Awareness and Experience regarding Child Abuse and Neglect Among Dentists in Turkey.

Objectives: This study assessed the level of knowledge, attitudes, and awareness of child abuse and neglect (CAN) among dentists. Study design: The sample, consisted of 20,298 Turkish Dental Association (TDA) members, which comprise about two thirds of all dentists, specialists, academics and dental PhD students in Turkey. Among the 20,298 emails sent, 1,020 responses were obtained Descriptive analysis was performed and correlations were tested using the Chi-square and Fischer's Exact tests. A p value of <0.05 was considered statistically significant. Results: Of the participating dentists, 32.7% were able to identify cases of CAN cases, while 17.1% had suspected cases of child abuse and only 1% of them, reported these, to the authorities. The most frequently cited reasons for hesitation to report CAN cases were lack of adequate history (45%), lack of knowledge about the healthcare worker's role in reporting CAN (18.3%), and considerations of the possible consequences against the child (18.8%). Only 11.6% of the participants had received undergraduate level training on the topic of CAN; The majority (86.5%) expressed the need for further education on this issue, and, also, 84.3% believed that it should be a part of postgraduate education. Conclusions: Improvements in CAN education and continuing education courses are necessary to equip dentistry professionals with adequate knowledge about the physical and behavioral indicators of possible abuse, the current legislation regarding mandated reporting and the procedures for reporting suspected cases.

Microbial Profile and Dental Caries in Cleft Lip and Palate Babies Between 0 and 3 Years Old.

OBJECTIVE: The aim of this study was to examine the microbiological changes in newborn babies with cleft lip palate from birth up to age 3 and to correlate them with their caries levels and mothers' microbiological data and to compare with normal infants. BASIC RESEARCH DESIGN: Prospective. SETTINGS: Marmara University, Faculty of Dentistry, Pediatric Dentistry Clinic, and Sisli Hamidiye Etfal Education and Research Hospital New Born Clinic. PATIENTS/PARTICIPANTS: Cleft lip palate (n = 21) and healthy (n = 13) newborns and their mothers. MATERIAL AND METHODS: Intraoral samples were taken from babies in each group at least 3 times over the 3 years. Saliva samples of the mothers were collected just after the birth of the babies and examined microbiologically. Dental caries was noted as either present or absent. RESULTS: The most frequent microorganisms were candida, found at birth (n = 9, 42%) in cleft palate with or without cleft lip (CP±L) group. The number of babies infected with Lactobacilli were found to be significantly higher in the CP±L group than in the control group at birth ( P = .029) and after eruption of the first primary tooth ( P = .030). Mutans Streptococci were found in 10% of babies with CP±L at birth. Initial caries was identified in 20% of the babies with an oral cleft compared with 0% of the controls after eruption of the first primary incisors. CONCLUSION: The results show that the CP±L babies must be considered as a group with an increased caries risk.

Fine-Mapping of Xq25.1-27.2 Shows Association of Early Childhood Caries with Genetic Variants Depending on Dietary Habits, Protecting Children Who Drink Milk before Going to Bed.

Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of unequal contributions of risk factors and protective factors that influence the disease. The aim of this study was to assess if the X chromosome region previously linked to caries was associated with ECC. Two hundred and fifty-nine unrelated children with no chronic illnesses from 2 to 5 years of age who had no systemic fluoride consumption were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire, and caries experience data were collected by clinical examination. Twenty-three markers in ten genes were studied. Genotyping of the selected polymorphisms was carried out by real-time polymerase chain reaction. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries free. The markers in Xq25.1-27.2 were associated with ECC when children were using milk bottle for longer times (p = 0.01) and had more snacks over the course of a day (p = 0.05). Conversely, the markers in the X chromosome studied here were protective for ECC (p = 0.008) in children consuming milk before going to sleep. The genes located in the X chromosome possibly contribute to ECC and have an impact on ECC depending on the dietary habits.

Parent's attitudes and knowledge on oral health in a group of individual with Down syndrome in Turkey.

OBJECTIVE: To evaluate the knowledge and attitude of families having some Down syndrome patient about problems related to oral cavity and dental health issues. METHODS: The cross-sectional study was conducted at Marmara University, Faculty of Dentistry in July 2017. Families of individuals with Down Syndrome, who are members of the Turkish Down Syndrome Association, were included in the study. A self-generated questionnaire was used to collect information in 3 different sections through 43 questions related to patient's socio-demographic and medical information, data on dental visit(s) and tooth-brushing. The questionnaire was sent to the families via the Internet. They were asked to return the completed questionnaires within a month. SPSS 22 was used to analyse data. RESULTS: Of the 103 families, 25(24.27%) had never taken their children to a dentist; 12(11.65 %) thought their children were too young, 6(5.82%) thought they would have difficulty in the dental environment, and 2(1.94%) could not find a suitable dentist. There was a statistically significant relationship between the oral and dental health and the tooth-brushing frequency (p<0.05). There was a statistically significant difference between the frequency of helping the children brush their teeth and the mean age (p<0.05). CONCLUSIONS: Parents of individuals with Down syndrome needed high-level information and guidance to take proper care of affected individuals.

Aquaporin 5 Interacts with Fluoride and Possibly Protects against Caries.

Aquaporins (AQP) are water channel proteins and the genes coding for AQP2, AQP5, and AQP6 are clustered in 12q13. Since AQP5 is expressed in serous acinar cells of salivary glands, we investigated its involvement in caries. DNA samples from 1,383 individuals from six groups were studied. Genotypes of eight single nucleotide polymorphisms covering the aquaporin locus were tested for association with caries experience. Interaction with genes involved in enamel formation was tested. The association between enamel microhardness at baseline, after creation of artificial caries lesion, and after exposure to fluoride and the genetic markers in AQP5 was tested. Finally, AQP5 expression in human whole saliva, after exposure to fluoride in a mammary gland cell line, which is known to express AQP5, and in Wistar rats was also verified. Nominal associations were found between caries experience and markers in the AQP5 locus. Since these associations suggested that AQP5 may be inhibited by levels of fluoride in the drinking water that cause fluorosis, we showed that fluoride levels above optimal levels change AQP5 expression in humans, cell lines, and rats. We have shown that AQP5 is involved in the pathogenesis of caries and likely interacts with fluoride.

Early childhood caries is associated with genetic variants in enamel formation and immune response genes.

Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of an imbalance of risk factors and protective factors that influence the disease. The aim of this study was to assess genetic and environmental factors that may contribute to ECC. Two hundred and fifty-nine unrelated children were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire, and caries experience data were collected by clinical examination. Twenty-three markers in 10 genes were studied. Genotyping of the selected polymorphisms was carried out by real-time PCR. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries free. The genotype TT in ALOX15 (rs7217186) was a risk factor for ECC, whereas the genotypes GG in ENAM (rs1264848), AG and GG in KLK4 (rs198968), CT in LTF (rs4547741), and GG in TUFT1 (rs3790506) were protective for EEC. In conclusion, environmental factors and gene interactions can act as protective or risk factors for ECC. These factors together contribute to the presence and severity of the disease.

Evaluation of the bond strength of resin cements used to lute ceramics on laser-etched dentin.

OBJECTIVE: The purpose of this study was to investigate the shear bond strength (SBS) of two different adhesive resin cements used to lute ceramics on laser-etched dentin. BACKGROUND DATA: Erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation has been claimed to improve the adhesive properties of dentin, but results to date have been controversial, and its compatibility with existing adhesive resin cements has not been conclusively determined. MATERIALS AND METHODS: Two adhesive cements, one "etch-and-rinse" [Variolink II (V)] and one "self-etch" [Clearfil Esthetic Cement (C)] luting cement, were used to lute ceramic blocks (Vita Celay Blanks, Vita) onto dentin surfaces. In total, 80 dentin specimens were distributed randomly into eight experimental groups according to the dentin surface-etching technique used Er,Cr:YSGG laser and Er:YAG laser: (1) 37% orthophosphoric acid+V (control group), (2) Er,Cr:YSGG laser+V, (3) Er,Cr:YSGG laser+acid+V, (4) Er:YAG laser+V, (5) Er:YAG laser+acid+V, (6) C, (7) Er,Cr:YSGG laser+C, and (8) Er:YAG laser+C. Following these applications, the ceramic discs were bonded to prepared surfaces and were shear loaded in a universal testing machine until fracture. SBS was recorded for each group in MPa. Shear test values were evaluated statistically using the Mann-Whitney U test. RESULTS: No statistically significant differences were evident between the control group and the other groups (p>0.05). The Er,Cr:YSGG laser+A+V group demonstrated significantly higher SBS than did the Er,Cr:YSGG laser+V group (p=0.034). The Er,Cr:YSGG laser+C and Er:YAG laser+C groups demonstrated significantly lower SBS than did the C group (p<0.05). CONCLUSIONS: Dentin surfaces prepared with lasers may provide comparable ceramic bond strengths, depending upon the adhesive cement used.

In vivo evaluation of the treatment outcome of pulpotomy in primary molars using diode laser, formocresol, and ferric sulphate.

OBJECTIVE: The purpose of this study was to assess whether the diode laser (DL) pulpotomy method is a suitable alternative to formocresol (FC) and ferric sulphate (FS) pulpotomies in human primary teeth. BACKGROUND DATA: Pulpotomy is the amputation of infected coronal pulp to maintain radicular pulp vitality and function. Although FC is regarded as the gold standard for pulpotomy in primary teeth, concerns about its safety have been reported. Lasers are an effective nonpharmacological alternative for treating pulp in children. METHODS: This study included 120 primary molars in 58 children 5-9 years of age who underwent an identical conventional pulpotomy technique; the molars were allocated to FC, FS, and DL groups. After removal of the coronal tissue, complete hemostasis of the remaining pulp in the DL group was achieved by DL at 1.5 W, 30 Hz, and 50 mJ, with a 10 sec exposure time. For the FC group, diluted FC (1:5 Buckley's formocresol) was used for 5 min., and for the FS group, a 15.5% FS solution was used for 15 sec. Treatments in all groups were completed with stainless steel crowns and monitored clinically and radiographically at 1, 3, 6, 9, and 12 months. RESULTS: The clinical success rates at 12 months were 97%, 95%, and 100%, whereas the radiographic success rates were 87%, 79%, and 75%, for the FC, FS and DL groups, respectively. The differences in the results were not statistically significant according to the χ(2) test (p>0.05). CONCLUSIONS: DL pulpotomy offers a high clinical success rate, however considering radiographic success rate, it may not replace traditional FC and FS pulpotomies in primary molars.

Outcome of a dentigerous cyst following decompression using a removable appliance: a case report.

A dentigerous cyst is a benign odontogenic cyst that is associated with the crown of an unerupted permanent tooth. This report describes a conservative approach to treatment using a customised removable appliance for managing a large dentigerous cyst in a 7-year-old female. At the 2-year follow-up, healing of the lesion and ossification of the bony defect was observed.

The effect of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser therapy on pain during cavity preparation in paediatric dental patients: a pilot study.

INTRODUCTION: Standard treatment for caries removal and cavity preparation for restorations using mechanical means is often accompanied by fear and pain for the patient. Although the pain may be reduced by local anaesthesia, fear of the needle, noise, and the vibration of mechanical preparation remain a cause of discomfort. Erbium, chromium:yttriumscandium- gallium-garnet (Er,Cr:YSGG) laser irradiation indicates that pain perception may be reduced relative to that caused by mechanical preparation. AIM: The aim of this pilot clinical study was to perform a preliminary evaluation of pain perception during cavity preparation comparing the mechanical removal and Er,Cr:YSGG laser removal of caries from enamel and dentine. METHODS: The study sample was ten children aged 7 to 12 years. Half of the preparations were completed by the laser alone and the other half were mechanically prepared. All cavities were restored with light-cured composite resin following the application of acid etch and a bonding agent. The time spent on cavity preparation and the behaviour of the patients during cavity preparation were recorded. Children were instructed to rate their pain on a visual analogue scale. In addition, the patients were asked to decide which was the more uncomfortable form of treatment and the preferred treatment for future caries therapy. RESULTS: Children showed considerably more body and head movement with the conventional mechanical preparation. The subjects rated the perception of pain lower when the laser technique was used. CONCLUSION: In the small number of children studied, the application of the Er,Cr:YSGG laser system was a more comfortable alternative or adjunctive method to conventional mechanical cavity preparation. A far larger study is necessary to confirm this finding.

Dental erosion among children in an Istanbul public school.

The aim of this study was to evaluate the prevalence, clinical manifestations, and etiology of dental erosion among children. A total of 153 healthy, 11-year-old children were sampled from a downtown public school in Istanbul, Turkey comprised of middle-class children. Data were obtained via: (1) dinical examination; (2) questionnaire; and (3) standardized data records. A new dental erosion index for children designed by O'Sullivan (2000) was used. Twenty-eight percent (N=43) of the children exhibited dental erosion. Of children who consumed orange juice, 32% showed erosion, while 40% who consumed carbonated beverages showed erosion. Of children who consumed fruit yogurt, 36% showed erosion. Of children who swam professionally in swimming pools, 60% showed erosion. Multiple regression analysis revealed no relationship between dental erosion and related erosive sources (P > .05).

Dental trauma and mouthguard usage among ice hockey players in Turkey premier league.

An epidemiological survey was carried out among the ice hockey players of Turkish Premier Ice Hockey League. The purpose of the present study was to evaluate the prevalence of dental trauma in youth and adult ice hockey players, as well as to check if the players were aware of mouthguards and had used any. The players were interviewed to determine the occurrence of dental trauma during ice hockey and mouthguard usage level. Results revealed that awareness of Turkish ice hockey players to dental trauma is neglected while the majority of players also demonstrated limited utilization of mouthguard.

Treatment of avulsed teeth with Emdogain--a case report.

The present case report describes the reimplantation of avulsed teeth with the treatment of Emdogain. Case was avulsed right maxillary permanent central and lateral incisor in a 9-year-old girl suffering from a traumatic injury. After pretreatment of avulsed teeth, Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical percussion sound and periapical radiographs. At 1-2-6-12-month follow-up period, the clinical and radiographic appearance of the teeth showed resolution of mobility and no signs of replacement resorbption.

History of water fluoridation.

Fluoride, the milestone element of pediatric dentistry, as well as modern dentistry, has been utilized for the last six decades in practice. Researchers all over the world have used fluoride in several forms in the prevention of tooth decay. Today, we are aware that most of this work has involved clinical research with children. It is particularly pertinent that the subject be adequately presented in the field of pediatric dentistry. In 1940's and 1950's were the years of ten-year studies, where caries reductions were first described. The industry of systemic fluoridation, public campaigns and advertisements became popular mostly in western world in 1960's and 1970's. The fluoridated dentifrices and changes of dentifrice formulations were established in 1980's. Many stated that children should receive one form of systemic fluoride and appropriate forms of topical fluoride in 1990's. Analyses showed that maximum protection against caries is obtained when teeth erupt into an environment with low concentrations of ionic fluoride. The similarity in caries reductions obtained in water fluoridation studies and long-term studies with topically administered fluoride regimens, including fluoride-containing dentifrices, indicates that the pre-eruptive effect of fluoride is of borderline significance relative to the more significant post-eruptive effect. It has taken a long time to show that water fluoridation and topical fluoride programs were thus important measures for the control of caries at the community level. Today, we are aware of the fact that the trio of diet, dentifrice and supplementation should exceed the optimal levels.

Dental trauma in Turkish children, Istanbul.

Numerous studies focus on visits to dental clinics for emergent dental problems. Many are all-inclusive, studying traumatic injuries as well as visits for infection and other causes. Epidemiologic studies have focused on the investigation of the prevalence or incidence of dental injury. The patients were evaluated at Pediatric Dentistry, Marmara University Dental School, Istanbul over a 2-year period. For these 300 patients (446 teeth), specific diagnoses were evaluated. Dental injuries that presented most frequently in permanent dentition were crown fractures of enamel only and crown fractures of enamel and dentin. The most frequently presented dental injury in primary dentition were avulsions and crown fractures of enamel. The more frequent treatments for primary teeth were examination only. Bandage restoration, space maintainer were common procedures for permanent teeth.