Evaluation of knowledge and practice behaviors of a group of Iranian obstetricians, general practitioners, and midwives, regarding periodontal disease and its effect on the pregnancy outcome

Background. Periodontal disease is considered as a risk factor for poor pregnancy outcomes, including preterm birth and low birth weight. Only few studies have assessed the knowledge and practice behaviours of healthcare providers, concerning oral health during pregnancy, periodontal diseases and their role in adverse pregnancy outcomes. The present study aimed to compare the knowledge and practice behaviours of a group of Iranian obstetricians, general practitioners, and midwives about periodontal disease.Design and methods. A cross-sectional study was conducted using a self-administered, structured questionnaire that was previously used in North Carolina. The questionnaire was translated into Persian language and was randomly distributed among 200 obstetricians, general practitioners, and midwives participating in an international congress. Data were analysed by Chi-square and spearman correlation tests using SPSS statistical software (version PASW 18).Results. A total of 150 completed the questionnaires, achieving a response rate of 75%. Totally, the knowledge of the obstetricians was more accurate compared to the two other groups and the midwives were the worst. More experienced general practitioners (P=0.002) and obstetricians (P=0.049) did less dental examinations for their patients during their first visit or periodically. More experienced obstetricians also referred their patients for dental examinations during pregnancy less than their less experienced colleagues (P<0.001).Conclusions. Although the participants had some knowledge about periodontal disease and its association with adverse pregnancy outcomes, there is much space for improvements. The participants’ attitude and knowledge were consistent

Comparison of pH and Flow Rate of Saliva After Using Black Tea, Green Tea and Coffee in Periodontal Patients and Normal Group

Objectives: Periodontal pathogens need acidic environments to proliferate in periodontium, and their growth is affected by the salivary flow rate and pH of the mouth. Alterations in flow and acidity of saliva have an important effect on oral diseases such as periodontitis. This study was designed to compare salivary pH and flow rate before and after using green tea, black tea and coffee in patients with periodontitis and healthy subjects.Methods: The present case control study was conducted on 60 subjects that were allocated into two groups: 30 subjects without periodontitis and 30 subjects with chronic periodontitis. Gingival index (GI), plaque index (PI), probing depth (PD) and clinical attachment loss (CAL) were recorded. Next, 5mL of saliva from both groups was collected for analysis before and after green tea, black tea and coffee rinsing and salivary pH and flow rate were recorded.Results: The result showed significant increase in salivary flow rate and pH after rinsing of green tea in periodontitis group but there was no significant change in pH and flow rate after rinsing of black tea and coffee in both groups.Conclusion: The results suggest that green tea causes a significant increase in salivary flow rate and pH and seems to be a safe and applicable adjunct treatment for periodontitis

Homeopathy in Dentistry and Oral Medicine: A review

Objectives: Homeopathy is the most important field of alternative medicine. At present, over 3000 organic medications have been registered in the homeopathy pharmacopeia; out of which, 70% have herbal, 20% have mineral and the remaining have animal origins. Evidence shows that homeopathy may be beneficial in dentistry and oral medicine. However, this is a less known field for dentists. Therefore, this study aimed to do a review on the most common homeopathy medicines used for oral and dental problfems and to present it in a simple and practical way for general dental practitioners.Review of Literature: Google Scholar and PubMed data bases were searched for any article related to both homeopathy and dentistry. Several recent meta-analyses, randomized control trials, animal and laboratory trials, and other interventional papers were studied.Homeopathy drugs are basically produced from natural origin; they have less side effects in comparison with chemical drugs. In this method, only small doses of medications with low cost are used. The positive effects of homeopathy drugs on several oral conditions have been emphasized.Conclusion: Homeopathy may be a suitable adjunct to conventional medicine for management of many conditions since it is affordable, effective and uplifting for patients

A comparison of photographic, replication and direct clinical examination methods for detecting developmental defects of enamel

Different methods have been used for detecting developmental defects of enamel (DDE). This study aimed to compare photographic and replication methods with the direct clinical examination method for detecting DDE in children's permanent incisors

Validation of a Farsi version of the Early Childhood Oral Health Impact Scale (F-ECOHIS)

<p>Abstract</p> <p>Background</p> <p>The Early Childhood Oral Health Impact Scale (ECOHIS) has recently been developed to assess oral health-related quality of life (OHRQoL) of pre-school children in English speaking communities. This study aimed to translate the ECOHIS into Farsi and test its psychometric properties for use on 2- to 5-year-old children of Farsi speaking Iranian families.</p> <p>Methods</p> <p>EHOHIS questionnaire was translated into Farsi using a standardized forward-backward linguistic translation method. Its face and content validity was tested in two small pilot studies. In the main study, a convenience sample of 260 parents of 2- to 5-year-old children in Isfahan and Tehran were invited to complete the final Farsi version of the ECOHIS (F-ECOHIS) and answer two global self-rating questions about their children's dental appearance and oral health. Association between F-ECOHIS scores and answers to the two self-rating questions, and the correlation between child (9 items) and family (4 items) sections of the F-ECOHIS were used to assess the concurrent and convergent validity of the questionnaire. Internal consistency reliability of the F-ECOHIS was tested using Cronbach's alpha coefficient test and item total and inter-item correlations. One third of participants were invited to complete the F-ECOHIS again after 2 weeks to evaluate the test-retest reliability of the questionnaire.</p> <p>Results</p> <p>Two hundred and forty six parents were included in the main study. The association between the F-ECOHIS scores and the two self-rating questions and the correlation between its child and family sections were significant (P < 0.001). Cronbach's alpha coefficient of the F-ECOHIS and its child and family sections were 0.93, 0.89, and 0.85 respectively. Coefficients did not increase by deleting any item. The corrected item total correlation coefficient ranged from 0.52 to 0.74. The inter-item correlation coefficient ranged between 0.30 and 0.73. Seventy three parents participated in the follow up study for re-testing the questionnaire. Comparison of their test and re-test scores had a weighted kappa of 0.81 and inter-class correlation (ICC) of 0.82.</p> <p>Conclusion</p> <p>The F-ECOHIS questionnaire was valid and reliable for assessing the OHRQoL of 2- to 5-year-old pre-school children of Farsi speaking parents.</p

The oral health park: a new experience in delivering preventive services in Iran

BACKGROUND AND AIM: Effective and acceptable preventive dental services are hard to achieve in conjunction with treatment services. The Oral Health Office of Fars Province in Iran established the Oral Health Park in a deprived part of the city of Shiraz to attract families and school children to receive preventive services. No other treatment was provided in the setting. The aim of this study was to compare the number and the cost-efficiency of preventive dental services provided in such settings with those of other dental care settings in which preventive services are provided in conjunction with treatment services. METHODS: The Oral Health Park and its activities were closely monitored for three years. Data on the number of provided services and their costs were compared with available data on other state settings. RESULTS: From 2008 to 2011, more than 6000 children from about 3200 families used the Oral Health Park’s free services. The number of preventive services provided in the Park was tens of times more than similar clinical settings in which both preventive and treatment services were provided. At the same time, the cost of each process provided in the Park was, in average, a quarter of a similar process in other clinics. CONCLUSIONS: The oral health policy in developing countries such as Iran should move towards establishment of settings in which only preventive dental services are provided for a more effective and cost efficient approach. KEY WORDS: Oral Health, Oral Health Services, Preventive Services, Shiraz, Ira

An evaluation of willingness to pay for orthodontic treatments in patients of Shiraz Dental School Clinic

BACKGROUND AND AIM: Estimation of need and demand for orthodontic treatment is important for both health professionals and health policymakers. Need assessment is traditionally done using experts’ opinions; however, patientcentered evaluation can provide a bigger picture of patient’s esthetic and psychological needs. The willingness to pay (WTP) technique is a potentially valid tool for assessing the patient views on their needs and for market research in healthcare. The aim of this study was to evaluate the need and demand for orthodontic treatment with a patient-centered approach using economic analysis. METHODS: A cross-sectional study was designed. Two hundred people attending Shiraz Dental School Clinic were interviewed. Their views on the importance and costs of orthodontic treatments and the maximum amount that they would pay for such treatments were obtained along with their demographic and socioeconomic factors. Their WTP was used to elicit values for orthodontic treatment using contingent valuation method (CVM) and econometric techniques. RESULTS: The response rate was 95%. Although 53.5% of respondents felt they needed orthodontic treatment, only 33.7% had expressed their need, and just 17.5% had actually gone for such treatment. The main reason for not taking the treatment was its cost (56.5%). More than 60% of respondents viewed orthodontics as only a luxury treatment and 70% considered beauty and elegant smile as the most, or one of the most, benefit(s) of orthodontic treatments. WTP results showed that orthodontic services have high demand elasticity. Assuming fixed monthly income of 8 million Rials, 61% of subjects were ready to pay 20 million Rials for a course of orthodontic treatment. CONCLUSIONS: The result showed that esthetics and high cost of treatment were respectively the most intriguing and the main inhibiting factors for getting orthodontic treatment. Economic evaluation showed a high elastic estimation for orthodontic treatment. KEYWORDS: Willingness to Pay, Orthodontics, Shira

An evaluation of willingness to pay for orthodontic treatments in patients of Shiraz Dental School Clinic

BACKGROUND AND AIM: Estimation of need and demand for orthodontic treatment is important for both health professionals and health policymakers. Need assessment is traditionally done using experts’ opinions; however, patient-centered evaluation can provide a bigger picture of patient’s esthetic and psychological needs. The willingness to pay (WTP) technique is a potentially valid tool for assessing the patient views on their needs and for market research in healthcare. The aim of this study was to evaluate the need and demand for orthodontic treatment with a patient-centered approach using economic analysis. METHODS: A cross-sectional study was designed. Two hundred people attending Shiraz Dental School Clinic were interviewed. Their views on the importance and costs of orthodontic treatments and the maximum amount that they would pay for such treatments were obtained along with their demographic and socioeconomic factors. Their WTP was used to elicit values for orthodontic treatment using contingent valuation method (CVM) and econometric techniques. RESULTS: The response rate was 95%. Although 53.5% of respondents felt they needed orthodontic treatment, only 33.7% had expressed their need, and just 17.5% had actually gone for such treatment. The main reason for not taking the treatment was its cost (56.5%). More than 60% of respondents viewed orthodontics as only a luxury treatment and 70% considered beauty and elegant smile as the most, or one of the most, benefit(s) of orthodontic treatments. WTP results showed that orthodontic services have high demand elasticity. Assuming fixed monthly income of 8 million Rials, 61% of subjects were ready to pay 20 million Rials for a course of orthodontic treatment. CONCLUSION: The result showed that esthetics and high cost of treatment were respectively the most intriguing and the main inhibiting factors for getting orthodontic treatment. Economic evaluation showed a high elastic estimation for orthodontic treatment

The oral health park: a new experience in delivering preventive services in Iran

BACKGROUND AND AIM: Effective and acceptable preventive dental services are hard to achieve in conjunction with treatment services. The Oral Health Office of Fars Province in Iran established the Oral Health Park in a deprived part of the city of Shiraz to attract families and school children to receive preventive services. No other treatment was provided in the setting. The aim of this study was to compare the number and the cost-efficiency of preventive dental services provided in such settings with those of other dental care settings in which preventive services are provided in conjunction with treatment services. METHODS: The Oral Health Park and its activities were closely monitored for three years. Data on the number of provided services and their costs were compared with available data on other state settings. RESULTS: From 2008 to 2011, more than 6000 children from about 3200 families used the Oral Health Park’s free services. The number of preventive services provided in the Park was tens of times more than similar clinical settings in which both preventive and treatment services were provided. At the same time, the cost of each process provided in the Park was, in average, a quarter of a similar process in other clinics. CONCLUSIONS: The oral health policy in developing countries such as Iran should move towards establishment of settings in which only preventive dental services are provided for a more effective and cost efficient approach

Distinguishing between enamel fluorosis and other enamel defects in permanent teeth of children

Background. The inconsistent prevalence of fluorosis for a given level of fluoride in drinking water suggests developmental defects of enamel (DDEs) other than fluorosis were being misdiagnosed as fluorosis. The imprecise definition and subjective perception of fluorosis indices could result in misdiagnosis of dental fluorosis. This study was conducted to distinguish genuine fluorosis from fluorosis-resembling defects that could have adverse health-related events as a cause using Early Childhood Events Life-grid method (ECEL). Methods. A study was conducted on 400 9-year-old children from areas with high, optimal and low levels of fluoride in the drinking water of Fars province, Iran. Fluorosis cases were diagnosed on the standardized one view photographs of the anterior teeth using Dean’s and TF (Thylstrup and Fejerskov) Indices by calibrated dentists. Agreements between examiners were tested. Early childhood health-related data collected retrospectively by ECEL method were matched with the position of enamel defects. Results. Using both Dean and TF indices three out of four dentists diagnosed that 31.3% (115) children had fluorosis, 58.0%, 29.1%, and 10.0% in high (2.12–2.85 ppm), optimal (0.62–1.22 ppm), and low (0.24–0.29 ppm) fluoride areas respectively (p < 0.001). After matching health-related events in the 115 (31.3%) of children diagnosed with fluorosis, 31 (8.4%) of children had fluorosis which could be matched with their adverse health-related events. This suggests that what was diagnosed as fluorosis were non-fluoride related DDEs that resemble fluorosis. Discussion. The frequently used measures of fluorosis appear to overscore fluorosis. Use of ECEL method to consider health related events relevant to DDEs could help to differentiate between genuine fluorosis and fluorosis-resembling defects