Eman I. Alsagob

Tobacco use poses significant public health challenges globally, with profound implications for oral health among adolescents. This study assessed the prevalence of tobacco use and its association with oral health perceptions, practices, and clinically assessed oral conditions among female adolescents in Riyadh, Saudi Arabia. A cross-sectional study was conducted among 1197 female adolescents aged 12-15 years from Fethipublic and private schools in Riyadh, Saudi Arabia. Data were collected using adapted questionnaires from the National Youth Tobacco Survey and WHO Oral Health Questionnaire. Clinical oral examinations were performed on 964 participants. Statistical analyses included chi-square tests and logistic regression. Tobacco use prevalence was 6.9%, with electronic cigarettes being most common (72.0%), followed by waterpipe smoking (59.8%) and traditional cigarettes (57.3%). Curiosity was the primary driver for initiation (74.5%). Significant associations were found between tobacco use and poor self-perceived gingival health ( p < 0.001), school absenteeism due to toothache ( p = 0.009), and avoiding smiling due to dental appearance ( p = 0.021). Among examined participants, 76.6% had active carious lesions, 46.8% had gingivitis, and mean DMFT score was 5.72 ± 4.73. Despite relatively low prevalence, tobacco use was significantly associated with adverse oral health and psychosocial outcomes. These findings highlight the need for gender-sensitive preventive strategies, improved healthcare-based tobacco screening, and stricter regulation of adolescent access to tobacco products.

Background/Objectives: The miswak, crafted from the Salvadora persica tree, is a traditional teeth-cleaning twig that has served as a natural substitute for toothbrushes and toothpaste across diverse regions for centuries. This study aimed to evaluate and compare the effectiveness of miswak and a conventional toothbrush in reducing dental plaque and gingivitis over a two-week period. Methods: This two-week randomized, single-blind (clinical investigator), two-parallel-arm clinical trial was conducted at Princess Nourah University College of Dentistry (PNUCD). Stratified random sampling identified sixty participants who were then randomly assigned to two study groups: the miswak group and the toothbrushing group. To facilitate data collection, a self-designed form was employed to document participants’ initials, assigned group, the Silness and Loe plaque index, and the Loe and Silness gingival index. The clinical examination, conducted by two blinded and trained examiners using a mouth mirror and explorer under natural light, aimed to assess the specified indices. The collected data were analyzed using IBM SPSS Statistics, Version 22. Results: Following the intervention, the miswak group exhibited no significant change in the plaque scores (p = 0.58) compared to the toothbrush group (p = 0.007). A notable rise in gingival score was observed within the miswak group (p < 0.001), whereas no significant change was noted within the toothbrush group (p = 0.52). Conclusions: Over a two-week period, miswak was successful in controlling dental plaque; however, gingival scores were higher, which could be attributed to the aggressive use of miswak. With proper training, the use of miswak has the potential to contribute positively to gingival health, particularly in regions where it is readily accessible and affordable.

Objectives To investigate the psychosocial impact of malocclusion and self-rated and clinician-rated orthodontic treatment need on young adult patients in the Western Province of Saudi Arabia. Materials and Methods Eighteen- to 30-year-old patients (n=355) attending a tertiary dental care facility were included. Three instruments were used for data collection: (1) Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ), (2) aesthetic component of the Index of Orthodontic Treatment Need (IOTN-AC), self-rated and clinician-rated, and (3) clinician-rated Dental Aesthetic Index (DAI). Data analysis included descriptive statistics, Kruskal–Wallis test, Mann–Whitney U-test, and multiple linear regression analysis. Results Females were significantly more impacted than males on all domains with the exception of the dental self-consciousness domain. For both the self-rated and clinician-rated IOTN and the DAI, it was found that the more severe the malocclusion, the higher the impact on all domains except for the dental self-confidence domain, which showed that patients with mild malocclusions were more affected than those with moderate and severe malocclusions. Significant associations were observed between independent variables (age, sex, self-rated IOTN, and DAI) and total PIDAQ score. Conclusions Perceived psychosocial impact of dental aesthetics is directly related to severity of malocclusion (self-rated and clinician-rated) for all domains of the PIDAQ accept the DSC, and females showed higher psychosocial impact than males. Clinicians should consider the impact of malocclusion and certain demographic characteristics on the psychosocial well-being of an individual when determining the orthodontic treatment need.

Objectives. This study aimed to compare the effectiveness of super floss and water flosser in plaque removal for patients undergoing orthodontic treatment. Methods. A single‐blind, randomized, controlled, parallel clinical trial with a split‐mouth protocol was conducted on young adult orthodontic patients who were recruited from Riyadh Specialized Dental Center in Riyadh, Saudi Arabia. The type of floss used was randomly assigned to each side of the oral cavity; Super‐Floss® (Oral‐B) was used on one side, while the Waterpik® water flosser was used on the other. Patients’ plaque level was assessed using Rustogi et al. modified navy plaque index (RMNPI) at baseline and immediately after cleaning. Results. A total of 62 subjects were screened; however, only 34 subjects were enrolled in the study with an equal number of males and females. Overall, the plaque score was significantly reduced from 0.56 ± 0.35 to 0.13 ± 0.26 in the super floss group and from 0.61 ± 0.35 to 0.13 ± 0.28 in the water flosser group. There was no significant difference between the mean difference of super floss and water flosser (p = 0.951). On the other hand, there was no significant difference between both groups in terms of the preintervention plaque score (p = 0.379). The water flosser had a greater effect size on plaque removal compared to super floss on distal interproximal surface of the molar tooth with a mean difference of (−0.21, 95% CI: 00.37 to −0.04, p = 0.033). Conclusions. The use of super floss or water flosser as interproximal aids for plaque removal in patients undergoing orthodontic treatment are both effective. Trial registration. ISRCTN, ISRCTN83875016. Registered 12 September 2021‐retrospectively registered, https://www.isrctn.com/ISRCTN83875016.

Knowledge about the influence of fillers in denture base resin is vague. This systematic review aimed to report the reinforcing effect of fillers on the mechanical properties of denture base resin by following PRISMA guidelines. Two electronic databases (Pubmed/Medline & Web of Science) were searched for articles using the keywords: fibers in denture base, fillers in denture base, and reinforcement of denture base. Laboratory studies complying with the inclusion criteria were reviewed according to the set protocol. The established focus question was: “Do reinforcing fillers positively influence the mechanical properties of polymethyl methacrylate (PMMA) heat polymerized denture base material?” A total of twenty-nine relevant papers qualified for final inclusion. Of these, 24 were determined to have a moderate risk of bias. Micron or nano-sized metal/metal oxides particles and glass fibers were the frequently used reinforcing agents. The trend of evaluating fractural strength (FS) was common. Most of the studies limited the use of reinforcing agents up to 5 wt.%. FS, fracture toughness (FT), and impact strength (IS) tend to increase if the fillers are chemically bonded and well-dispersed in denture base resin. Though fillers with a higher elastic modulus increase the hardness of the reinforced denture base resin, they compromise other mechanical properties. Well-dispersed lower filler loading PMMA denture base resin can enhance the FS, FT, and other related mechanical properties.

The aim was to determine the cytotoxicity of Khat (Catha edulis (Vahl) Forssk. ex Endl) on normal oral fibroblasts (NOFs) and SCC4 (squamous carcinoma cells) along with expression of α-smooth muscle actin (α-SMA) in fibroblasts. Khat filtrate was prepared to obtain a concentrated viscous solution. NOFs and SCC4 cells were cultured in biological cabinets and were grown in Dulbeccos’ modified Eagles medium. Frozen cells were thawed at 37 °C and cell seeding was performed. NOFs and SCC4 cells were seeded on 96 well plates and allowed to attach. The medium was removed and a fresh medium containing different concentrations of Khat was added. The group without Khat served as a negative control and 4% paraformaldehyde as the positive control. Cell viability was assessed using the MTT assay and effect of Khat on fibroblast and SCC4 phenotypes was evaluated by immunostaining. Analysis of variance was used to assess data (p < 0.05). NOF 316 showed cell death in response to 4% paraformaldehyde, 12.5, 6.25, and 3.12 mg/mL of Khat. The highest concentration of Khat (25 mg/mL) failed to cause cytotoxicity of NOF 316. NOF 319 and NOF 26 displayed cell death at all concentrations of Khat, however, cytotoxicity was not dose dependent. NOF 18 and SCC4 cells showed dose-dependent cell death. NOF 316 showed α-SMA expression after 1 mg/mL of Khat exposure. Not all fibroblasts were α-SMA-positive, suggesting specific activation of a subset of fibroblasts. Khat is cytotoxic to NOF and SCC4 cells. Furthermore, it can also cause activation and phenotypic changes in oral fibroblasts, indicating a potential role in progression of oral squamous cell carcinoma.