Impact of a Dental Storybook on Parents' Knowledge of Children's Oral Health: A Randomized Controlled Trial.

Purpose: To evaluate the effectiveness of a dental storybook on parents' knowledge about oral health of their children and to assess their perception of its effect in reducing dental anxiety levels among their children, as well as improving their oral health knowledge. Patients and Methods: This was a two-arm parallel, single-blind, randomized controlled trial (RCT) which was performed at the pediatric dental clinics in the Dental University Hospital, King Saud University, Riyadh, Saudi Arabia. Parents of 88 children (6-8 years old) were included in the present study. Parents and their children were randomly divided into two groups as follows: the intervention group (received the storybook and verbal oral hygiene instructions) and the control group (only received verbal oral hygiene instructions; same information included in the book). Three dental visits, including screening, examination/cleaning and treatment, were provided for each child. In the screening visit, baseline parental oral health knowledge was evaluated for all parents. Afterward, parental oral health knowledge was re-evaluated in the examination visit. In the treatment visit, a parental perception questionnaire was administered to parents following treatment to evaluate their satisfaction regarding the use of the storybook in reducing anxiety levels among their children. Results: There was a significant improvement in the total knowledge score at the follow-up visit in the intervention group compared to the control group (P<0.0001). Overall, the majority of parents perceived the storybook as a useful source of information, and they found it to be effective in reducing dental anxiety levels among their children. Conclusion: The dental storybook is an effective educational tool that can help parents become more knowledgeable about their children's oral health. Moreover, parents perceived the storybook as an effective tool for enhancing their oral health knowledge and lowering their children's dental anxiety.

The Use of a Dental Storybook as a Dental Anxiety Reduction Medium among Pediatric Patients: A Randomized Controlled Clinical Trial.

This randomized clinical trial aimed to evaluate the effectiveness of a specially designed dental storybook in reducing dental anxiety among children. Eighty-eight children (6−8 years old) were randomly divided into two groups: the intervention group (received the storybook) and the control group (did not receive the storybook). Three dental visits (screening, examination and cleaning, and treatment) were provided for each child. Anxiety was assessed following each visit using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the Venham clinical anxiety scale (VCAS). The behavior was assessed using the Frankl's Behavior Rating Scale (FBRS). The intervention group showed significantly lower anxiety and more cooperative behavior during treatment than the control group (p < 0.0001). The intervention group showed a significant decrease in anxiety scores and more cooperative behavior across time according to the CFSS-DS (p = 0.001) and Frankl behavior scale OR = 3.22, 95% CI 1.18−8.76. Multivariate models found that using the storybook was a significant independent factor in reducing anxiety and improving behavior after controlling for sex, previous visits, family income, and mother's education. In conclusion, the dental storybook can decrease children's dental anxiety and improve their behavior during dental treatment.

A systematic review of population-based gingival health studies among children and adolescents with autism spectrum disorder.

The prevalence of autism spectrum disorder (ASD) is close to 1% in the United States of America and other countries. Special attention should be given to oral health in individuals with ASD as they are often affected by oral diseases. However, gingival health in children with ASD and adolescents is controversial in terms of the severity of disease and number of people affected. AIM: To conduct a systematic review and meta-analysis to assess the gingival health status of children and adolescents with ASD. METHODS: The search was conducted using eight databases for articles that met the inclusion and exclusion criteria. This search produced 742 relevant papers, but only five with sufficient data on gingival and plaque indices were eligible for inclusion in this systematic review and meta-analysis. RESULTS: The homogeneity of the sample was tested using the Cohen Q test, which identified significant heterogeneity (P < 0.0001), indicating the use of the random effect's standard mean difference. Significantly higher gingival index and plaque index values were found in children and adolescents with ASD than in children without ASD. CONCLUSION: Individuals with ASD need help and better access to oral healthcare. Further investigation is needed with regard to gingival health in individuals with ASD and caries risk assessment to understand how this disorder affects oral health. A standardized index for gingival health will help in the inclusion of more studies to assess gingival health in children and adolescents with ASD.

Practicing Dentists' Self-Efficacy and Associated Factors in Managing the Treatment of Adults with Mental and Physical Disabilities: An Exploratory Cross-Sectional Study in Riyadh, Saudi Arabia.

Background: Provision of oral healthcare to adults with mental and physical disabilities (AMPD) remains a challenging area across various healthcare systems. The present study aimed to assess self-reported efficacy and investigate factors associated with self-efficacy in the management of AMPD among practicing dentists in Saudi Arabia. Methods: A pilot-tested, self-administered questionnaire was distributed to a convenience sample of 1000 dentists. Descriptive and inferential analyses were performed on the collected responses. Results: Among the respondents (54%), 43% were males. Only 14% described their self-efficacy in managing AMPD as "High". Multivariable regression analyses revealed significant associations between "High" self-efficacy and male gender (Odd ratio (OR) = 2.39, 95% CI = 1.16-4.89), experience practicing dentistry for 11 years or more (OR = 2.19, 95% CI = 1.04-4.47), specialization in pediatric dentistry (OR = 3.98, 95% CI = 1.31-12.07), previous experience in managing AMPD (OR = 4.23, 95% CI = 1.59-11.22), and awareness of regulations for managing AMPD (OR = 2.62, 95% CI = 1.42-4.38). The interaction of gender x age was significantly associated (p = 0.028) with "High" self-efficacy. Gender-stratified analyses revealed a significant association between age and "High" self-efficacy among male dentists only. Conclusions: The findings of the present study highlight that a large percentage of dentists reported "Low/Moderate" self-efficacy in managing AMPD, particularly among female dentists. However, further studies are required to verify the factors associated with self-efficacy in the present study, and to identify other factors that may influence self-efficacy in managing AMPD.

Effectiveness of a preparatory aid in facilitating oral assessment in a group of Saudi children with autism spectrum disorders in Central Saudi Arabia.

OBJECTIVES: To evaluate the effectiveness of a specially-designed dental book (preparatory aid) on the behavior of a group of Autism Spectrum Disorder (ASD) Saudi children during their first dental visit to the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Methods: A cross-sectional double-blinded pre-and post clinical study consisting of 2 parts; a survey targeting the parents, and a clinical oral examination of their ASD children was conducted between January and June of 2016.  Results: A total of 40 children (75% males and 25% females) with an average age of 6.1 years were included. Approximately 47.5% children acted positively during the dental procedure. The dental book had a positive effect on the behavior of 37.5%  children according to their parents' evaluation and highly effective in enhancing the parents' dental knowledge (67.5%).  Conclusion: Parents expressed positive opinions regarding the use of preparatory aids in the dental environment. Approximately half of the ASD children benefit from the preparatory aid used according to the parents' opinion, and the follow up survey showed improvement in the parent's dental knowledge and oral hygiene practices.

Children's ages and reasons for receiving their first dental visit in a Saudi community.

OBJECTIVE: Epidemiological studies conducted in different parts of the world have revealed the postponement of first dental visits and an increased prevalence of early childhood caries in general populations in developed and developing countries. This study aimed to assess the average age of and most common reasons for first dental visits in children attending governmental and private dental clinics in Riyadh, Saudi Arabia. SUBJECTS AND METHODS: Data were collected retrospectively from the dental records of new pediatric patients attending a governmental institute (College of Dentistry, Department of Pediatric Dentistry and Orthodontics, King Saud University) and a private clinic (the investigator's private practice) in Riyadh. Only children attending their first dental visits with no previous dental experience were included in the study. Descriptive statistics, cross-tabulation analysis, and chi-squared test were done. The significance level was set at P â©½ 0.05. RESULTS: Initial dental visitation occurred at 1-3 years in 32.2% of children, 3-5 years in 52.9% of children, at >5 years in 14% of children. Pain was the dominant reason (71.5%) for first dental visits. Dental check-up was the main reason for 27.3% of dental visits, and fluoride application was the main reason for 20.5% of visits. Emergency cases accounted for 44.7% of first dental visits during the study period. Most (68%) children were medically fit, and 67.2% behaved positively during their first dental procedures. CONCLUSIONS: Parental compliance with the standard age for initial dental visitation recommended by the major dental academies is lacking.

Dental knowledge of educators and healthcare providers working with children with autism spectrum disorders.

OBJECTIVES: To evaluate dental knowledge and attitudes toward oral health care among healthcare providers and educators working with children with autism spectrum disorders (ASD) in central Saudi Arabia.   METHODS:  There were 305 questionnaires distributed to 7 special-needs centers between September and November 2014. A total of 217 questionnaires were collected with a response rate of 71.1%. The study took place in the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.  RESULTS: Approximately 50.2% of the participants did not offer any toothbrushing advice, and 73.3% never recommended dental checkup visits to parents, and 75.6% never performed dental examinations to children under their care. Ten percent thought that children should have their first dental visit after 6 years of age. Almost all participants agreed that children should practice oral hygiene, and 60.4% think they should brush twice per day. In general, the participants choose toothbrushes and toothpaste as the main tools to perform oral hygiene. There were 35% of participants who believed that parents should be responsible for the children's oral hygiene, and a few participants mentioned teachers and therapists to be responsible. Most of the participants (71.4%) did not receive any dental information from dental professional resources, only 14.3% of participants believed bacteria to be the cause of dental cavities.   CONCLUSION: There is a clear lack of dental knowledge and attitudes, and its practical application among the participating group of healthcare providers working with children with ASD in Riyadh.

Diet, oral hygiene practices and dental health in autistic children in Riyadh, Saudi Arabia.

UNLABELLED: Studies reporting the dietary habits of children with ASD in relation to dental health are scarce, and similar studies are non-existent in Saudi Arabia. PURPOSE: to report baseline information about the diet, oral hygiene and dental health of a group of autistic children in Riyadh. METHODOLOGY: 450 self-administered cross-sectional questionnaires were distributed to parents of autistic children enrolled in three major autistic rehabilitation centers. RESULTS: parents reported that (70.9%) of the children preferred food that is high in sugar and (96.7%) consumed soft drinks regularly. Parents reported their children brushing once 34.0% or twice 29.0% a day, and 28.8% brushed on an irregular basis. 82.6% of the children had no gingival bleeding during brushing. 51.5% of the children had no previous dental visits or dental treatment, 48.5% had undergone dental treatment using different behavioral management techniques. CONCLUSION: Children in this study showed frequent consumptions of foods with high sugar contents and soft drinks, which coupled with improper oral hygiene practices and insufficient dental visits, may have contributed to the risk of developing dental caries and teeth erosion. Frequent tooth brushing, low-sugar diets and early dental visits for check-ups and regular fluoride applications are highly recommended for ASD children.

Characteristics and dental experiences of autistic children in Saudi Arabia: cross-sectional study.

The purpose of this study is to report base line information about characteristics, and dental experiences of a group of autistic children in three major cities of Saudi Arabia. Most of the children (76.2%) included in the study were diagnosed with autism before the age of 5 years. More than half of the children (53.7%) had no previous dental experience while 33% were treated under general anesthesia. The American Academy of Pediatrics' recommendations should be applied in Saudi Arabia to help improve the average age of diagnosis and make a positive effect on children with autism and their families. Regular visits to dental clinics should be recommended to all families with autistic children to reduce dental disease.