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Alla Alsharif,1,* Maha T Alsharif,2,* Meyassara Samman,3,* Nada Binmadi,2,* Saba Kassim,1,* Samah Mourad,4,* Saman Warnakulasuriya5,6,* 1Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Al-Madinah Al-Munawwarah, Saudi Arabia; 2Department of Oral Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia; 3Department of Dental Public Health at King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia; 4Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, ElMansoura, Eldaqahlia, Egypt; 5Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK; 6World Health Organization Collaborating Centre for Oral Cancer, London, UK*These authors contributed equally to this workCorrespondence: Maha T Alsharif, Department of Oral Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, P.O. Box 80209, Jeddah, 21589, Saudi Arabia, Tel +966582862000, Email mtyalsharif@kau.edu.saPurpose: The data available on the incidence and mortality rates of head and neck cancer types (HNCs) in the Gulf Cooperation Council countries (GCC) have relied on global trends and covered only certain cancer sites, types or certain age groups. This study aimed to assess the incidence and mortality rates of head and neck cancer (HNCs) within the Gulf Cooperation Council (GCC) countries, providing insights into their geographic variability in 2020.Methods: Prediction of the magnitude of the disease to 2040 was explored based on demographic projections. Estimates of incidence and mortality and the population projections were extracted from the Global Cancer Observatory (GLOBOCAN) database and the United Nations Department of Economic and Social Affairs respectively for the time frame 2020 to 2040. Additionally, we analyzed the distribution of cases and deaths by age and sex for both time periods.Results: The analysis indicates varying patterns in HNC rates across GCC countries in 2020, with Oman and Saudi Arabia carrying the highest burden. Projections for 2040 reveal a substantial increase in new HNC cases and related deaths, particularly in Qatar, UAE, and Bahrain. Furthermore, incidence rates are predicted to rise significantly for individuals aged 50 and older, while remaining relatively stable for those under 50. With regards to sex, males generally exhibit higher rates, except in Qatar.Conclusion: HNC burden is anticipated to rise significantly in the GCC, with variations per age, sex and geographical location. By 2040, a 2-3-fold increase in HNCs in the GCC is anticipated, emphasizing the need for focused public health strategies to address this rising health challenge.Keywords: head and neck neoplasms, projection, globocan, cancer prevention

(1) Background: Human papillomavirus (HPV) infection is significantly associated with oropharyngeal squamous cell carcinoma (HPV-OPSCC), which is one of the fastest-growing cancer incidences globally. Dental practitioners play a crucial role in the primary and secondary prevention of HPV-OPSCC. There is little known about dental students' awareness regarding HPV-OPSCC and HPV vaccination, as well as their intention to promote 'primordial prevention' among their patients. HPV vaccine, and the extent of their professional responsibilities. (2) Methods: This cross-sectional study was conducted in the western region of Saudi Arabia and involved undergraduate dental students ( n = 688) from six public and private dental schools. Participants were requested to complete a sequential-section anonymous online survey, with 257 successfully completing all sections of the questionnaire. The association between participant characteristics and HPV-OPSCC, HPV vaccination awareness ratings, and perceived engagement in prevention were analyzed using ANOVA and chi-squared testing. A binary logistic regression analysis was conducted to examine the variables linked to these outcomes. (3) Results: Generally, the overall level of awareness of HPV-OPSCC and HPV vaccination was acceptable, with an average score of 53.44 ± 29.3 out of 100. However, a significant knowledge gap was observed, with 53% of respondents being unaware of the common sites for HPV-OPSCC and 63.8% being uninformed of the appropriate age for HPV vaccination. Females and those with a prior history of sexually transmitted diseases (STDs) had considerably higher levels of HPV vaccination knowledge ( p < 0.05). The participants showed a favorable attitude towards their responsibility of informing patients about HPV-OPSCC and advocating HPV immunization. (4) Conclusions: This study underscores the need to enhance dental students' understanding of HPV-OPSCC and HPV immunization, enabling them to effectively engage in primary and secondary preventative efforts against HPV-OPSCC.

Objectives: This is the first national study to investigate the incidence of non-syndromic oro-facial clefts (NSOFC) and Pierre-Robin-Sequence in Saudi Arabia over the Covid-19 pandemic period., Methods: All maternity hospitals (30-hospitals) in the major regions and cities of Saudi from November 2020-to-2021 were included in the study. Patients were evaluated for cleft phenotype using the LASHAL-classification system. The incidence of NSOFC in Saudi Arabia was calculated by comparing the number of NSOFCs cases born out of all live births during the study period at the included hospitals. Clinical examination was performed and information was gathered using a validated data collection form., Results: In one year, 140,380 live-infants were born at the selected hospitals. Of these, 177 were diagnosed with NSOFC giving an incidence of 1.26/1,000 live-births in Saudi Arabia and the highest incidence in Medina city (2.46/1000 live-births). The incidence of cleft lip-and-palate (0.67/1000 live-births) was higher than that of cleft-palate (0.37/1000 live-births) and cleft-lip (0.22/1000 live-births). Pierre-Robin Sequence incidence was (0.04/1000 live-births). There were 21(12.1) or 23(13.2%) of NSOFC's mothers exposed or vaccinated with Covid-19, respectively., Conclusion: The national incidence of NSOFC in Saudi Arabia was 1.26/1000 live births with variation between phenotypes and regions in the country. In addition, to reporting Covid-19 infection prevalence and vaccine exposure among NSOFC's mothers, this study represents the first of its type to evaluate NSOFC prevalence in Saudi Arabia on a national level., (© 2023. The Author(s).)

Background: The aim of this study was to assess practicing dentists' characteristics and professional aspects that influence users to adopt Digital Technologies in Dentistry (DTD) in Saudi Arabia (SA). Moreover, we aimed to identify dentists' perceived barriers and challenges and to anticipate future potential developments towards implementing DTDs in their practices in SA., Methods: This analytical cross-sectional study based on a validated questionnaire was conducted using a snowball sampling technique to include a conveniently selected sample of dentists from all dental specialties currently working in SA., Results: The response rate was 64% completed and returned. A statistically significantly large share of Gen X (10.1%) used digital technologies (DTs) in dental practice compared with non-digital users. 40% received sufficient postgraduate education on DT, 92% agreed that DT should be included in the undergraduate dental curriculum. However, 79% actually gained skills or knowledge on DT through workshops and formal courses. 'Lack of practitioners' awareness', 'lack of education and pioneers' and 'lack of clinical evidence' were highlighted as the foremost barriers. Lower-frequency DT users believed that treating patients with DT makes treatment more predictable. Together, clinical trials and hands-on training courses can help overcome the barriers to the adoption of new dental technologies., Conclusions: Exploring technology adoption and usage amongst practicing dentists allows healthcare stakeholders and policymakers to set a clear direction towards the digitalisation of the healthcare system and within healthcare organisations. The study also highlighted the foremost barriers, challenges and actions towards the adoption of DTDs., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2023.)

Objectives: An error in the diagnosis of an oral or maxillofacial lesion could potentially be detrimental to a patient's prognosis and management. Major discrepancies between the initial and subsequent diagnoses of head and neck pathologies range from 7 to 53%. This study determined the rate of discrepancies found in the diagnoses of oral and maxillofacial lesions after a second opinion in Saudi Arabia., Methods: A retrospective single-center study was conducted by oral and maxillofacial pathology consultants to review all cases referred for a second opinion to the oral and maxillofacial pathology laboratory between January 2015 and December 2020. If the second-opinion diagnosis matched the original diagnosis, this was described as "agreement." If the second-opinion diagnosis did not match the original diagnosis but would not change the management or prognosis of a patient, this was classified as a "minor disagreement." If the second-opinion diagnosis resulted in the changing of a patient's management or prognosis, this was categorized as a "major disagreement." Chi-square test and Fisher's exact test were used to compare data between original and second-opinion diagnoses. A p-value of less than 0.05 was considered significant., Results: Of 138 cases, 59 (43%) had an initial diagnosis and a second-opinion diagnosis that were in major disagreement. The most common tumor for which there was a major disagreement was squamous cell carcinoma. No single factor influenced the occurrence of major disagreements., Conclusions: Our evaluation reiterates the importance of obtaining a second opinion from a specialist in oral and maxillofacial pathology to improve the diagnostic accuracy for lesions. A formal system for this step, in addition to the obtaining of adequate clinical and radiographic information about a patient, is mandatory for the review of difficult cases., (© 2023. The Author(s).)

Background: The environmental etiology of non-syndromic orofacial clefts (NSOFCs) is still under research. The aim of this case-control study is to assess COVID-19 associated factors that may be related to the risk of NSOFC in five Arab countries. These factors include COVID-19 infection, COVID-19 symptoms, family member or friends infected with COVID-19, stress, smoking, socioeconomic status and fear of COVID-19., Methods: The study took place in governmental hospitals in five Arab countries from November 2020 to November 2021. Controls are matched in the month of delivery and site of recruitment. A clinical examination was carried out using LASHAL classification. Maternal exposure to medication, illnesses, supplementation, COVID-19 infection during their pregestation and 1st trimester periods were evaluated using a validated questionnaire. Maternal exposure to stress was assessed using the Life Events scale, fear of covid-19 scale, family member or friend affected with covid-19 infection, pregnancy planning and threatened abortion., Results: The study recruited 1135 infants (386 NSOFC and 749 controls). Living in urban areas, maternal exposure to medications 3-months pregestation, maternal exposure to any of the prenatal life events and maternal fear of COVID-19 significantly increased the risk of having a child with NSOFC. On the other hand, mothers exposed to supplementation 3-months pregestation, mothers suspected of having COVID-19 infection, family members or friends testing positive with COVID-19 significantly decreased the risk of having a child with NSOFC., Conclusions: This study suggests that NSOFC may be associated with maternal exposure to lifetime stress and COVID-19 fear in particular, with no direct effect of the COVID-19 infection itself. This highlights the importance of providing psychological support for expecting mothers during stressful events that affect populations such as the COVID-19 pandemic, in addition to the usual antenatal care., (© 2023. The Author(s).)

Background: COVID-19, caused by SARS-CoV-2, has impacted the world in an unprecedented way since December 2019. SARS-CoV-2 was found in the saliva of patients, and entry points for the virus may have been through the numerous angiotensin-converting enzyme 2 receptors in the oral cavity. Oral manifestations of COVID-19 could contribute to the burden of oral disease., Objective: To determine the prevalence of oral manifestations of COVID-19 in patients and their association with disease severity., Methods: Interviews were conducted with adult participants diagnosed with COVID-19 between October 2021 and March 2022 to document their demographic and health status data, symptoms, and the presence of oral manifestations of COVID-19. Chi-square and the Fisher's exact test were used to compare data on the presence or absence of oral manifestations of COVID-19., Results: Of 195 participants interviewed, 33% were 18 to 24 years old, 33% were 25 to 34 years old, and 75% were female. A total of 57 (29%) had oral manifestations; the most common were taste disorders (60%), xerostomia (42%), and oral ulcers (11%). There was no relationship between the severity of COVID-19 and the presence of the oral manifestations., Conclusion: Oral manifestations of COVID-19 were common among female patients and linked to certain general COVID-19 symptoms regarding frequency and extent.

Objectives:  This study sought to present a view of head and neck neoplasms (HNN) prevalence with specific focus on sociodemographic determinants in Al-Madinah Province, Saudi Arabia., Materials and Methods:  This was a hospital-based retrospective study based on retrieval of histopathological data for a period of 6 years between 2012 and 2018. Data was collected from the archives of the Oral and Maxillofacial Pathology Laboratory at King Fahad Hospital (the only referral center for biopsy services) in Al-Madinah City., Statistical Analysis:  An independent t -test and/or nonparametric (Mann-Whitney U test, chi-squared test) tests were used to determine the differences between groups. Statistical significance was set at the p -value < 0.05., Results:  Out of 96 patients, a total of 58 patients had valid biopsy data with preoperative diagnosis. Over three quarters of the cases ( n = 44) were benign with only 24% were malignant. Males were more likely to be diagnosed with a benign tumor than females (54.5 vs. 45.6%, respectively), and malignancy was also more common in males (64.3 vs. 24.1). A significant difference was found in relation to mean age of older patients who were more likely to be diagnosed with malignant tumors ( p = 0.001)., Conclusions:  The findings suggest that most of biopsied HNN cases are benign neoplasms. Age is a significant risk factor for head and neck malignancy in this region. Delays in diagnosis of HNN need to be explored., Competing Interests: None declared., (European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)