Anxiety, Stress and Coping Patterns in Children in Dental Settings.

BACKGROUND: Fear of the dentist and dental treatment is a common problem. It can cause treatment difficulties for the practitioner, as well as severe consequences for the patient. As is known, the level of stress can be evaluated thought electrodermal activity, cortisol measure in saliva, or indirectly by psychometric tests. AIM: The present study examined the psychological influence of dental interventions on the child as well as coping patterns used for stress diminution. METHODS: We examined two matched groups of patients: a) children with orthodontic problems (anomalies in shape, position and function of dentomaxillofacial structures) (N = 31, mean age 10.3 ± 2.02) years; and b) children with ordinary dental problems (N = 31, mean age 10.3 ± 2.4 years). As psychometric instruments, we used: 45 items Sarason's scale for anxiety, 20 items simple Stress - test adapted for children, as well as A - cope test for evaluation coping patterns. RESULTS: Obtained scores confirmed the presence of moderate anxiety in both groups as well as moderate stress level. For Sarason's test obtained scores for the group with dental problems are 20.63 ± 8.37 (from max 45); and for Stress test 7.63 ± 3.45 (from max 20); for the orthodontic group obtained scores are 18.66 ± 6.85 for Sarason's test, while for the Stress test were 7.76 ± 3.78. One way ANOVA confirmed a significant difference in values of obtained scores related to the age and gender. Calculated Student t - test shows non-significant differences in obtained test results for both groups of examinees. Coping mechanisms evaluated by A - cope test shows that in both groups the most important patterns used for stress relief are: developing self-reliance and optimism; avoiding problems and engaging in demanding activity. CONCLUSION: This study confirmed that moderate stress level and anxiety are present in both groups of patients (orthodontic and dental). Obtained scores are depending on gender and age. As more used coping patterns in both groups are developing self-reliance and optimism; avoiding problems and engaging in demanding activity. Some strategies for managing this problem are discussed.

Oral Hygiene Index in Early Childhood Caries, Before and After Topical Fluoride Treatment.

BACKGROUND: Circular caries occurs in the earliest age of the children (1 - 1.5 year), immediately after the eruption of the deciduous teeth. During this period, children are too young to be able to properly implement oral hygiene. Consequently, it is at a negligible level, with plenty of soft plaque on the deciduous tooth surfaces. OBJECTIVE: The main objective of this clinical trial was to determine the correlation between oral hygiene shown with Oral Hygiene index, and the initial stages of circular caries (initial lesion and superficial form), before and after topical fluoride treatment. MATERIAL AND METHODS: For determination of the OHI - index we used the method of Green - Vermillion. It was determined two times in 117 patients, during the first visit and immediately before physiological replacement of deciduous teeth. Patients were two to three years old and diagnosed with initial stages of circular caries. Amino fluoride solution was applied once a week, during six months. RESULTS: We obtained statistically significant improvement of OHI - index at the end of the test, among treated subjects from both major groups. CONCLUSION: It can be concluded that the level of oral hygiene is correlated with the progression of changes in enamel. Topical fluoride treatment has a positive impact on reducing ECC.

National strategy for prevention of oral diseases in children from 0 to 14 years old age in the Republic of Macedonia for the period 2008-2018.

Human principles and the fundamental values are the main principles stipulated in the Constitution of Republic of Macedonia. The Government of the Republic of Macedonia, within its program objectives, implementing the laws in the country, the international standards and the global health care as the worlds objective of the Constitution of WHO. According to the information received through the health monitoring system, as well as the results from target and selective studies, they have shown that the condition of oral health, especially the condition with the dental caries is serious health problem of all groups. The alarm was activated by the state of increase of the caries incidence, showing a value of DMFT=6.88 in children at 12 years of age, which is considered as a high value compared to the WHO recommendations for oral health (DMFT=3). The experience from the developed countries, as well as the knowledge based on scientific and professional evidence in RM, prove that this desease may be successfully prevented, eliminated and eradicated by conduction of primary preventive measures. The program objectives of the National Strategy for prevention of oral deseases are shared in shorth term, medium term and long term objectives, which aim is eradication of the caries. The Strategy include a prevention of periodontal desease and orthodontic anomalies. The prevention of the caries will be performed by using a five preventive measures: 1. mechanical and chemical control of the dental plaque 2. Discipline of sugar take regime 3. Application of fluorides (systemic and topic) 4. sealing fissures and cavities 5. Education and motivation for sustainnability of oral health. In the frame of the Strategy, we planed a dental dispensarisation of children through registering data in the patients file, as propose by WHO, and arrangement of preventive teams and professional assistance of paediatrics and gynecologists. The evaluation of the effects from the preventive program shall be performed two years from the initiation of the program implementation and the follow-up evaluations shall be performed every year, on the representative sample from the group of children at 6, 8 and 12 years of age covered with the program. The statistical data processing shall be presented at professional and scientific forums and published in the annual report of WHO.

Anxiety and personality characteristics in children undergoing dental interventions.

Anxiety about and fear of dental treatment have been recognized as sources of problems in the management of child dental patients. It has been suggested that some individuals who are fearful of or anxious about dental treatment have a constitutional vulnerability to anxiety disorders as is evidenced by the presence of multiple fears, generalized anxiety or panic disorders. Concerning the child population, maternal anxiety is considered to be a major factor affecting the behaviour of young children expecting dental intervention. The aim of the study was to the measure general anxiety of children undergoing dental intervention and to compare it with some personality characteristics, such as psychopathology, extroversion and neuroticism. The evaluated sample comprises 50 children (31 girls and 19 boys), randomly selected at the University Dental Hospital, Skopje. The mean age for girls was 11.4 (± 2.4) years, and for boys 10.7 (± 2.6) years. Two psychometric instruments were used: the General Anxiety Scale for Children (GASC) and the Eysenck Personality Questionnaire (EPQ). The study confirms the presence of a high anxiety level (evaluated with GASC) among all children undergoing dental intervention. It also confirmed differences in anxiety scores between girls and boys, girls having higher scores for anxiety. Personality characteristics (evaluated with EPQ) showed low psychopathological traits, moderate extroversion and neuroticism, but accentuated insincerity (evaluated with L scale). L scales are lower with increasing age, but P scores rise with age, which could be related to puberty. No correlation was found between personality traits (obtained scores for EPQ) and anxiety except for neuroticism, which is positively correlated with the level of anxiety. In the management of dental anxiety some response measures (psychological support, biofeedback, and relaxation techniques) are recommended.