Khalifa S. Al-Khalifa

The association between dental and periodontal diseases and sickle cell disease. A pilot case-control study

Objective This is a pilot case-control study conducted to investigate the prevalence of dental caries and periodontal disease and examine the possible association between oral health deterioration and SCD severity in a sample of Saudi SCD patients residing in the city of Al-Qatif, Eastern Province, Saudi Arabia. Materials and methods Dental examination to determine the Decayed, Missing and Filled Teeth index (DMFT), Community Periodontal Index (CPI), and plaque index system were recorded for 33 SCD patients and 33 age and sex-matched controls in the Al-Qatif Central Hospital, Qatif, Saudi Arabia. Self-administered surveys used to assess socio-economic status; oral health behaviors for both SCD patients and controls were recorded. In addition, the disease severity index was established for all patients with SCD. SPSS data analysis software package version 18.0 was used for statistical analysis. Numerical variables were described as mean with a standard deviation. Results Decayed teeth were significantly more in individuals with ages ranging from 18 to 38 years with SCD compared to the control group (p = 0.036) due to oral hygiene negligence. The mean number of filled teeth was significantly lower in individuals with SCD when compared to the control group (p = 0.015) due to the lack of appropriate and timely treatment reflected in the survey responses of SCD patients as 15.2% only taking oral care during hospitalization. There were differences between the cases and controls in the known caries risk factors such as income level, flossing, and brushing habit. The DMFT, CPI, and plaque index systems did not differ significantly between the SCD patients and the control group. Conclusion Data suggest that patients with SCD have increased susceptibility to dental caries, with a higher prevalence of tooth decay and lower prevalence of filled teeth. Known caries risk factors influenced oral health more markedly than did factors related to SCD.

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.

Total and soluble fluoride concentration present in various commercial brands of children toothpastes available in Saudi Arabia – A pilot study

Objective The aim of this pilot study was to perform chemical analysis and investigate the total and soluble fluoride concentrations in various brands of children toothpastes. Materials and methods Three samples of five different commercial brands of children toothpastes were collected and divided into five groups; group A – Biorepair Oral Care toothpaste containing no fluoride (control), group B – Signal Kids Strawberry toothpaste having 500 ppm fluoride, group C – Aquafresh Milk Teeth toothpaste having 500 ppm fluoride, group D – Aquafresh Little Teeth toothpaste having 500 ppm fluoride, and group E – Siwak F Junior having 400 ppm F. The total fluoride (TF) and total soluble fluoride (TSF) concentration of the toothpastes was determined using fluoride ion selective electrode. Data were analysed using Paired sample t-test. Results The measured TF values were inconsistent with that of the declared concentrations by the manufacturers. Mean TF found in the toothpastes ranged between 2.37 and 515.74 ppm whereas, the mean TSF ranged between 2.00 and 503.4 ppm. For two groups, TF was more than the declared TF whereas for the other three groups, it was less than the declared concentration. All the differences between the declared and observed TF concentration were statistically significant (p < .05) except for one group. All the toothpastes demonstrated mean TSF slightly lower than their respective observed mean TF concentrations. Conclusion The analysis of TF and TSF concentrations revealed variations from the labelled claims. Therefore, some of the toothpastes may have doubtful anti-caries effectiveness owing to deficiency of total and soluble fluoride.

Impact of Denture Cleansing Solution Immersion on Some Properties of Different Denture Base Materials: An In Vitro Study: Immersion Impact of Denture Cleansing Agents

Purpose To evaluate the effect of several denture cleansing solutions on the color stability, surface roughness, and flexural strength of three denture base materials. Materials and Methods Twenty-seven specimens were prepared using heat-polymerized (HP) denture base material, 27 using autopolymerized (AP) denture base material, and 27 using visible-light-polymerized (VLP) denture base, creating a total of 81 specimens. The specimens were randomly divided into three groups (n = 27): the distilled water group (DWG), Corega group (CG), and Renew group (RG). Color changes (ΔE), surface roughness (Ra, nm), and flexural strength (MPa) of each specimen were measured using a spectrophotometer, an optical profilometer, and a universal testing machine, respectively. The results were statistically analyzed using a one-way ANOVA and a post hoc Tukeys test (α = 0.05). Results The only statistically significant color change detected was in the VLP resin treated with Corega and Renew. There was a significant increase in the surface roughness of all denture resin groups after immersion in Corega. Immersion in Renew significantly increased surface roughness only in the HP and AP specimens. The only significant reduction in flexural strength was detected in the HP resin after immersion in Corega (p < 0.05). Conclusions Within the limitations of this study, it can be concluded that Corega has a significantly greater negative impact than distilled water on the flexural strength of HP resin base materials. Renew significantly increased the surface roughness of AP and HP, while Corega increased the surface roughness of all resin materials.PURPOSE To evaluate the effect of several denture cleansing solutions on the color stability, surface roughness, and flexural strength of three denture base materials. MATERIALS AND METHODS Twenty-seven specimens were prepared using heat-polymerized (HP) denture base material, 27 using autopolymerized (AP) denture base material, and 27 using visible-light-polymerized (VLP) denture base, creating a total of 81 specimens. The specimens were randomly divided into three groups (n = 27): the distilled water group (DWG), Corega group (CG), and Renew group (RG). Color changes (ΔE), surface roughness (Ra, nm), and flexural strength (MPa) of each specimen were measured using a spectrophotometer, an optical profilometer, and a universal testing machine, respectively. The results were statistically analyzed using a one-way ANOVA and a post hoc Tukeys test (α = 0.05). RESULTS The only statistically significant color change detected was in the VLP resin treated with Corega and Renew. There was a significant increase in the surface roughness of all denture resin groups after immersion in Corega. Immersion in Renew significantly increased surface roughness only in the HP and AP specimens. The only significant reduction in flexural strength was detected in the HP resin after immersion in Corega (p < 0.05). CONCLUSIONS Within the limitations of this study, it can be concluded that Corega has a significantly greater negative impact than distilled water on the flexural strength of HP resin base materials. Renew significantly increased the surface roughness of AP and HP, while Corega increased the surface roughness of all resin materials.

Impact of Denture Cleansing Solution Immersion on Some Properties of Different Denture Base Materials: An In Vitro Study

Purpose To evaluate the effect of several denture cleansing solutions on the color stability, surface roughness, and flexural strength of three denture base materials. Materials and Methods Twenty-seven specimens were prepared using heat-polymerized (HP) denture base material, 27 using autopolymerized (AP) denture base material, and 27 using visible-light-polymerized (VLP) denture base, creating a total of 81 specimens. The specimens were randomly divided into three groups (n = 27): the distilled water group (DWG), Corega group (CG), and Renew group (RG). Color changes (ΔE), surface roughness (Ra, nm), and flexural strength (MPa) of each specimen were measured using a spectrophotometer, an optical profilometer, and a universal testing machine, respectively. The results were statistically analyzed using a one-way ANOVA and a post hoc Tukeys test (α = 0.05). Results The only statistically significant color change detected was in the VLP resin treated with Corega and Renew. There was a significant increase in the surface roughness of all denture resin groups after immersion in Corega. Immersion in Renew significantly increased surface roughness only in the HP and AP specimens. The only significant reduction in flexural strength was detected in the HP resin after immersion in Corega (p < 0.05). Conclusions Within the limitations of this study, it can be concluded that Corega has a significantly greater negative impact than distilled water on the flexural strength of HP resin base materials. Renew significantly increased the surface roughness of AP and HP, while Corega increased the surface roughness of all resin materials.PURPOSE To evaluate the effect of several denture cleansing solutions on the color stability, surface roughness, and flexural strength of three denture base materials. MATERIALS AND METHODS Twenty-seven specimens were prepared using heat-polymerized (HP) denture base material, 27 using autopolymerized (AP) denture base material, and 27 using visible-light-polymerized (VLP) denture base, creating a total of 81 specimens. The specimens were randomly divided into three groups (n = 27): the distilled water group (DWG), Corega group (CG), and Renew group (RG). Color changes (ΔE), surface roughness (Ra, nm), and flexural strength (MPa) of each specimen were measured using a spectrophotometer, an optical profilometer, and a universal testing machine, respectively. The results were statistically analyzed using a one-way ANOVA and a post hoc Tukeys test (α = 0.05). RESULTS The only statistically significant color change detected was in the VLP resin treated with Corega and Renew. There was a significant increase in the surface roughness of all denture resin groups after immersion in Corega. Immersion in Renew significantly increased surface roughness only in the HP and AP specimens. The only significant reduction in flexural strength was detected in the HP resin after immersion in Corega (p < 0.05). CONCLUSIONS Within the limitations of this study, it can be concluded that Corega has a significantly greater negative impact than distilled water on the flexural strength of HP resin base materials. Renew significantly increased the surface roughness of AP and HP, while Corega increased the surface roughness of all resin materials.

In Vitro Evaluation of the Inhibitory Activity of Thymoquinone in Combatting Candida albicans in Denture Stomatitis Prevention

Candida albicans adhesion and proliferation on denture bases may lead to denture stomatitis, which is a common and recurrent problem in denture wearers. The goal of this study was to assess the inhibitory effect of thymoquinone incorporated in the polymethyl methacrylate denture base material against Candida albicans. Eighty acrylic resin specimens were fabricated and divided into eight groups (n = 10) according to thymoquinone concentrations of 0.5%, 1%, 1.5%, 2%, 2.5%, 3%, and 5% of acrylic powder. Two methods were used to evaluate the effect of thymoquinone on Candida albicans: the slide count and the serial dilution test. A multivariate analysis of variance (MANOVA) and the post-hoc Tukey’s Honestly Significant Difference (HSD) test were performed to compare the difference of means between the observations taken at various intervals with baseline. The p value was statistically significant at ≤0.05. According to the slide count and the serial dilution test, the mean number of adhered Candida albicans in the control group was 5436.9 ± 266 and 4691.4 ± 176.8; however, this number dramatically decreased to 0 ± 0 and 32.4 ± 1.7 in group 8 (concentration 5%). These results suggest that the incorporation of thymoquinone into the acrylic resin denture base material might be effective in preventing Candida albicans adhesion.

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.

Prevalence of dental anxiety in two major cities in the kingdom of Saudi Arabia

Aims: The aim was to assess the level of dental anxiety in adult patients in two major cities in the Kingdom of Saudi Arabia and identify the etiological factors linked to this condition. Settings and Designs: A cross-sectional study using a questionnaire. Materials and Methods: A self-administered questionnaire based on the modified dental anxiety scale was distributed to dental patients who attended the dental clinics of the University of Dammam and King Abdulaziz University in Jeddah, respectively. The questionnaire included information about socio-demographic factors and other questions indicative of dental anxiety. Results: A total of 132 forms was received from subjects in Dammam and 144 forms from Jeddah. The level of dental anxiety in patients was relatively higher (27.5%) than other studies. In this study, patients in Jeddah showed higher levels of dental anxiety than those in Dammam (31.9% vs. 22.7%). As expected, females demonstrated a higher level of anxiety than males (19.2% vs. 8.3%). Most of the participants who had severe dental anxiety thought a bad experience at the dentist was the main cause of their anxiety. Conclusions: Dental anxiety was perceived as a problem in the sample examined. This was clearly seen irrespective of age, gender, social status, and/or place of residence. Patients′ fear of dental treatment continues to pose a great threat to the dental profession. Dental professionals are encouraged to further assess the extent of this problem in order to find methods and techniques to help patients overcome it.

Assessment of dental students' psychomotor skills using oral surgery simulation models

Aim: The aim of this study was to determine the validity of using oral surgery simulation models as a tool to assess the psychomotor skills of dental students. Materials and Methods: All students in the 4 th year of a 6 years dental program were enrolled in the study. 23 dental students were asked to display their competency in the injection of local anesthesia and dental extraction in two summative testing environments namely; in the simulation and in the outpatient clinic. A panel of four experts assessed the students′ performance during the injection of local anesthesia and tooth extraction on patients and simulation using a pre-validated checklist. Students′ scores were compared in both settings. Results: The results showed no significant correlation between the scores on patients and simulation in the two settings (P = 0.759). Conclusion: The study revealed that the real patient remains the gold standard in summative assessment of dental students′ psychomotor skills.

An observation of the concentration and type of fluoride compound present in "over-the-counter" adult toothpastes available in Saudi Arabia

Objectives: This study was performed to observe the type and level of fluoride compounds existent in ′over-the-counter′ (OTC) adult toothpastes available in the open market of Saudi Arabia and to compare them with local and international guidelines. Materials and Methods: More than 100 hyper stores, shops and pharmacies of Dammam and Al Khobar cities were selected randomly and searched for the availability of fluoride containing adult toothpastes. Only toothpastes in which fluoride was present as an active ingredient were included and name of the compound of fluoride and its concentration stated on the packaging of the toothpaste were noted. Results: There were 59 different commercial brands of OTC toothpastes in which sodium fluoride was found in 59.3% of the toothpaste brands (35 of 59), 32.2% of the brands (19 of 59) had sodium monofluorophosphate, 3.3% toothpaste brands (2 of 59) had a combination of sodium fluoride and sodium monofluorophoshpate as an active ingredient, and 5% of the brands (3 of 59) mentioned the fluoride concentration in parts per million (ppm) but did not indicate the type of compound of fluoride present in them. Fluoride concentration found in toothpastes ranged between 1,000-1,470 ppm. Conclusions: Types of fluoride compounds found in toothpastes were consistent with internationally published guidelines. However, majority of toothpastes had 1,450 ppm fluoride which was consistent with Gulf Cooperation Council (GCC) and European guidelines but exceeded the normal range set by United States Food and Drug Administration (US-FDA) and American Dental Association (ADA). Care should be taken when these toothpastes are being used to prevent possible side-effects of fluoride over-exposure.