Alon Livny

Traumatic dental injuries and related factors among sixth grade schoolchildren in four Palestinian towns

BACKGROUND Traumatic dental injuries (TDI) are recognized as an important dental public health issue among children. The West Bank, a part of the Palestinian Authority, is in immediate neighborhood to Israel. There are inadequate epidemiologic data among the Palestinian people, on dental health issues. AIM To determine the occurrence of TDI to permanent teeth among sixth grade Palestinian schoolchildren living in four large towns of the West Bank and to investigate associations with anatomic and demographic factors. MATERIAL AND METHODS Eight hundred and four children were sampled and examined in Ramallah, Bethlehem, Hebron and Jericho. Data collection included clinical examinations in schools and questionnaires for demographic and socio-economic background. RESULTS The prevalence of traumatic dental injuries was 17.7%. Enamel fractures and injuries involving dentine accounted for 41% and 42.5% of all injuries, respectively. The most affected teeth (89%) were upper central incisors. Only 5% of the injured teeth were treated. Results of multiple logistic regression confirmed that TDI were significantly (P < 0.001) more prevalent among boys, children presenting incisal overjet larger than 5 mm, and incompetent lip coverage. CONCLUSIONS The relative high prevalence and very low levels of treated TDI identified in this study suggested that both prevention and treatment of TDI in the West Bank were inadequate.

Psychological distress and social support are determinants of changing oral health status among an immigrant population from Ethiopia

OBJECTIVES To examine associations between psychosocial profile (psychological distress and social support) and changing oral health status (dental caries and periodontal disease), among a group of immigrants from Ethiopia to Israel. METHODS Three hundred and forty immigrants, aged 18-75 years, with a mean age of 38.4±13.5 years, comprised the study population and were followed over a 5-year period. Dental caries was recorded employing the DMFT index. Periodontal health status was recorded employing the Community Periodontal Index (CPI). Participants were interviewed using a structured written questionnaire which included two validated psychosocial scales, for psychological distress and social support. Bivariate and multivariate analyses were performed. RESULTS Among subjects with psychological distress, the adjusted mean caries (DMFT) increment in 2004-2005, since baseline (1999-2000), was 3.52±0.19 when compared to 0.35±0.15 among subjects with no psychological distress (P<0.001). Correspondingly, the percentage of people with increased periodontal pockets was 40%, when compared to 7%, respectively (P<0.001). In multiple linear regression analysis employing the DMFT as a continuous variable, and in multiple logistic regression analysis employing the DMFT as a dichotomous variable (% caries versus % caries-free), the four variables that reached statistical significance as predictors of caries status were previous caries experience, psychological distress, social support, and age. Gender, income, and education were not significantly related to current caries prevalence. In a multiple logistic regression analysis, the three variables that reached statistical significance as predictors of periodontal disease (shallow and deep pockets) were previous periodontal disease experience, psychological distress, and age. Social support, gender, income, and education were not significantly associated with periodontal disease prevalence. CONCLUSIONS This study presents persuasive evidence that supports the role of psychological distress and social support as determinants of changing oral health levels, among a low socioeconomic, relatively homogenous immigrant minority population.

Periodontal health status and smoking among young adults

AIM Our aim was to evaluate the periodontal status and present smoking habits among a representative sample of young adult Israelis and to investigate possible associations. MATERIAL AND METHODS A representative sample of young adult Israelis was examined and interviewed on the day of release from compulsory military service. Collected data included demographic background (gender, education level, family size and fathers country of origin) and current smoking habits. Clinical examination included the recording of periodontal health status according to the Community Periodontal Index (CPI). RESULTS Seven thousand and fifty-six young adults were examined. Sixteen per cent were classified as CPI 0, 78% as CPI 1-2 and 6% as CPI 3-4. In total, 36% of the sample reported a current smoking habit. Periodontal status was significantly improved among non-smokers, females and children of fathers born in Israel or Western countries. CONCLUSION Only 7% of the participants demonstrated signs of periodontitis and most young adults did not smoke; a dose-response association was revealed between present smoking habits and periodontal disease.

Dental Students’ Attitudes and Behavior Toward Smoking Cessation as Part of Their Professional Education

Background: Dental professionals have a major role in promoting tobacco use cessation (TUC). Purpose: The objective is to assess dental students’ knowledge, attitudes, behavior, and perception regarding their potential expected role. Methods: Self-administered anonymous questionnaires were used for all students of the Jerusalem Dental Medicine School. Results: Among 275 responding students, 17% reported smoking. Most students reported asking patients about smoking, counseling against smoking, and advising to quit. Only a minority reported providing antismoking educational material, suggesting nicotine replacements, and arranging follow-ups. Most students did not consider a list of suggested potential obstacles (lack of resources, not their role, etc.) as true barriers. Analysis by stage of studies revealed significant differences in reported TUC strategies and positive attitudes and decreases in perceived potential obstacles. Conclusions: These results indicate specific and practical areas for promoting antismoking intervention. Dental schools need to emphasize their role in preparing the next generation with a clear dedication toward TUC.