Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-Sectional Questionnaire Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear authors, 

 

Thank you for submitting your manuscript to this journal. 

The article provides valuable insights regarding the prevalence and associated factors of malocclusion in preschoolers. The study is well-conceived and executed, however, I would like the authors to address the following issues:

 

-some figures need to be added

-line 101-103: explain in details and write the definition of the variables considered.

-in the introduction add data regardin the prevalence of malocclusion in the area and worldwide.

-line 117: study population age is reported to be 26-80 months, however in the inclusion criteria is set 2-6 years. Please clarify.

-explain and describe data collection instruments and procedures

 

 

Thank you in advance for all the corrections. Good luck!

Comments on the Quality of English Language

-moderate editing of English language is required

Author Response

We would like to thank you for your valuable comments, which greatly contributed to improving the technical and scientific quality of the manuscript. We have included the changes made below:

-some figures need to be added

The authors prefers to mantain tables because it is more explicative for the analysis of data

 

-line 101-103: explain in details and write the definition of the variables considered.

 

Done in the methodology

 

-in the introduction add data regardin the prevalence of malocclusion in the area and worldwide.

 

Information added to the end of the first paragraph of the introduction

 

-line 117: study population age is reported to be 26-80 months, however in the inclusion criteria is set 2-6 years. Please clarify.

 

Although the methodology contains an inclusion criterion of 2-6 years old, children under 7 years old (84 months) were admitted. For this reason, children aged 80 months were admitted. In light of the question, this point will be reviewed and clarified in the methodology. Furthermore, in the study population, children aged 24 months (2 years) were not found at the time of the examination. Thus, the results explained the minimum age found in the study population, which was 26 to 80 months.

 

-explain and describe data collection instruments and procedures

 

A better detail on the oral examination was carried out at the end of the 6th paragraph of the methodology. In addition, instruments were detailed with greater precision.

Reviewer 2 Report

Comments and Suggestions for Authors

Malocclusion and Associated Factors in Preschoolers: New Associations in The 21st Century

Reviewer Report:

The authors investigated the prevalence of malocclusion and associated factors in 523 preschooler children aged 2 to 6 years. They observed statistical significance between malocclusion and increased screen time, experience of physical or psychological aggression, consumption of ultra-processed foods, digital sucking, and the habit of biting objects. As a conclusion, they recommended that in order to reduce this issues, emphasis should be placed on comprehensive health-promoting actions and psychosocial interventions in early childhood. Considering the beginning of the early mixed dentition period, which is the earliest time for preventive orthodontic treatment to be applied (approximately 6 years old at the earliest), the clinical significance of the results of this study is controversial. Therefore, this needs to be further strengthened.

My detailed opinions about the study are below:

Title:

The title does not clearly reflect the type of the study. It appears to be a book chapter and review title. It should be revised. As a suggestion:

‘Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-sectional Questionnaire Study’

Abstract:

A concrete recommendation should be presented along with the prevalence results. The current conclusion can already be said without the need for this study.

Introduction:

-        The citations throughout the manuscript should be written according to the journal rules.

-        The introduction is poorly documented. It should be expanded.

-        Why was this study needed? What is its clinical significance? It must be stated.

-        Why was it associated with Covid 19? The relationship between malocclusion and covid 19 should be clarified by stating it in the literature. More information on the subject should be provided.

-        The study was planned based on which gap in the literature? This should be stated as a strong justification for the purpose of the study.

Materials and Methods:

-        How was the sample size of the study calculated? It should be specified.

-        The name of the institution from which ethical approval was obtained should be stated in detail. All abbreviations should be used after being explained where they first appear.

-        The examiners’ clinical experience should be noted.

-        The name of the program used for statistical analysis, its version, and its origin such as city and country should be written.

Results:

All abbreviations in the tables should be stated below the table as footnote.

Discussion:

-        The prospective clinical significance of the study should be emphasized more strongly here.

Conclusion:

-        The conclusion section should not be stated as a repetition of the Results.

-        Based on the results, it should present a current or prospective concrete clinical conclusion/interpretation/opinion that answers the aim of the study. In this context, it should be revised.

-        Line 321-326: These lines should be written according to the journal rules.

References:

-        It should be revised according to the journal writing rules.

Comments on the Quality of English Language

Minor editing of English language required.

Author Response

We would like to thank you for your valuable comments, which greatly contributed to improving the technical and scientific quality of the manuscript. We made several modifications, highlighted in the text, to accommodate the requested changes, which are detailed below:

Title:

The title does not reflect the type of the study. It appears to be a book chapter and review title. It should be revised. As a suggestion:

‘Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-sectional Questionnaire Study’

Thanks for the suggestion, the title has been modified accordingly.

Abstract:

A concrete recommendation should be presented along with the prevalence results. The current conclusion can already be said without the need for this study.

By the 200 word limitation and suggestions, changes were made

Introduction:

-        The citations throughout the manuscript should be written according to the journal rules.

Correction made

-        The introduction is poorly documented. It should be expanded.

The expansion was carried out based on reviewers' suggestions, and changes were made to the article's introduction.

-        Why was this study needed? What is its clinical significance? It must be stated.

Correction made to the penultimate paragraph of the introduction

-        Why was it associated with Covid 19? The relationship between malocclusion and covid 19 should be clarified by stating it in the literature. More information on the subject should be provided.

An adjustment was made to facilitate understanding of the potential association in the 2nd paragraph of the introduction.

-        The study was planned based on which gap in the literature? This should be stated as a strong justification for the study.

Correction made to the penultimate paragraph of the introduction

Materials and Methods:

-        How was the sample size of the study calculated? It should be specified.

Correction made and presented in the 4th paragraph of the methodology

-        The name of the institution from which ethical approval was obtained should be stated in detail. All abbreviations should be used after being explained where they first appear.

Correction made

-        The examiners’ clinical experience should be noted.

Correction made

-        The name of the program used for statistical analysis, its version, and its origin such as city and country should be written.

Correction made

Results:

All abbreviations in the tables should be stated below the table as footnote.

In tables 1,3 and 4, the presence of abbreviations without their respective meanings was identified. The correction was made in the footnote of the tables.

Discussion:

-        The prospective clinical significance of the study should be emphasized more strongly here.

Correction made

Conclusion:

-        The conclusion section should not be stated as a repetition of the Results.

Correction made

-        Based on the results, it should present a current or prospective concrete clinical conclusion/interpretation/opinion that answers the aim of the study. In this context, it should be revised.

Correction made

-        Line 321-326: These lines should be written according to the journal rules.

Correction made

References:

-        It should be revised according to the journal writing rules.

Correction made

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Thanks to the authors. The study has improved significantly.Only one situation stands out that needs to be revised:

- Sample size calculation should be carried out with reference to a similar previous article. It should be revised accordingly.

Comments on the Quality of English Language

Minor editing of English language required.

Author Response

Thanks for your contributions. The parameters used for the sample calculation have been added to the text in pink. A convenience sample was chosen since early childhood education schools were returning to their activities after the pandemic, and they agreed to participate in the study.