BackgroundAntimicrobial resistance (AMR) is an escalating global threat, and dentists significantly contribute to antibiotic misuse. In Saudi Arabia, limited national data exist on the appropriateness of dental antibiotic prescribing and the impact of behavioral and One Health factors from prescribing practices.ObjectivesThis study aimed to assess the prescribing practices of dentists across Saudi Arabia, identify predictors of adherence to antibiotic prescribing guidelines, and explore awareness of emerging AMR drivers such as climate and diet.MethodsA national cross-sectional survey was conducted among 905 practicing dentists. The structured questionnaire assessed knowledge, prescribing behaviors, and awareness of antimicrobial resistance, prophylactic use, and One Health factors (climate and diet). Good prescribing practice was defined as correctly answering ≥60% of clinical scenarios. Prescribing appropriateness was evaluated according to established international evidence-based clinical practice guidelines, including recommendations from the American Dental Association (ADA), the American Heart Association (AHA), and the European Federation of Periodontology (EFP), as cited in the manuscript. Descriptive statistics and logistic regression analyses were used to identify predictors of appropriate prescribing.ResultsThe results show that only 39.6% adhered to guideline-supported antibiotic prescribing. Adherence was highest in restorative scenarios but notably poor in surgical and prophylaxis conditions. Only 5.5% assessed plaque before prescribing, and less than 10% correctly applied prophylaxis for infective endocarditis. Younger age and female gender were positively associated with appropriate prescribing. Awareness of climate and dietary influences on AMR was low (4.5% and 5.9%, respectively).ConclusionDespite high awareness of antimicrobial resistance (AMR), inappropriate antibiotic prescriptions remain prevalent among dentists in Saudi Arabia. This study highlights the need for continuous review and enforcement of dental antibiotic guidelines. By integrating One Health perspectives, it underscores that AMR is influenced not only by clinical practice but also by environmental and behavioral factors such as climate and diet. These findings emphasize the importance of interdisciplinary stewardship interventions and targeted educational initiatives to promote rational antibiotic use within dental care.
BackgroundOral squamous papilloma (OSP) is a benign epithelial proliferation commonly linked to human papillomavirus (HPV) and usually affects the palate, tongue and lips. Anterior mandibular alveolar mucosa involvement is uncommon, and overlap between koilocytic HPV-suggestive change and chronic denture-related trauma is rarely documented. A review of the literature indicates limited documentation of such overlapping clinicopathological features at this anatomical site.Case presentationA 49-year-old non-smoking male with absence of alcohol consumption history, presented with a 12-month painless, slowly enlarging papillary mass on the anterior mandibular alveolar mucosa beneath a poorly maintained removable denture. Intra-oral examination showed firm papillary folds of near-normal color and an adjacent traumatic ulcer at the denture-contact point. Excisional biopsy showed hyperplastic stratified squamous epithelium forming fingerlike papillary projections over narrow fibrovascular cores, with parakeratosis, basilar hyperplasia, regular mitotic activity, koilocytes in the spinous layer, and chronic lymphocytic stromal inflammation, with absence of dysplasia or invasion was confirmed. The diagnosis was squamous papilloma with koilocytic change suggestive of HPV cytopathic effect and chronic denture-associated inflammation. These findings supported a diagnosis of squamous papilloma with HPV-suggestive cytopathic effect in the setting of chronic denture-associated irritation.Management and outcomesThe lesion was completely excised, followed by denture adjustment and reinforcement of oral hygiene measures. Healing was uneventful at one-month review; longer-term follow-up is ongoing.ConclusionsThis case highlights a rare oral squamous papilloma at an atypical mandibular alveolar site, demonstrating overlapping reactive denture-induced and HPV-associated epithelial changes. Histopathological evaluation, particularly koilocyte identification, is essential for diagnosis. Supported by the literature, this case underscores that chronic denture irritation does not preclude an HPV-related etiology, and clinicians should maintain a broad differential for papillary lesions at prosthesis-bearing sites.
BackgroundFamily medical history (FMH) is a practical and cost-effective tool for identifying individuals at increased risk of genetic and chronic diseases. However, its effective utilization depends on awareness, attitudes, and the translation of these factors into health-related practices and preventive behaviors, which may vary across populations.ObjectiveTo assess and compare FMH awareness, attitudes, health-related practices, and preventive behaviors among adults in Saudi Arabia and Syria.MethodsA cross-sectional study was conducted using a structured online questionnaire distributed via digital platforms. A total of 586 participants (Saudi Arabia: 307; Syria: 279) were included. Four domains were evaluated: awareness, attitudes, health-related practices, and preventive behaviors. Outcomes were classified as favorable using Bloom’s cut-off (≥60%). Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression.ResultsFavorable levels were observed in 53.4% for awareness, 74.2% for attitudes, 48.5% for health-related practices, and 44.0% for preventive behaviors. Although a majority of participants demonstrated awareness of FMH and positive attitudes toward genetic screening, engagement in preventive actions was limited. Only 45.2% had undergone medical testing and 45.1% reported lifestyle modifications based on familial risk. A pronounced intention–behavior gap was identified, with 74.2% expressing willingness to undergo screening but substantially fewer reporting actual engagement. Participants from Saudi Arabia exhibited significantly higher levels of preventive practices compared to those from Syria (p < 0.001). Multivariate analysis identified age, gender, education level, and country of residence as significant predictors of preventive behaviors.ConclusionDespite moderate awareness and favorable attitudes, engagement in preventive practices remains suboptimal, indicating a clear gap between intention and action. These findings highlight the need for context-specific, multi-level strategies that address both behavioral and structural barriers to improve the effective use of FMH in preventive healthcare.
Importance:Public awareness of oral cancer is crucial for prevention, early detection, and improved survival rates. Knowledge gaps in Middle Eastern and North African countries and areas for public education need to be assessed. Objective:To evaluate public knowledge and awareness of oral cancer, including risk factors, signs and symptoms, and protective measures, in Middle Eastern and North African countries. Design, Setting, and Participants:This cross-sectional study was conducted using an open, web-based questionnaire from January to December 2022 across 13 Middle Eastern and North African countries (Saudi Arabia, Syria, Egypt, Jordan, Lebanon, Iraq, Sudan, Morocco, Algeria, Yemen, the United Arab Emirates, Qatar, and Oman). Participants were recruited from the general adult population via social media platforms. Main Outcomes and Measures:Primary outcomes included knowledge of risk factors, signs and symptoms, and protective measures. Factors associated with good knowledge were evaluated based on age, sex, education level, country income level, smoking status, smokeless tobacco use, and exposure to dental education on oral cancer. Results:Among 4197 participants (2243 aged 18-30 years [53.4%]; 2372 female [56.5%] and 1825 male [43.5%]), 1559 participants (37.2%) demonstrated good knowledge of oral cancer risk factors, 2028 participants (48.4%) were aware of its signs and symptoms, and 2478 participants (59.1%) recognized associated protective measures. Factors associated with good knowledge across all domains included university education (eg, risk factor knowledge: odds ratio [OR] vs ≤intermediate school, 1.52; 95% CI, 1.20-1.92), no tobacco use (eg, risk factor knowledge: OR for never smoking, 1.44; 95% CI, 1.20-1.74), and receiving education from a dentist (eg, risk factor knowledge: OR, 8.60; 95% CI, 7.33-10.08) at the P < .05 significance threshold. Being female (eg, 1491 females [62.9%] vs 987 males [54.1%] with good knowledge) and residing in upper-middle- or high- vs low- and lower-middle-income countries (eg, 1230 of 1891 participants [65.1%] vs 1248 of 2306 participants [54.2%] with good knowledge) were also associated with increased awareness of protective measures at the P < .00036 significance threshold with Bonferroni adjustment. Conclusions and Relevance:This study found a significant lack of oral cancer awareness in Middle Eastern and North African populations, particularly among individuals with lower levels of education and those who used tobacco. Findings also underscore the critical role of dental professionals in improving public knowledge of oral cancer through targeted educational interventions.
Objective Studying dentists' knowledge of dry mouth management is crucial for effective diagnosis and treatment, improving patient outcomes and oral health. This study aimed to evaluate their knowledge and awareness of dry mouth and its predictors. Materials and Methods A pre-validated online survey was administered to a convenience sample of dentists across six countries. The questionnaire evaluated knowledge in various domains, including predisposing factors, diagnosis, clinical signs and symptoms, and management of dry mouth. Results A total of 884 dentists participated. Knowledge and awareness of dry mouth management varied significantly between countries (p < 0.05). Overall, 34.3% of participants demonstrated good knowledge, while 53.7% had moderate knowledge. Regarding management awareness, 55.4% had good awareness and 35.5% had moderate awareness. A majority (69.2%) showed good knowledge of common signs, symptoms, and consequences of dry mouth. Significant predictors of better knowledge and awareness included the country of practice and attendance at continuing education courses on dry mouth. Conclusion The findings suggest that dentists in the surveyed countries require improved education on dry mouth and its management. Dental educators and healthcare planners can use this data to design targeted continuing education activities to enhance knowledge and awareness of dry mouth.
