Cost-effectiveness analysis of fissure sealants for caries prevention in children.

OBJECTIVE: To evaluate the cost-effectiveness of resin-based and glass ionomer-based fissure sealants compared with no intervention for children. METHODS: We developed a Markov-based decision analytic model that simulated Turkish children from aged 6 to 15 years. Two types of costs were explored from the payers' perspective and the health care system perspectives. A cost-effectiveness analysis of resin-based and glass ionomer-based fissure sealants was conducted to quantify their effectiveness using the number of caries prevented and the quality-adjusted tooth years (QATYs). Costs and effectiveness measures were discounted at 3% per year. RESULTS: The most cost-effective intervention was resin-based fissure sealant, with an additional $5.34 per caries prevented and $1.86 per QATY gained compared with no treatment. CONCLUSION: Fissure sealants particularly resin-based sealants are cost-effective for children in Turkey due to their low cost and highly preventive characteristics.

Accessibility to dental services by immigrant and refugee children residing in Turkey.

BACKGROUND: Turkey is hosting the world's largest immigrant population under temporary and international protection. Due to the social inequalities contributing to early childhood dental caries, the effectiveness of dental care service for immigrant children should be evaluated. AIM: To evaluate the accessibility of immigrant and refugee children residing in four different regions of Turkey to oral health products and dental treatment services. DESIGN: A questionnaire consisting of 21 questions was administered: The first six questions elicited demographic data, and the remaining 15 questions asked about oral health habits, access to oral hygiene materials, and dental treatment services. Participants included the parents of 430 children under the age of 18, who were registered with migrant associations in the regions where they lived (Istanbul, Samsun, Hatay, or Ankara). RESULTS: The majority of the participants were from Syria and Iraq. Of the participants, 42.1% reported that their children's oral hygiene habits had changed negatively after they migrated, 71.9% reported that they had not been to the dentist in the last year, and 82.8% reported that they had not been to the dentist for more than 12 months. Access to oral and dental hygiene products was not difficult for 68.4%. About 62.6%, however, reported that they had difficulty accessing dental treatment. CONCLUSION: The findings showed that this disadvantaged group had difficulty accessing dental treatment. Therefore, there is a need for national and international health strategies to ensure that immigrant and refugee children have effective access to dental treatment.

Synergistic effect of thymoquinone and nystatin in the treatment of oral candidiasis; an in vitro study.

The effectiveness of antifungal agents may be insufficient against resistant strains in some cases of oral candidiasis. The aim of this study was to evaluate the antifungal effect of thymoquinone against Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei strains and the synergistic antifungal activity of these strains in combination with nystatin. To evaluate in vitro antifungal activity and interactions between thymoquinone and nystatin, substances were tested against Candida albicans ATCC 10,231, C. tropicalis ATCC 750, C.krusei ATCC 6258 and C. glabrata ATCC 2001 standard strains both individually and combinationally via microdilution method. MIC and ΣFIC index value were analysed. The Kruskal Wallis test and Bonferroni test were used for statistical evaluations. Statistical significance was set at p < 0.05. A statistically significant difference was observed between the mean ranks of all Candida species and doses of thymoquinone, nystatin, and the combination thymoquinone-nystatin (p < 0.05). MIC values for thymoquinone were determined as 15 µg/mL for C. albicans, C. tropicalis and C. krusei while it was 30 µg/mL for C. glabrata. Moreover, MIC for nystatin was found as 1.875 µg/mL for C. albicans, C. tropicalis and C. krusei, whereas it was 7.5 µg/mL in C. glabrata. Interaction assays and ΣFIC index value revealed that, TQ and nystatin have a synergistic effect against to all strains. Thymoquinone was found to have antifungal activity on Candida species and synergistic effect when combined with nystatin.

Effect of work environment and specialty degree of dentists on cross-infection control in COVID-19 pandemic.

OBJECTIVES: The aim of this study was to evaluate the effect of the work environment and expertise/specialty degree  of dentists on their behavior, awareness, and  attitudes regarding cross-infection control during the COVID-19 pandemic. DESIGN: The study population consisted of Turkish dentists who work in private clinics, public clinics and university hospitals. The demographic information of the participants, their awareness of the COVID-19 acute respiratory disease, and clinical measures taken against cross-infection were evaluated with an online survey. Between the 10th and 20th of November 2020, 2,400 surveys were e-mailed to dentists. RESULTS: A total 454 professionals answered the survey. According to the results, 29.3% of the participants performed only urgent care during the pandemic period, whereas 59.9% of them performed both urgent and routine treatments. Among the responding dentists, 90.6% stated that they were worried about aerosol-generating dental procedures, but there was no differences between genders (p = 0.119). Most participants, especially specialists (p = 0.160) , applied strict cross-infection control methods during the COVID-19  pandemic (77.2%). These dentists used personal protective equipment (PPE) at rates that varied between 75.5% and 98.4%. Nonetheless, the rate of PPE use was different between genders and degrees of expertise: women used PPE more frequently than men (p = 0.025), and specialists used PPE more often than the other dentists (p = 0.04). Finally, there was a weak positive correlation between the level of PPE use and expertise (r = 0.121; p = 0.010). CONCLUSIONS: Despite the overall knowledge of the participants regarding COVID-19 symptoms, transmission routes, and the guidelines needed to prevent the virus from spreading, the dental specialists followed infection control methods more strictly. Even though the participants were concerned about dental practices that create microbial aerosols during the pandemic period, they continued their clinical routines using high PPE levels and taking extra clinical precautions to avoid cross-infection.

Self-reported knowledge, attitudes, and practice of final-year dental students in relation to child abuse: A multi-centre study.

BACKGROUND: The number of child abuse cases is increasing worldwide; therefore, it is important to educate individuals having contact with children about it. This includes dentists who play a pivotal role in detecting and reporting child abuse. AIM: To identify and compare the final- year dental student's knowledge, attitudes, and practice in relation to child abuse. DESIGN: A 38- item and four- part online questionnaire was distributed to students of 11 dental schools in 10 countries. SPSS and GraphPad Prism were used for data analysis. The levels of statistical significance were determined using a chi- square test. P ≤ .05 was considered to be statistically significant. RESULTS: A total of 660 students completed the survey. Fifty- six percent of the students received formal training on child abuse, and 86% wanted additional training. The knowledge of child abuse was significantly higher in Australia, the United States, and Jordan compared with other countries. Internet (60.3%) was commonly used as an information source for child abuse. CONCLUSIONS: The study showed that dental students lack knowledge and experience in recognizing and reporting child abuse. Most respondents indicated a desire for additional training; therefore, dental schools should review what they are currently teaching and make changes as appropriate.

Evaluation of mesial root canal configuration of mandibular first molars using micro-computed tomography.

PURPOSE: The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars. MATERIALS AND METHODS: Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level. RESULTS: The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant (P>0.05) and the kappa value for inter-observer agreement was found to be 0.957. CONCLUSION: Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.

Effect of work environment and specialty degree of dentists on cross-infection control in COVID-19 pandemic

ABSTRACT Objectives: The aim of this study was to evaluate the effect of the work environment and expertise/specialty degree of dentists on their behavior, awareness, and attitudes regarding cross-infection control during the COVID-19 pandemic. Design: The study population consisted of Turkish dentists who work in private clinics, public clinics and university hospitals. The demographic information of the participants, their awareness of the COVID-19 acute respiratory disease, and clinical measures taken against cross-infection were evaluated with an online survey. Between the 10th and 20th of November 2020, 2,400 surveys were e-mailed to dentists. Results: A total 454 professionals answered the survey. According to the results, 29.3% of the participants performed only urgent care during the pandemic period, whereas 59.9% of them performed both urgent and routine treatments. Among the responding dentists, 90.6% stated that they were worried about aerosol-generating dental procedures, but there was no differences between genders (p = 0.119). Most participants, especially specialists (p = 0.160), applied strict cross-infection control methods during the COVID-19 pandemic (77.2%). These dentists used personal protective equipment (PPE) at rates that varied between 75.5% and 98.4%. Nonetheless, the rate of PPE use was different between genders and degrees of expertise: women used PPE more frequently than men (p = 0.025), and specialists used PPE more often than the other dentists (p = 0.04). Finally, there was a weak positive correlation between the level of PPE use and expertise (r = 0.121; p = 0.010). Conclusions: Despite the overall knowledge of the participants regarding COVID-19 symptoms, transmission routes, and the guidelines needed to prevent the virus from spreading, the dental specialists followed infection control methods more strictly. Even though the participants were concerned about dental practices that create microbial aerosols during the pandemic period, they continued their clinical routines using high PPE levels and taking extra clinical precautions to avoid cross-infection.

Are YouTube videos useful as a source of information for oral care of leukemia patients?

OBJECTIVES: Video sharing sites are a popular and useful way to spread information. The aim of this study was to evaluate information about oral care for leukemia patients and quality of information related to videos available on YouTube. METHOD AND MATERIALS: In this cross-sectional study, YouTube videos were analyzed according to the information content. The search was performed in English and using the search term: leukemia/oral care. The following information was registered: date of upload, source of upload, duration, total views, number of likes, number of dislikes, number of comments, overall quality. The overall quality of videos was assessed using the following quality criteria presented in the Global Quality Scale (GQS): poor, generally poor, moderate, good, and excellent. In addition, videos were classified as useful, misleading, and patient personal experience. Videos were assessed in terms of definition, etiology, pathogenesis, symptoms, treatment, and oral care for leukemia. RESULTS: Sixty-three videos (78.8%) were classified as useful, 6 (7.5%) as misleading and 11 (13.8%) as a patient's personal experience. Thirteen videos (16.3%) discussed the definition of leukemia, 8 (10.0%) discussed etiology, 6 (7.5%) discussed pathogenesis, 7 (8.8%) discussed symptoms of leukemia, 50 (62.5%) discussed treatment choices, and 15 videos (18.8%) discussed oral care of leukemia. Thirteen videos (16.3%) were assessed as poor, 17 (21.3%) as generally poor, 39 (48.8%) as moderate, 10 (12.5%) as good quality, and 1 (1.3%) as excellent. There was a significant difference between the content of videos and the number of views, number of likes, number of dislikes, and number of comments (P < .05). There was a significant difference between the content of videos and number of views, number of likes, number of dislikes, and number of comments (P = .007, P = .006, P = .049, and P = .011 respectively). There was no significant difference between demographic parameters and quality of video. There was no significant difference between demographic parameters (except duration, P = .025) and source of information. CONCLUSIONS: YouTube is a useful source of information on leukemia. Health care professionals should take into consideration that YouTube is an effective information tool for the patient.