Proceedings of a workshop, held in Constanta, Romania on 22 May 2014, on Oral Health of Children in the Central and Eastern European Countries in the context of the current economic crisis

This report presents the proceedings of a workshop held in Constanta, Romania on 22 May 2014. During the workshop, representatives from 18 Central and Eastern European countries gave oral presentations on the current oral health of children and young adults aged 16 years and younger. The aim of the workshop was to collect and present data relating to the oral health of children from Central and Eastern European countries and to discuss them in the context of the political changes that have taken place over the last two decades and the recent economic crisis. The presenters had previously completed a series of questions on oral epidemiological studies, prevention of oral disease, treatment and payment, dental personnel, uptake of oral health care and other considerations and structured their presentations on these topics plus the influence of the economic crisis on oral health. It should be remembered that this paper is a report of the proceedings of a workshop and not a study. Ethics approval is not required for workshops. After the 18 oral presentations a 90 min discussion took place during which further points were raised. The presentations, the discussion and the conclusions which were reached are reported in this manuscript

Motivation to Follow a Career in Dentistry of Students in Three South-East European Countries

Uvod: Željelo se istražiti i usporediti čimbenike koji su potaknuli studente na studij stomatologije uzemljama sličnog okružja (Albanija, Hrvatska i Republika Sjeverna Makedonija) i procijeniti je li se njihova motivacija tijekom godina promijenila ili ne.Materijal i metode: U 2014./2015. Godini provedenasu poprečno-presječna istraživanja (cross-sectional) na državnim stomatološkim fakultetima u Tirani(Albanija), Zagrebu (Hrvatska) i Skoplju (Makedonija) kako bi se procijenilo stajalište studenata o njihovoj motivaciji za karijeru. Dobrovoljno i anonimno sudjelovali su studenti stomatologije s prve, trećei završne godine. Upitnik s pet stavki preveden je na jezike zemalja sudionica. Etičko odobrenje daloje Etičko povjerenstvo Sveučilišta sveti Ćiril i Metod iz Skoplja. Chi kvadrat testom ispitano je postojeli statistički značajne razlike u odgovorima između studenata u trima državama i između godina studija.Rezultati: Ukupno je bilo uključeno 739 ispitanika (319 u Tirani, 211 u Zagrebu i 208 u Skoplju).Razlike u odgovorima studenata prve godine u svim trima zemljama bile su statistički značajne (χ2 = 82,65; p < 0,01). Najintrigantnije je bilo pitanje o pritisku roditelja da studiraju stomatologiju nakoje je najviše pozitivnih odgovora bilo u Tirani (čak 27,7 %). Pozitivna slika bio je najčešći odgovorzagrebačkih studenata (do 79,7 %), ali se smanjuje od prve do posljednje godine u Skoplju. Takođersu postojale značajne razlike između fakulteta unutar trećih i posljednjih godina studija.Zaključci: Pozitivna slika stomatološke profesije bila je glavni razlog za upis na svim trima fakultetima – tako jeodgovorilo čak 97 % studenata na završnoj godini u Hrvatskoj, članici Europske unije (EU). U dvjemadržavama koje nisu članice EU-a (Albanija, Sjeverna Makedonija) činilo se da stomatološka profesi-ja nema tako dobar status, a očekivanja studenata se ne ispunjavaju, posebno u Skoplju (čak 33,9 %spremno je promijeniti zvanje i njih do 64,5 % izgubilo je motivaciju za studij). Jedna od strategija zapoboljšanje stanja mogla bi biti uključivanje više kliničke prakse i bolja organizacija pojedinih studijaObjective: To investigate and compare the factors that motivated students to study dentistry in countries with similar background (Albania, Croatia and the Republic of Northern Macedonia) and to as-sess whether or not their motivation changed during time. Material and methods: In 2014/2015,cross-sectional studies were conducted in state funded dental schools in Tirana (Albania), Zagreb(Croatia) and Skopje (North Macedonia) to assess student views on their career motivation. All den-tal students from the first, third and final years of study were invited to participate. The participationwas voluntary and anonymous. A five-item questionnaire was translated into languages of the par-ticipating countries. Ethics approval was granted by the Ethics Committee of the University of SaintsCyril and Methodius, Skopje. The Chi square test was used to test if there were statistically significantdifferences in answers between students in 3 countries, furthermore between years of the study.Re-sults: The total number of respondents was 739 (319 in Tirana, 211 in Zagreb and 208 in Skopje) Thedifferences in the answers between the first-year students from all three countries were statistical-ly significant (χ2=82.65; p<.01). The most striking answer was to the question on parents’ pressureto study dentistry, which was far more frequent in Tirana (up to 27.7%). A “positive image” was themost frequent response from students from Zagreb (up to 79.7%), but it declined from the first to thefinal year in Skopje. There were also significant differences the schools within the 3rdand final years of study. Conclusions: A positive image of dental profession was the main reason for students studying dentistry at all three schools; as many as 97% of the students of the final year in Croa-tia, a member of the European Union (EU). In the two non-EU countries (Albania, North Macedonia) itseemed that dental profession does not have such good status and student expectations are not be-ing fulfilled, especially in Skopje (up to 33.9% willing to change their vocation and up to 64.5% losttheir motivation to study) One of the strategies to improve the situation could be to include more clinical practice and to better organize the study

European student wellness, stress, coping, support and perceptions about remote dental training during COVID-19

Objectives: The aim of this study was to compare wellness, stress, ability to cope, social support and perceptions about remote training amongst European dental students during COVID-19. Methods: 1795 undergraduate dental students from six countries and eight dental schools participated. The anonymous survey collected data about different aspects in each of the following domains: wellness, stress, ability to cope, social support and perceptions about remote training. Complex multi-item scales were used for all domains. Results: There were differences amongst countries in all the domains. Overall, student stress scores were lower than either their coping or support scores. The highest wellness score (mean ±sd) was observed in Romania: 62.5% ± 11.2% whilst the highest mean stress scores were observed in Albania: 46.3% ± 11.7% and Lithuania: 42.2% ± 13.8%. Overall, student stress and coping ability scores were lower and their support scores higher. About 10% of students did not have any support. In the linear multivariable regression analysis, significant predictors of wellness were being female (β = 0.073), not being in a graduating year (β = 0.059), having less stress (β = 0.222), ability to cope (β = 0.223) and having support (β = 0.179). The student positive perceptions about remote training were predicted by less stress (β = 0.080), coping (β = 0.182) and support (β = 0.057). Conclusions: Students varied in wellness, stress, coping, social support and perceptions of remote training. Also, there were significant differences amongst students from different countries. Coping was the best predictor of both student wellness and their positive perceptions about remote training

Role of “Video Assisted Lecture” on Changing Albanian Undergraduate Students’ Opinion Regarding Pain-free Dental Injections in Children

Svrha: Željela se procijeniti koliko je predavanje uz videodemonstraciju utjecalo na promjenu mišljenja studenata dentalne medicine o injekcijama kad je riječ o djeci. Metode: U istraživanju su sudjelovali studenti pete godine (n: 62) Stomatološkog fakulteta Medicinskog fakulteta u Tirani, a provedeno je u dvije faze – u prvoj je održano teorijsko predavanje (faza 1) o bezbolnoj tehnici lokalne analgezije za djecu, nakon čega je slijedilo drugo predavanje koje je bilo vizualizirano snimkama stvarnih kliničkih slučajeva (faza 2). Mišljenje studenata evaluirano je na temelju kratke ankete obavljene prije predavanja, nakon teorijskog predavanja i nakon videodemonstracije. Rezultati: Prije istraživanja samo 47,9 % ispitanika vjerovalo da se djeci može dati (slažu se i potpuno se slažu) bezbolna lokalna anestezija, a nakon istraživanja postotak je porastao na 67,7 % (p = 0,0001). Polazna stajališta studenata značajno su se promijenila nakon videodemonstracije (p = 0,0001). No nema statistički značajne razlike između srednjih rezultata teorijskog predavanja (faza 1) i predavanja uz videodemonstraciju (faza 2). Zaključci: Ustanovljeno je da je teorijsko predavanje (faza 1) znatno utjecalo na promjenu mišljenja o bezbolnim dentalnim injekcijama za djecu, no pokazalo se da je i videodemonstracija (faza 2) razmjerno učinkovita u podupiranju promjene mišljenje studenata stomatologije.Aim: To evaluate the effectiveness of video assisted lecture in changing the opinions of dental students toward pain-free dental injections in children. Methods: The fifth-year students (n:62) of University of Medicine of Tirana, Faculty of Dental Medicine participated in the study. The study was conducted in two stages: first a Theoretical lecture (Stage 1), “Pain-free Local Analgesia Techniques in Children” was provided, and was followed by a second lecture supported by video recordings of real clinical cases (Stage 2). Students’ opinions were evaluated by means of a short survey administered before the lectures, after the theoretical lecture, and after the video assisted lecture. Results: Before the study, only 47.9% of students believed in the possibility (agree and definitely agree) of pain-free local anesthesia in children, whereas after the study, the percentage had risen to 67.7% (p=0.0001). Baseline opinions of students changed significantly after the video-assisted lecture (p=0.0001). However, there is no statistical difference between mean scores of theoretical lecture (Stage 1) and video-assisted lecture (Stage 2). Conclusions: Theoretical lecture (Stage 1) was found to be significantly effective in changing the opinions regarding “Pain-free dental injections in children,” however, a video based dental education (Stage 2) was found to be relatively effective in supporting the change in dental students’ opinion

Self-reported psychological problems amongst undergraduate dental students: A pilot study in seven European countries

Aim - To map psychological problems amongst undergraduate dental students with a focus on different time points in clinical work in seven Eastern European and Scandinavian countries. Materials and Methods - A total of 1063 3rd‐ and 5th‐year dental students (response rate 70%) participated in this pilot study and completed a pre‐tested, structured questionnaire, which collected information on sociodemographic characteristics and self‐reported psychological problems. Data were analysed by bivariate and multivariate methods. Results - The majority of participants were female and were younger than male participants. Most participants, though more females than males, agreed that the clinical work of dentistry was psychologically difficult. Almost half of participants felt nervous before working with patients (N = 506, 48%) and experienced a lot of stress whilst working with patients (N = 488, 46%); almost one‐third (N = 287, 27%) felt anxious/worried after working with patients. Being a 3rd‐ and 4th‐year student (vs 5th‐year) reduced the odds for anxiety after working with patients; being a 3rd‐year student (vs 5th‐year) increased the odds for stress whilst working with patients. Studying in countries other than Norway reduced the odds for stress whilst working with patients. Less than good self‐perceived health, presence of psychological health complaints before starting dental education, female gender and lack of physical activity increased the odds for psychological problems. Conclusion - A high number of undergraduate dental students reported psychological problems in connection with clinical work. It is unlikely that “one size fits all”; therefore, further qualitative investigations on stressors in clinical learning environments should be done in order to design tailor‐made supportive strategies

White Spots Prevalence and Tooth Brush Habits during Orthodontic Treatment

White spots (WS) are one of the most undesirable side effects in patients undergoing orthodontic therapy and are usually located around bracket bases and even detected under the molar bands. The aim of the present cross-sectional study was to evaluate the WS lesion during orthodontic therapy and the correlation between WS and oral hygiene habits. Patients requiring orthodontic treatment with a fixed appliance were screened for the inclusion/exclusion criteria, and 74 subjects were finally enrolled. Each patient received three examinations: at T0, the day of the application of the fixed appliance; at T1, three months later; and at T2, six months after treatment start. After calculating descriptive statistics, differences between groups were evaluated with an independent sample t-test. The first type error was set as p ≤ 0.01. The observed prevalence of WS lesions was 59.5% on T1 and 60.8% on T2. The most affected teeth result to be upper molars, lower left first molar, upper right central incisor and upper left lateral incisor, upper right canine, upper left first premolar, and lower right first molar. A higher frequency of daily tooth brushing was accompanied by a lower prevalence of WS. No significant effect of sex was observed

Effectiveness of Two Different Fluoride-Based Agents in the Treatment of Dentin Hypersensitivity: A Prospective Clinical Trial

Hyperesthesia is related to increased sensitivity of dental tissues to mechanical, chemical and thermal stimuli. The aim of this prospective clinical trial was to compare the effectiveness of a calcium-fluoride-forming agent (Tiefenfluorid®, Humanchemie GmbH, Alfeld, Germany) with that of a fluoride varnish (EnamelastTM, Ultradent Inc., Cologne, Germany) in the treatment of dental hyperesthesia in adult patients. In total, 176 individuals (106 females and 70 males, aged 18–59 years old) diagnosed with dental hyperesthesia (DH) were enrolled. The main clinical symptoms were hyperesthesia from coldness and sweetness during chewing; the types of clinical lesions were also determined and recorded. The patients were selected randomly and divided into two groups: (i) the first group of 96 patients was treated with Tiefenfluorid® applied in three appointments at 7-day intervals; (ii) the second group of 80 patients was treated with EnamelastTM, applied seven times at 7-day intervals. All the patients were recalled 7 days, 14 days, 1 month, 3 months, and 6 months from the last application. At the baseline and during every follow-up visit, the DH was measured with a pulp tester. A random intercept/random slope model was used to evaluate the effect of the treatment, at various times with respect to the initial diagnosis. Within the limits of the present study, Tiefenfluorid® was more effective than EnamelastTM against DH in that it provided long-lasting results, with a significant improvement still detected at the latest 6-month follow-up