The extent of food advertising to children on Greek television: focus on foods potentially detrimental to oral health.

OBJECTIVES: To investigate the extent and nature of food advertising to children on Greek television, focusing on the adverts for foods with potential harmful effects on oral health, and to examine the persuasive marketing techniques used to promote food products. METHODS: Advertisements broadcast on six TV-channels during children's peak viewing times on two weekdays and two weekend days in the period May-June 2010 were recorded (166.7 hours). Each advertisement was coded according to: date, day, length, type of program in which the ad appeared, type of product advertised and promotional technique used. Food advertisements were subdivided according to their sugar and/or acid content as potentially harmful or non-harmful to teeth. RESULTS: Food advertisements had an average frequency of 8.0 per hour during children's peak viewing times with highest frequency (11.4 per hour) on weekends during child-focused programs. Of all advertisements, 1330 (26.7%) were for foods, and 595 (44.7%) of these deemed to be potentially harmful to teeth. The most commonly advertised food product during children's programs was confectionery, 80 (27.7%). Of food advertisements, 199 (15.0%) used at least one of the promotional techniques likely to appeal to children. Advertisements for foods potentially harmful for teeth were more likely to be shown during child-focused programs (OR 2.92, 95% CI 2.04-4.16) and to promise a free gift with purchase (OR 35.43, 95% CI 10.83-115.88). CONCLUSION: Children in Greece are exposed to a large volume of advertisements for unhealthy foods and drinks, which intensively use persuasive techniques proved to affect children's food preferences and consumption. Our study provides evidence that could support advocacy and interventions for the regulation of food advertising.

Caries prevalence of 5, 12 and 15-year-old Greek children: a national pathfinder survey.

AIM: To study the caries prevalence and caries experience of 5, 12 and 15-year-old children in Greece and evaluate how the disease pattern is related to their sociodemographic parameters. METHODS: A stratified cluster sample of 1209, 1224 and 1257 of five, twelve and fifteen-year-old Greek children were randomly selected according to WHO guidelines for national pathfinder surveys and examined for dental caries, according to the BASCD criteria and standards. d3mft, D3MFT and their components, as well as d3mfs, D3MFS, Care Index (CI) and SiC were recorded and related to the demographic data collected concerning age, gender, counties, urban/rural areas and parents' educational status. RESULTS: Dental caries varied considerably between the different districts, with a mean dmft/DMFT value for each age group being 1.77, 2.05 and 3.19 respectively, while 64%, 37% and 29% of them, were with no obvious dentinal caries. Children living in rural areas demonstrated significantly higher dmft/DMFT values and less dental restorative care (CI), whereas children with fathers of a higher educational level showed significantly lower dmft/DMFT values. The significant caries (SIC) index value for the three age groups was 5.01, 4.83 and 7.07 respectively. Posterior occlusal surfaces of the permanent teeth presented most of the caries in the 12 (68%) and 15-year-old group (78%). CONCLUSIONS: Despite the decrease in the prevalence of caries in Greek children disparities remain. Children in rural areas and children with less educated parents had more caries and more untreated caries. All the above call for immediate intervention with comprehensive preventive programs and better geographic targeting of the dental services at a national level including targeted prevention of pit and fissure sealants on posterior permanent molars.

Oral hygiene and periodontal status of 12 and 15-year-old Greek adolescents. A national pathfinder survey.

AIM: To investigate oral hygiene and periodontal status of 12- and 15-year old Greek adolescents, in relation to sociodemographic and behavioural parameters. METHODS: A stratified cluster sample of 1,224 12-year old and 1,257 15-year old adolescents of Greek nationality were selected and examined by calibrated examiners. Periodontal and oral hygiene status were assessed using the Community Periodontal Index (CPI) and the simplified Debris Index (DIs) respectively. The socio-demographic and behavioural data collected included region, location, gender, parental educational level, tooth brushing frequency and reason for dental attendance. RESULTS: The majority of adolescents aged 12 (75.0%) and 15-years (61.4%) had fair oral hygiene levels. The most frequently observed condition in both ages was calculus with or without bleeding (42.8% in the younger and 53.3% in the older age group). Bleeding on probing was found in 41.5% of the 12-year-olds and in 30.0% of the 15-year-olds. The occurrence of shallow and/ or deep periodontal pockets was very low (0.2%). Multivariable modelling revealed that gender, location and tooth brushing frequency were strongly associated with oral hygiene status in both ages; girls, those living in urban areas and brushing teeth more frequently had significantly lower DI-s. Tooth brushing frequency was also associated with periodontal status in both ages, while living in urban areas was associated with better periodontal health only in the 15-year-olds. CONCLUSIONS: The study demonstrated that oral hygiene conditions among Greek children and adolescents are not satisfactory and that the occurrence of gingivitis is high. More efforts on oral health education and oral hygiene instruction are needed to improve their periodontal and oral hygiene status.

Socio-behavioural factors influencing oral health of 12 and 15 year old Greek adolescents. A national pathfinder survey.

AIM: To estimate the frequency in use of oral health services, oral health self-assessment, oral hygiene practices of 12- and 15-year-old Greek children and adolescents, to investigate possible influences of these factors and other socio-demographic parameters on oral health. METHODS: A stratified cluster sample of 1224 12 year old and 1257 15 year old children and adolescents of Greek nationality were selected and examined by calibrated examiners. Clinical examination included recording of caries according to the British association for the study of community dentistry diagnostic criteria, while oral hygiene and periodontal status were assessed by means of the simplified debris and the community periodontal index. Subjects were interviewed to answer questions on socio-behavioural risk factors through a structured questionnaire. The student's t-test and ANOVA were used for statistical evaluation of the means and the chi-square test was applied for statistical comparison of the proportions. Multiple linear regression analysis was performed to assess the statistical association between variables. RESULTS: Caries experience and untreated caries were significantly higher among children and adolescents who visited the dentist only when in pain or for restoring a tooth, compared to those visiting for check-ups or prevention and having more frequent application of topical fluorides. Tooth brushing, at least twice a day, and flossing were significantly associated with periodontal and oral hygiene status, but not with caries presence. The multivariate analysis revealed that parental educational status and reason for visiting a dentist were strong determinants for caries experience and oral hygiene status but not for periodontal health of children and adolescents. CONCLUSIONS: This study has identified several socio-demographic and behavioural determinants for dental caries, oral hygiene and periodontal health of Greek children and adolescents.

Effect of fluoride and of calcium sodium phosphosilicate toothpastes on pre-softened dentin demineralization and remineralization in vitro.

OBJECTIVES: The purpose of this in vitro study was to evaluate the effect of toothpastes containing sodium fluoride in different concentrations or a calcium sodium phosphosilicate system on pre-softened dentin demineralization and remineralization. METHODS: During a ten day pH-cycling protocol, pre-softened bovine root dentin slabs were immersed twice daily, after the demineralization periods, for 2min, in the following toothpaste slurries: (a) non-fluoridated (control), (b) 7.5% calcium sodium phosphosilicate, (c) 1450 ppm F, (d) 2800 ppm F and (e) 5000 ppm F. Subsequently, the specimens were subjected to a 15-h acid resistance test. Surface microhardness was assessed initially and during the pH-cycling and the acid resistance test period. Repeated measurements in each group were analyzed through appropriate regression models for longitudinal data. RESULTS: All fluoride groups, during pH cycling, showed significantly less microhardness loss (p < or = 0.010, p < or = 0.002, p < or = 0.002) and subsequently exhibited increased acid resistance (p < or = 0.010, p < or = 0.001, p < or = 0.001) compared to the control. The 5000 ppm and 2800 ppm F toothpastes, inhibited demineralization significantly more effectively than the 1450 ppm F (p < or = 0.001, p < or = 0.030) and the calcium sodium phosphosilicate toothpaste (p < or = 0.001), while no significant differences were found between the two high fluoride groups (p=0.130). The calcium sodium phosphosilicate toothpaste, during pH cycling showed a difference that approached statistical significance compared to control (p=0.079), but its acid resistance behavior was similar to control (p=0.610). CONCLUSIONS: Under these experimental conditions, the high fluoride toothpastes promoted remineralization and inhibited demineralization more effectively, than the 1450 ppm F, the non-fluoridated (control) and the calcium sodium phosphosilicate toothpastes.

The microbiota on different oral surfaces in healthy children.

INTRODUCTION: Knowledge of the early oral colonization patterns could provide a better understanding of oral biofilm development and disease initiation that in turn could be the basis for early preventive programmes. METHODS: Microbial samples were collected from five different oral habitats from a total of 93 children (age 3-12 years), attending the Dental School of the University of Athens, who were split into three age groups. A total of 38 microbial species were sought out by the checkerboard DNA-DNA hybridization technique. RESULTS: All of the test species, except Parvimonas micra and Porphyromonas gingivalis, differed significantly among sample locations providing quite distinct microbial profiles for the different oral surfaces. Supragingival and subgingival plaque had similar profiles and exhibited higher proportions of Actinomyces species and Green complex while soft tissue samples were dominated by streptococci of the Yellow complex. The profiles of the tongue dorsum and saliva were also similar. Many of the species were in similar proportions in all three age groups for a given location. Periodontal pathogens showed increases in proportions with increasing age. Specifically, the Red complex species (Tannerella forsythia, P. gingivalis, Treponema denticola) showed a significant increase in proportion with age (P < 0.05) in all sample locations. CONCLUSIONS: The results showed a pattern of colonization in children similar to that previously found in adults. Differences in the profile between age groups suggest a gradual maturation of the oral microbiota, with it being made up of an increasing number of Orange and Red complex species.

A standardized photographic method for evaluating enamel opacities including fluorosis.

OBJECTIVES: The objective of this study was to demonstrate the reproducibility of a standardized photographic technique for recording fluorosis when used by a group of epidemiologists as part of a large multicentred European study. METHODS: Studies were first carried out to develop the equipment specification and photographic method. The author (JAC) was then trained and calibrated in this method. She was then responsible for the training and calibration of examiners from a further six European study sites. The method involved taking two transparencies of the permanent maxillary central incisors of 8-year-old children, the first after 8 s while the teeth were still wet and the second after 105 s when the teeth had been allowed to dry out naturally. Data were collected at a central location during a training/calibration exercise and subsequently, during the conduct of a large study to measure fluorosis prevalence, at the seven sites. Intra- and interexaminer reproducibility of the photographic method were measured by grading the transparencies produced by all the examiners according to the DDE and TF indices. RESULTS: The time period in which the transparencies were taken was to within 4 s among the examiners. Transparencies scored according to the TF index gave a range of Kappa values of 0.45-0.66 for intraexaminer reliability and 0.32-0.55 for interexaminer reliability. When using the DDE index Kappa values ranged from 0.43 to 0.70 for intraexaminer reliability and from 0.34 to 0.69 for interexaminer reliability. CONCLUSION: The photographic method was mostly robust and reproducible when used by epidemiologists from seven European study sites.

Dental caries changes between 1982 and 1991 in children aged 6-12 in Athens, Greece.

The aim of this study was to compare dental caries and oral hygiene status in children aged 6-12 years in the Athens area between 1982 and 1991. Dental examinations were carried out by the same examiners in 773 children attending the same randomly selected schools sited in areas of different socioeconomic levels. The findings concerning the deciduous dention showed that the percentage of caries-free children increased in 1991 compared to 1982 by 38%. The mean deft scores were reduced by an amount ranging from 21 to 34%. Changes in caries prevalence were also observed in the permanent dention. The percentage of caries-free children for the total examined population increased by 94% while the reduction in DMFT index ranged between 38 and 70%. Treatment need was significantly lower in 1991 compared to 1982 in both dentitions. Debris index scores were similar while oral hygiene habits had slightly improved by 1991. The decline in caries levels may be attributed to the increased use of various forms of fluoride. Furthermore, dental health awareness of the population has improved.

[Quality assessment of fillings by place and type of provider]. / Axiologese tes poiotetas emphraxeon kata topo kai phorea therapeias.

The purpose of this study was to determine the quality of 1310 fillings among third-year dental students of Athens University. The mean age of fillings was 5.6 years. The classification of fillings into three categories of quality showed that 41.4% were satisfactory, 47.2% were acceptable but needed to be refinished, and finally 11.4% had to be replaced. The main reasons for failure were poor performance of anatomic form, secondary caries, poor marginal adaptation and soft tissues damage. The comparison of quality of fillings by place and type of provider showed that University Dental Clinic's fillings were of significantly better quality than those rendered in private or public dental clinics either in Athens or elsewhere. On the contrary the comparison of quality of fillings by place and type of provider (University Clinic excluded) did not show any significant differences.