Prevalence and Pattern of Dental Anomalies Among Schoolchildren in Aden, Yemen

Prevalence and Pattern of Dental Anomalies Among Schoolchildren in Aden, Yemen | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and Pattern of Dental Anomalies Among Schoolchildren in Aden, Yemen Omar Abdullah Rageh, Ali N. M. Gubran, Abdullah N. Yousef, Nasser Omar Jama, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9645794/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Dental anomalies (DAs) are clinically relevant developmental anomalies that impact oral health and overall quality of life. Objectives : Our study aimed to determine the prevalence of dental anomalies among schoolchildren in Aden, Yemen. Methods : A cross-sectional study was performed involving 1,026 schoolchildren aged 8–13 years in Aden, Yemen. The DAs were evaluated by clinical examinations and the nutritional status was checked using BMI z-scores. The data was entered and then analyzed using SPSS. Results : Out of 1,026 schoolchildren, the overall prevalence of DA was showed in 304 (29.6%). The DA was significantly higher among children in age group less than 10 years, males and those children who had low BMI (34.1%, 40.9% and 69.4%), respectively and ( P = 0.0001), each. tongue tie was the most frequent anomaly that found in 11.6% of children and it was significantly higher in males (68.1%, P = 0.001). the significant highest rates for impacted teeth, Supernumerary teeth and Tongue Tie were noticed in children aged below 10 years, (90.9%, 72.7%, 52.1; p=0.0001, 0.01, 0.005), respectively. all cases had supernumerary teeth had low BMI (P = 0.034). the two anomalies talon cusp and tongue tie also were correlated with low BMI (P = 0.024 and 0.007), respectively. Conclusion : The prevalence of dental anomalies in Aden, Yemen was relatively high comparing to most global studies. The DA was associated with children aged less than 10 years old, males and the low BMI. The tongue tie is the most frequent anomaly among the children and it significantly associated with the males and children aged below 10 years. Dental anomalies tongue tie developmental Pediatric dentistry BMI Yemen Paradox Figures Figure 1 Figure 2 Introduction Dental anomalies (DAs) are clinical deviations from normal odontogenesis and include differences in number, size, shape, position and structure of the teeth ( 1 ). These conditions are not only aesthetic concerns; they are often associated with malocclusion ( 2 ), increased caries susceptibility ( 3 ), periodontal disease( 4 ), and significant impacts on oral health-related quality of life (OHRQoL) in pediatric populations ( 5 ). The prevalence of DAs varies markedly between different ethnic groups across the world, from 10% to over 30% which is the consequence of a complex interaction between genetic predisposition and environmental triggers ( 6 ). Recent meta-analyses have shown a wide variation in the overall prevalence in the Middle East of between 2.6% and 45.1% with different patterns seen in some subpopulations ( 7 ). But Yemen is a different epidemiological story. Because of the specific genetic lineage of the region and the severe and long-lasting environmental stressors with a malnutrition prevalence > 45%, the clinical reality of the Yemeni situation may not be well reflected by the standard international dental benchmarks ( 8 , 9 ). There is limited evidence in the literature for the association of dental developmental stability with these systemic stressors, in particular Body Mass Index (BMI) as a proxy for nutritional status ( 10 ). Research has suggested that environmental insults may lead to enamel defects and eruption delays ( 11 ). However, the theory of ‘genetic canalization’ suggests that dental development may be highly mixed from nutritional stress from external sources ( 12 ). Furthermore, the capacity to prioritize clinical cases is crucial in healthcare systems with limited resources or those affected by conflict, such as Yemen's. To optimize specialist referral pathways, there are currently no validated, data-driven models that can stratify dental anomalies by clinical urgency. By offering a comprehensive analytical map of dental anomalies among schoolchildren in Aden, the current study aimed to determine the prevalence of dental anomalies and to identify the contributions of age, sex, and BMI to the occurrence of these anomalies. Subjects and Methods Yemeni primary school students in the Aden Governorate participated in this cross-sectional epidemiological study. To capture the varied socioeconomic landscape of the post-conflict urban environment, data were collected between January and May 2025 at different representative schools. Children aged 8–13 years who were enrolled in participating schools and had signed consent forms from their parents were eligible for inclusion. Children with a history of extensive orthodontic treatment, those with systemic syndromes (such as Down syndrome or ectodermal dysplasia), or those who were uncooperative during the clinical examination were excluded. Sample size Based on a previous study and using Stephen Thompson's formula, the minimum required sample size was 528, calculated using a 95% confidence level, a 5% margin of error, and an estimated DA prevalence of 20.1% from previous regional studies ( 13 ).The final sample was increased to 1,026 schoolchildren after adjusting for a non-response rate (20%) and a design effect associated with multistage cluster sampling to account for district-level variation and to boost the power of multivariate analysis. Clinical Examination and Diagnostic Criteria Two trained pediatric dentists performed the examinations, using portable light sources and disposable mirrors and periodontal probes. No radiographs were taken in the field due to logistical limitations, so hypodontia and impactions were identified by tooth absence beyond the normal eruption window (± 2 years). Anomalies were grouped as: ( 1 ) high-priority anomalies with possible functional impact with a need for referral to a specialist (e.g. tongue-tie affecting speech/feeding and impacted permanent teeth); and ( 2 ) low-priority anomalies including morphological variations requiring monitoring only (e.g. peg laterals, minor talon cusps). Anthropometric measurements were carried out for all participants. Height was measured to the nearest 0.1cm and weight to the nearest 0.1kg. Children were classified according to age- and sex-specific z-scores based on WHO growth references, and Body Mass Index (BMI) was calculated (kg/m2) ( 14 ). Statistical Analysis Data were entered and analyzed using the Statistical Package for the Social Sciences (SPSS®) software (Version 26). Children's ages were normally distributed; therefore, mean and standard deviation (SD) values were determined. Qualitative data were presented as frequencies and percentages. Significant associations between different variables were determined by calculating p-values using the chi-square (χ²) test, where a p-value ≤ 0.05 indicated statistical significance. Multivariable logistic regression was used to assess the impact of independent variables and to control for confounders. Results A total of 1,026 schoolchildren who met the inclusion criteria were included in the study, consisting of equal numbers of male and female children (513 each, 50%). The mean ± SD age was 10.54 ± 1.44 years, with most participants (399, 38.9%) falling below the age of 10 years. The majority (755, 73.6%) had low BMI (Table 1 ). Table 1 General characteristics of schoolchildren in Aden, Yemen (n = 1026) Category Frequency Percentage (%) Age group years 11 304 29.6 Mean ± SD 10.54 ± 1.44 Sex Male 513 50.0 Female 513 50.0 BMI Normal 213 20.8 Low 755 73.6 High 58 5.7 The overall prevalence of dental anomalies among children was 304 (29.6%) (Fig. 1 ). The highest rates were136 (34.1%) in age group less than 10 years, 210(40.9%) among male children, and 211(69.4%) among those children who had low BMI. All these results were highly statistically significant ( P = 0.0001), each (Table 2 ). Table 2 Prevalence of dental anomalies among schoolchildren by their demographic characteristics (n = 1026) Category Dental Anomalies P value No % Age group years 11(n = 304) 64 21.1 Sex Male (n = 513) 210 40.9 0.0001 Female (n = 513) 94 18.3 BMI Normal (n = 213) 85 28.0 0.0001 Low (n = 755) 211 69.4 High (n = 58) 8 2.6 P < 0.05 is considered significant. The most frequent anomaly among schoolchildren was tongue tie, found in 119 (11.6%) children, followed by macrodontia in 51 (5.0%) children (Fig. 2 ). Tongue tie occurred significantly more often in males (68.1%, P = 0.001) (Table 3 ). Table 3 The prevalence specific dental anomalies among schoolchildren by their sex in Aden, Yemen (n = 1026) Dental Anomaly Male Female P value No % No % Hypodontia (n = 11) 3 8 72.7 0.112 Impacted Teeth (n = 33) 12 36.4 21 63.6 0.078 Macrodontia (n = 51) 21 41.2 30 58.8 0.125 Peg-shaped Laterals (n = 39) 19 48.7 20 51.3 0.500 Supernumerary (n = 11) 5 45.5 6 54.5 0.500 Talon Cusp (n = 40) 16 40.0 24 60.0 0.129 Tongue Tie (n = 119) 81 68.1 38 31.9 0.001 P < 0.05 is considered significant. According to age, the results indicated a significantly higher prevalence of impacted teeth, supernumerary teeth, and tongue tie in the youngest age group (children aged below 10 years): 90.9%, 72.7%, and 52.1%, respectively (p = 0.0001, 0.01, and 0.005, respectively). Conversely, hypodontia, macrodontia, and talon cusp were significantly associated with children in the age group 10–11 years: 90.9%, 62.7%, and 57.5%, respectively (p = 0.0001, 0.0001, and 0.001, respectively) (Table 4 ). Table 4 The prevalence specific dental anomalies among schoolchildren by their age group in Aden, Yemen (n = 1026) Dental Anomaly Age group years P value Less than 10 10–11 More than 11 No % No % No % Hypodontia (n = 11) 0 0.0 10 90.9 1 9.1 0.0001 Impacted Teeth (n = 33) 30 90.9 2 6.1 1 3.0 0.0001 Macrodontia (n = 51) 14 27.5 32 62.7 5 9.8 0.0001 Peg-shaped Laterals (n = 39) 20 51.3 10 25.6 9 23.1 0.269 Supernumerary (n = 11) 8 72.7 3 27.3 0 0.0 0.01 Talon Cusp (n = 40) 12 30.0 23 57.5 5 12.5 0.001 Tongue Tie (n = 119) 62 52.1 26 21.8 31 26.1 0.005 P < 0.05 is considered significant. Regarding the BMI of children, our data noticed that all eleven children (100%) who has Supernumerary teeth had low BMI (P = 0.034). the talon cusp and tongue tie were correlated with low BMI (P = 0.024 and 0.007), respectively (Table 5 ). Table 5 The prevalence specific dental anomalies among schoolchildren by their BMI in Aden, Yemen (n = 1026) Dental Anomaly BMI P value Normal Low High No % No % No % Hypodontia (n = 11) 2 18.2 9 81.8 0 0.0 0.500 Impacted Teeth (n = 33) 3 9.1 29 87.9 1 3.0 0.122 Macrodontia (n = 51) 10 19.6 39 76.5 2 3.9 0.827 Peg-shaped Laterals (n = 39) 10 25.6 26 66.7 3 7.7 0.614 Supernumerary (n = 11) 0 0.0 11 100.0 0 0.0 0.034 Talon Cusp (n = 40) 3 7.5 32 80.0 5 12.5 0.024 Tongue Tie (n = 119) 17 14.3 100 84.0 2 1.7 0.007 Multivariate regression analysis showed that children aged above 11 years had 60% decreased odds of experiencing dental anomalies compared to younger children (AOR = 0.404; p = 0.0001; 95% CI: 0.300–0.645). Female sex was a significant protective factor against dental anomalies (AOR = 0.319; p = 0.0001; 95% CI: 0.238–0.427). Low BMI was strongly associated with the development of DA, with more than four times the risk (AOR = 4.13; p = 0.001; 95% CI: 1.8–9.5) (Table 6 ). Table 6 Multivariate analysis of factors associated with presence of dental anomalies among children (n = 1026), Anomaly AOR SE P value 95% CL Age group years 11 0.404 0.195 0.0001 0.300-0.645 Sex Male 1.00 - - - Female 0.319 0.149 0.0001 0.238–0.427 BMI Normal 1.00 - - - Low 4.13 0.425 0.001 1.8–9.5 High 1.73 0.411 0.182 0.77–3.9 AOR; Adjusted Odds Ratio, SE; Standard Error, 95% CI; 95% Confidence Interval Discussion This is the first epidemiological study on dental anomalies among schoolchildren from Aden, Yemen, reporting an occurrence of 29.6%, which is among the highest recorded in the literature. This rate is significantly higher than that found in other population groups, such as 26.6% in a Nigerian schoolchildren ( 15 ), 25.8% in an Indian school children ( 16 ), 25.4% among Saudi children ( 17 ), 39.9% in a Brazilian schoolchildren ( 18 ), 20.1% in a Kuwaiti children ( 19 ), 16.7% in a Slovenian population ( 20 ), and 5.2% in an Australian children ( 21 ). A study conducted among Nigerian schoolchildren revealed one of the lowest rates at 4.2% ( 22 ). This introduced burden defines the “Yemen Paradox”—where high nutritional stress is associated with some, but not all, dental anomalies—a special epidemiological phenomenon demanding further investigation. For the current study, the highest significantly high prevalence was recorded for the children under the age of 10 years ( p = 0.0001). There were conflicting results in studies conducted in Kuwait ( 19 ). For this particular study, there was a significant strong inverse association between the age of the children and dental anomalies. The 10-11-year-old children showed a non-significantly high risk of developing dental anomalies compared to children below 10 years (AOR = 0.795; p = 0.188). The 11-years-and-above category showed a 60% decrease in the odds of having anomalies compared to their counterparts (AOR = 0.404; p = 0.0001; 95% CI = 0.300–0.645). Children under the age of 10, who participated in our study, grew up amidst the most challenging periods of the war in Yemen, characterized by widespread maternal malnutrition and stress. On the other hand, children aged over 11 were already past the most important period of tooth formation when the conflict escalated into its most difficult stages, which is why the frequency of anomalies among them was relatively low. In terms of sexual distribution, the prevalence rate of DA that was statistically significant was 40.9% in males. Multivariate analysis indicated that being female was significantly associated with protection against dental abnormalities (AOR = 0.319; p = 0.0001; 95% CI: 0.238–0.427). In contradiction to previous studies conducted in Kuwait and Nigeria that found higher DA prevalence in females ( 19 , 22 ), our results indicate that environmental factors have different effects on odontogenesis in females and males in Yemen. Males have been described as more biologically vulnerable during certain developmental periods according to the concept of “male fragility”( 23 ) . Our research revealed that low BMI subjects exhibited the highest DA prevalence rate (69.4%). Our multivariate analysis (see Table 6 ) indicated that low BMI was found to be a very significant independent predictor of having dental anomalies, with four times higher chances for having such abnormalities compared to those with normal body weight (AOR = 4.13; p = 0.001; 95% CI: 1.8–9.5). This is one of the first empirical studies to provide evidence for this finding. Tongue tie was the most common DA (11.6%), while macrodontia was the second most common (5.0%). According to research conducted by Olatosi et al., hypoplasia was the most common DA, followed by the retention of primary tooth ( 24 ). According to Alanzi et al., tooth number anomaly and taurodontism were the most common anomalies, respectively ( 19 ). A Saudi Arabian study found that the most common DA was hypodontia, followed by hyperdontia ( 25 ). The reason for this difference can be related to diagnostic criteria, genetic predisposition, and types and number of anomalies detected. Concerning a relation between anomalies and sex, ankyloglossia (tongue tie) is the only DA that had a statistical difference between male and female children, with twice more males (68.1%) than females (31.9%, p = 0.001). This is highly consistent with findings from Saudi Arabia, where a systematic review demonstrated a male-to-female ratio of approximately 2:1 for ankyloglossia ( 25 ). The physiological explanation for increased risk among males may be associated with their greater vulnerability to prenatal and perinatal stress. The anomaly-specific analysis (Table 4 ) indicated a significantly higher prevalence of impacted teeth, supernumerary teeth, and tongue tie among children aged below 10 years (90.9%, 72.7%, and 52.1%, respectively; p = 0.0001, 0.01, and 0.005, respectively), while hypodontia, macrodontia, and talon cusp were significantly associated with children in the age group 10–11 years (90.9%, 62.7%, and 57.5%, respectively; p = 0.0001, 0.0001, and 0.001, respectively). These results differ from those reported in Nigeria ( 24 ). These age-specific patterns indicate that the developmental timing of dental anomalies may be affected by population-specific genetic, nutritional, and environmental factors. The data obtained in our study indicate strong correlations between underweight (low BMI) and certain dental anomalies (Table 5 ). The prevalence of supernumerary teeth was limited to low-BMI subjects only (100.0%, n = 11; p = 0.034). The prevalence of talon cusp was also high among low-BMI children (80.0%, n = 32; p = 0.024). The strongest correlation between low BMI and dental anomaly was identified for tongue tie (84.0%, n = 100; p = 0.007). Shrestha, et al. noted that dental developmental anomalies may be associated with nutrition during odontogenesis due to delays in tooth eruption in the low-BMI group ( 26 ).Talon cusp occurs in higher prevalence among children with low growth percentiles, and ankyloglossia causes feeding difficulties, which can lead to nutritional disorders and result in low BMI ( 27 ). The normal prevalence of hypodontia (0.49%) in the presence of extensive malnutrition (73.6% low BMI) indicates that the development of tooth number is genetically determined and resistant to nutritional stress—termed the "Yemen Paradox" for the first time in this setting. Strengths and Limitations One of the major strengths of this study is its relatively large sample size (n = 1,026) and the equal division of the participants between males and females (50% each). The thorough examination of seven types of anomalies in connection with the variables such as age, sex, and BMI provides a multi-faceted approach to studying the epidemiology of dental anomalies among people in conflict zones. However, there are certain drawbacks that should be highlighted. The absence of OPGs, for example, means that conditions such as hypodontia, extra teeth, and impacted teeth may not have been well reported because they are commonly identified using radiography. Second, although BMI was chosen as a nutritional marker, actual nutritional status is not fully assessed because BMI fails to account for micronutrient deficiencies (e.g., vitamins D and A, iron, zinc, folic acid, and calcium), which can be essential for tooth formation Third, the cross-sectional study design cannot prove causative relationships; longitudinal studies are needed to establish temporal relationships. Furthermore, using samples from a single city limits generalizability, as other cities in Yemen may not be equally affected by conflict or nutritional deficiencies. Conclusions The prevalence of dental anomalies in Aden, Yemen, was relatively high compared to most global studies. The development of DAs is associated with age less than 10 years, male sex, and low BMI. The most frequent anomalies among schoolchildren were tongue tie and macrodontia. Tongue tie was significantly associated with male sex and children aged below 10 years. Furthermore, impacted teeth and supernumerary teeth were associated with children aged below 10 years, while hypodontia, macrodontia, and talon cusp were significantly associated with children in the age group 10–11 years. Low BMI was strongly correlated with supernumerary teeth, talon cusp, and tongue tie. High rates of tongue-tie and impacted teeth, especially among malnourished and younger patients, indicate severe developmental problems due to nutritional stress caused by prolonged warfare. Future investigations with radiographic diagnosis and genetic evaluation are needed. Declarations Acknowledgments The authors of this research wish to thank all schoolchildren and their parents who agreed to participate in this study. They would also like to express their gratitude to the pediatric dentists who clinical examined the children for the presence of DA as well as taken anthropometric measurements. Ethics declarations Ethics approval and consent form: Ethical approval for this study was obtained from the Ethics Committee of the College of Medicine and Health Sciences at the University of Science and Technology (MEC No. MEC/AD0105). The study was based on the standards of the Helsinki Declaration. Written consent forms were obtained from parents before performing any procedures. Funding Not applicable. Data availability and materials All data was presented in the manuscript, no further data available and it will be available at any time. Competing interests: The authors declare no conflict of interest. Authors' contributions O. A. R. formulated the initial draft, conceived the key idea, wrote the introduction and methodology, and analyzed the data; A. N. M. G. oversaw the work, revised the manuscript, and edited the manuscript finally; A. N. Y. carried out the literature review and revised the manuscript; N. O. J. gathered the data and assisted with statistics; G. A. A. gathered the data and undertook anthropometric measures; A. A. G. gathered the data and assisted with the clinical examination; and A. M. A., A. B. A., T. N. A., and F. R. A. conducted the clinical examinations. References Kör Y, Zortuk FB. Dental Anomalies and Orthodontic Approach. Livre de Lyon; 2026. Sanchez-Hernandez OE, Lopez-Hernandez D, Brito-Aranda L, Izquierdo-Vega AJ, Beltran-Lagunes L, Fuentes-Torres GP, et al. Risk Factors Associated with Dentofacial Anomalies [Including Malocclusion] in Adults. Bioengineering. 2026;13(1):64. Dong H, Zhang Z. Effects of graded preventive measures on dental caries prevention in young children susceptible to caries. Am J Translational Res. 2025;17(7):5493. Malek S, Haque SM, Saha B. Evaluating the Oral Hygiene and Periodontal Status of Patients Undergoing Hemodialysis. Asia Pac J Med Innovations. 2026;3(1):1–5. Bahammam SA. Impact of Dental Status on Oral Health-related Quality of Life in Children with Missing or Multiple Teeth in Saudi Arabia: A Cross-sectional Analysis. J Int Soc Prev Community Dentistry. 2026;16(2):139–47. Gopinath VK, Elderini D, Salama R, Narasimhan S, Kamath V, Shetty S. A two stage radiographic study of the prevalence of anomalies associated with tooth number. Int Arab J Dentistry. 2025;16(1):8. Zailai A, Mubarki O, Masoud MA, Majrashi MH, Alhazmi A, Alqurayshah MM et al. Prevalence and Associated Factors of Specific Dentofacial Characteristics in Saudi Populations: A Systematic Review and Meta-Analysis. Cureus. 2026;18(1). Bandaru BK, Thankappan P, Nandan SRK, Amudala R, Annem SK, Santosh ABR. The prevalence of developmental anomalies among school children in Southern district of Andhra Pradesh, India. J Oral Maxillofacial Pathol. 2019;23(1):160. Gillman MW. Mothers, babies, and disease in later life. BMJ. 1995;310(6971):68–9. Mack KB, Phillips C, Jain N, Koroluk LD. Relationship between body mass index percentile and skeletal maturation and dental development in orthodontic patients. Am J Orthod Dentofac Orthop. 2013;143(2):228–34. Budak I, Oz E. Influences of genetic and environmental factors on developmental dental anomalies: a twin study. BMC Oral Health. 2026;26(1):63. Bakhromovich DR, Raximjonovna GN, EPIDEMIOLOGY AND PREVALENCE OF PARTIAL PRIMARY, TOOTH AGENESIS IN CHILDREN ACROSS DIFFERENT AGE GROUPS. Ideal J Multidisciplinary Res. 2026;1(3):341–7. Ashour AA, Alqarni AA. Prevalence of dental abnormalities, soft tissue pathologies and occlusion disorders in patients with high BMI: a cross-sectional study. Oral Health Prev Dent. 2024;22:b5656148. Kumar S, Kroon J, Lalloo R, Kulkarni S, Johnson NW. Relationship between body mass index and dental caries in children, and the influence of socio-economic status. Int Dent J. 2017;67(2):91–7. Temilola DO, Folayan MO, Fatusi O, Chukwumah NM, Onyejaka N, Oziegbe E, et al. The prevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife. Nigeria BMC oral health. 2014;14(1):125. Kathariya MD, Nikam AP, Chopra K, Patil NN, Raheja H, Kathariya R. Prevalence of dental anomalies among school going children in India. J Int oral health: JIOH. 2013;5(5):10. Yassin SM. Prevalence and distribution of selected dental anomalies among saudi children in Abha, Saudi Arabia. J Clin experimental dentistry. 2016;8(5):e485. Paranaiba LMR, Coletta RD, Swerts MSO, Quintino RP, De Barros LM, Martelli-Júnior H. Prevalence of dental anomalies in patients with nonsyndromic cleft lip and/or palate in a Brazilian population. Cleft Palate-Craniofacial J. 2013;50(4):400–5. Alanzi A, Bufersen N, Haider S, Abdulrahim M. Prevalence and distribution of dental anomalies in schoolchildren in Kuwait. Int Dent J. 2024;74(3):566–72. Vinjolli F, Zeqaj M, Dragusha E, Malara A, Danesi C, Laganà G. Dental anomalies in an Albanian orthodontic sample: a retrospective study. BMC Oral Health. 2023;23(1):47. Dang H, Constantine S, Anderson P. The prevalence of dental anomalies in an Australian population. Aust Dent J. 2017;62(2):161–4. Orikpete EV, Osagbemiro BB, Alade GO, Umanah AU, Raymond SC, Eigbobo JO. Prevalence of developmental oral anomalies among school children in Port Harcourt: a cross-sectional study. BMC Oral Health. 2025;25(1):1631. McGill J. The Modern Woman and Male Fragility: A Catalyst for. 2024. Olatosi OO, Oyapero A, Akinwande KO, Ayedun OS, Aladenika ET, Obe OI. Pattern and prevalence of dental anomalies among a paediatric population in Lagos, Nigeria. Nigerian Postgrad Med J. 2022;29(2):167–72. Aljohani K, Shanab H, Alqarni A, Merdad K, editors. Dental anomalies in Saudi Arabia: a systematic review. Healthcare: MDPI; 2024. Shrestha A, More CB, Keshwar S, Shrestha B, Raut T. Nutritional status influencing orofacial developmental anomalies. Curr Oral Health Rep. 2019;6(3):169–76. Messner AH, Lalakea ML, Aby J, Macmahon J, Bair E. Ankyloglossia: incidence and associated feeding difficulties. Archives Otolaryngology–Head Neck Surg. 2000;126(1):36–9. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9645794","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":636834563,"identity":"1281aa16-6438-4015-81b8-01513c34bf4d","order_by":0,"name":"Omar Abdullah Rageh","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Omar","middleName":"Abdullah","lastName":"Rageh","suffix":""},{"id":636834564,"identity":"d7706457-bb74-425a-b2d2-764a822cdea7","order_by":1,"name":"Ali N. M. Gubran","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIie3RMUvDQBTA8XcGXpdru144TL7CC4FCwQ+TLE5ugpPgSeFc1L1gyVeom+OVQLKIc8eKa4W6FKUqJlXEJdeOBe8/Hcf7cRwPwOXaydi5AQgAWwrE7yW3Es9UJAbk5ofgRoLJmoBItiRdxSnnpxR0/KfH6csdpFmm2OxZNxNhalJQjPIw7g/vIR0X4EUjC4E1wfdUy6Qn27oiCFgfGgtNd5HzTzrTfrmUHxXJNLRWNkL1K21NCQrek6wiqgD0bCTKOU1G1xRpfnTcv9IiHhfpwL95aCZBeRnN5ksKw4vydvqmD/azQT5ZzE8s3/cA9v5soV4NU5b579jrxhGXy+X6130Biy5NtjXDuKwAAAAASUVORK5CYII=","orcid":"","institution":"University of Science and Technology","correspondingAuthor":true,"prefix":"","firstName":"Ali","middleName":"N. M.","lastName":"Gubran","suffix":""},{"id":636834565,"identity":"112fb7f0-2b7c-4821-94ec-86cea93f9bba","order_by":2,"name":"Abdullah N. Yousef","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Abdullah","middleName":"N.","lastName":"Yousef","suffix":""},{"id":636834566,"identity":"e0c25257-af46-4264-9111-0cef7a4d965c","order_by":3,"name":"Nasser Omar Jama","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Nasser","middleName":"Omar","lastName":"Jama","suffix":""},{"id":636834567,"identity":"6223f1b3-ffdb-4f69-a8b6-896498487383","order_by":4,"name":"Ghazah. A. Ahmed","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Ghazah.","middleName":"A.","lastName":"Ahmed","suffix":""},{"id":636834568,"identity":"391649ff-39f2-466e-98b3-304e2a374dbf","order_by":5,"name":"Aamer A. Gabr","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Aamer","middleName":"A.","lastName":"Gabr","suffix":""},{"id":636834569,"identity":"b6f7b9a7-c95f-4c49-ba8c-73dc5543d95d","order_by":6,"name":"Ali M. Ali","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"M.","lastName":"Ali","suffix":""},{"id":636834570,"identity":"3b90a0b8-fea6-4c46-a33a-c477580d7d14","order_by":7,"name":"Ahmed B. Abdo Alaredha","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"B. Abdo","lastName":"Alaredha","suffix":""},{"id":636834571,"identity":"8a7d1d0b-a725-4954-a5ca-f4452a6fe774","order_by":8,"name":"Toga N. Algabery","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Toga","middleName":"N.","lastName":"Algabery","suffix":""},{"id":636834572,"identity":"69835f47-a45b-4b1f-9071-934d2b873aca","order_by":9,"name":"Fadhl R. AL-Sanbi","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Fadhl","middleName":"R.","lastName":"AL-Sanbi","suffix":""}],"badges":[],"createdAt":"2026-05-07 18:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9645794/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9645794/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109012362,"identity":"98baaa80-691b-4afe-bc8f-051f1d14912d","added_by":"auto","created_at":"2026-05-11 16:52:06","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":12149,"visible":true,"origin":"","legend":"\u003cp\u003ePrevalence of dental anomalies among schoolchildren in Aden, Yemen (n=1026)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9645794/v1/10cc6d2fac9b158d5cdb97d3.png"},{"id":109012363,"identity":"df6af174-46d4-41b7-a8c7-2108f6085ce3","added_by":"auto","created_at":"2026-05-11 16:52:06","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":23627,"visible":true,"origin":"","legend":"\u003cp\u003eThe prevalence of specific dental anomalies among schoolchildren in Aden, Yemen (n=1026)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9645794/v1/ac1c7a17d27e9dc8035326b3.png"},{"id":109067742,"identity":"73397502-f400-452c-a71b-dfc2460b54de","added_by":"auto","created_at":"2026-05-12 10:00:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":410205,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9645794/v1/cc8b3b9c-67f4-430a-ae04-54210a8ea490.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and Pattern of Dental Anomalies Among Schoolchildren in Aden, Yemen","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDental anomalies (DAs) are clinical deviations from normal odontogenesis and include differences in number, size, shape, position and structure of the teeth (\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e). These conditions are not only aesthetic concerns; they are often associated with malocclusion (\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e), increased caries susceptibility (\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e), periodontal disease(\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e), and significant impacts on oral health-related quality of life (OHRQoL) in pediatric populations (\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e). The prevalence of DAs varies markedly between different ethnic groups across the world, from 10% to over 30% which is the consequence of a complex interaction between genetic predisposition and environmental triggers (\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRecent meta-analyses have shown a wide variation in the overall prevalence in the Middle East of between 2.6% and 45.1% with different patterns seen in some subpopulations (\u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e). But Yemen is a different epidemiological story. Because of the specific genetic lineage of the region and the severe and long-lasting environmental stressors with a malnutrition prevalence \u0026gt; 45%, the clinical reality of the Yemeni situation may not be well reflected by the standard international dental benchmarks (\u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere is limited evidence in the literature for the association of dental developmental stability with these systemic stressors, in particular Body Mass Index (BMI) as a proxy for nutritional status (\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e). Research has suggested that environmental insults may lead to enamel defects and eruption delays (\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e). However, the theory of ‘genetic canalization’ suggests that dental development may be highly mixed from nutritional stress from external sources (\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e). Furthermore, the capacity to prioritize clinical cases is crucial in healthcare systems with limited resources or those affected by conflict, such as Yemen's. To optimize specialist referral pathways, there are currently no validated, data-driven models that can stratify dental anomalies by clinical urgency. By offering a comprehensive analytical map of dental anomalies among schoolchildren in Aden, the current study aimed to determine the prevalence of dental anomalies and to identify the contributions of age, sex, and BMI to the occurrence of these anomalies.\u003c/p\u003e \n\n "},{"header":"Subjects and Methods","content":"\u003cp\u003e Yemeni primary school students in the Aden Governorate participated in this cross-sectional epidemiological study. To capture the varied socioeconomic landscape of the post-conflict urban environment, data were collected between January and May 2025 at different representative schools. Children aged 8–13 years who were enrolled in participating schools and had signed consent forms from their parents were eligible for inclusion. Children with a history of extensive orthodontic treatment, those with systemic syndromes (such as Down syndrome or ectodermal dysplasia), or those who were uncooperative during the clinical examination were excluded.\u003c/p\u003e\u003ch3\u003eSample size\u003c/h3\u003e\u003cp\u003eBased on a previous study and using Stephen Thompson's formula, the minimum required sample size was 528, calculated using a 95% confidence level, a 5% margin of error, and an estimated DA prevalence of 20.1% from previous regional studies (\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e).The final sample was increased to 1,026 schoolchildren after adjusting for a non-response rate (20%) and a design effect associated with multistage cluster sampling to account for district-level variation and to boost the power of multivariate analysis.\u003c/p\u003e\u003ch2\u003eClinical Examination and Diagnostic Criteria\u003c/h2\u003e\u003cp\u003eTwo trained pediatric dentists performed the examinations, using portable light sources and disposable mirrors and periodontal probes. No radiographs were taken in the field due to logistical limitations, so hypodontia and impactions were identified by tooth absence beyond the normal eruption window (± 2 years). Anomalies were grouped as: (\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e) high-priority anomalies with possible functional impact with a need for referral to a specialist (e.g. tongue-tie affecting speech/feeding and impacted permanent teeth); and (\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e) low-priority anomalies including morphological variations requiring monitoring only (e.g. peg laterals, minor talon cusps).\u003c/p\u003e\u003cp\u003eAnthropometric measurements were carried out for all participants. Height was measured to the nearest 0.1cm and weight to the nearest 0.1kg. Children were classified according to age- and sex-specific z-scores based on WHO growth references, and Body Mass Index (BMI) was calculated (kg/m2) (\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eData were entered and analyzed using the Statistical Package for the Social Sciences (SPSS®) software (Version 26). Children's ages were normally distributed; therefore, mean and standard deviation (SD) values were determined. Qualitative data were presented as frequencies and percentages. Significant associations between different variables were determined by calculating p-values using the chi-square (χ²) test, where a p-value ≤ 0.05 indicated statistical significance. Multivariable logistic regression was used to assess the impact of independent variables and to control for confounders.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 1,026 schoolchildren who met the inclusion criteria were included in the study, consisting of equal numbers of male and female children (513 each, 50%). The mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD age was 10.54\u0026thinsp;\u0026plusmn;\u0026thinsp;1.44 years, with most participants (399, 38.9%) falling below the age of 10 years. The majority (755, 73.6%) had low BMI (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGeneral characteristics of schoolchildren in Aden, Yemen (n\u0026thinsp;=\u0026thinsp;1026)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eAge group years\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e304\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e10.54\u0026thinsp;\u0026plusmn;\u0026thinsp;1.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e513\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e513\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e755\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe overall prevalence of dental anomalies among children was 304 (29.6%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The highest rates were136 (34.1%) in age group less than 10 years, 210(40.9%) among male children, and 211(69.4%) among those children who had low BMI. All these results were highly statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0001), each (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of dental anomalies among schoolchildren by their demographic characteristics (n\u0026thinsp;=\u0026thinsp;1026)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eDental Anomalies\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAge group years\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 (n\u0026thinsp;=\u0026thinsp;399)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;11(n\u0026thinsp;=\u0026thinsp;323)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;11(n\u0026thinsp;=\u0026thinsp;304)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale (n\u0026thinsp;=\u0026thinsp;513)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale (n\u0026thinsp;=\u0026thinsp;513)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal (n\u0026thinsp;=\u0026thinsp;213)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow (n\u0026thinsp;=\u0026thinsp;755)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh (n\u0026thinsp;=\u0026thinsp;58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered significant.\u003c/p\u003e \u003cp\u003eThe most frequent anomaly among schoolchildren was tongue tie, found in 119 (11.6%) children, followed by macrodontia in 51 (5.0%) children (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Tongue tie occurred significantly more often in males (68.1%, P\u0026thinsp;=\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe prevalence specific dental anomalies among schoolchildren by their sex in Aden, Yemen (n\u0026thinsp;=\u0026thinsp;1026)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDental Anomaly\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypodontia (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e72.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImpacted Teeth\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e63.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMacrodontia (n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeg-shaped Laterals (n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e51.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.500\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSupernumerary (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e54.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.500\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTalon Cusp (n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e60.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.129\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTongue Tie (n\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered significant.\u003c/p\u003e \u003cp\u003eAccording to age, the results indicated a significantly higher prevalence of impacted teeth, supernumerary teeth, and tongue tie in the youngest age group (children aged below 10 years): 90.9%, 72.7%, and 52.1%, respectively (p\u0026thinsp;=\u0026thinsp;0.0001, 0.01, and 0.005, respectively). Conversely, hypodontia, macrodontia, and talon cusp were significantly associated with children in the age group 10\u0026ndash;11 years: 90.9%, 62.7%, and 57.5%, respectively (p\u0026thinsp;=\u0026thinsp;0.0001, 0.0001, and 0.001, respectively) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe prevalence specific dental anomalies among schoolchildren by their age group in Aden, Yemen (n\u0026thinsp;=\u0026thinsp;1026)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDental Anomaly\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eAge group years\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eLess than 10\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e10\u0026ndash;11\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eMore than 11\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypodontia (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e90.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImpacted Teeth\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e90.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMacrodontia (n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e9.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeg-shaped Laterals (n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e23.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.269\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSupernumerary (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTalon Cusp (n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e57.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTongue Tie (n\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered significant.\u003c/p\u003e \u003cp\u003eRegarding the BMI of children, our data noticed that all eleven children (100%) who has Supernumerary teeth had low BMI (P\u0026thinsp;=\u0026thinsp;0.034). the talon cusp and tongue tie were correlated with low BMI (P\u0026thinsp;=\u0026thinsp;0.024 and 0.007), respectively (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe prevalence specific dental anomalies among schoolchildren by their BMI in Aden, Yemen (n\u0026thinsp;=\u0026thinsp;1026)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDental Anomaly\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypodontia (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e81.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.500\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImpacted Teeth\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e87.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMacrodontia (n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e76.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.827\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeg-shaped Laterals (n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e66.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.614\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSupernumerary (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTalon Cusp (n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTongue Tie (n\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e84.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMultivariate regression analysis showed that children aged above 11 years had 60% decreased odds of experiencing dental anomalies compared to younger children (AOR\u0026thinsp;=\u0026thinsp;0.404; p\u0026thinsp;=\u0026thinsp;0.0001; 95% CI: 0.300\u0026ndash;0.645). Female sex was a significant protective factor against dental anomalies (AOR\u0026thinsp;=\u0026thinsp;0.319; p\u0026thinsp;=\u0026thinsp;0.0001; 95% CI: 0.238\u0026ndash;0.427). Low BMI was strongly associated with the development of DA, with more than four times the risk (AOR\u0026thinsp;=\u0026thinsp;4.13; p\u0026thinsp;=\u0026thinsp;0.001; 95% CI: 1.8\u0026ndash;9.5) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate analysis of factors associated with presence of dental anomalies among children (n\u0026thinsp;=\u0026thinsp;1026),\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnomaly\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95% CL\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eAge group years\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.795\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.565\u0026thinsp;\u0026minus;\u0026thinsp;0.112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.300-0.645\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.319\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.238\u0026ndash;0.427\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.8\u0026ndash;9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.411\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.77\u0026ndash;3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAOR; Adjusted Odds Ratio, SE; Standard Error, 95% CI; 95% Confidence Interval\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis is the first epidemiological study on dental anomalies among schoolchildren from Aden, Yemen, reporting an occurrence of 29.6%, which is among the highest recorded in the literature. This rate is significantly higher than that found in other population groups, such as 26.6% in a Nigerian schoolchildren (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), 25.8% in an Indian school children (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), 25.4% among Saudi children (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), 39.9% in a Brazilian schoolchildren (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), 20.1% in a Kuwaiti children (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), 16.7% in a Slovenian population (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), and 5.2% in an Australian children (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). A study conducted among Nigerian schoolchildren revealed one of the lowest rates at 4.2% (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). This introduced burden defines the \u0026ldquo;Yemen Paradox\u0026rdquo;\u0026mdash;where high nutritional stress is associated with some, but not all, dental anomalies\u0026mdash;a special epidemiological phenomenon demanding further investigation.\u003c/p\u003e \u003cp\u003eFor the current study, the highest significantly high prevalence was recorded for the children under the age of 10 years (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0001). There were conflicting results in studies conducted in Kuwait (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). For this particular study, there was a significant strong inverse association between the age of the children and dental anomalies. The 10-11-year-old children showed a non-significantly high risk of developing dental anomalies compared to children below 10 years (AOR\u0026thinsp;=\u0026thinsp;0.795; p\u0026thinsp;=\u0026thinsp;0.188). The 11-years-and-above category showed a 60% decrease in the odds of having anomalies compared to their counterparts (AOR\u0026thinsp;=\u0026thinsp;0.404; p\u0026thinsp;=\u0026thinsp;0.0001; 95% CI\u0026thinsp;=\u0026thinsp;0.300\u0026ndash;0.645). Children under the age of 10, who participated in our study, grew up amidst the most challenging periods of the war in Yemen, characterized by widespread maternal malnutrition and stress. On the other hand, children aged over 11 were already past the most important period of tooth formation when the conflict escalated into its most difficult stages, which is why the frequency of anomalies among them was relatively low.\u003c/p\u003e \u003cp\u003eIn terms of sexual distribution, the prevalence rate of DA that was statistically significant was 40.9% in males. Multivariate analysis indicated that being female was significantly associated with protection against dental abnormalities (AOR\u0026thinsp;=\u0026thinsp;0.319; p\u0026thinsp;=\u0026thinsp;0.0001; 95% CI: 0.238\u0026ndash;0.427). In contradiction to previous studies conducted in Kuwait and Nigeria that found higher DA prevalence in females (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), our results indicate that environmental factors have different effects on odontogenesis in females and males in Yemen. Males have been described as more biologically vulnerable during certain developmental periods according to the concept of \u0026ldquo;male fragility\u0026rdquo;(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) .\u003c/p\u003e \u003cp\u003eOur research revealed that low BMI subjects exhibited the highest DA prevalence rate (69.4%). Our multivariate analysis (see Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e) indicated that low BMI was found to be a very significant independent predictor of having dental anomalies, with four times higher chances for having such abnormalities compared to those with normal body weight (AOR\u0026thinsp;=\u0026thinsp;4.13; p\u0026thinsp;=\u0026thinsp;0.001; 95% CI: 1.8\u0026ndash;9.5). This is one of the first empirical studies to provide evidence for this finding.\u003c/p\u003e \u003cp\u003eTongue tie was the most common DA (11.6%), while macrodontia was the second most common (5.0%). According to research conducted by Olatosi et al., hypoplasia was the most common DA, followed by the retention of primary tooth (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). According to Alanzi et al., tooth number anomaly and taurodontism were the most common anomalies, respectively (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). A Saudi Arabian study found that the most common DA was hypodontia, followed by hyperdontia (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). The reason for this difference can be related to diagnostic criteria, genetic predisposition, and types and number of anomalies detected.\u003c/p\u003e \u003cp\u003eConcerning a relation between anomalies and sex, ankyloglossia (tongue tie) is the only DA that had a statistical difference between male and female children, with twice more males (68.1%) than females (31.9%, p\u0026thinsp;=\u0026thinsp;0.001). This is highly consistent with findings from Saudi Arabia, where a systematic review demonstrated a male-to-female ratio of approximately 2:1 for ankyloglossia (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). The physiological explanation for increased risk among males may be associated with their greater vulnerability to prenatal and perinatal stress.\u003c/p\u003e \u003cp\u003eThe anomaly-specific analysis (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) indicated a significantly higher prevalence of impacted teeth, supernumerary teeth, and tongue tie among children aged below 10 years (90.9%, 72.7%, and 52.1%, respectively; p\u0026thinsp;=\u0026thinsp;0.0001, 0.01, and 0.005, respectively), while hypodontia, macrodontia, and talon cusp were significantly associated with children in the age group 10\u0026ndash;11 years (90.9%, 62.7%, and 57.5%, respectively; p\u0026thinsp;=\u0026thinsp;0.0001, 0.0001, and 0.001, respectively). These results differ from those reported in Nigeria (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). These age-specific patterns indicate that the developmental timing of dental anomalies may be affected by population-specific genetic, nutritional, and environmental factors.\u003c/p\u003e \u003cp\u003eThe data obtained in our study indicate strong correlations between underweight (low BMI) and certain dental anomalies (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). The prevalence of supernumerary teeth was limited to low-BMI subjects only (100.0%, n\u0026thinsp;=\u0026thinsp;11; p\u0026thinsp;=\u0026thinsp;0.034). The prevalence of talon cusp was also high among low-BMI children (80.0%, n\u0026thinsp;=\u0026thinsp;32; p\u0026thinsp;=\u0026thinsp;0.024). The strongest correlation between low BMI and dental anomaly was identified for tongue tie (84.0%, n\u0026thinsp;=\u0026thinsp;100; p\u0026thinsp;=\u0026thinsp;0.007). Shrestha, et al. noted that dental developmental anomalies may be associated with nutrition during odontogenesis due to delays in tooth eruption in the low-BMI group (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).Talon cusp occurs in higher prevalence among children with low growth percentiles, and ankyloglossia causes feeding difficulties, which can lead to nutritional disorders and result in low BMI (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe normal prevalence of hypodontia (0.49%) in the presence of extensive malnutrition (73.6% low BMI) indicates that the development of tooth number is genetically determined and resistant to nutritional stress\u0026mdash;termed the \"Yemen Paradox\" for the first time in this setting.\u003c/p\u003e\n\u003ch3\u003eStrengths and Limitations\u003c/h3\u003e\n\u003cp\u003eOne of the major strengths of this study is its relatively large sample size (n\u0026thinsp;=\u0026thinsp;1,026) and the equal division of the participants between males and females (50% each). The thorough examination of seven types of anomalies in connection with the variables such as age, sex, and BMI provides a multi-faceted approach to studying the epidemiology of dental anomalies among people in conflict zones.\u003c/p\u003e \u003cp\u003eHowever, there are certain drawbacks that should be highlighted. The absence of OPGs, for example, means that conditions such as hypodontia, extra teeth, and impacted teeth may not have been well reported because they are commonly identified using radiography. Second, although BMI was chosen as a nutritional marker, actual nutritional status is not fully assessed because BMI fails to account for micronutrient deficiencies (e.g., vitamins D and A, iron, zinc, folic acid, and calcium), which can be essential for tooth formation Third, the cross-sectional study design cannot prove causative relationships; longitudinal studies are needed to establish temporal relationships. Furthermore, using samples from a single city limits generalizability, as other cities in Yemen may not be equally affected by conflict or nutritional deficiencies.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe prevalence of dental anomalies in Aden, Yemen, was relatively high compared to most global studies. The development of DAs is associated with age less than 10 years, male sex, and low BMI. The most frequent anomalies among schoolchildren were tongue tie and macrodontia. Tongue tie was significantly associated with male sex and children aged below 10 years. Furthermore, impacted teeth and supernumerary teeth were associated with children aged below 10 years, while hypodontia, macrodontia, and talon cusp were significantly associated with children in the age group 10\u0026ndash;11 years. Low BMI was strongly correlated with supernumerary teeth, talon cusp, and tongue tie. High rates of tongue-tie and impacted teeth, especially among malnourished and younger patients, indicate severe developmental problems due to nutritional stress caused by prolonged warfare. Future investigations with radiographic diagnosis and genetic evaluation are needed.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors of this research wish to thank all schoolchildren and their parents who agreed to participate in this study. They would also like to express their gratitude to the pediatric dentists who clinical examined the children for the presence of DA as well as taken anthropometric measurements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent form:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Ethical approval for this study was obtained from the Ethics Committee of the College of Medicine and Health Sciences at the University of Science and Technology (MEC No. MEC/AD0105). The study was based on the standards of the Helsinki Declaration. Written consent forms were obtained from parents before performing any procedures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data was presented in the manuscript, no further data available and it will be available at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e The authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eO. A. R. formulated the initial draft, conceived the key idea, wrote the introduction and methodology, and analyzed the data; A. N. M. G. oversaw the work, revised the manuscript, and edited the manuscript finally; A. N. Y. carried out the literature review and revised the manuscript; N. O. J. gathered the data and assisted with statistics; G. A. A. gathered the data and undertook anthropometric measures; A. A. G. gathered the data and assisted with the clinical examination; and A. M. A., A. B. A., T. N. A., and F. R. A. conducted the clinical examinations.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eK\u0026ouml;r Y, Zortuk FB. Dental Anomalies and Orthodontic Approach. Livre de Lyon; 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSanchez-Hernandez OE, Lopez-Hernandez D, Brito-Aranda L, Izquierdo-Vega AJ, Beltran-Lagunes L, Fuentes-Torres GP, et al. Risk Factors Associated with Dentofacial Anomalies [Including Malocclusion] in Adults. Bioengineering. 2026;13(1):64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDong H, Zhang Z. Effects of graded preventive measures on dental caries prevention in young children susceptible to caries. Am J Translational Res. 2025;17(7):5493.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMalek S, Haque SM, Saha B. Evaluating the Oral Hygiene and Periodontal Status of Patients Undergoing Hemodialysis. Asia Pac J Med Innovations. 2026;3(1):1\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBahammam SA. Impact of Dental Status on Oral Health-related Quality of Life in Children with Missing or Multiple Teeth in Saudi Arabia: A Cross-sectional Analysis. J Int Soc Prev Community Dentistry. 2026;16(2):139\u0026ndash;47.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGopinath VK, Elderini D, Salama R, Narasimhan S, Kamath V, Shetty S. A two stage radiographic study of the prevalence of anomalies associated with tooth number. Int Arab J Dentistry. 2025;16(1):8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZailai A, Mubarki O, Masoud MA, Majrashi MH, Alhazmi A, Alqurayshah MM et al. Prevalence and Associated Factors of Specific Dentofacial Characteristics in Saudi Populations: A Systematic Review and Meta-Analysis. Cureus. 2026;18(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBandaru BK, Thankappan P, Nandan SRK, Amudala R, Annem SK, Santosh ABR. The prevalence of developmental anomalies among school children in Southern district of Andhra Pradesh, India. J Oral Maxillofacial Pathol. 2019;23(1):160.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGillman MW. Mothers, babies, and disease in later life. BMJ. 1995;310(6971):68\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMack KB, Phillips C, Jain N, Koroluk LD. Relationship between body mass index percentile and skeletal maturation and dental development in orthodontic patients. Am J Orthod Dentofac Orthop. 2013;143(2):228\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBudak I, Oz E. Influences of genetic and environmental factors on developmental dental anomalies: a twin study. BMC Oral Health. 2026;26(1):63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBakhromovich DR, Raximjonovna GN, EPIDEMIOLOGY AND PREVALENCE OF PARTIAL PRIMARY, TOOTH AGENESIS IN CHILDREN ACROSS DIFFERENT AGE GROUPS. Ideal J Multidisciplinary Res. 2026;1(3):341\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAshour AA, Alqarni AA. Prevalence of dental abnormalities, soft tissue pathologies and occlusion disorders in patients with high BMI: a cross-sectional study. Oral Health Prev Dent. 2024;22:b5656148.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumar S, Kroon J, Lalloo R, Kulkarni S, Johnson NW. Relationship between body mass index and dental caries in children, and the influence of socio-economic status. Int Dent J. 2017;67(2):91\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTemilola DO, Folayan MO, Fatusi O, Chukwumah NM, Onyejaka N, Oziegbe E, et al. The prevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife. Nigeria BMC oral health. 2014;14(1):125.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKathariya MD, Nikam AP, Chopra K, Patil NN, Raheja H, Kathariya R. Prevalence of dental anomalies among school going children in India. J Int oral health: JIOH. 2013;5(5):10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYassin SM. Prevalence and distribution of selected dental anomalies among saudi children in Abha, Saudi Arabia. J Clin experimental dentistry. 2016;8(5):e485.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParanaiba LMR, Coletta RD, Swerts MSO, Quintino RP, De Barros LM, Martelli-J\u0026uacute;nior H. Prevalence of dental anomalies in patients with nonsyndromic cleft lip and/or palate in a Brazilian population. Cleft Palate-Craniofacial J. 2013;50(4):400\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlanzi A, Bufersen N, Haider S, Abdulrahim M. Prevalence and distribution of dental anomalies in schoolchildren in Kuwait. Int Dent J. 2024;74(3):566\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVinjolli F, Zeqaj M, Dragusha E, Malara A, Danesi C, Lagan\u0026agrave; G. Dental anomalies in an Albanian orthodontic sample: a retrospective study. BMC Oral Health. 2023;23(1):47.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDang H, Constantine S, Anderson P. The prevalence of dental anomalies in an Australian population. Aust Dent J. 2017;62(2):161\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrikpete EV, Osagbemiro BB, Alade GO, Umanah AU, Raymond SC, Eigbobo JO. Prevalence of developmental oral anomalies among school children in Port Harcourt: a cross-sectional study. BMC Oral Health. 2025;25(1):1631.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcGill J. The Modern Woman and Male Fragility: A Catalyst for. 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlatosi OO, Oyapero A, Akinwande KO, Ayedun OS, Aladenika ET, Obe OI. Pattern and prevalence of dental anomalies among a paediatric population in Lagos, Nigeria. Nigerian Postgrad Med J. 2022;29(2):167\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAljohani K, Shanab H, Alqarni A, Merdad K, editors. Dental anomalies in Saudi Arabia: a systematic review. Healthcare: MDPI; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShrestha A, More CB, Keshwar S, Shrestha B, Raut T. Nutritional status influencing orofacial developmental anomalies. Curr Oral Health Rep. 2019;6(3):169\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMessner AH, Lalakea ML, Aby J, Macmahon J, Bair E. Ankyloglossia: incidence and associated feeding difficulties. Archives Otolaryngology\u0026ndash;Head Neck Surg. 2000;126(1):36\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Dental anomalies, tongue tie, developmental, Pediatric dentistry, BMI, Yemen Paradox","lastPublishedDoi":"10.21203/rs.3.rs-9645794/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9645794/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Dental anomalies (DAs) are clinically relevant developmental anomalies that impact oral health and overall quality of life.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e: Our study aimed to determine the prevalence of dental anomalies among schoolchildren in Aden, Yemen.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A cross-sectional study was performed involving 1,026 schoolchildren aged 8–13 years in Aden, Yemen. The DAs were evaluated by clinical examinations and the nutritional status was checked using BMI z-scores. The data was entered and then analyzed using SPSS.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Out of 1,026 schoolchildren, the overall prevalence of DA was showed in 304 (29.6%). The DA was significantly higher among children in age group less than 10 years, males and those children who had low BMI (34.1%, 40.9% and 69.4%), respectively and (\u003cem\u003eP \u003c/em\u003e= 0.0001), each. tongue tie was the most frequent anomaly that found in 11.6% of children and it was significantly higher in males (68.1%, P = 0.001). the significant highest rates for impacted teeth, Supernumerary teeth and Tongue Tie were noticed in children aged below 10 years, (90.9%, 72.7%, 52.1; p=0.0001, 0.01, 0.005), respectively. all cases had supernumerary teeth had low BMI (P = 0.034). the two anomalies talon cusp and tongue tie also were correlated with low BMI (P = 0.024 and 0.007), respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The prevalence of dental anomalies in Aden, Yemen was relatively high comparing to most global studies. The DA was associated with children aged less than 10 years old, males and the low BMI. The tongue tie is the most frequent anomaly among the children and it significantly associated with the males and children aged below 10 years.\u003c/p\u003e","manuscriptTitle":"Prevalence and Pattern of Dental Anomalies Among Schoolchildren in Aden, Yemen","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-11 16:52:03","doi":"10.21203/rs.3.rs-9645794/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3394ed37-90cf-4f82-80c4-beda8858bc36","owner":[],"postedDate":"May 11th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvited","content":"","date":"2026-05-18T03:37:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-11T07:37:32+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-05-08T11:08:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2026-05-07T18:01:24+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-11T16:52:03+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-11 16:52:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9645794","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9645794","identity":"rs-9645794","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}