Age at and reasons for the first dental visit.

INTRODUCTION: The ideal time for the first dental visit of a child as recommended by many professional dental organizations across the world is by the age of one year. The aim of this study was to survey the age and the most common causes for the first visit to the dental office, as well as the recommendations of dentists regarding this visit. PATIENTS AND METHODS: The present study included 289 children visiting a dentist for the first time. The children were divided into 5 age groups and the reasons for the visit were categorized into 9 groups. The variables we assessed were the percentages of children in each age group and the reasons for the first visit to the dentist. Respondents to a questionnaire were 145 dentists. The survey included questions on gender, years of professional experience, specialty, ability to work with children and recommendations concerning the age of the first visit to the dentist. RESULTS: The greatest number of children making their first dental visit were in the 3-6 year-olds (51.90 percent) and the smallest number were the children younger than 1 year (1.73%). The most common reason for making this visit was caries and its complications (59.86%). The second most common reason was parents' decision to have a prophylactic examination of their child (26.99%). The number of dentists in this country that recommended that the first visit should be before the age of 1 year is small (17.93%). 39.31% of the respondents recommended that the first dental visit should take place between 1 and 2 years of age, and 31.03 percent between 2 and 3 years. It was only pediatric dentists that recommended a dentist appointment in the first year of life - 47.37%. This study found that it was the female dentists that predominantly admit and treat children in their dental practices. CONCLUSIONS: The results of the study show that in this country there is no established practice for children to make their first dental visit before they turn one year of age. The predominant cause to make the first visit is caries and its complications. It is necessary to work out recommendations on the age for the first visit to the pediatric dentist and related prophylactic measures.

Comparative study of dental caries and dental fluorosis in populations of different dental fluorosis prevalence.

INTRODUCTION: There is evidence that the prevalence of dental fluorosis in many countries has increased over the last three decades along with a noted decrease of dental caries. To date no comparative studies of dental caries and dental fluorosis have been conducted in Bulgaria reflecting the present-day conditions of life. AIM: To study comparatively the prevalence of dental fluorosis and dental caries and to establish what relationship, if any, there is between them. MATERIAL AND METHODS: We performed a comparative analysis of three epidemiological studies carried out in Plovdiv and Dimitrovgrad in 2004, 2005 and 2008. The hypothesis tested was that dental caries was less frequent in populations with higher prevalence of dental fluorosis (with predominance of mild fluorosis cases). Dental fluorosis was diagnosed using Dean's criteria, and dental caries was scored using the WHO criteria. The results were analysed using the alternative analysis and analysis of variance at a level of significance P < 0.05. RESULTS: The prevalence of dental fluorosis in the studied populations in Dimitrovgrad in 2004 was 56.99%, in Plovdiv in 2005--7.80%, and in 2008--23.18%. The comparison of the studies in Dimitrovgrad and Plovdiv in 2005 showed lower prevalence of dental caries and lower DMFT values in all age groups (P < 0.001) in Dimitrovgrad, where the prevalence of dental fluorosis was greater than that in Plovdiv (P < 0.001). The comparison between the studies in Plovdiv alone in 2005 and 2008 showed an increase in dental fluorosis in 2008 (P < 0.001). The prevalence of dental caries was higher in almost all groups, but the differences failed to reach statistical significance (P < 0.001). The DMFT index was higher in 2008 (P < 0.001) with the exception of some age groups. CONCLUSION: The higher prevalence of dental fluorosis does not necessarily lead to low prevalence of dental caries and low DMFT values in the specific population.

Prevalence of dental fluorosis among 4- to 14-year-old children from the town of Dimitrovgrad (Bulgaria).

INTRODUCTION: There has been no study on the prevalence of dental fluorosis in Bulgaria of today where people have free access to some fluoride-containing products. AIM: The aim of the study was to investigate the prevalence of dental fluorosis among children 4 to 14 years old from the town of Dimitrovgrad, where due to unsatisfactory qualities of tap water people consume bottled water including such with fluoride levels higher than 1.5 mg/l. PATIENTS AND METHODS: The study included 1504 randomly selected children. We analysed subjects with dental fluorosis according to Dean's modified criteria. The following severity levels were defined: 0 - normal; 0.5 - suspicious; 1 - very mild; 2 - mild; 3 - moderate; 4 - severe. Data were analyzed separately for the different types of dentitions. RESULTS: Results showed that 54.52% of all children included in the study had dental fluorosis in different degrees. Primary teeth were affected by dental fluorosis less frequently than permanent teeth (P < 0.001). In mixed dentition cases 41.41% of the children had fluorosis of permanent teeth only, 1.64% had dental fluorosis of primary teeth only and 12.50% had both their primary and permanent teeth affected. The proportion of individuals with the lowest degree of severity - 0.5, was the greatest both for the primary and permanent teeth. Comparison with the proportions of children with more severe degrees of fluorosis revealed significant differences (P < 0.001). CONCLUSION: The results of the study showed excessive fluoride intake during tooth development and suggested a need for further research of risk factors.

Prevalence of early childhood caries and risk factors in children from 1 to 3 years of age in Plovdiv, Bulgaria.

INTRODUCTION: Available data show that Early Childhood Caries (ECC) has a very wide range of prevalence (5% to 55%). Contemporary studies investigate the specific etiologic factors contributing to the appearance of ECC. As these questions are inadequately addressed in the stomatological literature in Bulgaria, we decided to investigate them in the present study. AIM: To determine the prevalence of ECC and the risk factors in children aged 12 to 47 months in Plovdiv. METHODS: The study is representative by design and is conducted in compliance with the requirements of World Health Organization. It includes 370 children 1 to 3 years of age, selected randomly. The dental caries was diagnosed by the visual-tactile method with a dental explorer and mirror at the cavitation level. A survey for determining the risk factors for ECC is carried out among the mothers of all affected children. RESULTS: The results of the study demonstrate high prevalence of ECC in the studied populations--20.82% in 1-year-old children, 40.0% in 2-year-old children and 56.15% in 3-year-old children. The analysis of the questionnaire data shows that the knowledge of mothers about the appropriate feeding of their children is insufficient. The use of baby's comforter with honey is not the only risk factor for developing caries. It is ascertained that frequent consumption of quickly soluble carbohydrates, as well as their prolonged contact with the tooth surface is highly significant risk factors too. CONCLUSIONS: The prevalence of ECC is high in the studied populations. The results of the questionnaire survey demonstrate the need for recommending adequate feeding practices of children till the age of 3 years to their mothers.