# Quality and Readability of Arabic Online Resources on Early Orthodontic Intervention in Children: An Infodemiologic Study

## TL;DR

This study evaluates the quality and readability of Arabic online resources about early orthodontic treatment for children, finding them generally readable but lacking in reliability and transparency.

## Contribution

The study provides the first infodemiologic assessment of Arabic-language resources on early orthodontic intervention using validated quality and readability tools.

## Key findings

- Arabic websites on early orthodontic treatment show high readability but moderate informational quality.
- University-affiliated websites scored significantly higher in quality than commercial or nonprofit sites.
- Only 9.5% of websites met all JAMA benchmarks, and none were HONcode-certified.

## Abstract

Background

Early orthodontic intervention during the primary or mixed dentition phase can effectively address malocclusion, mitigate detrimental oral habits, and enhance long-term oral and psychosocial outcomes. Although the American Association of Orthodontists recommends initiating orthodontic assessments for children at age seven, most caregivers consult the internet for information. The quality, reliability, and readability of Arabic-language internet sources regarding early orthodontic treatment remain deficient. This study aimed to assess Arabic websites on early orthodontic treatment in children using validated quality and readability instruments.

Methods

In October 2024, a Google search (Google Inc., Mountain View, CA, USA) was conducted using four Arabic search terms equivalent to “early orthodontic treatment in children.” The eligible websites were classified into different categories based on specialization, organizational affiliation, material type, and presentation style. Website quality was assessed using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmarks, and the Health on the Net (HON) Code. Readability was assessed using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Simplified Measure of Gobbledygook (SMOG) indices. Analysis of variance (ANOVA) and chi-square tests were used for statistical analysis, with p ≤ 0.05 considered statistically significant.

Results

The initial 200 search results were screened, resulting in 63 eligible sites. The DISCERN assessment indicated that Arabic-language websites concerning early orthodontic treatment exhibited moderate overall quality. The findings from the Journal of the American Medical Association (JAMA) benchmark analysis reinforce these conclusions, with only six (9.5%) websites meeting all four items. None of the included websites was HONcode-certified. University-affiliated websites achieved significantly higher DISCERN and JAMA benchmark scores than commercial or nonprofit websites (p ≤ 0.05). All websites demonstrated high readability (mean FRES > 80), with university-affiliated content written at the most accessible level (p = 0.001).

Conclusions

Arabic websites on early orthodontic treatment generally display high readability and moderate informational quality. Nonetheless, major gaps remain in authorship transparency, source citations, and the disclosure of conflicts of interest. Increasing government participation and standardizing transparency practices are essential to ensure reliable, evidence-based Arabic orthodontic content for caregivers and patients.