Comparing fracture resistance on bovine incisors restored by tooth fragment reattachment versus direct composite restoration techniques.

BACKGROUND/AIM: Anterior teeth are prone to traumatic dental injuries (TDIs). Although a number of techniques ranging from original tooth fragment reattachment (TFR) to direct composite restoration (DCR) can be used to restore uncomplicated crown fractures, there is no consensus on which method is best. The purpose of this study was to investigate the fracture resistance of bovine incisors restored by two different techniques (TFR and DCR) in three different fracture models. MATERIALS AND METHODS: Sixty extracted bovine lower incisors were randomly divided into three groups (n = 20). Angle, oblique, or transverse sections of all the teeth in a group were prepared by using a disk. The cut surfaces were scanned, and the cross-sectional areas (CSA) of the enamel and dentin were measured. Half the teeth in each group were restored by DCR (n = 10) and the other half by TFR (n = 10). The forces required to fracture the restored teeth were then measured using a Universal testing machine, and the fracture modes were analyzed (cohesive, adhesive, or mixed). RESULTS: No statistically significant differences between the TFR and DCR restorations were detected for total and enamel CSAs in any of the restoration shapes (p > .067). The fracture forces required to break DCR angle and transverse restorations were significantly greater than for the corresponding shapes restored with TFR (p < .033). However, the difference in the forces needed to fracture oblique section restorations by DCR or TFR was not statistically significant (p = .239), despite a similar trend (143.4 ± 51 N and 120.9 ± 25 N, respectively). CONCLUSION: This study revealed that a greater force is required to fracture teeth restored by the DCR than by the TFR technique, especially for a transverse section. This demonstrates that restoring a fractured tooth provides a superior outcome compared to reattaching the fractured fragment.

Knowledge and Decision-Making among Israeli Dentists Treating Young Patients with Type 1 Diabetes Mellitus: A Cross-Sectional Survey.

OBJECTIVE: To assess decision making process and knowledge level of dentists treating children with type 1 diabetes. STUDY DESIGN: Cross-sectional survey among dentistry residents and dental specialists working in clinics that provide dental care to children with type 1 diabetes. RESULTS: A total of 166 respondents were included. 42% of respondents perceived that they have sufficient knowledge to treat children with diabetes, in correlation with an average score of 1.9 out of 4 on knowledge questions. Over 80% of dentists decided to treat patients by consulting with the treating physician or by checking HbA1c and glucose blood levels independently. Greater knowledge was associated with a significantly higher tendency of the dentists to determine if the child's diabetes is controlled, and to refer less often to the hospital. Furthermore, greater knowledge was also associated with dentists' greater perception that they have enough knowledge, skills and confidence to treat children with diabetes. CONCLUSIONS: The study revealed significant gaps in the knowledge on diabetes among dentists who provide dental care to children. Dentists, pediatricians, endocrinologists, and other healthcare professionals who provide care for children should be encouraged to collaborate to create a mutual knowledgeable work environment for delivering best care to their patients.

Characteristics and attitudes of general and pediatric dentists who use loupes.

BACKGROUND: Dental loupes are used by dental professionals to improve visual performance, reduce eye strain and prevent musculoskeletal disorders. Data on their usage in pediatric dentistry are scarce. STUDY DESIGN: We performed a cross-sectional survey to evaluate the approach, knowledge, and frequency of using loupes among 100 general and pediatric dentists. RESULTS: showed that the use of loupes is significantly more prevalent among general dentists (64.3%) compared to pediatric specialists and residents (35.7%). Among dentists who reported that they do not use loupes, 63.6% were pediatric dentists and residents, and 82.5% were dentists working with children. A significantly higher percentage of dentists who self-reported as loupes users perceived that the loupes afford comfortable and stable posture, confidence while working, and contribute to the detection of tooth decay. A significantly higher percentage of dentists who self-reported as non-users of loupes (compared to loupes users), claimed that they weaken the eyes, require long adjustment, and cause discomfort. CONCLUSION: Although the use of loupes in general dentistry is becoming more prevalent, there is still a need to raise awareness for this vision aid among pediatric dentists while promoting its advantages, to reap benefits associated with their usage.

Transfer Deep Learning for Dental and Maxillofacial Imaging Modality Classification: A Preliminary Study.

OBJECTIVE: To apply the technique of transfer deep learning on a small data set for automatic classification of X-ray modalities in dentistry. STUDY DESIGN: For solving the problem of classification, the convolution neural networks based on VGG16, NASNetLarge and Xception architectures were used, which received pre-training on ImageNet subset. In this research, we used an in-house dataset created within the School of Dental Medicine, Tel Aviv University. The training dataset contained anonymized 496 digital Panoramic and Cephalometric X-ray images for orthodontic examinations from CS 8100 Digital Panoramic System (Carestream Dental LLC, Atlanta, USA). The models were trained using NVIDIA GeForce GTX 1080 Ti GPU. The study was approved by the ethical committee of Tel Aviv University. RESULTS: The test dataset contained 124 X-ray images from 2 different devices: CS 8100 Digital Panoramic System and Planmeca ProMax 2D (Planmeca, Helsinki, Finland). X-ray images in the test database were not pre-processed. The accuracy of all neural network architectures was 100%. Following a result of almost absolute accuracy, the other statistical metrics were not relevant. CONCLUSIONS: In this study, good results have been obtained for the automatic classification of different modalities of X-ray images used in dentistry. The most promising direction for the development of this kind of application is the transfer deep learning. Further studies on automatic classification of modalities, as well as sub-modalities, can maximally reduce occasional difficulties arising in this field in the daily practice of the dentist and, eventually, improve the quality of diagnosis and treatment.

Quantifying Coronal Permanent Tooth Discoloration Caused by Different Pulpotomy Materials.

INTRODUCTION: Bioceramic materials, gray and white mineral trioxide aggregate (GMTA, WMTA), have been shown to have high rates of success in various endodontic applications. A major drawback is their tendency to discolor teeth compared to Biodentine (BD), that has been claimed not to discolor teeth. The aim of this study was to compare tooth discoloration after applying different pulpotomy base materials (BD, GMTA and WMTA). STUDY DESIGN: Forty human incisors teeth were used in this study. Coronal access was achieved by a Tungsten Carbide drill, and the pulp chambers were accessed and chemo-mechanically debrided. Each material was placed in the pulp chamber, up to the cervical sectioning level. All specimens were incubated at 37°C and 100% humidity for three months and have been evaluated before the study and weekly. Color was assessed according to the CIE L*a*b* color space system. RESULTS: ΔE of all experimental groups (GMTA, WMTA and BD) were significantly different from the control group at all time points (P<0.05). Color changes in the GMTA and WMTA groups, had no statistically significant differences, but showed higher discoloration compared to BD group in the cervical part of the crown, since week 1 (P<0.05). WMTA group showed significant discoloration in the cervical part as of week 1 (P<0.05), and gradually increased over time (Figure 2). BD group showed no significantly discoloration over time. GMTA group showed the significant discoloration at week 1 and week 14 (P<0.05). CONCLUSIONS: both GMTA and WMTA pulpotomy materials may discolor tooth structure over time in an extracted permanent anterior tooth model. When choosing bioceramic pulpotomy material, BD may be preferable in esthetic area.

Bilateral Symmetry of Number and Size of Dental Caries Lesions among Children.

AIM: To determine the bilateral occurrence of caries lesions in 5-12-year-old children, and to assess whether one bitewing photograph can predict caries size and occurrence in the homologous tooth on the other side of the mouth. STUDY DESIGN: The study was carried out on 222 medical files of children 5-12 years old who were first examined in the university dental clinic. The presence and size of the caries lesions in the first and second primary molars and first permanent molars were recorded. RESULTS: No correlation was found when comparing the caries lesion distribution of each tooth's proximal surface. Seventy-one of the X-rays demonstrated a single caries lesion in a first or second primary molar or in a first permanent molar on one side of the mouth, of which 21.3% demonstrated a single caries lesion in the collateral side, 43.6% demonstrated 2 or more lesions, and 35.21% did not have any caries lesion on the collateral side of the mouth. CONCLUSION: One bitewing cannot determine the presence and size of a caries lesion on the same site of the homologous tooth.

Visual Examination, Fluorescence-Aided Caries Excavation (FACE) Technology, Bitewing X-Ray Radiography in the Detection of Occlusal Caries in First Permanent Molars in Children.

OBJECTIVES: To compare the effectiveness of visual examination, radiographic examination and fluorescence-aided caries excavation (FACE) in detecting occlusal caries in first permanent molars in 150 children aged 6-14 years with intact occlusal surface with caries lesions without cavitation, or with darkened or deep fissures that had no clear diagnosis. STUDY DESIGN: Two dentists independently performed a visual oral examination, FACE and bitewing radiography. The inter-rater reliability of each detection method was determined and their specificity and sensitivity. RESULTS: All caries detection methods showed high inter-rater reliability with absolute agreement between raters above 90%. Most caries lesions were detected by visual (75.8%) and FACE (79.1%), while only 28.8% of lesions were detected by radiography. Detection by visual examination was strongly correlated with detection by FACE (X2=37.9, Phi=0.498, p<0.001). A lower, yet statistically significant, correlation was found between visual examination and X-ray radiography (X2=5.53, Phi=0.190, p<0.001). FACE had higher sensitivity (87%) and specificity (65%) for detecting occlusal caries in comparison with radiography (60% specificity and 55% sensitivity). CONCLUSION: Although visual examination remains the best method to detect occlusal caries in young permanent molars in children, FACE is an effective and accurate diagnostic tool that may aid in detection and treatment decisions.

Function of the Family Unit, Oral Hygiene Rules and Attitudes to Dental Health in Children During First-Wave 2020 COVID-19 Lockdown.

OBJECTIVE: To examine whether general and dental health and habits of families were affected by the first-wave lockdown due to COVID-19, and whether these habits were related to family functioning, resilience and stress. STUDY DESIGN: A cross-sectional study using an online survey disseminated among families with kindergarten and primary school-aged children during the lockdown of March and April 2020. RESULTS: A total of 361 respondents completed the survey. Most respondents adapted well to the changes imposed by lockdown and reported that they and their children had low anxiety levels and high mental resilience. Family functioning and behavior were positively correlated with nutrition habits and hygiene. General hygiene was positively correlated with oral hygiene. Respondents who reported requiring dental care had difficulties gaining access to it. Most respondents perceived that it is important to improve patients' digital access to pediatricians and dentists during crises. CONCLUSION: The study showed that better family functioning was associated with better family hygiene and nutrition, parental resilience and lower mental stress among children.

Neural Network Detection and Segmentation of Mental Foramen in Panoramic Imaging.

Objective: To apply the technique of deep learning on a small dataset of panoramic images for the detection and segmentation of the mental foramen (MF). Study design: In this study we used in-house dataset created within the School of Dental Medicine, Tel Aviv University. The dataset contained randomly chosen and anonymized 112 digital panoramic X-ray images and corresponding segmentations of MF. In order to solve the task of segmentation of the MF we used a single fully convolution neural network, that was based on U-net as well as a cascade architecture. 70% of the data were randomly chosen for training, 15% for validation and accuracy was tested on 15%. The model was trained using NVIDIA GeForce GTX 1080 GPU. The SPSS software, version 17.0 (Chicago, IL, USA) was used for the statistical analysis. The study was approved by the ethical committee of Tel Aviv University. Results: The best results of the dice similarity coefficient ( DSC), precision, recall, MF-wise true positive rate (MFTPR) and MF-wise false positive rate (MFFPR) in single networks were 49.51%, 71.13%, 68.24%, 87.81% and 14.08%, respectively. The cascade of networks has shown better results than simple networks in recall and MFTPR, which were 88.83%, 93.75%, respectively, while DSC and precision achieved the lowest values, 31.77% and 23.92%, respectively. Conclusions: Currently, the U-net, one of the most used neural network architectures for biomedical application, was effectively used in this study. Methods based on deep learning are extremely important for automatic detection and segmentation in radiology and require further development.

Dental Anxiety, Fear and Anxiety of Performing Dental Treatments among Dental Students during Clinical Studies.

PURPOSE: Dental student's dental anxiety may negatively affect patient's attitude towards dental treatment. We evaluated dental anxiety among dental students in different clinical stage of their studies. We assessed the student's anxiety prior to treating patients. STUDY DESIGN: A cross-sectional study. Fourth to sixth-year dental students completed questionnaires containing: 1) Dental Anxiety Scale (DAS); 2) Dental Fear Survey (DFS); and 3) visual analogue scale questions relating to the student's anxiety when performing dental treatments in children and adults. RESULTS: 124 dental students completed the questionnaires (mean age, 26.4±3.1 years, 59.7% women). Average DAS in the study population was 7.55±2.15 with similar scores observed across the years. Average DFS score was highest among fourth-year students (1.62±0.65) and lowest among sixth year students (1.36±0.32). DFS scores decreased as the students progressed through the clinical years (p=0.059). The students' average anxiety scores prior to treating children were significantly higher than the anxiety scores prior to treating adults (3.82±2.42 vs. 2.67±1.9, p<0.001). Fifth-year students had significantly higher anxiety scores prior to treating children and adults compared to fourth and sixth-year students. CONCLUSION: Dental anxiety among dental students is relatively low and decreases gradually as they progress through the clinical years. Anxiety prior to treating patients, particularly children, is at its highest just before starting to treat patients for the first time. As dental students are future healthcare providers, it is important that they learn techniques to help them manage their own dental anxiety and fear as well as deal with anxiety related to treating patients.

Effectiveness and Safety of Nitrous Oxide as a Sedative Agent at 60% and 70% Compared to 50% Concentration in Pediatric Dentistry Setting.

Objective: Sedation using 50% nitrous oxide (N2O) concentration is common in pediatric dentistry. The aim to assess sedation and cooperation levels following sedation with 60% and 70% N2O concentrations in children whose dental treatment failed using 50% N2O concentration. Study design: Children (n=51) aged 5-10 years were included. Sedation started with N2O concentration of 50%; when appropriate cooperation and sedation were not achieved, N2O concentration was increased to 60%, and subsequently to 70% during the same session. Sedation and cooperation levels were the primary outcomes. Adverse events were defined as secondary outcomes. Results: At 50% N2O concentration, five children reached adequate sedation and cooperation and completed their dental treatment, where 32 children completed the treatment at 60% N2O concentration. Fourteen children required a concentration of 70% to complete treatment. For ten of the latter, treatment was successfully completed, while for four, treatment failed, despite the achievement of adequate sedation. Adverse events were observed in 9%, 22%, of the children who received 60%, 70% N2O concentrations, respectively. Conclusions: When sedation with 50% N2O concentration does not achieve satisfactory cooperation to complete pediatric dental treatment, 60% N2O concentration appears to be more effective than 50% and safer than 70%.

Canine Transposition - Prevalence, Distribution and Treatment Considerations among Orthodontic Patients.

Tooth transposition is a relatively rare dental anomaly of interchange in position of two adjacent teeth. AIM: To determine the prevalence and distribution of canine transposition in a sample of orthodontic patients and present treatment alternatives and outcome. STUDY DESIGN: The records of 3000 consecutively treated orthodontic patients from a university clinic were surveyed to detect canine transposition in both dental arches. The data was recorded according to gender, age, number and location. RESULTS: Canine transpositions were detected in 15 subjects, 3 (20%) males and 12 (80%) females presenting a prevalence of 0.5%. Of them, 6 were between the maxillary canine and first premolar, 7 between the maxillary canine and lateral incisor, 2 transpositions were between the mandibular canine and the lateral incisor. A female to male ratio of 4:1 with left side predominance was found. Treatment options include extracting the transposed teeth, maintaining them in their transposed position, or repositioning them in their normal place within the dental arch. CONCLUSION: The prevalence of canine transposition in the present sample was found to be 0.5% with a greater frequency in the maxilla. Treatment options include extraction of one of the transposed teeth, alignment of the teeth in their transposed position or correction of the anomaly. The latter gives the best esthetic outcome.

Success of Dental Treatments under Behavior Management, Sedation and General Anesthesia.

Objective: To present comparative data with the aim of assisting the practitioner to choose between behavior modification (BM) techniques, pharmacologic sedation (N2O-O2 alone or combined with midazolam 0.5 mg/kg) or routine general anesthesia (GA) for the most successful approach in enabling pediatric dental care. Study design: Dental records of 56 children treated in a university dental clinic between 2006-2016 were reviewed, and data on age, gender, required treatment (amalgam restorations, composite restorations, pulpotomy, and stainless steel crowns [SSC]), treatment approaches and therapeutic success at final follow-up were retrieved. Results: Treatment under GA had the best success rates compared to both BM and pharmacologic sedation. N2O-O2 alone had a 6.1-fold greater risk of failure compared to N2O-O2+midazolam (p- <0.008). Amalgam restorations had a 2.61-fold greater risk of failure than SSC (p- <0.008). Conclusions: The GA mode yielded significantly greater success than the N2O-O2 mode alone. There were no significant differences in success rates between GA and combined midazolam 0.5 mg/kg+N2O-O2. When choosing restoration material, it is important to remember the high success rate of SSC compared to amalgam restoration.

Dental Anxiety among Israeli Postgraduate Pediatric Dental Students and their Instructors.

Objective: To measure the dental anxiety levels of post-graduate pediatric dental students (PGS) and their instructors, and their ranking of the most anxiety provoking situations in the dental situation; to investigate gender differences with regard to dental anxiety. Study design: Twenty-four PGS and 31 of their instructors completed a three-section questionnaire on sociodemographic information, dental anxiety scale (DAS) and dental fear survey (DFS). Results: The overall mean DAS and DFS scores were similar for both groups. The scores of the PGS were significantly higher on the DFS for perspiration when dental work was done (p = 0.032), the smell of the dentist's office (p = 0.009), and seeing the dentist enter the treatment room (p = 0.005). The total DAS score was significantly higher among females than among males (8.03 ± 3.08 and 6.63 ± 1.77, p = 0.037), and for item on waiting for the dentist to scrape the teeth, (p = 0.05). The DAS and DFS scores were strongly correlated (r = 0.768, p = 0.000). The highest DAS score was for the item on anticipation of dental treatment before arrival to the clinic and waiting for the drilling. The response pattern for both groups was similar. Conclusions: Overall dental anxiety of PGS and their instructors was similar. Female PGS and instructors had higher dental anxiety levels than males.

Preemptive Analgesia by Paracetamol, Ibuprofen or Placebo in Pediatric Dental Care: A Randomized Controlled Study.

OBJECTIVE: To compare postoperative pain among children who received an oral dose of paracetamol, ibuprofen or a placebo, prior to tooth extractions. STUDY DESIGN: Thirty minutes prior to dental treatment, children received a liquid dosage, fruit flavored and orange colored, of paracetamol, ibuprofen, or a placebo. Data accessed included children's dental history, their behavior, and their feeling of pain or anxiety according to Wong-Baker FACES: before treatment, following local anesthesia, and following treatment. Parents were interviewed by telephone regarding their children's need for a postoperative analgesia (paracetamol or ibuprofen), and their feeling of pain at four and 24 hours posttreatment. RESULTS: Parents reported administering paracetamol or nurofen following the dental procedure to 9/43 (21%), 2/33 (6%) and 12/29 (41%) of the children in the preemptive paracetamol, ibuprofen, and placebo groups, respectively. For the 3 groups, mean pain assessment were similar: around the middle of the Wong-Baker FACES scale at baseline, slightly higher following local anesthesia, and low (pain-free) at four and 24 hours postoperative. CONCLUSION: Children who received paracetamol or ibuprofen prior to tooth extractions were less likely to need an analgesic following treatment, compared to children who received a placebo.

Maternal Knowledge of Oral Health of Children Aged 1-4 Years.

INTRODUCTION: Knowledge of oral health (KOH) among mothers has an important influence on their children's oral habits and routines. Lack of maternal KOH had been related to the development of early childhood caries among preschool children. AIM: To assess KOH among mothers of 1-4 year-olds. STUDY DESIGN: Participating mothers completed a 3-part questionnaire on general demographic information, KOH of their children, and ranking of six food items according to their cariogenic potential. RESULTS: Most of the 285 participating mothers had an academic education. Only 47% of the mothers correctly answered seven questions on KOH. The dentist was the main source for KOH. Most of the mothers (94.39%) were aware of the need to brush their children's teeth twice daily. Most of them (72.29%) did not know the correct fluoride concentration in their child's toothpaste. They ranked salty snacks as the least cariogenic food item. Most of the mothers were not aware that snacks and sweetened drinks should be consumed during meals, and two-thirds reported tasting food from their child's spoon. CONCLUSION: Overall, mothers of toddlers lacked basic knowledge of oral health issues and practices to follow for the prevention of their children's caries.

Prevalence and Characteristics of Supernumerary Teeth in Israeli Orthodontic Patients.

BACKGROUND: Supernumerary teeth are one of the most common anomalies in the human dentition, found most frequently in the maxillary anterior region causing impaction or displacement of the adjacent permanent teeth. AIM: The purpose of this retrospective study was to determine the prevalence and characteristics of supernumerary teeth in orthodontically treated patients. STUDY DESIGN: Pre-treatment facial and intraoral photographs, study models, panoramic and periapical radiographs of 3,000 consecutively treated orthodontic patients (mean age 12.2 years) from the Department of Orthodontics Tel Aviv University, were examined to detect supernumerary teeth in both arches. They were recorded according to gender, age, number, location, position and morphology. RESULTS: Thirty-six patients, 22 (61%) males and 14 (39%) females with 50 supernumerary teeth, of which 42 (84%) were found in the maxillary anterior region, and 8 (16%) in the mandible, presenting a prevalence of 1.2%. CONCLUSIONS: A prevalence of 1.2% was found in our study. The most common supernumerary tooth is mesiodens located at the maxillary anterior region. The characteristics of supernumeraries were based on their morphology, location and position. The most frequent complications caused were rotations, displacement and arrested eruption of maxillary incisors.

Effect of intravenous paracetamol as pre-emptive compared to preventive analgesia in a pediatric dental setting: a prospective randomized study.

BACKGROUND: Efficacy of pre-emptive analgesia compared to preventive regimen, managing postoperative pain is still controversial. AIM: Evaluating the efficacy of intravenous (IV) paracetamol as pre-emptive analgesia compared to preventive post-treatment administration in pediatric dental setting. DESIGN: In a prospective trial, 60 noncooperative children of ASA I, II aged 3-10 years who underwent dental rehabilitation under general anesthesia were randomly divided into two groups. Pre-emptive group (n = 30) received 15 mg/kg of IV paracetamol before the start of treatment. Preventive group (n = 30) received 15 mg/kg of paracetamol at the end of treatment. Analgesic efficacy was measured by visual analog scale of faces (VASOF), percentage of children received postoperative analgesia. RESULTS: The VASOF results in the pre-emptive group were significantly lower compared to the preventive group at 4, 8, 12, and 24 h (0.0146, 0.0188, 0.0085, and 0.0001, respectively). Less children in the pre-emptive group received supplemental fentanyl postoperatively compared to the preventive group (27.6%, 58.6%, respectively, P = 0.0170). Time to first rescue dose of fentanyl postoperatively in the pre-emptive group was later than in the preventive group (P = 0.0432). CONCLUSIONS: Administration of IV paracetamol pre-emptively provides lower pain scores, and a decreased percentage of children required pain relief and less amount of postoperative opioids, compared to preventive administration.

The Prevalence of ADHD Patients among Pediatric Dentists in Israel and Knowledge of Dental and Behavioral Aspects of Treating Them.

OBJECTIVE: There are no clear guidelines for managing the dental treatment of children with attention deficit hyperactivity disorder (ADHD). The use of sedation in combination with chronic ADHD medication use is also not well defined. This study surveyed the prevalence of ADHD children, management techniques and knowledge of pharmacologic therapies of these children among Israeli dentists. STUDY DESIGN: A specially designed questionnaire was distributed to all Israeli dentists attending a national conference in 2016. RESULTS: Of the 160 dentists who attended the conference, 96 completed the survey (60% response rate), and they included 46 (51%) pediatric dental specialists and 50 (49%) general dental practitioners. The medications Ritalin and Concerta were most familiar to the respondents (98.9%). Eighty-seven (91.1%) of the practitioners responded that their ADHD patients take their usual doses of any drug for treating ADHD symptoms, regardless of whether or not the dentists intended to use sedatives. The practitioners invented their own behavior management techniques with varying degrees of success. CONCLUSIONS: There are no specific guidelines for the most effective pharmacologic protocol (co-administration of ADHD drugs and dental sedatives) or behavior management techniques for the provision of optimal dental care to children with ADHD.

Parents' Attitude towards the Use of Fluorides and Fissure Sealants and its Effect on their Children's Oral Health.

OBJECTIVES: To characterize the attitudes of Israeli parents towards caries preventive measures. STUDY DESIGN: participating parents completed a 21-item questionnaire on their demographics, dental history, attitudes and satisfaction from fluorides and fissure sealants. RESULTS: One hundred parents (average age 41.62±4.9 years, 85 females) participated. Most of the parents (88% of the mothers and 84% of the fathers) had an academic education. Most of the parents (54%) had a favorable attitude towards the use of fluoridated gels, while only 37% of them had a positive opinion regarding fluoridated water. The satisfaction levels were very high regarding fissure sealants, fluoridated mouth rinses and fluoridated gels (78.1%, 73.6% and 72.5% respectively). The satisfaction from fluoridated water was split almost equally (50.8% were 'pleased' and 49.2% 'not pleased'). The main source for parental oral health knowledge was the dentist (83%). Parents' attitude towards caries preventive measures was significantly correlated to their gender, dental experience, level of education and the number of children in the family. CONCLUSIONS: positive attitude towards caries preventive measures was found among parents with higher awareness for preventive oral health measures and among bigger families. Mothers were more positive about fissure sealants than fathers. Mothers with up to 12 years of education tended to have a positive opinion regarding water fluoridation.