Impact of rheumatic diseases on oral health and quality of life.

OBJECTIVE: We investigated the effects of rheumatic diseases on oral symptoms, health habits, and quality of life in subjects with and without rheumatic diseases. The hypothesis was that patients with rheumatic diseases have more oral symptoms impairing their quality of life than healthy controls. METHODS: A questionnaire was mailed to a random sample of 1500 members of the Finnish Rheumatism Association, including those with and without rheumatic diseases. We focused on symptoms of the mouth and temporomandibular area, and health habits. Oral Health Impact Profile (OHIP14) was used to evaluate the oral health-related quality of life. We analyzed differences between subjects with and without rheumatic diseases, controlled for age, gender, smoking, and non-rheumatic chronic diseases. RESULTS: Completed questionnaires were received from 995 participants (response rate 66%). Of them, 564 reported rheumatic disease, 431 were used as controls. The patients reported significantly more all orofacial symptoms than controls. Severe dry mouth was reported by 19.6% of patients and 2.9% of controls (P < 0.001), and temporomandibular joint symptoms by 59.2% and 27.2% (P < 0.001), respectively. In the OHIP-14 questionnaire, the mean total score was significantly higher in patients (8.80 ± 11.15) than in controls (3.93 ± 6.60; P < 0.001). CONCLUSION: The study hypothesis was confirmed by showing that the patients with rheumatic diseases reported oral discomfort and reduced quality of life more often when compared with controls.

Oral health literacy and information sources among adults in Tehran, Iran.

OBJECTIVE: To assess oral health literacy level and oral health information of Iranian adults in Tehran, and to determine the factors related to oral health literacy. BASIC RESEARCH DESIGN: A cross-sectional population study. PARTICIPANTS: A random sample of 1,031 adults in Tehran, Iran. METHODS: Oral health literacy was measured using an oral health adult literacy questionnaire (OHL-AQ). Variation in use of information sources by socio-economic and demographic background was estimated by odds ratios. A multiple linear regression model served to determine predictor factors of OHL-AQ scores controlling for characteristics of the subjects and number of information sources. RESULTS: The mean OHL-AQ score was 10.5 (sd 3.0). Women (p < 0.001), younger (p < 0.001), and better educated participants (p < 0.001) had higher OHL-AQ scores. The most common sources of oral health information were dentists (52.6%), and TV/Radio (49.5%). According to the regression model, females (p = 0.001), high educational level (p < 0.001), and use of multiple information sources (two sources p = 0.01, three sources or more p = 0.002) were the main predictor factors of OHL-AQ scores. CONCLUSIONS: The average oral health literacy level of Iranian adults was low. Disseminating evidence-based oral health care information from multiple sources including TV/radio, dentists, and other health professionals in different settings should improve public oral health literacy.

Attitude towards preventive dentistry among Iranian senior dental students.

OBJECTIVE: To investigate attitudes of Iranian senior dental students towards preventive dentistry in relation to their background factors and self-perceived competency in providing preventive care. MATERIALS AND METHODS: In spring 2008, a questionnaire survey was conducted with all the senior dental students of seven randomly selected state dental schools in Iran. In addition to the respondents' age and gender, the voluntary questionnaire assessed the students' attitudes towards preventive dentistry by means of a seven-point semantic differential scale of nine qualities and their opposites, and their self-perceived competency in providing preventive care by five separate questions. To identify the underlying dimensions for attitude, a factor analysis with principle component method and varimax rotation was applied. Independent sample t-test served for statistical analysis. Of the 242 students receiving the questionnaire, 182 students (75%) responded. The mean age of the participants was 26 years and 42% of them were men. RESULTS: Based on the factor analysis, which explained 60% of the total variance, two attitude dimensions were identified; the profession-related dimension and the health service-related dimension. Competency in giving preventive care in all the five specified areas was reported by 44% of the students with no significant gender differences. The mean for the dentist-related dimension was significantly higher among the students who reported competency in giving preventive care (P=0.005). CONCLUSION: There is room for improvement in senior dental students' attitudes towards preventive dentistry. In order to create more positive attitudes for future dental professionals, there should be an early and sufficient exposure to preventive aspects of dentistry in the dental curricula.

Smoking and drinking habits and attitudes to smoking cessation counselling among Tanzanian dental students.

UNLABELLED: The present research was carried out at the School of Dentistry, Muhimbili University of Health and Allied Sciences, Tanzania. OBJECTIVE: To assess smoking and drinking habits as well as attitudes towards smoking cessation counselling among dental students in Tanzania. BASIC RESEARCH DESIGN: A 28-item pretested and self-administered questionnaire was delivered to all dental students enrolled at the end of the 2006 academic year. The questionnaire covered socio-demographics, smoking and drinking habits, knowledge concerning health effects and attitudes towards smoking cessation counselling. PARTICIPANTS: Dental students enrolled at the end of the 2005/2006 academic year in the School of Dentistry, University of Dar-es-Salaam, Tanzania. MAIN OUTCOME MEASURES: Self-reported smoking, alcohol use and attitudes to smoking cessation counselling. RESULTS: The response rate was 73.2% (109/149) and 76.1% of respondents were male. Smoking was reported by 12.8%, all being male. Alcohol use during the last 30 days was reported by 23.8% and binge drinking during the last two weeks by 11.8%. Both smoking and alcohol use were more common among clinical than basic science students. The majority (67.0%) reported that they had not received education on smoking cessation counselling although 86.2% considered that dentists and physicians should provide such counselling. CONCLUSION: Reported smoking and alcohol consumption are on a low level compared to dental students internationally. Willingness and need for cessation counselling training was expressed by the majority of Tanzanian dental students. This should be taken into consideration in dental curriculum development.

Smoking and its determinants among Iranian dental students.

OBJECTIVE: The objective of the present study was to investigate smoking habits of Iranian dental students in relation to their background characteristics and oral self-care (OSC). SUBJECTS AND METHODS: A survey in the form of a questionnaire was conducted of 327 senior dental students in seven randomly selected state dental schools in Iran. In addition to smoking habits and background characteristics, the students were asked about OSC. A recommended level of OSC was defined as a combination of brushing at least twice a day, frequent use of fluoridated toothpaste, and eating sugary snacks less than daily. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 263 students (113 males and 150 females) completely answered the questions and were included in the analyses. RESULTS: Of the 263 students, 59 (23%, 37 males and 22 females) reported current smoking (cigarette, pipe, or water pipe). Current smoking was associated with male gender (OR = 2.9, 95% CI = 1.4-5.6), level of father's education (OR = 1.4, 95% CI = 1.1-1.8), and OSC (OR = 4.4, 95% CI = 1.3-14.9). CONCLUSION: Smoking among Iranian dental students is similar to their socioeconomic group, and is associated with the characteristics of their background, such as gender and father's level of education, as well as the quality of OSC. The results indicate a need to include smoking cessation education and public health activities in the dental curriculum to provide future health care professionals and role models for patients with adequate training in up-to-date patient management to control smoking.

Genetic and environmental factors in oral health among twins.

To date, studies on the contributions of genetic factors to oral health have been inconclusive. We hypothesized that major dental diseases show a significant genetic component. The study was based on self-reported oral health among young adult twins. The data were derived from the fourth wave of the longitudinal FinnTwin16 study, in which participants completed a questionnaire in 2000-2002 enquiring about the number of filled teeth and the prevalence of gingival bleeding. We used quantitative genetic modeling, based on the genetic similarity of identical and non-identical twins, to calculate the most probable model for both filled teeth and gingival bleeding. The models revealed a strong genetic component behind the number of filled teeth, differing between males (49%) and females (68%), and a weaker genetic component affecting gingival bleeding, being similar for males and females (32%). Genetic factors contribute to inter-individual differences in oral health among young adults.

Tobacco use and reported bruxism in young adults: a nationwide Finnish Twin Cohort Study.

INTRODUCTION: Higher levels of smoking, leading to increased levels of nicotine and dopamine release, may be more strongly related to bruxism, although this relationship has remained unclear. Thus, the aim of the present study was to investigate the possible effect of cumulative tobacco use on bruxism in a large sample of young adults. METHODS: The material of the present study derives from the FinnTwin16, which consists of five birth cohorts born in 1975-1979. A total of 3,124 subjects (mean age 24 years, range 23-27 years) provided data in 2000-2002 on frequency of bruxism and tobacco use. Multinomial logistic regression was used to explore the relationships of frequency of bruxism with smoking and smokeless tobacco use while controlling covariates (alcohol intoxication, alcohol problems [Rutgers Alcohol Problem Index, RAPI], illicit drug use, psychological distress [General Health Questionnaire], and coffee use). RESULTS: Based on subjective response and multivariate analyses, weekly bruxers were more than two times more likely to report heavy smoking than never bruxers (odds ratio [OR] 2.5, 95 % CI 1.8-3.4). The significant association between heavy smoking and bruxism held when the effects of other tobacco use and multiple covariates were controlled. In addition, the use of smokeless tobacco emerged as an independent risk factor for bruxism. DISCUSSION: Given the observed associations with both heavy smoking and smokeless tobacco and a dose-response relationship, the present results support our hypothesis of a link between nicotine intake and bruxism.

Effect of directorial intervention on web-based student feedback.

UNLABELLED: The Medical Faculty of the University of Helsinki decided to employ a web-based evaluation system as an integral and essential part of all courses beginning in the autumn term of 2006. OBJECTIVES: To analyse the effects of the intervention on dental students' web-based responses at the University of Helsinki, Finland. SUBJECTS AND METHODS: A previously developed web-based tool was used for all preclinical and clinical courses from the beginning of the 2006-2007 academic year. We analysed data sets of student feedback for all courses before (2005-2006) and after (2006-2007) the intervention. We then compared the quantity and quality of the students' feedback for the six standardised questions used in the evaluation, and calculated the means and standard deviations of values obtained with a Likert scale. The students' assessments in the open questions were categorised according to key issues. RESULTS: Implementation of the system resulted in a considerable increase in student feedback: the mean response rate for the preclinical phase rose from 59% (SD 15.0; range 25-80) before the intervention to 90% (SD 9.6; range 72-100) after it. In the clinical phase, the response rates more than doubled from 34% (SD 15.9; range 9-69) to 73% (SD 12.9; range 45-100). The students' assessments showed no significant change despite the marked rise in response rates. The educators' positive attitude towards the students was appreciated (4.2-4.3) whereas the general goals for the courses in the clinical phase seemed unclear to the students (3.4) (P < 0.05). CONCLUSIONS: Web-based evaluation as an integral part of all courses in the dental curriculum proved successful: shortly after the intervention, we observed a considerable increase in student feedback with no significant change in quality.

School-based intervention to promote preadolescents' gingival health: a community trial.

OBJECTIVES: Evaluation of the effectiveness of a school-based oral health promotion intervention on preadolescents' gingival health. METHODS: A community trial designed for a 3-month intervention study in a representative sample of 9-year-olds (n = 457) in 16 schools in Tehran, Iran. The schools were randomly assigned to three intervention groups and one control group, each group comprising two boys' and two girls' schools. The first group of children (n = 115) received intervention via class work, solving a set of puzzles containing oral health messages, under supervision of their health counsellor. The second group (n = 114), intervention via parents, included an oral health education leaflet and a brushing diary for supervising the child's tooth-brushing; the third group (n = 111) received a combination of both these interventions. The control group (n = 117) had no intervention. Effects of the intervention were assessed as changes in dental plaque and gingival bleeding. Improvements in gingival health were recorded when half of the index teeth with plaque at baseline became clean (acceptable oral hygiene) or when all index teeth with bleeding at baseline became healthy (healthy gingiva). Statistical analysis included chi square, anova, t-test, Number Needed to Treat (NNT) and generalized estimating equations (GEE). RESULTS: At baseline, none of the children were free of plaque and all except for three boys had bleeding. After the trial, acceptable oral hygiene was more frequent in the parental-aid (P < 0.001) and the combined groups (P < 0.05), and healthy gingiva in both groups (P < 0.001) in comparison with the control group. Outcomes in the class-work group did not differ from those in the control group. The GEE models confirmed a strong intervention effect on healthy gingiva in both groups where parents were involved: parental-aid group (OR = 7.7, 95% CI: 2.2-27.7) and combined group (OR = 6.6, 95% CI: 2.0-22.1). In all intervention groups more girls than boys achieved healthy gingiva (OR = 2.5-2.6). Parents' education showed no impact on the outcome. CONCLUSIONS: When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingival health at baseline.

A holistic food labelling strategy for preventing obesity and dental caries.

Obesity and dental caries in childhood are among the major public health concerns described as a global pandemic because of their global distribution and severe consequences. A consensus has developed as to a recently emerging and alarming common risk factor that leads to the double burden of dental caries and obesity; energy-dense foods (sugar-coated cereals, high-sugar yogurt, soft drinks) are becoming very popular among children because of their dense marketing, cheaper price, increased supply and variety. Implementation of health-promoting and -supporting marketing strategies for healthy food can be one initial cornerstone for successful application of the common risk factor approach in prevention of obesity and dental caries, as also suggested by World Health Organization. Labelling healthy food with a 'health-friendly' logo, illustrating that the teeth and the heart are both parts of the whole body (standing side by side supporting each other as close friends), both happy and protected because of consumption of healthy food for the whole body, can promote the foods that are friendly to health of the whole body, implementing the common risk factor approach under a single theme. Labelling healthy food as 'health-friendly' based on an international consensus will provide a clear and uniform picture of what is healthy to eat and result in an international integrated programme for prevention of obesity and caries.

Restorative treatment threshold reported by Iranian dentists.

OBJECTIVE: To study Iranian dentists' conceptions of the earliest stage to place a restoration on proximal caries lesions. BASIC RESEARCH DESIGN: A questionnaire survey was carried out among the participants of two annual dental meetings in Tehran, Iran, in December 2004 and July 2005. The questionnaire was filled in anonymously and returned during the meeting days. The questions covered two patient paper cases with schematic drawings of the radiolucency of proximal caries lesions according to bitewing radiographs from 20-year-old patients: one high-caries case and one low-caries case. Dentists' gender, age, working experience and place, and participation in continuing education served as background data. In total, 1,033 dentists completed the questionnaire, 63% were men. Statistical evaluation was by the Chi square test and logistic regression. MAIN OUTCOME MEASURES: Respondents were to select from four alternatives the earliest stage in the progression of a lesion at which they would intervene by restorative treatment. RESULTS: For the high-caries case, 77% of the respondents chose to restore a caries lesion confined to enamel; activity in continuing education was the strongest factor (OR = 1.4) to explain dentists' restoring a lesion no earlier than in dentine. For the low-caries case, 32% chose to restore a lesion in enamel. Restoring a lesion no earlier than in dentine was more likely (OR = 1.5) among female dentists. CONCLUSION: Iranian dentists seem to prefer early restorative intervention, which indicates a need to focus on the preventive aspects of caries treatment both in dental curricula and in continuing education.

Individual and maternal determinants of self-reported dental health among Turkish school children aged 10-12 years.

OBJECTIVE: To assess the influence of maternal and individual characteristics on self-reported dental health of Turkish school children aged 10-12 years with different socio-economic backgrounds. METHOD: A cross-sectional study of children aged 10 to 12 (n = 611) using paired matches of self-administered questionnaires for children and their mothers. Clinical examinations based on World Health Organization criteria were conduced. The participation rate was 97% (n = 591) for the children, 87% (n = 533) for the mothers, and 95% (n = 584) for the clinical examinations. Multiple linear regression, descriptive statistics, Spearman correlation coefficient and chi-square test were applied. RESULTS: Private school children's mothers were more likely to have had higher education (95% at least high school) than public school children's mothers (11%); they reported better dental health (above average) than did mothers of public school children (p = 0.001). Among all mothers, those with above average self-reported dental health reported more regular dental visits than did those with below average scores (p = 0.001). Frequency of regular dental visits and toothbrushing among children attending public schools (5%, 65%) were lower than those attending private school (43%, 79%), (p = 0.001). The mean DMFS was negatively correlated with self-reported dental health (r(s) = -0.187, p = 0.001). Toothbrushing frequency and school performance were the common factors positively associated with self-reported dental health, among all children. CONCLUSION: The results emphasize the important role of mothers and their socio-economic background in enhancement of children's dental health. Their active role in conjunction with the potential of self-assessment provides a good basis for establishing and improving self-care among children, in developing countries in particular.

Influence of mothers' oral health knowledge and attitudes on their children's dental health.

AIM: This was to evaluate the influence of mothers' oral health-related knowledge and attitudes on the tooth-brushing behaviour and dental health of their children and to compare the effect of these maternal aspects on child's oral health. STUDY DESIGN AND METHODS: In 2005, an oral health study conducted among a random sample of 457 mother and child pairs in Tehran, Iran, used self-administered questionnaires to provide data on mothers' oral health-related knowledge and attitudes and children's tooth-brushing behaviour. Clinical data allowed assessment of dental status of the primary and permanent dentition. STATISTICS: Chi-square test and binary logistic regression models were employed. RESULTS: Generally, mothers had extensive knowledge of and positive attitudes towards oral health. Mothers' higher level of oral health knowledge and better attitude scores were associated with children's sound dentition (p<0.05), while only mothers' better attitude was associated with children's twice-daily tooth brushing (p=0.001). The multivariate analyses showed that children of mothers with higher attitude scores were more likely to brush their teeth twice daily (OR = 2.1; 95% CI 1.2 - 3.7) and have sound dentition (OR = 12.4; 95% CI 1.8 - 85.9). The models revealed that mother's knowledge per se had no effect on children's sound dental health, but showed an additive effect with mother's attitudes. CONCLUSIONS: Because twice-daily tooth-brushing behaviour and sound dentition in 9-year-olds were associated with their mothers' positive oral health-related attitudes, in developing oral health promotion programs for children and adolescents, the considerable potential of mothers should be a major focus of oral health professionals.

Psychological stress and health in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools.

UNLABELLED: Psychological stress in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools. OBJECTIVE: To compare the levels of a series of health-related indicators from a cohort of fifth year dental students from five European schools with their first year scores, and to investigate the relationship between these follow-up measures. METHODS: Burnout was measured using the Maslach Burnout Inventory (MBI), consisting of three scales: Emotional Exhaustion (EE, alpha = 0.90), Depersonalisation (alpha = 0.80) and Personal Accomplishment (alpha = 0.72). Physical health was measured by the Physical Symptoms Questionnaire (alpha = 0.82), psychological distress was measured using the General Health Questionnaire (GHQ, alpha = 0.89) and student stress was captured using seven subscales of the Dental Environment Stress questionnaire (DES, alpha = 0.92). A total of 132 fifth year students responded from five dental schools (Manchester, Belfast, Cork, Helsinki and Amsterdam), a 51% response. RESULTS: Fifth year students showed relatively high mean MBI scores when compared with first year results, especially on EE; 39% could be labelled 'high scorers'; 44% of the students met the criteria for 'cases' on the GHQ. Highest mean scores on the DES were obtained on the subscales: Study Obligations, Patient-Related Aspects and Study Pressure respectively. Between schools interesting differences were detected on all variables. As hypothesised, a clear direct effect of stress on both burnout and physical symptoms was shown. An indirect effect of stress on mental health via burnout was shown. CONCLUSIONS: Dental students showed a negative development through the years from first to fifth year with regard to EE and psychological distress. Both burnout constructs related to physical and mental health. It is recommended that dental faculty focus on the importance of prevention and intervention of stress amongst undergraduates.

Study motives and career choices of Iranian dental students.

OBJECTIVES: To investigate the study motives and career choices of Iranian senior dental students in relation to their background factors. SUBJECTS AND METHODS: During the spring term 2005, a questionnaire survey was administered to 327 senior dental students in seven randomly selected state dental schools in Iran. The questionnaire requested information on age, gender, parents' employment in dentistry, previous education and employment in dental hygiene, study motives, and career choices. Statistical analyses were made using independent sample t test, factor analysis, and binary logistic regression model. RESULTS: Based on the factor analysis, which explained 73% of the total variance, five motive dimensions were identified: altruism and intellectual challenges, characteristics of the profession, social status and security, other person's recommendation, and failure to be admitted to other study programmes. The mean for the 'characteristics of the profession' dimension was lower among the students with at least one parent employed in dentistry (p = 0.03). The 'altruism and intellectual challenges' dimension was reported to be more influential by the students with background in dental hygiene (32 students) compared to the others (p < 0.001). Engaging in postgraduate studies was the first career preference of 189 (70%) of the respondents. Those with a background in dental hygiene were less inclined to enter postgraduate courses (p < 0.001), but more eager to be employed in either the public or the private sector (p < 0.001), and to enter the community oral health and research field (p < 0.001) than the others. CONCLUSION: Personal characteristics and motives of the students play a major role in shaping their career preferences.

The global network on dental education: a new vision for IFDEA.

The advent of globalization has changed our perspectives radically. It presents increased understanding of world affairs, new challenges and exciting opportunities. The inequitable distribution and use of finite energy resources and global warming are just two examples of challenges that can only be addressed by concerted international collaboration. Globalization has become an increasingly important influence on dentistry and dental education. The International Federation for Dental Educators and Associations (IFDEA) welcomes the challenges it now faces as a player in a complex multifaceted global community. This report addresses the new circumstances in which IFDEA must operate, taking account of the recommendations made by other working groups. The report reviews the background and evolution of IFDEA and describes the extensive developments that have taken place in IFDEA over the past year with the introductions of a new Constitution and Bylaws overseen by a newly established Board of Directors. These were the consequence of a new mission, goals and objectives for IFDEA. An expanded organization is planned using http://www.IFDEA.org as the primary instrument to facilitate the exchange of knowledge, programmes and expertise between colleagues and federated associations throughout the world, thereby promoting higher standards in oral health through education in low-, middle- and high-income countries of the world. Such aspirations are modified by the reality and enormity of poverty-related global ill health.

Tooth loss and prosthodontic rehabilitation among 35- to 44-year-old Iranians.

This study aimed to investigate the frequency of tooth loss and the magnitude of prosthodontic rehabilitation based on socio-demographic information among 35- to 44-year-old Iranians. Data (n = 8240) were collected by 33 examiners as part of a national survey using WHO criteria for sampling and clinical diagnosis. Gender, age, place of residence and level of education served as socio-demographic information. The number of teeth, functional dentition (subjects with 20 or more teeth) and prosthodontic rehabilitation were used as clinical variables. The chi-square test and logistic regression analysis were the methods of statistical evaluation. Of all subjects, 3% were edentulous. Of dentate subjects, 3% had 1-9 teeth, 21% had 10-19 teeth, 37% had 20-24 teeth and 39% had 25-28 teeth. In total, 76% of dentate subjects enjoyed a functional dentition. Among dentate subjects, 11% of the men and 16% of the women had prosthodontic rehabilitation with higher figures (P < 0.001) among women, older subjects and urban residents. Having a functional dentition was more likely among those with higher levels of education [odds ratios (OR) = 1.8, 95% confidence intervals (CI) = 1.6-2.1]. Women (OR = 2.4, 95% CI = 1.8-3.0) and urban residents (OR = 2.4, 95% CI = 1.8-3.3) were the most likely groups to have prosthodontic rehabilitation. Having prosthodontic rehabilitation was more likely among those lacking a functional dentition (OR = 6.0, 95% CI = 4.8-7.6). The greatest unmet treatment needs were found among those without a functional dentition. Functional dentition should be set as a primary oral health goal among working-age adults.

Oral health and treatment needs among 15-year-olds in Tehran, Iran.

OBJECTIVES: To study oral health status and treatment need among 15-year-olds in Tehran, Iran in relation to their parents' level of education. METHODS: A cross-sectional study based on the WHO criteria, was carried out in 2004 among 15-year-olds (n=506) in Tehran. Data collection was by a self-administered questionnaire and a clinical dental examination to assess dental caries, periodontal conditions and orthodontic treatment needs. RESULTS: Mean DMFT was 2.1 (95%CI=1.9, 2.4), which comprised DT=0.9, MT=0.2, and FT=1.0. The mean SiC index was 5.2 (95%CI=4.8, 5.5). Mean numbers of sextants with PI scores 0, 1, and 2 were 0.6, 2.1, and 3.3 respectively, and with CPI scores 0, 1, and 2, were 2.1, 3.5 and 0.4 respectively. Need for caries (DT>0) treatment existed in 40% of subjects, for scaling (CPI=2) in 24%, for oral hygiene instructions in 100%, and for orthodontic treatment in 26%. Subjects with caries and dental plaque were fewer among those whose parents had a high level of education (p<0.05). Presence of dental plaque was associated with DT>0 (OR=1.8, p=0.01) and CPI>0 (OR=11.2, p<0.001). CONCLUSION: Poor level of oral hygiene among the present 15-year-olds calls for school-based oral health promotion activities focusing on oral self-care.

Dental findings in diabetic adults.

The dental status of dentate diabetic adults (n = 299) and its associations with diabetes-related factors was explored in Tehran, Iran. Presence of diabetes-related complications made no difference in mean values of DMFT, but was associated with a higher number of decayed and missing teeth, and fewer filled teeth. Higher level of HbA1c was associated with higher DMFT for men, but not for women. In conclusion, the results suggest a possible association between the level of metabolic control of diabetes mellitus and cumulative caries experience.