis before and 10 ± 2 days after the CBCT scan (p < 0.05). There were no statistically significant differences in the frequency of micronuclei, condensed chromatin, karyorrhexis, or pyknosis before and 1 month after the exposure (p > 0.05) except for karyolysis (p < 0.05). CONCLUSIONS: CBCT may induce genotoxicity and cytotoxicity in buccal mucosa cells of children. Therefore, CBCT should not be prescribed unless necessary as it cannot be considered a risk-free procedure.

Repair bond strength of dental computer-aided design/computer-aided manufactured ceramics after different surface treatments.

OBJECTIVE: To evaluate the microtensile bond strength of four dental computer-aided design/computer-aided manufactured (CAD/CAM) ceramics after application of four different surface treatments. MATERIALS AND METHODS: Four dental CAD/CAM ceramics were tested: feldspathic ceramic (VITABLOCKS-Mark II), polymer-infiltrated ceramic network (VITA ENAMIC), zirconia-reinforced lithium silicate (VITA SUPRINITY), and yttria-stabilized zirconia (VITA YZ T). Four surface treatments were applied: no treatment, 5% hydrofluoric acid-etching, airborne particle abrasion, and tribochemical silica coating. The ceramic blocks were repaired with nanohybrid composite (Tetric N-Collection). Sixteen test groups of 12 specimens were prepared. After thermocycling, microtensile bond testing was performed. The microtensile strengths values were statistically analyzed using two-way analysis of variance and Tukey's post-hoc test. RESULTS: Repaired feldspathic and resin polymer-infiltrated ceramic network ceramics demonstrated superior microtensile bond strengths compared to zirconia-reinforced lithium silicate and yttria-stabilized zirconia. Etched feldspathic and polymer-infiltrated ceramic network ceramics had higher bond strength than the untreated groups. Surface treatments did not affect the bond strength of zirconia-reinforced lithium silicate and yttria-stabilized zirconia with the exception of etching, which reduced the bond strength of yttria-stabilized zirconia. CONCLUSION: Feldspathic ceramic and polymer-infiltrated ceramic network were repaired with dental composite after surface etching with hydrofluoric acid. Repair of zirconia-reinforced lithium silicate and yttria-stabilized zirconia did not demonstrate promising results. CLINICAL SIGNIFICANCE: Repair of feldspathic ceramic and polymer-infiltrated ceramic network restorations may be a cost-effective means to promote the longevity of dental restorations. However, zirconia and zirconia-reinforced lithium disilicate restorations do not offer such an option.

Management of dental waste in dental offices and clinics in Jeddah, Saudi Arabia.

Management of dental wastes became a recent challenge facing health care practitioners and is one of the highly-sensitive environmental problems. The main purpose of this study was to assess oral health care provider's knowledge and behavior about dental waste management and evaluate their behavior toward it. A cross-sectional descriptive study was conducted on 314 dental health care providers working in four dental colleges, and 20 private dental clinics in Jeddah, Saudi Arabia. A pretested questionnaire composed of close-ended questions was used. The mean age of the participants was 27 years. About 78% of the participants reported that they were working in the public sector. Only 33.4% of the study sample received professional training on waste management. The mean behavior and knowledge scores were 3.7 ± 1.3 (out of 6) and 1.4 ± 1.3 (out of 8), respectively. Statistically significant association was noted between gender and knowledge scores but not between gender and behavior scores. On the other hand, statistically significant associations were noted between both knowledge and behavior scores and rank of the participant, type of practice, and years of experience. Oral health care providers' knowledge about the effective procedure that should be followed for segregating, collecting, transporting, and treating dental waste was weak and substandard. There is an urgent need to develop policies and regulations for dental waste management in Saudi Arabia. Implications: This study shed light for the first time on the knowledge and behavior of dentists in Jeddah, Saudi Arabia in regard to the dental waste management. Participants knowledge and behavior in regard to dental waste segregation, collection, transportation, and treatment were determined to be week and substandard. Currently, different procedures related to dental waste management in health care facilities are not clearly described. The urgent need for the development of policies and regulations for the dental waste management is obvious. This study can be a starting point for future nation-wide surveys to assess knowledge, behavior and practices related to dental waste management among oral health care providers. In addition, more efforts should be directed to incorporate this subject into dental curriculum and continuous education courses.

Dental injuries in taekwondo athletes practicing in Saudi Arabia.

OBJECTIVES: To assess the incidence and awareness of taekwondo athletes in Saudi Arabia regarding oral and maxillofacial (OMF) injuries and their prevention. Methods: In this cross-sectional study, an online questionnaire about the incidence and awareness of OMF injuries and their prevention was developed and distributed to taekwondo athletes in Saudi Arabia via their coaches.  Results: Sixty-eight responses were collected. The mean age of the participants was 29.3±9.1 years and 97% of them were males. Most of the participants (83%) believed that they are vulnerable to OMF injuries during practice. Approximately 23% of the participants reported a previous injury of the OMF area, while approximately 56% reported injuries in other areas. Most dental injuries (94%) were tooth fracture or displacement, while 6% were tooth avulsion. Eight participants (12%) were aware of the possibility of returning an avulsed tooth to its socket. More than 50% of those participants had inadequate knowledge on the appropriate storage media for the avulsed tooth or the maximum time allowed to return it to its socket. Eighty-one percent of the participants knew about the mouthguard, while 56% reported that they are actually using one. The most frequently reported barriers for not using a mouthguard during practice were difficulty in practicing with it, not being convinced of its importance, and lack of information where to get one. Conclusions: Most of the participants are aware of OMF injuries; however, their knowledge and behavior towards preventing and managing them are inadequate.

Development and evaluation of an oral health literacy instrument for adults.

OBJECTIVES: To develop and validate an instrument to measure the functional oral health literacy of adults. METHODS: For the generation of items different dental patient educational materials and text types were selected that had reading levels similar to materials used for the Test of Functional Health Literacy in Adults (TOFHLA) which was the model for our Oral Health Literacy Instrument (OHLI). The OHLI contains reading comprehension and numeracy sections. The reading comprehension section is a 38-item test with words omitted from one passage on dental caries and another on periodontal disease. The numeracy section has 19 items to test comprehension of directions for taking common prescriptions associated with dental treatment, postextraction instructions and dental appointments. We also developed a 17-item oral health knowledge test. The OHLI, the TOFHLA, the oral health knowledge test and a brief questionnaire were administered to a convenience sample of 100 patients. Internal reliability of OHLI was assessed with Cronbach's alpha. Test-retest reliability was examined by intra-class correlation coefficient (ICC). Concurrent validity was tested by comparing OHLI scores across categories of education level and frequency of dental visits. Construct validity was assessed by correlating OHLI scores with TOFHLA scores and with the oral health knowledge scores using Spearman's rho (rho) and multiple linear regression. RESULTS: Participants averaged 39 years (SD = 12.4); 73% were female; 64% had college/university education; 40% visited a dentist every 3-6 months. Total OHLI and TOFHLA weighted mean scores were 87.2 and 91.7, respectively (possible range 0-100). The Cronbach's alpha values were high (>0.7) for OHLI and its components. The ICC values indicated good agreement between the test and retest results for OHLI and the oral health knowledge test. Patients visiting a dentist every 3-6 months had significantly higher levels of oral health literacy than those visiting only when they felt pain. The association between OHLI and education level was not significant. OHLI scores were significantly correlated with the scores on the TOFHLA (rho = 0.613) and the test of oral health knowledge (rho = 0.573). These associations remained significant in multiple regression models. CONCLUSION: Initial testing of OHLI suggested that it is a valid and reliable instrument to evaluate oral health literacy among adults, although additional work is needed to investigate the instrument's predictive validity and sensitivity to change using oral health outcomes with population groups known to be at high risk of low functional oral health literacy.