Parental Attitudes towards Child Oral Health and Their Structural Analysis.

The relationship between parental attitudes towards health and child development has been a topic of interest for many years; however, research results in this field are still inconsistent. This study aimed to develop a structural equation model of the Parental Attitudes toward Child Oral Health (PACOH) scale, using this model to analyse the relationship between parental attitudes with demographic variables and the oral health-related behaviour of parents and children. A total of 302 parents (87% mothers) answered questions regarding their own and their children's, aged 4-7 years, oral health-related actions and completed the 38-item PACOH scale. The structural equation model indicated that parental attitudes captured by the PACOH scale can be fitted to a second-order factorial model, even with the scale shortened to 21 items. The model demonstrated good fit characteristics (CFI = 0.925; IFI = 0.927; GFI = 0.915; RMSEA = 0.049), making it a reliable tool for examining the structure of parental attitudes. This model was employed in the multi-group analysis, revealing the close relationship between positive parents' attitudes towards their child's oral health and oral health-promoting behaviour both in parents and children, such as regular tooth brushing (p < 0.001), visiting the dentist (p = 0.027), and parents helping their child brush his/her teeth (p < 0.001). In light of these findings, it was concluded that Parental Attitudes towards Child Oral Health should be considered an essential factor influencing the development of oral health-promoting behaviour in children.

Oral care in intensive care units: Lithuanian nurses' attitudes and practices.

AIM: This study examines the attitudes and practices of ICU nurses towards the provision of oral care to their patients. OBJECTIVE: We conducted this cross-sectional survey about oral health care practices in ICUs in Lithuania. METHODS: We used a self-administered 20-item questionnaire to survey the current oral care practices, training, and attitudes of 108 nurses. The questionnaire was based on previous studies to gather information related to the attitudes, oral care practices, and training of ICU nurses. We used the chi-square test to analyze relationships between the categorical variables. RESULTS: Most (88, 82%) of the nurses stated that oral care is important. Although most (83, 77%) had adequate training, a clear majority (98, 91%) of the nurses reported a willingness to learn more. Most (78, 72%) of the nurses found the oral cavity difficult to clean, and (71, 66%) found doing so unpleasant. When performing oral care, the nurses used mostly foam swabs (62, 61%) and moisturizers (54, 53%). More than half (57, 57%) of the nurses expressed a need for more hospital support. CONCLUSIONS: Nurses working in ICUs reported that oral care is a high priority for their patients, but a difficult and unpleasant task. Nurses provided oral care mainly with toothbrushes, foam swabs, and moisturizers.

Traumatic Dental Injuries, Treatment, and Complications in Children and Adolescents: A Register-Based Study.

OBJECTIVE: Traumatic dental injury (TDI) is a common dental concern among children worldwide. We performed a retrospective patient register study among children under 18 years to investigate TDIs with respect to causes, treatment, and complications. MATERIALS AND METHODS: We collected information on TDIs from the original patient records of 407 child patients visiting dental clinic of Lithuanian University of Health Sciences, Kaunas, Lithuania. We analyzed all child patients' (n = 407) background, cause, type of TDI, treatment, complications, and time elapsed from injury to visit to the dentist. STATISTICAL ANALYSIS: The χ 2-test, analysis of variance (ANOVA), and Kruskal-Wallis and Mann-Whitney tests served in the statistical analyses. RESULTS: A total of 579 TDI cases occurred during 2010 to 2016. Lateral luxation (19.8%) and intrusion (14.8%) occurred more often in the primary than the permanent dentition (p < 0.05). The most common cause of TDI was falling (56%). Avulsion occurred in approximately 10% of cases. Follow-up (44.5%) and tooth extraction (48.3%) were the most frequent treatments in the primary and splinting (25.3%) in the permanent teeth. Pulp necrosis was the most frequent complication in primary (92%) and permanent (54%) dentition. About 1% of the patients obtained dental care during the first hour after injury. CONCLUSION: The most frequent TDIs included lateral luxation in primary teeth and enamel-dentine fractures in permanent teeth. We observed a delay in patients obtaining emergency dental care.

Stress and associated factors among dentists.

OBJECTIVE: Studies have shown that dentists are experiencing stress at work and it might have an impact on general health. Dental students have reported negative effect of stress starting in undergraduate studies period. The various predisposing factors have been identified and determined. The aim of our study was to determine and compare stress among dentists of different specializations. MATERIALS AND METHODS: A cross-sectional study was conducted in March-September 2016 among 317 dentists. 151 (48%) form public and 166 (52%) from private clinics. All participants were dental practitioners working in Kaunas, Lithuania. A modified version of Occupational stress questionnaire (Institute of Health, Helsinki, Finland, 1992) was used. Chi-square, Kolmogorov-Smirnov test Mann-Whitney U tests, Student's (t) criterion and logistic regression analysis model served for statistical analysis. RESULTS: Majority of dentists were women (85%) and 61.8% of all participants were general practitioners. More general practitioners and paediatric dentists specialists were working in public clinics. The most stressful factors were: restrictions, work tension, and responsibility, while least stressful were value of work, work and life satisfaction (p<0.05). The intensive stress (>3) was indicated mostly by general practitioners, pediatric dentists and periodontologists. CONCLUSIONS: Stress is more experienced by dentists working in public clinic being as a general practitioner or having specialization of periodontologist or pediatric dentist. Dentists should be encouraged to take stress management course to cope with.

Primary school teachers' knowledge and attitude regarding traumatic dental injuries.

AIM: According to the WHO, 16%-40% of children aged 6-12 years experience dental traumas. Long-term treatment success depends on immediate emergency care and early professional management after the injury occurred. The primary school teachers can play a crucial role in managing traumatic dental injuries (TDIs) because they are often in proximity to children and often need to assist when dental trauma occurs. The aim of the present study was to assess primary school teachers' knowledge and attitude regarding TDI and describe their behavior in emergency situations. MATERIALS AND METHODS: A four-part anonymous questionnaire comprised questions on demographic data, attitude, knowledge toward TDI, and behavior in case of accident and self-assessment questions were distributed among 147 teachers from 16 schools. The data were obtained from 106 participants (72.1%). The Kruskal-Wallis and independent t-tests served for statistical analysis. RESULTS: More than half of teachers (56.6%) have witnessed TDI. Almost all respondents (94.3%) indicated that in case of dental trauma is important to take emergency management as soon as possible. However, two-thirds of them (75.5%) thought that teachers cannot provide appropriate emergency management in case of TDI. In addition, teachers had little knowledge regarding TDI and the proper emergency management: 91.3% of participants do not know the right storage media for the avulsed tooth, 40.6% have thought that tooth replantation is impossible, and 17.1% would throw an avulsed tooth away, when it fells on the ground. CONCLUSION: The study revealed inappropriate knowledge and attitude regarding TDI among primary school teachers and their behavior in first-aid management.

Oral health behaviour, attitude towards, and knowledge of dental caries among mothers of 0- to 3-year-old children living in Kaunas, Lithuania.

OBJECTIVES: This study aimed to investigate the oral health behaviours of mothers with young children and their attitudes towards dental caries. METHODS: The survey targeted all mothers with children under 3 years attending a primary healthcare centre (Department of Family Medicine at the Lithuanian University of Health Sciences [LSMU] Hospital) in Kaunas, Lithuania. The Bioethics Centre of the LSMU approved the study (No. BEC-OF-14). Of 176 mothers, 123 (69.9%) took part in the 2016-2017 study. The self-administered questionnaire enquired about mothers' attitudes towards oral health and behaviours related to the potential transmission of oral bacteria to their children, dietary habits, tooth brushing, smoking, and background factors. The chi-squared test and univariate/multivariate logistic regression analyses served for the statistical analysis. (p values ≤ .05 indicated statistically significant differences). RESULTS: Most (76; 68.5%) of the mothers brushed their teeth twice daily, and 97 (87.4%) reported themselves as nonsmokers. We found a statistically significant association between mothers who brushed their own teeth twice daily and those who cleaned their children's teeth likewise (OR = 5.42, 95% CI [1.28-6.63]; p = .005). We observed significant associations among mothers who gave their children sugar-sweetened beverages (SSBs) daily and the mothers' college or lower education (OR = 6.51, 95% CI [1.59-27.19]; p = .01) and maternal tooth brushing less than twice daily (OR = 3.88, 95% CI [0.99-15.18]; p = .05). CONCLUSIONS: A majority of mothers who took part in this survey did not brush their children's teeth as recommended. Mothers with a lower education and who brushed their teeth less than twice daily offered their children SSBs more frequently.

Graduating dentists' perceptions about their professional competence in Finland and Lithuania.

AIMS: Efforts to harmonise dental education in Europe have been put into action by the Association for Dental Education in Europe (ADEE). The aim of the study was to explore graduating dentists' perceptions about their professional readiness for clinical work in Finland and Lithuania. MATERIALS AND METHODS: The survey targeted fifth-year dental students at the University of Oulu and the University of Turku in Finland, and at the Lithuanian University of Health Sciences, Kaunas, Lithuania (Lithuanian and international students) in 2016-2017. The competences were evaluated in the questionnaire in 21 dental procedures based on ADEE competences by options: "I'd manage well," "I'd need more training" or "It would not quite succeed." The option "I'd manage well" was chosen in the analyses. RESULTS: Students felt that they were most competent in producing and maintaining accurate patient records (91.9%), implementing sterilisation and hygiene in dental practice (91.3%) and working with other members of dental team and health profession (90.0%). The largest differences between Finnish and Lithuanian students were in designing and adjusting occlusal splints (87.0% vs. 14.3%) and in undertaking subgingival scaling (95.7% vs. 57.1%). The biggest differences between Lithuanian and international students were in identifying (and treating) abnormal and anxiety-related patient (73.1% vs. 25.5%) and implementing tobacco cessation (65.3% vs. 31.9%). CONCLUSIONS: The graduating dental students in Finland and Lithuania manage well in most of the clinical procedures based on the ADEE competences. The students were most confident when dealing with tasks that are common in dental practice.

Impact of Fluorosis on the Tensile Bond Strength of Metal Brackets and the Prevalence of Enamel Microcracks.

The objective of this in vitro study was to determine the effects of dental fluorosis on the tensile bond strength of metal brackets bonded to human teeth and to evaluate the changes in the tooth enamel surface after debonding. The study sample consisted of 68 recently extracted human upper premolars, which were divided into 2 groups: the fluorosis group (34 fluorosed teeth) and the control group (34 healthy teeth). Identical premolar metal brackets were bonded on the buccal surfaces of the teeth. Both groups were submitted to a tension test using a universal testing machine. The number and length of the enamel microcracks in the buccal surface of each tooth were determined before bracket bonding and after debonding using a stereomicroscope. The percentage adhesive remnant index (PARI) was calculated after debonding. The results showed that the tensile bond strength (TBS) of brackets bonded to fluorosed teeth was 21.08% lower than that of brackets bonded to healthy teeth (p < 0.0001). The length of the enamel microcracks on fluorosed teeth increased by 47.4% after debonding, whereas the control group showed an increase of only 12.6%. The PARI showed lower values for fluorosed teeth in comparison to the control group (p = 0.047). In conclusion, dental fluorosis has a negative impact on tensile bond strength and the length of microcracks formed after bracket debonding.

Influence of preterm birth for child's oral health status.

OBJECTIVES: To search the publications related to this topic, subsequently to find out a prevalence of prematurity worldwide and classification of preterm birth, to analyze the both maternal and foetal risk factors related to preterm birth, to depict relationship between prematurity and developmental defects of enamel and development of dental caries. MATERIAL AND METHODS: A review was carried out to identify relevant studies reporting data on risk factors of prematurity, low birth weight and its' relationship between developmental defects of enamel and early childhood caries. The data was extracted from the selected papers. RESULTS: A total 75 of articles were identified after initial search and 48 publications were enrolled in this review. CONCLUSION: Prematurity and low birth weight of child can cause both general and oral health complications and altered infant's development or growth.

Oral Health Awareness among International Dental and Medical Students at Lithuanian University of Health Sciences: a Cross-Sectional Study.

OBJECTIVES: To evaluate the self-reported oral health awareness, knowledge and attitude among international dental and medical students at the Lithuanian University of Health Sciences (Kaunas, Lithuania). MATERIAL AND METHODS: A cross-sectional study was conducted among international medical and dental students at the Lithuanian University of Health Sciences in 2016 - 2017. The students were invited to participate in the survey before the beginning of a lecture, and they were informed that participation was voluntary and anonymous. In total, 282 students participated in the study, with a response rate of 92.1%. A self-administered English questionnaire consisting of 25 items with options on a Likert scale (agree, neither agree nor disagree and disagree) about oral health problems and their relation to general health status was used to assess a student's oral health awareness, attitude and knowledge. The level of significance was set at P < 0.05. RESULTS: Overall good, fair and poor oral health awareness was reported by 71.3%, 24.1% and 4.6%, respectively, of the international dental and medical students (P < 0.05). The mean score of oral health awareness was 18.2 (standard deviation [SD 3.27]), showing overall good oral health awareness. Moreover, the international dental students reported higher oral health awareness than medical students (19.14 [SD 3.25] vs 17.44 [SD 3.1]) (P < 0.001). Comparing this mean score by gender, no statistically significant difference was found (18.33 [SD 3.39] vs 18.05 [SD 3.16]) (P = 0.371). CONCLUSIONS: Overall oral health awareness among international dental and medical students was high. Meanwhile, international dental students reported higher oral health awareness than international medical students.

Smoking and attitudes towards its cessation among native and international dental students in Lithuania.

BACKGROUND: Dental professionals are uniquely positioned to discourage smoking among their patients. However, little is known about the role of cultural background and attitudes towards smoking in the education of these professionals. Our study aimed to compare native Lithuanian and international dental students' smoking habits, knowledge about the harmfulness of smoking and attitudes towards smoking cessation. METHODS: We conducted a cross-sectional survey of smoking and its cessation among dental students at the Lithuanian University of Health Sciences (Kaunas, Lithuania) in 2012. All Lithuanian and international dental students in each year of dental school were invited to participate in the survey during a compulsory practical class or seminar. Altogether 606 students participated in the survey with a response rate of 84.2%. Explanatory factorial analysis (EFA), multivariate Discriminant Analysis (DA) and Binary Logistic Regression (BLR) served for the statistical analyses. RESULTS: The percentages of occasional/current regular smokers were 41.1% and 55.7% (p = 0.068) among Lithuanian and international male students, and 22.7% and 22.9% (p = 0.776) among Lithuanian and international female students, respectively. The international dental students had a deeper knowledge of the harmfulness/addictiveness of smoking and held more positive attitudes towards smoking cessation among their patients than did the native Lithuanian dental students. CONCLUSIONS: The findings of the study underscored the need to properly incorporate tobacco cessation training into the curriculum of dental education. However, consideration of the cultural background of dental students in building up their capacity and competence for intervening against smoking is essential.

Follow-up of children's oral health-related quality of life after dental general anaesthesia treatment.

OBJECTIVE: Our aim was to analyze longitudinally the impact of young children's dental general anaesthesia (DGA) treatment on their OHRQoL and to determine their post-operative oral health status at the six-month follow-up together with parental ratings of their children's oral health. MATERIAL AND METHODS: We conducted a prospective follow-up study of OHRQoL among Lithuanian child patients treated under general anaesthesia (n = 144). The study consisted of clinical dental examinations performed by two examiners at the time of DGA and at the six-month recall, along with OHRQoL surveys and data collected from the patients' files. The dmft index and Silness-Löe plaque index served as clinical measures. The survey tool for assessing the children's OHRQoL was the previously tested Lithuanian version of the ECOHIS. The Wilcoxon signed-rank test served for the statistical analysis (p < 0.05). RESULTS: The ECOHIS scores clearly decreased post-operatively, indicating a significant (p < 0.001) improvement in the children's OHRQoL after the DGA treatment. The ECOHIS scores were lower immediately after the DGA treatment and remained low at the six-month recall. Parents rated their child's oral health as higher after the DGA treatment (p < 0.001). The majority (75%) of the patients had poor or satisfactory oral hygiene at follow-up. CONCLUSIONS: This longitudinal study showed a sustained improvement in the children's OHRQoL six months after their DGA treatment. Post-operative parental ratings of their child's oral health were higher after the DGA treatment, but the children exhibited insufficient oral hygiene and new caries lesions. An appropriate follow-up system for children receiving DGA treatment with special focus on preventive care is needed.

Effect of Supragingival Irrigation with Aerosolized 0.5% Hydrogen Peroxide on Clinical Periodontal Parameters, Markers of Systemic Inflammation, and Morphology of Gingival Tissues in Patients with Periodontitis.

BACKGROUND Various studies have shown that non-surgical periodontal treatment is correlated with reduction in clinical parameters and plasma levels of inflammatory markers. The aim of this study was to evaluate the effect of long-term weekly supragingival irrigations with aerosolized 0.5% hydrogen peroxide as maintenance therapy followed by non-surgical periodontal treatment on clinical parameters, plasma levels of inflammatory markers, and morphological changes in gingival tissues of patients with periodontitis. MATERIAL AND METHODS In total, 43 patients with chronic periodontitis were randomly allocated to long-term maintenance therapy. The patients' periodontal status was assessed using clinical parameters of approximal plaque index, modified gingival index, bleeding index, pocket probing depth, and plasma levels of inflammatory markers (high-sensitivity C-reactive protein and white blood cell count) at baseline and after 1, 2, and 3 years. The morphological status of gingival tissues (immediately after supragingival irrigation) was assessed microscopically. RESULTS Complete data were obtained on 34 patients. A highly statistically significant and consistent reduction was observed in all long-term clinical parameters and plasma levels of inflammatory markers. Morphological data showed abundant spherical bubbles in gingival tissues. CONCLUSIONS 1. The present study showed that non-surgical periodontal treatment with long-term weekly supragingival irrigations with aerosolized 0.5% hydrogen peroxide improved clinical periodontal status and plasma levels of inflammatory markers and may be a promising method in periodontology. 2. We found that supragingival irrigation with aerosolized 0.5% hydrogen peroxide created large numbers of spherical bubbles in gingival tissues.

Dental caries risk indicators in early childhood and their association with caries polarization in adolescence: a cross-sectional study.

BACKGROUND: Based on the hypothesis that biological and social risks accumulate during life, it is important to identify possible dental caries risk indicators from the life course of early childhood and assess their association with caries polarization in adolescence. METHODS: A cross-sectional design was applied to the study, and a multistage cluster sampling method used to draw a representative sample of 1063 18-year-old Lithuanian adolescents. The dental examinations were performed according to the methodology for oral status evaluation recommended by the World Health Organization. Parents of the participating adolescents completed a self-administered questionnaire about their children's life course during early childhood. The interdependence of characteristics was evaluated by chi-square (χ (2)) and Student's (t) criteria. A multivariate logistic regression model with the Significant Caries (SiC) index as an outcome was performed. RESULTS: The mean scores for the number of decayed, missing, and filled teeth (DMFT) and decayed teeth (DT) in the SiC positive group were higher than the corresponding values in the SiC negative group (6.14 [SD, 2.30] and 1.67 [SD, 2.02] vs 1.28 [SD, 1.11] and 0.34 [SD, 0.69], p < 0.001, respectively). Three dental caries risk indicators were identified that were independently associated with a SiC positive outcome: gender(OR = 1.32 [95 % CI: 1.01-1.73]), earlier eruption of the first primary tooth(OR = 1.43 [95 % CI: 1.03-1.97]), and past caries experience in the primary dentition (OR = 1.62 [95 % CI:1.22-2.14]). CONCLUSIONS: These study findings provide reliable evidence that gender, earlier eruption of the first primary tooth, and past caries experience in the primary dentition should be considered to be dental caries risk indicators and may have an adverse effect on caries polarization in adolescence.

Variation in fluorosis and caries experience among Lithuanian 12 year olds exposed to more than 1 ppm F in tap water.

AIM: The aim of the present study was to analyze caries experience in relation to the occurrence of fluorosis in 12 year olds in a natural fluoride area. METHODS: This cross-sectional study was conducted among 12-year-old lifetime residents (n = 301) of Klaipeda, Lithuania, where the natural fluoride content is 1.7-2.2 ppm F. Data collection included a clinical dental examination and an inquiry about toothbrushing habits. Dental caries was diagnosed according to the World Health Organization criteria and described in terms of decayed, missing, and filled teeth (DMFT)/decayed, missing and filled surfaces (DMFS) indices and decayed, filled surfaces (DFS) on selected proximal surfaces. Dental fluorosis was diagnosed according to the Thylstrup-Fejerskov (TF) index and categorized as none (TF = 0), mild (TF = 1-2), moderate (TF = 3-7), or severe (TF = 8-9). The χ(2)-, Kruskal-Wallis, and Mann-Whitney tests, Pearson's correlation, and linear regression served for statistical analyses. RESULTS: A total of 34% of the 12 year olds studied had no signs of fluorosis, while the rest had mild (42%) or moderate (24%) fluorosis. Caries experience was negatively related to the presence of fluorosis. When present (TF > 0), the mean DMFT was 1.8 (standard deviation [SD]: 1.7) versus 2.6 (SD: 2.3) in the absence of fluorosis (TF = 0, P = 0.008). The corresponding mean DMFS values were 2.6 (SD: 3.1) versus 3.8 (SD: 4.3, P = 0.014). CONCLUSION: The presence of fluorosis associates with lesser caries experience in 12-year-old lifetime residents of an area with moderately-elevated natural fluoride.

Effectiveness of a Motivation and Practical Skills Development Methods on the Oral Hygiene of Orphans Children in Kaunas, Lithuania.

OBJECTIVES: The aim of this study was to evaluate the effect of a motivation and practical skills development methods on the oral hygiene of orphans. MATERIAL AND METHODS: Sixty eight orphans aged between 7 and 17 years from two orphanages in Kaunas were divided into two groups: practical application group and motivation group. Children were clinically examined by determining their oral hygiene status using Silness-Löe plaque index. Questionnaire was used to estimate the oral hygiene knowledge and practices at baseline and after 3 months. Statistical analysis included: Chi-square test (χ(2)), Fisher's exact test, Student's t-test, nonparametric Mann-Whitney test, Spearman's rho correlation coefficient and Kappa coefficient. RESULTS: All children had a plaque on at least one tooth in both groups: motivation 1.14 (SD 0.51), practical application 1.08 (SD 0.4) (P = 0.58). Girls in both groups showed significantly better oral hygiene than boys (P < 0.001). After 3 months educational program oral hygiene status improved in both groups significantly 0.4 (SD 0.35) (P < 0.001). Significantly better oral hygiene was determined in practical application group 0.19 (SD 0.27) in comparison with motivation group 0.55 (SD 0.32) (P < 0.001). By comparing results of first and second questionnaire surveys on use of soft drinks, the statistically significant decline of their use was in both groups (P = 0.004). CONCLUSIONS: Educational programs are effective in improving oral hygiene, especially when they're based on practical skills training.

Oral health-related quality of life after dental general anaesthesia treatment among children: a follow-up study.

BACKGROUND: Many young paediatric patients with severe dental caries receive dental treatment under general anaesthesia. Oral health-related quality of life (OHRQoL) can be evaluated to assess the outcome of dental general anaesthesia (DGA) treatment. The aim of our study was to examine the OHRQoL of young Lithuanian children in need of DGA treatment and analyse the impact of DGA treatment on children's OHRQoL. METHODS: We carried out a prospective clinical follow-up study on OHRQoL among all young Lithuanian child patients who received DGA treatment at the Lithuanian University of Health Sciences Hospital during 2010-2012. The study consisted of clinical dental examinations of patients younger than six years, data collected from their patient files, and an OHRQoL survey completed by their parents prior to the child's dental treatment. We conducted a follow-up OHRQoL survey one month after the DGA treatment. The Early Childhood Oral Health Impact Scale (ECOHIS) and its effect size (ES) served to evaluate children's OHRQoL, and the Wilcoxon signed-rank test served for statistical analyses. RESULTS: We obtained complete baseline and follow-up data for 140 and 122 participants, respectively (84.7% follow-up rate). Pain and eating problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. The parents reported greater impacts on boys than on girls. The ECOHIS score decreased significantly (69.5%, p < 0.001) after DGA treatment, revealing a large ES for the child (1.6) and family (2.4) sections of the ECOHIS. CONCLUSIONS: The OHRQoL of young Lithuanian children requiring DGA treatment is seriously impaired. Dental general anaesthesia treatment results in significant improvement of the children's OHRQoL. The children's parents also greatly appreciate this treatment modality for its positive impact on the family's quality of life.

Treatment under dental general anesthesia among children younger than 6 years in Lithuania.

BACKGROUND AND OBJECTIVE: Dental general anesthesia (DGA) is an efficient treatment modality for young pediatric dental patients. The aim of this study was to identify the reasons for DGA, characteristics of patients receiving treatment under DGA, and treatment performed under DGA for children under school age in Kaunas, Lithuania. MATERIAL AND METHODS: The study population comprised all patients younger than 6 years treated under GA for dental reasons (n=144) at the University Hospital during a 3-year period from 2010 to 2012. The data were collected by means of clinical dental examinations, a survey of the parents, and the patients' dental records and included personal background, reasons for DGA, dental status, and treatment provided. RESULTS: More than half (54%) of the children were younger than 4 years; 40% of them resided in cities. The dental caries experience was high: the mean dmft and d were 12.9 (SD, 3.5) and 12.1 (SD 3.9), respectively. The majority (81%) of the children had multiple reasons for DGA, with the need for excessive treatment (93%), followed by dental fear and uncooperativeness (66%), being the most common. The extent of treatment increased with age and was greater among patients from rural areas. Of the 1975 primary teeth treated under GA, 50% were restored, 32% extracted, and 18% targeted with preventive procedures. CONCLUSIONS: Young children with very high levels of untreated tooth decay are treated under DGA at the Lithuanian University of Health Sciences Hospital. The need for complex treatment as well as dental fear and uncooperativeness are the major reasons for DGA. Multiple caries treatments and extractions are performed for these patients. This study highlights a great need to develop the healthcare system with regard to the appropriate management of caries among young children and postoperative DGA care.

Adaptation and validation of the early childhood oral health impact scale in Lithuania.

BACKGROUND: The Early Childhood Oral Health Impact Scale (ECOHIS) is a parent--assessed oral health related quality of life measure developed to assess the impact of oral health problems on preschool children. AIM: The aim of this study was to develop a Lithuanian version of the ECOHIS and evaluate its validity and reliability among preschool children in Lithuania. DESIGN: A lithuanian version of ECOHIS (L-ECOHIS) was developed through a forward-backword translation. A cross-sectional study was performed to assess discriminant and convergent validity and internal consistency. Data was collected from 130 parents of 0-5 year-old children visiting the dental department. A subsample of parents filled the questionnaire again to assess the test-retest reliability. RESULTS: Cronbach's alpha for the instrument was 0.869. Item-total correlation coefficients ranged from 0.389 to 0.797. Scores of the child and family sections were significantly correlated (P<0.001). The scale scores indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health and problem-based dental attendance. The intra-class correlation coefficient was 0.98. CONCLUSION: The L-ECOHIS is a valid and reliable measure to assess OHRQoL of 0-5 year-old children with Lithuanian speaking parents.

Changes in oral health-related quality of life among children following dental treatment under general anaesthesia. A systematic review.

AIM: To review the results of studies reporting data on changes in aspects of children's oral-health-related quality of life (OHRQoL) following dental treatment under general anaesthesia (GA). To describe instruments measuring children's OHRQoL used in the studies. METHODS: A literature review was carried out to identify relevant studies reporting data on changes in aspects of children's OHRQoL following dental treatment under GA. The data was extracted from the selected papers. RESULTS: The review included 11 journal articles, which presented the results of clinical trials. The studies were based on different questionnaires measuring children's OHRQoL and parental satisfaction. CONCLUSIONS: Oral rehabilitation under GA results in the immediate improvement of children's oral health and physical, emotional and social quality of life. It also has a positive impact on the family. However, a more accurate comparison of results is not possible due to differences in instruments used. And no single decision exists on the choice of the instrument measuring children's OHRQoL following dental treatment under GA. It may be concluded that further studies on measuring long term OHRQoL changes and studies surveying children are needed.