Longitudinal changes in the prevalence of dental fear and anxiety in 9–12-year-old children in clinical setting in Bosnia and Herzegovina

Introduction: Dental fear and anxiety (DFA) is a ubiquitous entity among dental patients in terms of their prevalence and incidence. It is among the major clinical problems in dentistry. In addition, the differences in DFA prevalence were present considering the age and gender of patients and over time, but with some opposite reports. The aim of this study is to examine the prevalence of DFA presence in children concerning their age, gender, and over time. Methods: The survey sample comprised 200 of 9–12-year-old children. The DFA presence was determined twice by the modified version of the CFSS-DS scale (CFSS-DS-mod scale) during a 6-months long period between the first and the subsequent dental appointment due to the need for restorative dental treatment. The scale was applied before the restorative treatment started on both occasions. Results: The prevalence of DFA was 17.5% in the study sample and decreased over time. It was slightly higher in girls. Conclusions: The DFA prevalence in 9–12-year-old children is decreasing over time. Latent manifestations of DFA presence should be considered for evaluation in the future

Demarcated Opacities as Predictors of Progression of the Molar Incisor Hypomineralisation: a Pilot Study

Svrha rada: Opservirani su demarkirani opaciteti (DO) na zubima zahvaćenima molarno-incizivnim hipomineralizacijama (MIH) sa svrhom ispitivanja povezanosti izgleda DO-a te broja zahvaćenih zuba s predikcijom progresije bolesti. Materijal i metode: Na uzorku od 446 sarajevskih ispitanika pregledanih 2009. godine (dob 6 do 9 godina), utvrđena je prevalencija MIH-a od 11,5 %, (n = 51). Istraživanjem su bili obuhvaćeni ispitanici s potvrđenom dijagnozom MIH-a čiji su se roditelji složili sa sudjelovanjem u jednogodišnjoj studiji (n = 25). Rezultati: U uzorak je bilo uključeno 29 stalnih inciziva i 14 prvih stalnih molara na kojima su uočeni DO-i. Broj zuba sa svijetlim demarkiranim opacitetima bio je znatno veći negoli s tamnima. Brojniji su bili demarkirani opaciteti locirani na glatkim plohama koje nisu izložene silama tijekom žvakanja. U postotku se zahvaćenost zubnih površina demarkiranih opacitetom kretala se od 1,33 % do 56,56 %. Broj zahvaćenih zuba iznosio je od 2 do 6. Uočena je pozitivna korelacija između progresije bolesti i tamnih opaciteta na okluzalnim/incizalnim površinama zuba. Tamniji opaciteti zahvaćali su veće površine zuba. DO na incizivima češće je lociran na vestibularnim površinama, a na prvim stalnim molarima okluzalno. Zaključci: Tamnija boja DO-a pokazala se najboljim pojedinačnim pokazateljem progresije bolesti te tamnija boja u kombinaciji s brojem zahvaćenih zuba. Kao dobar nezavisni prediktor progresije MIH-a pokazala se lokalizacija demarkiranog opaciteta. Zato je važno zabilježiti podatke o boji i lokalizaciji DO-a.Objectives: Demarcated opacities (DO) on teeth affected by Molar Incisor Hypomineralisation (MIH) were observed to investigate if parameters of DO existence and the number of teeth affected could be used to predict the progression of disease. Material and methods: In 2009, the MIH prevalence was 11.5% (n=51) among 446 subjects in Sarajevo, aged from 6 to 9 years. In subjects with MIH who gave consent for further participation (n=25), the teeth with DO were observed after a 12-month period. Results: our sample included 29 permanent incisors and 14 first permanent molars with DO. The number of teeth with light opacities was significantly higher than the number of teeth with dark opacities. Opacities were more numerous on surfaces which were not exposed to masticatory pressure. The size of tooth surface affected by DO occurrence ranged from 1.33% to 56.56%. The number of affected teeth ranged from two to six. A strong positive correlation between MIH progression and dark colored opacities located on the occlusal/incisal surface of teeth was noted. Larger part of tooth surface was affected by hypomineralisation in the case of dark-colored opacities. The DO presence on incisors was more likely to be located on vestibular surfaces and on the first permanent molars on their occlusal surfaces. Conclusions: The color of DO occurrence was the best predictor for MIH progression both independently and in combination with the number of affected teeth. Location of DO occurrence was a good independent predictor for MIH progression. It is important to collect information about color and location of DO presence

Evaluation of Dental Fear and Anxiety in Displaced Persons in Bosnia and Herzegovina

Uvod: U Bosni i Hercegovini (BiH), uz stalno stanovništvo, živi i određen broj raseljenih osoba. Najviše ih je na području Tuzlanskog kantona. Oni se ubrajaju u rizičnu skupinu kad je riječ o bolestima općenito, pa i o orofacijalnima. Dentalni strah i anksioznost (DSA) pojavljuje se nužno i kod raseljenih osoba i velik je u odnosu na opću populaciju. Na osnovi navedenoga željeli smo evaluirati prisutnost DSA-e i čimbenika za njezin nastanak kod raseljenog stanovništva u Bosni i Hercegovini. Ispitanici i metode: U studiji je sudjelovalo 310 osoba u dobi od 35 do 44 godine, a bile su podijeljene u ispitivanu skupinu raseljenih osoba (n = 153) i kontrolnu skupinu domicilnog stanovništva (n = 157) iz gradova Tuzlanskog kantona. Kod ispitanika se procjenjivala prisutnost DSA-e s pomoću prilagođene Korahove ljestvice dentalne anksioznosti te prisutnost čimbenika za njezin nastanak. Rezultati: U uzorku je ustanovljena općenito visoka prevalencija DSA-e (38,71 %), a posebno u skupini raseljenih osoba (57,52 %). Pritom raseljeni u uzorku rjeđe posjećuju stomatologa, uglavnom samo kada je to potrebno (najčešće zbog odontalgije) i snažnije reagiraju na stresore koji mogu uzrokovati DSA-e. Zaključak: Raseljene osobe ubrajaju se u rizičnu skupinu s visokom prevalencijom DSA-e. To je mogući razlog da ova populacijska skupina ima prosječno lošije parametre oralnoga zdravlja te lošije uzorke ponašanja sa stajališta učestalosti posjeta i razloga za posjete stomatologu. Sve to pojačava začarani krug u kojemu loše oralno zdravlje pospješuje pojavu DSA-e i obrnuto.Introduction: In Bosnia and Herzegovina, apart from domicile population, there is a certain number of displaced persons. Most of them are situated in the area of Canton Tuzla. These persons are generally at risk of and being watched for various diseases, including the disease of the orofacial area. Dental fear and anxiety (DFA) is also inevitably present in displaced persons, with higher prevalence compared with general population. Therefore, the aim was to evaluate the DFA presence and the most common reasons for dental fear and anxiety in displaced persons in our country. Patients and methods: 310 interviewed persons were included in this study, aged 35 to 44 years, from several cities of Canton Tuzla. They were divided in the group of displaced persons (n=153), and the group of domicile inhabitants (n=157). The study participants were interviewed about the DFA presence, as well as about the risk factors for DFA, which was subsequently evaluated by the Modified Corah’s Dental Anxiety Scale. Results: A high prevalence of DFA presence was determined in the total sample (38.71%), and particularly in the displaced persons group (57.52%). The results showed that displaced persons rarely visited dentists, mainly when it was necessary (odontalgia), with stronger reactions to factors that could cause DFA appearance. Conclusion: Displaced persons are regarded as one of the highest risk groups for prevalence of DFA. This could be mainly due to poor oral health status, rare dental office visits and the urgent need for dental treatment, which could lead to vicious circle of mutual strengthening between bad oral health and DFA appearance

The effect of immersion in beverages and dental bleaching agents on the surface roughness of resin composites

Introduction: Composite materials may be exposed to chemicals in food and beverages in the oral cavity, which can lead to changes in surface roughness. The aim of this in vitro study was to evaluate the surface roughness of two restorative materials after exposure to coffee and green tea followed by a dental bleaching procedure. Methods: For nanofilled composite and microhybrid composite, 15 samples each were fabricated. Five specimens from each composite were stored in instant coffee and green tea for 4 h a day. After 30 days of immersion, specimens received dental at-home bleaching, using 16% carbamide peroxide (CP), for 7 h a day. The control group was stored in deionized water for 30 days. Surface roughness was determined by profilometry 24 h after polymerization, after 30 days of immersion, and after bleaching. The data were analyzed using a t-test for paired samples and mixed analysis of variance, at a 0.05 significance level. Results: Neither beverages nor CP treatment significantly altered the surface roughness of the composites. There was no difference between the tested composite materials regarding roughness. Conclusion: Surface roughness of the microhybrid and nanohybrid composites was not modified by coffee, green tea, and subsequent whitening treatment

Karijes u djece u javnim vrtićima u Sarajevu, Bosna i Hercegovina

Objectives: Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day’s busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well. Aims: To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers. Methods: The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits. Results: ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%), dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children’s parents (CI=10.55%, RI=10.80%, TI=12.98%). Conclusion: Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions.Uvod: Prva pojava zubnog karijesa događa se u mliječnoj denticiji male i predškolske djece i to u obliku karijesa ranog djetinjstva (KRD). U današnjem užurbanom i opterećenom roditeljstvu, osobe i institucije koje čuvaju djecu postale su još važnije, ne samo zato što oblikuju opće ponašanje i karakter djeteta, nego i zato što održavaju njegovo opće i oralno zdravlje. Cilj: Željela se procijeniti prisutnost i težina KRD-a kod djece koja su pohađala javne vrtiće u Sarajevu te roditeljima i odgajateljima ponuditi osnovne informacije o održavanju i poboljšanju oralnoga zdravlja njihove djece. Metode: Istraživanjem su bila obuhvaćena 1722 djeteta predškolske dobi od 3 do 6 godina koja su pohađala vrtiće u sklopu javnih vrtićkih ustanova u Sarajevu zajedno sa svojim roditeljima i odgajateljima. Članovi stomatološkog tima postupno su posjećivali sve vrtiće u četirima gradskim općinama i pregledali djecu prema Priručniku za pregled oralnoga zdravlja Svjetske zdravstvene organizacije. Tijekom tih posjeta također su roditeljima i odgajateljima podijeljeni materijali za promicanje oralnoga zdravlja. Rezultati: KRD je pronađen kod djece u sarajevskim predškolskim ustanovama – prevalencija je bila visoka, čak 67,71%, kep-vrijednost iznosila je 3,97, a težina je imala SiC indeks od 8,79. Kod pregledane djece uočen je i znatan nedostatak dentalne zdravstvene zaštite, a uglavnom je bio povezan s neodlaskom roditelja s djecom u stomatološke ordinacije (CI = 10,55 %, RI = 10,80 %, TI = 12,98 %). Zaključak: Skrb roditelja za očuvanje i poboljšanje oralnoga zdravlja njihove djece potrebno je sustavno i temeljito unaprjeđivati. Službenici i osoblje vrtića trebali bi u svojim ustanovama prepoznati važnost antikariogenih dijetetskih jelovnika i održavanja oralne higijene

Attitude, knowledge and practice of pediatricians in the prevention of early childhood caries

Background/Aim: The aim of the research was to examine the general attitude, knoweledge and practice of pediatricians about caries in children of preschool age. Material and Methods: The research was conducted from November 2019 to the end of January 2020. The research consisted of a survey of pediatricians. The questionnaire consisted of 4 modules and 37 questions, which related to the attitude, knowledge and practice of pediatricians on the prevention of early childhood caries. Results: The majority of pediatricians (84.9%) stated that they assess the nutrition of their patients, while 32.1% of them always do oral health assessment, and half of them in the second month of the child's life; and 39.6% assess oral health only if there is a problem. The majority of pediatricians (86.8%) recommended the first dental examination, most often in the first year of the child's life (79.5%), and then every 6 months (43.5%). The majority of respondents did not required information about the dental health of their patients' mothers, fluoride toothpastes and topical application of fluoride as well (62.3-75.5%). The majority of pediatricians (79.2%) have never provided or sometimes provided educational material on caries prevention and control to the parents of their patients. The most accurate answers and the highest percentage of correct answers that the pediatricians had were about attitudes (Z=8.98, 66.63%), while the fewest correct answers and the lowest percentage of correct answers regarding the practices on the prevention of early childhood caries (Z=11.91, 58.90%). Conclusions: The research showed that pediatricians have the good attitudes and knowledge, but do not implement prevention of early childhood caries in practice. The basic deficiency of attitude, knowledge and perception of the importance of prevention is a consequence of insufficient education of pediatricians

Lesion sterilization and tissue repair (LSTR) method in irreversible dental pulp changes of primary teeth

Background/Aim: Deep carious lesions on primary teeth usually have been causing infectious dental pulp changes. If indicated, traditional endodontic root canal treatment for these kinds of pulpal infections in primary teeth usually should involve the performing of pulpectomy methods, but often with questionable prognosis. The lesion sterilization and tissue repair (LSTR) approach is one of the good endodontic therapeutic alternatives for affected primary teeth with a poor prognosis, which could otherwise be condemned to premature extraction. Aim was to evaluate the medium-term clinical success in everyday practice of the LSTR method applied in affected primary teeth with irreversible pulpal tissue infections by observation of reduction/absence of their clinical symptoms. Material and methods: The study sample included child patients who had one or more of their affected primary molars with irreversible pulpal tissue changes of poor prognosis treated with the LSTR method. For each patient whose primary molar tooth was endodontically treated with the LSTR method a clinical evaluation of treated tooth was performed at intervals of 1 and 12 months afterwards. Results: Study sample was consisted of 40 child patients aged 4 to 9 years, with 45 primary molars included in total. It was obvious that the symptoms related to affected sample teeth have already been decreased almost immediately after initial action of triple antibiotic paste. Final outcome after 12-months follow-up period was success of applied LSTR method in 43 (95.6%) affected sample teeth in a way that initial clinical symptoms completely decreased and disappeared. Conclusions: LSTR method has been shown as successful pulpotomy technique for noninstrumental endodontic approach in non-vital pulp treatment of primary molar teeth in a 12-months follow-up period

Prediktori dentalnoga straha i anksioznosti kod djece u dobi od 9 do 12 godina u Bosni i Hercegovini

Objectives: Oral health in children is additionally burdened with the presence of dental fear and anxiety (DFA). These clinical psychologic entities in their progressive stages inevitably lead to avoidance of dental appointments, which makes prevention and therapy of oral diseases more difficult. Upon the onset of DFA in general, as one of the emotional outcomes of stress in a dental office, most children patients could define the specific stressors that were most intense for them, which could predict the presence of DFA. Aim: To examine the predictors of DFA presence in 9-12 year-old children, and investigate how they could explain the DFA occurrence in study participants. Material and Methods: The sample consisted of 200 children aged from 9 to 12 years. The DFA presence was determined by the modified version of the CFSS-DS scale. The child’s behavior in the dental office during the treatment was evaluated by the trained observer using Venham anxiety and behavior rating scales. Socioeconomic status, characteristics of dental office visits, and previous caries experience were also analyzed. Results: The main DFA predictors were related to invasive dental treatments, where the behavior during dental treatment was the most accurate expression of the DFA appearance. Conclusions: Invasive dental procedures are the main stressful factor for DFA occurrence. Predisposing factors could strengthen the DFA occurrence.Uvod: Oralno zdravlje djece dodatno opterećuju dentalni strah i anksioznost (DSA). Ti klinički psihološki entiteti u svojim progresivnim stadijima nužno završavaju izbjegavanjem stomatoloških pregleda, što otežava prevenciju i terapiju oralnih bolesti. U nastanku toga stanja općenito, kao jednoga od emocionalnih ishoda stresa u stomatološkoj ordinaciji, većina dječjih pacijenata mogla je definirati specifične stresore koji su za njih bili najintenzivniji, a na temelju njih mogla se predvidjeti prisutnost DSA-e.Cilj: Željelo se ispitati prediktore DSA-e kod djece u dobi od 9 do 12 godina kako bi se mogla objasniti ta pojava kod ispitanika u studiji. Materijal i metode: Uzorak se sastojao od 200 djece u dobi od 9 do 12 godina. Prisutnost DSA-e određena je prilagođenom verzijom ljestvice CFSS-DS. Ponašanje djeteta u stomatološkoj ordinaciji tijekom tretmana ocjenjivao je educirani promatrač s pomoću Venhamove ljestvice za ocjenu anksioznosti i ponašanja. Također su analizirani i socijalno-ekonomski status, obilježja posjeta stomatološkim ordinacijama te prethodno iskustvo s karijesom. Rezultati: Glavni prediktori DSA-e bili su povezani s invazivnim stomatološkim tretmanima pa je ponašanje tijekom stomatološkog tretmana bilo najprecizniji pokazatelj pojave DSA-e. Zaključci: Invazivni stomatološki zahvati glavni su stresni čimbenik za pojavu DSA-e. Predisponirajući čimbenici mogu pojačati tu pojav

COVID-19 Impact on Public Dental Healthcare in Bosnia and Herzegovina: Current Situation and Ongoing Perspectives

Background: As the pandemic time went by in Bosnia and Herzegovina (B&H), various patterns toward COVID-19 itself and its impacts, implementation of prescribed preventive measures among the team members, and those of their patients, including immunization process, have been revealed. These patterns were of both empirical and evidence-based kind and consequently formed dental personnel behavior. The aim was to evaluate and compare the COVID-19 status of dentists in B&H, implementation of prescribed preventive measures, and usage of various kinds of PPE, at the beginning of the pandemics and now, 2.5 years later, including dentists’ current vaccination status, and their opinions and attitudes toward the national COVID-19 economic impact on dental practice. Methodology: Study research was in a form of a cross-sectional longitudinally designed online survey and was conducted in two parts. Results and conclusions: Dental professionals in B&H had a high frequency of COVID-19 symptoms in the second pandemic year. The vaccination status of dentists in B&H was in line with the global average values of vaccinated professionals. Dentists used patient management preventive measures and PPE recommended by WHO, but some preventive measures have been changed and prioritized recently. The economic impact of pandemics on dentistry was predominantly negative

Reliability and validity of Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS) in children in Bosnia and Herzegovina

The most frequently used measuring instrument for determination of dental fear and anxiety (DFA) in children nowadays is the Dental Sub-scale of the Children’s Fear Survey Schedule (CFSS-DS). In this study we wanted to explore the reliability and validity of CFSS-DS scale in Bosnian children patients’ sample. There were 120 patients in the study, divided in three age groups (8, 12, and 15 years of age), with 40 patients in each group. Original CFSS-DS scale was translated into Bosnian language, and children’s version of a scale was used. The high value of the Cronbach’s coefficient of internal consistency (α=0.861) was found in the entire scale. Four factors were extracted by screen-test method with Eigen values higher than 1, which explained 63.79% variance of results. CFSS-DS scale is reliable and valid psychometric instrument for DFA evaluation in children in Bosnia and Herzegovina. The differences between our research and those of others may appear due to many factors