Knowledge, attitude, and practice of dental health professionals toward dental impression disinfection protocol during the COVID-19 pandemic in Saudi Arabia- a cross-sectional study.

BACKGROUND: Despite the updated guidelines on dental impression disinfection protocols during the COVID-19 pandemic, adherence to such procedures has not been studied among dental health professionals in Saudi Arabia. Understanding DHPs' knowledge, attitudes, and practices regarding COVID-19 is crucial in assessing a willingness to adhere to the recommendations provided by health authorities in mitigating the spread of COVID-19 via dental impressions impacting patient safety and infection control measures. Hence, this study aimed to assess dental health professionals' (DHPs) knowledge, attitudes, and practices (KAP) toward dental impression disinfection protocol during the COVID-19 pandemic in Saudi Arabia. METHODS: A cross-sectional study using an online survey was conducted from 14 December 2022 to 21 March 2023 among practicing dentists, dental assistants (DA), dental laboratory technicians (DT), and dental hygienists in Saudi Arabia. A validated and reliable questionnaire that consisted of 38 items along with demographic variables was prepared to collect the data. Using Google Forms, a questionnaire link was prepared and shared on the social media platforms of DHPs in Saudi Arabia. A descriptive analysis was conducted to report the percentages and frequencies. The mean knowledge, attitude, and practice scores were analyzed using an Independent t-test, ANOVA, and Pearson's correlation tests. RESULTS: A total of 718 DHPs voluntarily participated in the survey. Most of the DHPs exhibited average knowledge 392 (54.6%), neutral attitudes 393(54.7%), and adequate 549 (76.5%) practice towards dental impression disinfection protocol. The mean knowledge score differed significantly across nationality (p = 0.013), type of DHPs (p < 0.001), qualification (p = 0.045), and experience (p = 0.028) of the study participants. Significant differences in attitude towards impression disinfection were observed in different age groups (p = 0.002), qualifications (p = 0.015), and experiences (p = 0.024) of the DHPs. Similarly, practice varied across different age groups (p = 0.010), nationality (p = 0.013), type of DHPs (p = 0.019), qualification (p = 0.044), experience (p = 0.041), and COVID-19 Infection (p = 0.006). Moreover, a significant positive correlation between knowledge-attitude (r = 0.258, p < 0.01), knowledge-practice (r = 0.283, p < 0.01), and attitude-practice (r = 0.196, p < 0.01) was observed. CONCLUSION: DHPs considered in this study demonstrated average knowledge and attitudes toward impression disinfection, requiring improvement through continuous dental education and training. However, they displayed acceptable dental impression disinfection practices during the COVID-19 pandemic. It is highly recommended that continuing education programs should mainly reinforce the knowledge of sodium hypochlorite, iodophor, and phenolics and their concentrations to be used as an impression disinfectant. Additionally, it should focus on techniques of disinfecting elastomeric, hydrocolloid, zinc oxide and eugenol, and impression compound materials to mitigate the spread of COVID-19 based on Saudi ministry of health guidelines.

Comparative Assessment of Oral Health Attitudes and Behaviors of First-Time and Previous Dental Patients Undergoing Exodontia Treatment During the COVID-19 Pandemic in Private Dental Clinics in Riyadh City, Saudi Arabia.

Background: The COVID-19 lockdown affected oral health behaviors. This study aims to assess and compare the oral health attitudes and behaviors of first-time and previous patients undergoing dental extractions during the COVID-19 pandemic at private dental clinics in Riyadh City, Saudi Arabia. Methods: This cross-sectional study was conducted among patients aged 18-65 years undergoing dental extractions at private dental clinics in Riyadh City, Saudi Arabia. Four hundred and eighty patients were selected using a convenient sampling methodology. A structured, close-ended questionnaire investigated demographic information, tooth extraction attendance, and oral health attitudes and behaviors using 20 items Hiroshima University Dental Behavioral Inventory (HUDBI). Results: A total of 480 exodontia patients [282 (58.8%) males and 198 (41.2%) females] participated in this study. All patients used a stiff-bristled toothbrush and were concerned about their teeth' color and bad breath. Similarly, all the participants did not feel brushed unless they used strong strokes, and the dentist told them to brush very well. An overall mean HUDBI score of 6.34±1.12 was observed. Patients with a primary education (5.61±0.79), income ≤5000 SAR (6.00±0.92), residing in rural areas (5.84±0.93), and government employees (5.62±0.96) exhibited lower HU-DBI scores compared to their counterparts. The study revealed a significant variation in HUDBI scores across different demographic factors, including education, income, residence, occupation, and reason for extraction (p<0.001). The HUDBI score of first-time attendees to dental extraction (5.88±1.03) was found to be significantly poorer than to those of previous attendees (6.63±1.09), (p<0.001). Conclusion: Patients who underwent dental extractions at private dental clinics in Riyadh City, Saudi Arabia, during the post-lockdown COVID-19 pandemic exhibited average oral health attitudes and behaviors. Oral health attitudes and behaviors differed by socioeconomic status. Patients undergoing dental extractions for reasons other than dental caries and periodontal diseases and first-time attendees demonstrated poor oral health attitudes and behaviors.

Long term remineralizing effect of casein phosphopeptide amorphous calcium phosphate in white spot lesions: A systematic review and meta-analysis.

BACKGROUND: White spot lesions (WSLs) appear as white, opaque areas on the teeth and are caused by a demineralization of the enamel. OBJECTIVE: The purpose of this systematic review and meta-analysis was to determine whether casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has beneficial effects on WSLs and provides remineralizing benefits that are superior to those of placebo or no treatment. METHODS: Following a thorough analysis of the literature across major online sources, 103 papers - 54 of which underwent in-depth evaluation - were found. We used inclusion and exclusion criteria to choose research articles that were appropriate for our review. RESULTS: 10 papers met this review's requirements and were subsequently included. As compared to the controls, CPP-ACP demonstrated increased efficacy in treatment of WSLs in terms of remineralisation and other parameters which included microhardness tests and enamel surface roughness. The forest plots present the results of meta-analyses comparing the effect of CPP-ACP versus control/other agents on white spot lesions (WSLs). In terms of odds ratios (OR), CPP-ACP showed a small increase in the odds of WSLs compared to control/other agents. In-vitro studies showed no significant difference in relative risk (RR) between CPP-ACP and control/other agents. Randomized control trials indicated a small increase in the risk of WSLs with CPP-ACP treatment, but the overall effect was not statistically significant. CONCLUSION: There was evidence to support the use of CPP-ACP over other agents for WSL prevention or treatment, but further research is needed to confirm these findings.

Assessment of Salivary pH, Buffer Capacity, and Flow in COVID-19-Infected and Vaccinated Dental Patients.

Background The impact of COVID-19 infection and immunization on salivary gland function has not yet been fully understood. Therefore, a study to determine salivary pH (SP), salivary buffer capacity (SBC), and salivary flow (SF) in COVID-19-infected and immunized patients seeking dental care is necessary. Therefore, the main goal of this study was to evaluate saliva production at five minutes, SP, and salivary SBC in COVID-19-infected and vaccinated dental patients who were undergoing treatment at a private university dental hospital in Riyadh, Saudi Arabia. Methodology Dental students at Riyadh Elm University were included in this observational study, which involved dental patients. Based on Tawakkalna application records, patients were asked to provide their COVID-19 infection and vaccination status. Mean, standard deviation, and descriptive statistics of the frequency distribution were computed. Results The study included individuals aged 18 to 39 years old, with an average age of around 28.5 years old. The sample had slightly more males than females, but the difference was not significant. In terms of COVID-19 testing, most individuals had tested positive for the virus two or three times. The most common amount of unstimulated saliva produced was 3.5 mL, with most individuals producing between 2 and 3.5 mL of saliva. According to the observations, there were substantial variations between people who tested positive and negative for the COVID-19 virus in terms of SP and buffering capacity, suggesting that these factors could be possible indications of infection. Conclusions This study also emphasizes the value of evaluating several salivary factors to enhance diagnostic precision and the possibility of saliva-based testing as a non-invasive and affordable substitute for conventional diagnostic techniques in relation to oral issues. The study does, however, have several drawbacks, such as the limited sample size and the inability to be generalized to different populations.

Effect of Silver Diamine Fluoride on Bacterial Biofilms-A Review including In Vitro and In Vivo Studies.

Caries/carious lesions are a growing concern among the general population across the world, and different strategies are evolving to combat the bacterial invasion that resultantly leads to caries. In this systematic review, we are looking to analyse the role of silver diamine fluoride (SDF) on the growth of bacterial biofilms. The search strategy for the studies to be selected for the review was initiated by a search across multiple databases, which ultimately yielded 15 studies that were in accordance with our objectives. The reviewed articles indicate a very clear correlation between the usage of SDF and the decrease in bacterial biofilms, which are limited not just to one or two but multiple bacterial species. As shown by the events favoring SDF's odds ratio of 3.59 (with a 95% confidence interval of 2.13 to 6.05), a risk ratio of 1.63 (1.32 to 2.00), and a risk difference of 0.28 (0.16 to 0.40), there was strong evidence that SDF is a successful treatment for reducing bacterial biofilms in dental practice. This study offers substantial proof that SDF works well to reduce bacterial biofilms in dentistry practices. We advise further investigation to examine the potential of SDF as a standard therapy choice for dental caries and related conditions given the obvious relationship between the use of SDF and the reduction in bacterial biofilms.

Impact of the COVID-19 Pandemic on the Dental Preferences of Patients at Private University Hospitals in Riyadh, Saudi Arabia.

Studies that particularly look into how the pandemic has affected Saudi Arabian patients' dental preferences are scarce. The majority of the research done so far has focused on the pandemic's broad effects on oral health rather than the specific changes in patient preferences for dental care. Therefore, the primary goal of the study was to examine how patients at a private university dental hospital underwent dental procedures both before and after the pandemic. The study is a retrospective analysis of patient data from March 2019 to February 2022 obtained from electronic hospital records (Dentoplus). The data extracted information pertaining to the number of patients and their periodic visits. The data was examined via statistical tests. At 0.05, the significance level was chosen. According to the research, compared to non-lockdown times, lockdown times saw a considerable drop in the number of patients scheduling appointments. There was also a significant decrease in the number of first-time patients during lockdown periods. The study also revealed a significant increase in the number of cancelled appointments and patients who discontinued treatment during lockdown periods. The age and gender of the patients did not have a significant effect on these findings. The study's findings suggest that dental professionals need to be aware of these changes in patient behavior and adapt their services accordingly. Dental clinics may need to focus on promoting their services and ensuring that patients feel safe and comfortable seeking dental care during the pandemic.

Comparison of Salivary Secretion, pH, and Buffer Capacity Between COVID-19 Vaccinated and Unvaccinated Child Patients Visiting Dental Clinics of University Hospitals in Riyadh City, Saudi Arabia.

Objective: This study aimed to assess and compare the salivary secretion, pH, and buffer capacity between COVID-19 vaccinated and unvaccinated child patients visiting the clinics of private university dental hospitals in Riyadh, Saudi Arabia. Methods: This is the first comparative assessment of salivary parameters between unvaccinated and COVID-19-vaccinated child patients. The study sample comprised COVID-19 unvaccinated (n = 66) and vaccinated (n = 66) pediatric dental patients aged 4-12 years seeking dental care in clinics of private university hospitals. Paraffin-stimulated saliva was collected from unvaccinated and vaccinated study participants, and the amount of saliva secreted per minute was noted. Salivary pH and buffering capacity (by 5 mmol Hydrochloric acid titration) were measured using a benchtop digital pH meter. The data obtained were compared between unvaccinated and vaccinated participants using an independent t-test. Results: The results showed a significantly higher salivary secretion rate in unvaccinated than vaccinated study participants (0.83 ± 0.24 mL/min vs 0.67 ± 0.24 mL/min, p = 0.001). Similarly, unvaccinated subjects compared to vaccinated subjects exhibited a significantly higher pH (7.33 ± 0.39 vs 7.04 ± 0.46, p < 0.001) and buffering capacity (6.31 ± 1.55 vs 5.40 ± 1.22, p < 0.001). Moreover, unvaccinated females demonstrated a significantly higher salivary secretion (0.87 ± 0.23 vs 0.71 ± 0.25, t = 2.627, p = 0.011) and buffering capacity 6.19 ± 1.52 vs 5.34 ± 1.25, t = 2.404, p = 0.019) than vaccinated females. Similarly, unvaccinated male exhibited significantly higher salivary secretion (0.80 ± 0.25 vs 0.64 ± 0.23, t = 2.670, p = 0.009), salivary pH (7.39 ± 0.45 vs 6.94 ± 0.41, t=4.309, p<0.001) and buffering capacity (6.42 ± 1.60 vs 5.45 ± 1.21, t = 2.875, p = 0.005) than the vaccinated male subjects. Conclusion: The vaccinated subjects showed a significantly lower mean salivary secretion, pH, and buffering capacity than unvaccinated participants. Hence, COVID-19 vaccination is likely to affect salivary parameters among pediatric patients.

Impact of Invisalign G-series Updates on Improving Predicted Outcomes: A Retrospective Study.

BACKGROUND: Understanding the real-world implications of periodic changes to orthodontic appliances can provide valuable insights for future treatment strategies and patient outcomes. This study aimed to investigate the impact of the latest updates added to the G7 and G8 Invisalign series on actual versus predicted outcomes and the percentage accuracy of the treatment. METHOD: This retrospective study was conducted in private orthodontic practices in Riyadh, Saudi Arabia. Orthodontists carried out Invisalign® treatment using the latest updates added to the G7 and G8 Invisalign series. The study group comprised patients with different malocclusion types who received non-extraction Invisalign treatment. The Invisalign treatment plan was provided by the ClinChecks program (Invisalign, San Jose, United States) for patients treated throughout the years (2016-2022). Different dimensions were assessed to record predicted and actual treatment outcomes with the aid of iTero® (Align Technology, San Jose, United States) and ClinCheck® (Invisalign, San Jose, United States). The percentage accuracy was determined using the formula (100%-((Predicted-Actual)/Predicted) *100%). RESULTS: A total of 108 patients (male = 34 (31.5%) and female = 74 (68.5%)) treated with Invisalign G7 and G8 series were considered in this study. The overall mean and standard deviation values of vertical distance (2.91±1.42), intermolar distance in the lower arch (52.68±3.15), overjet (2.71±1.06), and inter-incisal angle (138.24±12.18) were higher than the predicted model. However, the predicted model showed higher mean and standard deviation values for intercanine distances in the upper (36.94±1.57) and lower arches (28.48±1.40) and upper intermolar distances (57.21±2.91). The G7 versus G8 intercanine distance in lower (61.28±47.67 vs. 80.51±38.32), intermolar distance in upper (61.72±47.67 vs. 69.95±44.11), and intermolar distance in lower (100.68±3.80 vs. 100.89±2.52) were relatively higher in the G8 series than the G7. The accuracy percentage was higher with the G8 series than with the G7 regarding the intercanine distance in the upper arch. In contrast, the G7 series showed a higher mean percentage accuracy of vertical distance (91.11±84.83 vs. 76.76±65.45), overjet (58.44±35.17 vs. 53.71±45.87), and inter-incisal angle (34.47±44.06 vs. 27.53±37.98) than the G8 series. CONCLUSION: The percentage accuracy of aligner therapy administered using the Invisalign G7 and G8 series demonstrated no significant variation.

Oral Impacts Experienced by Orthodontic Patients Undergoing Fixed or Removable Appliances Therapy in Saudi Arabia: A Cross-Sectional Study.

PURPOSE: The objective of this study is to compare the orthodontic patient's experiences with removable and fixed orthodontic appliances on daily activities, food consumption, and oral symptoms in Riyadh city, Saudi Arabia. METHODS: This was a cross-sectional observational study carried out among orthodontic patients. A total of 150 adult patients, including 118 in the fixed orthodontic appliance group and 32 in the removable (Invisalign) orthodontic group, who met the inclusion criteria completed a validated and self-administered questionnaire. In addition, the study participants reported their experience in terms of daily routine, food consumption, and oral symptoms one week after appliance activation. Data were analyzed using the chi-square test and Fisher's exact tests for the categorical variables. In addition, Mann-Whitney U, Kruskal-Wallis, and Spearman's tests were also applied to the data. RESULTS: The fixed orthodontic patients compared to the removable orthodontic cases showed significantly higher difficulty in sleeping (1.28±1.10 vs 0.94±0.88, p=0.024), sores on the tongue (0.97±1.00 vs 0.56±0.76, p=0.042) and cheeks (1.20±1.11 vs 0.72±0.81, p=0.027), and the presence of food debris under the appliance (1.53±1.16 vs.1.00±0.95, p=0.021). Moreover, the oral health impact score showed a significant positive correlation with the duration of the orthodontic treatment (r=0.339, p<0.001) and pain intensity (r=0.309, p<0.001). CONCLUSION: The fixed orthodontic treatment compared to removable orthodontic treatment resulted in more severe pain, sleeping difficulty, sores on the tongue and cheeks, and food impaction after one week of appliance activation.

Self-Reported Basic Oral Health Knowledge of Primary School Students and Teachers in Rural Areas of Saudi Arabia.

BACKGROUND: Oral health knowledge is essential for establishing healthy behaviors. AIM: The purpose of the study was to determine and compare the basic oral health knowledge of 3-6th grade government primary school students and teachers in rural areas of Saudi Arabia. METHODS: A cross-sectional study was conducted among government primary school students and teachers in a rural area (Thadig and Ad-Delam) of the Riyadh region of Saudi Arabia using validated, structured, close-ended and self-administered questionnaires. The questionnaire comprised demographic variables and 18 multiple-choice items. A convenience sampling methodology was employed to select the study sample. RESULTS: A total of 1864 subjects from rural area government primary schools [students (N = 1538) and teachers (N = 326)] participated in this study. The majority of the students were females 841 (54.7%), Saudi nationals 1376 (89.5%), and studying in 5th grade 446 (29%). Most teacher participants were females, 199 (61.0%), and Saudi nationals, 326 (100.0%). Teachers (12.62 ± 2.36) demonstrated significantly higher overall mean knowledge scores compared to the students (9.63 ± 2.36) (p < 0.001). Females and non-Saudi students showed significantly higher mean knowledge scores compared to their counterparts. However, 4th standard students showed significantly lower mean knowledge scores compared to other graders. Female teachers (13.17 ± 2.25) demonstrated significantly higher overall oral health knowledge scores compared to male teachers (11.75 ± 2.26) (p < 0.001). CONCLUSION: Basic oral health knowledge was adequate among 3-6th grade government primary school students and teachers in rural areas of the Riyadh region.

Correlations Between Mandibular Asymmetries and Temporomandibular Disorders: A Systematic Review.

OBJECTIVE: This systematic review aimed to investigate the correlation between mandibular asymmetry and temporomandibular disorders (TMDs). MATERIALS AND METHODS: A systematic search of the published literature was performed in electronic databases such as PubMed (MEDLINE), Scopus, Web of Science, Cochrane, Google Scholar, Clinicaltrials.gov, and Saudi Digital Library. Gray literature was searched through System for Information on Grey Literature through OpenGrey. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed in the investigation. The focussed question according to PICO format was: "does the mandibular asymmetry contribute to temporomandibular disorders"? Eligibility criteria included clinical trials (CTs), observation studies, cross-sectional and cohort studies in English that investigated mandibular asymmetries and TMD among patients. Blind and duplicate study selection, data extraction, and risk of bias assessment were carried out. RESULTS: The initial search resulted in 1906 articles, of which 11 (8 CTs, 1 cross-sectional, 1 retrospective, and 1 observational) studies were selected for qualitative synthesis after fulfilling the eligibility criteria. CONCLUSION: Most of the studies included in this review showed either very high risk or high risk of bias. Despite the low certainty of evidence, the current study indicated a likely relationship between mandibular asymmetries and TMDs.

Noise levels encountered in university dental clinics during different specialty treatments.

BACKGROUND: Noise levels encountered during the dental treatments in different departments have deleterious effects on the ears of dental healthcare providers and there is scarcity of data in the literature in Saudi Arabia. Hence, the aim of the study was to determine the noise levels resulting from the usage of different specialty instruments and equipment. MATERIAL AND METHODS: A cross-sectional study was conducted to measure the level of noise produced by different specialty instruments and equipment within the dental clinics of the College of Dentistry, Riyadh Elm University (REU), Riyadh. The noise produced during the restorative treatments, endodontics and prosthodontics was recorded objectively using a decibel (dB) meter placed at a distance of 30 cm from the operator's ear. Mean noise levels were calculated and compared among the various specialty treatments using Analysis of Variance (ANOVA). Furthermore, Tukey's test was applied to perform a pairwise comparison between the groups. RESULTS: An overall noise of 73.83 ± 4.39 dB was found to be generated within the dental clinical setting. A highest sound level of 79.44 ± 2.10 dB was observed during restorative treatment followed by 74.14 ± 3.08, 73.22 ± 1.93, 71.39 ± 3.37 and 70.97 ± 4.70 dB for endodontic, periodontal, and prosthodontic treatments, respectively. A statistically significant difference was observed in the noise levels produced from the different specialty treatments (P = 0.000). CONCLUSION: The greatest noise level was recorded with the use of the amalgamator in restorative dental treatment. It was inferred that the noise emanating from all the specialty dental treatments was below the hazardous levels. Long-term exposure may, however, have adverse effects on auditory as well as general health.

Dental Professional's Knowledge, Preventive Awareness and Attitude Towards COVID-19 in Saudi Arabia: A Cross-Sectional Survey.

BACKGROUND: Given the COVID-19 pandemic, it is necessary to assess the dentist's knowledge, preventive awareness, and attitude towards COVID-19 in Saudi Arabia. This study aimed to assess dental professionals' knowledge, preventive awareness, and attitude towards dental care during the COVID-19 pandemic in Saudi Arabia. STUDY SUBJECTS AND METHODS: The study participants consisted of dental professionals working in government, private and academic sectors in Saudi Arabia. An online questionnaire (Whatsapp and Twitter) was sent to dental professionals in July 2020. The questionnaire consisted of questions on dental professional's demographic variables, their knowledge of the incubation period, the symptoms, mode of transmission, preventive awareness of COVID-19, and their attitude toward treating patients with COVID-19. Mann-Whitney U and Kruskal-Wallis tests were applied to compare mean ranks and a p<0.05 is considered statistically significant. RESULTS: This study included a total of 356 dental professionals (dentists and dental students) aged 22-60 years (mean±SD, 32.14±7.48 years). Majority of the participants were graduates/general practitioners (GP) 145 (40.7%), followed by post graduate (PG) student 108 (30.3%), undergraduate students 23 (6.5%) and specialist 80 (22.5%). Dental professionals showed a high level (>90% correct responses) of knowledge of COVID-19 except for the infection among comorbid patients 283 (79.5%) and incubation period of COVID-19, 164 (46.1%). An overall high knowledge of COVID-19 (87.26%), preventive awareness (88.64%) and a positive attitude (65.26%) towards dental care were observed among the study participants. The mean knowledge ranks differed significantly in different genders (p=0.029) and marital status (p=0.023), whereas preventive awareness differed significantly across various qualifications (p=0.004). The mean attitude rank was significantly higher among Saudi (182.29) compared to non-Saudi (141.36) study participants (p=0.025). CONCLUSION: The dental professionals participated in this study demonstrated adequate knowledge of symptoms, preventive awareness, and a positive attitude towards dental care of the COVID-19 infected patients.

Knowledge, Attitudes, and Practices Toward COVID-19 in a Saudi Arabian Population: A Cross-Sectional Study.

Background Preventative measures are necessary to control a pandemic such as coronavirus disease 2019 (COVID-19), and different platforms to communicate guidelines have varying levels of effectiveness. Objective At the time of this study, there were no published studies investigating knowledge, attitudes, and practices related to COVID-19 within the Saudi population. Therefore, this study aims to address this gap in current knowledge and provide baseline data to the government and other health associations for preventive measurements for future outbreaks. Methods This study was conducted among the Saudi population using an online questionnaire. The questionnaire assessed the awareness of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incubation period, the known symptoms of COVID-19, the mode of transmission of SARS-CoV-2, and infection control measures for prevention. Results The study included 6000 participants. Most respondents (84.93%) of the population reported awareness of the virus, 78.78% reported a belief that the virus leads to death, 89.47% reported a belief that 14 days is the incubation period, and 93.73% were aware of the possibility of asymptomatic carriers. Conclusions The Saudi population is aware of the attitudes and practices of prevention as well as the mode of transmission. The efforts by the Ministry of Health were effective in increasing awareness among the Saudi population toward COVID-19.

Impact of severity of tooth loss on oral-health-related quality of life among dental patients.

BACKGROUND: Tooth loss has a negative impact on the person's life so this study was done to assess the impact of tooth loss on oral-health-related quality of life (OHRQoL) in adult patients seeking dental care in private university dental clinics using Arabic version of 14-item Oral Health Impact Profile (OHIP-14) questionnaire in Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was conducted among 152 patients seeking dental care at a private university dental clinics in Riyadh city, Saudi Arabia. A structured and close-ended OHIP-14 questionnaire was self-administered by the study participants. Descriptive statistics, Kruskal-Wallis, Mann-Whitney, and Spearman's correlation tests were applied to the data. RESULTS: Patients with categories 1-5, 6-10, and >10 teeth loss showed a mean OHIP-14 scores of 10.51 ± 10.36, 13.46 ± 10.06, and 21.46 ± 14.41, respectively. A statistically significant difference in OHIP-14 score was observed among different categories of tooth loss (P = 0.005). Participants with >10 teeth loss showed significantly higher OHIP-14 score compared with 1-5 and 6-10 teeth loss categories (P < 0.05). Teeth loss significantly affected the functional limitation (P = 0.000) and social disability (P = 0.044) subscales. CONCLUSION: Tooth loss adversely affected the OHRQoL among the dental patients. As the severity of teeth lost increased, the OHIP-14 score also increased with higher oral health impairments.

Dental esthetic and the likelihood of finding a job in Saudi Arabia. A cross-sectional study.

BACKGROUND: Person's physical, dental appearance, and sexual identity are the characteristics most obvious to others. Prior researches suggest that visible sign of unhealthy dental status may lead to an individual's social or professional exclusion, so the aim of the study was to measure the influence of dental appearance on hiring managers' perception of intelligence, honesty and efficiency of job applicants in Saudi Arabia, and the likelihood of employment opportunity. MATERIALS AND METHODS: This cross-sectional study comprised 280 hiring managers. All participants were assigned randomly into two groups and received a survey with 10 different images for hypothetical job applicants. The images were digitally manipulated to have the Saudi national dress and to represent different dental conditions. The photos in both surveys were the opposite with no repetition except for 3 for reliability. Each evaluator randomly received one survey without knowing of the other. Participants were asked questions about their perception of honesty, intelligence, efficiency, and potential employability of the provided applicants' photos. RESULTS: There was no statistically significant difference in demographics data between the hiring managers assigned to both groups. Hypothetical job applicants with smiles affected by malocclusion were perceived to be less intelligent with P value = 0.0001, but there was no altered perception for honesty and efficiency. Moreover, applicants with caries were perceived to be less honest, intelligent, and efficient by the hiring managers with P value of 0.0007, 0.0011 and 0.0138, respectively. Applicants with dental imperfections compared to normal smile were 52% less likely to be employed. CONCLUSION: Dental appearance might alter people perception about the character of the affected person, and it might influence the judgment of future employers when screening for candidates; as a result, we recommend more educational programs for the public and hiring managers.

Evaluation Distal Caries of the Second Molars in the Presence of Third Molars among Saudi Patients.

OBJECTIVES: To evaluate the prevalence of distal caries in second permanent molars in the presence of third molar among patients attending university dental clinics in Riyadh City, Kingdom of Saudi Arabia. MATERIALS AND METHODS: Clinical and radiographic data (orthopantomographs and right and left bite wings) from 313 patients attending Riyadh Elm University dental clinics, department of oral diagnosis were collected and analyzed for the presence of third molars and caries on the distal surface of the second molar. Descriptive statistics of frequency distribution, mean and standard deviation, and binary logistic regression analysis were applied to assess the association between distal surface caries on second molars and impaction status of the teeth. RESULTS: The mean decayed, missing, and filled teeth score of the study participants was found to be very high, that is, 23. The prevalence of caries affecting the distal aspect of the second molar was 48.6% (n = 609) in the population. The prevalence of distal caries was significantly high in patients with fully erupted wisdom teeth followed by vertical, horizontal, and mesial impacted third molars (P < 0.05). Wisdom teeth with mesioangular, vertical, and horizontal impactions showed significant association with distal caries of second molars below the contact point, whereas, fully erupted and vertically impacted wisdom teeth showed significant association with distal surface caries of second molars above contact point. Similarly, vertically impacted wisdom teeth were found to have significant association with caries of distal surface of second molars on noncontact areas (P < 0.05). CONCLUSION: This study showed that the distal surface of the second molars is at risk of caries in the presence of third molars. However, this risk depends on eruption status, type of angulation, and contact between third and second molars. All the preventive measures should be taken to avoid caries on distal surface of second molar.

The Effect of Oral Health Knowledge, Attitude, and Practice on Periodontal Status among Dental Students.

OBJECTIVES: The primary aim of the current study is to relate oral health knowledge, attitude, and oral hygiene practice with the periodontal condition of both undergraduate and postgraduate dental students. MATERIALS AND METHODS: Data were collected through a combination of self-reported questionnaire and clinical examination. The estimated sample size was 246. Probing depths and clinical attachment loss were measured in interproximal sites, whereas the gingival index was calculated based on Ramfjord teeth. The Centers for Disease Control and the American Academy of Periodontology classification was used for periodontal diagnosis. The subjects were divided into three groups. Group 1 was composed of undergraduate, preclinical dental students, group 2 consisted of undergraduate clinical-year dental students, whereas group 3 included postgraduate residents. RESULTS: A total of 296 dental students participated in this study. Significant differences were found among the groups in their oral health knowledge, attitude, and practice scores. Gingival disease was detected among most of the participants (99.2-100%) with significant differences between different educational levels (group 1 = 1.13, group 2 = 1.16, group 3 = 0.96, p-value = 0.001). Sixty percent of dental students were diagnosed with periodontal disease regardless of its severity. A positive correlation was established between oral health knowledge and attitude and oral hygiene practice. In addition, gingival inflammation severity and the severity of periodontal disease showed a positive correlation. CONCLUSIONS: This study highlighted the need to improve the oral health knowledge, attitude, and practice of dental students. Gingival and periodontal inflammation was highly prevalent among participants.

Oral Health Status, Treatment Needs and Oral Health Related Quality of Life among Hearing Impaired Adults in Riyadh City, Saudi Arabia.

AIM: The primary objective was to determine the oral health status and treatment needs among hearing-impaired (HI) adults. Second, to assess the relationship between the oral health variables and oral health-related quality of life (OHRQoL) by using General Oral Health Assessment Index (GOHAI)-Ar questionnaire among HI adults in Riyadh city, Saudi Arabia. MATERIALS AND METHODS: A total of 146 HI adults between the age groups of 18-21, 22-25, and >25 years were included in the study. A convenient sampling technique was used to obtain the study sample. Oral health condition was recorded by using oral hygiene index-simplified (OHI-S), plaque index (PI), and gingival index (GI). The WHO methodology was used to record dental caries and treatment needs. The Saudi Arabian version of GOHAI-Ar questionnaire was used to gather information with regard to OHRQoL. A sign language expert communicated information between HI and investigator while answering the questionnaire. RESULTS: More than half of the HI had fair OHI-S (55.2%) and PI score (54.2%), while 60.1% of HI had moderate gingival inflammation. The prevalence of dental caries (82.2%) and treatment needs (85.6%) were found to be high. Mean oral hygiene scores between Saudi and non-Saudi nationals [(1.64) vs (1.12), p = 0.041] showed significant differences. Missing and filled teeth showed significant differences across different age groups (p = 0.000). The mean GOHAI-Ar was found to be low (14.44 ± 9.59). Spearman's test showed a significant positive correlation between the GOHAI-Ar score and the toothbrushing method (r = 0.164, p = 0.047). Toothbrushing time, oral hygiene material, last visit to dentist, OHI-S score, PI score, decayed, missing, and decayed missing filled teeth (DMFT) scores were negatively correlated with GOHAI-Ar. Speech was the main concern for the HI. CONCLUSION: There was a fair oral hygiene, moderate gingival inflammation, high caries experience, and treatment needs with low GOHAI-Ar scores indicating poor OHRQoL among HI.

Efficacy of Resin Infiltrate in Noncavitated Proximal Carious Lesions: A Systematic Review and Meta-Analysis.

OBJECTIVES: Resin infiltration is a minimally invasive technique for treating noncavitated proximal caries. It slows/stops the carious lesion progression rate by creating a diffusion barrier inside the porous enamel lesion body. The aim was to evaluate the efficacy of resin infiltration on noncavitated proximal carious lesions in primary and permanent teeth. MATERIALS AND METHODS: The records were obtained using electronic and other sources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to ensure transparent reporting. Eligible studies were randomized controlled trials evaluating the efficacy of resin infiltration for noncavitated proximal carious lesions by comparing it with control/placebo. Each included study was assessed concerning the "risk of bias" using the Cochrane Collaboration's "risk-of-bias" assessment tool. High risk-of-bias studies were excluded from the meta-analyses due to selective reporting matters. The statistics were performed by RevMan software (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark) utilizing the random effect model. The GRADE approach was implemented for assessing the quality of evidence. RESULTS: From 106 studies identified, 17 were assessed for eligibility. After "risk-of-bias" assessment, two meta-analyses were conducted to eliminate the limitation of the significant heterogeneity between trials inspecting primary teeth (n = 2) and permanent teeth (n = 3). I 2 = 0% indicates the absence of statistical heterogeneity. The risk of carious lesions' progression with resin infiltration was significantly lower in primary (risk ratio [RR]; 95% confidence interval [CI]: 0.48; 0.30-0.75, P = 0.001) and in permanent teeth (RR; 95% CI: 0.19; 0.11-0.33, P < 0.00001) compared to that of control/placebo. The GRADE approach revealed high quality of evidence. CONCLUSION: The available evidence conveys high confidence that proximal resin infiltration has superior efficacy in slowing/arresting the carious lesions' progression rate in comparison to conventional management modalities.