Carious status and socio-behavioral risk factors among 12 year-old children in South-Central region in Romania.

BACKGROUND: Regular screenings at children population level are necessary in order to assess communities' need for education, prevention, as well as early detection and intervention programs The study aims to assess dental caries experience and oral health-related behaviors among Romania children from the South and Central region. METHODS: The cross-sectional study conducted in 2019-2020 is part of the national survey "Romanian Oral Health Survey", under the endorsement of the World Health Organization (WHO). The stratified, randomized and representative sample included 98 children of 12 years of age. The assessment included a clinical examination, using International Caries Detection and Assessment System (ICDAS) and the Oral Health Questionnaire for Children recommended by the World Health Organization. RESULTS: Results revealed that the frequency of caries-free children among 12 year-olds was 36.7% and the mean DMFT was 2.89. Regarding the oral health-related habits, 38.8% of children brushed twice daily; the consumption of sugary foods multiple times per day has been frequently met and 11.2% at the age of 12 never visited the dental office. CONCLUSIONS: The findings revealed that caries prevalence was high and behaviors negatively influence oral health. The presented data are of utmost importance for Romanian policy makers to promote oral health education among children, to support consistent preventive oral health campaigns and to stimulate dental attendance, irrespective of children' living areas or gender.

The Impact of Parental Education on Schoolchildren's Oral Health-A Multicenter Cross-Sectional Study in Romania.

The present study is part of the first national oral health survey for children in Romania. The aim of this study was to determine caries prevalence in correlation with the level of the parents' education, preventive behavior, and socioeconomic parameters in 11-14-year-old schoolchildren in Romania. A cross-sectional epidemiological survey was designed and conducted in 2019-2020. The sampled children were selected from 49 schools distributed in rural and urban areas of Romania, including its capital. Data were collected using the Oral Health Questionnaire for Children developed by the World Health Organization and described in the WHO Oral Health Surveys-Basic Methods, 5th edition, 2013, after positive informed consent. To express prevalence and severity of carious lesions, International Caries Detection and Assessment System (ICDAS) criteria were recorded in school for 814 schoolchildren (388 boys and 426 girls) aged between 11 and 14 years old (mean age 12.29 ± 0.6). Elements regarding the specificity of the child (gender, age, and parental education) were tabulated against preventive behavior. The parents' education was correlated with three clinical indices in order to assess the existence or lack of certain significant differences among schoolchildren in Romania. In terms of correlation between the mother's education and preventive behavior, results showed a significant positive correlation in case of dental check-ups (rs = 0.08 *, p < 0.05), brushing (rs = 0.02 **, p < 0.01), and use of different types of dental hygiene aids (rs = 0.06 **, p < 0.01) and a negative correlation with tooth pain or discomfort (rs = -0.01 **, p < 0.01). A statistically significant positive relationship was highlighted between the mother's education and the presence of restorations (rs = -0.09 **, p < 0.01). Regarding the father's education, there was a positive relationship with oral hygiene behavior (rs = 0.18 **, p < 0.01) but a negative relationship with the D3T index (rs = -0.18 **, p < 0.01). In conclusion, there was a strong correlation between the parents' education, preventive behavior, and oral health status of Romanian schoolchildren.

Oral Habits during the Lockdown from the SARS-CoV-2 Pandemic in the Romanian Population.

Background and Objectives: The SARS-CoV-2 pandemic led to changes in population daily patterns. In order to adapt oral health promotion measures for future similar conditions, the main objective of the study was to assess changes in dental hygiene and eating and smoking habits during the government lockdown in Romania. Materials and Methods: The cross-sectional study was conducted immediately after the end of the lockdown and consisted of 800 adult subjects. Data collection was done via an online survey. Participants were divided into two groups: non-medical/dental practitioners (N-M/D group) and medical/dental practitioners (M/D group). Results: An increased use of dental floss from 27% (pre-lockdown) to 30.5% (during lockdown) was identified in the M/D group, while the manual toothbrush usage increased to 64.8% (during lockdown) from 61.7% (pre-lockdown) in the N-MD/group. No significant differences regarding toothbrushing frequency were observed in either group. A change in the number of daily snacks was identified in both groups (3-4 snacks per day: from 11% to 20.2% in the N-M/D group, from 13.1% to 22.2% in the M/D group). The consumption of sweets as a preferred snack was also noticed. A decrease of tobacco consumers was assessed in the lockdown period (from 66.6% to 60.4% in the M/D group, from 68.5% to 61.9% in the N-/M/D group). Conclusions: Oral habits were changed during the pandemic lockdown through the increase in the frequency of the consumption of snacks and sweets and the decrease in frequency of smokers. Only minor changes were observed in oral hygiene.

Caries Prevalence Associated with Oral Health-Related Behaviors among Romanian Schoolchildren.

Oral health-related behaviors and living conditions play an important role in general and oral health. This study aimed to evaluate caries prevalence and severity in schoolchildren residing in rural and urban areas of Romania, and to correlate these with oral health-related behaviors. An estimation of the required sample size was conducted (sampling error of ±3% at a 95% confidence level), followed by the stratification of administrative units and then the selection of 49 schools. The Hurdle approach was used to analyze the dataset, requiring two sets of analyses for each outcome variable: a multilevel binary model to predict prevalence, and a multilevel Poisson analysis using only non-zero values. The mean and standard deviation (SD) for the dentinal caries index was 4.96 (5.33). Girls were more likely to have non-zero restoration codes (ß = 0.14, SE = 0.08, p < 0.05). Low education levels of each parent were associated with an increased likelihood of having non-zero carious tooth surfaces (ß = 0.23, SE = 0.06, p = 0.01; ß = 0.22, SE = 0.06, p < 0.01). The presence of cavities was predicted by the consumption of carbonated soft drinks (ß = 0.19, SE = 0.07, p < 0.01), candies (ß = 0.13, SE = 0.06, p < 0.01), sweetened milk (ß = 0.12, SE = 0.06, p < 0.05), tea (ß = 0.16, SE = 0.08, p < 0.05), or cocoa (ß = 0.13, SE = 0.06, p < 0.05). Furthermore, the non-zero values of the dentinal caries index were more likely in rural schools (ß = -0.37, SE = 0.11, p < 0.01), and a negative association between the county development index and the fillings/restorations index (ß = -0.01, SE = 0.01, p < 0.05) was also established. The outcome of this research highlights that the presence of caries (dentinal caries index) in Romanian schoolchildren is influenced by their socioeconomic background, as well as their specific consumption behaviors.

Patients' Perspective on Their Experience of Dental Treatments Covered by Public Health Insurance in Romania-A Pilot Study.

Although the aims of any public health coverage are prevention, diagnosis, treatment, rehabilitation, and maintenance, dental services are hardly ever included in services. The goal of our pilot study is to assess the perspective of a group of adult patients on their covered dental treatments. The present cross-sectional study was conducted on 140 patients who reported their perception by filling in a questionnaire. All the collected data were statistically analyzed using IBM SPSS Statistics 25. Most of the subjects (40.7%, n = 57) were treatment oriented, visiting the dentist only in an emergency situation. A total of 40.7% (n = 57) of the participants stated that all the dental treatments had coverage and 22.8% (n = 13) had to split their treatment plan because of the insurance budget limit. The subjects who had chosen covered dental services because they considered it was a right they should benefit from (53.7%, n = 22) and those who had chosen covered dental services because of financial reasons (29.3%, n = 12) were more frequently unsatisfied with the types of covered dental services. The reduced level of satisfaction was associated mainly with the list of dental procedures accepted for coverage and also with younger and highly educated patients. For a more accurate description, the present study should be completed by future studies not only on a representative population at national level, but also by assessing the perspective of dental professionals.

A pilot study on the effectiveness of a 2-year school-based oral health educational programme using experiential learning among adolescents.

OBJECTIVE: The aim of the present study was to assess the influence of a school-based experiential education programme on oral health status, knowledge and behaviour among a group of schoolchildren in Bucharest. MATERIALS AND METHODS: The study was part of an Erasmus+ project that focused on oral health promotion in schools and covered a 2-year period. Data were collected from 120 teenagers from three schools in Bucharest, Romania. At baseline, all subjects were clinically examined and received a questionnaire. They were split into two groups at baseline: a test group with 76 schoolchildren and a control group with 44 schoolchildren. The schoolchildren included in the test group received three experiential lessons. After every lesson, they filled in the same questionnaire. At the end, all subjects were clinically examined again. RESULTS: The prevalence of dental caries was increased in the control group by 8.58% (N = 3, P = 0.31) and decreased in the test group by 1.64% (N = 1, P = 0.8). Regarding incipient carious lesions, a higher decrease was observed in the test group (D1-2 S: 0.78 vs 0.63, P = 0.867). There was a statistically significant plaque index decrease in the test group (1.32 vs 1.12; P = 0.01) and an increase in the control group (1.15 vs 1.79; P = 0.0001). More children from the test group (N = 5, 7.9%, P = 0.225) adopted twice-daily tooth brushing compared to the control group (N = 1, 2.9%, P = 0.52). CONCLUSIONS: In the group studied, the oral health programme had positive effects on oral health status, oral health knowledge and behaviour among adolescents.

Experiential learning for adolescents - results from a 2-year school-based oral health educational program.

BACKGROUND: For oral health promotion, teenagers represent an important target group, given that appropriate personal oral hygiene and dietary behaviors are established during this period of life. Experiential learning is an educational approach where learning comes through experience. THE AIM: of the Erasmus+ project "Youth Community-Based Oral Health Learning Model" was to assess the influence of a school-based experiential education program on oral health status, knowledge and behavior among a group of schoolchildren in Bucharest. METHODS: This longitudinal interventional study started in 2015 and enrolled 120 adolescents from three public schools. At baseline, all subjects were clinically examined and received a questionnaire. They were split into two groups: the test group received three experiential lessons and control group benefited from a demonstration of tooth brushing technique. RESULTS: were presented for the test group, 76 schoolchildren, divided in two age groups: 13-14 years and 15-16 years. More children from the test group adopted twice-daily tooth brushing compared to the control group. The level of knowledge was good, but the role of a noncariogenic diet must be emphasized. CONCLUSIONS: The oral health program had positive effects on oral health knowledge and behavior among adolescents. The present study indicated that intervention using experiential learning involving dental students was effective in increasing oral health attitudes and behavior among adolescents from 13-16 years of age included in the study.

Considerations on morphological abnormalities of permanent teeth in children with cleft lip and palate.

Oral clefts are commonly associated with dental anomalies of number, size, shape, structure, position and eruption affecting both dentitions. Dental malformations may affect the development, growth and functions of the dento-maxillary apparatus (chewing, aesthetics, speech). The purpose of this paper was to assess the dental morphological variations in a group of patients with cleft lip and/or palate (CLP), as compared with a group of healthy subjects. The study sample included 48 patients with various types of CLP (15 girls and 33 boys) aged between 12.6 years and 17.3 years. The control group (without CLP) consisted of 1447 patients (545 girls and 903 boys). The proportion of patients with dental shape anomalies in the control group was 8.6%, while the proportion of patients with dental shape anomalies in the CLP group was 56.3% (p<0.01). With this regards, the frontal area was more affected in CLP group than controls. The most common morphological abnormality in the control group was supplementary cusp, while in the CLP sample it was dilaceration. Teeth from the dental hemiarch affected by CLP were most affected in their morphology.