Bleaching System and Dentists Awareness of Any Potential Side Effects in Saudi Arabia

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Introduction

Tooth discoloration is known to affect the appearance of the patient’s teeth. One of the most popular treatments for this effect is tooth bleaching by using hydrogen peroxide as the main ingredient. Despite its popularity, many types of research have shown that the increased use of hydrogen peroxide has led to defects such as tooth sensitivity, gingival irritation, and effect on dental hard tissue. It is for this purpose that dental practitioners offering bleaching services to their patients should be fully aware of the potential side- effects of using hydrogen peroxide.

This project aims at assessing the bleaching system and the awareness of dentists of any potential side effects in Saudi Arabia.

Purpose of the project and its academic rationale

Purpose of project

This project aims at exploring the type of bleaching system delivered to patients in Saudi Arabia and assessing the knowledge of the dentists toward the side- effects of hydrogen peroxide. Secondly, this project also aims at drawing attention to the misuse of the bleaching materials, convincing the Ministry of Health to establish safety regulations and to consider the bleaching system as a medical device and not as a cosmetic product.

Academic rationale

The presence of an unsightly discolored tooth may be of great concern to some patients. This concern leads them to seek professional dental advice and treatment if need be. Normally, the aesthetic improvement of a patient’s smile can have a profound effect on his confidence and oral health, and an improvement in oral health can significantly contribute to his total well-being. In this respect, several techniques have been developed to manage discolored tooth, and bleaching happens to be one of these techniques. Unfortunately, bleaching has some side effects such as teeth sensitivity and gingival irritation, and to some extent, dentists are not aware of or ignore these complications.

Data collection methods and measurements

Stratified cluster sampling

The data collection method used in this study will be the stratified cluster sampling procedures. This procedure is most preferred as it ensures that the sample represents the target population, and it increases the precision of the population estimation. The samples will be the dental clinics, and the stratifying variables will be the clinic types (public and private). An updated list of all dental clinics in Saudi Arabia (public and private) will be obtained from the Ministry of health and used as the sampling frame.

Procedures and methods

The small clinics will be excluded from the list obtained from the Ministry of health. In the first stage, clinics in each stratum will be selected by simple random sampling, with an equal number of clinics in each stratum. At the second stage, dentists within the selected clinics will be randomly chosen using a random number table. This will be done in such a way that, each clinic will have a minimum of 5 dentists for each cluster. After the samples have been selected, a copy of ethical approval and letters of introduction explaining the details of the survey will be sent to schools before the day of the survey.

Data collection

Subjects and participants have the option and freedom of withdrawing from the study at any stage. This information which is a requirement of every experiment done with human subjects; is clearly stated in both the information sheet and consent forms sent to the subjects. Data collection shall be through the use of questionnaires developed specifically for this study. The questionnaires are developed in English and will be tested by a visitor dentist at Dundee dental hospital.

The questionnaire includes both open and close-ended questions that dentists will be asked to fill out. The dentists will not be required to write out their names in the questionnaires which will take around three to five minutes to complete. A unique identity number will be given to each dentist to match their names; this will improve the chances of anonymity of the data obtained.

The questionnaires will contain carefully worded questions; appropriate for the social and cultural context in which it is being given. The questionnaires will not contain any offensive language and embarrassing or sensitive issues. The use of identification numbers will be employed instead of names to improve the anonymity of the data. These identity numbers will be validated before they are used during the exercise. At the end of the exercise, the researchers will review and check the questionnaire for completeness and accuracy of recording.

Statement of ethical consideration

Before the implementation of this study, ethical approval on human research will be obtained from the Ethical Committee in the University of Dundee. In addition, approval from the Saudi medical Authority to visit clinics will also be obtained. These approvals are obtained to ensure that this survey will conform to ethical principles. Additionally, consent from subjects will be obtained before the data collection exercise, and the participants are free to withdraw at any time without giving any reason.

Conclusion

The information obtained from this research will improve dental health in Saudi Arabia through the awareness it will create about the side effect of using hydrogen peroxide as a discoloring agent. This will help to get rid of infections like teeth sensitivity and gingival irritation; which are side effects of using hydrogen peroxide and help place restrictions on the use of this agent as a cosmetic.

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