Managing dental caries in children in Saudi Arabia

This paper describes oral health among children in Saudi Arabia, the dental health system in the country, and some possible solutions and recommendations to improve the oral health status.     

A needs assessment survey of dental public health graduate education in Saudi Arabia

Objectives

The Faculty of Dentistry at King Abdulaziz University (KAU) is planning to develop a master’s program in dental public health (DPH). To develop a curriculum for this program, a needs assessment was conducted in order to identify the level of DPH expertise that currently exists in Saudi Arabia, to identify gaps in knowledge, and to explore current perceptions regarding this type of program.

Methods

A competency-based survey instrument was administered to private and government affiliated dental practitioners in Jeddah, Saudi Arabia. Participants’ knowledge, attitudes, and competencies in DPH were assessed. In addition, questions were submitted that addressed preferred strategies of teaching, curriculum delivery methods, course content, and prerequisites for DPH. These data were combined with data previously collected from dentists holding academic positions at KAU (n = 146) and were analyzed using Statistical Analysis System version 9.3 software. Mean values and frequencies were calculated for the study variables. Proportional odds ratios and 95% confidence intervals were estimated to assess differences in educational preferences and DPH competencies according to age, gender, and qualification.

Results

Most of the participants (95%) reported a need for a DPH graduate program. The respondents had a basic knowledge of DPH and moderate experience in DPH competencies. A variety of preferred educational strategies and methods were identified and differences in educational preferences according to age, gender, and qualification of the respondents were identified. The responses obtained also acknowledged skills and competencies that the participants considered most important for a DPH practice and that would be important for students accepted into a DPH graduate program.

Conclusions

This needs assessment survey represents a preliminary step in establishing a DPH graduate program that addresses current gaps in knowledge and in the practice of public health dentistry. This survey also provided valuable feedback regarding the development of course content for a graduate education program in DPH.     

A systematic review of population-based dental caries studies among children in Saudi Arabia

ObjectiveDental caries critically impacts the health and development of children. Understanding caries experience is an important task for Saudi Arabian policymakers to identify intervention targets and improve oral health. The purpose of this review is to analyze current data to assess the nationwide prevalence and severity of caries in children, to identify gaps in baseline information, and to determine areas for future research.MethodsA search of published and unpublished studies in PubMed, Google, and local Saudi medical and dental journals was conducted for the three keywords “dental,” “caries,” and “Saudi Arabia.” The inclusion criteria required that the articles were population-based studies that assessed the prevalence of dental caries in healthy children attending regular schools using a cross-sectional study design of a random sample.Results/discussionThe review was comprised of one unpublished thesis and 27 published surveys of childhood caries in Saudi Arabia. The earliest study was published in 1988 and the most recent was published in 2010. There is a lack of representative data on the prevalence of dental caries among the whole Saudi Arabian population. The national prevalence of dental caries and its severity in children in Saudi Arabia was estimated to be approximately 80% for the primary dentition with a mean dmft of 5.0 and approximately 70% for children’s permanent dentition with a mean DMFT score of 3.5. The current estimates indicate that the World Health Organization (WHO) 2000 goals are still unmet for Saudi Arabian children.ConclusionChildhood dental caries is a serious dental public health problem that warrants the immediate attention of the government and the dental profession officials in Saudi Arabia. Baseline data on oral health and a good understanding of dental caries determinants are necessary for setting appropriate oral health goals. Without the ability to describe the current situation, it is not possible to identify whether progress is being made toward these goals. A roadmap with a clear starting point, destination, and pathway is a desperately needed tool to improve the oral health of Saudi Arabian children.     

The Saudi Arabian national demographic and health survey, 2017: Study design and oral health-related influences

ObjectiveTo describe the study design, and the distal and proximal influences on oral health reported in the national demographic and health survey (DHS) of the Kingdom of Saudi Arabia (KSA) in 2017.MethodsThe 2017 KSA DHS used an innovative multistage stratified random-sampling technique to select the population sample by using primary health care centers’ (PHCs) catchment areas as the primary sampling unit. Over 45,000 household heads plus a family member were interviewed. A conceptual framework for distal and proximal oral health influences specific to the KSA was adapted based on the oral health surveillance model. Cross-tabulation and Chi-square tests were performed with consideration for sample weights to provide estimates representative for the KSA population. Frequencies and weighted percentages for each variable reflecting each construct were reported.ResultsThe total number of individuals included in the analysis was n = 55,511, ages ranging between 2 and > 65 years. Lack of dental care when needed was reported for 22.5 % of the population (males = 20.8 %/females = 24.7 %). Proportion of population from Central, West, East, South, and North regions who reported available dental care services when needed was 62.3 %, 58.0 %, 58.9 %, 62.3 %, and 60.1 %, respectively. PHCs were the most regular source for dental care (55.1 %). In total, 48.3 % visited the dentist at least once last year (males = 49.4 % /females = 46.8 %). Dental pain was the most common reason for last dental visit (69.0 %), while only 6.4 % reported visited the dentist for routine visit. Only 15.3 % reported brushing their teeth at least twice per day (males = 14.6 % /females = 16.4 %).ConclusionTwo major oral health influences previously reported to have a significant negative influence on oral health, namely, limited routine dental check-up visits and inadequate oral hygiene, were present among KSA residents. Further inferential study is needed to investigate such influence on oral health status within the KSA population.     

Dental fluorosis prevalence in Saudi Arabia

AimIn order to improve the understanding of dental fluorosis prevalence in Saudi Arabia and have a good idea of the quality of the studies that have been conducted, a systematic review was conducted to evaluate the prevalence of dental fluorosis among people who live in Saudi Arabia.MethodsOnline databases EMBASE and MEDLINE and the Cochrane Library were searched, without any restriction regarding age. In addition, there were no study design filters applied to the search engine. Study selection and data extraction were conducted in duplicate. Studies were included if they were conducted in Saudi Arabia on any population (adults and children) and collected dental fluorosis data. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies. A narrative synthesis was conducted.ResultsSeven cross-sectional studies were identified. Areas of weakness in study design/conduct were low response rates, and identification and handling of confounding factors. Statistical pooling of data was not appropriate due to substantial heterogeneity, due in part to variation in sample size, variation of water fluoridation concentration, index used, targeted population and age group. Seven studies present dental fluorosis at any level. The proportion of dental fluorosis prevalence at any level ranged from 0.00 to 0.91. Six studies explored the prevalence of dental fluorosis of aesthetic-only level of concern. The proportion of dental fluorosis in this category ranged from 0.07 to 0.76.ConclusionThe proportion of dental fluorosis at any level ranged from 0.00 to 0.91 and fluorosis at aesthetics level ranged from 0.07 to 0.76. However, current data does not provide a complete assessment of dental fluorosis across Saudi Arabia. Existing studies are limited in terms of the population covered. The included studies had methodological flaws.     

Smokeless tobacco (shamma) and oral cancer in Saudi Arabia

Oral use of smokeless tobacco has been associated with the development of oral cancer. Shamma is a preparation of smokeless tobacco. Previous investigators in the Kingdom of Saudi Arabia (KSA) have reported a relationship between their patients with oral cancer and a history of using shamma. The purpose of this study was to explore the possible relationship between a smokeless tobacco preparation (shamma) and oral cancer, among the provinces of the KSA. Tumor Registry (TR) data from the King Faisal Specialist Hospital and Research Centre (KFSH&RC) were reviewed for the period from 1976 to 1995. A total of 26510 Saudi cancer patients were referred over this 20-year period. The frequency of oral cancer was investigated, specifically for those primary sites located near the habitual placement of this smokeless tobacco product. Notably, 35.4% of these oral cancers were referred from one province - Jizan. The percentage of oral cancer cases from this province is significantly higher than the percentage of total malignant cases referred to KFSH&RC from this province, and the Saudi population of this province when compared to the whole of the KSA. These data suggest that there is a relationship between the factors smokeless tobacco product (shamma), frequency of oral cancer, and Jizan province: oral cancer appears to be more common in this province where shamma is also common.     

Periodontal disease prevalence and dental needs among schoolchildren in Saudi Arabia

Abstract The study population consisted of 1174 intermediate Saudi schoolchildren; 601 girls and 573 boys, aged 13, 14 and 15 years. Periodontal disease was assessed by the method recommended by WHO and data were computerized by using IBM 3033, SAS package. Boys had significantly higher debris, calculus deposits and intense gingivitis counts than girls by sex and age. But for advanced periodontal involvement, the result shows no significant differences by sex and age. There was a position correlation between debris, calculus and periodontal diseases There was a highly significant difference between girls and boys. The results of this study suggest the need for an oral health program for the entire community.     

Dental caries in preschoolchildren in Gizan, Saudi Arabia

Abstract 296 preschoolchildren attending the pediatric clinic at Gizan Hospital were examined over a period of 3 months. Caries was recorded using the criteria described by WHO. One third of the children had untreated caries and none of the children had received any restorative dental care. A strategy for development of preventive dental services for this age group is discussed.     

Roles of community pharmacists in improving oral health awareness in Plateau State,Northern Nigeria

Introduction: There is poor oral health awareness in Nigeria because of limited access to correct information on oral health as well as a lack of oral health-care providers. The purpose of this study was to describe the roles of community pharmacists (CPs) in Plateau State, Northern Nigeria, as sources of oral health information in their communities. Methods: A quantitative cross-sectional study on CPs spanning the entire State. Data collection was a survey method using a structured paper-based self-administered questionnaire. Analysis, which included t-tests and binary logistic regression, was carried out using SPSS ver. 23. Results: A one-sample t-test to assess the attitudes of CPs on oral health showed that they had a very good disposition towards engaging in oral health services [advice, referrals, recommendations and basic treatment (e.g. of pain); mean = 4.54, standard deviation = 0.59, t(111) = 27.8, P < 0.001]. Although CPs presently provide some services to patients with oral health problems, 94.7% were willing to do more to advance the cause of oral health care. Training of CPs on oral health (32%), removal of restrictive policies in the health bill (1.8%) and sensitising the public (6.3%) were some suggestions on how to improve these services. Conclusion: The disposition of CPs towards improving oral health could serve as a platform to help propagate oral health care and awareness in their communities. Engaging the CPs might help to reduce oral health disparities by increasing oral health awareness and improving the quality of life via cost-effective delivery of pharmacy-based oral health-care services.Key words: Oral health, community pharmacists, access to oral care, oral health promotion     

A comparative study of the health care systems of Canada and Saudi Arabia: lessons and insights

Introduction : Understanding the structure of a health care system is essential in improving public health policies and health outcomes. Objectives : To describe and compare the health care systems of Canada and Saudi Arabia; to discuss possible lessons that could be learned from both for policy‐making purposes. Methods : A comprehensive method was used to describe the national health care systems of both countries. For each country, the system is described by: context, ownership, delivery, financing, organisational structure, target groups, and comprehensiveness of services. Results : In Canada, the Medicare system provides comprehensive medical services except for dental, optometric, chiropractic, pharmacologic and home care services. The dental care system is financed privately (94%) and is owned and delivered by private for‐profit dental practitioners. In Saudi Arabia, the government sector is owned, delivered, and financed by the government and provides free comprehensive medical and dental services. The same services are provided by the private sector, but under governmental supervision. Among the relevant lessons: access to care, accountability, quality assurance, mix and reimbursement of providers. Conclusions : Canada can learn about different approaches to socialising the dental care system. Saudi Arabia can improve the implementation of quality assurance practices and management.     

Analysis of the pattern of maxillofacial injuries in Saudi Arabia: A systematic review

ObjectivesMaxillofacial trauma (MFT) is a serious health problem and in Saudi Arabia is mainly caused by road traffic accidents (RTAs). MFT commonly associated with injuries to the face, head, and jaws and may cause soft tissue lacerations and bruises. MFT can also cause fatal blood loss and airway obstruction. The objective of this review was to determine the prevalence of MFT, identify the major causative factors in males and females in the main cities of Saudi Arabia.Materials and methodsWe performed literature searches of all published studies describing MFT from KSA during the last 20 years.ResultsIn Saudi Arabia, males are more prone to MFT than females, although the male: female ratio of MFT varies between different cities. Specifically, Aseer has the highest male: female ratio (10:1), followed by AlHofuf (8.3:1) while AlQurayyat had the least gender ratios of MFT (2:1). Most cases of MFT are associated with RTAs, which accounted for (63%–90.3%) in Medina, (89.1%) in Aseer, (86.1% –87.1%) in Riyadh, (67%–73.1%) in Jeddah, (71%) in Khamis Mushait, (64.2%) in Makkah and (63.3%) in Al-Hofuf. The least percentage of RTA resulting into MFT was recorded in AlQurayyat (24%).ConclusionMaxillofacial trauma is a serious health problem in Saudi Arabia. RTAs remain the major cause of maxillofacial injuries especially among males, thus strict implementation of traffic rules is a must to minimize maxillofacial injuries and its physical and psychological impact.     

Self-reported differences between oral health attitudes of pre-clinical and clinical students at a dental teaching institute in Saudi Arabia

ObjectiveTo compare the attitudes of preclinical and clinical dental students toward their own oral health using the Hiroshima University-Dental Behavioral Inventory (HU-DBI).MethodsThe English-language version of the 20-item HU-DBI was distributed to all preclinical and clinical students at the College of Dentistry, University of Dammam, Kingdom of Saudi Arabia. Dichotomized (agree/disagree) responses to 12 HU-DBI items were used in this study, with a maximum possible score of 12. Responses to the remaining eight statements reflected general oral health attitudes and were excluded from the analysis. Data were analyzed statistically.ResultsThe overall response rate was 72.2% (preclinical, 72.5%; clinical, 72%). The mean HU-DBI score was significantly higher among clinical than among preclinical dental students (7 vs. 5.8; P < 0.05). Higher proportions of preclinical than clinical students did not worry about visiting the dentist but postponed dental visits until they experienced toothache. Furthermore, more preclinical than clinical students reported that their gums bled upon brushing, used a child-sized toothbrush, had observed white, sticky deposits on their teeth, and used strong strokes for toothbrushing. More clinical than preclinical students reported that they did not feel that the condition of their teeth was worsening despite brushing, worried about the color of their teeth, brushed each of their teeth carefully, and checked their teeth in the mirror after brushing.ConclusionsDental health awareness programs should be implemented and information about positive oral health attitudes should be provided to the students at an initial stage of dental training.     

社区口腔健康教育对居民口腔菌斑控制的影响

目的 探讨社区口腔健康教育对居民口腔菌斑控制的影响.方法 对237例在社区健康服务中心口腔科就诊的患者,在实施个性化口腔健康教育前后,就口腔健康知识、态度、行为等进行问卷调查,检查口腔菌斑控制情况,并对结果进行统计学分析.结果 237例社区居民患者在实施口腔健康教育前各项口腔健康知识知晓率均在68％以下,且在态度上不够重视,口腔保健行为不规范.经个性化的社区口腔健康教育后,237例患者的口腔健康知识知晓率、口腔保健态度和行为均有明显改善,差异有统计学意义(P＞0.05).237例患者实施口腔健康教育1年后的菌斑指数为1.61±0.21,明显低于实施教育前的2.12±0.31,差异有统计学意义(P＜0.05).结论 个性化社区口腔健康教育模式能够明显提高社区居民的口腔健康知识知晓率、改善其口腔保健态度和行为,改善口腔菌斑控制情况,具有较大的推广价值.     

Need for dental care drives utilisation of dental services among children in Saudi Arabia

Objectives: This study used Andersen’s predisposing, enabling and need behavioural model to predict factors that influence utilisation of oral health services for children in Saudi Arabia. Methods: The model was tested in a random sample of parents of third- and eighth-grade children in Jeddah (n = 1,668) using the access to care questionnaire adapted from the Basic Screening Survey. Predisposing (sex, parent education, nationality); enabling (school type, family income, government financial support, health insurance); and need for dental care (examined or perceived) were modelled to assess children’s use of dental services. Univariate and multivariate logistic regression models were conducted. Significant findings were reported at P ≤ 0.05. Results: About 84% of parents responded to our questionnaire (n = 1,397). One in four children have never visited a dentist. Our findings indicate that need and predisposing factors explained oral health services’ use among younger children, whereas need, predisposing and enabling factors predicted use of services among older children. Perceived barriers to dental care for children who never went to a dentist and for those who needed dental care and could not get it included oral health illiteracy (82.3%, 49.7%), dentist-related (19.9%, 42.1%), financial (22.8%, 37.1%) and transportation (9.8%, 20.8%), respectively. Conclusions: The need for dental care, predominantly for illness-related dental care, drives utilisation of dental health services among children in Saudi Arabia. Enhancing oral health literacy and mitigating organisational and financial barriers to dental care for families will increase children’s access to quality oral healthcare, and promote better oral health practices and outcomes.Key words: Utilisation, oral health services, oral health literacy, children, Basic Screening Survey, Saudi Arabia     

Fluoride content of bottled drinking waters available in Riyadh,Saudi Arabia

Aims

This study aimed to examine the fluoride concentration of commercially available bottled water products in Riyadh, Saudi Arabia, and to assess the accuracy of the labeling of fluoride concentration on the tested brands.

Methods

Fifteen randomly selected commercial brands of bottled water were obtained from supermarkets in Riyadh, Saudi Arabia. Three bottles of each brand were purchased, and fluoride content was measured using a combination fluoride-ion-selective electrode. The average reading for each brand was estimated and also compared with the fluoride content printed on the label.

Results

The mean (±SD) fluoride content of the 12 local bottled water samples was 0.79 (±0.09) mg/L with a range from 0.5 to 0.83 mg/L. The mean fluoride concentration of the three imported brands was 0.67 (±0.02) mg/L with a narrow range of fluoride content (0.65–0.69). All tested samples mention the fluoride content on the label except two imported brands. Five samples showed a significant difference between our evaluation and stated content of fluoride that ranged between +0.46 and −0.2 mg/L.

Conclusions

Bottled drinking waters available in Riyadh, Saudi Arabia contain differing concentration of fluoride, but within a safe range for use as a source of systemic fluoride. In addition, the manufactures’ labeling of fluoride content may be inaccurate.     

Effectiveness of oral health education intervention among female primary school children in Riyadh,Saudi Arabia

Objective

This study aimed to examine the effectiveness of oral health intervention on the improvement in knowledge and self-reported oral health behavior among 6–8?year old female primary school children in Riyadh, Saudi Arabia.

上海市社区口腔公共卫生人力资源及工作满意度调查

目的:调查上海市社区口腔公共卫生人力资源现状及其工作满意度,为完善社区口腔公共卫生服务能力建设提供依据.方法:采用普查方法,对上海市246家社区卫生服务中心参与口腔公共卫生服务的人员进行问卷调查,内容包括人员基本情况和工作满意度.采用SPSS 20.0软件包对工作满意度及人员基本情况进行统计学分析.结果:上海市有759...