Socio-demographic and area-related factors associated with the prevalence of caries among preschool children in Greece.

OBJECTIVE: To assess dental caries experience in 4-6 year old children of the Athens Metropolitan Area attending public kindergartens and investigate the association of area deprivation and immigration status on dmft. BASIC RESEARCH DESIGN: A cross-sectional study of a large area-stratified sample of 683 kindergarten children was conducted during the academic years 2009-2011. Dental caries experience and oral hygiene level were assessed using dmft and the Simplified Debris index (DI-s). Area deprivation was defined using a pre-established Geo-demographic System for Attica. Zero-inflated Poisson regression models were used to test associations between the dmft index and related factors; gender, age, immigrant background and area deprivation. Differences were reported in terms of predicted probabilities. RESULTS: Caries prevalence was 20.8% (95% CI17.8,24.0%). The mean dmft and DI-s scores were 0.67 (95% CI0.61,0.74) and 0.16 (95% CI0.14,0.18) respectively. The mean predicted probability of having no detectable caries experience was 79% (95% CI75, 83%), while the probability of having dmft=1 or 2 was 6% (95% CI5,8%) and 2% (95% CI1,3%) respectively. The predicted probability of having no caries experience was substantially lower for males, those from the least affluent areas and non-Greeks by 5%, 18% and 31% respectively. Regarding dmft scores, deprived children were more likely to have 1 or 2 teeth with caries experience by 9% (95% CI4,13%) and 6% (95% CI2,10%) respectively, while the corresponding differences for non-Greeks were 10% (95% CI7,14%) and 12% (95% CI7,15%). CONCLUSIONS: Socio-demographic and area-related variations in oral health exist among kindergarten children in Athens.

The healthcare system and provision of oral healthcare in European Union member states. Part 4: Greece.

This paper presents a description of the healthcare system and how oral healthcare is organised and provided in Greece, a country in a deep economic and social crisis. The national health system is underfunded, with severe gaps in staffing levels and the country has a large private healthcare sector. Oral healthcare has been largely provided in the private sector. Most people are struggling to survive and have no money to spend on general and oral healthcare. Unemployment is rising and access to healthcare services is more difficult than ever. Additionally, there has been an overproduction of dentists and no development of team dentistry. This has led to under or unemployment of dentists in Greece and their migration to other European Union member states, such as the United Kingdom, where over 600 Greek dentists are currently working.

The extent of food advertising to children on Greek television: focus on foods potentially detrimental to oral health.

OBJECTIVES: To investigate the extent and nature of food advertising to children on Greek television, focusing on the adverts for foods with potential harmful effects on oral health, and to examine the persuasive marketing techniques used to promote food products. METHODS: Advertisements broadcast on six TV-channels during children's peak viewing times on two weekdays and two weekend days in the period May-June 2010 were recorded (166.7 hours). Each advertisement was coded according to: date, day, length, type of program in which the ad appeared, type of product advertised and promotional technique used. Food advertisements were subdivided according to their sugar and/or acid content as potentially harmful or non-harmful to teeth. RESULTS: Food advertisements had an average frequency of 8.0 per hour during children's peak viewing times with highest frequency (11.4 per hour) on weekends during child-focused programs. Of all advertisements, 1330 (26.7%) were for foods, and 595 (44.7%) of these deemed to be potentially harmful to teeth. The most commonly advertised food product during children's programs was confectionery, 80 (27.7%). Of food advertisements, 199 (15.0%) used at least one of the promotional techniques likely to appeal to children. Advertisements for foods potentially harmful for teeth were more likely to be shown during child-focused programs (OR 2.92, 95% CI 2.04-4.16) and to promise a free gift with purchase (OR 35.43, 95% CI 10.83-115.88). CONCLUSION: Children in Greece are exposed to a large volume of advertisements for unhealthy foods and drinks, which intensively use persuasive techniques proved to affect children's food preferences and consumption. Our study provides evidence that could support advocacy and interventions for the regulation of food advertising.

Health-related lifestyle behaviours, socio-demographic characteristics and use of dental health services in Greek adults.

OBJECTIVE: To investigate the association between certain socio-demographic characteristics, health-related lifestyle behaviors and the use of dental services in Greek adult population. BASIC RESEARCH DESIGN: A total of 1,005 adults from all the geographical areas of Greece were randomly selected and interviewed. Gender, age, place of residence, marital and socioeconomic status, educational level, obesity, smoking, physical inactivity, adherence to Mediterranean diet were recorded and associated with the use of dental services. RESULTS: Almost one half of the participants (47%) visited a dentist during the past 12 months. Only 31.7% of the visits were for a regular dental check up. Subjects belonging to high socioeconomic status were 1.86 times more likely to visit a dentist in the past 12 months, while those aged more than 56 years and with low educational level were less likely to visit a dentist in the past 12 months with odds ratios equal to 0.63 and 0.73, respectively. Physically inactive (OR = 0.59; 95% CI: 0.38-0.93) and obese subjects (OR = 0.48; 95% CI: 0.24-0.97) were less likely to visit the dentist for a regular dental check up. Additionally, high socioeconomic status and healthier diet were associated with greater likelihood for visiting the dentist for a regular dental check up. CONCLUSIONS: Socio-demographic factors including age, education and social status are strong determinants of dental health services utilization in Greece. In addition, health-related lifestyle behaviors and conditions such as healthy diet, physical activity and obesity might be good predictors of regular check up or symptomatic dental visits.

Effect of fluoride and of calcium sodium phosphosilicate toothpastes on pre-softened dentin demineralization and remineralization in vitro.

OBJECTIVES: The purpose of this in vitro study was to evaluate the effect of toothpastes containing sodium fluoride in different concentrations or a calcium sodium phosphosilicate system on pre-softened dentin demineralization and remineralization. METHODS: During a ten day pH-cycling protocol, pre-softened bovine root dentin slabs were immersed twice daily, after the demineralization periods, for 2min, in the following toothpaste slurries: (a) non-fluoridated (control), (b) 7.5% calcium sodium phosphosilicate, (c) 1450 ppm F, (d) 2800 ppm F and (e) 5000 ppm F. Subsequently, the specimens were subjected to a 15-h acid resistance test. Surface microhardness was assessed initially and during the pH-cycling and the acid resistance test period. Repeated measurements in each group were analyzed through appropriate regression models for longitudinal data. RESULTS: All fluoride groups, during pH cycling, showed significantly less microhardness loss (p < or = 0.010, p < or = 0.002, p < or = 0.002) and subsequently exhibited increased acid resistance (p < or = 0.010, p < or = 0.001, p < or = 0.001) compared to the control. The 5000 ppm and 2800 ppm F toothpastes, inhibited demineralization significantly more effectively than the 1450 ppm F (p < or = 0.001, p < or = 0.030) and the calcium sodium phosphosilicate toothpaste (p < or = 0.001), while no significant differences were found between the two high fluoride groups (p=0.130). The calcium sodium phosphosilicate toothpaste, during pH cycling showed a difference that approached statistical significance compared to control (p=0.079), but its acid resistance behavior was similar to control (p=0.610). CONCLUSIONS: Under these experimental conditions, the high fluoride toothpastes promoted remineralization and inhibited demineralization more effectively, than the 1450 ppm F, the non-fluoridated (control) and the calcium sodium phosphosilicate toothpastes.

Private dental health expenditure in Greece by region and income: comparison between the years 1987 and 1998.

OBJECTIVE: The purpose of this study was to describe the evolution of private dental health expenditure in Greece, between the years 1987 and 1998, and to investigate whether there is evidence of variation by region and income. BASIC RESEARCH DESIGN: The primary data were derived from the Household Budget Survey of the National Statistical Service of Greece from which private dental expenditure was estimated using the Consumer Price Index (CPI). RESULTS: 1. In both years the greatest annual dental health expenditure per capita was observed in urban areas and in 1998 it had increased by 9.4% while in semi-urban and rural areas it decreased (by 33.33% and 11.25% respectively). 2. The annual expenditure per capita was distributed according to the monthly income of the population, but in 1998 the differences were more pronounced and higher income groups showed an increase of 67.2%. 3. Statistical analysis showed no significant differences in the distribution of expenditure between geographic areas over the decade (p>0.05). CONCLUSIONS: Private dental health expenditure in Greece is differentiated by income level and geographic region and these variations became more pronounced over the decade. Similar percentages in the distribution of dental expenditure between the geographic areas suggest that during the decade no changes have been made towards increasing the amount of dental care for members of populations in semi-urban and rural areas.

Dental caries changes between 1982 and 1991 in children aged 6-12 in Athens, Greece.

The aim of this study was to compare dental caries and oral hygiene status in children aged 6-12 years in the Athens area between 1982 and 1991. Dental examinations were carried out by the same examiners in 773 children attending the same randomly selected schools sited in areas of different socioeconomic levels. The findings concerning the deciduous dention showed that the percentage of caries-free children increased in 1991 compared to 1982 by 38%. The mean deft scores were reduced by an amount ranging from 21 to 34%. Changes in caries prevalence were also observed in the permanent dention. The percentage of caries-free children for the total examined population increased by 94% while the reduction in DMFT index ranged between 38 and 70%. Treatment need was significantly lower in 1991 compared to 1982 in both dentitions. Debris index scores were similar while oral hygiene habits had slightly improved by 1991. The decline in caries levels may be attributed to the increased use of various forms of fluoride. Furthermore, dental health awareness of the population has improved.

[Dental concerns and oral health in population of Greece--future perspectives]. / Die zahnmedizinische Versorgung und die orale Gesundheit der Bevölkerung in Griechenland--Zukunftsperspektiven.

With a profusion of statistical data the authors describe the dental service in Greece, pointing out in particular the difference between the facilities available in the cities and in the country. This is followed by details of the dental insurance system, epidemiological data on the oral health of the population, and examples of prophylactic dentistry. The article concludes with some thoughts on the outlook for the future.

Oral health status of adult population in Athens, Greece.

An epidemiological study of dental caries, periodontal disease, and oral hygiene status in 736 employed adults aged 19-64 yr, was conducted in Athens, Greece. Dental caries was found to be prevalent, affecting almost the entire population examined. The mean DMFT values varied from 8.99 +/- 5.98 to 17.05 +/- 6.58 in different age groups. No difference was found in the mean DMFT values between sexes. Periodontal disease affected the 92.7% of the examined sample. The PI scores increased with age from 1.08 +/- 0.84 in the age group 19-24 yr to 3.7 +/- 1.84 in the age group 55-64 yr. Women showed lower PI index values than men but this difference was not statistically significant. The mean values of oral hygiene index varied from 1.60 +/- 1.05 to 1.97 +/- 1.42 in different age groups. Women presented better oral hygiene status than men and this difference was statistically significant for the younger age groups. Data concerning the toothbrushing frequency of the examined population are also presented. The results of this baseline study indicate that effective dental care is needed for the improvement of oral health status of the adult population.

[Quality assessment of fillings by place and type of provider]. / Axiologese tes poiotetas emphraxeon kata topo kai phorea therapeias.

The purpose of this study was to determine the quality of 1310 fillings among third-year dental students of Athens University. The mean age of fillings was 5.6 years. The classification of fillings into three categories of quality showed that 41.4% were satisfactory, 47.2% were acceptable but needed to be refinished, and finally 11.4% had to be replaced. The main reasons for failure were poor performance of anatomic form, secondary caries, poor marginal adaptation and soft tissues damage. The comparison of quality of fillings by place and type of provider showed that University Dental Clinic's fillings were of significantly better quality than those rendered in private or public dental clinics either in Athens or elsewhere. On the contrary the comparison of quality of fillings by place and type of provider (University Clinic excluded) did not show any significant differences.

[Evaluation of dental behaviour in adults with an advanced level of education in Athens]. / Diereunese tes odontiatrikes symperiphoras enelikon atomon ypselou ekpaideutikou epipedou sten Athena.

The purpose of this study was to evaluate the dental health behaviour in adults of advanced education. Ninety adults, aged 31-60, men and women were randomly selected from a population of advanced education. All the subjects had a thorough oral examination in order to record their dental health indices. Before the examination each participant was interviewed personally for determining, among others, their knowledge about oral health in general and more specifically about prevention of oral diseases. Their responses were correlated with the dental health indices that were determined by the dental examination. The results of the study indicate that this segment of the population demonstrates better oral health status than other population groups of the same age in Greece; the values of the restorative treatment indices were especially very high. From their responses it was found that although their theoretical knowledge on general dental health was satisfactory their information on prevention of oral disease was very limited. It is therefore concluded that although the level of education of adult population correlates well with the level of dental care received, an effective control of oral disease could be realised only if prevention procedures and dental health education is initiated early in life.

[Expenditures for dental care in Greece. Comparison with other countries]. / Oi dapanes gia odontiatrike perethalpse sten Ellada. Eugkritika stoicheia me alles chores.

The health expenditures in developed countries show a remarkable increase over the last two decades representing 7-10% of their G.N.P. In Greece, the public health expenditures amounted to an average of 3.5% of the G.N.P. for the period 1977-1983. The private sector represents a very significant component, amounting to 2.4% of the G.N.P. Dental health expenditures in Greece are considered significantly low. They account 2% of the total health expenditures. For comparison, in other developed countries this percentage is quite higher of the order of 5 to 10%. It follows that there is a great need to increase the dental health expenditures in Greece so that the needs for dental treatment of the population can be met more easily achieved by increasing the emphasis of the dental care in preventive measures starting especially with the younger segment of the population.