Prevalence and Distribution of Dental Anomalies among Arab Orthodontic Patients in Israel: Is There a Correlation to Consanguinity Marriage? [PERSON]  
1 Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine,  
Tel Aviv University, Tel Aviv 69978, Israel 11 Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine,
Several studies have shown variations in the percentages of various dental anomalies among different populations, and in different regions in the world. These differences were attributed to differences in race, sampling techniques and diagnostic criteria [3; 4; 5; 6]. The Arab population in Israel is characterized by high rates of relative marriages and congenital malformations. An epidemiological review of various types of non-syndromic clefts among Israeli Jews and Arabs, conducted by the Department of Orthodontics at Tel Aviv University, found that the prevalence of congenital malformations was significantly higher among the Arab population [7]. One of the possible explanations for this was attributed to the high prevalence of consanguinity marriages among the Arab population [8]. Consanguinity is defined in genetics as a union between two relatives; second cousins or closure in family. Consanguinity marriages are favored by certain populations; it is usually closely associated with their traditions, beliefs, and the importance of family unity. They are frequently practiced in the Middle East. The rate of relative marriages in various Middle Eastern countries varies from 23.3% to 57.9% [9]. A study was conducted in Israel to assess the prevalence of relative marriages among its Arab population. It was found that 44.3% of the married couples were relatives, and that approximately 22.6% of them were first cousins [10]. Many studies have shown that consanguinity marriages had negative effects on the consanguineous couples' offspring; for example they could lead to; a diminished fertility, a rise in the incidence of mortality and the involvement of congenital malformations, mental retardation, asthma, and epilepsy [11; 12; 13]. The offspring of consanguinity marriages are also more prone to develop rare recessive syndromes [14], fetal, newborn, and child mortality [15; 16; 17], birth abnormalities [18; 19; 20], and later disabilities like deafness [21; 22]. Consanguinity may also play a role in--long-term outcomes, such as malignancies in children and young people, breast cancer [23; 24] as well as complicated disorders later in life [25; 26]. A case report from northern India found that consanguineous marriages are a major risk to the health of offspring and can even cause various craniofacial abnormalities; they increase autosomal recessive allele expression [27]. Despite these negative consequences, the rate of relative marriages is still high among Arabs in Israel, with prevalence of 42% according to a data survey from 2017 [28]. Two studies on dental anomalies among the Arab population in Israel have found a prevalence of 3.7% of impacted canines [29], and 1.1% of missing maxillary lateral incisors [30]. The prevalence of other dental anomalies among the Arab population in Israel has never been investigated. The Arab population constitutes about 20.9% of the total population in Israel [31]. To date, the incidence and distribution of dental anomalies have been examined in Israel only among the Jewish population [32].