Association among COVID-19, multisystem inflammatory syndrome in children, and oral health status.

The pathophysiology of multisystem inflammatory syndrome in children (MIS-C) and associated oral symptoms have not been clarified yet. The aim of the present study was to compare the oral health status of children with MIS-C-associated Coronavirus disease 2019 (COVID-19) and COVID-19. A total of 54 children with SARS-CoV-2 infection, 23 with MIS-C-associated COVID-19 and 31 with asymptomatic, mild, and moderate COVID-19 were recruited for the present cross-sectional study. Sociodemographic variables, medical examinations, oral hygiene habits, and extraoral and intraoral findings (DMFT/dmft index, OHI scores, and oral mucosal changes) were recorded. The t-test for independent samples and the Mann-Whitney U test were used (p < 0.05). MIS-C was found to be associated with chapped lips (all patients) and oral mucosal changes, including erythema, white lesion, strawberry tongue, and swelling of the gingiva as compared to the COVID-19 group (frequency of more than one mucosal change: 100% vs. 35%) (p < 0.001). Children with MIS-C presented higher DMFT/dmft scores (DMFT/dmft 5.52 ± 3.16 for the MIS-C group vs. 2.26 ± 1.80 for the COVID-19 group) (p < 0.01). Elevated OHI scores were also associated with MIS-C (mean ± SD: 3.06 ± 1.02 (MIS-C) vs. 2.41 ± 0.97 (COVID-19) (p < 0.05). Oral manifestations, mainly strawberry and erythematous tongue, were characteristic features of MIS-C. Prevalence of oral/dental symptoms was elevated in children with MIS-C when compared to COVID-19. Therefore, dental professionals should be aware of the oral manifestations associated with MIS-C, which may have high mortality and morbidity rates.

Association among COVID-19, multisystem inflammatory syndrome in children, and oral health status

Abstract The pathophysiology of multisystem inflammatory syndrome in children (MIS-C) and associated oral symptoms have not been clarified yet. The aim of the present study was to compare the oral health status of children with MIS-C-associated Coronavirus disease 2019 (COVID-19) and COVID-19. A total of 54 children with SARS-CoV-2 infection, 23 with MIS-C-associated COVID-19 and 31 with asymptomatic, mild, and moderate COVID-19 were recruited for the present cross-sectional study. Sociodemographic variables, medical examinations, oral hygiene habits, and extraoral and intraoral findings (DMFT/dmft index, OHI scores, and oral mucosal changes) were recorded. The t-test for independent samples and the Mann-Whitney U test were used (p < 0.05). MIS-C was found to be associated with chapped lips (all patients) and oral mucosal changes, including erythema, white lesion, strawberry tongue, and swelling of the gingiva as compared to the COVID-19 group (frequency of more than one mucosal change: 100% vs. 35%) (p < 0.001). Children with MIS-C presented higher DMFT/dmft scores (DMFT/dmft 5.52 ± 3.16 for the MIS-C group vs. 2.26 ± 1.80 for the COVID-19 group) (p < 0.01). Elevated OHI scores were also associated with MIS-C (mean ± SD: 3.06 ± 1.02 (MIS-C) vs. 2.41 ± 0.97 (COVID-19) (p < 0.05). Oral manifestations, mainly strawberry and erythematous tongue, were characteristic features of MIS-C. Prevalence of oral/dental symptoms was elevated in children with MIS-C when compared to COVID-19. Therefore, dental professionals should be aware of the oral manifestations associated with MIS-C, which may have high mortality and morbidity rates.

Knowledge, attitude, and behavior of Turkish dentists about radiation protection and radiation safety.

OBJECTIVES: Dentists use dental imaging methods frequently in the diagnosis and treatment of dental diseases. This study aimed to determine dentists' knowledge, attitudes, and behaviors about radiation protection during dental imaging procedures. METHODS: Dentists from two major dental health centres in Izmir province were asked to participate in this study. The participants replied to a questionnaire that consisted of questions on the use of radiographic devices, knowledge on the radiation protection of patients and staff, and attitudes and behaviors regarding radiation protection. The questionnaire also included questions about the socio-demographic characteristics of the participants. Descriptive statistics of data were performed using the SPSS software program. RESULTS: Sixty-six dentists participated in the survey. The mean knowledge score of dentists on dental imaging, radiation, and radiation protection was 8.3 ± 2.6 out of 17, while the mean attitude and behavior score was 8.3 ± 2.1 out of 27.97% of the participants stated that medical imaging technicians should carry out imaging procedures. The use of rectangular collimators was 9.1%, and using E/F film was 56.3% among dentists. 23.3% of participants stated that they applied the bisecting angle technique during dental imaging, 23.8% stated that they wear a lead apron during imaging, and 37.8% stated that they always used thyroid shields on the patients. In addition, 37.2% of the dentists stated that the patient holds the film during preapical radiography, and 81.5% used the same imaging parameters for adult and pediatric patients. 62% of dentists stated that they question the pregnancy of female patients before imaging. CONCLUSION: Findings of the study suggest that the knowledge of dentists about dental imaging procedures and radiation protection needs to be improved. The implementation and the follow-up of quality training programs in accordance with the standards set by the national authority will be of great importance.

Effects of Oral pH Changes on Smoking Desire.

BACKGROUND: Nicotine addiction is associated with nicotine absorption from the buccal mucosa, and it is stated that the main factor that determines nicotine absorption is saliva pH. In the literature, the effects of changes in saliva pH values after eating and drinking on smoking desire in smokers were not questioned. AIM: To show the effect of saliva pH changes on smoking desire. The secondary aim was to show the impact of coffee and water drinking on saliva pH and smoking on oral-dental health (oral hygiene and gingival bleeding). STUDY DESIGN: Case-control study. METHODS: A questionnaire was administered that included "Sociodemographic Data Form" and smoking history and Fagerström Test for Nicotine Dependence (FTND). Oral and dental examinations were performed with mirror sonds and using oral hygiene standard Silness and Leöe plaque index and DMFT Index (Index of Decayed Missing or Filled Teeth). Untreated saliva samples were taken, and baseline saliva flow rate and pH values were measured. To assess pH changes, saliva pH was remeasured after sugar-free instant coffee and water consumption. Smoking desire was evaluated with the Visual Analog Scale (VAS). RESULTS: In this study, 24 (55.8%) females and 19 (44.2%) males were among the 43 smoking and 39 nonsmoking cases. Smoking was significantly associated with poor oral hygiene (in smokers 4.71 (±1.40), in non-smokers 2.30 (±1.59); P < .01). DMFT index was higher in smokers than in non-smokers (in smokers 6.45 (±3.69), in non-smokers 3.87 (±2.67); P < .01). Gingival bleeding was more prevalent in smokers (0.68 (±0.76)) than non-smokers (1.20 (±0.90); P = .009). Salivary flow rates were lower in smokers (in smokers 2.56 (±1.34), in non-smokers 3.00 (±1.22), P = .06). In both groups, pH values increased after coffee consumption and decreased after water; in smokers basal: 6.67 (±0.41), pH coffee: 6.93 (±0.36), pH water: 6.85 (±0.33); in non-smokers pH basal: 6.84 (±0.37), pH coffee: 7.02 (±0.37), pH water: 6.97 (±0.31), P < .01. The VAS values of smokers at basal 4.73 (±3.21); P < 0.01, after coffee consumption 4.91 (±3.08); P < .01, and after water 3.15 (±2.72); P < .01. CONCLUSION: The saliva pH increased after coffee consumption and decreased after drinking water. Besides, VAS values decreased significantly after drinking water. The results suggest that a simple behavior such as drinking water may be used in conjunction with behavioral and cognitive therapies to pursue smoking cessation.

An evaluation of the effectiveness of dental health training administered at a health services school.

ISSUE ADDRESSED: The aim of this study was to determine the knowledge and behaviour of health technician students to determine their oral health (OH) status, and to evaluate the effectiveness of a structured education administered for increasing OH awareness. METHODS: Interventional research was performed between December 2018 and March 2019 on 445 Vocational School of Health Services students in … University. Questionnaires were conducted under observation. The first questionnaire (Q1) included socio-demographic characteristics, OH knowledge level, attitudes and behaviours. One month after the OH training was given to the students, the same questions in Q1 were asked again in the second questionnaire (Q2). Dental caries and Simplified Oral Hygiene Index (OHI-S) status were determined by a dentist via a clinical oral examination. RESULTS: Of the 445 students, 416 (93.5%) participated in the study and completed the Q1 and Q2 questionnaires. A total of 277 (66.6%) students were female and 139 (33.4%) were male, with the age range being 17-33 years (average: 19.2 ± 1.86 years). Of the 416 students who answered the Q1 and Q2 questionnaires, 385 received oral examinations. While the Q1 knowledge score was 7.06 ± 2.08, the Q2 was found to be 12.36 ± 2.90 (P < .001). It was seen that 119 (30.9%) students who had poor OHI-S and 120 (31.2%), had a mean number of decayed, missing and filled teeth (DMFT) value of 6 and above. It was found that the females had better OH values ​​than males (P < .001) and smokers had worse OH values overall (P < .016). CONCLUSION: It was observed that the health technician students had a low level of knowledge about OH before the training but after receiving the training, their knowledge, attitude and behaviour changed positively. SO WHAT?: It was concluded that the OH education given to students caused a positive change in their behaviour, attitude and knowledge.

Prevalence, aetiology, and treatment of molar incisor hypomineralization in children living in Izmir City (Turkey).

BACKGROUND: Molar incisor hypomineralization (MIH) is frequent in children and etiology is different. AIM: The aim of this study was to determine the prevalence, severity, and risk factors of MIH and to investigate the relationship between the severity of the defect in the teeth affected by MIH and the risk factors. DESIGN: The study included patients at the age range of 9 and 10 years, who were admitted to the clinic of paediatric dentistry in Dokuz Eylul University and had four-first molar teeth (FMT) and eight incisor teeth eruptions in the jaws. The presence of only demarcated opacities in one or several FMT and incisor teeth was defined as MIH1, and the presence of post-eruptive breakdown (PEB), atypical restorations, and extracted teeth was defined as MIH2. RESULTS: MIH was detected in 142 (11.5%) of 1237 children. Although there was no statistically significant difference between upper and lower FPM and the occurrence of MIH (P < 0.902), there was a difference between upper and lower central and lateral teeth (P < 0.001; P < 0.009). A significant difference was detected between birth week, birthweight, high fever, and asthma/bronchitis and MIH1 and MIH2 (P < 0.001). CONCLUSION: The prevalence of MIH was found to be 11.5%. It was observed that the patients undergoing low birthweight, preterm delivery, high fever, and asthma/bronchitis were more severely affected by MIH.

Long-term Dental Anomalies after Pediatric Cancer Treatment in Children

Objective: The aim of this study is to determine the frequency of dental anomalies (DAs) (microdontia, hypodontia, hyperdontia, enamel defect, root malformation) in pediatric cancer patients at the ages <5 years and between 5 and 7 years, and understand their relationship with the received therapy. Materials and Methods: Pediatric patients who were diagnosed with cancer and treated before the age of 7 years were investigated in a case- control design. The study included 93 pediatric patients whose ages at diagnosis were between 9 months and 7 years and whose treatments were completed before 5-8 years. Group A consisted of patients in the age range of 9 months to 4 years and Group B consisted of patients in the age range of 5-7 years. Seventy-two siblings with compatible dental age ranges were included in the control group. For both groups, intraoral examinations were performed and panoramic radiographs were taken. Results: Among the 93 pediatric patients, the mean age was 9.54±1.25 (range: 8-13 years) and 48 (51.6%) patients were male. The most common diagnosis was hematologic malignancy with a rate of 65.5%. At least one DA was detected in 7 (9.7%) individuals of the control group and in 78 (83.9%) of the patient group. While the patients in the study group had all kinds of DAs, those in the control group had only enamel defects. The rates of microdontia (p=0.077) and hypodontia (p=0.058) were detected to be significantly higher in Group A than in Group B. Root malformation was more common in patients receiving chemotherapy and radiotherapy than in those receiving only chemotherapy (p=0.006). Conclusion: In this study it was found that the pediatric patients who received cancer treatment before the age of 7 years constituted a high-risk group for DAs. The frequencies of microdontia and hypodontia were increased even more when the patient was treated for cancer before 5 years of age.

Agenesis of Third Molars among Turkish Children between the Ages of 12 and 18 Years: A Retrospective Radiographic Study.

PURPOSE: The aim of this study was to investigate the agenesis of third molars (M3) in children with permanent dentition in a limited population in the province of Izmir, Turkey. STUDY DESIGN: The panoramic radiographs of 773 patients (457 females, 316 males) were evaluated retrospectively at the Dental Hospital of Ministry of Health in Izmir, Turkey. The patients' ages ranged from 12-18 years. The agenesis of M3 teeth was investigated according to maxilla and mandible and right and left distribution. RESULTS: In 593 of the patients (76.7%), all of the M3 teeth were present in the mouth; while in the other 180 (23.3%) patients, agenesis of a varying number of M3 teeth was identified. In 31 patients (4.0%), total M3 tooth agenesis was observed. A statistically significant relationship was not found between gender and M3 teeth (p=0.091). A statistically significant relationship was found between congenital M3 tooth agenesis and the maxilla (14.3%) and mandible (9.6%) (p<0.001). However, a statistically significant difference was not found between the right-left area of the jaw (p=0.100). CONCLUSION: As a result, while all M3 teeth were present in 76.71% of the population studied in the province of Izmir, agenesis of one or more than one M3 tooth was found in the other 23.29% of the patients studied.

Effect of dental care programme and fluoridation in the prevention of dental caries in asthmatic children.

OBJECTIVE: To investigate the effect of a regular dental care programme on the dental health of asthmatic children. METHODS: This prospective, controlled study was conducted at Dokuz Eylul University, Izmir, Turkey, between 2012 and 2014, and comprised asthmatic and non-asthmatic children between 4 and 16 years of age who used inhaler corticosteroid treatment for at least 1 year. Patients were examined for dental caries, gingival index, salivary flow rate, and salivary pH values at baseline, 6 months, and at the end of the first year. Demographic features and tooth-brushing habits of the asthmatic and non-asthmatic children were also analysed. SPSS 20 was used for data analysis. RESULTS: Of the 102 patients, there were 51(50%) each in asthmatic and non-asthmatic groups. Besides, 38(70.6%) participants were boys and 15(29.4%) were girls in the first group compared to 30(58.8%) boys and 21(41.2%) girls in the second group. The mean age was 11.16±3.10 years and 10.33±2.62 years, respectively, in the two groups. The number of asthmatic patients was 45(88.2%) in visit 2 and 37(72.5%) in visit 3, whereas the number of participants for the control group was 41(80.4%) in visit 2 and 36(70.4%) in visit 3. During the first visit, mean values for salivary pH and flow rate were 7.135 0.15 and 3.878 0.71 mL/min among asthma patients, and 7.158 0.14 and 4.684 0.50 among controls. In the first visit, the rate of gingivitis was 31(60.8%) in asthmatic children and 12(23.5%) in the control group. During the third visit, the rate was 4(11.1%) and 5(13.5%) among the two groups, respectively. CONCLUSIONS: Decreased salivary flow rates associated with the drugs used by asthmatic patients caused an increase in the rate of dental caries and gingival disorders.

Evaluation of children's dental anxiety levels at a kindergarten and at a dental clinic.

This study evaluated the dental anxiety levels of preschool children at a kindergarten and at a dental clinic. The anxiety levels of ninety 4-6-year-old (4.99 ± 0.81) preschool children were evaluated according to pulse rates, the facial image scale (FIS), the Venham picture test (VPT), and the Frankl behavior rating scale. The children's mothers were asked to complete the state-trait anxiety inventory (STAI) forms 1 and 2 (STAI 2 and STAI 2). The sample t-test, Mann-Whitney U test, and Pearson's correlation test were used. A statistically significant difference was observed between the children's pulse rates when measured at the dental clinic and those when measured at the kindergarten (p < 0.001). Although the results were not statistically significant, more negative facial expressions were observed in the children at the dental clinic than in those at the kindergarten when assessed using FIS and VPT (p = 0.090 and p = 0.108, respectively). There was a statistically significant correlation between the transient anxiety levels (STAI 1) of mothers and the VPT scores of their children evaluated at the dental clinic (r = 0.506, p < 0.001). The continuous anxiety level of the mothers of males was found to be significantly higher (p = 0.033) than that of the mothers of females (STAI 2). Although the children had been informed about dentistry and were introduced to a dentist at the kindergarten, their anxiety levels seemingly increased as they arrived at the dental clinic. The significant increase observed in the children's pulse rates was a physical indicator that their anxiety levels had increased. It can be concluded that the children felt more anxious at the dental clinic that at the kindergarten.

The Prevelance of Tobacco Use and the Factors Influencing in Students Studying at Two Dentistry Faculties in Turkey.

OBJECTIVES: The objective of this study was to determine the pattern and effects of tobacco and tobacco products use among students of dentistry. MATERIAL AND METHODS: A cross sectional study was performed in the Dentistry Faculty of Ege and Dicle Universities between April and May 2013. All freshmen and senior year students receiving education in both universities were included into the study (n= 321). A questionnaire consisting of 26 questions was used to determine the smoking habits of the students and the influencing factors regarding this habit. Students replied the questions under supervision. RESULTS: A survey was conducted among 298 students out of 321 who were attending both universities. 46.6% of the participants were female and 53.4% were male. Smoking prevelance of the students was 29.9%. It was 19.9% in freshmen students and 45.8% in senior students. According to the first class of students in the fifth grade students in the prevalence of smoking in was found to be highly statistically significant (p< 0.001). Among other tobacco products the following was identified as mostly used: waterpipe, also known as narghile (27.4%), cigarwraps (9.7%), cigar (9.4%) and smoking pipe (2.0%). While 22.5% of the students stated that they started smoking after the age of 15, 36.0% started between the ages of 15 and 18 and 41.5% after the age of 19. The rate of smoking in the house was significantly higher (p< 0.001) among smokers than non-smokers. While 78.7% of the students stated that they would like to quit, 64.3% tried once or more to quit. CONCLUSION: Smoking habit was found to be higher among medical students than the social average. Smoking is more frequent in higher classes. From early years onwards, students of dentistry should be intensively educated regarding the harmful effects of tobacco on health, and efforts should be made to prevent and control of tobacco epidemic.

Evaluation of children's dental anxiety levels at a kindergarten and at a dental clinic

Abstract This study evaluated the dental anxiety levels of preschool children at a kindergarten and at a dental clinic. The anxiety levels of ninety 4-6-year-old (4.99 ± 0.81) preschool children were evaluated according to pulse rates, the facial image scale (FIS), the Venham picture test (VPT), and the Frankl behavior rating scale. The children's mothers were asked to complete the state-trait anxiety inventory (STAI) forms 1 and 2 (STAI 2 and STAI 2). The sample t-test, Mann-Whitney U test, and Pearson's correlation test were used. A statistically significant difference was observed between the children's pulse rates when measured at the dental clinic and those when measured at the kindergarten (p < 0.001). Although the results were not statistically significant, more negative facial expressions were observed in the children at the dental clinic than in those at the kindergarten when assessed using FIS and VPT (p = 0.090 and p = 0.108, respectively). There was a statistically significant correlation between the transient anxiety levels (STAI 1) of mothers and the VPT scores of their children evaluated at the dental clinic (r = 0.506, p < 0.001). The continuous anxiety level of the mothers of males was found to be significantly higher (p = 0.033) than that of the mothers of females (STAI 2). Although the children had been informed about dentistry and were introduced to a dentist at the kindergarten, their anxiety levels seemingly increased as they arrived at the dental clinic. The significant increase observed in the children's pulse rates was a physical indicator that their anxiety levels had increased. It can be concluded that the children felt more anxious at the dental clinic that at the kindergarten.