Evidence map›Paper›PMID 41313948›Full record

ArticleInternational dental journal2026

Enamel Defects Among Orphanage Children: A Multi-Country Case-Control Study.

Heba Jafar Sabbagh, Mohammed Jamal Barry, Ola B Al-Batayneh, Yazeed Thamer Alshobaili, Sarah Lutf Sennain, Nuraldeen Maher Al-Khanati, Basma Mahmoud Nagi, Sarah Al-Rai, Nouran Nabil, Randa Yassin and 15 more

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Article in International dental journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

25 authors.

Heba Jafar SabbaghPediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: hsabbagh@kau.edu.sa.
Mohammed Jamal BarryPediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Ministry of Health, Al Madinah, Saudi Arabia.
Ola B Al-BataynehDepartment of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates; Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
Yazeed Thamer AlshobailiPediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia.
Sarah Lutf SennainDepartment of Conservative, Preventive Dentistry and Orthodontics, Saba University, Sana'a, Yemen.
Nuraldeen Maher Al-KhanatiDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria.
Basma Mahmoud NagiPediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Sarah Al-RaiDepartment of Conservative, Preventive Dentistry and Orthodontics, Saba University, Sana'a, Yemen.
Nouran NabilFaculty of Dentistry, Alexandria University, Alexandria, Egypt.
Randa YassinFaculty of Dentistry, Alexandria University, Alexandria, Egypt.
Maryam QuritumDepartment of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Azarita, Alexandria, Egypt.
Nada Atef Ahmed AboushadyPediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Muhammad HassanRehman College of Dentistry, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Siddiq YousufiKhyber College of Dentistry, Khyber Medical University Campus, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Nagwa Mohamed Ali KhattabPediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Yousef S KhaderDepartment of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Shahd AbushgairMinistry of Health, Amman, Jordan.
Dunia TahaDepartment of Pediatric Dentistry, Faculty of Dental Medicine, Damascus University, Damascus, Syria.
Ghina ArnabehFaculty of Dentistry, Syrian Private University, Damascus, Syria.
Iman ElareibiPediatric Dentistry Department, Faculty of Dentistry, University of Benghazi, Benghazi, Libya.
Sarah FakronPediatric Dentistry Department, Faculty of Dentistry, University of Benghazi, Benghazi, Libya.
Alaa Saleh Al JameelDental Department, Al Yamamah Hospital, Ministry of Health, Riyadh, Saudi Arabia.
Sara M BagherPediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Heba M ElkhodaryDepartment of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt.
Rana A AlamoudiPediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION AND

aimsEnamel defect, molar incisor hypomineralisation (MIH) and hypominiralised second primary molars (HSPM) are linked to increased treatment complexity. Early-life stress is a risk factor, though difficult to measure because of reliance on subjective recall. Orphaned children, often exposed to chronic stress and deprived of parental care, represent a vulnerable population. Accordingly, this case-control study aims to compare the prevalence of enamel defects and MIH/HSPM among children living in orphanages with the same in children living with both parents across 6 countries.

methodsA matched case-control study was conducted across 6 countries (Saudi Arabia, Egypt, Yemen, Syria, Jordan and Pakistan) from December 2023 to December 2024. Dental examinations for children living in orphanages and living with both parents were performed using WHO and EAPD diagnostic criteria. Caregivers were interviewed using a questionnaire on child's demographic data and medical history.

resultsA total of 1,838 children aged 7-10 years were included: 539 orphans and 1,299 controls living with both parents. Orphaned children had a significantly higher prevalence of enamel defects and MIH in first permanent molars (39.9% and 29.1%) compared to controls (29.8% and 22.3%) (P < .001). HSPM prevalence was also higher among orphans (15.4% versus 7.9%). However, no significant difference was found in MIH affecting incisors. The results showed a chronological pattern: earlier-developing teeth were more affected.

conclusionLiving in an orphanage is associated with a higher risk of MIH and enamel defects, particularly in early-forming teeth. These findings support a possible role for early-life stress in enamel development. Preventive programs and early screening are recommended for at-risk populations.

Indexed as

Child, OrphanedDental Enamel HypoplasiaCase-Control StudiesChildDental EnamelEgyptFemaleHumansJordanMaleOrphanagesPakistanPrevalenceRisk FactorsSaudi ArabiaSyriaHypomineralised second primary molars (HSPM)Living environmentLiving statusMolar-Incisor Hypomineralisation (MIH)OrphanageRisk factorsStress

Identifiers

PMID41313948
PMCPMC12702328

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.