Oral health status in Saudi Arabia

Abstract

Dental caries is the most common oral disease around the world. However, caries levels can be reduced by improving of oral health behaviours, minimising sugar intake and accessing appropriate dental care. Broadly, this thesis focuses on caries levels within Saudi Arabia. The aims are: (1) to evaluate the dental caries and fluorosis prevalence in Saudi Arabia; (2) to explore the attitudes of fathers’ and teachers’ of 6 to 7 years old schoolchildren with regard to oral health; (3) identify potential evidence-based approaches for the prevention of caries in children in Saudi Arabia. Methods: (1) two systematic reviews were undertaken identifying and appraising studies conducted in Saudi Arabia which collected data on either caries or fluorosis in adults or children; (2) a qualitative study, using semi-structured interview methods and following thematic analysis steps to interpret the results was undertaken; (3) an evaluation of published systematic reviews and guidelines aimed at overcoming barriers to oral health, identified through the qualitative work, was undertaken to identify evidence-based approaches applicable to the Saudi setting. Results: (1) 49 studies evaluating caries levels were identified from across 11 provinces of Saudi Arabia; none of the included studies were assessed as being of high quality, the heterogeneity between studies was high I2= 100. Seven studies, none of which was assessed as being of high quality, evaluated fluorosis. Again, heterogeneity was high (I2= 100), (2) 45 participants were interviewed: 18 fathers and 27 teachers; seven themes were identified: perception of oral health, knowledge around prevention of oral disease, knowledge around dietary behaviours for oral health, attitudes to dental visits, priorities and daily structure oral health education within schools and responsibility for oral health. (3) Ten systematic reviews were identified assessing interventions aimed at improving oral health practice, decreasing sugar consumption and improving dental attendance. Potential interventions 16 include education, one to one advice, motivational interviewing and screening school. Conclusions; studies assessing caries and fluorosis levels are weak due to their methodological rigour. Their findings may be influenced by potential biases. Qualitative research highlighted that Fathers have anxiety regarding the teaching of their children about oral health. They attend dentists for treatment rather than prevention. Teachers welcome the idea of being part of oral health promotion. Initiatives need to be put in place to improve the oral health of children in Saudi Arabia, through improved oral hygiene behaviour, dental attendance and diet.

Date of Award	31 Dec 2020
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Anne-Marie Glenny (Supervisor) & Lucy O'Malley (Supervisor)