PONE-D-20-34066

Oral health practices and oral hygiene status as indicators of suicidal ideation among Nigerian adolescents

PLOS ONE

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This is an extremely relevant subject with an impressive sample; it deserves publication and requires only minor adjustments. Below are suggestions to improve the article. Congratulations on your beautiful study!

Introduction

1. I suggest removing the excerpt about 2014 from the first paragraph, leaving only the information about 2017. It is a bit repetitive.

2. Rephrase the following excerpt in a more clear and objective way - “Suicidal ideation/attempt may also increase the risk for poor toothbrushing and plaque accumulation through a common link - depression. Depression leads to reduction in energy, self-worth, and esteem, which may lead to poor toothbrushing, plaque accumulation, and poor oral hygiene. Poor oral health is also a risk factor for depression.”

3. The introduction section is too long, it requires more objectivity. In addition, the results fill a gap not only in the study’s region but a worldwide gap. We know that studies like these, with a large sample size, are scarce.

Methods and Results

1. Could the studied community have influenced the results?

2. Were mental health, medication and substance (drugs) use also investigated? Could these factors influence the results?

3. Why were the results not compared with a control group? Adolescents with no intention to commit or no attempted suicide? We know that adolescence is a period when oral hygiene decreases and sugar consumption increases.

4. The article mentions caries evaluation in the methods section. How was it accomplished? Where is the result? Was periodontal disease evaluated? Oral injuries?

5. The numerical values can be better described, at least by presenting minimum, maximum and median values as well.

6. The use of graphs showing associations and trends can further enhance the article.

Discussion

1. The discussion section could extrapolate a little more by using data from the literature, as well as touch a little more on the visible plaque index and on the questionnaire used to assess suicide.

Conclusion – this section is objective and impactful!

Reviewer #2: The reviewer would like to thank the authors for their interesting study. However some minor comments should be considered to improve the manuscript.

1- The abstract is very long and does not summarize the study. Please provide a short abstract that presents only the most important information of the investigation.

2- The authors discussed the limitations of the study in the first part of the discussion. It would be much better if the authors created a paragraph at the end of the discussion about the limitations. This makes it easier for the reader to understand all aspects and limitations discussed.

3- The authors provided a clear discussion of the relationship between high sugar consumption, depression and the suicidal rate. Nevertheless, some points need to be further discussed, as the role of the socioeconomical status. Is the number of meals per day also an effective instrument to conclude the socioeconomical status of the participants? This also needs to be discussed further.

4- Are there similar studies in other countries, maybe outside Africa? Please discuss and compare if available.

5- Formatting mistakes should be corrected

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Reviewer #1: Yes: bruna lavinas sayed picciani

Reviewer #2: No

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Oral health practices and oral hygiene status as indicators of suicidal ideation among adolescents in Southwest Nigeria

PONE-D-20-34066R1

Dear Dr. Folayan,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Frédéric Denis, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: