Cross-Sectional Study of Paediatric Preventive Care in Saudi Arabia

The high prevalence of dental caries is recognised as a public health challenge in Saudi Arabia. The shift from treatment-based approaches to prevention is one of the objectives to control caries prevalence. Two evidence-based methods to prevent caries are applying fluoride varnish (FV) and fissure sealants (FS). However, data on practices related to their application is limited. Therefore, this study aims to: (1) assess the extent to which General Dental Practitioners (GDPs) in primary healthcare centres in Saudi Arabia provide FV and FS for children aged 14 years and younger; and (2) identify overall preventive measures they deliver in practice.

A multicentre, prospective, descriptive cross-sectional study was conducted in Jazan province, Saudi Arabia, April to August 2024. Direct clinical observation allowed quantification of GDPs' application of FV and FS in routine clinical care for children aged 14 years and younger. This was compared against current evidence-based practice guidelines.

Thirty-five GDPs were observed treating 643 children. Although 98% of children met eligibility criteria to receive FV, only 4% received it. Similarly, 74% were eligible for FS, and only 2% received one or more sealants. Caries prevention advice was provided in 80% of consultations, and the most frequently delivered preventive measure was toothbrushing instruction.

Despite high levels of eligibility according to recommendations, there were low delivery rates of FV and FS by GDPs, for children in primary healthcare centres in Saudi Arabia, highlighting the gap between evidence-based guidelines and clinical practice.

The finding of this study indicates that the adoption of international guideline recommendations on the use of FV and FS in Saudi Arabia has been insufficient to optimise the delivery of these preventive interventions. This highlights the need for further research to understand the behaviour determinants that influence GDPs in delivering them. Review retrospectively registered: Open Science Framework https://doi.org/10.17605/OSF.IO/2XS6G.