Dania Bahdila

Objectives: Although previous studies explored parents' perceptions of accessing dental care, few examined their link to treatment completion, follow‐up and children's quality of life. This study aimed to (1) examine the association between parents' perceptions and utilisation outcomes (access, treatment completion and follow‐up) alongside children's quality of life; and (2) identify barriers reported by parents for failing to complete treatment or adhere to follow‐up. Methods: A cross‐sectional study was conducted among primary schoolchildren in Jeddah, Saudi Arabia, using stratified cluster sampling. Caregivers completed surveys on access and barriers, whereas children completed the Caries Impacts and Experiences Questionnaire for Children (CARIES‐QC) and underwent clinical examinations. Multilevel logistic regression models analysed predictors of care utilisation and CARIES‐QC scores. Results: 785 schoolchildren and their parents from 11 schools were included. Perceived difficulty accessing care increased the odds of treatment incompletion (AOR: 5.84, 95% CI: 2.98–11.44), lack of follow‐up (AOR: 2.11, 95% CI: 1.15–3.87) and poorer CARIES‐QC scores ( β = 1.70, 95% CI: 0.56–2.85). The most common reported barriers for incomplete treatment or not following up were financial barriers (25.6%, n = 72 and 45.9%, n = 56) and dismissive attitudes toward primary teeth (17.4%, n = 49 and 22.1%, n = 27), respectively. Conclusion: Perceived difficulty in accessing dental care was significantly associated with incomplete treatment, missed follow‐ups and poorer caries‐specific quality of life. Financial constraints and misconceptions about primary teeth were key reported barriers, emphasising the need to address both parents' perceptions and reported barriers to improve oral health outcomes.

Introduction: The cascade of care (COC) approach assesses key stages in care, including screening, diagnosis, treatment, and control. It has been applied to communicable and noncommunicable diseases but is yet to be used in oral health. Objectives: To adapt the COC framework for pediatric oral health and apply it in a cross-sectional study of schoolchildren in Jeddah, Saudi Arabia, to assess dental needs, diagnosis, treatment, and follow-up. Methods: A 2-stage process was used to first adapt the 4-step COC model for pediatric dental needs and to produce a survey questionnaire. Stratified random sampling was then used to recruit children in grades 4 to 6 in primary schools in Jeddah, Saudi Arabia, from October 2023 to January 2024. Parents completed COC questions, and children completed dental examinations. Descriptive statistics and multilevel logistic regression models were used to assess outcomes, including unmet dental needs in context. Results: A total of 783 schoolchildren from 11 primary schools were included in the cross-sectional study. The largest loss of care occurred at the treatment stage, where 41.3% of those who had visited a dentist and were diagnosed had completed their treatment. Children who had not visited a dentist in >12 mo were less likely to be diagnosed, complete treatment, or receive follow-up care when compared with those who had seen a dentist within 12 mo ( P < 0.05). Conclusion: This study is the first to adapt and apply the COC framework in pediatric oral health. The total unmet dental need was high, particularly for children visiting the dentist for symptomatic reasons (i.e., pain or extraction). This model lays the groundwork for more targeted assessments at national or subnational levels. Knowledge Transfer Statement: This is the first time that the cascade of care (COC) approach has been adapted and applied in a pediatric oral health case study in Jeddah, Saudi Arabia, to understand gaps in children’s dental care. It showed how the COC can highlight where systems might be underperforming and where additional data are needed. Introducing the COC framework in pediatric oral health could improve data collection across key stages of care, such as access, diagnosis, treatment, and follow-up.

Background Little is known about factors associated with the severity of cleft lip with or without cleft palate (CL/P) especially during the COVID-19 pandemic with its dramatic changes. Objectives The aim of this multi-national study is to measure the association between CL/P severity, COVID-19 infection, and fear of COVID-19 in five Arab countries. Methods This cross-sectional study took place in major governmental hospitals in five Arab countries from November 2020 to April 2023. Participants were infants born with CL/P and their mothers who were in their 1st trimester during the COVID-19 pandemic. Clinical examination was carried out, and CL/P cases were grouped according to phenotype: cleft lip and palate (CLP) versus cleft lip (CL), cleft extension (incomplete versus complete), and site (unilateral versus bilateral) to assess severity. Information on maternal COVID-19 infection and fear of COVID-19 were gathered. Results The study recruited 273 CL/P infants. Maternal COVID-19 infection during one-month pre-gestation and 1st trimester was significantly associated with higher odds of CL/P severity (AOR = 2.707; P = 0.002) than mothers without the COVID-19 infection. Using supplements during pregnancy showed a protective effect (AOR = 0.573; P = 0.065). Conclusion Mothers infected with COVID-19 before and during pregnancy had more than twofold higher odds of having an infant with a more severe CL/P phenotype.

Background: Health literacy (HL) refers to an individual's ability to access, understand, and apply health information to make informed decisions about their health. On the contrary, oral health literacy (OHL) focuses on an individual's ability to understand and utilize oral health information to maintain good oral health.Aim: This study presents a comprehensive literature review that explores the theoretical foundations and practical applications of HL and OHL.Design: A comprehensive search was conducted using keywords on the following databases: PubMed, Google Scholar, and Cochrane Database of Systematic Reviews.Results: The existing literature on various aspects of HL, including the most common used definitions of HL, conceptual frameworks, and consequences of limited health and OHL, was summarized. Additionally, the review discussed the significance of HL and OHL. Also, the relation between parent level of OHL and children's oral health was described. It further highlights modern approaches that have been shown in previous studies to improve the OHL of primary caregivers.Conclusions: Understanding the significance of HL and OHL is crucial in developing effective interventions that can address disparities and improve oral health outcomes for individuals of all backgrounds.

Objectives Risk factors for non-syndromic orofacial cleft (NSOFCs) include genetic profile and environmental exposure to medication and illnesses during pregnancy. We assessed the association between the COVID-19 vaccination and the incidence of NSOFC across five Middle Eastern countries. Materials and methods This multi-country, hospital-based, case-control study included infants with NSOFCs whose first 3 intrauterine months coincided with the time when pregnant women were allowed to receive COVID-19 vaccination in the countries participating in the study. Newborns with NSOFCs were examined for cleft type and their parents were interviewed for maternal exposures and COVID-19 vaccination. Controls were newborns matched to cases in gender and setting. Results The study recruited 977 (348 children with NSOFCs and 629 controls). Maternal use of nicotine (Adjusted Odds Ratio (AOR): 2.437; P = 0.044) and family history of NSOFC (AOR: 11.059; P < 0.001) increased significantly the AOR of having a child with NSOFC. On the other hand, COVID-19 vaccine administration to pregnant mothers have significantly decreased the AOR of having a child with NSOFC (AOR: 0.337; P = 0.006). Conclusion This study suggests that COVID-19 vaccination is not related to NSOFC and might protect against having a child affected with such a congenital anomaly. Clinical relevance The finding of this study is important for healthcare providers for considering COVID-19 vaccination for pregnant woman. Clear communication and education about the potential risks and benefits would be crucial for informed decision-making. The study’s results would directly impact pregnant individuals, as they would need accurate information to make informed decisions about their health and the health of their infants.

The aim of this cross-sectional study was to explore the eye tracking (ET) performance of postgraduate pediatric dental students in correctly detecting abnormalities in different sets of panoramic radiographs. This observational study recruited postgraduate pediatric dental students to evaluate seven panoramic radiographs. RED-m^® SMI software (Sensomotoric Instruments, Teltow, Germany) was used to track the participants’ eye movements as they looked at the radiographs. The data collected for areas of interest (AOIs) included revisit counts, fixation counts, fixation times, entry times, and dwell times. Univariate and bivariate analyses were conducted to summarize the participants’ characteristics and ET measures. The overall percentage of correctly located AOIs was 71.7%. The residents had significantly more revisits and fixation counts in AOIs located in one sextant than in multiple sextants (p < 0.001). Similar patterns were observed for fixation and dwell times (p < 0.001), but not for entry time. Heatmaps showed that the highest density of fixations was on the AOIs and the residents fixated more on dentition than on bony structures. In single-sextant radiographs, residents had significantly more revisits and fixation counts for AOIs compared to those of multiple sextants. Residents had slower entry times and dwelled less on AOIs located in multiple sextant(s). The reported findings can direct dental educators to develop a standardized scan scheme of panoramic radiographs to minimize misdiagnosis.

Objectives: The Coronavirus Disease‐19 (COVID‐19) pandemic highlighted the need for pandemic preparedness (PP) in health professions training. We aimed to (1) establish a current profile on curricular content of PP in US dental schools and (2) examine how schools were adapting their curricula in response to COVID‐19.Methods: An online survey was developed and sent to senior leadership to all 66 Commission on Dental Accreditation (CODA)‐accredited US dental schools including Deans of Academic or Clinical Affairs from November 2020–February 2021. Questions addressed PP curricular content, teaching methods, and evaluation. Participants were asked about the barriers and facilitators for the inclusion of this content. The survey also included questions on redeployment of the clinical workforce in response to the pandemic.Results: The response rate was 31.8% (n = 21) with representation from every US Census Bureau‐designated division. While all responding dental schools agreed that dental professionals can play an important role during pandemics, 38.1% reported including content on PP into their pre‐ or postdoctoral curriculum. In response to the COVID‐19 pandemic, approximately 47.6% indicated redeployment of their clinical workforce to participate in disaster life support, assisting physicians in COVID‐19 cases, and assisting hospitals with personal protective equipment (PPE).Conclusion: There was general agreement that dental professionals can play an important role during pandemics. The participating US dental schools responded to the COVID‐19 pandemic by integrating novel clinical activities. More efforts are required to include PP in dental education.

Objectives: Methamphetamine (MA) is a widely used illicit drug and a nationwide public health concern. Although dental complications are consistently reported among MA users, yet limited nationally representative studies on the associations between MA use and oral health currently exist.Methods: Using the National Health and Nutrition Examination Survey 2009–2014, we analyzed 8,762 respondents aged 30–64 years who had completed a periodontal examination. MA use was self‐reported; periodontitis, untreated caries, and missing teeth were assessed by calibrated dentists. Descriptive statistics as well as multivariable regression analyses were performed. Data were weighted to yield representative estimates of the US adult population.Results: Overall 7.8 percent of US adults aged ≥30 years had ever used MA. Ever‐use prevalence was higher among males, whites, and individuals below the federal poverty level. Established MA users had a higher prevalence of untreated dental caries (36.6 percent), any periodontitis (54.8 percent), and severe periodontitis (12.2 percent) than those who had never used MA. The prevalence of any periodontitis was higher among current MA users (PR: 1.31; 95% CI: 1.05–1.62) than those who never used MA. Prevalence of untreated dental caries was higher among current MA users (PR: 1.53; 95% CI: 1.10–2.13) and established users (PR: 1.21; 95% CI: 1.02–1.48) than never users. Taking MA orally and/or through injection was associated with higher odds of severe periodontitis than orally only (AOR: 3.72; CI: 1.79–7.75).Conclusions: MA users had a higher prevalence of periodontitis and dental caries. Continued research assessing the relationship between MA use and oral health can inform clinical interventions and management of dental diseases in MA users.

Background: Cocaine is the second most abused illicit drug in the United States. To date, no study has examined the association between cocaine use and oral health with a nationally representative sample. Our study examined the association between cocaine use—singly and with other substances—and oral health outcomes, including periodontitis and untreated caries, among US adults.Methods: Data for 11,753 individuals, aged ≥30 years, who completed a periodontal examination, in the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Descriptive analyses and multivariable binary logistic regression analyses were conducted on weighted data.Results: Overall, 17% (20.5 million) of US adults aged ≥30 years had ever used cocaine, with higher likelihood seen among males, non‐Hispanic whites, and those living in poverty. Current cocaine use prevalence was 2.6% (3.2 million). By number of co‐used substances, the odds of having any periodontitis were higher among cocaine users who consumed ≥3 other substances (adjusted OR = 2.47; 95% CI = 1.15 to 5.30) when compared with solely cocaine users. By type of substance co‐used, odds of having untreated caries were greater among those reporting cigarettes (adjusted OR = 1.94; 95% CI = 1.21 to 3.11) or methamphetamine (adjusted OR = 5.40; 95% CI = 1.92 to 15.14) usage. Odds of any periodontitis were higher among those reported ancillary cigarette use (adjusted OR = 2.84; 95% CI = 1.60 to 5.04) compared with cocaine‐only users.Conclusions: In addition to a positive association between periodontal disease, dental caries, and cocaine use, select co‐usage elevated the risk of oral disease. Patients should be screened for and counseled regarding substance abuse to facilitate a successful quit.