Is There any Commitment for Oral and Dental Health Promotion in Iran?

Despite oral health reform introduced by the Ministry of Health and Medical Education, not much oral health improvement has been reported so far. The dmft index in 6 year old children has been steadily increasing since 1998 when the first national oral health survey was conducted in Iran. The dmft index for primary dentition was 4.8 in 1377 (1998); 5 in 1383 (2004); 5.16 in 1391 (2012) and 5.84 in 1395 (2016) national survey. Without timely attention to primary dentition, permanent teeth will be affected during the mixed dentition period and if not attended early enough, tooth loss would be the inevitable consequence. Local national data shows that over 52 percent of our elderly population are completely edentulous. Aside from these local effects in the oral cavity, there are ample evidence on the association of oral and systemic conditions. Meaning that, oral diseases may cause or intensify systemic diseases such as stroke, cardiovascular, respiratory, urinary, and digestive system; as well as low birth weight and premature birth in pregnant ladies. The good news is that all these problems are preventable because oral diseases are preventable.   Based on 2012 national data, only 12% of 5-6 year old children were caries-free meaning that dental caries is a silent epidemy in Iran. According to this data 27.4% of the 12 year old children were caries-free. However, after laps of 3 years when these children are 15, only 0.4% of them are caries-free! New caries development in this 27% of children, clearly shows our collective failure in oral health promotion strategies. But why and for how long more we should witness such a tragedy despite having all the necessary means to tackle this problem. When comparing our country to many other developing countries, we are very happy to have an oral health system in Iran, but unfortunately this system doesn’t work properly, because it does not have a proper leadership and structure. There are dental and oral health units in different departments, working independently like isolated islands without any coordination with each other. For the same reason there is no coordination between prevention, treatment, education, research and dental equipment departments. That’s why we do not implement a nationwide policy for oral health promotion and we do not have a leadership to plan, coordinate and improve the oral health of the nation according to appropriate evidence-based strategies. Although, we are living under resistive economy, many decision makers do not pay any attention to low cost preventive dentistry for improving the nation’s oral health, rather follow the costly and wrong remedy suggestions. Increasing the number of dental schools, increasing the number of dental students without considering the current shortcomings of dental schools are just a few to mention. There is no report of oral health improvement by increasing the number of dentist or dental schools. While, spending the cost of one dental school on prevention, promotion and maintenance of community oral health could help a lot. Based on local investigations, developing an oral health structure at the national level is the first priority (1-3) in order to unify all dental and oral health related units located in different departments, in order to follow a single national oral health policy and strategy. Another important priority is manpower development plan with special attention to national prevention activities. If called on local Dental Public Health experts, they can provide a well-defined comprehensive national oral health plan.   Although, under current situation we are going to miss the 2025 (1404) health system national objectives, but we can plan for definitely having caries-free generation in a 12-year period if proper oral structure is approved by the Ministry of Health and Medical Education in Iran. Although, a single country is the focus of discussion in this commentary, sharing of the information may be useful for other developing nations as well.  &nbsp

The Israel-Palestine Question – A Case for Application of Neutrosophic Game Theory

In our present paper, we have explored the possibilities and developed arguments for an application of principles of neutrosophic game theory as a generalization of the fuzzy game theory model to a better understanding of the Israel-Palestine problem in terms of the goals and governing strategies of either side. We build on an earlier attempted justification of a game theoretic explanation of this problem by Yakir Plessner (2001) and go on to argue in favour of a neutrosophic adaptation of the standard 2x2 zero-sum game theoretic model in order to identify an optimal outcomeIsrael-Palestine conflict, Oslo Agreement, fuzzy games, neutrosophic semantic space

Computational Modeling in Applied Problems: collected papers on econometrics, operations research, game theory and simulation

Computational models pervade all branches of the exact sciences and have in recent times also started to prove to be of immense utility in some of the traditionally \u27soft\u27 sciences like ecology, sociology and politics. This volume is a collection of a few cuttingedge research papers on the application of variety of computational models and tools in the analysis, interpretation and solution of vexing real-world problems and issues in economics, management, ecology and global politics by some prolific researchers in the field

Perceived oral health among adults in Tehran, Iran; a telephone survey

Objective: In comparison to clinical oral health indices, perceived oral health measures are less applied in large-scale epidemiological oral health studies in Iran. The aim of this study was to measure perceived oral health among adults in Tehran, Iran.Methods: In this cross-sectional study, perceived oral health was measured in 1100 adults in Tehran by two measures: 1- non-replaced extracted teeth, and 2- revised Rand dental health questions including pain, chewing problems and communication problems. Data was gathered by telephone interview using gender, age and level of education as socio-demographic information.Results: The mean number of non-replaced extracted teeth was 1.28 with 53.8% of adults reporting no extracted teeth. Extracted teeth was significantly less in younger (p<0.001) and more educated people (p<0.001). Rand dental health scores increased by age (p<0.001) but had no significant changes in different educational levels. The three items of Rand dental health were highly correlated (p<0.01) with Chronbach’s Alpha=0.73 but were not correlated with extracted teeth.Conclusion: Approximately half of Tehran adults have the experience of lacking one or more teeth, with a small group of them suffering from pain, chewing problems and communication problems

School-Based Oral Health Promotion: A Thorough Review

Objectives Schools are considered as important platforms for oral health promotion worldwide. Oral diseases are preventable and any focus on schoolchildren can minimize suffering, reduce inequity, and create productive years of healthy adulthood later on. Hence, we need to explore oral health promotion methods conducted within the school systems in different countries. This is especially required for developing countries with limited resources.Methods The PubMed database was searched for English peer-reviewed articles published from January 2000 to June 2017 with available abstracts, specifically focusing on primary school children aged between 7 and 12 years. “Oral health”, “health promotion” and “school” were used as keywords in our search strategy. Relevant papers  were selected and reviewed by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers.Results From a total of 257 articles, 22 were eligible for analysis. Of all oral health related activities implemented in schools, oral health education was mentioned in most studies (n=15) followed by supervised tooth brushing program in schools with fluoride toothpaste (n=5), administration of fluoride (varnish/gel) (n=3), provision of nutritious food (n=3), multimedia game or campaign (n=3), and tooth examination with screening (n=3).Conclusion Improvement of children’s oral health related to school-based oral health programs is the result of a combination of several interventions. The governments and other policy makers should consider implementing some appropriate health promotion schemes in schools, which take local needs and resources into accoun

Knowledge of Shahid Beheshti Dental School Faculty Members about Open Access Electronic Journals

Objectives It is important to evaluate the gap of information regarding the online scientific resources available to college and university instructors.  The aim of this study was to assess the knowledge of Shahid Beheshti Dental School faculty members about open access electronic journals. Methods A questionnaire was used to collect information on 68 available faculty members of the Shahid Beheshti Dental School in this descriptive, cross-sectional study. Among others, the questionnaire asked for demographic information, academic level and current status of using electronic journals. The validity and reliability of the questionnaire were assessed using Cronbach’s alpha and content validity statistics. The collected data were analyzed using SPSS software. The descriptive statistics such as percentage, mean and standard deviation and non-parametric tests such as binomial, Friedman, Kruskal Wallis and Mann Whitney tests were used. Results The mean and standard deviation of score on acquaintance with open access electronic journals, the mean score of using these journals and the mean score of attitude of faculty members towards these journals were 3.45 (±0.7), 2.76 (±0.88) and 3.13 (±0.4), respectively. Conclusion The attitude and acquaintance level of the faculty members with open access journals were moderate; while their usage was less than moderate. Therefore, faculty members must be encouraged to use open access journals more frequently in order to keep up with scientific advances in their field

Self-Reported Dental Public Health Competencies of Senior Dental Students: A Cross-Sectional Study

Objective: To reach the World Health Organization's goal of improving community oral health, Iranian oral health policy-makers expanded the scope of oral health by including dental public health (DPH) courses in the latest dental curriculum to improve students' competencies. The aim of the current study was to evaluate DPH competencies in senior dental students at Shahid Beheshti University of Medical Sciences, according to specified educational objectives. Methods: In the present cross-sectional study, 195 senior dental students (enrolled in 2014-2015) filled up an online standardized questionnaire. The instrument included demographic information as well as 31 statements about ten domains of DPH. Participants used self-assessment method to report the level of their competencies on a Likert scale of 0-10; Zero indicating "not competent at all", and 10 indicating "fully competent" for each statement. Then the mean score was calculated for each domain. Data analysis was conducted using Independent samples, T-test, One-way ANOVA, Mann-Whitney U-test, and Kruskal-Wallis via SPSS version 21. ResultsThe sum of scores for each participant was within the range of 63 to 310, and the mean (SD) was 216.68 (±43.69). Students were most competent in "Providing preventive dental care" (8.22±1.59), "Adherence to professional ethics" (7.56±1.68), and" Understanding determinants of oral health" (7.50±1.52). They were least competent in "Understanding components and functions of healthcare system" (5.96±2.06), "Planning" (6.06±2.45), and "Oral health research" (6.24±2.44). The mean score for females' (223.30±38.21) was significantly higher than males' score (207.15±49.25), (P=0.011). Conclusion: Although higher competencies were achieved in "Providing preventive dental care", "Adherence to professional ethics", and" Understanding determinants of oral health"; there are more areas to be accomplished, such as "Understanding components and functions of healthcare system", "Planning", and "Oral health research". These findings could be helpful either in revising the content materials, teaching methods, or both

Pregnancy, child bearing and prevention of giving birth to the affected children in patients with primary immunodeficiency disease;a case-series

Background: Patients with primary immunodeficiency disease (PID) who survive to adulthood and willing to have a child mostly are worried whether their disease affects their fertility and/or pregnancy and also if their child would be predisposed to PID. Case presentation: We report the outcome of conception, pregnancy and their management in 9 families with definite diagnosis of PID. A chronic granulomatous disease subject with an uneventful pregnancy developed fungal sacral osteomyelitis few weeks after delivery. A pregnant common variable immunodeficiency disease (CVID) patient with idiopathic thrombocytopenia had platelet count dropped before delivery. A sever neutropenic mother who refused to get IFN gamma. delivered two healthy children. A CVID case intolerant to Mg with eclampsia and PTE delivered a baby. Another CVID female gave birth to a baby without being on any treatment since she was not diagnosed with immunodeficiency disease at that time. A healthy girl was implanted via preimplantation gender selection in a family who owned a Wiskott Aldrich-affected son. A family who had two children with Ataxia Telangiectasia used donated oocyte for their 3rd child. Prenatal genetic diagnosis was used to screen the fetus for the impaired BTK and CVID genes detected in sibling and father respectively in 2 separate families. Conclusion: Pregnancy in PID patients is more complex than normal population. Because, not only it has the chance of being inherited by the offspring, but also there are some risks for the mother if she has any kind of immunity component defects. So consultation with a clinical geneticist is crucial to choose the best available approach. They also should be observed and followed by a clinical immunologist to take the best possible safe care