Sedin Kobašlija

Caries prevalence of children and adolescents in Bosnia and Herzegovina

OBJECTIVE The aim of this study was to present epidemiological parameters of caries prevalence in children and adolescents in index age groups on a national and regional level in Bosnia and Herzegovina (BH). MATERIALS AND METHODS The study was conducted during 2004 year for children aged 6 and 12, and during 2007 for adolescents aged 15. An oral health survey was performed on a total number of 1,240 children and adolescents in line with World Health Organization methodology and criteria. Results for caries prevalence and treatment needs were presented and discussed in this paper. RESULTS Mean dmft (decay, missing, filled teeth for primary dentition) for children aged six was 6.7 (SD±3.9) in that the decayed teeth constituted the major part of the index (88.8%), followed by extracted teeth (8.9%) and a small percentage of filled teeth (2.3%). In 12-year-olds DMFT (Decay, Missing, Filled Teeth for permanent dentition) was 4.2 (SD±2.9), Significant Caries index (SiC) was 7.7 (SD±2.9), the decayed teeth constituted the major part of the index (45.4%), followed by 42.1% of FT and 12.5% of extracted teeth. Among 15-year-olds the DMFT was 7.6 (SD±4.1), SiC was 9.2 (SD±1.2), and filled teeth constituted the major part of the index. CONCLUSION The present study provides some evidence of relatively high caries prevalence and severity in comparison with Western European countries. It is necessary to devote more attention to the oral health of children and adolescents. Community based oral health promotion, preventive programs and preventive oriented public dental health care services should be made available and accessible to all children in Bosnia and Herzegovina.

Cariogenic Potential of Inhaled Antiasthmatic Drugs.

Introduction: The organism of children with asthma is exposed to the effects of the disease but also the drugs for its treatment. Antiasthmatic drugs have different modes that promote the caries formation which varies according to their basic pharmacological composition. Namely, these drugs have a relatively low pH (5.5), can contain sweeteners such as lactose monohydrate in order to improve the drug taste or both. Frequent consumption of these inhalers in combination with reduced secretion of saliva increases the risk of caries. Material and methods: The study sample consisted of 200 patients, age from 7-14 years, divided into two groups: control group (n1 = 100) consisted of healthy children and the experimental group consisted of children suffering from asthma (n2 = 100). In both groups of respondents are determined the DMFT index, plaque index value and hygienic-dietary habits using the questionnaire. The subjects in the control group had significantly higher DMFT index than subjects in the experimental group (p = 0.004). It is determined that there are no significant differences in the values of plaque index (p>0.05). Conclusion: The effect of different diseases or medications from their treatment, diet and fermentable carbohydrates in the etiology of dental caries cannot be observed outside the living conditions of subjects, their social epidemiologic status, age, habits, oral hygiene, fluoride use, etc.

The prevalence and severity of early childhood caries in preschool children in the Federation of Bosnia and Herzegovina.

OBJECTIVE The aim of this study was to assess caries prevalence and severity in preschool children in the Federation of Bosnia and Herzegovina. In addition, the relationship between the frequency and clinical types of early childhood caries and behavioral factors, oral hygiene and eating habits were assessed. SUBJECTS AND METHODS An oral health survey was performed in line with the World Health Organization methodology and criteria. The research consisted of clinical examinations of children to determine dentition status, oral hygiene and severity of caries distribution according to Wynes classification. Information about behavioral factors was collected by means of a questionnaire administered to parents/guardians. RESULTS The sample consisted of a total of 165 preschool children aged 3-5 years. Mean dmft (decay, missing, filled teeth index for primary dentition) was 6.79. The percentage of caries-free children was 17.0%. The results showed a statistically significant correlation between oral hygiene and eating habits, and also the frequency and types of early childhood caries. CONCLUSION The present study demonstrates high caries prevalence in preschool children in the Federation of Bosnia and Herzegovina. Community based preventive programs should be developed and urgently implemented, in order to achieve the WHO goals, improve oral and general health, thus improving the quality of life of these populations.

Reliability and Validity of the Modified Version of Children's Fear Survey Schedule-Dental Subscale in 9-12 Years Old Schoolchildren in Bosnia and Herzegovina

Background: Dental fear and anxiety (DFA) are present worldwide globally, as well as in children. These psychological clinical entities in its progressive phase lead to avoiding of dentists and dental appointments, and consequtive impairments of oral health. If we ignore these facts, we would have the strenghtening of this relationship in a way of further oral health impairments and lost of dental hard and soft tissues, as well as appearance of dental phobia as the most negative form of psychological reaction to dental stimuli. Original CFSS-DS scale and its modifications, as the most used instruments for evaluation of DFA presence so far, showed various disadvantages. These were the reasons why we wanted to design new psychometric instrument for better evaluation of DFA presence in children compared to evaluation which the existed scales could offer nowadays, in a form of the Modified Version of CFSS-DS scale (CFSS-DS-mod scale). Materials and methods: There were 809 schoolchildren from 8 cities of Bosnia and Herzegovina aged 9-12 years that participated in the study. There was one school per city where the schoolchildren answered to the questions from the CFSS-DS-mod scale. Results: 636 schoolchildren correctly answered to the scale questions. The CFSS-DS-mod scale showed excellent internal consistency reliability values (with Cronbach α>0.9), and also validity results (mostly over 60% of explained variance of obtained results) with two-dimensional concept of DFA presence. Conclusion: The CFSS-DS-mod scale represents good psychometric instrument for evaluation of the DFA presence in 9-12 year old schoolchildren in Bosnia and Herzegovina. Some of normative values of this psychometric instrument should be determined, in order to expand its usage in children.

The Reliability and Validity of the Three Modified Versions of the Children’s Fear Survey Schedule-Dental Subscale of 9-12 Year Old Children in a Clinical Setting in Bosnia and Herzegovina

OBJECTIVE This study sought to obtain a comprehensive, reliable and valid instrument for evaluation of the presence of dental fear and anxiety (DFA) in children, through evaluation of the reliability and validity of three modified versions of the Childrens Fear Survey Schedule-Dental Subscale (CFSS-DS). MATERIALS AND METHODS The study sample comprised children aged 9, 10, 11 and 12 years. The first sample group (200 patients) filled in a modified version of the CFSSDS scale, the second sample group (100 patients) filled in a short form of the Dental Fear Survey Schedule, and the third sample group (100 patients) filled in a short version of the CFSS-DS scale, prior to dental treatment, respectively. In order to determine test-retest reliability, the 184 patients from the first sample group filled in the modified version of the CFSS-DS scale again, prior to their next scheduled dental appointment. RESULTS The modified version of the CFSS-DS scale had the best internal consistency reliability (α=0.907), as well as validity results, compared to the other two instruments used. Test-retest reliability was moderate (Intraclass correlation coefficient: 0.58). CONCLUSIONS Of the three psychometric instruments used for evaluation of DFA presence in children, the modified version of the CFSS-DS scale showed the most clinically adequate reliability and validity values. This study thus provides a new psychometric instrument that should be considered for clinical use in evaluation of DFA presence in 9-12 year-olds, in a clinical setting sample type of children.

Factors that Determine Child Behavior during Dental Treatment

Summary In this review paper we wanted to summarize all the aspects which could affect the behavior of the child patients in the dental office. At the beginning, the factors that are related to the child patients are mentioned. Various segments of child psychological, cognitive, physiological and other kinds of development are discussed. Also, the reasons for dental fear and anxiety (DFA) and dental behavior problems (DBP) were analyzed, and how the child dental patients could cope with them. Finally, types of patients according to their behavior in the dental office were discussed. Furthermore, the influences of child patients’ parents were studied, including parenting styles, as well as factors related to dentist, dental team and the dental office. Finally, critical evaluation of administration of assets to measure the presence of DFA and DBP is provided. Every part of the text was corroborated by the results from our own and other authors’ recent bibliography data.

KNOWLEDGE AND ATTITUDES REGARDING CHILD ABUSE AND NEGLECT

Purpose: The aim of this study was to assess knowledge and attitude of dentists in Bosnia and Herzegovina (BH) regarding signs and symptoms of child abuse and neglect (CAN), reporting procedure and level of education. Methods: Data were collected through a self-administrated structured questionnaire adopted and modified from previous studies. It was administrated to 300 dentists out of which a total number of 210 subjects were in final sample for statistical analyses. Response rate was seventy percent. Descriptive statistics, Chi-square and Kruskal-Wallis H test were used to analyze statistical differences in responses. The level of significance was set at p<0.05. Results: Dentists in BH are very rarely provided (80%) with training related to recognition and reporting of CAN. Sixty six percent of dentists had never suspected CAN in their practice. Only nine percent of dentists would report suspicious of CAN. Prevailing reasons for not reporting suspected case of CAN was lack of knowledge of the reporting procedure (43%), and combination of indicated answers that never had a case and lack of knowledge about the procedure (31%). Conclusion: Results of this study suggest that dentists need an effective education to increase their knowledge and awareness of all aspects of CAN.

Antiasthmatic Inhaled Medications as Favoring Factors for Increased Concentration of Streptococcus Mutans.

Introduction: The negative impact of inhaled antiasthmatic drugs (IAD) on oral health is reflected primarily in the increased incidence of caries in asthmatic children compared to healthy children. It is believed that one of the causes of the increased incidence of caries in asthmatic children is from bronchodilator effect in reduced secretion of saliva. Decreased salivation favors bacterial colonization and studies have shown that the concentration of Streptococcus mutans, a bacterium that has the primary role in the development of caries, is higher in asthmatic than in healthy children. Material and methods: The study sample consisted of 200 patients, age from 7-14 years, divided into two groups: control group (n1 = 100) consisted of healthy children and the experimental group consisted of children suffering from asthma (n2 = 100). In both groups of respondents are identified the DMFT values, the concentration of Streptococcus mutans, the amount of stimulated saliva and plaque index value. Results: It was found that there are significant differences in the values of plaque index, salivary index and streptococcus mutans between the control and experimental groups (p> 0.05 for each of the examined variables). Those in the control group had significantly higher DMFT index than subjects in the experimental group (p = 0.004). Conclusion: IAD does not cause reduced saliva production and thus do not represent a factor favoring increased concentration of Streptococcus mutans.