Towards a better understanding of the psychosocial determinants associated with adults' use of smokeless tobacco in the Jazan Region of Saudi Arabia: a qualitative study.

BACKGROUND: Most diagnosed oral cancer cases in Saudi Arabia are in the Jazan region. A common type of smokeless tobacco "Shammah" is prevalent in this region. This study aimed to gain an in-depth understanding of the possible psychosocial determinants of Shammah consumption among adult Shammah users in Jazan region. METHODS: A qualitative study was conducted by means of one-on-one interviews among thirty adult Shammah users. Participants were recruited by means of a purposive sampling technique. Data were collected using a semi-structured interview guide utilizing face-to-face and phone-call interviews. Thematic analysis with hybrid approach was used to analyze the dataset. RESULTS: Twenty-four sub-codes within four overarching themes were generated. Participants revealed uncertainty related to Shammah composition, how to quit knowledge and Shammah prevention/cessation programs. Shammah use identified as a normal phenomenon in society. Its use was frequently reported in participants' close network but most users faced family and peers' disapproval. Some users expressed joy, happiness and focused when using Shammah. Others were disgusted or neutral. Many users believed Shammah causes cancer and tears oral tissues. Others believed it relieves toothache or has no effect. Majority of users were confident to quit and recalled some quitting aids. Toothache, craving, drinking tea and chewing Khat (leaves of Catha edulis plant that causes moderate euphoria) perceived to be triggers to use Shammah. Availability of Shammah, withdrawal symptoms, stress, lack of support, seeing others using Shammah, losing part of routine and toothache were barriers to quit. CONCLUSIONS: Shammah use was associated with uncertainty about Shammah composition and quitting knowledge, social acceptability, influence from family/friends, a range of positive and negative attitudinal beliefs toward its use and high quitting efficacy beliefs. Future interventions targeting Shammah should address the acknowledged triggers and barriers in the present study including the dual use of Shammah and Khat.

Dentists Behavioral Factors Influencing Early Detection of Oral Cancer: Direct Clinical Observational Study.

This study aimed to investigate the possible factors affecting dentists' behavior relating to performing oral cancer examinations as part of routine clinical examination. A total of 95 direct clinical observation sessions-utilizing an instrument consisting of 19 evidence-based observational criteria for oral cancer examinations-were observed by four calibrated dentists. Thirty-two final-year students, 32 interns, and 31 faculty members of Jazan Dental School were examined between April 9 and May 4, 2017. A descriptive analysis was conducted to investigate the frequencies/percentages of the performed observing criteria by all examiners. ANOVA and Tukey tests were carried out to investigate the difference between the examiner groups. A total number of 32 patients participated in the study, whereby each patient was examined by three different examiners from each group, as well as by the attending observer/s. Fewer than 50% of the examiners performed the clinical steps necessary for an oral cancer examination-for example, taking into account past medical history, as well as extra and intra-oral examinations. More than 90% of the examiners examined hard tissue, whereas fewer than 30% of them educated their patients about possible risk factors. A significant difference between examiner groups was found in favor of faculty members. A gap between knowledge and actual practice of oral cancer examinations was evident: majority of participants failed to perform the necessary steps for an oral cancer examination. Previous experience and confidence in performing oral cancer examination are possible explanations for the dentist's behavior toward oral cancer examination.

Transitioning to Private Dental Practice: An In-depth Exploration of Dental Graduates' Perspectives in Saudi Arabia.

Background: Graduates of the Bachelor of Dental Surgery program meet the qualifications set by Saudi universities and pass the Saudi Commission for Health Specialties License Examination to practice dentistry. However, ambiguity persists concerning their preparedness for private dentistry. This study explored how dental graduates perceive their readiness to operate in the private sector. Materials and methods: A qualitative study was conducted by interviewing dental graduates from different dental schools across Saudi Arabia using a semistructured interview guide with convenience sampling until thematic saturation was achieved. All interviews were verbatim transcribed and analyzed manually by two researchers working independently using Braun and Clarke's thematic analysis approach. Results: A total of 35 participants from Saudi dental schools across five distinct regions (North, South, East, West, and Central) were included in the study. Data analysis revealed four prominent themes believed to influence participants' readiness for private practice: (1) communication skills-concerns regarding proficiency in areas crucial for ensuring patient satisfaction, (2) technical management skills-uncertainty in aspects such as practice setup and dental insurance, (3) pedagogical curriculum design-primarily tailored to public sector roles, and (4) legal and ethical issues-concerns about legal and ethical issues intrinsic to dental practice. Conclusion: The transition of Saudi dental graduates into private practice is influenced by multiple obstacles, encompassing factors related to their knowledge and skills in patient communication, technical management, education curriculum design, and familiarity with legal intricacies. Clinical significance: Exploring dental graduates' perceptions in relation to private practice is clinically significant as it highlights specific areas, including communication skills, where effective communication with both children and parents is paramount in private dentistry; technical management; curriculum adaptation; and legal/ethical awareness, where targeted interventions can enhance the quality and safety of dental care provided in private practice. These insights can lead to improvements in dental education and practice management, ultimately benefiting both dentists and patients in the private dental sector. How to cite this article: Moafa I, Jafer A, Almashnawi M, et al. Transitioning to Private Dental Practice: An In-depth Exploration of Dental Graduates' Perspectives in Saudi Arabia. Int J Clin Pediatr Dent 2024;17(7):777-782.

Comparison of Tooth Color and Enamel and Dentinal Thickness between Orthodontically Treated and Untreated Individuals.

This study compared tooth color and enamel and dentinal thickness between orthodontically treated and untreated individuals. (1) Methods: A matched case-control study was conducted. The sample included 26 patients who had received orthodontic treatment and 31 matched controls. The color assessment was performed subjectively using the VITA 3D-Master (VM) shade guide and objectively using the VITA Easyshade (VE) spectrophotometer. Differences in L*, a*, and b* (lightness, red/green, and blue/yellow) were calculated. The color change was evaluated using ΔE*ab and the whiteness index (WID). Tooth structure thickness (labiolingual, labial enamel, and labial dentin) was evaluated using cone-beam computerized tomography. The correlations between overall tooth color and tooth structure thickness were evaluated. (2) Results: A total of 228 teeth were evaluated. Color assessment using VM showed significant differences between orthodontically treated and untreated teeth (p < 0.001), while VE revealed no significant differences. Both groups showed no difference in tooth enamel and dentinal thickness. Significant differences in tooth color (p < 0.05) were observed between genders. Both VM and VE showed weak to moderate correlations with tooth color and enamel and dentinal thickness (p < 0.05). (3) Conclusions: Orthodontic treatment may demonstrate visually perceptible but acceptable and clinically undetectable tooth color alteration.

Effectiveness of mobile phone applications in improving oral hygiene care and outcomes in orthodontic patients.

OBJECTIVES: To assess the effectiveness of mobile phone applications in improving oral hygiene care and oral health outcomes in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, and Web of Science were systematically searched for original studies published between January 2000 and March 2020. The eligibility criteria being: (i) observational study [cross-sectional, case-control, cohort study, or RCTs] that reported mobile phone application as an intervention or exposure for oral hygiene care. Standard Protocol Items Recommendations for Interventional Trials (SPIRIT) statement was used for quality assessment of interventional studies. The comprehensive search strategy yielded 154 studies after the removal of duplicates. Based on eligibility criteria only 5 studies were included in the data extraction phase. RESULTS: This review finds that smartphone applications have a significant short term effect in the improvement of oral hygiene when measured using plaque index and gingival index scores. The mean plaque index and gingival index reduced significantly in three out of five studies. The intervention groups [62%] had a lower level of plaque at a 12-week interval as compared to the control group [72%]. Short term follow-ups showed greater improvement in oral hygiene following smartphone application administration. CONCLUSION: Within the available evidence, a recommendation can be made for the use of mobile applications in the orthodontic process [oral hygiene] care. CLINICAL RELEVANCE: Further research for the development of patient-centered applications for patient safety, clinical decision making, and increasing their effectiveness in the treatment of orthodontic patients are required.

Genetic Mutations Associated with Pierre Robin Syndrome/Sequence: A Systematic Review.

Pierre Robin syndrome/sequence (PRS) is associated with a triad of symptoms that includes micrognathia, cleft palate, and glossoptosis that may lead to respiratory obstruction. The syndrome occurs in 2 forms: nonsyndromic PRS (nsPRS), and PRS associated with other syndromes (sPRS). Studies have shown varying genetic mutations associated with both nsPRS and sPRS. The present systematic review aims to provide a comprehensive collection of published literature reporting genetic mutations in PRS. Web of Science, PubMed, and Scopus were searched using the keywords: "Pierre Robin syndrome/sequence AND gene mutation." The search resulted in 208 articles, of which 93 were excluded as they were duplicates/irrelevant. The full-text assessment led to the further exclusion of 76 articles. From the remaining 39 articles included in the review, details of 324 cases were extracted. 56% of the cases were sPRS, and 22% of the cases were associated with other malformations and the remaining were nsPRS. Genetic mutations were noted in 30.9% of the 300 cases. Based on the review, SOX9 was found to be the most common gene associated with both nsPRS and sPRS. The gene mutation in sPRS was specific to the associated syndrome. Due to the lack of original studies, a quantitative analysis was not possible. Thus, future studies must focus on conducting large-scale cohort studies. Along with generating data on genetic mutation, future studies must also conduct pedigree analysis to assess potential familial inheritance, which in turn could provide valuable insights into the etiopathogenesis of PRS.