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The manuscript has been satisfactorily revised. All reviewer suggestions were addressed. I recommend acceptance.
Corrections have been made to the manuscript, the results and tables are correct.
Both the objective of study and methodology are clear and precise, and the statistical analysis is consistent with the description of the results.
The conclusions are related to the results of study, and like any cross-sectional study, it has limitations that are described in the discussion section.
The suggested comments were made to manuscript; I have no further comments.
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Thank you for allowing me to review the manuscript. I only found a few details that could be corrected. The manuscript is clear regarding the methodology used.
The results are interesting and can be used to design oral health programs for the population.
You could perhaps add the prevalence of caries in the population examined to determine their oral health status.
1. In the abstract, the "P" is in lowercase
2. Introduction: update the Global Burden of Diseases in 2017 with the most recent one.
World Health Organization abbreviation in parentheses
The materials and methods section is well-explained and follows the STROBE criteria for cross-sectional studies.
The reported results are consistent and can be extrapolated to other populations.
The manuscript is written in generally clear and professional English. The tone is appropriate, technically correct, though a few sentences are long and could be simplified for smoother readability. The introduction provides sufficient global and national background on the burden of dental caries and contextualizes the rationale for conducting the study in Yanbu. References are relevant and mostly up to date, but a few older citations (e.g., salivary flow studies from 2001 and 2008) could be supplemented with more recent literature to strengthen the background. The manuscript follows a standard article structure with clearly defined sections. Figures and tables are relevant and informative; however, Table 3 contains formatting issues with symbols and alignment that should be corrected to ensure clarity.
The study addresses a clear and meaningful research question: establishing baseline caries risk assessment using the CAMBRA tool in Yanbu, an underrepresented region in Saudi Arabia. This fills an identifiable knowledge gap, as most previous Saudi studies focused on caries prevalence rather than risk. The sampling method is explained, with participants randomly selected from Ministry of Health clinic lists, and inclusion and exclusion criteria are appropriately outlined. One limitation is that the sample size fell short of the calculated requirement (141 participants versus 196), due to a low response rate. While this is acknowledged, a deeper explanation of the impact on statistical power would strengthen the methods. Data collection was performed by a single examiner, which ensured consistency but meant that inter-rater reliability could not be assessed. The authors also acknowledge recall bias but took reasonable measures to minimize it, such as verifying oral hygiene products and medications.
The decision not to impute missing data is acceptable, but a short rationale would improve transparency. Results are presented clearly, and significant associations are supported by the analysis, though formatting errors in Table 3 should be corrected for accuracy and readability. The findings are similar to previous research, while adding novel insights for the Yanbu population. The conclusions are well linked to the research question, limited to the results, and avoid overstating causality, maintaining the distinction between correlation and causation. The discussion acknowledges key limitations, such as recall bias, underreporting of stigmatized behaviors, and the recruitment of participants only from Ministry of Health clinics, which may limit generalizability.
1. The abstract could be tightened to focus more on the main findings and their implications, avoiding repetition of background details already given in the introduction.
2. The introduction would benefit from a clearer statement of the specific objectives at the end, framed as research questions or hypotheses.
3. The methods section should describe in more detail how potential confounders were selected for the regression models.
4. The results section is lengthy and sometimes repeats information from the tables; it could present findings more concisely.
5. The discussion could be improved by structuring it around the main findings, then comparing each with existing literature, rather than blending results and interpretations together.
6. The limitations section should be expanded with a stronger explanation of how each limitation (sample size shortfall, recall bias, lack of inter-rater reliability) may have influenced the study outcomes.)
7. Figures and tables should be checked for consistency in formatting, terminology, and clarity (e.g., Table 3 currently has alignment and symbol errors that must be corrected).
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