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Article History

Received: 18 November 2025

Accepted: 17 February 2026

First Online: 26 February 2026

Declarations

:

: The authors declare no competing interests.

: Ethical approval was obtained from the Research Committee of University of the Western Cape and the Biomedical Research Ethics Committee (BM19/07/10) and the institutional review board (IRB) of King Khalid University, College of Dentistry (IRB/KKUCOD/ETH/2020–21/030). as required by the investigator’s doctoral program affiliation and local data collection regulations."

: Written informed consent was sought from parents or care givers, and assent was obtained from children aged 10 years and older, in accordance with the approved protocol and local bioethical guidelines. Examinations and interviews were conducted privately to ensure confidentiality, and all data were securely stored using encrypted digital files and regular backups. Intraoral photographs were taken ensuring participant’s anonymity.