Altındağ İlçe Milli Eğitim Müdürlüğü’ne Bağlı Anaokullarındaki 3-6 Yaş Çocukların Ağız-Diş Sağlığı Durumunun Belirlenmesi

Pre-school children are under risk considering general health and oral health. During this period,basic habits related to general health have been gained; learning how to care their mouth and teeth under parent’s supervision is also important in these ages.. Early childhood caries is one of the most frequent diseases in nursery children among the world as well as our country. In this study, it was aimed to determine some socio-demographic characteristics, oral hygiene practices, oral health related habits, feeding habits and oral health status of nursery children.The ethical approval of Hacettepe University and the written informed consent of the parents were obtained before the data collection and examinations. Eleven public nursery schools in one low socio-economical level districts of the capital city of Turkey (Ankara) were covered; the data were gathered via a structured, pre-tested questionnaire from 729 parents and children’s oral examinations were done under the field conditions by a Pediatric Dentistry research assistant The oral health status was evaluated by using dmft/s, D0-D4, ICDAS II, pufa, dental plaque and gingival indices. Furthermore, posterior and anterior occlusion, dental anomalies, anthropoid diastemas and crowding existence were also evaluated. Of the 729 children, 55.4% was male; mean age was 58.8±8.6 months; mean dmft was 4.8±4.7 and the mean dmfs was 8.3±10.2. 538 children (73.8%) had early childhood caries (ECC) while severe ECC was 51.0%. Only 23 boys and 35 girls had totally healthy primary teeth according to D0-D4 and ICDAS II. Of all children, 17.1% had initial, 28.0% had moderate and 46.9% had extensive decay according to ICDAS II.64 boys and 30 girls had symptoms due to pufa index; a total of 179 teeth had clinical consequences of untreated dentine carious lesions with the mean pufa index 0.25±0.79. The mean plaque and gingival indices were 0.31±0.32 and 0.08±0.16, respectively. Child’s age, child’s gestational age, child’s sharing spoon/fork with mother, active dental caries in the mother, child’s previous dental visits have been found significantly associated with ECC. In conclusion, pre-school children enrolled to the public nursery schools in a low-middle socio-economic level district in Turkey had high prevalence of carious lesions and low oral health habits.There is an urgent need of preventive programs in the area.Okul öncesi dönemdeki çocuklar, genel sağlık ve ağız sağlığı açısından toplumun önemli risk grupları arasındadır. Bu yaşlarda çocuklarsağlıkla ilgili birçok temel alışkanlıkları kazanmaya başladıkları gibi, yine bu dönemde, ağız diş bakımının nasıl yapıldığını öğrenmeleri ve ebeveynleri eşliğinde uygulamaları da büyük önem taşımaktadır.Erken çocukluk çağı çürüğü dünyada ve ülkemizde sıklıkla görülen bir hastalıktır. Bu çalışma, 36-71 ay arası çocukların ve ailelerinin sosyo-demografik özelliklerini, ağız hijyeni alışkanlıklarını, ağız sağlığına yönelik davranışlarını, çocukların ağız sağlığı ile ilgili alışkanlıklarını, beslenme alışkanlıklarını ve ağız- diş sağlığı durumlarını incelemek üzere planlanmış ve yürütülmüştür. Çalışmanın örneklemini, Ankara İli’nde sosyo-ekonomik düzeyi düşük seviyede olan Altındağ İlçesi’nde yer alan toplam 11 devlet anaokuluna devam eden çocuklar oluşturmuştur. Hacettepe Üniversitesi Girişimsel Olmayan Araştırmalar Etik Kurulu Başkanlığı’ndan onay alındıktan sonra veriler,velilerden Hacettepe Üniversitesi Diş Hekimliği Fakültesi Çocuk Diş Hekimliği Kliniği’ne başvurmuş hastaların velilerine uygulanarak ön testi yapılmış olan bir anket formu aracılığıyla toplanmıştır.Velilerden yazılı onam alındıktan sonar, çocukların ağız-diş muayeneleri ayna, sond, gazlı bez ve kafa lambası kullanılarak yapılmıştır.Diş çürükleri dmft/dmfs indeksleri, D0-D4 skalası, ICDAS II indeksleri ile; tedavi edilmemiş diş çürüklerinin yumuşak dokuda doğurmuş olduğu klinik sonuçlar pufa indeksi ile; dişeti sağlığı ve plak durumu ile ilişkili kayıtlar ise gingival indeks ve plak indeksi kullanılarak değerlendirilmiş ve kaydedilmiştir. Ayrıca çocuklarda posterior, anterior ve kanin diş ilişkileri, anterior çapraşıklık durumu, maymun diasteması varlığı ve var ise dental anomaliler ile dental travma bulguları değerlendirilmiştir. Ortalama yaşın 58,8±8,6 ay olduğu; yaşları 36-71 ay arasında değişen toplam 729 çocuğun %55,4’ünü erkekler oluşturmaktadır. Ortalama dmft 4,8±4,7; ortalama dmfs 8,3±10,2 olarak bulunmuştur. Çocukların %73,8’i erken çocukluk çağı çürüğüne (EÇÇ) sahipken, %51,0’i ciddi-EÇÇ’ye sahiptir. D0-D4 skalası ve ICDAS II indeksi ile değerlendirme yapıldığında yalnızca 23 erkek ve 35 kız çocuğun sağlıklı dişlerinin olduğu tespit edilmiştir. Çocukların dişleri ICDAS II indeksi ile değerlendirildiğinde, çocukların %17,1’nde başlangıç seviyesinde, %28,0’ında orta seviyede ve %46,9’nda ise ciddi derecede çürük olduğu saptanmıştır. 64 erkek ve 30 kız çocukta toplam 179 dişte tedavi edilmemiş derin dentin çürüğünün neden olduğu klinik sonuçlar pufa indeksi kullanılarak kaydedilmiş olup, ortalama pufa indeksi 0,25±0,79 olarak bulunmuştur. Ortalama plak indeksi ve gingival indeks ise sırasıyla 0,31±0,32 ve 0,08±0,16 olarak saptanmıştır. EÇÇ ile ilişkili olabilecek faktörler incelendiğinde çocuğun yaşının, annenin çocuk ile ortak kaşık-çatal kullanmasının, annenin çürük dişinin bulunmasının, çocuğun önceden diş hekimine gidip gitmemesinin, çocuğun gestasyon yaşının EÇÇ ile anlamlı ilişkisi olduğu görülmüştür. Sonuç olarak, Türkiye’ de düşük-orta ekonomik seviyede bir bölgede devlet anaokullarına devam etmekte olan çocukların ağız sağlığı durumlarının ve ağız sağlığı alışkanlıklarının iyi olmadığı görülmüştür. Ağız sağlığının düzeltimesi, iyileştirilmesi ve geliştirilmesi için programların oluşturulması gerekmektedir

What do Turkish sports sciences students know about dental trauma and mouthguards? A descriptive study

Objective: Sports-related dental-orofacial-injuries can be reduced significantly through training on primary prevention and using proper equipment before engaging in sporting activities. This study aimed to determine the level of knowledge regarding dental trauma and prevention by mouthguards among the students in the Faculty of Sport Sciences. Materials and Method: This was a descriptive study conducted at Ankara, Gazi, and Hacettepe Universities. Although intended to include all students at the faculties (N=3097), only those who were at the faculty and volunteered (28.2%) on the day the data were gathered participated. Data were gathered via a questionnaire comprising 31 questions on sociodemographic characteristics, dental trauma history, mouthguard use, and knowledge of dental trauma. Results: In total, 875 students with a mean age of 22.5±2.9 (60.3% male) participated. Of these students, 20.6% had dental trauma history, 72.0% had first aid and emergency training, and 20.9% had oral dental injuries training. Of the students, 69.5% had heard about mouthguards, although only 19.7% of these had used them. Mouthguards were mostly used in professional sports activities such as far-eastern sports and ice hockey. The average number of true answers out of ten dental trauma-related questions was 2.75±1.68 and 66.6% stated they wished to learn more about the topic. Conclusion: Results showed a lack-of-knowledge about both dental trauma and mouthguards and inadequate use of mouthguards in sports activities. Therefore, basic information about these topics should be implemented in the curriculum to instruct students before they graduate

Evaluation of periodontal status and cytokine response in children with familial Mediterranean fever or systemic juvenile idiopathic arthritis

Objectives: Familial Mediterranean fever (FMF) and systemic juvenile idiopathic arthritis (sJIA) are chronic inflammatory diseases and anti-inflammatory agents are used in their treatment. This study evaluates the periodontal status and cytokine response in pediatric patients with FMF or sJIA. Materials and methods: Forty-eight FMF/sJIA patients were under treatment/control and in attack-free period; 20 systemically healthy children participated in the study. FMF/sJIA patients were divided into two subgroups based on the treatment they received: receiving anti-IL-1 therapy (anti-IL-1 (+)) and not receiving anti-IL-1 therapy (anti-IL-1 (−)). The clinical periodontal indices were recorded. Gingival crevicular fluid (GCF) and serum samples were collected. Cytokine levels (IL-1β, IL-1α, TNF-α, IL-6, IL-8, IL-10, IL-17, IL-33) in GCF and serum were measured using ELISA kits. Results: There was no significant difference between the groups in terms of GCF IL-1β and IL-1α levels although, BoP and GI were significantly lower in the anti-IL-1 (+) group compared to the control group. GCF IL-10 level was higher in the anti-IL-1 (−) group than in the control group; GCF IL-8 levels were lower in both FMF/sJIA subgroups versus controls. There was no significant difference between serum cytokine levels of FMF/sJIA subgroups. Conclusions: Considering the significant decrease in GI, BoP, and GCF IL-8 levels in the anti-IL-1 (+) group, it can be concluded that anti-IL-1 medications may suppress periodontal inflammation clinically and immunologically. Clinical relevance: Anti-IL agents are not currently used in periodontal therapy. However, this study demonstrated the positive effect of anti-IL-1 medications on periodontal inflammation in pediatric patients with FMF or sJIA

Evaluation of periodontal status and cytokine/chemokine profile of GCF in patients with severe congenital neutropenia

Severe congenital neutropenia (SCN) is a primary immunodeficiency characterized by defect in neutrophil count. Increased risk of infections in addition to periodontal problems, such as ulcerations of oral mucosa, gingival inflammation, and rapid loss of attachment are common in the course of the disease. The aim of the present study is to define the causal relationship between the severity of periodontal inflammation and severe congenital neutropenia through identification of cytokine profile in gingival crevicular fluid (GCF). A case–control study was performed in patients diagnosed with SCN and healthy controls. Demographic data, the molecular defect, laboratory work-up were gathered from the hospital registry. Periodontal indices were recorded and GCF samples were analyzed using multiplex analysis for the simultaneous measurements of the particular cytokines and chemokines. The present study included 14 patients and 22 control subjects. Both groups were comparable in terms of age and sex. Severity of gingival inflammation measured by the criteria of Löe was higher in the SCN cases (p < 0.05). Moreover, GCF levels of IFN-α, TNF-α, IL-10, IL-13, IL-15, IL-17, IL-2, IL-7, IL-33, IP-10, MIG, MIP-1β were significantly higher in the controls. Decreased cytokine secretion seems to correlate with the decrease in neutrophil counts. The severity of gingival inflammation in SCN patients may be due to the bacterial overgrowth and the change in the content of the oral flora due to the decreased neutrophil counts. Therefore, regular periodontal examinations, the motivation of oral hygiene as well as the compliance with therapy in SCN patients contribute to the periodontal health

Levels of pro- and anti-inflammatory cytokines in cystic fibrosis patients with or without gingivitis

Background: Inflammatory periodontal diseases are caused by interaction between gram negative, anaerobic bacteria and host response. Persistent infection of Pseudomonas aeruginosa in cystic fibrosis (CF) patients also cause increased pro-inflammatory response and the imbalance of pro- and anti-inflammatory response in brochoalveolar lavage fluid which leads to destruction of lungs. The aim of this study is to evaluate periodontal status of CF patients, to measure level of cytokines and biochemical molecules in gingival crevicular fluid (GCF), and to detect presence of P. aeruginosa in dental plaque samples. Materials and methods: GCF samples were collected from 41 CF patients and 39 healthy (non-CF) subjects. Interleukin (IL)-1ß, IL-17, IL-10, human neutrophil elastase (HNE), cystic fibrosis transmembrane regulator (CFTR) protein, and human β-defensin-1 (HBD1) in GCF were evaluated by ELISA method. Dental plaque samples were collected from 18 CF patients with history of P. aeruginosa colonization and 15 non-CF subjects. Presence of P. aeruginosa was evaluated by using conventional culture methods and molecular methods. Results: Levels of IL-1ß, HNE, and HBD1 in CF patients were significantly higher than non-CF subjects. However, IL-10 level was significantly lower in CF patients. Increased pro-inflammatory (IL-1ß) and decreased anti-inflammatory (IL-10) cytokine levels were observed in GCF samples from CF patients, irrespective of their periodontal status. P. aeruginosa were detected in four samples of 18 CF patients, and all were negative in non-CF group. Conclusions: As a result of this study, CF coexists increasing pro-inflammatory and decreasing anti-inflammatory response locally. Due to increasing pro-inflammation, CF patients should be followed-up more often than non-CF children