A qualitative analysis of Arabic language websites about extraction of third molars

Abstract

Aim

The study aimed to evaluate the quality and readability of Arabic-language web-based online information regarding surgical third molar extraction.

Methods

In this observational web-based analytical study, the top 150 Arabic search results for surgical wisdom tooth extraction were collected from Google, Yahoo, and Bing. The quality of the websites was evaluated using the DISCERN tool and the Journal of American Medical Association (JAMA) guidelines for online content analysis. Readability was measured using the Flesch-Reading Ease (FRE) scale, the Flesch-Kincaid Grade Level (FKGL) scale, and the Simplified- Measure of Gobbledygook (SMOG).

Results

A total of 450 websites related to the extraction of wisdom teeth were initially identified. 146 websites were included in the final analysis after exclusion according to specific exclusion criteria. Significant difference was observed in the domain of treatment alternatives and the quality of information provided, according to the DISCERN criteria. The median scores for reliability-related questions ranged from 1.5 to 4.5. The overall quality rating had a median score of 2.5 (IQR = 0.5). There were significant differences in the number of achieved JAMA items per webpage between the groups (P-value = 0.000). However, there was no significant difference in the DISCERN quality evaluations between the affiliations (P-value = 0.450).

Conclusion

the study results indicating a broad spectrum in the explicitness and relevance of information with moderate quality across the evaluated websites and the investigation revealed significant variations in the content quality and readability provided by websites belonging to various affiliations, with non-profit websites generally achieving higher scores in JAMA criteria and readability measures.

Keywords

Web-based knowledge wisdom tooth extraction impacted teeth

Introduction

The use of web-based information as a source of medical information related to oral health and dental procedures increased nowadays.¹ Additionally, dental patients search for relevant dental information online even before taking a consultation with the dentist.¹ Patients who require third molar extraction are more likely to consider collecting adequate information about the procedure.^2,3 Web-based information about third molar extraction surgery varies in quality and accuracy, potentially misleading patients.⁴ Therefore, it is crucial to have access to high-quality, evidence-based online medical information in order to better understand patients’ expectations for surgery and their decision-making process.

Although a study was conducted on the quality and readability of internet-related information about third molars, the reviewed websites were limited to those in the English language only.^5,6 Furthermore, other recent studies have evaluated the web-based health information to evaluate Arabic information's readability and quality on various dental procedures such as dental implants, periodontal diseases and denture hygiene however there is still need for Arabic web-based health information sites.^7–11

The third molar, frequently referred to as the wisdom tooth, is the last permanent tooth to erupt in the dental arch distal to the second molar. It is one of the most commonly impacted teeth, with a prevalence of 58.3% in Saudi Arabia, and no significant gender predilection.^12–16 Extraction of third molar is indicated for several causes such as pain, pericoronitis, infection or swelling, associated pathology however Impacted third molar extraction could be associated with post-operative complications as any other surgical procedures such as excessive hemorrhage, delayed healing, infection, trismus, damaging the near anatomical structures as teeth, nerves, oroantral communication, maxillary tuberosity fracture or even mandibular fracture.^17–19 One of the most common post-operative complications in lower wisdoms is alveolar osteitis with frequency reaches 26%.^18–21

Currently, patients of the Generation Z, and Millennials generations depend on internet sources for every daily information they need.^22,23 And so, the information should be introduced to them in very accurate and readable rapid ways. However surgical extraction Arabic information about impacted wisdom removal on the internet is unregulated and can lead to patients being misinformed or having unrealistic expectations and so there is doubt about the quality and readability of this information. Therefore, the current study aimed to assess the level of quality and readability of Arabic-language web content related to the surgical extraction of the impacted third molars.

Materials and method

Study design

In this infodemiologic, web-based analysis study, we use Arabic keywords to search for relevant websites on popular search engines, including Yahoo (http://www.yahoo.com), Google (http://www.google.com), and Bing (http://www.bing.com). To maintain the objectivity of the results, searches were conducted in incognito mode, and browser cookies and history were cleared before each search session. The search items “extraction of third molar” were translated into Arabic for the searches.

Inclusion and exclusion criteria

In order to be as comprehensive and thorough as possible, we included the top 150 websites from each search engine in our survey. Advanced search options were not used; instead, the default search parameters were maintained. Excluded websites included those that did not provide Arabic content, had only brief coverage of “extraction of third molar (EOTM),” consisted of pure audio or visual material, were scientific papers, contained banner ads, were discussion forums or sponsored links, had restricted access, or lacked any information about EOTM. The remaining websites were included and classified based on their affiliations (non-profit organization, commercial, or university/medical Centers), their specialization (whether partially or entirely related to EOTM), the type of content they provided (medical facts, question sections, clinical trials, answers, and human stories, and how the content was presented (through images, audio, or videos) (Table 1).

Table 1.

Affiliation and content type and presentation of the included websites (n = 146).

Category	Criteria	Frequency	Percentage
Affiliation	Commercial	29	19.9
	Non-profit organization	62	42.5
	University/medical center	55	37.7
Specialization	Exclusively related	0	0
Specialization	Partly related	146	100.0
Content type	Medical facts	136	93.2
	Clinical trials	0	0
	Human interest stories	8	5.5
	Question and answer	78	53.4
Content presentation	Image	99	67.8
	Video	20	13.7
	Audio	0	0

Quality assessment

The quality of the websites was evaluated using the Journal of American Medical Association (JAMA) guidelines for website analysis,²⁴ and the DISCERN assessment tool.²⁵

The DISCERN questionnaire provided a trustworthy way to assess the level of written data about potential treatments for a given medical condition. There are a total of 16 questions in the survey, which are separated into three categories. The first segment, which consists of questions 1 through 8, focuses on evaluating the publication's credibility in order to decide if it can be trusted as a reliable information source about a specific management. The second section discusses treatment options, range from 9 to 15. The final question (question 16) represents the total quality score. Each question is rated on a five-point Likert scale, with 1 indicating low quality and 5 indicating high quality. An experienced oral surgeon reviewed the websites to ensure consistency in the DISCERN ratings. Scores range from 16 to 80, with 80 being the highest. Results were categorized into low (16–32), moderate (33–64), and high (>65) scores.

The JAMA benchmarks consist of four criteria: authorship (clearly identifying the authors of the website along with their affiliations), disclosure (ownership and disclosure of any conflicts of interest), attribution (sources of the medical content, including references), and currency (clearly indicating the date of publication or update).

Readability assessment

Readability was evaluated using the Flesch-Reading Ease (FRE) scale, the Flesch-Kincaid Grade Level (FKGL) scale, and the Simplified Measure of Gobbledygook (SMOG). These are the tests that are relevant for Arabic notwithstanding the existence of additional readability tests. FKGL ranged from 0 to 18, where 18 representing the most challenging text to read. The more points a text receives on SMOG, the greater difficulty in understanding. The FRE score ranges from 0 to 100, with higher scores indicating simpler language. For all readability assessments, the automated formulas were accessed via the website www.readabilityformulas.com. Based on several studies conducted in Arabic, the acceptable levels were set at an FRE score of 80 or above and FKGL and SMOG scores below 7.^7–10

Data analysis

The statistical analysis was performed using IBM SPSS, version 25. The results were presented in tables, including the median value with interquartile range (IQR), as well as the maximum and minimum values for quantitative variables, since the data were not normally distributed according to the Kolmogorov-Smirnov test. For qualitative variables, frequencies and percentages were calculated. The Chi-square test was used to compare qualitative variables, while the Kruskal-Wallis test was employed to compare the medians of quantitative data. A p-value of less than 0.05 was considered statistically significant for all comparison tests.

Results

Search strategy and website inclusion

A total of 450 websites related to the extraction of wisdom teeth were initially identified. After screening, 85 websites were excluded due to advertisements, 33 were not related to the topic, 19 required indirect access, 31 were purely videos, and 63 were from social media platforms. This left 219 websites for further analysis, including duplicates. Upon removing 73 duplicate websites, 146 unique websites were included in the final analysis (Fig.1).

Figure 1.

Diagram showing the search strategy flow.

Website categorization and quality assessment

The assessment of 146 websites related to wisdom teeth extraction using the DISCERN criteria revealed significant variation in the quality of online Arabic information provided. The median scores for reliability-related questions ranged from 1.5 to 4.5, indicating a broad spectrum in the explicitness and relevance of information. The highest median score was observed for Q3 (Relevance) with a median of 4.5 (IQR = 0.5), while the lowest median score was for Q7 (Additional sources) at 1.5 (IQR = 1.5).

In the domain of treatment options, the scores varied widely as well, with median scores ranging from 1 to 3. The highest median score in this category was for Q11 (Risk of treatment) with a median of 3 (IQR = 2), and the lowest median scores were observed for Q14 (All alternatives described) and Q15 (Shared decision), both with a median of 1 (IQR = 0.5).

The overall quality rating (Q16) had a median score of 2.5 (IQR = 0.5), indicating moderate quality across the evaluated websites (Table 2).

Table 2.

DISCERN evaluation for the included websites (n = 146).

Domain	DISCERN question	Median	(IQR)	Maximum	Minimum
Reliability	Q1. Explicit aims	3.5	1	5	1
	Q2. Aims achieved	3.5	1	5	1
	Q3. Relevance	4.5	0.5	5	2
	Q4. Explicit sources	2	2	5	1
	Q5. Explicit date	2	1.5	4.5	1
	Q6. Balanced and unbiased	4	1.5	5	1
	Q7. Additional sources	1.5	1.5	4.5	1
	Q8. Areas of uncertainty	2.5	1	4	1
Treatment options	Q9. How treatment works	2	2.1	5	1
	Q10. Benefits of treatment	2	1	4.5	1
	Q11. Risk of treatment	3	2	5	1
	Q12. Effects of no treatment	1.5	1	5	1
	Q13. Effects on quality of life	2	1	4	1
	Q14. All alternatives described	1	0.5	4	1
	Q15. Shared decision	1	0.5	3.5	1
Overall rating	Q16. Overall quality rating	2.5	0.5	4	2

Quality and readability by affiliation

The analysis of websites based on various affiliations: (Non-profit, Commercial and University/Medical Centers) revealed significant variability in the achievement of JAMA items and readability. Regarding the number of fulfilled JAMA items per website, there were significant differences among the groups (P-value = 0.000). Specifically, 2 commercial, 3 non-profit, and 19 university/medical center websites did not achieve any JAMA items. Conversely, only non-profit websites achieved all four JAMA items, with 8 websites in this category.

For individual JAMA criteria, significant differences were also noted (P-value = 0.000* for each criterion). Authorship was reported by 22 commercial, 53 non-profit, and 9 university/medical center websites. Attribution was noted in 7 commercial, 38 non-profit, and 5 university/medical center websites. Currency was the most frequently reported item, present in 26 commercial, 56 non-profit, and 29 university/medical center websites. Disclosure was the least reported, with only 1 commercial and 18 non-profit websites including it.

The DISCERN quality ratings showed no significant difference across the affiliations (P-value = 0.450), with most websites falling into the medium quality category (27 commercial, 58 non-profit, and 48 university/medical center). Thirteen websites were rated as low quality, and no websites achieved a high-quality rating.

Regarding readability, significant differences were observed in the FRES scores (P-value = 0.043*), with 26 commercial, 62 non-profit, and 50 university/medical center websites deemed readable. Eight websites were classified as difficult to read based on FRES. The FKGL scores did not show significant differences across affiliations (P-value = 0.201), with 13 commercial, 40 non-profit, and 33 university/medical center websites classified as readable, while 60 websites were deemed difficult (Table 3). Overall, the analysis highlighted significant variances in the quality and readability of online Arabic information provided by websites from various affiliations, with non-profit websites generally achieving higher scores in JAMA criteria and readability measures.

Table 3.

Quality and readability of the included websites based on their affiliation, reported as frequency and percentage (n = 146).

Variable	Variable type	Commercial (n = 29)	Non-profit organization (n = 62)	University/Medical Center (n = 55)	Total	P-value
Number of achieved JAMA items per website	None	2	3	19	24	0.000*
	One	4	2	30	36
	Two	17	16	5	38
	Three	6	33	1	40
	Four	0	8	0	8
JAMA items	Authorship	22	53	9	84	0.000*
	Attribution	7	38	5	50	0.000*
	Currency	26	56	29	111	0.000*
	Disclosure	1	18	0	19	0.000*
DISCERN	Low	2	4	7	13	0.450
	Medium	27	58	48	133
	High	0	0	0	0
FRES	Readable	26	62	50	138	0.043*
FRES	Difficult	3	0	5	8	0.043*
FKGL	Readable	13	40	33	86	0.201
FKGL	Difficult	16	22	22	60	0.201

* Significant at level 0.05 or less

The analysis of DISCERN and readability metrics across websites from different affiliations—Commercial, Non-profit, and University/Medical Center—revealed significant differences in several categories. For the overall DISCERN score, non-profit websites had the highest median score of 42.0 (IQR = 7.1), compared to 37.5 (IQR = 8.0) for commercial and 37.0 (IQR = 7.0) for university websites, with a significant P-value of 0.000*. In terms of reliability, non-profit websites also scored the highest with a median of 23.25 (IQR = 5.6), followed by commercial at 20.5 (IQR = 5.8) and university at 19.5 (IQR = 3.5), again showing a significant difference (P-value = 0.000*). For treatment information, non-profit websites had a median score of 16.0 (IQR = 5.1), higher than university websites at 15.5 (IQR = 4.0) and commercial websites at 14.5 (IQR = 2.3), with a P-value of 0.039**.

In terms of readability, the FRES scores showed non-profit websites as the most readable with a median of 98.04 (IQR = 0.97), followed closely by university websites at 97.80 (IQR = 2.17) and commercial websites at 97.80 (IQR = 4.6), with a significant P-value of 0.041**. The FKGL scores indicated no significant difference (P-value = 0.187) among the websites, with commercial websites having a median of 7.95 (IQR = 6.74), non-profit at 5.16 (IQR = 4.51), and university at 5.45 (IQR = 6.04). The SMOG scores also showed no significant difference (P-value = 0.821), with medians of 2.58 (IQR = 2.18) for commercial, 2.36 (IQR = 2.00) for non-profit, and 2.89 (IQR = 2.18) for university websites (Table 4).

Table 4.

Comparison between median with interquartile range (IQR) according to websites’ affiliation (n = 146).

Variable	Variable Type	Commercial (Median, IQR)	Non-profit (Median, IQR)	University (Median, IQR)	P-value
DISCERN	Overall	37.5 (8.0)	42.0 (7.1)	37.0 (7.0)	0.000*
	Reliability	20.5 (5.8)	23.25 (5.6)	19.5 (3.5)	0.000*
	Treatment	14.5 (2.3)	16.0 (5.1)	15.5 (4.0)	0.039*
Readability	FRES	97.80 (4.6)	98.04 (0.97)	97.80 (2.17)	0.041*
	FKGL	7.95 (6.74)	5.16 (4.51)	5.45 (6.04)	0.187
	SMOG	2.58 (2.18)	2.36 (2.00)	2.89 (2.18)	0.821
	Words	586.5 (537.5)	721.75 (491.0)	769.5 (441.5)	0.069
	Sentences	23.5 (20.8)	30.25 (24.5)	35.0 (27.5)	0.005*

* Significant at the level of 0.05 or less

Regarding content length, measured by the number of words, non-profit websites had a median of 721.75 (IQR = 491.0), university websites had 769.5 (IQR = 441.5), and commercial websites had 586.5 (IQR = 537.5), with a P-value of 0.069, indicating no significant difference. However, the number of sentences showed a significant difference (P-value = 0.005**), with university websites having the highest median at 35.0 (IQR = 27.5), followed by non-profit at 30.25 (IQR = 24.5) and commercial at 23.5 (IQR = 20.8). These results highlight significant differences in the quality and readability of information across different website affiliations.

Discussion

The present study aimed to evaluate Arabic information content about impacted third molar surgical extraction. The website categorization and quality assessment of the present study highlight that while some websites offer relevant and balanced information, there are notable gaps in providing defined sources and comprehensive treatment options, including the discussion of conservative alternatives and shared decision-making. The highest median score for relevance (Q3) reflects the websites’ ability to address the topic, whereas the lowest scores in providing additional sources and describing all treatment alternatives indicate areas needing improvement. Overall, the investigation revealed significant variations in the content quality and readability provided by websites belonging to various affiliations, with non-profit websites generally achieving higher scores in JAMA criteria and readability measures.

Arabic is the Holy language of Quran and Islam and is an official language in 25 countries: Saudi Arabia, Egypt, Qatar, Tunisia, Sudan, Bahrain, Comoros, Algeria, Eritrea, Chad, Iraq, Djibouti, Kuwait, Libya, Jordan, Mauritania, Oman, Lebanon, Palestine, Somalia, Syria, Tanzania, United Arab Emirates, Morocco and Yemen and recognized as a national minority language in another six states: Iran, Turkey, Cyprus, Senegal, Niger and Mali.²⁶ In addition Arabic is a macrolanguage with more than 30 different varieties and Arabic migrants’ speakers scattered across the globe and so they are estimated that there are about 1.7 billion Arabic Muslims and non-Muslims speakers in the whole world, making it the fifth spoken language in the world.^27,28 Researchers on Arabic websites highlight a critical need for improvement in the quality of oral and dental health online information to support informed decision-making among Arabic-speaking patients, emphasizing the importance of creating more reliable and comprehensive resources. Nowadays the online information about surgical extraction of impacted wisdom teeth is very important of for patients specially patients without prior extraction experience who are worry about wisdom teeth surgery because of significant fear and increased pre-operative anxiety levels about pain, pre-surgery medications, anesthesia techniques, time off work, ability to eat, and loss of self-esteem.^29,30

Recent research has assessed the readability and quality of Arabic-language oral health information found on the internet including assessments of websites on various dental health problems as apicoectomy,¹¹ root canal treatment³¹ dental caries³² and periodontal disease⁸ and these studies consistently reported insufficient evidence-based information across various dental topics in Arabic language and despite most sites having readable content their quality was generally moderate to low.

Similar concerns were raised about English-language information on wisdom tooth extraction and is not unique to Arabic content. M. O'Donnell et al., 2001 found the quality of English materials and patient information about third molar extraction did not reflect current research evidence.²⁹ However, Ciara et al. (2022) state that the Arabic-language internet resources regarding third molar pain and extraction are of a fair quality, and clinicians should use quality assessment tools when developing online content.⁴ On the other hand earlier in 2015 Hanna found the quality of online information about third molar extraction is below the required level, with less than 25% of websites having high scientific information quality which indicates more need to create more reliable websites explaining surgical wisdom extraction.⁵

In the present study we used the most common quality assessment tools included DISCERN, and JAMA benchmarks, with readability measured using metrics of FRES and SMOG as used by other researchers.³³ While readability was generally good, the overall quality of information was found to be low to moderate, highlighting a significant gap in reliable online resources for Arabic-speaking patients.^31,32 These findings underscore the need for improved quality and accuracy in web-based dental health information to support informed decision-making among patients and improve their surgical experiences.

Additionally, the present study focused on three different most popular websites which gave reliability to the study outcomes other than studies which used only one websites,¹¹ but there is till now 2024 moderate accuracy of the most readable websites and low readability of academic university web sites. The present study outcomes could be explained by the fact that University websites face unique challenges compared to nonprofit sites. Academic websites differ significantly from commercial sites in their objectives and target audience, focusing on educational development. Universities have been criticized for not understanding patient needs and having poor website architecture. However, implementing certain web-based technologies, such as online donation capabilities and secure login access, has been associated with higher reported revenue for nonprofits organizations which primarily use their websites for information distribution and two-way communication.³⁴

Conclusion

The study results indicating a broad spectrum in the explicitness and relevance of information with moderate quality across the evaluated websites. The analysis highlighted significant differences in the quality and readability of information provided by websites from different affiliations, with non-profit websites generally achieving higher scores in JAMA criteria and readability measures.

Study limitations

The present study has several limitations that should be acknowledged. Firstly, the evaluation was based on static content at a specific point in time, and websites are subject to frequent updates, which could lead to changes in their quality and readability. Another limitation is the subjective nature of some quality assessment tools, such as DISCERN and JAMA benchmarks, which, while standardized, still require evaluator judgment. Furthermore, this study did not assess multimedia elements, such as videos or interactive features, which are increasingly important in patient education.

Recommendations

- Future studies comparing multiple languages web-based information of surgical extraction of impacted wisdoms is recommended in future studies.

- University websites should be improved and socialized more than nonprofit organizations since academic websites would contain more trustworthy, cited, updated material.

Supplemental Material

sj-xlsx-1-dhj-10.1177_20552076251321053 - Supplemental material for A qualitative analysis of Arabic language websites about extraction of third molars

Supplemental material, sj-xlsx-1-dhj-10.1177_20552076251321053 for A qualitative analysis of Arabic language websites about extraction of third molars by Muath Saad Alassaf, Mohannad Mohammed Abu Aof, Osama Ayidh Alharbi, Abdulrahman Turkustani, Moataz Ibrahim Karbouji, Nebras Althagafi, Ahmed Mohammed Almghamsi, Ghayda Yousof Zolaly and Shadia Elsayed in DIGITAL HEALTH

Footnotes

Availability of data and materials

The datasets used and analyzed in this study are available from the corresponding author upon reasonable request.

Consent statement

This manuscript does not involve any research conducted on human participants or animals. As such, no ethical approval or informed consent was required.

Contributorship

MSA conceived and designed the analysis and was a major contributor in writing the manuscript. MMA co-collected the data, contributed to data analysis and interpretation, and assisted in writing the manuscript. OAA contributed to the methodology and was involved in the review and editing of the manuscript. AT assisted in data collection and contributed to the analysis and interpretation of data. MIK participated in the design of the study and was involved in the critical revision of the manuscript for important intellectual content. NA contributed to the conception of the study and assisted in drafting the manuscript and revising it critically for important intellectual content. AMA contributed to the data collection and analysis. GYZ assisted with data interpretation and participated in drafting the manuscript. SE contributed to the final review, critical revision and editing of the manuscript. All authors read and approved the final manuscript.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

This type of study does not require ethical approval as it uses generally public online data.

Funding

The authors did not receive any financial support for the research, authorship or publication of this article.

ORCID iD

Muath Saad Alassaf

Supplemental material

Supplemental material for this article is available online.

Guarantor

MSA

References

Luo

Song

, et al. Patients’ attitudes towards online dental information and a web-based virtual reality program for clinical dentistry: a pilot investigation in China. Int J Med Inf 2009; 78: 208–215.

Muirhead

Marcenes

Wright

. Do health provider-patient relationships matter? Exploring dentist-patient relationships and oral health-related quality of life in older people. Age Ageing 2014; 43: 399–405.

Alsahafi

Alolayan

Alraddadi

, et al. The impact of the method of presenting instructions of postoperative care on the quality of life after simple tooth extraction. Saudi J Oral Sci 2021; 8: 143–149.

Mulvihill

O’Donoghue

Pierse

. Quality Assessment and Review of Online Information relating to Third Molar Pain and Removal. J Ir Dent Assoc 2022; 68.

Hanna

Brennan

Sambrook

, et al. Third molars on the internet: a guide for assessing information quality and readability. Interact J Med Res 2015; 4: 19.

Alassaf

Hammudah

Almuzaini

, et al.

Is online patient-centered information about implant bone graft valid?

Cureus 2023; 15: e46263.

Alkhateeb

Alhadidi

. Information about epilepsy on the internet: an exploratory study of arabic websites. Epilepsy Behav 2018; 78: 288–290.

Al-Ak'hali

Fageeh

Halboub

, et al. Quality and readability of web-based Arabic health information on periodontal disease. BMC Med Inform Decis Mak 2021; 21: 41.

Halboub

Al-Ak'hali

Alqahtani

, et al. Quality of web-based Arabic health information on dental implants: an infodemiological study. BMC Oral Health 2023; 23: 32.

10.

Alsulaimani

Alassaf

Hamadallah

, et al. Assessment of Arabic web-based knowledge about clear aligners: an infodemiologic study. Cureus 2023; 15: e46879.

11.

Bafail

Mohammad

Shahada

, et al. Assessment of quality and readability of online patient-centered arabic web-based knowledge about apicoectomy. Cureus 2023; 15: e48333.

12.

Elsayed

Althagafi

Bahabri

, et al. Retrospective radiographic survey of unconventional ectopic impacted teeth in al-madinah al-munawwarah, Saudi Arabia. Open Access Macedonian J Med Sci 2020; 8: 203–208.

13.

Shaari

Awang Nawi

Khaleel

, et al. Prevalence and pattern of third molars impaction: a retrospective radiographic study. J Adv Pharm Technol Res 2023; 14: 46–50.

14.

Al-Anqudi

Al-Sudairy

Al-Hosni

, et al. Prevalence and pattern of third molar impaction: a retrospective study of radiographs in Oman. Sultan Qaboos Univ Med J 2014; 14: e388–e392.

15.

Alfadil

Almajed

. Prevalence of impacted third molars and the reason for extraction in Saudi Arabia. Saudi Dent J 2020; 32: 262–268.

16.

Alassaf

Hasubah

Sharbib

, et al. Assessment of the relation between patterns of third-molar impaction and blood group: a retrospective study. Cureus 2023; 15: e45130.

17.

Elsayed

. Iatrogenic displacement of an impacted mandibular third molar to the neighbouring pharyngeal space. J Coll Physicians Surg Pak 2020; 30: 1107–1108.

18.

Bouloux

Steed

Perciaccante

. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am 2007; 19: 117–128.

19.

Steed

. The indications for third-molar extractions. J Am Dent Assoc 2014; 145: 570–573.

20.

Rothamel

Wahl

d'Hoedt

, et al. Incidence and predictive factors for perforation of the maxillary antrum in operations to remove upper wisdom teeth: prospective multicentre study. Br J Oral Maxillofac Surg 2007; 45: 387–391.

21.

Farish

Bouloux

. General technique of third molar removal. Oral Maxillofac Surg Clin North Am 2007; 19: 23–43.

22.

Engelmann

Fischer

Nkenke

. Quality assessment of patient information on orthognathic surgery on the internet. J Craniomaxillofac Surg 2020; 48: 661–665.

23.

Fox

Rainie

. The online health care revolution: How the web helps Americans take better care of themselves. Pew Research Center, 1999.

24.

Silberg

Lundberg

Musacchio

. Assessing, controlling, and assuring the quality of medical information on the internet: caveant lector et viewor–let the reader and viewer beware. Jama 1997; 277: 1244–1245.

25.

Charnock

Shepperd

Needham

, et al. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 1999; 53: 105–111.

26.

Ekawati

Hidayat

Rosyada

. Enhancing vocabulary, dialogue, and writing skills in Arabic through communicative language teaching: an experimental study. International Journal of Religion 2024; 5: 896–907.

27.

Al Shlowiy

. Language, religion, and communication: the case of Islam and Arabic in the Asia-pacific. Journal of Asian Pacific Communication 2019; 32: 198–213.

28.

Nurcholis

. Elimination of gender bias in learning arabic/ حذف التحيز الجنسي في اللغة العربية. Ijaz Arabi Journal of Arabic Learning 2019; 2.

29.

Brasileiro

de Bragança

Van Sickels

. An evaluation of patients’ knowledge about perioperative information for third molar removal. J Oral Maxillofac Surg 2012; 70: 12–18.

30.

Kolte

Shenoi

Ghodeswar

, et al. Effectiveness of patients’ knowledge about perioperative information prior to third molar removal. International Journal of Dental Research 2014; 3: –4.

31.

Qurban

Alturki

Alharbi

, et al. Assessment of Arabic web-based knowledge about root canal treatment: an infodemiologic study. Cureus 2024; 16: e59794.

32.

Aboalshamat

. Quality and readability of web-based information on dental caries in Arabic: an infodemiological study. BMC Oral Health 2023; 23: 97.

33.

Khazaal

Chatton

Zullino

, et al. HON Label and DISCERN as content quality indicators of health-related websites. Psychiatr Q 2012; 83: 15–27.

34.

Ott

Wang

Bortree

. Communicating sustainability online: an examination of corporate, nonprofit, and university websites. Mass Communication and Society 2016; 19: 671–687.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.01 MB