Awareness and Knowledge of the Adult Population in Saudi Arabia on Teeth Discoloration and Treatment Options: A Cross-Sectional Study

Background: Tooth discoloration is a common condition. Discoloration can be a major aesthetic concern for some people and it can indicate pathology, so it needs to be addressed. The success of treatment of tooth discoloration is largely dependent on the knowledge and attitude of people towards it. Hence the aim of this cross-sectional questionnaire-based study was to evaluate knowledge and awareness of the adult Saudi population about the causes of tooth discoloration and its treatment options. Materials and Methods: An online close-ended questionnaire consisting of 21 questions about tooth discoloration causes and treatment options were uploaded in Google Forms and was sent to 2000 adults in Saudi Arabia via email and social media websites. The questions were designed to evaluate patients’ knowledge about the various causes of tooth discoloration. Results: A total of 1041 participants responded to our questionnaire. The study included 560 females (53.79%), and 448 participants aged between 18 and 24 years (43.04%), 192 (18.44%) between 25 and 35 years, 246 (23.63%) between 36 and 51 years, and 155 (14.89%) above 51 years. Most of the participants (n= 649; 62.34%) had a bachelor's degree. The most common answer to the type of teeth discoloration was internal and surface discoloration (n= 511; 49%). There was a positive response to the effect of diet, smoking, aging, and bacteria on tooth discoloration. 79% of the participants did not know what dental fluorosis is. The response to the effect of drugs on teeth discoloration split between "Yes" and "I don't know," and 688 of the participants (66.09%) did not know which drugs cause teeth discoloration. The personal effort was the most common way to obtain information about teeth discoloration (n= 678; 65.13%). Conclusion: Within the limitations of this study, the level of knowledge about tooth discoloration was more concentrated on extrinsic factors, and the majority of the participants demonstrated poor knowledge about the intrinsic causes of tooth discoloration. The preferred treatment option of teeth discoloration was in office bleaching.

Dental fluorosis among people and livestock living on Gihaya Island in Lake Kivu, Rwanda

Background Dental fluorosis is caused by prolonged exposure to excessive fluoride during the period of permanent tooth formation and is characterized by tooth discoloration, pitting, and loss of shape. Communities living near Lake Kivu in Western Rwanda exhibit a high prevalence of dental fluorosis; however, data on prevalence and risk factors are scarce. Methods This cross sectional, quantitative study used a One Health approach to investigate dental fluorosis prevalence among people and livestock and to measure fluoride content in the environment. In 2018, oral health examinations were conducted to assess the prevalence of fluorosis in children (aged 9 to 15 years), cattle and goats residing on Gihaya Island (Rwanda, East Africa). All children and cattle/goats meeting basic eligibility criteria (e.g., island residence) were invited to participate. Presence and severity of dental fluorosis was categorized according to the Dean’s Fluorosis Index. Samples of local foods, water, soil and grass were collected from communal sources and individual households and analyzed for fluoride content using standard laboratory techniques. Descriptive and binomial analyses (Fisher Exact Test) were used to assess this dataset. Results Overall, 186 children and 85 livestock owners (providing data of 125 livestock -23 cattle and 102 goats) participated. Dental fluorosis was recorded in 90.7% of children and 76% of livestock. Moderate to severe fluorosis was observed in 77% children while goats and cattle most often exhibited mild or absent/questionable severity, respectively. Water from Lake Kivu (used primarily for human cooking water and livestock drinking water) contained fluoride levels that were consistently higher than the maximum threshold (1.5 mg/L) recommended by the World Health Organization. Other sources (borehole and rainwater) were within safe limits. All food, soil and grass samples contained fluoride. The highest levels were observed in porridge (0.5 mg/g) and small fishes (1.05 mg/g). Conclusions Altogether, dental fluorosis was highly prevalent among children and goats on Gihaya Island with various food and water sources contributing a cumulative exposure to fluoride. An immediate and coordinated response across human, animal and water professionals is needed to reduce fluoride exposure within safe limits for island residents.

Small Molecule Compounds, A Novel Strategy against Streptococcus mutans

Dental caries, as a common oral infectious disease, is a worldwide public health issue. Oral biofilms are the main cause of dental caries. Streptococcus mutans (S. mutans) is well recognized as the major causative factor of dental caries within oral biofilms. In addition to mechanical removal such as tooth brushing and flossing, the topical application of antimicrobial agents is necessarily adjuvant to the control of caries particularly for high-risk populations. The mainstay antimicrobial agents for caries such as chlorhexidine have limitations including taste confusions, mucosal soreness, tooth discoloration, and disruption of an oral microbial equilibrium. Antimicrobial small molecules are promising in the control of S. mutans due to good antimicrobial activity, good selectivity, and low toxicity. In this paper, we discussed the application of antimicrobial small molecules to the control of S. mutans, with a particular focus on the identification and development of active compounds and their modes of action against the growth and virulence of S. mutans.

Knowledge, Attitude and Practice among Dentists Regarding Tetracycline Teeth Staining and Treatment Protocol - A Questionnaire Study

Introduction: Aesthetics is an important attribute to man’s overall view of himself .The term “tooth discoloration‟ refers to the fading away of the natural colour of the tooth or replacement with a stain, usually of a different colour to the point of notice. Tooth discoloration has been classified as extrinsic or intrinsic. Tetracycline staining which is characteristic in children born of mothers who were on tetracycline medication. These children develop a brown staining on most of their deciduous and permanent teeth. A variety of treatment methods including tooth-whitening options have been sought. The aim of this KAP survey was to assess the knowledge , attitude and practice of various clinical practitioners both undergraduate and postgraduate regarding Tetracycline tooth staining, its aetiology and treatment modalities. Methodology: A cross-sectional study was conducted across various Dental Clinics and Hospitals in Chennai, Tamil Nadu.Theself-administered questionnaire was written in English was adapted based on many other previous surveys of similar nature. It was circulated as digital questionnaires (GoogleForms) It had 15 items, 5 in the knowledge, 5 practice components and 5 in the attitude component, and took about 10 min to complete. Results: Among the 250 responses it was observed that 66.7% of the respondents were endodontists and the remaining 33.3% were general practitioners.33.3% of respondents had an experience of 2 to 6 years while 16.7% of respondents had a 8 year or more experience. All the respondents were based in and around Chennai, Tamil Nadu. The mean Knowledge score was 70%, while mean attitude and practice scores varied between 87% to 91% and were considerably much better. Conclusion: The fabrication of a detailed treatment protocol for the treatment of tetracycline based tooth staining in various clinical scenarios and the standardization of such a protocol, while also upgrading the basic theoretical knowledge is necessary. This could in tern help delivering better treatment to the patient while considering both the affordability as well as aesthetic satisfaction of the patient.

Quantifying Coronal Permanent Tooth Discoloration Caused by Different Pulpotomy Materials

Introduction: Bioceramic materials, gray and white mineral trioxide aggregate (GMTA, WMTA), have been shown to have high rates of success in various endodontic applications. A major drawback is their tendency to discolor teeth compared to Biodentine (BD), that has been claimed not to discolor teeth. The aim of this study was to compare tooth discoloration after applying different pulpotomy base materials (BD, GMTA and WMTA). Study design: Forty human incisors teeth were used in this study. Coronal access was achieved by a Tungsten Carbide drill, and the pulp chambers were accessed and chemo-mechanically debrided. Each material was placed in the pulp chamber, up to the cervical sectioning level. All specimens were incubated at 37°C and 100% humidity for three months and have been evaluated before the study and weekly. Color was assessed according to the CIE L*a*b* color space system. Results: ΔE of all experimental groups (GMTA, WMTA and BD) were significantly different from the control group at all time points (P<0.05). Color changes in the GMTA and WMTA groups, had no statistically significant differences, but showed higher discoloration compared to BD group in the cervical part of the crown, since week 1 (P<0.05). WMTA group showed significant discoloration in the cervical part as of week 1 (P<0.05), and gradually increased over time (Figure 2). BD group showed no significantly discoloration over time. GMTA group showed the significant discoloration at week 1 and week 14 (P<0.05). Conclusions: both GMTA and WMTA pulpotomy materials may discolor tooth structure over time in an extracted permanent anterior tooth model. When choosing bioceramic pulpotomy material, BD may be preferable in esthetic area.

Generalized Dentin Dysplasia in a Four-Year-old dog

Dentin dysplasia is an autosomal-dominant genetic abnormality that occurs in humans and results in diffuse radiographic dental abnormalities and variable tooth discoloration due to an underlying defect in secondary dentinogenesis. This case report presents distinctive radiographic and histopathologic dental abnormalities in a dog that are consistent with generalized dentin dysplasia. These findings are similar to but not completely analogous to any specific clinical type of dentin dysplasia in humans. Grossly, the majority of the teeth in this case were discolored and most were determined to be vital. Dentin dysplasia should be included in the list of differential diagnoses of discolored teeth and notably this form of discoloration does not necessarily indicate loss of vitality.