Gender-Specific Variations in Greater Palatine Foramen Anatomy: Insights from CBCT Scans in the North Cyprus Population.

BACKGROUND The greater palatine foramen (GPF) is anatomically located distal to the third maxillary molar tooth, midway between the midline of the palate and the dental arch. The GPF contains the major palatine artery, vein, and nerve, traversing the palatine sulcus. This study aimed to evaluate the anatomical position of the GPF in 93 women and 67 men at a single center in Cyprus using cone beam computed tomography (CBCT). MATERIAL AND METHODS A retrospective analysis was conducted on 160 CBCT scans. Measurements of the GPF's horizontal and vertical diameters, distances from GPF to the incisive foramen, posterior nasal spine, anterior nasal spine, and midaxillary suture, and positional relationships to molars were recorded. Statistical analyses compared these measurements between males and females. RESULTS The study included 93 females and 67 males with an average age of 46.6 (±11.6) years. Significant sex differences were observed in most GPF measurements, with males showing larger dimensions such as the anterior nasal spine, posterior nasal spine, mid-maxillary suture, and incisive foramen to the GPF. The GPF was predominantly located in the third molar region (96.25% on the right, 96.9% on the left). The left GPF showed a significantly larger horizontal diameter than the right (P<0.05). CONCLUSIONS There was a significant difference in the average distances from the anterior nasal spine, posterior nasal spine, mid-maxillary suture, and incisive foramen to the GPF, as well as in the size of the GPF, between males and females. Recognizing these variations enhances clinical planning and reduces the risk of complications.

Morphological Variations of the Nasopalatine Canal in the North Cyprus Population: A Cone Beam Computed Tomography Study.

BACKGROUND This study aimed to evaluate the morphological characteristics of the anterior maxillary nasopalatine canal and the width of the buccal bone using cone-beam computed tomography (CBCT) in 150 adults in Northern Cyprus. MATERIAL AND METHODS The study included 150 participants, and their anterior maxillary morphometric measurements (eg, length of the nasopalatine canal and anteroposterior diameter of the nasal foramen) were taken using CBCT with the scanning parameters of 90 kvP, 24 s, 4 mA, voxel size 0.3 mm, and field of view 10×6 cm. The shapes of the nasopalatine canal (NPC) were categorized into 4 types: cylindrical, hourglass, funnel-shaped, and banana (54%, 20.6%, 18.6%, and 4%, respectively). RESULTS The findings showed a clear link between the shape of the NPC and the horizontal dimensions of the anterior maxilla's morphometric properties. In general, decreased horizontal bone dimensions were found in the premaxilla at the banana- and funnel-shaped type for the nasopalatine canal. Also, the anteroposterior diameter of a nasal foramen in the hourglass shape was significantly larger in diameter than all other shapes. Additionally, the morphology of the nasopalatine canal is influenced by its shape. The sagittal cross-section has shown significant correlations with the sizes of the incisive foramen, nasal foramen, and the length of the nasopalatine canal. CONCLUSIONS The study found a correlation between the shape of the NPC and the horizontal dimensions of the anterior maxilla's anatomy. The measurements of NPC in a North Cyprus population slightly differ from the established standards found in the existing literature. Conducting more extensive studies with a larger number of CBCT images will offer additional insights.

Gender-Based Variation in Alveolar Bone Thickness of Maxillary Incisor Teeth: A CBCT Retrospective Study.

BACKGROUND This retrospective study from a single center in Cyprus aimed to assess labial (buccal) and palatal bone thickness in 6 anterior maxillary teeth of 120 adults using cone-beam computed tomography (CBCT). MATERIAL AND METHODS The CBCT scans of 120 patients (720 teeth) were examined, with scanning parameters of 90 kvP, 24 s, 4 mA, voxel size 0.3 mm, and field of view of 10×6 cm. All maxillary incisors were categorized into 3 distinct points in terms of buccal (B) and palatal (P) points, with points B1 (buccal) and P1 (palatal) 4 mm below the cementoenamel junction; points B2 and P2 at the midpoint between the labial and palatal alveolar crest plane extending to the root apex; and points B3 and P3 at the root apex. Evaluation was done by measuring the distance from these points to the labial and palatal alveolar bone. RESULTS When the thicknesses were measured between all 6 points and labial and palatal bone, the thickness of point B3 of tooth 13 in men was significantly higher than that in women. At points P1, P2, and P3 for teeth 11 and 13, the palatal bone thickness of men was significantly higher than that of women. At points P2 and P3 of tooth 12, the palatal bone thickness of men was significantly higher than that of women. CONCLUSIONS The study found a correlation between alveolar bone thickness and patient sex in the North Cyprus population. Alveolar bone thickness in the anterior maxillary should be considered in implant treatment and orthodontic techniques.

Dental students' and faculty perception of online exams with e-invigilation in Cyprus.

INTRODUCTION: During the recent pandemic, e-learning and e-assessment methods have been implemented worldwide, providing opportunities for further implementation in the dental curriculum. This study aims to research the dental students' and dental faculty's perceptions of online exams with e-invigilation. MATERIALS AND METHODS: Online questionnaires were developed and delivered, after three semesters of online exams, to all students and faculty. Descriptive statistics were performed, and answers were grouped into Principal Components (PC) using Principal Component Analysis (PCA). Statistical significance was set at p < .05. RESULTS: Two-hundred and sixty dental students (83.7%) and 24 dental faculty members (63.1%) answered the online questionnaires. PCA of students' responses revealed 4 PC, 'University support to students', 'Comparison between online and face-to-face exams', 'Preparation for the online exams' and 'Attitudes towards the technology used for the online exams'. PCA of faculty responses revealed 5 PC: 'Comparison between online and face-to-face exams', 'University support to faculty', 'Faculty attitudes towards the exam procedures', 'Human factors associated with the exam procedures' and 'Exam invigilation'. The overall satisfaction was high for both staff and students (higher for students and female staff). Students with previous experience in online exams scored more positively than first-year students. University support, process-related stress and e-invigilation were highlighted. CONCLUSIONS: The overall satisfaction with the e-exams was high, despite the technical problems, time-consuming processes and related stress. University support (training, IT support and resources) and mock exams emerged as important elements of online exams, as was the e-invigilation, which students perceived as efficient and non-intrusive.

Knowledge, attitudes and behaviours regarding antibiotics use among Cypriot university students: a multi-disciplinary survey.

BACKGROUND: The present study aims to investigate the knowledge and attitudes towards antibiotics among students studying medicine, dentistry, and pharmacy at the Near East University in Northern Cyprus. The influence of personality characteristics on antibiotic use were also evaluated, in order to identify predictors of antibiotic misuse. METHODS: Students were enrolled in the study during the 2020-2021 academic year. Study participants were asked to complete an online questionnaire that measured their knowledge, attitudes and practice (KAP) towards antibiotic use and antibiotic resistance. The KAP of students from the three faculties were compared using Kruskall-Wallis H statistics, Mann-Whitney U statistics, and Spearman's rho. The influence of personality traits on the propensity to use antibiotics without a prescription, as well as their attitudes and knowledge of antibiotic use and misuse, were also investigated. RESULTS: In total, 314 students completed the survey, 52% of which were female. The mean age of the students was 20.5 years. The results showed that among the different disciplines, medical students were significantly more knowledgeable about pharmacological agents, compared to dentistry and pharmacy students, while pharmacy students were more knowledgeable about the effectiveness of antibiotics against different pathogenic microorganisms. All student groups were aware of how antibiotic resistance develops and their role as healthcare personnel in implementing measures against resistance. Appropriate antibiotic use among the student community correlated with study year, highlighting the importance of knowledge and education in the prevention of antibiotic resistance. Personality traits were found to be a contributing factor in students' tendency to use antibiotics without a prescription. CONCLUSION: This study demonstrates the importance of conveying knowledge about antimicrobials in the education programmes of future dentists, pharmacists and physicians.

Awareness of dental practitioners and intern dental practitioners in Northern Cyprus towards pandemic of SARS-CoV-2.

AIMS: This study aimed to evaluate the perception, attitude, and awareness of dental practitioners (DPs) and intern DPs towards SARS-COV-2 by comparing the awareness-attitude score (AAS). MATERIALS AND METHODS: An online survey was generated in Google Forms. An invitation email was sent to all DPs in Northern Cyprus (n = 270) and intern DPs at Near East University (n = 200). Data were blindly collected from March 2020 to May 2020. Participants received 1 point for each correct answer. By adding up all collected points, an AAS was determined. Data were statistically analyzed. RESULTS: The questionnaire was answered by 228 DPs (84% response-rate). No statistically significant difference was detected between gender-groups in terms of AAS (P = 0.301). A significant difference was detected between occupation groups in terms of AAS (P = 0.006), and of these, dentist-academician-group exhibited superior score. Other tested variables (specialty, way of occupation, place of occupation, and duration of occupation) had no influence on the AAS (P > 0.05). Relation between age and AAS was statistically significant (P = 0.054, Spearmen Correlation). Increasing age increases AAS as linear relation was detected between these variables (P = 0.011, Linear Regression). The questionnaire was also answered by 182 intern DPs (91% response-rate). No significant difference was detected between gender-groups (P = 0.378). Correlation was insignificant between age and AAS (P = 0.933). CONCLUSIONS: Occupation is the only variable influencing AAS of DPs. Academicians exhibited superior knowledge regarding SARS-CoV-2. The AASs of DPs and intern DPs were analogous.

Strong association between VDR FokI (rs2228570) gene variant and serum vitamin D levels in Turkish Cypriots.

Vitamin D is an important molecule to keep teeth, bones and muscles healthy. It is obtained from diet, supplements and primarily from exposure to sunlight. In recent years, vitamin D deficiency is recognised as a worldwide health problem, which results in disturbances in mineral metabolism and skeletal problems. Deficiency might be caused due to sedentary lifestyle, insufficient diet, age as well as some polymorphisms in the VDR gene. In this study the four most common VDR polymorphisms (rs1544410 (BsmI), rs731236 (TaqI), rs7975232 (ApaI) and rs2228570 (FokI)) are investigated in a cohort of Turkish Cypriots and aimed to detect any possible links between low serum vitamin D levels and these variants. The rs2228570 (FokI) variant but not others were shown to have a significant association with decreased serum vitamin D levels in the Turkish Cypriot population.

Persistent marine litter: small plastics and cigarette butts remain on beaches after organized beach cleanups.

Cyprus is an island country in the Eastern Mediterranean whose economy is largely dependent on coastal tourism. It boasts some of the cleanest waters in Europe and has the largest number of Blue Flag awarded beaches per capita in the world. These beaches are managed by local authorities and are regularly cleaned, throughout the year, at least once per day. This paper presents findings from cleanups that were organized over the summers of 2016 and 2017 on nine Blue Flag beaches around the island of Cyprus, after the beaches were cleaned by the responsible authorities. The aim was to answer the following questions: 'Are regular beach cleanups by local authorities efficient?' and 'What is left on a "clean" beach?' The results suggest that local authority cleanup efforts are quite successful at collecting larger pieces of marine litter, leaving the beach seemingly clean. However, small pieces of litter, such as cigarette butts and small pieces of plastic items related to recreational activities, remain on the beach. They likely accumulate or are buried over time, with some items becoming a nuisance to beach goers and a potential source of marine litter.

First wave of cultivators spread to Cyprus at least 10,600 y ago.

Early Neolithic sedentary villagers started cultivating wild cereals in the Near East 11,500 y ago [Pre-Pottery Neolithic A (PPNA)]. Recent discoveries indicated that Cyprus was frequented by Late PPNA people, but the earliest evidence until now for both the use of cereals and Neolithic villages on the island dates to 10,400 y ago. Here we present the recent archaeological excavation at Klimonas, which demonstrates that established villagers were living on Cyprus between 11,100 and 10,600 y ago. Villagers had stone artifacts and buildings (including a remarkable 10-m diameter communal building) that were similar to those found on Late PPNA sites on the mainland. Cereals were introduced from the Levant, and meat was obtained by hunting the only ungulate living on the island, a small indigenous Cypriot wild boar. Cats and small domestic dogs were brought from the mainland. This colonization suggests well-developed maritime capabilities by the PPNA period, but also that migration from the mainland may have occurred shortly after the beginning of agriculture.

Association between water consumption from polycarbonate containers and bisphenol A intake during harsh environmental conditions in summer.

With the exception of polycarbonate (PC) baby bottles, little attention has been paid to bisphenol A (BPA) intake from packaged water consumption (PC water dispensers), especially during summer weather conditions. We determined the magnitude and variability of urinary BPA concentrations during summer in 35 healthy individuals largely relying upon PC packaged water to satisfy their potable needs. We used liquid chromatography-tandem mass spectrometry to measure urinary BPA concentrations. A questionnaire was administered in July/August and a spot urine sample was collected on the same day and 7 days after the completion of the interview (without intervention). Linear regression was performed to assess the association of variables, such as water consumption from different sources, on urinary BPA levels for the average of the two urine samples. A significant positive association (p = 0.017) was observed between PC water consumption and urinary BPA levels in females, even after adjusting for covariates in a multivariate regression model. The geometric mean of daily BPA intake back-calculated from urinary BPA data was 118 ng · (kg bw)(-1) · day(-1), nearly double the average intake levels observed in biomonitoring studies worldwide. High urinary BPA levels were partially ascribed to summer's high PC water consumption and weather characteristics (high temperatures, >40 °C; very high UV index values, >8), which could be causing BPA leaching from PC. It is suggested that PC-based water consumption could serve as a proxy for urinary BPA, although the magnitude of its relative contribution to overall daily intake requires further investigation.

The efficiency of the public dental services (PDS) in Cyprus and selected determinants.

BACKGROUND: Currently there is a dual system of oral healthcare delivery in Cyprus: the public dental system (PDS) run by the Government and the private system provided by private dental practitioners. Although 83% of the population is entitled to free treatment by the PDS only 10% of the population make use of them. As Cyprus faces now the challenges of the introduction of a new health care system and rising healthcare costs in general, surveys that examine, among other things, the efficiency of the PDS become very important as tools to make important cost savings. The aims of this study are to assess trends regarding the number of visits and the age distribution of patients using PDS from 2004 to 2007, to measure the technical efficiency of the PDS and to investigate various factors that may affect it. METHODS: Non-parametric Data Envelopment Analysis (DEA) was employed to assess technical efficiency. Two separate cases were examined. Efficiency was calculated, firstly using as inputs the wages and the working hours of the personnel, and secondly the working hours of the personnel and the cost of the materials. As outputs, in both cases, the treatment offered (divided into primary, secondary and tertiary care) and the numbers of visits were used. In the second stage Tobit analysis was used to explore various predictors of efficiency (time per patient, location, age of dentists, age of patients and age of assistants). RESULTS: The study showed that whilst there was an increase in the number of patients using the PDS from 2004 to 2007, only a small proportion of the population (10%) make use of them. Women, middle and older aged patients, make more use of the PDS. Regarding efficiency, there were large differences between the units. The average Technical Efficiency score was 68% in the first model and 81% in the second. Urban areas and low time per patient are predictors of increased efficiency. CONCLUSION: The results suggest that many of the rural PDS are underperforming. Given that the option of shutting them down is undesirable, measures should be taken to reduce inputs (e.g. by reducing the personnel's working hours) and to increase outputs (remove barriers, make PDS more accessible and increase the number of patients).

Caries prevalence in 12-year-old Cypriot children.

OBJECTIVE: To determine caries prevalence and caries experience in 12-year-old children living in the Republic of Cyprus and to evaluate whether different variables were associated with caries experience. METHODS: According to the WHO recommendation, schools were randomly selected by taking into account the distribution between rural and urban regions, so that 10% of Cypriot children attending the sixth grade could be examined. In the school year 2003/2004 the children were examined in schools by one person with the aid of artificial light but without taking radiographs or fibre-optic transillumination. DMFT, presence of fissure sealants and black stain were recorded. RESULTS: In total 951 children were examined. Caries prevalence was 32.6% (95% CI 29.62-35.6). The mean DMFT was 0.65 (sd 1.17) and the SiC was 1.95. Fissure sealants were found in 14.3% of the children. No association between frequency of tooth brushing, presence of fissure sealants or presence of black stain and caries experience was observed. Children living in rural areas had significantly higher mean DMFT values than children living in urban areas. CONCLUSION: A further caries decline may be attained by promoting a more extensive use of preventive measures like application of fluoride varnish or fissure sealants.

Seasonal and geographic variations of marine litter: A comprehensive study from the island of Cyprus.

Twenty beaches located around the island of Cyprus, in the eastern Mediterranean, were identified as monitoring sites. They were monitored over four monitoring sessions from January to September 2021 to assess marine litter amounts, categories, and spatiotemporal distribution. A total of 42,499 marine litter items were collected. The average marine litter density was 0.19 items/m2. Most of the collected items were plastics, with single-use plastics being ubiquitous. Plastic fragments >2.5 cm made a significant proportion of the plastic litter collected, particularly in the northern coasts of the island. Cigarette butts were abundant on touristic beaches, especially in the tourism period. The study identifies significant temporal and spatial variations in the abundance and distribution of marine litter, as well as variations related to waste management or lack thereof.

The Knowledge and Attitude of Parents About the Dental Treatment of Their Children During the New Type of Coronavirus Outbreak in Northern Cyprus.

Background: The aim of this study was to assess the knowledge and attitude of parents living in Northern Cyprus about the oral care and dental treatments of their children during the outbreak of the new type of Coronavirus (COVID-19). Methods: An online self-administered questionnaire was conducted consisting of 33 questions. A total of 256 parents participated in this study. The questionnaire was divided into two parts. The first part consists of demographic information and the second part consists of the awareness and knowledge of parents about dental treatments during COVID-19. SPSS software was used for statistical data analysis. Results: In total, 81.9% of the mothers and 59.6% of the fathers stated that their children could be infected with COVID-19 during dental treatments and were apprehensive about their children undergoing such treatment because of the outbreak. Participants were asked about their knowledge regarding the transmission of COVID-19 through air droplets during dental treatments and the findings revealed that mothers (89.5%) were more aware of this than fathers (77.2%). The majority of the participants (77%) stated that their children could become infected with COVID-19 during dental treatments and were apprehensive about their children undergoing such treatment because of the outbreak; however, 65.1% did not take any extra precautions regarding their children's oral health and care. Conclusion: The majority of the parents in Northern Cyprus have good knowledge about dental clinics being one of the high-risk areas where COVID-19 can be transmitted by aerosols from infected people. However, further steps need to be taken to strengthen parents' motivations for home oral care and more studies are needed to assess the continuing impact of the COVID-19 pandemic on parents' attitudes toward and knowledge about dental procedures.

Anthropogenic marine litter on the north coast of Cyprus: Insights into marine pollution in the eastern Mediterranean.

The eastern Mediterranean is a region that has been relatively understudied with regards to anthropogenic marine litter despite potential for environmental and social costs. Here, coastal marine litter accumulation was assessed at eight beach locations along the coast of Northern Cyprus. Monthly surveys were performed between January 2017 and January 2019. All items ≥ 2.5 cm in diameter within the same 250 m2 plot were collected and processed. A total of 59,556 separate items were collected with a total mass of 697 kg. At the worst affected site (Ronnas Bay) litter accumulation averaged 1114 items and 11.9 kg per month. Plastic and polystyrene litter accounted for 82% (622.71 kg) of all litter types by mass and 96% (57,231) by frequency. Plastic bags, plastic pieces, drinks containers, caps/lids were the four most abundant forms of plastic by mass and by frequency. This suggests dumping/poor domestic waste governance as the main driver of marine litter in the region.

Big Concern for Public Health: Microbial Contamination of Mobile Phones.

INTRODUCTION: Mobile phones are dynamic source of microorganisms in households and professional settings. The aim was to determine the prevalence of bacterial contamination of the mobile phones, identify bacterial isolates, assess their antimicrobial susceptibility patterns and define the efficiency of using disinfectant. METHODOLOGY: This study included 233 dental students from Near East University, Faculty of Dentistry. Swab samples taken from mobile phones before and after disinfection were inoculated onto 5% sheep blood medium and eosin methylene blue medium and incubated aerobically at 37°C for 24-48 hours. Mold-growing mix cultures were sub-cultured on the sabouraud dextrose medium and allowed to grow at room temperature. Conventional microbiological techniques and VITEK 2 automated identification system were used for bacterial identification and antimicrobial susceptibility testing. Antibiotic susceptibility tests were verified by Kirby-Bauer disc diffusion technique according to the European Antimicrobial Susceptibility Test Committee criteria. Mold colonies were identified macroscopic and microscopically according to their phenotypic properties using lacto-phenol cotton blue stain. RESULTS: Microbial contamination of mobile phones was 81% (120.953 cfu/ml) in swab samples taken without using alcohol-based wipes however, microbial contamination in swab samples taken after one-time disinfection was determined to be 21% (201 cfu/ml). The most common microorganisms isolated were coagulase negative Staphylococci (69%) and Aspergillus niger (13%). All of the isolated bacteria were susceptible to all antibiotics used. CONCLUSIONS: This study represents the first data on the rate of microbial contamination on mobile phones in Northern Cyprus and the efficiency of the use of alcohol to disinfect the mobile phones.

Teledentistry as a Supportive Tool for Dentists in Diagnosing MRONJ in Northern Cyprus.

OBJECTIVE: This web-based survey, as a tool of teledentistry, is aimed at assessing the level of knowledge, attitudes, and awareness regarding MRONJ among dental professionals in Northern Cyprus. METHODS: An online self-administered questionnaire about MRONJ was sent to all dentists in Northern Cyprus through Google Forms. The first part of the questionnaire consists of demographic and professional information, and the second part included questions about knowledge and awareness questions about MRONJ. The SPSS software was used for statistical data analysis. A Chi-square test was performed to compare between the groups. The significance level was set at p < 0.05. RESULTS: A total of 112 dentists participated in this survey. The participants showed an insufficient level of knowledge regarding MRONJ, as only 56.6% of the participants stated that they had general knowledge about MRONJ. Regarding the practical questions of the survey, the participants showed poor knowledge about implant and tooth extraction procedures while a patient is using antiresorptive or antiangiogenic drugs, particularly the usage of oral antiresorptive or antiangiogenic drugs for less than 3 years. Participants showed adequate knowledge in terms of usage area of medications and administration of them. CONCLUSION: Teledentistry can be used as a supportive tool for dentists in diagnosing MRONJ. Similar to previous studies, the knowledge and awareness of MRONJ of dentists in Northern Cyprus were found to be inadequate. There is a significant need to provide more professional information as part of undergraduate programs so that the next generation of dentists can practice more confidently.

Charcot-Marie-Tooth disease in Cyprus: epidemiological, clinical and genetic characteristics.

BACKGROUND: Charcot-Marie-Tooth disease (CMT) is the most common inherited neuropathy. CMT is classified into 2 main subgroups: a demyelinating and an axonal type. Further subdivisions within these 2 main categories exist and intermediate forms have more recently been described. Inheritance can be autosomal dominant, recessive or X-linked. CMT is associated with more than 30 loci, and about 25 causative genes have been described thus far. METHODS: We studied epidemiological, clinical and genetic characteristics of CMT in the Cypriot population. RESULTS: The prevalence of CMT in Cyprus on January 15, 2009, is estimated to be 16 per 100,000. Thirty-three families and 8 sporadic patients were ascertained. CMT was demyelinating in 52%, axonal in 33% and intermediate in 15% of the patients. Thirteen families had PMP22 duplication, 3 families had the PMP22 S22F mutation, 4 families had GJB1/Cx32 mutations, 2 families had different MPZ mutations, 1 of them novel, and 2 families had different MFN2 mutations. Nine families and 8 sporadic patients were excluded from the common CMT genes. CONCLUSION: The most frequent CMT mutation worldwide, the PMP22 duplication, is also the most frequent CMT mutation in the Cypriot population. Five out of the 8 other mutations are novel, not reported in other populations.

The System of The Provision of Oral Healthcare in the Republic of Cyprus and the Effect of the Economic Crisis.

PURPOSE: To investigate recent developments in the provision of oral healthcare in Cyprus and the population's oral health, with special reference to the impact of the recent economic crisis. RESEARCH DESIGN: cross-sectional study. MATERIALS AND METHODS: Data from oral health surveys in Cyprus over the last 30 years were reviewed and analysed together with policy documents. Information regarding oral health behaviour, dental visits and the consequences of the economic crisis on the latter was also obtained with the help of self-completed questionnaires by patients and dentists. RESULTS: Although the overall level of oral health in Cyprus can be considered satisfactory, there were statistically significant variations between districts and different socioeconomic and ethnic groups. Beyond these variations, it seemed that the three-year economic crisis (2013-2016) had negatively affected the behaviour of the population in seeking dental care, reducing the frequency of visits to the dentist, and avoiding costly dental work, especially among those from the lower socioeconomic strata. This change in citizens' behaviour led to a statistically significant decrease in dentists' income in the private sector. CONCLUSIONS: The economic crisis brought about new difficulties and challenges for both the public and the private sectors of oral healthcare, and into the implementation of a new National Health System.

Risk factors for voice disorders in public school teachers in Cyprus.

AIMS: The purpose of this study was to investigate risk factors for self-perceived voice disorders in teachers in Cyprus in order to determine the necessity for a preventative vocal hygiene education program which could improve their work performance. METHODS: An online questionnaire was completed by 449 teachers. The questionnaire extracted data regarding risk factors that may contribute to the development of voice disorders, occupational consequences of voice disorders and vocal hygiene education, as well as, a self-perceived severity of a participant's voice problem. Subjects were split into two groups, teachers with Voice Disorder Index (VDI) ≤ 7 and teachers with VDI > 7. The chi-squared test was used to explore the differences in responses for each voice risk factor, occupational consequence and vocal hygiene education between the two groups. RESULTS: Teachers in the VDI > 7 group were more likely to frequently experience nasal allergies and respiratory infections, coughing, throat clearing, stress and yelling, have shorter breaks between classes, use loud voice, use their voice to discipline students, teach above students talking, etc. than teachers in the VDI ≤ 7 group. Moreover, teachers in the VDI > 7 group were more likely to limit their ability to perform certain tasks at work and reduce their activities or interactions "3-5 or more days" annually due to voice problems. CONCLUSIONS: Health, voice use, lifestyle, and environmental factors may play a part in the development of voice disorders in teachers and have an impact on their job. Therefore, a preventative vocal hygiene education program is suggested.