The knowledge, attitude and practice level of dental auxiliaries regarding oral health care for pregnant patients in the eastern province of Saudi Arabia

Daneah Alibrahim; Azza El. Mahalli

doi:10.12688/f1000research.72903.2

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Research Article

Revised

The knowledge, attitude and practice level of dental auxiliaries regarding oral health care for pregnant patients in the eastern province of Saudi Arabia

[version 2; peer review: 1 approved, 1 approved with reservations]

Daneah Alibrahim¹, Azza El. Mahalli ²

PUBLISHED 28 Mar 2022

Author details Author details

¹ University Dental Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
² Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

Daneah Alibrahim
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation

Azza El. Mahalli
Roles: Supervision, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Background:The purpose of this research was to assess the knowledge, attitude, and practice of dental auxiliaries related to oral health care for pregnant patientsin the Eastern Province of Saudi Arabia.
Methods: A cross-sectional study using a questionnaire survey was conducted. The knowledge, attitude, and practice were rated using the Likert scale out of 5. Knowledge and practice were categorized using bloom’s cut off point methods (80% and above isgood, and less than 80% is bad).Concerningattitude, (80% and above is positive, and less than 80% is negative) The questionnaires were sent to all dental hygienists and assistants (N=358), and responses were collected from 218. Statistical Package for the Social Sciences (SPSS) software was utilised to conduct statistical analysis.
Results: Out of the 358, 218 responded (response rate = 61%). More than half of the respondents showed relatively good knowledge (57.3%). Most respondents had a positive attitude (89.4%). Regarding practice, approximately two-thirds had a good practice (67.4%). The knowledge score of hygienists was significantly higher than dental assistants, and respondents with experience in treating pregnant patients had significantly higher knowledge scores than others who did not have experience in treating pregnant patients. There is a statistically significant positive correlation between practice scores and education.
Conclusions: The findings suggest the need to establish continuous education programs and for dental hygienists and dental assistants to adopt the best practice guidelines on perinatal oral health.

Keywords

Dental auxiliaries; Pregnancy; Oral care; Knowledge; Attitude; Practice; Saudi Arabia

Corresponding author: Azza El. Mahalli

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2022 Alibrahim D and El. Mahalli A. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Alibrahim D and El. Mahalli A. The knowledge, attitude and practice level of dental auxiliaries regarding oral health care for pregnant patients in the eastern province of Saudi Arabia [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2022, 11:216 (https://doi.org/10.12688/f1000research.72903.2) First published: 23 Feb 2022, 11:216 (https://doi.org/10.12688/f1000research.72903.1) Latest published: 23 Feb 2023, 11:216 (https://doi.org/10.12688/f1000research.72903.3)

Revised Amendments from Version 1

Spelling mistakes edited and added a little information in the Introduction

See the authors' detailed response to the review by Mohammad Abdul Baseer

Introduction

Pregnancy is an experience that most females undergo during their lives, which contributes to physiological and psychological changes. One of the most apparent changes is the one in hormonal levels such as estrogen and progesterone that significantly influences various health issues. Hormonal changes can increase the risk of gingivitis and periodontitis.¹^–⁴ Preventing plaque formation during pregnancy is important for both the mother and the fetus.⁵ Health care practitioners from diverse backgrounds work together during pregnancy to meet the health and well-being of mothers and their developing fetuses.⁶ Dental professionals such as dentists and dental auxiliaries (dental hygienists and assistants) are well-positioned to provide oral care for pregnant patients and facilitate referrals to other health care providers.³^,⁶ To improve the services provided to pregnant patients, researchers need to understand the knowledge and awareness level of dental auxiliaries regarding oral health care for pregnant patients.⁶ A few studies have been performed in the United States that discuss dental hygienists' awareness, attitude, and practice towards pregnant patients.⁶ However, in Saudi Arabia, no studies have been conducted to assess the awareness, attitude, and practice of dental auxiliaries towards pregnant patients. Health planners and providers may be better informed from the findings of this study for the benefit of the patients and the public. Dental hygienists are well positioned to provide oral care, introduce pregnancy oral health information, and encourage referrals to other health care providers. Thus, the study aims to assess the level of knowledge, attitude, and practice of dental auxiliaries regarding oral health care for pregnant patients in the Eastern Province of Saudi Arabia.

Methods

Ethics statement

Ethical approval was obtained from Imam Abdulrahman Bin Faisal University research ethical review board (IRP-PGS-2020-03-378). Written informed consent was obtained from all subjects who agreed to participate in the study. The confidentiality and privacy of the subjects were maintained.

Study design and setting

This population-based cross-sectional study was conducted at the governmental dental hospitals in the Eastern province of Saudi Arabia from 17 February 2021 to 17 March 2021.

Participants

Study participants were all dental auxiliaries (dental hygienist and dental assistant) at the governmental dental hospitals in the Eastern province of Saudi Arabia.

Data collection and instrument

The questionnaire was used by Schramm et al. (2016) but modified in the current study.⁶ It comprised of four sections which included socio-demographic characteristics. Knowledge, attitude, and practice were rated using the Likert scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree. Knowledge and practice were categorized using Bloom’s cut off point methods (≥80% is good, and <80% is bad). Concerning attitude, (≥80% is positive, and <80% is negative).⁷ The survey was administered via Google forms services to all dental auxiliaries through e-mail obtained from hospital database. There was no missing data. See the Extended data for a copy of the questionnaire.

Pilot study

A pilot study was conducted on a representative sample of dental auxiliaries from a private hospital. The questionnaire was validated for face and content validity, reliability, and ease of use. Cronbach’s alpha results of the pilot study were acceptable for knowledge (α = 0.778), and attitude (α = 0.791) and good for practice (α = 0.862).

Analysis

Statistical analysis was performed using SPSS version 23 for Mac. Frequencies and percentages were calculated for categorical variables. The mean and standard deviation were calculated for continuous variables. The median score of 4 was a cut-off point that was considered satisfactory for knowledge, attitude, and practice.⁸ Mann Whitney and Kruskal Wallis tests were performed to compare the knowledge, attitude, and practice scores. The Spearman rho test was used to correlate the knowledge, attitude, and practice scores with age, education, and experience. A p-value of ≤0.05 was considered statistically significant.

Results

Of the total of 358, 218 responded, resulting in a response rate of 61% which is considered excellent in most circumstances.⁹

Table 1 shows the socio-demographic characteristics of study participants.

Table 1. Distribution of study participants according to socio-demographic characteristics (2021).

Socio-demographic characteristics	No %
Age category	X ± SD (32.2 ± 9.3)
20-	145 (66.5)
35-	67 (30.7)
45-	6 (2.8)
Gender
Male	50 (22.9)
Female	168 (77.1)
Nationality
1-Saudi	152 (69.7)
2-Non-Saudi	66 (30.3)
Marital status
1-Single	107 (49.1)
2-Married	103 (47.2)
3-Divorced	8 (3.7)
Education level
1-High diploma	56 (25.7)
2-Bachelors	155 (71.1)
3-Master (MA, MSc, etc.)	7 (3.2)
Specialty
1-Hygienist	73 (33.5)
2-Dental assistant	145 (66.5)
Workplace
1-Imam Abdulrahman Bin Faisal University	90 (41.3)
2-Dammam medical complex	39 (17.9)
3-Qatif Central Hospital	16 (7.3)
4-King Fahad military complex	55 (25.2)
5-Airbase Hospital	18 (8.3)
Years of experience
1-<5 years	111 (50.9)
2-5-10 years	55 (25.2)
3->10 years	52 (23.9)
Experience in treating pregnant women
1-Yes	138 (63.3)
2-No	80 (36.7)

Table 2 shows that more than half of the study participants (57.3%) had good knowledge regarding oral health care for pregnant patients. Concerning the attitude of dental practitioners towards the pregnant patients, (89.4%) had a positive attitude. Finally, approximately two-thirds of participants had good practice (67.4%).

Table 2. The knowledge, attitude, and practice level of dental auxiliaries regarding oral health care for pregnant patients in the Eastern Province of Saudi Arabia (2021).

Variable	No %
Knowledge
1-Good knowledge	125 (57.3)
2-Poor knowledge	93 (42.7)
Attitude
1-Positive attitude	195 (89.4)
2-Negative attitude	23 (10.6)
Practice
1-Good practice	147 (67.4)
2-Bad practice	71 (32.6)

Table 3 shows that the knowledge score of hygienists was higher than dental assistants and of those experienced in treating pregnant women was higher than participants without experience and these differences were significant (P < 0.05).

Table 3. Association of knowledge with socio-demographics of dental auxiliaries (2021).

Socio-demographic characteristics	Median	P-value
Gender
Male	4	0.248
Female	4
Nationality
1-Saudi	4	0.399
2-Non-Saudi	4
Marital status
1-Single	4	0.359
2-Married	4
3-Divorced	4
Specialty
1-Hygienist	4	0.006*
2-Dental assistant	3.5
Workplace
1-Imam Abdulrahman Bin Faisal University	4
2-Dammam medical complex	4	0.333
3-Qatif Central Hospital	3.7
4-King Fahad military complex	4
5-Airbase Hospital	4
Experience in treating pregnant women
1-Yes	4	0.008*
2-No	3.5

* P ≤ 0.05.

Table 4 shows that there is no statistically significant difference in the attitude score by gender, nationality, marital status, specialty, workplace nor experience in treating pregnant females (P > 0.05).

Table 4. Association of attitude with socio-demographics of dental auxiliaries (2021).

Socio-demographic characteristics	Median	P-value
Gender
Male	4	0.632
Female	4
Nationality
1-Saudi	4	0.523
2-Non-Saudi	4
Marital status
1-Single	4	0.134
2-Married	4
3-Divorced	4
Specialty
1-Hygienist	4	0.902
2-Dental assistant	4
Workplace
1-Imam Abdulrahman Bin Faisal University	4
2-Dammam medical complex	4	0.298
3-Qatif Central Hospital	4
4-King Fahad military complex	4
5-Airbase Hospital	4
Experience in treating pregnant
1-Yes	4	0.486
2-No	4

Table 5 shows that there is no statistically significant difference in the practice score by gender, nationality, marital status, specialty, nor workplace (P > 0.05). However, there is a significant difference between participants with experience in treating pregnant patients and those without experience (P < 0.05).

Table 5. Association of practice with socio-demographics of dental auxiliaries (2021).

Socio-demographic characteristics	Median	P-value
Gender
Male	4	0.935
Female	4
Nationality
1-Saudi	4	0.629
2-Non-Saudi	4
Marital status
1-Single	4	0.848
2-Married	4
3-Divorced	4
Specialty
1-Hygienist	4	0.168
2-Dental assistant	4
Workplace
1-Imam Abdulrahman Bin Faisal University	4
2-Dammam medical complex	4	0.452
3-Qatif Central Hospital	4
4-King Fahad military complex	4
5-Airbase Hospital	4
Experience in treating pregnant women
1-Yes	4	0.009*
2-No	4

* Statistically significant at P ≤ 0.05.

Table 6 shows the results of the correlation between knowledge and age, education and experience. There is a positive correlation between the knowledge score and age, education, and experience; however, these correlations are not statistically significant.

Table 6. Correlation between the knowledge and socio-demographics of dental auxiliaries (2021).

Socio-demographics	Rho	P-value
Age	0.103	0.128
Education	0.131	0.054
Experience	0.110	0.104

Table 7 shows the results of the correlation between attitude and age, education and experience. There is a negative correlation between the attitude score and age, education, and experience; however, these correlations are not statistically significant.

Table 7. Correlation between the attitude and socio-demographics of dental auxiliaries (2021).

Socio-demographics	Rho	P-value
Age	−0.037	0.587
Education	−0.086	0.207
Experience	−0.022	0.742

Table 8 shows the results of the correlation between practice and (age, education and experience). There is positive correlation between the practice score and age, education and experience. However, the only statistically significant correlation is with education (P < 0.05).

Table 8. Correlation between the practice and socio-demographics of dental auxiliaries (2021).

Socio-demographics	Rho	P-value
Age	0.063	0.355
Education	0.160	0.018*
Experience	0.032	0.643

* P ≤ 0.05.

Discussion

Pregnant women should receive routine and emergency dental treatment; however, there is limited information about the current practices among dental auxiliaries providing care to pregnant women.¹⁰

Knowledge of dental auxiliaries

In this study, dental auxiliaries demonstrated relatively good knowledge (57.3%) regarding oral care provided throughout pregnancy. In addition, they agreed that women should receive preventive dental care during pregnancy (75.2%), which is consistent with the available literature and studies on the subject.¹¹ Of the dental auxiliaries in this study, only 69.7% advocated for the risk of radiographs during this period. Similar disagreement about the use of radiographs for pregnant women has been identified in other studies.¹¹^,¹² The current findings demonstrated that the knowledge score of hygienists was significantly higher than dental assistants (p = 0.006). This finding is consistent with a study conducted in North Carolina in 2008 where respondents with low or moderate levels of knowledge were significantly less likely to provide comprehensive treatment for pregnant women than those with high levels of knowledge.¹³

Attitude of dental auxiliaries

Dental auxiliaries had a very positive attitude toward perinatal oral health (89.4%). Other studies also found almost universal agreement that dental treatment should be included in prenatal care, with most dentists and dental auxiliaries having favorable attitudes toward pregnancy-specific counselling.⁶^,¹¹^-¹³ The present findings revealed that 81.6% of participants believe that they need educational material for pregnant patients. These findings were consistent with the literature where dental auxiliaries required continuing education to improve their awareness about pregnant women’s oral health.⁶^,¹¹^,¹⁴

Practice of dental auxiliaries

The results of this study revealed that only 36.3% of study participants practiced administration of anesthetic injections. This contradicted previous study results where benzocaine, procaine and lidocaine were administered safely.¹²^,¹⁵ In addition, the current study showed that there was a statistically significant correlation between practice and level of education. This finding has been supported by another study which agreed that continuous dental education could be a useful strategy in improving dental practice.¹²

Limitations

In this study, only 218 dental auxiliaries participated and thus the results may not be representative of the dental auxiliaries in the kingdom, and the findings may be not generalizable and may lack validity.

Conclusion

Dental auxiliaries had positive knowledge, attitudes, and practices regarding offering oral health care to pregnant women. The research results confirmed that many dental auxiliaries shared the desire for continuing education on oral health care during pregnancy to improve oral health practices. Preventive measures for pregnant women would be beneficial not only for the mothers but also for their babies.

Data availability

Underlying data

Figshare: main study 2.sav, https://doi.org/10.6084/m9.figshare.17197283.v2.¹⁶

This project contains the following underlying data:

- Main study 2.sav (Data for gender, age, nationality, marital status, education, specialty, work place, experience in treating pregnant patients, and questions 11 to 36)

Extended data

Figshare: main study 2.sav, https://doi.org/10.6084/m9.figshare.17197283.v2.¹⁶

This project contains the following extended data:

- Survey for magazine.docx (Questionnaire)

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

References

1. Turton M, Africa CW: Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes. Int. Dent. J. 2017; 67(3): 148–156. PubMed Abstract | Publisher Full Text
2. NIH: Periodontal (gum) disease: Causes, symptoms, and treatments. 2017. Reference Source
3. Brown A: Access to oral health care during the perinatal period: A policy brief. 2008. Reference Source
4. Jared H, Boggess KA: Periodontal diseases and adverse pregnancy outcomes: a review of the evidence and implications for clinical practice. American Dental Hygienists' Association. 2008; 82(3): 1–20.
5. Bakhshi M, Tofangchiha M, Bakhtiari S, et al.: Oral and dental care during pregnancy: A survey of knowledge and practice in 380 Iranian gynaecologists. J. Int. Oral Health. 2019; 11(1): 21–27. Publisher Full Text
6. Schramm SA, Jacks ME, Prihoda TJ, et al.: Oral care for pregnant patients: A survey of dental hygienists' knowledge, attitudes and practice. J. Dent. Hyg. 2016; 90(2): 121–127. PubMed Abstract
7. Bloom BS: Taxonomy of educational objectives. Vol. 1: Cognitive domain. New York: McKay; 1956; 20(24): 1.
8. Barua A: Methods for decision-making in survey questionnaires based on Likert scale. Journal of Asian Scientific Research. 2013; 3(1): 35–38.
9. Kiess HO, Bloomquist DW: Psychological research methods: A conceptual approach. Allyn & Bacon; 1985.
10. Kumar J, Samelson R: Oral health care during pregnancy recommendations for oral health professionals. N. Y. State Dent. J. 2009; 75(6): 29–33. PubMed Abstract
11. George A, Ajwani S, Bhole S, et al.: Knowledge, attitude and practises of dentists towards oral health care during pregnancy: A cross sectional survey in New South Wales, Australia. Aust. Dent. J. 2017; 62(3): 301–310. PubMed Abstract | Publisher Full Text
12. Huebner CE, Milgrom P, Conrad D, et al.: Providing dental care to pregnant patients: A survey of Oregon general dentists. J. Am. Dent. Assoc. 2009; 140(2): 211–222. Publisher Full Text
13. Da Costa EP, Lee JY, Rozier RG, et al.: Dental care for pregnant women. J. Am. Dent. Assoc. 2010; 141(8): 986–994. Publisher Full Text
14. Umoh AO, Azodo CC: Nigerian dentists and oral healthcare of pregnant women: Knowledge, attitude and belief. Sahel Medical Journal. 2013; 16(3): 111–115. Publisher Full Text
15. Turner MD, Singh F, Glickman RS: Dental management of the gravid patient. N. Y. State Dent. J. 2006; 72(6): 22–27. PubMed Abstract
16. Alibrahim D: main study 2.sav. figshare. Dataset. 2021. Publisher Full Text

Comments on this article Comments (0)

Version 3

VERSION 3 PUBLISHED 23 Feb 2022

Author details Author details

Azza El. Mahalli
Roles: Supervision, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

Article Versions (3)

version 3

Revised

Published: 23 Feb 2023, 11:216

https://doi.org/10.12688/f1000research.72903.3

version 2

Revised

Published: 28 Mar 2022, 11:216

https://doi.org/10.12688/f1000research.72903.2

version 1

Published: 23 Feb 2022, 11:216

https://doi.org/10.12688/f1000research.72903.1

© 2022 Alibrahim D and El. Mahalli A. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Alibrahim D and El. Mahalli A. The knowledge, attitude and practice level of dental auxiliaries regarding oral health care for pregnant patients in the eastern province of Saudi Arabia [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2022, 11:216 (https://doi.org/10.12688/f1000research.72903.2)

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Open Peer Review

Version 2

VERSION 2

PUBLISHED 28 Mar 2022

Revised

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Reviewer Report 25 Jan 2023

Catherine Maybury, Center for Health Literacy, University of Maryland School of Public Health, College Park, MD, USA

Approved with Reservations

https://doi.org/10.5256/f1000research.122785.r159891

The authors have taken an important first step in understanding what dental auxiliaries in their country know and practice related to oral health care for pregnant patients. The article is easy to read and concise.

I have a few suggestions.

Introduction - The authors state that a few studies have been performed in the US that discuss dental hygienists' awareness, attitude and practice towards pregnant patients but they only cite one article. I did a quick search and found the following (Rainchuso, 2013).¹ Please look for additional articles.

Methods - This section should be expanded to explain: a) how you adapted the Schramm instrument; b) how many items were in the survey overall; c) describe the measures (what types of items comprise knowledge, attitudes and practice?); d) for the survey, how many times was the survey link sent to the potential respondents? and e) was the data normal or skewed?

Discussion - Knowledge is low (57%). Why is this - is it because they do not receive training? Is it because practices do not treat pregnant women? If ONLY slightly more than half of auxiliaries have adequate knowledge this is a problem. One suggestion is to include this in the training as well as continuing education.

Limitations - Why would the findings lack validity? Please explain.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Partly

References

1. Rainchuso L: Improving oral health outcomes from pregnancy through infancy.J Dent Hyg. 2013; 87 (6): 330-5 PubMed Abstract

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: health literacy, oral health literacy, health education

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Reviewer Report 04 Apr 2022

Mohammad Abdul Baseer, Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia

Approved

https://doi.org/10.5256/f1000research.122785.r129028

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Author Response 06 Apr 2022

Daneah Alibrahim, University Dental Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

06 Apr 2022

Author Response

Thank you so much Dr. Mohammad Abdul Baseer.
Competing Interests: No competing interests were disclosed.
Thank you so much Dr. Mohammad Abdul Baseer.
Thank you so much Dr. Mohammad Abdul Baseer.
Competing Interests: No competing interests were disclosed. Close
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Author Response 22 Apr 2022

azza elmahalli, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia

22 Apr 2022

Author Response

Greetings
I'm professor Azza El.Mahalli. The 2nd author of this article. I acknowledge that we amended all the queries raised by Dr Abdul Bassir
Regards,
Competing Interests: No competing interest
Greetings
I'm professor Azza El.Mahalli. The 2nd author of this article. I acknowledge that we amended all the queries raised by Dr Abdul Bassir
Regards,
Greetings
I'm professor Azza El.Mahalli. The 2nd author of this article. I acknowledge that we amended all the queries raised by Dr Abdul Bassir
Regards,
Competing Interests: No competing interest Close
Report a concern
Author Response 19 Apr 2022

Daneah Alibrahim, University Dental Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

19 Apr 2022

Author Response

Dear Dr.Mohammed Abdul Baseer,

I acknowledge that I did all the amendment for all the queries raised by you. Thank you for the comment, I really appreciate it.
Competing Interests: No competing interests were disclosed.
Dear Dr.Mohammed Abdul Baseer,

I acknowledge that I did all the amendment for all the queries raised by you. Thank you for the comment, I really appreciate it.
Dear Dr.Mohammed Abdul Baseer,

I acknowledge that I did all the amendment for all the queries raised by you. Thank you for the comment, I really appreciate it.
Competing Interests: No competing interests were disclosed. Close
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Author Response 22 Apr 2022

Azza El.Mahalli, Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

22 Apr 2022

Author Response

Greetings
As a second author, I acknowledge that we did the amendments as requested from Dr Mohamed Abdul Basir
Thanks,
Competing Interests: No competing interests were disclosed
Greetings
As a second author, I acknowledge that we did the amendments as requested from Dr Mohamed Abdul Basir
Thanks,
Greetings
As a second author, I acknowledge that we did the amendments as requested from Dr Mohamed Abdul Basir
Thanks,
Competing Interests: No competing interests were disclosed Close
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COMMENTS ON THIS REPORT

Author Response 06 Apr 2022

Daneah Alibrahim, University Dental Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

06 Apr 2022

Author Response

Thank you so much Dr. Mohammad Abdul Baseer.
Competing Interests: No competing interests were disclosed.
Thank you so much Dr. Mohammad Abdul Baseer.
Thank you so much Dr. Mohammad Abdul Baseer.
Competing Interests: No competing interests were disclosed. Close
Report a concern
Author Response 22 Apr 2022

azza elmahalli, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia

22 Apr 2022

Author Response

Greetings
I'm professor Azza El.Mahalli. The 2nd author of this article. I acknowledge that we amended all the queries raised by Dr Abdul Bassir
Regards,
Competing Interests: No competing interest
Greetings
I'm professor Azza El.Mahalli. The 2nd author of this article. I acknowledge that we amended all the queries raised by Dr Abdul Bassir
Regards,
Greetings
I'm professor Azza El.Mahalli. The 2nd author of this article. I acknowledge that we amended all the queries raised by Dr Abdul Bassir
Regards,
Competing Interests: No competing interest Close
Report a concern
Author Response 19 Apr 2022

Daneah Alibrahim, University Dental Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

19 Apr 2022

Author Response

Dear Dr.Mohammed Abdul Baseer,

I acknowledge that I did all the amendment for all the queries raised by you. Thank you for the comment, I really appreciate it.
Competing Interests: No competing interests were disclosed.
Dear Dr.Mohammed Abdul Baseer,

I acknowledge that I did all the amendment for all the queries raised by you. Thank you for the comment, I really appreciate it.
Dear Dr.Mohammed Abdul Baseer,

I acknowledge that I did all the amendment for all the queries raised by you. Thank you for the comment, I really appreciate it.
Competing Interests: No competing interests were disclosed. Close
Report a concern
Author Response 22 Apr 2022

Azza El.Mahalli, Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

22 Apr 2022

Author Response

Greetings
As a second author, I acknowledge that we did the amendments as requested from Dr Mohamed Abdul Basir
Thanks,
Competing Interests: No competing interests were disclosed
Greetings
As a second author, I acknowledge that we did the amendments as requested from Dr Mohamed Abdul Basir
Thanks,
Greetings
As a second author, I acknowledge that we did the amendments as requested from Dr Mohamed Abdul Basir
Thanks,
Competing Interests: No competing interests were disclosed Close
Report a concern

Version 1

VERSION 1

PUBLISHED 23 Feb 2022

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Reviewer Report 25 Feb 2022

Mohammad Abdul Baseer, Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia

Approved with Reservations

https://doi.org/10.5256/f1000research.76514.r124732

The authors have made a good effort in conducting research on the topic that is not fully addressed in KSA, however:

Authors should improve the article's English and grammar.
Spelling mistakes in the abstract and other areas

The authors have made a good effort in conducting research on the topic that is not fully addressed in KSA, however:

Authors should improve the article's English and grammar.
Spelling mistakes in the abstract and other areas should be corrected.
The introduction should mention the intended benefits of the study.
Under the materials and methods section sample size calculations and sampling techniques utilized in the study should be elaborated.
How did the authors obtained email addresses of the participants should me mentioned in the study.
Descriptive analysis of each item in the questionnaire should be presented.
Normality assessment of the data should be indicated before deciding to opt for non-parametric analysis.
Results should also include correlation test among knowledge, attitude and practices.
The discussion is very brief, authors should elaborate it by including articles published from Saudi Arabia and elsewhere.
Authors should include more study limitations.
References should be updated with more than half being published within last 2-3 years.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

I cannot comment. A qualified statistician is required.
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Dental Public Health, Preventive Dentistry, Clinical Trials.

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Author Response 28 Mar 2022

Daneah Alibrahim, University Dental Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

28 Mar 2022

Author Response

Dear Dr. Mohammad Abdul Baseer

Thank you for the comments, I really appreciate it. I have addressed your comments and submitted the new version.

best regards
Competing Interests: No competing interests were disclosed.
Dear Dr. Mohammad Abdul Baseer

Thank you for the comments, I really appreciate it. I have addressed your comments and submitted the new version.

best regards
Dear Dr. Mohammad Abdul Baseer

Thank you for the comments, I really appreciate it. I have addressed your comments and submitted the new version.

best regards
Competing Interests: No competing interests were disclosed. Close
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Author Response 28 Mar 2022

Daneah Alibrahim, University Dental Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

28 Mar 2022

Author Response

Dear Dr. Mohammad Abdul Baseer

Thank you for the comments, I really appreciate it. I have addressed your comments and submitted the new version.

best regards
Competing Interests: No competing interests were disclosed.
Dear Dr. Mohammad Abdul Baseer

Thank you for the comments, I really appreciate it. I have addressed your comments and submitted the new version.

best regards
Dear Dr. Mohammad Abdul Baseer

Thank you for the comments, I really appreciate it. I have addressed your comments and submitted the new version.

best regards
Competing Interests: No competing interests were disclosed. Close
Report a concern

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Version 3

VERSION 3 PUBLISHED 23 Feb 2022

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	1	2
Version 3 (revision) 23 Feb 23		read
Version 2 (revision) 28 Mar 22	read	read
Version 1 23 Feb 22	read

Mohammad Abdul Baseer, Riyadh Elm University, Riyadh, Saudi Arabia
Catherine Maybury, University of Maryland School of Public Health, College Park, USA

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Reviewer Report

6 Views

29 Mar 2023 | for Version 3

Catherine Maybury, Center for Health Literacy, University of Maryland School of Public Health, College Park, MD, USA

6 Views Cite this report Responses(0)

Approved

Approved. I have no further comments.

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Health literacy, oral health literacy, health education

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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Reviewer Report

25 Views

25 Jan 2023 | for Version 2

Catherine Maybury, Center for Health Literacy, University of Maryland School of Public Health, College Park, MD, USA

25 Views Cite this report Responses(0)

Approved With Reservations

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Partly

References

1. Rainchuso L: Improving oral health outcomes from pregnancy through infancy.J Dent Hyg. 2013; 87 (6): 330-5 PubMed Abstract

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

health literacy, oral health literacy, health education

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Reviewer Report

30 Views

04 Apr 2022 | for Version 2

Mohammad Abdul Baseer, Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia

30 Views Cite this report Responses(4)

Approved

The authors have made improvements to the manuscript.

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Dental Public Health, Preventive Dentistry, Clinical Trials.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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Reviewer Report

20 Views

25 Feb 2022 | for Version 1

Mohammad Abdul Baseer, Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia

20 Views Cite this report Responses(1)

Approved With Reservations

The authors have made a good effort in conducting research on the topic that is not fully addressed in KSA, however:

Authors should improve the article's English and grammar.
Spelling mistakes in the abstract and other areas should be corrected.
The introduction should mention the intended benefits of the study.
Under the materials and methods section sample size calculations and sampling techniques utilized in the study should be elaborated.
How did the authors obtained email addresses of the participants should me mentioned in the study.
Descriptive analysis of each item in the questionnaire should be presented.
Normality assessment of the data should be indicated before deciding to opt for non-parametric analysis.
Results should also include correlation test among knowledge, attitude and practices.
The discussion is very brief, authors should elaborate it by including articles published from Saudi Arabia and elsewhere.
Authors should include more study limitations.
References should be updated with more than half being published within last 2-3 years.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

I cannot comment. A qualified statistician is required.
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Dental Public Health, Preventive Dentistry, Clinical Trials.

Respond to this report

Responses (1)

Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

[1] 1. Turton M, Africa CW: Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes. Int. Dent. J. 2017; 67(3): 148–156. PubMed Abstract | Publisher Full Text

[2] 2. NIH: Periodontal (gum) disease: Causes, symptoms, and treatments. 2017. Reference Source

[3] 3. Brown A: Access to oral health care during the perinatal period: A policy brief. 2008. Reference Source

[4] 4. Jared H, Boggess KA: Periodontal diseases and adverse pregnancy outcomes: a review of the evidence and implications for clinical practice. American Dental Hygienists' Association. 2008; 82(3): 1–20.

[5] 5. Bakhshi M, Tofangchiha M, Bakhtiari S, et al.: Oral and dental care during pregnancy: A survey of knowledge and practice in 380 Iranian gynaecologists. J. Int. Oral Health. 2019; 11(1): 21–27. Publisher Full Text

[6] 6. Schramm SA, Jacks ME, Prihoda TJ, et al.: Oral care for pregnant patients: A survey of dental hygienists' knowledge, attitudes and practice. J. Dent. Hyg. 2016; 90(2): 121–127. PubMed Abstract

[7] 7. Bloom BS: Taxonomy of educational objectives. Vol. 1: Cognitive domain. New York: McKay; 1956; 20(24): 1.

[8] 8. Barua A: Methods for decision-making in survey questionnaires based on Likert scale. Journal of Asian Scientific Research. 2013; 3(1): 35–38.

[9] 9. Kiess HO, Bloomquist DW: Psychological research methods: A conceptual approach. Allyn & Bacon; 1985.

[10] 10. Kumar J, Samelson R: Oral health care during pregnancy recommendations for oral health professionals. N. Y. State Dent. J. 2009; 75(6): 29–33. PubMed Abstract

[11] 11. George A, Ajwani S, Bhole S, et al.: Knowledge, attitude and practises of dentists towards oral health care during pregnancy: A cross sectional survey in New South Wales, Australia. Aust. Dent. J. 2017; 62(3): 301–310. PubMed Abstract | Publisher Full Text

[12] 12. Huebner CE, Milgrom P, Conrad D, et al.: Providing dental care to pregnant patients: A survey of Oregon general dentists. J. Am. Dent. Assoc. 2009; 140(2): 211–222. Publisher Full Text

[13] 13. Da Costa EP, Lee JY, Rozier RG, et al.: Dental care for pregnant women. J. Am. Dent. Assoc. 2010; 141(8): 986–994. Publisher Full Text

[14] 14. Umoh AO, Azodo CC: Nigerian dentists and oral healthcare of pregnant women: Knowledge, attitude and belief. Sahel Medical Journal. 2013; 16(3): 111–115. Publisher Full Text

[15] 15. Turner MD, Singh F, Glickman RS: Dental management of the gravid patient. N. Y. State Dent. J. 2006; 72(6): 22–27. PubMed Abstract

[16] 16. Alibrahim D: main study 2.sav. figshare. Dataset. 2021. Publisher Full Text

The knowledge, attitude and practice level of dental auxiliaries regarding oral health care for pregnant patients in the eastern province of Saudi Arabia

Abstract

Keywords

Revised Amendments from Version 1

Introduction

Methods

Ethics statement

Study design and setting

Participants

Data collection and instrument

Pilot study

Analysis

Results

Table 1. Distribution of study participants according to socio-demographic characteristics (2021).

Table 2. The knowledge, attitude, and practice level of dental auxiliaries regarding oral health care for pregnant patients in the Eastern Province of Saudi Arabia (2021).

Table 3. Association of knowledge with socio-demographics of dental auxiliaries (2021).

Table 4. Association of attitude with socio-demographics of dental auxiliaries (2021).

Table 5. Association of practice with socio-demographics of dental auxiliaries (2021).

Table 6. Correlation between the knowledge and socio-demographics of dental auxiliaries (2021).

Table 7. Correlation between the attitude and socio-demographics of dental auxiliaries (2021).

Table 8. Correlation between the practice and socio-demographics of dental auxiliaries (2021).

Discussion

Knowledge of dental auxiliaries

Attitude of dental auxiliaries

Practice of dental auxiliaries

Limitations

Conclusion

Data availability

Underlying data

Extended data

References

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