Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
Browse
10 results
Search Results
Item Restricted Evaluating Reported Patient Perspectives of Teledentistry Use for Dental Care Provision During the COVID-19 Pandemic in Saudi Arabia: A Scoping Review(University of Exeter, 2024) Althabit, Thabet; Carrieri, DanieleBackground: The COVID-19 pandemic significantly impacted dental services, increasing interest in teledentistry as an alternative. In Saudi Arabia, dental clinics' temporary closure in March 2020 made teledentistry crucial for maintaining dental care. Despite advanced technology, teledentistry use was low. Understanding patient perspectives is key to improving its adoption. Objective: This review synthesizes evidence on patient perspectives, satisfaction, and perceived outcomes of teledentistry during the COVID-19 pandemic in Saudi Arabia to guide future strategies and research. Methods: Following a scoping review methodology, we searched multiple databases from 2020 to 2024, identifying studies involving Saudi patients using teledentistry during the pandemic. Data were extracted and analyzed thematically. Results: Eleven studies from 2020 to 2023 were included. Key themes were accessibility, convenience, patient satisfaction, and security concerns. Teledentistry improved access and reduced costs, with high satisfaction for minor issues. However, data privacy concerns and limitations in handling complex cases were noted. Conclusion: Teledentistry offered significant benefits during the pandemic, enhancing accessibility and patient satisfaction for minor issues. Yet, managing complex cases and ensuring data security remain challenges. A hybrid model of teledentistry and in-person visits is recommended. Further research on long-term effects, cost-effectiveness, and data security is needed.41 0Item Restricted A Review and Appraisal of Saudi Arabia’s Health and Oral Health Strategies(University College London (UCL), 2024-08) Alanazi, Alanoud; Tsakos, Georgios; Heilmann, AnjaAbstract Background: Oral health is a critical component of overall health, yet oral diseases like dental caries and periodontal diseases remain prevalent globally, including in Saudi Arabia. Despite their preventability, these conditions contribute significantly to the disease burden. Saudi Arabia's Vision 2030 aims to reform healthcare, including oral health, aligning with global health initiatives such as the WHO's Global Oral Health Action Plan (2023–2030). Aims: This study aims to review and evaluate Saudi Arabia's health and oral health strategies, assessing their design, implementation, and alignment with global health policies. The goal is to identify strengths, gaps, and opportunities for enhancing policy effectiveness within the context of Vision 2030. Methods: The study employs the Health Policy Triangle (HPT) framework to analyse key health policies in Saudi Arabia. Document analysis was used to systematically identify and evaluate relevant policies, focusing on the interaction between policy content, context, processes, and actors. Results: The analysis revealed that Saudi Arabia has made strides in aligning its health policies with global standards, particularly in tobacco control, sugar taxation, and water fluoridation. However, gaps still need to be in fully integrating oral health into primary healthcare and in systematically evaluating these policies. Conclusion: While progress has been made, Saudi Arabia's health policies would benefit from a more integrated and comprehensive approach to oral health. Enhancing policy coherence, improving access to care, and strengthening monitoring mechanisms are crucial for aligning with global health standards and achieving Vision 2030's objectives. Future efforts should focus on bridging identified gaps and fostering innovation through public-private partnerships to improve oral health outcomes in the Kingdom.39 0Item Restricted Rapid review of longitudinal studies on the association between oral health and frailty(King’s College London , 2024-08) Alhumaidi, Meshari; sabbah, waelAbstract Background Frailty and sarcopenia are prevalent conditions in the elderly, contributing to increased healthcare costs and higher mortality rates. Poor oral health, characterized by issues such as tooth loss and periodontal disease, has been associated with the onset and progression of these conditions. Despite this, there is a lack of comprehensive longitudinal studies examining the relationship between oral health and frailty in older populations. Objective This rapid review aims to consolidate and analyse the existing body of research from longitudinal studies on the association between various oral health conditions and frailty among older adults. The goal is to identify key oral health issues that significantly impact frailty and to provide insights for healthcare providers and policymakers. Methods The review systematically gathered and synthesized data from relevant studies using a standardized methodological approach. It focused on studies involving older adults aged 65 and above, examining conditions such as tooth loss, periodontal diseases, and overall oral hygiene status. The analysis included comparisons between individuals with poor oral health and those with healthier oral conditions, assessing the impact on frailty indicators. From an initial search yielding 1404 records (702 from PubMed, 93 from Ovid, and 609 from Cochrane Library), 609 records remained after removing duplicates. After screening titles and abstracts, 16 articles were assessed for eligibility. Ultimately, 11 studies met the inclusion criteria and were included in the final review. Results The findings highlight significant associations between poor oral health and increased frailty in the elderly. Conditions like tooth loss and periodontal disease were found to be major risk factors for frailty, affecting physical functions such as strength, mobility, and overall vitality. The review also identified gaps in the literature, particularly the need for more longitudinal studies to establish causal relationships. A total of 11 longitudinal studies met the inclusion criteria and were included in this systematic review. These studies provide valuable insights into the association between various oral health conditions and frailty among older adults, highlighting the importance of maintaining good oral health to mitigate the progression of frailty. However, the predominance of cross-sectional designs in some studies limits the ability to establish causal relationships and introduces potential biases, including measurement bias from self-reported data and residual confounding. Conclusion The review underscores the importance of integrating oral health assessments into routine geriatric care. Early interventions targeting oral health could potentially delay the onset of frailty, improving quality of life and reducing healthcare costs. These findings provide a foundation for developing comprehensive geriatric care models that prioritize oral health and for future research to address the identified gaps in the literature.23 0Item Restricted Progress of multimorbidity among older adults and the role of Oral Health(King's College London, 2024-08-14) Mira, Rolla; Sabbah, WaelThe world's ageing population has rapidly increased because of the demographic shift that has occurred over the last several decades. Multimorbidity is one of the most significant effects of the ageing population on public health. When a person has more than two chronic conditions, this is known as multimorbidity. Furthermore, multimorbidity is common, increases with age, and is more prevalent in those from lower socioeconomic backgrounds, according to all current studies. Multimorbidity is linked to worse outcomes such as lower quality of life, increased mortality, polypharmacy, high treatment burden, higher rates of adverse drug events, and much higher use of health services, including emergency hospital admissions. The mechanism of multimorbidity development is a multifactorial dynamic process, oral health could be associated with multimorbidity through different pathways. One of the most plausible pathways is the impact of poor oral health on nutritional status. Aim: The thesis aimed to explore socioeconomic inequalities in the progress of multimorbidity, among older adults. The second aim is to assess whether tooth loss is associated with the progress of multimorbidity. The objectives of the thesis were to (1) examine socioeconomic inequalities in the progress of multimorbidity among older adults in the U.S.A. (2) Assess whether tooth loss is longitudinally associated with the progress of multimorbidity and (3) explore the nutritional pathway between tooth loss and the progress of multimorbidity. (4) Examine the relationship between allostatic load and the progress of multimorbidity and whether it mediates socioeconomic inequalities in multimorbidity. Methods: Seven waves were used (2006-2018) of the Health and Retirement Study, a longitudinal survey of older Americans. Multimorbidity was indicated by self-reported diagnosis of 5 conditions: diabetes, heart conditions, lung diseases, cancer, and stroke. Socioeconomic indicators were ethnicity, education, wealth, and income. Behavioural factors were smoking, excessive alcohol consumption, physical activity, and body mass index. Allostatic load was used as a biomarker of stress and was indicated by high-density lipoprotein, glycosylated haemoglobin, c-reactive protein, waist circumference, and high blood pressure. Nutritional intake was calculated in 2013 by summing 10 nutrients (Protein, Vitamins C, D, B12, E, Calcium, Zinc, Polyunsaturated fatty acids, Folate and ß- carotene). Finally, edentulism (total tooth loss) was assessed in three waves (2006, 2012, and 2018). Multilevel models for the analysis of longitudinal data were used to assess the association between socioeconomic factors and multimorbidity and whether behavioural factors mediate this association. Multilevel models were used to examine the relationship between oral health and multimorbidity and whether nutritional intake mediates this association. The association between allostatic load as a marker of chronic stresses with progress of multimorbidity was also assessed using multilevel models for longitudinal panel data. Results: Socioeconomic indicators showed different significant associations with the progress of multimorbidity demonstrating social gradients. However, after adjusting for behavioural factors these associations were attenuated. Incidence rate ratios (IRR) of multimorbidity was considerably higher in those who did not finish high school (IRR 1.21; 95% CI 1.18, 1.23) compared to those who attended college. After adjusting for behaviours, IRR decreased to 1.11 (95% CI 1.07, 1.14). Furthermore, IRR of multimorbidity was greater in the lowest quartiles of total wealth and income, with IRR 1.47 (95% CI 1.44, 1.51) and 1.25 (95% CI 1.22, 1.28), respectively. These IRRs decreased to 1.31 (95% CI 1.26, 1.36) and 1.22 (95% CI 1.18, 1.27), respectively, after accounting for behaviours. Moreover, longitudinal associations were found between edentulism in the years 2006 and 2012 and the progress of multimorbidity. After adjusting for behavioural factors, and total nutrients, the IRR for multimorbidity among edentate individuals was 1.12 (95%CI 1.06, 1.18) and 1.10 (95%CI 1.05, 1.16) in 2006 and 2012, respectively. Moreover, the analysis showed an association between edentulism (in 2006 and 2012) and total nutrition (2013) adjusting for age and gender. Total nutrients in 2013 were lower among those who were edentate in 2006 [IRR 0.97 (95%CI 0.95, 0.99)] and in 2012 [IRR 0.98 (95% CI 0.96, 0.99)]. A positive association was found between allostatic load and multimorbidity even after accounting for socioeconomic and behavioural factors. Conclusion: This thesis illustrated that socioeconomic factors were associated with the progress of multimorbidity, and behavioural factors appeared to mediate the association. It also demonstrated that the association between socioeconomic factors and multimorbidity was slightly attenuated after adjusting the allostatic load. Additionally, the allostatic load was significantly associated with multimorbidity even after accounting for socioeconomic and behavioural factors. Moreover, edentulism in 2006 and 2012 showed a statistically significant association with multimorbidity, although. The association between total nutrition and multimorbidity was significant only in the unadjusted models.18 0Item Restricted Association between Activities of Daily Living (ADLs) and oral health among older Saudi adults(King's College London, 2024-08-07) Almazam, Abdulmalik; Sabbah, Wael; Hakeem, FaisalAim: To investigate the association between Activities of Daily Living (ADLs) and oral health among older Saudi adults. Method: This cross-sectional investigation was carried out in Medina, Saudi Arabia, encompassing 362 individuals aged 60 years or older. The study's ethical conduct (HR-18/19-8791) was approved by the Research Ethics Committee of King's College London and both organisations granted authorization. Additionally, the Research Ethics Committee of Taibah University, College of Dentistry (TUCDREC/20190129/FHakeem) also offered approval. The participants were selected from outpatient clinics at Taibah University Dental College and social centres associated with the Ministry of Social Affairs. Participants were physically independent and provided informed consent. The data were obtained by conducting clinical oral examinations and administering structured questionnaires that encompassed sociodemographic characteristics, general health, oral health behaviours, and ADLs. The primary independent variable was the tooth count, determined by means of a clinical examination. Poisson regression models were utilised to conduct statistical analyses, aiming to investigate the associations between oral health and ADLs. Adjusting for sociodemographic and other covariates. Results: The study revealed significant associations between the number of teeth and the ability to perform ADLs. Older adults with a greater number of teeth demonstrated enhanced functional autonomy in ADLs. Both age and comorbidities were found to have a significant association with ADL performance. Specifically, older age and a higher number of comorbidities were associated with increased problems in performing ADLs. There is an association between socioeconomic characteristics, such as having a lower income and being divorced, and experiencing a higher level of impairment in ADLs. There was no association between gender, BMI, and ADLs after adjusting for other variables. Conclusion: The results emphasise the significance of maintaining proper oral hygiene in order to promote independence in ADLs in older individuals. Regular dental appointments and comprehensive healthcare that includes managing oral health are essential for improving the quality of life and performance of ADLs in this population. It is crucial for policymakers and healthcare professionals to provide a high priority to including oral health within the wider healthcare system for older individuals in order to support the process of ageing in a healthy manner and maintain their ability to function independently.41 0Item Restricted Dental Caries in Individuals living with Type 2 Diabetes: Exploring Severity, Risk Factors, and Salivary Metabolic Profiling for Comprehensive Insights(Queen Mary University of London, 2024-03-31) Alkahtani, Ashwaq; Baysan, Aylin; Anderson, PaulDiabetes mellitus is a well-known disease that is associated with several of general and oral health issues. However, evidence related to the association between type 2 diabetes mellitus (T2DM) and dental caries is controversial. Aim This study aimed to investigate the impact of type 2 diabetes mellites (T2DM) on severity of dental caries and evaluate the relative protective and risk factors for the development of dental caries. Material and method Firstly, a laboratory study evaluated the SoproLIFE fluorescence system for detecting dental caries on 56 extracted teeth. Subsequently, a case-control study was conducted with 182 participants, with 91 nondiabetics (ND) and 91 participants. A questionnaire including demographic and oral health and dietary for each participant were recorded. Clinical assessments including dental plaque, periodontal health, dental caries score using ICDAS and root caries, SoproLIFE and dental caries risk assessment using caries management by risk assessment (CAMBRA) were carried out. Unstimulated whole saliva was collected to measure the saliva properties and stimulated saliva for metabolic profiling using 1H-Nuclear Magnetic Resonance Spectroscopy. Results Results from laboratory study showed SoproLIFE had 90% sensitivity and 95.8% specificity for sound-initial caries, 100% sensitivity and 53.8% specificity for dentine caries. The case- control study reported that participants with diabetes showed higher British Asian representation (38%) compared to non-diabetes (12%). 98% of the participants had no dental insurance, with 31.8% on benefits and 39.5% of diabetes participants retired. Diabetes participants had significantly lower juice consumption (34%) compared to non-diabetes (27%). No significant associations were found in oral health behaviours except the presence of removable prosthesis. Significant differences were observed in juice and sweetened juice consumption between diabetes and non-diabetes groups. Saliva pH was slightly low in T2DM (6.65±1.12) vs. ND group (6.88±0.49), but not statistically significant (p=0.065). Saliva buffer capacity showed no significant difference, with values of 7.38 ± 3.2 in T2DM and 7.37±2.83 in ND (p=0.973). Saliva spinnbarkeit was slightly higher in T2DM (4.57±4.34) than ND (3.69±3.6), but not statistically significant (p=0.141). T2DM individuals were more likely to have very low or low saliva flow rates compared to non-diabetic individuals (18% vs. 5.5%, respectively). The plaque index was slightly high in T2DM (p>0.05). Overall ICDAS scores were significantly high with T2DM. ICDAS scores 3 and 6 were significantly high in in T2DM (2.7±2.66, 0.86 ±2.61) compared to ND (2.10±2.00, 0.26±0.96) respectively. SWS 1H-NMR spectroscopy profile for T2DM revealed significant upregulation of organic acid anions, specifically lactate and formate (lactic and formic acids), when compared to the non-diabetic group. Conclusion: The light fluorescence evaluator (SoproLIFE) reported promising performance in distinguishing early enamel carious lesions from sound surfaces in the laboratory study. The case-control study showed the mean age at diagnosis of 43±10 years, a gender disparity with more males (67.7%) in the T2DM group, and a notable representation of Asian British individuals (38.4%). T2DM participants had a significantly high reliance on medications (92.3%) and distinct oral health practices when compared to the non-diabetic group. There were differences in the presence of removable prostheses, as well as juice and sweetened juice consumption between the two groups. In addition, this case-control study revealed differences in severity of dental caries with high moderate and severe lesions in T2DM group. The study also provided valuable insights into metabolic changes in saliva among individuals with diabetes, demonstrated that the organic acid anions lactate and formate were significantly upregulated in the T2DM group. These bacterial catabolites have been previously implicated in the pathogenesis of dental caries. This highlights the significant differences in salivary metabolites between individuals with T2DM and healthy controls.9 0Item Restricted Effect of Prescribed Medications on Oral Health in Older Adults: A Review of Reviews(Saudi Digital Library, 2023-12-01) Alnashwan, Mohammed; Tsakos, GeorgeBackground The global demographic is experiencing an increasingly ageing population. Older adults are frequently prescribed medications to manage chronic diseases they accumulate over the years. Occasionally, these medications can have undesirable side effects on oral health, compromising oral health in the process. Implications of ageing, polypharmacy and systemic diseases can further complicate this issue in the context of older adults. Aim The aim of this is study to conduct a literature review on the existing reviews on the effect of prescribed medications on oral health in older adults. Methods A narrative literature review of reviews published between 2000 and 2023 on effect of prescribed medications on oral health in older adults was conducted. Literature search was conducted using online databases Ovid Medline and Embase, which retrieved 463 studies. Only 18 studies that matched the eligibility criteria were included for the review. Relevant findings were reported from each study and summarized in a narrative synthesis. Results Many side effects from certain medications have been reported in older adults, with one of most frequent being xerostomia, or dry mouth. Upwards of 400 medications including anticholinergics, anticonvulsants, antidepressants, antihypertensives, antipsychotics and bronchodilators have been identified as potential xerostomia inducers among many others. Cardiovascular medicines like beta-blockers and calcium channel blockers can cause symptoms ranging from taste disturbances to gingival enlargement in addition to dry mouth. Diabetes has bidirectional connections with oral health issues, where poorly managed diabetes can lead to infections and bone loss, and certain antidiabetic drugs cause taste disturbances and other complications. Mental health medications pose a significant risk to oral health as well, with antidepressants leading to dental caries due to xerostomia, and some types of antidepressants can induce teeth clenching and bruxism among other issues. Other medications such as anxiolytics and antipsychotics have been xerostomia. In addition, anticonvulsants has been reported to cause gingival enlargement and taste disturbance. Respiratory diseases medications are also associated with a number of oral health side effects. Some bronchodilators are associated with dry mouth, and certain respiratory inhalants can cause changes in taste perception. Systemic corticosteroid usage may cause impaired wound healing and taste disturbances, while chronic use of such medications might even induce osteoporosis in older adults. Conclusion Older adults are prone to side effects from medications, including xerostomia, which can further worsen existing oral health issues and induce new issues like speech difficulties and higher infection risk. This is often caused by medications for chronic illnesses, including those treating hypertension, diabetes, mental health conditions and respiratory diseases. Medications for such diseases can even lead to various oral problems such as gingival hyperplasia, lichenoid reactions and dysgeusia, ultimately leading to compromised oral health in older adults. Therefore, it is important to research medications with fewer negative impacts on oral health. The ultimate goal is to incorporate oral health for the comprehensive wellbeing of the elderly.17 0Item Restricted The Impact of the COVID-19 Pandemic on Dental Health Practices and Oral Health Outcomes in Children: A Scoping Review(Saudi Digital Library, 2023-09-15) Alsadoon, Mashael; Lodder, Annemarie; Heilmann, AnjaBackground: Oral health is a critical aspect of overall well-being. The COVID-19 pandemic has significantly affected children's oral health through dental clinic closures, disrupted school-based oral health programs, increased sugary snack consumption, and changes in oral hygiene behaviours Aim: The aim of this study was to undertake a scoping review of the literature on the global impact of the COVID-19 pandemic on dental health practices and oral Health outcomes in children. Methods: A literature search was carried out using three online databases (PubMed, Scopus, and Web of Science) to select studies published between 2020 and 2023. The initial search included 516 results, which were subsequently screened based on their titles and abstracts. After screening process, 16 studies were considered for the final review. Results: The COVID-19 pandemic disrupted access to dental care for children, especially in lower income countries and among those from disadvantaged backgrounds. Health behaviours, such as brushing frequency and dietary habits, varied during the pandemic, with some children improving their oral care and food choices while others experienced declines. Dental caries prevalence increased, affecting children's quality of life, particularly when parents were distressed. Conclusion: The pandemic had adverse effects on the availability of dental clinics and has exacerbated inequality. It has also impacted children's Oral Health-Related Quality of Life (OHRQOL) and behaviour, leading to reduced brushing and increased sugar consumption. Parental involvement and education play a crucial role in addressing these issues.24 0Item Restricted Association Between Diet Quality, Tooth Loss, and Dental Caries: Data from NHANES 2015-2018(Saudi Digital Library, 2023-04) Alghamdi, Sondos; AlDosari, Muath; Hayes, Catherine; Chamut, Steffany; Leung, CindyBackground: Optimum oral health and nutrition are essential to achieve and maintain overall and systemic health. The relationship between nutritional status and oral health has been examined in several studies. Cariogenic dietary patterns have been associated with tooth loss and dental caries. Dietary factors affect a variety of health factors, such as oral health, aside from social and psychological areas essential to maintaining the quality of life (QoL). This study aims to investigate the association between AHEI-2010, tooth loss and dental caries. Methods: Using the data from NHANES 2015-2018, we included adults 18 years and older. We measured the status of tooth loss, dental caries, and the diet quality of the individuals using AHEI-2010 and investigated the association between them while adjusting for covariates using Poisson and Logistic regression. Results: The mean AHEI-2010 score was 38.7±10.8 (out of 100). Our results showed an inverse association between the diet quality index (AHEI-2010) score and the presence of untreated coronal and root carious lesions and the loss of functional dentition. The mean ratio of teeth with untreated caries among the third quartile was 0.61 times the average number of teeth (95% CI=0.47, 0.78) and 0.49 times among individuals in the fourth quartile (95% CI=0.36, 0.66) compared to the lowest quartile group. Conclusion: This study indicates that lower diet quality measured using the AHEI- 2010 is associated with coronal and root dental caries and loss of functional dentition. Establishing a strong evidence-based foundation of the association between diet patterns and oral-systemic health can facilitate the development and promotion of sustainable, effective policies, strategies, and cost-effective interventions with the end goal of improving diet intake, oral-overall health, and food security while reducing the risk of developing malnutrition, diet-related NCDs, disability, and premature deaths.26 0Item Restricted Oral Health and Prevelance of Falls: A retrospective study of Caregivers and Non-caregivers(2023-07-20) Alshanbari, Mohammed; Knapp, KennethPurpose of the Study: This retrospective study was conducted to explore the correlation between oral health and the prevalence of falls among caregivers in the United States, using data from the Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2016, 2018, and 2020. The aim was to examine if a lower oral health status and less frequent utilization of dental services were associated with a higher risk of falls among caregivers. Methods: The sample included a total of 152,028 respondents from 24 states and territories, with a concentration on individuals aged 45 and older, amounting to 97,550 respondents. The correlation between oral health, frequency of dental service utilization, and risk of falls was analyzed using these data sets. Results: Analysis reveals that poor oral health, denoted by a higher number of lost teeth, and less frequent use of dental services significantly increased the odds of experiencing a fall among both caregivers and the general population. Yet, caregivers exhibited a heightened vulnerability to these factors. Higher Prevalence rates of falls were noticed among middle-aged white non-Hispanics, smokers, obese individuals, and those battling depression or multiple chronic conditions. On the other hand, fall incidences were less frequent among black non-Hispanics, married individuals, those employed, and people maintaining regular physical activity. Conclusion: The findings from this study emphasize the critical role of comprehensive oral health and dental care in reducing the risk of falls, especially among caregivers. The study advocates for regular oral health check-ups, improved access to dental care, and the inclusion of oral health in fall prevention strategies, starting from middle-aged adults. Suggested policy interventions comprise governmental subsidies for dental care, public awareness initiatives about oral health and fall prevention, and strategic collaborations to boost access to oral health care. Additionally, the expansion of dental insurance coverage and the inclusion of dental procedures in Medicaid programs are recommended to enhance oral health among middle-aged adults and caregivers, thereby mitigating fall risk and its subsequent consequences.35 0