Najlaa Alamoudi

Characteristics of dental fear among Arabic-speaking children: a descriptive study

BackgroundDental fear has not only been linked to poor dental health in children but also persists across the lifespan, if unaddressed, and can continue to affect oral, systemic, and psychological health. The aim of this study was to assess the factor structure of the Arabic version of the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), and to assess the difference in factor structure between boys and girls.MethodsParticipants were 220 consecutive paediatric dental patients 6–12 years old seeking dental care at the Faculty of Dentistry, King Abdulaziz University, Saudi Arabia. Participants completed the 15-item Arabic version of the CFSS-DS questionnaire at the end of the visit. Internal consistency was assessed using Cronbach’s alpha. Factor analysis (principal components, varimax rotation) was employed to assess the factor structure of the scale.ResultsThe Cronbach’s alpha was 0.86. Four factors with eigenvalues above 1.00 were identified, which collectively explained 64.45% of the variance. These factors were as follows: Factor 1, ‘fear of usual dental procedures’ consisted of 8 items such as ‘drilling’ and ‘having to open the mouth’, Factor 2, ‘fear of health care personnel and injections’ consisted of three items, Factor 3, ‘fear of strangers’, consisted of 2 items. Factor 4, ‘fear of general medical aspects of treatment’, consisted of 2 items. Notably, four factors of dental fear were found in girls, while five were found in boys.ConclusionsFour factors of different strength pertaining to dental fear were identified in Arabic-speaking children, indicating a simple structure. Most items loaded high on the factor related to fear of usual dental procedures. The fear-provoking aspects of dental procedures differed in boys and girls. Use of the scale may enable dentists to determine the item/s of dental treatment that a given child finds most fear-provoking and guide the child’s behaviour accordingly.

Environmental Risk Factors in the Etiology of Nonsyndromic Orofacial Clefts in the Western Region of Saudi Arabia

Objectives Nonsyndromic orofacial cleft (NSOFC) etiology is multifactorial and heterogeneous. This study aimed to identify environmental risk factors related to NSOFC in the Western Region of Saudi Arabia. Methods A case-control study carried out in seven hospitals in two main cities (Jeddah and Maddina) over 2 years on parents of 112 infants with NSOFC (infants were also examined) and 138 infant controls, matched for age (≤18 months), gender, and location, completed a questionnaire on 3-month pregestation and first trimester events. Results There was significantly increased NSOFC risk with twin pregnancies (P = .01, odds ratio [OR] = 9.5, 95% confidence interval [CI]: 1.15 to 78.4), maternal antibiotic use (P = .021, OR = 2.71, 95% CI: 1.11 to 6.62), antiemetic medication (P = .005, OR = 2.85, 95% CI: 1.3 to 6), severe morning sickness (P = .006, OR = 3.6, 95% CI: 1.34 to 9.65), illness (P = .009, OR = 2.19, 95% CI: 1.17 to 4.08), common cold/flu (P = .003, OR = 3.32, 95% CI: 1.48 to 7.58), Jorak smoking (P = .004, OR = 14.07, 95% CI: 1.55 to 128.1), and passive smoking (P = .05, OR = 2.05, 95% CI: 1.05 to 4.01). Reduced NSOFC risk was found with calcium supplementation (P = .02, OR = 0.32, 95% CI: 0.11 to 0.88), incense use (P = .03, OR = 0.58, 95% CI: 0.34 to 0.98), and maternal drinking water, with Zamzam water (which contains a high concentration of minerals) showing a significant protective effect compared with tap water (P = .01, 95% CI: 0.06 to 0.6) and bottled water (P = .02, 95% CI: 0.03 to 0.57). Conclusion Twin births, maternal antibiotic use, antiemetic medication, severe morning sickness, common cold/flu, Jorak smoking, and passive smoking were associated with infants born with NSOFC. Calcium supplementation, incense use, and Zamzam water reduced the risk of NSOFC, raising the possibility of community preventive programs.

Birth prevalence of non-syndromic orofacial clefts in Saudi Arabia and the effects of parental consanguinity

Objectives: To describe the characteristics and prevalence of non-syndromic orofacial clefting (NSOFC) and assess the effects of parental consanguinity on NSOFC phenotypes in the 3 main cities of Saudi Arabia. Methods: All infants (114,035) born at 3 referral centers in Riyadh, and 6 hospitals in Jeddah and Madinah between January 2010 and December 2011 were screened. The NSOFC cases (n=133) were identified and data was collected through clinical examination and records, and information on consanguinity through parent interviews. The diagnosis was confirmed by reviewing medical records and contacting the infants’ pediatricians. Control infants (n=233) matched for gender and born in the same hospitals during the same period, were selected. Results: The prevalence of NSOFC was 1.07/1000 births in Riyadh, and 1.17/1000 births overall; cleft lip (CL) was 0.47/1000 births, cleft lip and palate (CLP) was 0.42/1000 births, and cleft palate (CP) was 0.28/1000 births. Cleft palate was significantly associated with consanguinity (p=0.047, odds ratio: 2.5, 95% confidence interval: 1 to 6.46), particularly for first cousin marriages. Conclusion: The birth prevalence of NSOFC in Riyadh alone, and in the 3 main cities of Saudi Arabia were marginally lower than the mean global prevalence. While birth prevalence for CLP was comparable to global figures, the CL:CLP ratio was high, and only CP was significantly associated with consanguinity.

Prevalence of Child Abuse in Saudi Arabia from 2000 to 2015: A Reviewof thet Literature

Unfortunately, there have been only limited reports about the prevalence of child abuse and neglect in Saudi Arabia (SA). Determining the magnitude and extent of this phenomenon is essential to construct an effective strategy to counter and prevent it. The aim of this review was to provide an overview of the prevalence of child abuse and neglect in SA over the past 15 years (2000-2015). Studies were gathered by reviewing published papers in the Medline and Google Scholar databases reporting the prevalence of child abuse and neglect in SA over the past 15 years. In 2007, the prevalences of physical abuse, sexual abuse, and neglect in previous studies were 70%, 15%, and 15%, respectively. Between 2000 and 2008, the prevalence of child physical abuse and neglect was greater than other forms of abuse. Additionally, the annual report of the National Family Safety Registry noted the same findings. In 2014, a study in Al-Kharj found that psychological abuse was most prevalent among teenagers. In conclusion, child physical abuse and child neglect were the most prevalent forms of abuse over the last 15 years, whereas the recognition of emotional abuse started late compared with other forms of abuse. Awareness of the phenomenon of child abuse and neglect is improving in SA. Consequently, the detection and reporting of such cases are growing across the nation.

The Use of Pit and Fissure Sealants—A Literature Review

This paper reviews the literature and discusses the latest updates on the use of pit and fissure sealants. It demonstrates the effectiveness of pit and fissure sealants in preventing caries and the management of early carious lesions. It compares the use of different sealant materials and their indications. It describes the application technique for sealants. It also reviews the cost-effectiveness of sealants as a preventive strategy. From this review and after the discussion of recently published studies on pit and fissure sealants, it is evident that sealants are effective in caries prevention and in preventing the progression of incipient lesions. It is therefore recommended that pit and fissure sealant be applied to high-caries-risk children for optimum cost-effectiveness. It is a highly sensitive technique that needs optimum isolation, cleaning of the tooth surface, etching, and the application of a thin bonding layer for maximum benefit. Recall and repair, when needed, are important to maximize the effectiveness of such sealant use.

Prevalence of obesity in elementary school children and its association with dental caries

Objectives To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage. Methods This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child’s caries experience was assessed using the decay score in the primary and permanent teeth. Results Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p<0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p<0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p<0.05). Conclusion The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC.

Consequences of early extraction of compromised first permanent molar: a systematic review

BackgroundThe aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children. Meta-analysis was conducted when applicable.MethodsOur research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines used were PubMed, Scopus, and Science Direct. Study selection was performed independently by three reviewers. Articles published from 1960 to 2017 were reviewed based on inclusion and exclusion criteria. Meta-analysis was performed to compare space closure between upper and lower arches.ResultsEleven studies fulfilled the inclusion criteria. The consequences were decrease in post extraction space, accelerated development and eruption of second permanents molars (SPMs) and third molars, a decrease in caries and/or fillings on the proximal surfaces of adjacent teeth, lingual tipping and retrusion of incisors, and counter clockwise rotation of the occlusal plane.ConclusionThere were several consequences of early extraction of FPMs, which were related to skeletal and dental development. Our systematic review suggests that comprehensive evaluation of the compromised FPMs should be performed before planning an extraction. The ideal time for FPM extraction is when the SPM is at the early bifurcation stage in order to achieve complete closure of the extraction space by the SPM. Benefits should be weighed over the risks to decrease the risk of unfavorable outcomes as much as possible. However, due to the limited evidence on the outcomes and variables that influence them, high-quality prospective studies are needed.

Reliability and validity of the Children's Fear Survey Schedule-Dental Subscale for Arabic-speaking children: a cross-sectional study

BackgroundEarly recognition of dental fear is essential for the effective delivery of dental care. This study aimed to test the reliability and validity of the Arabic version of the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS).MethodsA school-based sample of 1546 children was randomly recruited. The Arabic version of the CFSS-DS was completed by children during class time. The scale was tested for internal consistency and test-retest reliability. To test criterion validity, children’s behavior was assessed using the Frankl scale during dental examination, and results were compared with children’s CFSS-DS scores. To test the scale’s construct validity, scores on “fear of going to the dentist soon” were correlated with CFSS-DS scores. Factor analysis was also used.ResultsThe Arabic version of the CFSS-DS showed high reliability regarding both test-retest reliability (intraclass correlation = 0.83, p < 0.001) and internal consistency (Cronbach’s α = 0.88). It showed good criterion validity: children with negative behavior had significantly higher fear scores (t = 13.67, p < 0.001). It also showed moderate construct validity (Spearman’s rho correlation, r = 0.53, p < 0.001). Factor analysis identified the following factors: “fear of invasive dental procedures,” “fear of less invasive dental procedures” and “fear of strangers.”ConclusionThe Arabic version of the CFSS-DS is a reliable and valid measure of dental fear in Arabic-speaking children. Pediatric dentists and researchers may use this validated version of the CFSS-DS to measure dental fear in Arabic-speaking children.

Interferon Regulatory Factor 6 (IRF6) and Gene – Environment Interactions in Non-Syndromic Orofacial Cleft Cases in Saudi Arabia-A Case Control Study

The association between interferon regulatory factor 6 (IRF6) and nonsyndromic orofacial cleft (NSOFC) is affected by ethnicity. Also, gene-environment interactions (GEI) may play an important role in its etiology.Objectives: This case-control study investigated whether IRF6 gene variants were associated with NSOFC in Saudi Arabian population and whether the gene was affected by maternal environmental exposures.Methods: We extracted DNA from saliva samples obtained from 171 infant–parent triad cases and 189 matched controls (age, gender, and location) from January 2010–December 2011; this study included a total of 11 referral hospitals in Saudi Arabia. IRF6 (rs2013162, rs2235375, and rs2235371) polymorphisms were genotyped using restriction-digestion polymerase chain reaction. Data on environmental exposures, for GEI analyses, were collected through questionnaire-led interviews with parents.Results: We found statistically significant over transmission of the common IRF6 rs2013162 allele among cleft lip with or without palate CL(P) cases. No associations were found for either of the other two IRF6 SNPs. Maternal exposure to antipyretics, folic acid, fever, antibiotics, illnesses, common cold/flu, paternal water pipe smoking, stress, x-rays, and/or chemicals could significantly interact with the maternal IRF6 (rs2013162 and rs2235375) gene variants, affecting the likelihood of having an offspring with NSOFC.Conclusion: The common allele at IRF6 rs2013162 was significantly over transmitted among CL(P) cases. This study provides hypotheses for future investigations into genetic and environmental factors and their interaction in the etiology of NSOFC.

Resin Infiltration of Non-Cavitated Proximal Caries Lesions: A Literature Review

Background: Noninvasive measures involving fluoridation, dietary control, and oral hygiene instruction, as well as invasive restorative methods, are the standard treatment options for interproximal caries. Intermediate treatment options, similar to pit-and-fissure sealing on occlusal surfaces that has been shown to be effective in preventing and inhibiting caries, have not yet been established on interproximal surfaces. Recently, the application of resins on interproximal caries lesions has been studied and improved, leading to the development of new materials, which infiltrate and seal the carious lesion, improving the inhibition of caries progression. Aim: The aim of this literature review was to revise the in vivo and in vitro scientific evidence of the ability of resin infiltration (RI) to arrest non-cavitated proximal caries lesions. Materials and methods: Electronic search of English scientific papers from 2007 to 2017 was accomplished using Pub Med search engine. The keywords used were ‘resin infiltration, dental caries’, ‘resin infiltration, carious lesions’, ‘resin infiltration, caries lesions’, ‘caries infiltration’ and ‘Icon DMG’ with the ‘clinical trial’ filter activated. Results: One hundred and forty articles were reviewed as well as some references of selected articles. Fifty studies described the ability of resin infiltration to arrest non-cavitated caries lesions. Conclusion: Data show this new technique complements existing treatment options for interproximal caries by delaying the time point for a restoration and consequently closing the gap between noninvasive and invasive treatment options.