Çoruh Türksel Dülgergil

Early childhood caries update: A review of causes, diagnoses, and treatments.

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the childs family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management.

Prevalence of dental anxiety in 7- to 11-year-old children and its relationship to dental caries.

Objectives: The aims of this cross-sectional study were to evaluate the level of fear of dental procedures among schoolchildren and assess the relationship between caries experience and fear of dental procedures. Subjects and Methods: 275 children aged 7–11 years were recruited for the study. Before conducting a dental examination, each subject was asked to independently complete a Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS) questionnaire. Children having a score of ≥38 were included in the group ‘with dental fear’ while those scoring <38 were placed in the ‘without dental fear’ group. All dental examinations were performed on the school premises according to WHO criteria. Results: Mean CFSS-DS value was 28.1, and the number of children who experienced dental fear was 40 (14.5%). It was found that Decayed, Missing and Filled Surface Index (DMFS-dfs) increased significantly with increasing CFSS-DS values. Fear scores were highest for ‘Choking’ (3.3), ‘Injections’ (2.6) and ‘Having somebody put instruments in their mouth’ (2.6). No significant differences in fear scores between boys and girls were found in this study. Conclusions: The data showed prevalence of dental fear in the 7–11-year-old children of this study. Dental fear scores decreased with increasing age.

Atraumatic Restorative Treatment with Resin-Modified Glass Ionomer Material: Short-Term Results of a Pilot Study

Objectives: The aim of this study was to assess the feasibility of the resin-modified glass ionomer (RMGI) material in atraumatic restorative treatment (ART) approach and compare RMGI with the high-strength traditional glass ionomer cement (GIC) in permanent teeth with one or more surface-carious cavities. Materials and Methods: This study was conducted in a village school in rural southeastern Anatolia, Turkey. The RMGI and GIC restorations with the ART technique were placed randomly employing a split mouth design. In addition, the ART approach was used when necessary for both primary and/or permanent teeth with no pulpal involvement and no perceived pain before treatment. Ninety-one fillings were placed on contralateral molar pairs of 37 children. Baseline and 6-month evaluation of the fillings were made with the classic ART, modified Ryge and USPHS criteria. Results: Based on the ART criteria, 100% of RMGI and 92.4% of GIC restorations were classified as successful after 6 months, and the difference between the 2 groups was statistically significant (p = 0.009). While marginal discoloration was the commonest failure in the RMGI group according to both the modified Ryge and USPHS criteria, unsatisfactory surface texture and low anatomic form were the commonly seen failures in the ART technique. Conclusion: Generally, for each rating system, RMGI exhibited better clinical performance than GIC in all categories, except for marginal discoloration. Results based on the 6-month evaluation show that RMGI can be an alternative material to the GIC.

Prevalence of caries among preschool-aged children in a central Anatolian population.

Objective: Early childhood caries (ECC) is a particularly destructive form of tooth decay that afflicts young children. The etiology and associated factors of ECC should be studied adequately to overcome this health hazard. The aim of this study was to determine caries prevalence and its consequences in toddlers in an Anatolian city, Kırıkkale. Materials and Methods: Examinations were performed in family medicine centers by three calibrated dentists during a period of 6 months. The status of dental caries was recorded according to the World Health Organization (WHO) criteria. We recorded the clinical indexes of decayed, missed, and filled teeth (DMFT and dmft; upper-case letters refer to permanent and lower-case letters to primary teeth), and decayed, missed, and filled surfaces (DMFS). Results: Totally 3171 toddlers were included (52% males and 48% females). The mean age was 25.8 ± 10.1 months. The prevalence of ECC in preschool children was 17.3%, while the mean df(t) was 0.63 ± 1.79. ECC increased significantly with age. Dental caries were mostly observed in primary maxillary central teeth. Occlusal and buccal surfaces were the most affected sites. The difference in distribution of caries between maxilla and mandibula was found to be statistically significant (P < 0.05). Conclusions: When compared to other data obtained from various epidemiologic studies, the toddlers living in Kırıkkale city center had a significant caries level. This observation had clearly suggested that early preventive measures should urgently be put into effect all over the city.

Anticaries effect of atraumatic restorative treatment with fissure sealants in suburban districts of Turkey

Background/Purpose This 3-year field trial was performed to compare the effectiveness of high-viscosity atraumatic restorative treatment with glass ionomer sealant (ARTGIS) on the development of caries in a population of children living in two distinct localities in Diyarbakir City in southeastern Anatolia, Turkey. One of these was a suburban district with low socioeconomic conditions and lacked routine dental care, and the other was located in the city center and had a moderate socioeconomic status with proximity to a well-designed dental center. Materials and methods Two primary schools were selected as study sites in these two locations. In total, 368 ART-GIS procedures were performed on 208 children aged 9-11 years, while 174 children who were students at another school in the center of the same city did not receive the sealant and served as controls. The clinical status of the ART-GIS was evaluated at the baseline and during the first, second and third years after placement. Differences between the two groups for each evaluation period were analyzed using Students t test for the two independent groups. Results The control group had nearly ten, five and three times greater numbers of new caries than did the ART group during the first, second and third years, respectively. The difference between the groups was statistically significant for each examination period with respect to the number of children having new caries (Students t test, P t test, P Conclusion These results clearly show that the ART-GIS procedure can be used as a preventive method in rural and/or suburban areas where other preventive approaches are neither available nor economical.

Evaluation of school-based prevention program in Turkey: Results of a 24-month study.

Objective: In this paper, cavity experiences of children with different levels of eruption and cavity activities that are enrolled at an elementary school with semi-rural characteristics in Kırıkkale Provincial center were monitored for 2 years after a variety of protective applications. Materials and Methods: Three hundred and twenty-two children at the age of 7–11 were included in this study. Children were grouped as follows according to their cavity experiences and applications done: Group 1 - control group (with or without cavities) – was given hygiene training only; Group 2 - with medium level cavity activity (2–4 cavities in average) – oral hygiene training + surface restoration applied; Group 3 - children with 2–4 cavities on average – oral hygiene training + professional flour gel applied; Group 4 - children with 2–4 cavities in average – oral hygiene training + flour gel applied with brush; Group 5 - children with extreme cavity activity (children with 5 or more cavities) – oral hygiene training + surface restoration + professional flour gel combination applied. Results: At the end of the 2nd year, 277 children were reached. The increase of number of cavities in permanent teeth was determined as 35%, 0%, 1%, 0%, and 7% in groups 1–5, respectively. The difference between groups was found to be significant (Chi-square analysis, Pearson Chi-square = 27.002, P < 0.01). Conclusion: These findings have showed that, in Kırıkkale Provincial center, some cavity-preventive measures such as surface restoration and gel applications, along with hygiene training, could provide optimum protection for school-age children.

Rural dentistry: Is it an imagination or obligation in community dental health education?

During the past two decades, epidemiologic studies in less developed or developing countries have clearly reported that caries prevalence shows the distinctive patterns over the word, even though it is declining in many developed countries. Due to huge rural districts where arrival is problematic and ineffective dental and preventive care centers in most suburban districts, there has been significant difference between the different parts of the communities to provide dental care service, and unfortunately the sole preventive measure has been limited with the advising of using the tooth brush and paste. The problems are usually arisen not only from the inadequacy of trained personnel but also from the absence of an effective economic and pragmatic system which aims to effectively dispense the dental service to all over the country. For this reason, the basic aim of dental care should be to carry out the many dental services in a multidisciplinary manner within the first appointment and to serve the people at their own homes and/or districts. Clearly, the needed multidisciplinary dental care system can lead to a new educational doctrine for rural dental practice. This versatile and practical training program based on specific perceived needs of a specific population(s) could need a new educational program. So, various preventive and/or restorative procedures included by this new doctrine could be named as “rural dentistry.” In this review, with the examples from the many in vivo studies carried out under rural conditions over the world, the probable practices in this specific dental doctrine have generally been exemplified.

Contents Vol. 18, 2009

493 Abstracts of Award-Winning Posters, 14th Annual Health Sciences Poster Conference, Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, April 21–23, 2009 498 Abstracts of Theses Approved for the MSc and PhD Degrees at the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait 504 Announcement 505 List of Reviewers 507 Author Index Vol. 18, 2009 510 Subject Index Vol. 18, 2009