Comparative Assessment of Oral Health Attitudes and Behaviors of First-Time and Previous Dental Patients Undergoing Exodontia Treatment During the COVID-19 Pandemic in Private Dental Clinics in Riyadh City, Saudi Arabia

Figures & data

Table 1 HU-DBI Questionnaire Items with Agree/Disagree Responses

HU-DBI Items	Correct Responses
1. I do not worry much about visiting the dentist
2. My gums tend to bleed when I brush my teeth	Disagree^a
3. I worry about the color of my teeth
4. I have noticed some white sticky deposits on my teeth	Agree^a
5. I use a child-sized toothbrush
6. I think that I cannot help having false teeth when I am old	Disagree^a
7. I bothered by the color of my gums
8. I think my teeth are getting worse despite my daily brushing	Disagree^a
9. I brush each of my teeth carefully	Agree^a
10. I have never been taught professionally how to brush	Disagree^a
11. I think I can clean my teeth well without using toothpaste	Agree^a
12. I often check my teeth in a mirror after brushing	Agree^a
13. I worry about having bad breath
14. It is impossible to prevent gum disease with brushing alone	Disagree^a
15. I put off going to the dentist until I have toothache	Disagree^a
16. I have used a dye to see how clean my teeth are	Agree^a
17. I use a toothbrush with hard bristles
18. I do not feel I have brushed well unless I brush with strong strokes
19. I feel I sometimes take too much time to brush my teeth	Agree^a
20. I have had my dentist tell me that I brush very well

Note: ^aCorrect responses scored 1.

Table 2 Relation Between Patient’s Characteristics and Dental Extraction Visiting Pattern

Variables		First-Time Attendees		Previous Attendees		Total		p
		n	%	n	%	n	%
Gender	Male	115	63.5	193	64.5	308	64.2	0.823
	Female	66	36.5	106	35.5	172	35.8
Education	Primary education	35	19.3	72	24.1	107	22.2	<0.001
	Intermediate	82	45.3	21	7.0	103	21.5
	Secondary	27	14.9	105	35.1	132	27.5
	College	37	20.4	101	33.8	138	28.8
Income (SAR)	<5000	101	55.8	112	37.5	213	44.4	<0.001
	5001–10,000	49	27.1	134	44.8	183	38.1
	10,000–15,000	31	17.1	53	17.7	84	17.5
Occupation	Government	90	49.7	56	18.7	146	30.4	<0.001
	Private	66	36.5	202	67.6	268	55.8
	Unemployed/student/homemaker	25	13.8	41	13.7	66	13.8
Reason for tooth extraction	Dental caries and its sequelae	56	30.9	203	67.9	259	54.0	<0.001
	Periodontal disease	51	28.2	96	32.1	147	30.6
	Other reason	74	40.9	0	0.0	74	15.4
Number of Extractions	Single extraction	137	75.7	228	76.3	365	76.0	0.889
	Multiple extractions	44	24.3	71	23.7	115	24.0

Abbreviation: SAR, Saudi Arabian Riyals.

Figure 1 Distribution of the study participant’s “agree” responses to the HUDBI items.

Table 3 HUDBI Items and Extraction Attendance Patterns of Patients

HUDBI Items	First-Time Attendees				Previous Attendees				p
	Agree		Disagree		Agree		Disagree
	n	%	n	%	n	%	n	%
1. I do not worry much about visiting the dentist	10	5.5	171	94.5	0	0	299	100	–
2. My gums tend to bleed when I brush my teeth^b	18	9.9	163	90.1	8	2.7	291	97.3	0.001
3. I worry about the color of my teeth	181	100	0	0	299	100	0	0	–
4. I have noticed some white sticky deposits on my teeth^a	148	81.8	33	18.2	237	79.3	62	20.7	0.505
5. I use a child-sized toothbrush	0	0	181	100	0	0	299	100	–
6. I think that I cannot help having false teeth when I am old^b	50	27.6	131	72.4	164	54.8	135	45.2	<0.001
7. I bothered by the color of my gums	171	94.5	10	5.5	299	100	0	0	–
8. I think my teeth are getting worse despite my daily brushing^b	140	77.3	41	22.7	147	49.2	152	50.8	<0.001
9. I brush each of my teeth carefully^a	13	7.2	168	92.8	5	1.7	294	98.3	0.002
10. I have never been taught professionally how to brush^b	79	43.6	102	56.4	24	8	275	92	<0.001
11. I think I can clean my teeth well without using toothpaste^a	54	29.8	127	70.2	171	57.2	128	42.8	<0.001
12. I often check my teeth in a mirror after brushing^a	83	45.9	98	54.1	260	87	39	13	<0.001
13. I worry about having bad breath	181	100	0	0	299	100	0	0	–
14. It is impossible to prevent gum disease with brushing alone^b	140	77.3	41	22.7	234	78.3	65	21.7	0.815
15. I put off going to the dentist until I have toothache^b	107	59.1	74	40.9	125	41.8	174	58.2	<0.001
16. I have used a dye to see how clean my teeth are^a	77	42.5	104	57.5	10	3.3	289	96.7	<0.001
17. I use a toothbrush with hard bristles	181	100	0	0	299	100	0	0	–
18. I do not feel I have brushed well unless I brush with strong strokes	181	100	0	0	299	100	0	0	–
19. I feel I sometimes take too much time to brush my teeth^a	138	76.2	43	23.8	207	69.2	92	30.8	0.098
20. I have had my dentist tell me that I brush very well	181	100	0	0	299	100	0	0	–

Notes: ^aAgree; ^bDisagree.

Table 4 Comparison of Mean HUDBI Score in Different Groups

Variables		Mean	SD	Mean Ranks	Median	Range	p
Gender	Male	6.30	1.22	234.51	7.00	3.00	0.241
	Female	6.42	0.98	249.03	7.00	4.00
Education	Primary	5.61	0.79	153.92^c	6.00	3.00	<0.001
	Intermediate	5.82	0.97	176.22^c	5.00	3.00
	Secondary	6.59	1.00	267.83^b	7.00	3.00
	College	6.87	1.12	303.33^a	7.00	3.00
Income (SAR)	<5000	6.00	0.92	198.50^b	6.00	4.00	<0.001
	5001–10,000	6.62	1.19	273.59^a	7.00	3.00
	10,000–15,000	6.63	1.24	274.90^a	7.00	3.00
Residence	Rural	5.84	0.93	180.08	6.00	4.00	<0.001
	Urban	6.78	1.10	292.06	7.00	3.00
Occupation	Government	5.62	0.96	155.70^a	5.00	4.00	<0.001
	Private	6.75	1.10	288.21^b	7.00	3.00
	Unemployed/student/homemaker	6.32	0.75	234.36^c	6.00	3.00
Reason for tooth extraction	Dental caries and its sequelae	6.78	1.10	292.06^a	7.00	3.00	<0.001
	Periodontal disease	6.20	0.93	222.87^b	6.00	4.00
	Others	5.14	0.34	95.07^c	5.00	1.00
Number of Extractions	Single tooth extraction	6.40	1.18	246.74	7.00	4.00	0.068
	Multiple teeth extractions	6.18	0.92	220.70	6.00	4.00
Extraction attendance	First-time attendees	5.88	1.03	185.20	6.00	4.00	<0.001
	Previous attendees	6.63	1.09	273.97	7.00	4.00

Notes: ^abc Within each column variable, mean ranks with different alphabetical superscript differ significantly at p<0.05 and similar alphabetical superscript indicates no significant difference.

Abbreviations: SD, Standard Deviation; SAR, Saudi Arabian Riyals.

Figure 2 Comparison of mean HUDBI score across the extraction related variables indicating *potential outlier position and probable outlier position.