Dental expenditure and catastrophic dental expenditure in Eastern Saudi Arabia : pattern and associated factors

Dental services have one of the highest expenses among health services. The aims of the study were to assess (1) dental expenditure (DE), (2) catastrophic dental expenditure (CDE), (3) dental services payment and (4) factors associated with DE and CDE. A cross sectional study was conducted in 2018 in Saudi Arabia. Using convenience sample, participants were recruited from governmental and private dental clinics/hospitals. A questionnaire assessed (a) personal information, (b) dental background: payment methods, type of clinics visited, perceived oral health status, frequency of pain and (c) payment for dental services received. The number of remaining teeth was clinically assessed. Two outcome variables were assessed (1) total DE in linear regression and (b) CDE (DE exceeds 10% of income) in logistic regression. Personal and dental background variables were explanatory variables. The response rate was 83.8% (419/500) with 43% reporting expenditure, 16.5% facing CDE and 36.3% using multiple payment methods. The greatest DE was for crowns and bridges, root canal therapy, fillings and implants. Income, payment method and pain were associated with DE and CDE. Participants used multiple payment methods including out of pocket and faced CDE. The bulk of expenditure was for rehabilitative services. The availability and quality of health-insured primary care services may reduce the financial burden facing dental patients

Gender differences in dentistry and oral sciences research productivity by researchers in Nigeria

The aim of the study was to assess gender differences in the productivity, impact, collaboration pattern and author position of dentistry and oral sciences researchers in Nigeria.MethodsWe examined the Web of Science (WoS) publication records of dentistry and oral sciences researchers to assess gender differences in productivity, impact, collaboration and authorship pattern (first authorship, last authorship and corresponding author). The analysis included the number of publications in journals ranked based on their quartile rating amongst the journals in the subject area (Q1–Q4). Chi square was used to make gender comparisons. Significance was set at >5%.Results413 unique authors published 1,222 articles on dentistry and oral sciences between 2012 and 2021. The number of WoS documents per female author was significantly higher than that per male author (3.7 vs. 2.6, p = 0.03). A non-significantly higher percentage of females authored papers in Q2 and Q3 journals and a higher percentage of males authored papers in Q4 journals. The number of citations per female author (25.0 vs. 14.9, p = 0.04) and the percentage of females listed as first authors (26.6% vs. 20.5%, p = 0.048) were statistically greater than men. The percentage of males listed as last authors was statistically greater than females (23.6% vs. 17.7%, p = 0.04). The correlation between the percentage of papers with researchers listed as first authors and that listed as last authors was not significant for males (p = 0.06) but was significant for females (p = 0.002). A non-significantly greater percentage of females were listed as corresponding authors (26.4% vs. 20.6%) and males were listed as international (27.4% vs. 25.1%) and domestic collaborators (46.8% vs. 44.7%). Also, there was no statistically significant gender difference in the proportion of articles published in open access journals (52.5% vs. 52.0%).ConclusionThough there were significant gender differences in the productivity, impact, and collaboration profile of dentistry and oral sciences researchers in Nigeria, the higher female research productivity and impact may be driven by cultural gender nuances that needs to be explored further

Oral health status and practices, and anthropometric measurements of preschool children : protocol for a multi-African country survey

BACKGROUND : Oral diseases are among the most prevalent conditions with significant impact on the growth and development of young children. Data are required to plan effectively for the management of early childhood caries (ECC) and other oral diseases in this age. There are currently very few African countries with updated and nationally representative data on ECC prevalence, and risk indicators and regional data on ECC and other oral diseases are scarce. OBJECTIVE : We aim to determine the oral health status and practices, dietary intake, and anthropometric measurements of preschool children in several African countries. METHODS : A cross-sectional study will be conducted in several African countries using a standardized questionnaire and clinical examination for data collection from healthy preschool children in kindergartens and primary health care facilities. The clinical examination will assess ECC using the decayed, missing due to caries, and filled teeth (dmft) index according to the World Health Organization (WHO) criteria, dental erosion (using the Basic Erosive Wear Examination Index), deciduous molar hypomineralization (using the European Association of Paediatric Dentistry criteria), dental fluorosis (using Dean’s Index), oral hygiene status (using the Oral Hygiene Index Simplified), and oral mucosal lesions. Oral hygiene habits and dental visits will be assessed using the WHO child questionnaire, and dietary intake will be assessed using the Food and Agriculture Organization method. Anthropometric measurements will be obtained following the International Society for the Advancement of Kinanthropometry standard protocol, and the children’s nutritional status will be assessed following the WHO child growth standards. To train and calibrate examiners, educational resources and electronic forms will be used to reach interexaminer and intraexaminer reliability with κ>0.6. Descriptive analysis will determine the prevalence of clinical conditions by age and sex. Bivariate analysis and multivariable regression will assess associations between the clinical conditions and sociodemographic factors, and oral health behaviors. RESULTS : Data collection will begin after approvals and ethical clearance are obtained. The first stage will include 3 countries, namely Egypt, Nigeria, and South Africa, and collaborators from other African countries will join afterward. CONCLUSIONS : This study will lay down the foundations for using validated tools to collect data on the oral health of young children in Africa, allowing researchers from different countries across Africa to collect standardized data on ECC and other oral conditions. This will facilitate comparisons and analysis of risk factors that might be unique to the African continent. The results will provide baseline data on the prevalence of oral diseases and enable planning to address the treatment needs of young African children and design programs to prevent oral diseases in the African continent.http://www.researchprotocols.orgCommunity Dentistr

Influence of tooth loss on mandibular morphology : a cone-beam computed tomography study

Tooth loss adversely affects patients? health and psychosocial wellbeing. In addition, it changes mandibular morphology. Objective: To evaluate the effect of tooth loss, age, and gender on mandibular morphology. Cone-beam computed tomographic (CBCT) scans of 101 patients were examined to measure the gonial angle (GA), ramus height (RH) and condylar height (CH). Patients? age, gender, and dental status were recorded. Repeated measures analysis of variance (ANOVA) was used to assess the impact of gender, age, and tooth loss on the GA, RH and CH. The mean measurements of the GA, RH and CH were compared between dentate/edentulous patients after splitting by gender. The GA was larger in edentulous patients compared to dentate ones, in females than in males, and in older than in younger. RH on the right side was significantly longer than on the left side (P< 0.0001), and also longer in males and younger patients. CH was shorter in younger than in older patients and in dentate than in edentulous patients. Tooth loss is associated with changes in mandibular morphology and its prevention would avoid these irreversible changes

Associations between early childhood caries, malnutrition and anemia: a global perspective

Background Malnutrition is the main risk factor for most common communicable diseases. The aim of this study is to determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children. Methods Matched country-level ECC, malnutrition and anemia prevalence were generated from databases covering the period 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for gross national income per capita. Adjusted regression coefficients (B) and partial eta squared were computed. Results The mean (standard deviation (SD)) ECC prevalence was 23.8 (14.8)% for 0-2 year-olds and 57.3 (22.4)% for 3-5-year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight 7.2 (4.9)%, stunting 24.3 (13.5)%, and anemia 37.8 (18.1)%. For 0-2-year-olds, the strongest and only significant association was between the prevalence of ECC and overweight (eta 2 = 0.21): 1 % higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B = 0.12, P = 0.03). In 3-5-year-olds, the strongest and only significant association was between the prevalence of ECC and anemia (eta 2 = 0.08): 1 % higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B = - 0.14, P = 0.048). Conclusion Country-level prevalence of ECC was associated with malnutrition in 0-2-year-olds and with anemia in 3-5-year-olds. The pathway for the direct relationship between ECC and overweight may be diet related. The pathway for the inverse relationship between ECC and anemia is less clear and needs further investigations

Influence of tooth loss on mandibular morphology: A cone-beam computed tomography study

Background: Tooth loss adversely affects patients’ health and psychosocial wellbeing. In addition, it changes mandibular morphology. Objective: To evaluate the effect of tooth loss, age, and gender on mandibular morphology. Materials and Methods: Cone-beam computed tomographic (CBCT) scans of 101 patients were examined to measure the gonial angle (GA), ramus height (RH) and condylar height (CH). Patients’ age, gender, and dental status were recorded. Repeated measures analysis of variance (ANOVA) was used to assess the impact of gender, age, and tooth loss on the GA, RH and CH. The mean measurements of the GA, RH and CH were compared between dentate/edentulous patients after splitting by gender. Results: The GA was larger in edentulous patients compared to dentate ones, in females than in males, and in older than in younger. RH on the right side was significantly longer than on the left side (P< 0.0001), and also longer in males and younger patients. CH was shorter in younger than in older patients and in dentate than in edentulous patients. Conclusions: Tooth loss is associated with changes in mandibular morphology and its prevention would avoid these irreversible changes.</p

Risk indicators for oral ulcers among people living with HIV during the first wave of the pandemic: A cross-sectional study

Background: Little is currently known about HIV-related parameters that may increase the risk for oral ulcers during the COVID-19 pandemic. This study aimed to overcome this gap in research by assessing the associations between HIV viral load, antiretroviral adherence profile, co-morbidity status, SARS-CoV-2 infection and oral ulcers among people living with HIV (PLHIV). Methods: This was a secondary analysis of data generated from 21,206 to 18 years and above, recruited from 152 countries through an online survey between July and December 2020. Data were extracted for 874 people who reported living with HIV. The dependent variable was reporting having oral ulcer. The independent variables were the viral load, adherence to antiretroviral treatment and a history of SARS-CoV-2 infection. The confounding variables were age at last birthday and sex at birth. A multivariable logistic regression analysis was conducted to determine the associations between the dependent and independent variables after adjusting for the confounding variables. Results: Of the 874 participants, 99 (11.3%) reported having oral ulcers during the first wave of the COVID-19 pandemic. The odds of PLHIV having oral ulcers during the first wave of the COVID-19 pandemic was significantly higher for people who did not know their viral load than those who had undetectable viral load (AOR: 2.036; 95% CI: 1.204–3.443; p = 0.008); and people who did not adhere to the use of antiretroviral treatment than those who adhered (AOR: 4.113; 95% CI: 2.567–6.589; p < 0.001). Also, PLHIV who had SARS-CoV-2 infection had significantly higher odds of having oral ulcers than those who did not have the infection (AOR: 14.556; 95% CI: 4.500-47.078; p < 0.001). PLHIV who had co-morbidities had non-significantly higher odds of having oral ulcers than those without co-morbidities (AOR: 1.170; 95% CI: 0.656–2.085; p = 0.595). Conclusion: Oral ulcers may be an indicator of poor adherence to antiretroviral therapy and unsuppressed viral load among PLHIV. It may also be an indicator of SARS-CoV-2 infection and a signal to take prompt and critical care of affected individuals because of the risk for severe COVID-19 for these individuals.publishedVersio