Prevalence of Caries among School Children in Saudi Arabia: A Meta-Analysis

Distribution of Private Dental Healthcare Facilities in Riyadh City: A GIS-Based Approach

BACKGROUND

The dental healthcare private sector in Riyadh city has been growing rapidly over the past few years; however, there is a lack of information on the accessibility and spatial distribution of private dental healthcare facilities (PDHFs) in the area. This study aimed to evaluate the spatial distribution of PDHFs in Riyadh city in relation to population density in each sub-municipality.

METHODS

The current information regarding the number, location, and operability of PDHFs in Riyadh city was obtained from the Ministry of Health. A total of 632 operating PDHFs were included with the precise location plotted on Quantum Geographic Information System software (version 3.32.1, Essen, Germany) using Google Earth. Four levels of buffer zones-1 km, 3 km, 5 km, and >5 km-were determined. The population statistics and mean monthly individual income per district were gathered from Zadd.910ths. Microsoft Excel (version 16.0, Microsoft, Redmond, WA, USA) and RStudio software (version 4.1.3, Posit Software, PBC, Boston, MA, USA) were used for additional data analysis.

RESULTS

There was an overall ratio of one PDHF per 9958 residents in Riyadh city. Olaya and Maather sub-municipalities had the largest PDHF-to-population ratios: (1:4566) and (1:4828), respectively. Only 36.3% of the city's total area was within a 1 km buffer zone from a PDHF. There was an overall weak positive correlation between the number of PDHFs and the total area in each sub-municipality (r = 0.29), and the distribution of PDHFs was uneven corresponding to the area (G* = 0.357).

CONCLUSIONS

There was an uneven distribution of PDHFs in Riyadh city. Some areas were underserved while others were overserved in several sub-municipalities. Policy-makers and investors are encouraged to target underserved areas rather than areas with significant clustering to improve access to care.

Caries prevalence among children at public and private primary schools in Riyadh: a retrospective study

Dental caries is a global oral health issue, especially critical in children, affecting their growth, nutrition, and education due to school absences or distractions from dental pain. The aim of the study was to investigate the correlation between school types (indicative of socioeconomic conditions) and dental caries prevalence among primary school children in Riyadh, alongside assessing the overall caries prevalence among schoolchildren in Riyadh. Retrospective study on 28,343 first and fourth-grade students from 960 public and private schools in Riyadh, using data from the Saudi Ministry of Health (Feb-April 2019). Utilized the DMFT/dmft index for assessment and collected demographic data. Most of the schools were public (76.1%), private national (17.1%), and private international (6.8%). Overall, the mean DMFT index for permanent teeth and the dmft index for primary teeth were 1.78 and 1.94, respectively. 58% of school children had no dental caries, 25% had mild caries, and 17% had moderate to severe caries. Public school children showed a higher caries prevalence than private schools. Oral disease rates were higher in girls than in boys, and grade four students had a higher prevalence than grade one students. Saudi Arabia, a developing nation, faces challenges in addressing oral health, especially in public schools. Targeted initiatives are crucial for awareness, preventive measures, and meeting oral health needs.

SEQUEL: Prevalence of dental caries in Saudi Arabia: A systematic review and Meta-analysis

This meta-analysis investigated the prevalence of dental caries throughout the Kingdom of Saudi Arabia (KSA) between 2011 and 2023 as a follow-up to a previously published review in 2013 by Khan et al. and aimed to provide an update on the current status of caries prevalence in the KSA. A literature search was conducted, and thirty-three articles were included in the final analysis. To determine the prevalence of caries in primary teeth, the 2- to 12-year-old Saudi population was included in the search, and an age range of 6-18 years was used for permanent teeth. The prevalence of caries in the primary and permanent dentition was analyzed separately. As the included studies for the primary and permanent teeth had insignificant heterogeneity, fixed-effect models and forest plots were used to evaluate caries prevalence in both dentitions. In the primary dentition, the mean decayed-missing-filled teeth (dmft) index was 4.14 (95 % confidence interval (CI): 3.11-5.18), with an average prevalence of 75.43 %. For the permanent teeth, the mean DMFT (uppercase used for permanent dentition) was 1.28 (95 % CI: 0.93-1.64), with an average prevalence of 67.7 %. The average dmft/DMFT scores decreased in both primary and permanent teeth compared to the previous meta-analysis by Khan et al., suggesting a beneficial effect of preventative measures on caries prevalence. Continuing these measures is necessary to maintain the downward trend of caries prevalence in the KSA.

Prevalence of Obesity and Dental Caries in High School Adolescents during the First Decade of Saudi Vision 2030: A Cross-Sectional Study

Saudi Vision 2030 was launched in 2016. Obesity and dental caries are both highly prevalent in Saudi adolescents and have been targeted by the Vision's health initiatives. The aim is to assess their prevalence in adolescents during the first decade since the launch of the Vision. This cross-sectional study was conducted in Jeddah, Saudi Arabia using a stratified sample of 571 high school students, with an average age of 16.7 (0.6). Their height and weight were measured, and their body mass index (BMI) was calculated. The decayed, missed, and filled scores (DMFTs) were recorded after an oral examination. Non-parametric tests were used to assess the associations of DMFT with BMI, sex, and school type; and its predictors were assessed. One-third of males were overweight/obese compared with 22% of females. Males exhibited higher DMFTs than females. DMFTs were higher among public school students than among their private school counterparts. No significant association was observed between DMFT and BMI. Sex and school type were significant predictors of DMFT. The prevalence of obesity has slowly decreased in adolescents, but the prevalence of dental caries has not. There was no significant relationship between these conditions. Saudi Vision 2030's current preventive/educational initiatives may be more effective in combating obesity than dental caries.

Factors for choosing a pediatric dentist in Saudi Arabia

The choice of a pediatric dentist is a crucial decision for parents, influenced by a variety of factors. This study aimed to investigate the key determinants that guide parents in the Kingdom of Saudi Arabia in their selection of a pediatric dentist. A cross-sectional survey was administered to a diverse participant pool. The survey captured demographic information, history of dental visits, parents' level of concern about dental treatment for their children, and the importance of specific factors in the choice of a pediatric dentist. The survey was completed by a balanced representation of different age groups and genders. Most participants from Riyadh and other regions had a history of dental visits. Parents' concern about dental treatment varied based on the number of children they had. The most significant factors influencing the choice of a pediatric dentist were the quality of the dental unit's disinfection process, the dentist's ability to communicate with the child and manage uncooperative behaviour, and the dentist's experience. The least influential factors were the proximity of the dental office to the child's school, the dentist's gender, and the number of pediatric dentists in the practice. This study provided valuable insights into the factors that influence parents' decision in choosing a pediatric dentist in The Kingdom of Saudi Arabia. Data helps dental professionals understand parents' priorities and improve their services accordingly to meet patient needs and expectations.

Comparison of Salivary Secretion, pH, and Buffer Capacity Between COVID-19 Vaccinated and Unvaccinated Child Patients Visiting Dental Clinics of University Hospitals in Riyadh City, Saudi Arabia

Objective

This study aimed to assess and compare the salivary secretion, pH, and buffer capacity between COVID-19 vaccinated and unvaccinated child patients visiting the clinics of private university dental hospitals in Riyadh, Saudi Arabia.

Methods

This is the first comparative assessment of salivary parameters between unvaccinated and COVID-19-vaccinated child patients. The study sample comprised COVID-19 unvaccinated (n = 66) and vaccinated (n = 66) pediatric dental patients aged 4-12 years seeking dental care in clinics of private university hospitals. Paraffin-stimulated saliva was collected from unvaccinated and vaccinated study participants, and the amount of saliva secreted per minute was noted. Salivary pH and buffering capacity (by 5 mmol Hydrochloric acid titration) were measured using a benchtop digital pH meter. The data obtained were compared between unvaccinated and vaccinated participants using an independent t-test.

Results

The results showed a significantly higher salivary secretion rate in unvaccinated than vaccinated study participants (0.83 ± 0.24 mL/min vs 0.67 ± 0.24 mL/min, p = 0.001). Similarly, unvaccinated subjects compared to vaccinated subjects exhibited a significantly higher pH (7.33 ± 0.39 vs 7.04 ± 0.46, p < 0.001) and buffering capacity (6.31 ± 1.55 vs 5.40 ± 1.22, p < 0.001). Moreover, unvaccinated females demonstrated a significantly higher salivary secretion (0.87 ± 0.23 vs 0.71 ± 0.25, t = 2.627, p = 0.011) and buffering capacity 6.19 ± 1.52 vs 5.34 ± 1.25, t = 2.404, p = 0.019) than vaccinated females. Similarly, unvaccinated male exhibited significantly higher salivary secretion (0.80 ± 0.25 vs 0.64 ± 0.23, t = 2.670, p = 0.009), salivary pH (7.39 ± 0.45 vs 6.94 ± 0.41, t=4.309, p<0.001) and buffering capacity (6.42 ± 1.60 vs 5.45 ± 1.21, t = 2.875, p = 0.005) than the vaccinated male subjects.

Conclusion

The vaccinated subjects showed a significantly lower mean salivary secretion, pH, and buffering capacity than unvaccinated participants. Hence, COVID-19 vaccination is likely to affect salivary parameters among pediatric patients.

Clinical and Radiographical Outcomes of Restorative Treatment With Stainless Steel Crowns Performed by Undergraduate Dental Students in Medina, the Kingdom of Saudi Arabia

Background and objective Stainless steel crown (SSC) placement has long been the preferred restorative treatment modality for treating multi-surface carious primary molars. This study aimed to assess the outcomes of SSC placement on primary molars performed by undergraduate dental students. Materials and methods A total of 112 children aged four to eight years were contacted for follow-ups 12 months after they underwent SSC restorations by fifth- or sixth-year female dental students in 2018-2020. Clinical and radiographic examinations were performed by trained dentists to evaluate for signs of failure. Descriptive statistics were applied for categorical variables and a Chi-squared test was used to assess the relationship between failure rate and demographic variables (i.e., age, gender, and type of tooth). Results The majority of the included children were aged seven years, with females (52.7%) slightly outnumbering males (47.3%). The failure rate clinically was 17.8%, involving one or more of the following signs: pain (16.1%), poor crown adaptation (16.1%), improper marginal seal (13.4%), fistula (6.3%), and mobility (4.5%). The rate of failure as per radiological examinations was 15%, involving one or more of the following signs: furcation involvement (9.8%), periapical radiolucency (3.6%), and pathological root resorption (1.8%). No significant association was found between failure rate and age, gender, or type of tooth. Conclusions The restorative treatment of primary molars with SSCs exhibited a high success rate when performed by less experienced undergraduate dental students from different academic levels. The failure rate did not appear to be associated with the child's age and gender or the type of tooth.

Impact of virtual supervised tooth brushing on caries experience and quality of life among primary school children: study protocol for a randomized controlled trial

BACKGROUND

Dental caries is one of the most common diseases affecting children world widely as well as in the Kingdom of Saudi Arabia. Supervised tooth brushing programs are implemented throughout the world to provide young children's developing teeth with additional fluoride as a form of dental caries prevention. While school-based supervised tooth brushing programs have been proven to improve young children's oral health, virtual supervised teeth brushing programs have not been assessed. The purpose of this protocol is to assess the impact of virtual supervised tooth brushing on caries experience and quality of life among primary school students in Riyadh, Saudi Arabia.

METHODS

This is a cluster randomized controlled trial comparing a virtual supervised tooth brushing program against no intervention applied. A total of 1192 (596 in each group) 8-9-year-old children in Riyadh primary schools, Saudi Arabia, will be recruited for the trial. Schools (cluster) will be randomly selected and allocated to either group. Clinical assessment for caries experience will be conducted in six points (baseline, + 3 months, + 6 months, + 12 months, + 24 months, + 36 months) by dental hygienists using the World Health Organization criteria. Data on sociodemographic behavioral factors and children's quality of life will be collected with every clinical assessment through a structured questionnaire. The primary outcome is the change in caries experience (the number of teeth with untreated dental caries, filled and missing teeth) in both primary and permanent teeth over 36 months.

DISCUSSION

Virtual education as well as some health consultation through the pandemic period had enabled an effective IT infrastructure in Saudi Arabia. Virtual supervised tooth brushing is a proposed initiative. It is also an opportunity for targeting a large portion of the population with a high level of disease as a quarter of the Saudi population is younger than 15 years. This project should provide high level evidence on the effectiveness of virtual supervised tooth brushing. The findings should potentially inform policies related to the continuation/implementation of school-based programs in Saudi Arabia.

TRIAL REGISTRATION

ClinicalTrials.gov, ID: NCT05217316. Registered on 19 January 2022.

School Dental Services Theoretical Model-Based on Geographic Information System in Al-Madinah, Saudi Arabia

The study aimed to design a geographic theoretical model for school dental services (SDS) in Al-Madinah, Saudi Arabia (SA), using a geographic information system (GIS). The location of all primary public schools and the student population at each school were obtained from the General Administration of Education in Al-Madinah Al-Munawwarah Region website. The geographic modeling for SDS was analyzed using GIS according to two models. A scenario was developed to simulate the demand for dental care for the two models based on schoolchildren's estimated oral health profile. The areas with the higher number of schools; higher number of students; and dense child population as presented in the map suggest the future location of SDS. The total number of dentists required to work in SDS settings was 415 for the first model, and 277 for the second model. The suggested average number of dentists per district in the highest child population density districts is 18 dentists in the first model, compared to 14 in the second model. Establishing SDS is suggested as a solution to the persistently high prevalence of dental caries among schoolchildren in Al-Madinah and SA in general. A model was suggested for SDS with a guide of the proposed SDS locations and the number of dentists to hire for the services to meet the child population's oral health needs.