Psychometric properties of the Greek version of the Jefferson Scale of Empathy and empathy levels in Greek dental postgraduate students.

PURPOSE: The aims of this study were to: (1) examine the psychometric properties of the Greek version of JSE-HP and (2) explore empathy among Greek dental postgraduate students. METHODS: The JSE-HP scale was translated into Greek using the back translation method. The questionnaire was given to 111 dental postgraduate students between November 2017 and February 2018. A random sample of 25% was retested to assess test-retest reliability. The reliability of the Greek version of JSE-HP was measured with Cronbach's alpha (α) and Discrimination Indices (DIs). Exploratory Factor Analysis, with varimax rotation of the factorial axes, was used to examine the dimensionality and the factorial validity of the Greek version of the JSE-HP. Comparisons between groups of postgraduate students were performed as appropriate with the Kruskal-Wallis or the Mann-Whitney U test. RESULTS: The response rate was 100%. The mean age was 28.9 years. The reliability, in the sense of internal consistency of the questionnaire was considered satisfactory (Cronbach's alpha: 0.76, average DI: 0.33.) The test-retest reliability was satisfactory (Pearson's r = 0.77, p < 0.001). Factor Analysis revealed 7 significant factors. No statistically significant differences in empathy scores were found among groups of postgraduate students. CONCLUSIONS: The Greek version of the JSE-HP shows good psychometric properties. Empathy scores do not differ among Greek dental postgraduate students.

Morphological, histological, and chemical analysis of first permanent molars with molar incisor malformation.

PURPOSE: Molar incisor malformation (MIM) is a dental anomaly rendering first permanent molar pulps inflamed/necrotic at a young age. It often affects permanent incisors, primary second molars and less frequently other teeth. The purpose of this study was to investigate the anatomy and histology of MIM in seeking insight into its pathogenesis. METHODS: Five MIM first permanent molars were examined with micro-computed tomography (micro-CT) for 3D morphology, with scanning electron microscopy for microanatomy, with energy-dispersive X-ray spectrometer (EDS) for chemical composition and for histology with optical microscopy. Composition differences were statistically determined using one-way ANOVA. RESULTS: Micro-CT confirmed dentin abnormalities in the middle and cervical third of the crown in the form of the radiodense 'cervical mineralized diaphragm' (CMD). This was peripherally intertwined with enamel fjords and projections severely disrupting the integrity of pulp chamber and its continuity with root canals. EDS showed increased Ca in CMD compared to dentin. The histological examination revealed anomalous osteodentin-like hard tissue with denticles in the CMD. CONCLUSION: An interconnection of anomalous cervical enamel with crown CMD dentin preceded to the severe pulp chamber and root dysplasias in MIM molar teeth.

Gagging and cooperation in 4-12-year-old children over a series of dental appointments.

PURPOSE: The purposes were to evaluate if gagging can affect children's cooperation with treatment, investigate possible changes in gagging and study factors that can predict children's behaviour over dental treatment. METHODS: 255 children aged 4-12 years, needing at least three consecutive dental appointments, completed the Children's Fear Survey Schedule-Dental Subscale before examination. The Gagging Problem Assessment was performed before the initial examination and after the third/final appointment. Frankl's Behaviour Rating Scale (FBRS) was used to rate children's behaviour. Multivariate Mixed Linear and Logistic Regression Models were used. RESULTS: Children with definitely positive behaviour were significantly older, less fearful and less likely to gag before treatment. Girls and older children had lower odds of gagging over time, while fearful children had higher odds. There were no statistically significant associations between gagging over time, FBRS and the type of dental treatment at the third appointment. The percentage of children who gagged after the third appointment (27.05%) was significantly lower as compared to the percentage found at the initial appointment (32.54%; p = 0.004). CONCLUSION: Among the variables studied, age, dental fear, initial GPA and type of treatment were good predictors of children's behaviour during dental treatment.

Tooth-coloured materials for class II restorations in primary molars: systematic review and meta-analysis.

PURPOSE: The aim of this systematic review was to compare the success rate of five tooth-coloured materials, namely Glass Ionomer (GI), Resin-Modified Glass Ionomer (RMGI), Composite Resin (CR), Polyacid-Modified Composite Resin or Compomer (CO) and High-Viscosity Glass Ionomer (HVGI) in primary molar Class II restorations. METHODS: Five databases were searched from inception to April 23, 2020 for randomized clinical trials comparing the failure rate of these materials. After duplicate study removal, data extraction and risk of bias assessment with the Cochrane tool, data synthesis was conducted, comparing all five tooth-coloured materials in pairs and computing the overall success rate for each one, respectively. RESULTS: A total of 5615 articles were obtained by electronic and hand literature search. After the application of the eligibility criteria, ten RCTs were included in this systematic review and six RCTs for meta-analysis. Their risk of bias was assessed to be high to moderate. Due to the small number of RCTs comparing the five restorative materials in pairs investigated in the same study, only three MAs were available for heterogeneity assessment. These were: (1) between CO-RMGI (RR 1.04 [0.59, 1.84]; p = 0.88; I2 = 1%), (2) CR-CO (RR 1.12 [0.41, 3.02]; p = 0.83; I2 = 57%), and (3) between CR-RMGI (RR 1.10 [0.74, 1.63]; p = 0.65; I2 = 0%). No statistically significant differences were found between the two materials in all three comparisons. CONCLUSION: CR, RMGI and CO presented no statistical differences. In comparison to other tooth-coloured materials, studies on GI were too few to allow recommendations about its use. More studies on HGVI are needed for evidence-based recommendations to be made. The evidence extracted from this meta-analysis was not strong enough (moderate), due to the small number of RCTs and the risk of bias ranging from high to moderate. More, well-designed RCTs comparing tooth-coloured materials for primary molar Class II restorations are necessary.

Factors associated with gagging during radiographic and intraoral photographic examinations in 4-12-year-old children.

AIMS: No studies are available in paediatric samples evaluating gagging during toothbrushing, radiographic and/or intraoral photographic examinations. The aims were to collectively examine potential factors associated with gagging during radiographs and intraoral photographs in 4-12-year-old children. METHODS: Parents/guardians of 395 children (aged 4-12 years old) completed questionnaires asking about their children's toothbrushing habits. Children completed Greek versions of the Gagging Assessment Scale (GAS) and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), while the dentist used the shorter version of the Gagging Problem Assessment (GPA-de-c/SF) to objectively assess gagging. X-ray and Photo Rating Scales were created to evaluate gagging during X-rays and photographs, respectively. Multivariate logistic regression was used to examine the relationship between the potential factors and gagging. RESULTS: 59 of 275 patients (21%) and 56 of 276 patients (20%) who needed X-rays and intraoral photographs, respectively, gagged. Children who gagged during X-rays had significantly higher GAS scores (p = 0.007). Boys, younger children, and those who gagged on GPA-de-c/SF were more likely to gag during X-rays, and children who gagged on GPA-de-c/SF were more likely to gag during photographs. Brushing habits were not related to dental fear or gagging. CONCLUSION: Of the variables which we studied, GPA-de-c/SF most strongly affected the odds of gagging during taking radiographs and/or intraoral photographs.

Distribution and morphology of enamel hypomineralisation defects in second primary molars.

PURPOSE: The purpose of this study was to investigate defect distribution and morphology in hypomineralised second primary molars (HSPM), presence of similar defects in other primary teeth and clinical similarities with molar-incisor hypomineralisation (MIH). METHODS: This clinical descriptive study involved children who attended a postgraduate paediatric dental clinic in a 20-month period and were diagnosed with HSPM. The updated MIH/HSPM index of Ghanim et al. (Eur Arch Paediatr Dent 16(3):235-46, 2015) was used to record defects on primary molars and canines. RESULTS: 54 children (23 boys) aged 4 to 12 years comprised the study sample. The mean number of affected second primary molars per child was 2.65 with no statistically significant difference between maxilla and mandible or between right and left side with defects more frequently located on buccal surfaces. 66.7% of the children were mildly affected (opacities only) with 29 out of 54 having defects occupying less than 1/3 of the surface. Severity increased with increasing number of affected teeth and extent of the defects per child. Similar defects were recorded in the first primary molars and canines in 55.5% of the children who had those teeth present. CONCLUSION: The distribution and morphology pattern of HSPM defects was similar to that in MIH, supporting the notion of a common hypomineralisation entity.

Structural and chemical enamel characteristics of hypomineralised second primary molars.

PURPOSE: Although hypomineralised second primary molars (HSPM) are considered belonging in the same entity as molar incisor hypomineralisation (MIH), the structure and chemistry of their defected enamel have not been described. We aimed to study these in justifying any similarities with MIH. METHODS: Nine HSPM and five first permanent molars with MIH were either fractured or sectioned longitudinally through their defective enamel and examined by scanning electron microscopy. Relative amounts of calcium (Ca), phosphorus (P), oxygen (O), carbon (C) and the Ca:P ratio were calculated in the primary molar samples by energy -dispersive spectrometry. RESULTS: Rod width was deficient in the defected enamel of HSPM resulting in wide interrod spaces and suggesting similarities to permanent enamel structure in MIH. In areas with breakdown, cracks and disrupted coherence between enamel rods were more marked. Differences in Ca, P, O, C and Ca:P ratio between hypomineralised and sound enamel in HSPM followed the same trend as in MIH without reaching statistical significance. CONCLUSION: Marked structural differences between sound and hypomineralised enamel of HSPM and similarity to MIH enamel were verified.

Three-year performance of a nano-filled resin-modified glass ionomer cement in class II primary molar restorations.

PURPOSE: To compare the clinical failure rate of two resin-modified glass ionomer cements (RMGICs) used for Class II primary molar restorations over a 3-year period. METHODS: Healthy, cooperative children aged 4-8 years with carious, asymptomatic primary molars requiring class II restorations received either nano-filled (Ketac Nano, 3 M ESPE) or regular (Vitremer, 3 M ESPE) RMGIC restorations. These were blindly assessed semiannually for 3 years using the modified USPHS criteria with all-cause failure as primary outcome and failure for each criterion as secondary outcome. Data was analysed with Fisher's exact tests and survival analysis with robust standard errors at 5%. RESULTS: Outcome assessment included 159 teeth at 12 months, 141 teeth at 24 months, and 98 teeth at 36 months. No difference in all-cause failure was found between regular and nano-filled RMGIC at 12 (8.6% versus 14.1%), 24 (9.0% versus 14.9%) or 36 months (7.4% versus 20.5%) (P > 0.05). The nano-filled RMGIC retained better its anatomical form and the regular RMGIC likewise its marginal integrity (P < 0.05), but only in the acceptable range (Alpha-Bravo). Overall, survival analysis found no significant difference for all-cause failure [hazard ratio (HR) 0.58; 95% confidence interval (CI) 0.25-1.31; P = 0.19] or any secondary outcomes other than contact point integrity. Finally, subgroup analysis by jaw indicated that the regular RMGIC performed better than the nano-filled RMGIC for mandibular molars (HR 0.36; 95% CI 0.13-0.96; P = 0.04), but further data are needed. CONCLUSION: Nano-filled RMGIC showed less occlusal wear but more mild marginal defects than regular RMGIC, but these findings were of limited clinical significance and both materials performed favourably for 3 years.

Biological effects of low-level laser irradiation (LLLI) on stem cells from human exfoliated deciduous teeth (SHED).

OBJECTIVES: To investigate the effects of low-level laser irradiation (LLLI) on viability/proliferation, migration, osteo/odontogenic differentiation, and in vitro biomineralization of stem cells from human exfoliated deciduous teeth (SHED). MATERIALS AND METHODS: SHED cultures were established by enzymatic dissociation from pulps of deciduous teeth. SHED were irradiated with a diode laser (InGaAsP; 940 nm; 0.2 W, continuous mode) at energy fluences 4, 8, and 16 J/cm2 in the dark, while non-irradiated SHED served as control. Cell viability/proliferation was evaluated by MTT assay and cell mobilization by Transwell™ migration assay. Expression of osteo/odontogenesis-related genes (ALP, BMP-2, BGLAP, DSPP, MSX2, RUNX2) was assessed by real-time PCR, while in vitro biomineralization by Alizarin Red staining. Statistical analysis was performed by two-way ANOVA and Tukey's post hoc tests (*p < 0.05, **p < 0.01). RESULTS: Statistically significant stimulation of cell viability/proliferation was observed at all energy fluences, reaching the highest effect for the 4 and 16 J/cm2. Although the 8 J/cm2 fluence showed the lowest stimulatory effect on cell viability/proliferation, it was the most effective in inducing SHED migration, upregulation of odontogenesis-related genes (DSPP, ALP, BMP-2) at specific time-points, and the in vitro biomineralization potential of SHED compared to the other two energy fluences. CONCLUSIONS: LLLI proved beneficial in promoting SHED biological processes critical for pulp repair in deciduous teeth. Overall, the 8 J/cm2 energy fluence showed the most beneficiary effects. CLINICAL RELEVANCE: These results provide insights on a narrow "therapeutic window" of LLLI application in vital pulp therapies of deciduous teeth, paving the way for the establishment of effective clinical protocols.

Child dental fear and past dental experience: comparison of parents' and children's ratings.

PURPOSE: To compare the parental and child versions of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the parental and child evaluations of the Child's Past Dental Experience (CPDE) in 4- to 12-year-old children in a sample from Greece. METHODS: 537 families (652 children) with 4- to 12-year-old children seeking dental care either at a University paediatric dental clinic (UC) (50.8%) or a paediatric private practice (PP) participated. Parents completed a sociodemographic questionnaire and the parental Greek version of the CFSS-DS, and children independently completed the child's Greek version. All family members answered questions about CPDE. Statistical analyses were based on multilevel models (p < 0.05). RESULTS: Mothers' and fathers' mean CFSS-DS total scores were not significantly different from each other (p = 0.655), but were significantly higher than the scores of their sons and daughters (p < 0.001), regardless of the child's age. There was a negative association between mother's age and CFSS-DS agreement, but not for fathers. There was poor agreement for CPDE ratings between children and both parents, regardless of gender. Parents' ratings of CPDE were not related to their assessment of their children's dental fear, whilst the children's ratings of their CPDE were significantly related to their current dental fear. Location (UC or PP) had no significant influence on CFSS-DS or CPDE parental-child differences. CONCLUSIONS: Both parents overestimated their sons' and daughters' dental fear. There was poor agreement on CPDE evaluation between parents and children. Parental CFSS-DS and CPDE evaluations are poor indicators of children's dental fear and prior dental experience.

Direct pulp capping versus pulpotomy with MTA for carious primary molars: a randomised clinical trial.

AIM: Aim of this randomised clinical trial was to compare the outcome of direct pulp capping (DPC) versus pulpotomy, both with MTA, for carious primary molars. METHODS: Healthy, cooperative children aged 3-9 years with at least one deep carious primary molar requiring vital pulp therapy were included. Data on the primary outcome (all-cause failure) and secondary outcomes (clinical or radiographic failure) were collected blindly semi-annually for a minimum of 1 year up to 3 years and analysed with survival analysis and generalised linear regression at alpha = 5%. RESULTS: A total of 74 children were randomly allocated on 1:1 basis to DPC (35 children; 40 teeth) or pulpotomy (39 children; 57 teeth). Survival from all-cause failure was 79.7% [95% confidence interval (CI) 69.3-86.9%] at 12 months and 66.0% (95% CI 53.4-76.0%) at 24 months which remained stable up to 36 months, with no differences between groups (P > 0.05). No significant difference was found in the survival rate of the two groups for all-cause [hazard ratio (HR) = 0.95; 95% CI 0.45-2.01; P = 0.88], clinical (HR = 0.74; 95% CI 0.0.19-2.92; P = 0.66), or radiographic failure (HR = 0.80; 95% CI 0.0.36-1.82; P = 0.60) throughout the 3-year follow-up. Regression analysis indicated that needing a second attempt for haemorrhage control was associated with higher clinical failure rate. All-case failure was significantly different for class II versus occlusal cavities and in the latter cavities pulpotomy performed better (P < 0.001). CONCLUSION: The results of the current trial indicate that both DPC and pulpotomy can be reliable options for the treatment of deep carious primary molars in cooperative children, in carefully selected cases.

Clinical evaluation of a surface pre-reacted glass (S-PRG) filler-containing dental sealant placed with a self-etching primer/adhesive.

AIMS: To clinically evaluate the retention rates and caries-prevention effect of a resin-based, non-etch and rinse, self-etch primed pit and fissure sealant containing Sealant Pre-reacted Glass Ionomer Cement (S-PRG) fillers, in comparison to a conventional resin-based sealant over an 18-month period. METHODS: There were 81 children, aged 6-12 years old, who were randomly assigned to one of two sealant-groups, either the self-etch primed sealant (Beautisealant, Shofu) or the conventional etch and rinse sealant (Seal it, Spident). A total of 218 sealants of both groups were placed on first permanent molars with either sound surfaces (The International Caries Detection and Assessment System [ICDAS], code 0) or incipient enamel caries lesions (ICDAS code 1) according to the manufacturers' instructions. Each sealant restoration was independently evaluated in terms of retention and caries status at 6, 12 and 18 months. The data were statistically analysed with the Chi-squared test and z-test and the level of significance was preset at α = 0.05. RESULTS: The differences between the complete retention rates of the two sealant groups were statistically significant in all periods of evaluation (p < 0.01). Survival rates of each sealant-group were comparable on sound (ICDAS 0) and enamel caries lesions (ICDAS1). Caries prevention effect of the two sealant groups was similar at the end of the evaluation period. CONCLUSIONS: The clinical performance of the S-PRG filler-containing dental sealant placed with a self-etching primer was poor regarding its retention. Its significantly higher loss did not lead to more carious occlusal surfaces at the 18-month recall.

Comparison of resin modified glass ionomer cement and composite resin in class II primary molar restorations: a 2-year parallel randomised clinical trial.

AIM: To compare the 2-year success rates of a Resin Modified Glass Ionomer Cement (RMGIC) with a composite resin in class II primary molar restorations. METHODS: Healthy, cooperative children aged 4-7.5 years with at least one carious primary molar requiring a class II restoration were included in this parallel randomised trial and allocated on a 1:1 basis to composite resin (Z250, 3M ESPE) or RMGIC (Vitremer, 3M ESPE). Restorations were assessed semiannually up to 2 years clinically and radiographically using modified United States Public Health Service criteria, with the primary outcome being all-cause failure. Data were analysed per protocol by binomial linear regression with Relative Risks (RR) and their 95% confidence intervals (CI). RESULTS: 55 patients were randomly allocated to either group and 44 analysed at 2 years; with 49 teeth in the Z250 and 55 teeth in the Vitremer group. The all-cause failure rate for both materials was 3% after 1 year (4 and 2% for Z250 and Vitremer, respectively) and 16% after 2 years (16% for both Z250 and Vitremer). Overall, no difference between materials could be found at 2 years (RR = 1.4; 95% CI 0.8, 2.4; P = 0.30). However, Vitremer was associated with more favourable gingival health compared to composite (RR = 0.2; 95% CI 0.1, 0.9; P = 0.03), but also occlusal wear, which was observed exclusively for Vitremer. CONCLUSION: No significant difference was found in the overall performance of the two materials, making them suitable for class II primary molar restorations, although RMGIC presented more pronounced occlusal wear of limited clinical importance after 2 years.

A study of parental presence/absence technique for child dental behaviour management.

AIM: To examine the effectiveness of parental presence/absence (PPA) technique on the dental behaviour management of children. MATERIALS AND METHODS: This randomised control study recruited 61 child dental patients with uncooperative behaviour (Frankl 1 or 2) managed with AAPD-endorsed non-pharmacological techniques at a post-graduate university clinic. PPA was only used in the test group (31 children). Using a mini video-tape device, recording commenced at the onset of uncooperative behaviour and this was later rated, minute by minute, by a blinded experienced paediatric dentist. STATISTICAL ANALYSIS: Data were analysed with SPSS v.13.0. The Kolmogorov-Smirnov test was used for normality analysis. The Mann-Whitney U-test and Log Rank analysis were also performed. RESULTS: The mean point in time, after behavioural problems commenced that PPA or alternatives were applied was 1.82 ± 1.04 min. Behaviour improvement (technique success) was shown by 65.6% of all children. There was no statistically significant difference between the study and control groups in age, gender, mean Frankl score, in Frankl score 2 min before/after technique application or regarding the time point at which the technique was first applied. Behaviour improvement was seen in 17 patients (54.8%) in the PPA group and in 23 patients (76.7%) in the control group. CONCLUSION: PPA applied to various dental sessions as a behaviour management technique showed no advantage over other basic, non-pharmacological techniques.

Dental fear and caries in 6-12 year old children in Greece. Determination of dental fear cut-off points.

AIM: To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece. METHODS: Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children⁁s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale. STATISTICS: Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of <0.05. RESULTS: First sample: The mean CFSS-DS score was 27.1±10.8. Age was significantly (p<0.05) related to dental fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DS< 33 was defined as 'no dental fear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DS<33). CONCLUSION: Dental fear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).

Streptococcus mutans, Streptococcus sobrinus and Candida albicans in oral samples from caries-free and caries-active children.

AIM: This was to examine the occurrence of S. mutans, S. sobrinus and C. albicans in dental plaque and saliva from caries-free and caries-active Greek children. METHODS: Saliva and dental plaque samples from 46 caries-free and 51 caries-active 3-to-13-year-old children were examined using selective media for the three microbes. Identification of isolated mutans streptococci (S. mutans and S. sobrinus) was performed with biochemical test and specific DNA probes. The salivary levels of mutans streptococci were additionally determined by a chair-side test (Dentocult® SM strips). RESULTS: The isolation frequencies of S. mutans, S. sobrinus and C. albicans were 66, 11 and 18 %, respectively. Caries-active children harboured more frequently and at significantly higher numbers the specific microbes than caries-free children. A similar pattern was observed with the Dentocult® SM strip scores. No correlation was found between the presence of these microbes and the age or gender of the children. CONCLUSIONS: Caries experience was statistically significantly related to the presence of all three microbes under study, both in dental plaque and saliva.

Association between dental caries and body mass in preschool children.

AIM: This was to explore the association between dental caries and body mass index (BMI) by conducting a cross-sectional study of a sample of preschool children from a major Greek city. METHODS: The sample consisted of 2180 children aged 2.5-5.9 years from 33 private day care centres of Thessaloniki. The examinations were performed on site in ample day light by one examiner using disposable dental mirrors and a penlight. Oral examinations included recording of dental caries by dmfs index. Subject's height and weight were measured using a portable measuring unit and a digital scale, respectively. RESULTS: The overall prevalence of underweight, normal weight, overweight and obese children in each BMI-based weight category was 11.8, 72.2, 12.8, and 3.2 %, respectively. The mean age of the total sample was 50.09 (±10.28) months, mean dmfs was 0.36 (±1.9) and the caries-free children were 90.0 %. Overweight children were 1.36 times and obese children 1.99 times more likely to have higher dmfs than normal weight children. The mean dmfs values of underweight children did not significantly differ than that of children with normal weight. The relatively higher dmfs of the obese and overweight children was mostly evident in the older (60-71 months) age group. CONCLUSIONS: Caries prevalence in this sample of Greek children attending private day care centres was low. Overweight and obese preschool children were at higher risk of dental caries than normal- and underweight children.

Molar incisor hypomineralisation (MIH): correlation with dental caries and dental fear.

AIM: This cross-sectional study was to investigate correlations between molar incisor hypomineralisation (MIH), dental caries and child dental fear. MATERIALS AND METHODS: The subjects in the study were representative samples of 8 and 14 year old children from three Greek cities (total N = 2335). Dental examinations were performed by one calibrated examiner in classrooms, after the children had brushed their teeth, using an intraoral mirror and artificial room light supplemented by a penlight. All the children completed the children's fear survey schedule-dental subscale (CFSS-DS) questionnaire. MIH scores were recorded using EAPD criteria and dental caries experience by DMFS/dmfs index. Data were analysed with the Chi-squared (χ (2)), Mann-Whitney and Spearman's rank correlation coefficient tests. RESULTS: The mean DMFS in children with MIH (8-year olds: 1.60 ± 2.01, 14-year olds: 4.60 ± 4.41) was statistically significantly higher than children without MIH (8-year olds: 1.01 ± 1.78, 14-year olds: 3.46 ± 4.28) (p < 0.001 for both age groups). Children with severe MIH had statistically significantly higher mean DMFS scores than children with mild or no MIH (p < 0.001), while the dmfs of the 8 year olds were unrelated to their MIH status (p = 0.332). Caries experience was associated with the MIH status of the first permanent molars in both age groups (p < 0.001). The mean CFSS-DS scores did not differ significantly between the groups of children without (26.2 ± 9.9) or with MIH (26.5 ± 9.6) (p = 0.339), regardless of MIH severity. CONCLUSIONS: A positive association between MIH and dental caries was confirmed and a lack of association found between MIH and dental fear in Greek children.