More than just a child: dental students' perceptions of children using a mixed-method approach.

It is important to understand perceptions of dental students towards children to better design relationship. This study aimed to determine and conceptualize dental students'perceptions of children. The study group consisted of 514 dental students who were asked to complete the statement "A child is like…, because…". The metaphors were sorted into conceptual categories and examined for any significant differences between gender, education level and occupational preference. Quantitative (metaphor analysis) and qualitative (chi-square) analyses were used. Participants produced 421 metaphors under 33 general metaphors. The metaphors were collected under five conceptual categories: children as (1) requiring care, attention and sensitivity; (2) raw material; (3) developing and changing; (4) unpredictable and surprisingly; and (5) hazard. The metaphors were mostly under the "developing and changing" category. There were no significant differences between the groups in terms of gender, education level and occupational preference. Female and clinical dental students mostly produced metaphors in the "requiring care, attention and sensitivity" and "developing and changing" categories, respectively. Metaphor analysis is a useful tool in determining dental students' perceptions. Understanding dental students' perceptions of children can be an important part of fostering positive perceptions in their professional life.

Reliability and validity of the Turkish version of the Oral Health Literacy Assessment Task: Pathways between parental oral health literacy and oral health consequences in children.

BACKGROUND: Parental oral health literacy (OHL) is a determinant of oral health behavior and oral health status of children. AIM: To delineate the pathways between parental OHL and oral health consequences in children and to validate the Turkish version of the Oral Health Literacy Assessment Task (TOHLAT-P). DESIGN: This cross-sectional study was conducted with 315 parent-child dyads. The TOHLAT-P was psychometrically evaluated. Item analysis was performed to determine the reliability of the TOHLAT-P. Construct validity was tested by comparing a commonly used instrument using Pearson's product-moment correlation coefficients. A path model was developed to evaluate associations between parental OHL and oral health consequences in children. The model consisted of five endogenous variables (parental oral health behaviors, children's oral health behaviors, children's dental anxiety, dental caries, and oral health-related quality of life [OHRQoL]) and one exogenous variable (parental OHL). A path analysis was used to test the compatibility of the conceptual model, with a statistical significance of p < .001. RESULTS: There was a statistically significant association between parental oral health behaviors and children's oral health behaviors, and between dental caries and OHRQoL. The variable most directly affected by parental OHL was parental oral health behaviors, whereas the variable most indirectly affected by parental OHL was children's oral health behaviors. CONCLUSIONS: The path analysis revealed significant associations between parental and children's oral health behaviors, and between dental caries and OHRQoL. Understanding these pathways is necessary to establish strategies to improve children's oral health. The TOHLAT-P will be useful for future assessments of Turkish children.

Knowledge, attitudes, and perceptions regarding child abuse and neglect among dentists in Turkey.

Limited research attention has been paid to Turkish dentists' perceptions of child abuse and neglect (CA/N). This study aimed to examine Turkish dentists' knowledge about, attitudes toward, and perceptions of CA/N. A total of 229 Turkish dentists responded to the self-administered, valid and reliable questionnaire. It consisted of 34 questions that could be classified into the following conceptual categories: a) sociodemographic data, b) knowledge about legal procedures and the orofacial characteristics and findings that are indicative of CA/N, and c) self-efficacy and attitudes toward CA/N. Multivariate analysis of variance was conducted and partial eta squared coefficients were used statistically. Knowledge about legal obligations was associated with occupational experience, highest CA/N education, frequency of child dental treatment. Prior experience with case of suspected CA/N demonstrated the greatest effects. Knowledge about the orofacial characteristics and findings that are indicative of CA/N was associated with prior experience with at least one case of suspected CA/N. The most frequently provided reasons for failure to report cases of suspected CA/N were fear that the child would be harmed. Turkish dentists demonstrated moderate levels of knowledge about their legal obligations and the orofacial characteristics and findings that are indicative of CA/N. Dentists should receive detailed education on CA/N in their undergraduate and postgraduate education. In addition, it is necessary to increase awareness and knowledge about CA/N by providing in-service trainings at the institutions where they work.

Knowledge, attitudes, and perceptions regarding child abuse and neglect among dentists in Turkey

Abstract Limited research attention has been paid to Turkish dentists' perceptions of child abuse and neglect (CA/N). This study aimed to examine Turkish dentists' knowledge about, attitudes toward, and perceptions of CA/N. A total of 229 Turkish dentists responded to the self-administered, valid and reliable questionnaire. It consisted of 34 questions that could be classified into the following conceptual categories: a) sociodemographic data, b) knowledge about legal procedures and the orofacial characteristics and findings that are indicative of CA/N, and c) self-efficacy and attitudes toward CA/N. Multivariate analysis of variance was conducted and partial eta squared coefficients were used statistically. Knowledge about legal obligations was associated with occupational experience, highest CA/N education, frequency of child dental treatment. Prior experience with case of suspected CA/N demonstrated the greatest effects. Knowledge about the orofacial characteristics and findings that are indicative of CA/N was associated with prior experience with at least one case of suspected CA/N. The most frequently provided reasons for failure to report cases of suspected CA/N were fear that the child would be harmed. Turkish dentists demonstrated moderate levels of knowledge about their legal obligations and the orofacial characteristics and findings that are indicative of CA/N. Dentists should receive detailed education on CA/N in their undergraduate and postgraduate education. In addition, it is necessary to increase awareness and knowledge about CA/N by providing in-service trainings at the institutions where they work.

Web-based dental trauma database using Eden Baysal dental trauma index: a turkish multicenter study.

PURPOSE: To describe the prevalence and pattern of traumatic dental injuries (TDIs) among Turkish children in a web-based and multicenter design using Eden Baysal Dental Trauma Index (EBDTI). MATERIALS AND METHODS: The study sample consisted dental trauma patients aging 1-15 years and a webbased form was developed and used to record the information of the patients' clinical and radiographic findings including EBDTI. The obtained data also included patient gender, age at the initial date of trauma, date of trauma, cause of injury and emergency treatment. Data were analyzed using Pearson Chi-square and Fisher's exact tests. RESULTS: A total of 280 traumatized teeth in 252 patients were evaluated. Dental trauma was seen more in boys and 7-10 years age group (p<0.05). There were significant differences between permanent and deciduous teeth with regard to uncomplicated and complicated crown fracture rate (p<0.05). The root fractures were mostly located at the apical third of the root in both dentitions. CONCLUSION: TDI was associated with age, gender, and type of dental trauma. EDBTI provided easy and proper recording of multiple dental injuries and maturity of the apex and it was found to be a very useful tool to facilitate online recordings of dental injuries.

Batman or Joker? A mixed-method approach to understanding children's perceptions of dentists.

It is important to understand children's perceptions of dentists in order to improve child-dentist communication. The aim of this mixed-methods study was to develop and validate a conceptual model of individual determinants of children's perceptions of dentists. A total of 1014 children completed an oral health behaviour form, a metaphor form, the Children's Fear Survey Schedule-Dental Subscale, the Dental Trust Scale, and the Early Childhood Oral Health Impact Scale. A conceptual model, which included five endogenous and two exogenous variables, was developed and validated. Qualitative (metaphor analysis) and quantitative (path analysis) analyses were conducted. The metaphors that were used to describe dentists were classified into seven conceptual categories: chaotic and unlovable; scary; artistic; protective and alleviative; restorative; scientific; and educative. Better oral health behaviours, greater trust in dentists, and lower dental anxiety were associated with positive perceptions of dentists. Oral health behaviours, trust in dentists, and dental anxiety had the strongest direct effects on perceptions of dentists, but age had the strongest indirect effect. The developed model should help dentists to understand pathways between children's individual determinants and perceptions of dentists. Coupled with behaviour management, this understanding can be an important part of improving dental visit behaviours and fostering positive post-visit attitudes among children.

Does Virtual Reality Affect Children's Dental Anxiety, Pain, And Behaviour? A Randomised, Placebo-Controlled, Cross-Over Trial

ABSTRACT Objective: To evaluate the effect of virtual reality (VR) on dental anxiety, pain, and behaviour at different time points among children undergoing dental treatment under local anaesthesia. Material and Methods: This randomised, two‐armed, within-subject, cross-over, placebo-controlled trial included 76 children. Eligible participants were treated in two dental visits using the following methods: with protective glasses only, without distraction (attention placebo-controlled - APC); and with the treatment condition (i.e., VR). Primary outcomes were dental anxiety and pain; secondary outcome was dental visit behaviour. Heart rate scores were recorded as an objective measure to evaluate dental anxiety and pain. Subjective measurements for each variable were also performed. Results: Significant reduction in dental pain and anxiety was observed in the VR group, according to the heart rate scores; however, no statistical differences were observed according to the self-reported measures. Decreased dental anxiety and pain were associated with the first visit sequence with VR. Dental pain and anxiety scores were lower during local anaesthesia in the VR group than in the APC group. Conclusion: Virtual reality significantly reduced pain and anxiety during local anaesthesia in children undergoing dental treatment; therefore, it may be recommended during dental treatment in school-age children.

Pathways between parental and individual determinants of dental caries and dental visit behaviours among children: Validation of a new conceptual model.

OBJECTIVES: To delineate the pathways between the parental and individual determinants of dental caries and dental visit behaviours among children, using path analysis. METHODS: The study employed an observational design; the study sample consisted of 583 parent-child dyads. Data were collected using a sociodemographic and oral health behaviour form, the Parenting Styles and Dimensions Questionnaire, the Corah Dental Anxiety Scale and the Children's Fear Survey Schedule-Dental Subscale. A conceptual model was developed, and it consisted of four endogenous variables (dental caries, children's oral health, dental visit behaviours and children's dental anxiety) and four exogenous ones (parental socioeconomic status, parental dental anxiety, parental oral health behaviours and parenting style). Path analysis was used to test the compatibility of the conceptual model, with a statistical significance at P < .001. RESULTS: 49.1% of participants (n = 286) were male. The mean age of participants was 8.3 (SD = 2.1). The mean DMFT score was 6.0 (SD = 3.0) and the mean Frankl behaviour score 3.0 (SD = 1.0). Parental socioeconomic status showed the strongest association with dental caries (ß = .276; P < .001), and children's dental anxiety had the strongest association with dental visit behaviours (ß = -.414; P < .001). Parental socioeconomic status and oral health behaviours were directly associated with dental caries (P < .001), and parental socioeconomic status had the most association. Parenting style and parental and children's dental anxiety were associated with dental visit behaviours (P < .001). Further, while all parental variables except prior exposure to training about oral and dental health were significantly correlated with dental caries, only educational level and coverage by health insurance were significantly associated with Frankl behaviour scale score. CONCLUSIONS: This study developed and validated a conceptual model that delineates the pathways between the parental and individual determinants of children's oral health and dental visit behaviours. The model should help us to understand these pathways to lower the incidence of dental caries and improve dental visit behaviours among children.

Conceptual modelling of the factors affecting oral health-related quality of life in children: A path analysis.

BACKGROUND: It is important to understand the interaction of various predictors with oral health-related quality of life (OHRQoL) to better design effective interventions to improve OHRQoL. AIM: The aim of this study was to develop and validate a conceptual model evaluating the factors affecting the OHRQoL in children. DESIGN: The study group consisted of 754 parent-child dyads. The data collection tools were a socio-demographic data form, the Early Childhood Oral Health Impact Scale (ECOHIS), Corah Dental Anxiety Scale (C-DAS), Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and an oral and dental health examination form. A conceptual model was developed to examine the factors affecting OHRQoL in children consisting of four endogenous and four exogenous variables. Path analysis was used to test the compatibility of the conceptual model. RESULTS: OHRQoL was associated with parental socio-economic status (ß = -0.12; P < .001), dental anxiety (ß = -0.15; P < .001), and oral health behaviours (ß = -0.13; P < .001). Although parental dental anxiety had the strongest direct effect on OHRQoL, children's oral health behaviours had the strongest indirect effect. CONCLUSIONS: This study revealed a valid demonstrable path of association between parental socio-economic status, dental anxiety, childhood dental anxiety, oral health behaviours, and OHRQoL.

Primary Tooth Extraction Pattern Among Turkish Children with Severe Early Childhood Caries Treated Under General Anesthesia

Abstract Objective: To determine the frequency and distribution of extracted primary teeth due to severe Early Childhood Caries (ECC) in young pediatric patients treated under general anesthesia. Material and Methods: This study employed a retrospective design and consisted of a total of 1644 children (1011 boys, 633 girls) children aged 3 to 5 who had been diagnosed with several ECC and treated under general anesthesia in a dental faculty between 2013-2019. The data was obtained from the medical and dental forms obtained from the faculty database. The patients were divided according to age groups and sex. A total of 2605 teeth were classified according to the sex, tooth number, and age groups. Results: Of the subjects, 14% (n = 245) were 3 years old, 31% (n = 505) were 4 years old, 55% (n = 894) were 5 years old. The mean ± SD age of subjects was 4.2 ± 0.8 yr. While the most extracted teeth were found to be maxillary primary central incisors and molar teeth, the less were found to be mandibular primary canines. While there was a statistically significant difference between canines and incisors with molars (p<0.05), no difference existed between incisors and molars. There was a statistically significance difference among all age groups (p<0.05). While 3 years old group had the less number of extracted teeth, 5 years old group had the most number of extracted teeth. Conclusion: Severe ECC causes higher tooth extraction in patients treated under general anesthesia. Effective personal and community programs should be initiated to prevent ECC and mitigate its potential disruptive impacts in children's oral health.

The effect of different chelating agents on the push-out bond strength of proroot mta and endosequence root repair material.

PURPOSE: This study aimed to evaluate the effects of 17% ethylenediaminetetraacetic acid (EDTA), 7% maleic acid (MA), and 10% citric acid (CA) on the push-out bond strength of ProRooT MTA and Endosequence Root Repair Material (ERRM) putty. MATERIALS AND METHODS: Eighty single-rooted extracted human teeth were instrumented to obtain a standardized immature teeth model. Based on the chelating agents tested, the specimens were randomly divided into three experimental groups: Group 1 (17% EDTA), Group 2 (7% MA), Group 3 (10% CA), and Group 4 (Positive Control) (n=20 for each group). Each group was further classified into two subgroups: Group A (ProRoot MTA) and Group B (Endosequence Root Repair Material (ERRM) putty) (n=10 for each subgroup). After irrigation and placement of cements, teeth were stored at 37°C and in 100% humidity for a week. A total of 240 dentine discs (three discs per teeth) were obtained and subjected to push-out assay. Data was analyzed using two-way analysis of variance and Tukey's post hoc t-test. RESULTS: Both types of chelating agent and calcium silicate-based cement were significantly associated with the push-out bond strength values. The push-out bond strength was significantly less for CA as compared to EDTA or MA. ERRM had higher bond strength values than ProRoot MTA (p<0.05). CONCLUSION: The use of chelating agents increased the push-out bond strength of CSC. Regardless of tested chelating agents, ERRM had higher bond strength values than ProRoot MTA.

Behavior Management in Pediatric Dentistry: An Overview and Interpretation

In 1895, the first definition of behavior management was mentioned by McElroy with the following words: "although the operative dentistry may be perfect, the appointment is a failure if the child departs in tears" [1]. This approach, which argues that the success of dental treatment in pediatric patients depends on the attitude created in children rather than in the technical or clinical evaluation, was supported by the following words in American Academy of Pediatric Dentistry (AAPD)'s guideline about 100 years later: "Behavior guidance techniques, both nonpharmalogical and pharmalogical, are used to alleviate anxiety, nurture a positive dental attitude, and perform quality oral health care safely and efficiently for infants, children, adolescents, and persons with special health care needs" [2]. The terms of behavior management, which is the global term of choice, or behavior guidance which is now used by AAPD are widely used in dental literature.

Factors Associated with Knowledge and Attitude of Management of Traumatic Dental Injuries: A Cross-Sectional Study among Turkish Dentists

Objective: To evaluate the factors associated with knowledge and attitude of dentists regarding management of traumatic dental injuries (TDI). Material and Methods: In this cross-sectional and correlational study, the sample consisted of 136 Turkish dentists. A specialized questionnaire was developed and validated to collect data. The first part of the questionnaire included questions about sociodemographic characteristics, education level, working experince, working place, last dental trauma course, self-efficacy about management of TDI, and treatment frequency. The second part included a total of 17 questions with multiple choice and single correct answers regarding the management of intrusion and extrusion, avulsion, complicated crown fracture and crown-root fracture injuries in children. Descriptive statistics, multivariate analysis of variance, and partial eta squared coefficient (η 2) were used for statistical analysis. Results: There was a moderate level of knowledge among participants. The level of knowledge was statistically correlated (p < 0.05) in terms of working experience, working place, last dental trauma course and education level of participants, but not according to gender, self-efficacy, and treatment frequency (p > 0.05). General dentists had lower self-efficacy than specialist dentists (p < 0.05). Conclusion: While Turkish dentists working in a province seem to have a moderate level of knowledge regarding treatment of different types of TDI, it is necessary to carry out necessary studies to improve the knowledge and raise self-efficacy.

Perceptions of the dental profession: a comparative analysis through scale development.

Dentistry is a science-based profession that has a close interaction with people and society. However, despite this close interaction, perceptions of the dental profession by both patients and dental professionals have received little research attention. The purpose of this study was to compare the perceptions of dentists, dental students, and patients toward the dental profession through the development and testing of the Dental Profession Perceptions Scale (DPPS). The DPPS contains a total of 17 items measured on a 5-point Likert response scale. The DPPS showed excellent internal reliability (Cronbach's α = 0.92) and test-retest reliability (r = 0.93). Explanatory and confirmatory factor analyses of the DPPS showed that dentists', dental students', and patients' perceptions of the dental profession could be grouped according to 'status', 'human', and 'scientific' factors. There were no statistically significant differences between participants' DPPS total or sub-scale scores according to dental group, gender, or income. The DPPS developed can be used in future studies as a psychometrically sound measuring tool. Further studies should examine the factors that may affect the perceptions of the dental profession in different societies and cultures.

Comparison of the Antimicrobial Efficacy of the EndoVac System and Conventional Needle Irrigation in Primary Molar Root Canals.

PURPOSE: The purpose of this study was to compare the antimicrobial efficacy of the EndoVac system and conventional needle irrigation to eliminate E faecalis in primary molar root canals. STUDY DESIGN: 60 extracted human primary second molar roots were instrumented up to an apical size .04/35 and randomly divided into two groups; Group 1: conventional needle (n=30) and Group 2: EndoVac (n=30), and four subgroups (two experimental subgroups; (a) 2.5% sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA) (n=20), (b) ozonated water (OW) + EDTA (n=20), and control groups (c) 5.25% NaOCl (n=10) and (d) saline (n=10). All roots were sterilized and then inoculated with E.faecalis. Before and after final irrigation procedures, root canals were sampled and the grown colony forming units (CFUs) were counted. Data were analyzed by Kruskall-Wallis and Mann-Whitney U tests using a 0.05 significance level. RESULTS: The EndoVac reduced more bacteria than the conventional needle did but it was not statistically significant (p>0.05). NaOCl alone or followed by EDTA totally eliminated bacteria. OW + EDTA showed higher reduction of bacteria but could not totally eliminate bacterias. CONCLUSIONS: In the context of bacterial elimination, the EndoVac was not significantly better than the conventional needle. Although, there were fewer CFU/mg when using EndoVac, there was not any statistically significant superiority to conventional needle irrigation. An OW+EDTA regimen showed antibacterial effect in the primary molar root canals but it was significantly less effective than NaOCl+EDTA.

Dental anomalies in the primary dentition of Turkish children.

OBJECTIVE: The aim of this study was to determine the prevalence of double teeth, hypodontia, microdontia, and hyperdontia of primary teeth in Turkish children. METHODS: The study group comprised 1149 children (554 girls, 595 boys). The children were examined in twelve local nurseries in Sivas, Turkiye. Clinical data were collected by four dentists according to Kreiborg criteria; which includes double teeth, hypodontia, microdontia, and supernumerary teeth. Statistical analysis of the data was performed using the chi-square test. RESULTS: Dental anomalies were found in 2.0% of children. The distribution of dental anomalies were significantly more frequent (P=.023) in boys (2.9%, n=17) than in girls (1.1%, n=6). In relation to anomaly frequencies at different ages, no difference was found (P = .760). CONCLUSION: Double teeth were the most frequently (1.3%) observed anomaly. The other anomalies followed as; 0.3% supernumerary teeth, 0.3% microdontia, 0.2% hypodontia. Identification of dental anomalies in the anterior region at an early age is of great importance for esthetic and orthodontic treatment planning.