Asim Al-Ansari

Prevalence, severity, and secular trends of dental caries among various saudi populations: A literature review

The prevalence of dental caries is increasing across different nations around the globe. A review of the literature shows that dental caries is adversely affecting the oral health of children, adolescents, adults and elderly populations in Saudi Arabia. The objective of this review is to report the prevalence, severity, and progression of dental caries in different age groups of Saudi communities. Digital databases such as PubMed, Medline, Google scholar, and the Saudi Dental and Medical Journals were searched to retrieve the published articles and reports on dental caries in Saudi Arabia. Search strategy included key words such as dental caries, dental decay, decayed missing filled teeth (dmft/DMFT), and oral health. Cross-sectional, retrospective and cohort studies (from 1982 to 2012) reporting the prevalence, incidence and severity of caries among children, adults and older individuals were included in the review. In children with primary dentition ages 3-7 years, the highest caries prevalence was almost 95% and maximum estimate of dmft was 7.34 during the last decade. Approximately, 91% was the highest caries prevalence and greatest DMFT value was 7.35 among the children/adolescents ages 12-19 years. The adults with a mean age between 30 and 45 years had maximum caries prevalence of 98% and DMFT of 14.53 while older individuals had greatest DMFT score of 24.3. Children, adults, and elderly populations demonstrate a higher prevalence and greater severity of caries, and secular trends also show a striking increase in dmft/DMFT and caries prevalence rates over the past few decades in Saudi Arabia.

Factors affecting student participation in extra-curricular activities: A comparison between two Middle Eastern dental schools

Objective This study was conducted to assess the level of participation of dental undergraduate students in extracurricular activities (ECAs) and the factors affecting this participation. Methods The study included dental students enrolled in undergraduate programs at the Faculty of Dentistry, Alexandria University, Egypt, and the College of Dentistry, University of Dammam, Saudi Arabia. A questionnaire was developed to collect background information about students, their participation in ECAs, and time allocated for these activities. Students were asked about their perceptions of the relationship between ECAs and academic studies, and their reasons for participating in and satisfaction with ECAs. Results The study included 199 students from Alexandria and 146 students from Dammam, with response rates of 99.5% and 73%, respectively. The percentages of those reporting ECA participation were 27.1% and 43.8%, respectively, mostly in community service, sports, and social activities. About 60% of students did not think that ECAs affected their studies, although the perceived difficulty of balancing ECAs and academics was associated with lower odds of participation (odds ratio = 0.51). Most students participated in ECAs to socialize and make friends, and the majority was dissatisfied with school-organized ECAs (52% and 59%, respectively). Gender and/or perceived relation between ECAs and academic studies affected actual participation in ECAs in one school but not the other. Conclusions ECA participation among these students was low. Gender and perception of ECAs in relation to academic studies affected ECA participation differently in the two schools. Better planning and management of ECAs that incorporate students’ preferences and reasons for participation is needed. Gender issues and the relationship between ECAs and academic performance should be addressed in relation to school and social characteristics.

The knowledge, attitude and practices of male sports participants to sports-related dental trauma in Khobar and Dammam, Saudi Arabia – A pilot survey

The risk of dental trauma may increase during sports participation. The purpose of this study was to evaluate the knowledge, attitude, and practices of sports participants concerning sports-related dental trauma and associated emergency/preventive practices. The study included 124 male subjects over 18 years of age participating in contact and non-contact sports in three clubs in the Eastern Province, Saudi Arabia. A questionnaire was used to assess past experience of dental trauma related to sports in addition to the use of a mouth guard and knowledge of related emergency procedures. Outcomes were compared between individuals practicing direct and non-direct contact sports. One third of the participants had experienced dental trauma while playing sports, mostly crown fracture, mobility, and avulsion. Their knowledge of first aid and emergency procedures was inadequate. A significantly higher proportion of non-direct contact sport participants sought the help of a dentist for themselves or others (P = 0.04 and 0.003, respectively). Only 33.9% used mouth guards, with higher odds of mouth guard use associated with participating in direct contact sports and believing a tooth can be lost during sports practice (odds ratio = 5.59 and 5.37, respectively). Educational programs are needed to increase the awareness in sports participants of the risk of dental trauma during sports participation, to improve their knowledge of first aid procedures, and to increase the use of mouth guards.

Academic advising and student support: Help-seeking behaviors among Saudi dental undergraduate students

Objective The purpose of this study was to assess the use of and satisfaction with the academic-advising and student-support systems available to undergraduate students in the College of Dentistry at the University of Dammam. In addition, the study aimed to also identify factors that explained the help-seeking behavior of students which they used to solve academic issues. Materials and methods Students enrolled in the five-year Bachelor of Dental Surgery (BDS) program in 2012–13 and 2013–14 first-year students were invited to respond to a self-administered questionnaire. Results The results showed that 66.2% of students had discussed academic issues with their advisor at least once, with a frequency ranging from zero to six times. Most students reported that their advisors were readily available, listened intently to their needs and questions, and helped them solve their problems. However, only 7.6% of students relied primarily on advisors for help with academic issues, whereas 51% depended first on colleagues and 13.8% did not seek help and relied on themselves. In total, 17.2% of students were very or somewhat satisfied with the academic advising system. Males had lower odds of discussing issues with their advisors, and the odds were higher with advisors who were more available (OR = 0.25 and 3.74, respectively). Alerting students to important dates in the academic calendar significantly increased the odds that a student would depend primarily on academic advisors for advice related to academic issues (OR = 6.53). Conclusions Few students were satisfied with the academic support system. We need to train advisors to help them develop their skills and knowledge and to enable them to provide the support needed by the students.

Factors Affecting Self-reported Implementation of Evidence-based Practice Among a Group of Dentists

OBJECTIVE The study aimed at assessing the factors affecting the implementation of evidence-based practice (EBP) among a group of dentists in Saudi Arabia. METHODS A cross sectional study design was used where a link to an electronic questionnaire was posted on the websites of the Saudi Dental Society and a social networking site for dentists. The questionnaire was available for three months after which responses were downloaded and analyzed. Descriptive statistics were calculated for various variables and logistic regression analysis was used to identify factors with significant effect on the implementation of EBP. RESULTS Implementation of EBP was reported by 69.3% of respondents. Most respondents reported knowing and using MEDLINE and being able to search for evidence. The most frequently reported barriers were lack of time and availability of evidence. Factors that significantly affected the implementation of EBP were 1) having some knowledge of terms related to EBP, 2) reporting lack of EBP skills as a barrier, and 3) reporting resistance to change as a barrier. CONCLUSIONS Background knowledge related to EBP and training in its skills are needed for the implementation of EBP whereas the presence of resistance to change does not necessarily prevent its implementation.

Carious lesions of permanent molars and oral health practices of parents and peers in Saudi male adolescents

Objectives: To assess the association between carious lesions in first and second permanent molars in adolescents and their parents’ and peers’ oral health practices. Methods: This cross-sectional study of 12-15 year-old male adolescents was conducted in Dammam, Kingdom of Saudi Arabia, on February 2016. Data collection included dental examination to measure carious lesions and plaque. There was a questionnaire to assess oral health practices such as brushing with fluoridated toothpaste, current daily tobacco use, and daily consumption of sugary food and drinks. Logistic regression models assessed the association between first and second molars carious lesions with adolescents’, parents’, and peers’ oral health practices. Results: Of 302 students, 294 participated. The mother’s brushing was significantly associated with a lower odds of carious lesions in the first molar (odds ratio [OR] = 0.17, 95% confidence interval [CI]: 0.04 - 0.77). The mothers’ sugary food intake and students’ own brushing were significantly associated with carious lesions in the second molar (OR = 1.95 and 0.36, 95% CI: 1.01-9.89 and 0.12-0.89). Friends’ intake of sugary drinks had a strong, but non-significant, association with second molar’s carious lesions (OR=3.61, 95% CI: 0.35 - 7.44). Conclusion: In Saudi society, mothers have a major influence on their adolescent sons’ carious lesions. Adolescents’ oral health strategies should involve parents to reduce their risk of caries.

Reach of Messages in a Dental Twitter Network: Cohort Study Examining User Popularity, Communication Pattern, and Network Structure

Background Increasing the reach of messages disseminated through Twitter promotes the success of Twitter-based health education campaigns. Objective This study aimed to identify factors associated with reach in a dental Twitter network (1) initially and (2) sustainably at individual and network levels. Methods We used instructors’ and students’ Twitter usernames from a Saudi dental school in 2016-2017 and applied Gephi (a social network analysis tool) and social media analytics to calculate user and network metrics. Content analysis was performed to identify users disseminating oral health information. The study outcomes were reach at baseline and sustainably over 1.5 years. The explanatory variables were indicators of popularity (number of followers, likes, tweets retweeted by others), communication pattern (number of tweets, retweets, replies, tweeting/ retweeting oral health information or not). Multiple logistic regression models were used to investigate associations. Results Among dental users, 31.8% had reach at baseline and 62.9% at the end of the study, reaching a total of 749,923 and dropping to 37,169 users at the end. At an individual level, reach was associated with the number of followers (baseline: odds ratio, OR=1.003, 95% CI=1.001-1.005 and sustainability: OR=1.002, 95% CI=1.0001-1.003), likes (baseline: OR=1.001, 95% CI=1.0001-1.002 and sustainability: OR=1.0031, 95% CI=1.0003-1.002), and replies (baseline: OR=1.02, 95% CI=1.005-1.04 and sustainability: OR=1.02, 95% CI=1.004-1.03). At the network level, users with the least followers, tweets, retweets, and replies had the greatest reach. Conclusions Reach was reduced by time. Factors increasing reach at the user level had different impact at the network level. More than one strategy is needed to maximize reach.

Contribution of preventive methods in controlling caries among Saudi primary schoolchildren: a population-based cross-sectional study

Abstract Objective: This study assessed the association between caries preventive measures including regular dental checkups, twice a day tooth brushing using fluoridated toothpaste and pit and fissure sealants on one side and the presence of caries among primary schoolchildren in the Eastern Province of Saudi Arabia. Materials and methods: A cross-sectional study was conducted in 2016 including 1198, 6–12-year-old children from 13 randomly selected schools. The outcome variable was caries presence. The explanatory variables were brushing twice a day using fluoridated toothpaste, the presence of sealant and regular dental checkups. Multivariable logistic regression model was conducted to assess the associations controlling for confounders (age, gender, ability to get treatment, being health insured and school) using SPSS version 20.0. Results: Data of 921 participants (83.8%) were available. The prevalence of caries was 63.5%, whereas 67.6% brushed their teeth twice a day, 28.3% visited the dentist for regular checkups and 7.6% had sealant. In multivariable regression, out of the three main explanatory variables, only having regular checkups was significantly associated with caries presence (OR = 0.65, 95% CI = 0.48, 0.88). Conclusions: Lower odds of caries presence were associated with regular dental checkups but not with regular brushing or having sealant.

Arab dentists’ refusal to treat HIV positive patients: a survey of recently graduated dentists from three Arab dental schools

Abstract Objective: To assess intended refusal of recent graduates from three Arab dental schools to treat HIV + patients and factors associated with this intention. Materials and methods: In 2015, convenience samples of recent dental graduates were included from Libya, Egypt and the United Arab Emirates. Participants responded to a questionnaire assessing personal background, knowledge of oral manifestations and fluids transmitting HIV, perceived adequacy of training and self-efficacy to manage blood exposures, attitude to risk of infection, moral beliefs and willingness to treat HIV + patients. Logistic regression assessed factors associated with intended refusal to treat HIV + patients. Results: The overall response rate was 552/710 (77.8%), mean age = 23.7 years with 41.8% males. The mean (SD) scores for knowledge of oral manifestations and fluids transmitting HIV were 5.5 (1.3)/8 and 4.2 (1.7)/7. The mean (SD) scores for attitude to risk of infection and moral beliefs were 2.9 (1.0)/4 and 2 (0.9)/3, respectively. One-third of respondents indicated intention to refuse treating HIV + patients. Knowledge of body fluids transmitting HIV and moral beliefs were associated with lower odds of refusing to treat HIV + patients (OR = 0.86 and 0.38) whereas attitude indicating greater concern for risk of infection was associated with higher odds (OR = 1.54). Conclusions: One third of dentists from three Arab dental schools indicated they would refuse to treat HIV + patients. Adequate knowledge and moral beliefs reflecting professional ethics were associated with lower odds of refusal counterbalancing the association with attitude indicating increased concern for risk of infection with implications for dentist education and training.

Influences of parents, close friends and classmates on four co-existing oral health practices in Saudi male teenagers

Abstract Objective: The objective of this study is to investigate the association between oral health practices and similar practices adopted by parents, close friends and classmates in a group of Saudi male teenagers. Material and methods: A cross-sectional study was conducted in Dammam, Saudi Arabia, in 2016 including 12–14-year-old intermediate school students (n = 478). A questionnaire assessed socioeconomic background, whether participants, their parents, close friends and classmates brushed twice daily, used tobacco, snacked on sugary foods or sugary drinks and perceiving a supportive classroom environment. Univariate and multivariate logistic regression models assessed the association of parents’, close friends’, classmates’ practices and classroom support with participants’ four practices, controlling for socioeconomic factors. Results: The response rate was 93.9%. In multivariate regression, close friends’ practices had a strong significant association with teenagers’ tooth brushing (OR = 4.45; 95%CI = 1.09, 18.12), tobacco use (OR = 5.63; 95%CI = 3.44, 7.88), snacking on sugary foods (OR = 14.42; 95%CI = 7.89, 21.89) and sugary drinks (OR = 7.05; 95%CI = 5.97, 9.20). The percentages of classmates perceived to brush their teeth and use tobacco were significantly associated with the respective practices in teenagers (OR = 1.03 and 1.02). Fathers’ snacking on sugary drinks was significantly associated with that of the teenagers (OR = 4.04; 95%CI= 1.03, 15.85). Conclusions: In early adolescence, four oral health practices of Saudi males were associated with those perceived to be adopted by their close friends. Fathers’ use of sugary drinks was also significantly associated with that of teenagers.