Journal of Dental Medicine

Background and Aims: School teachers have key role in providing the basic health information for their students, and their knowledge, attitude, and practice affect children's oral health through developing of the healthy behaviors. The goal of this study was to evaluate the effectiveness of an oral health education program for primary school teachers on their knowledge, attitude, and practice fields in the framework of oral health promoting schools.
Materials and Methods: This quasi-experimental pre-post study was conducted among five oral health promoting schools in Isfahan city in 2019. A validated and reliable questionnaire including four sections of demographic data, knowledge, attitude, and practice was applied for data collection. The questionnaire contained 24 knowledge, 9 attitudes, and 5 practice questions. It was distributed among 63 enrolled teachers at base line and two months later after two educational-emotional workshops. Before and after data were analyzed by SPSS21 (α=0.05) by related samples Wilcoxon signed rank test and background variables by Kruskall-wallis test.
Results: After the educational intervention, their knowledge score increased significantly from 14.1±3.8 to 18.5±3.7 (P<0.001). About 34% of teachers had a high level of knowledge proficiency at the beginning of the study which eventually rose to 76%. Teachers’ attitude decreased significantly from 34.6±5 to 31.4±4.6 (P<0.001). At the beginning of the study, 89% of them had a positive attitude towards oral health programs which decreased to 84% at the end of the study. In the performance part, 63.5% of the teachers paid attention to the fluoride in their toothpaste which reached 87.3% after the workshop and the teachers' performance score increased from 3.07 to 3.39 after the intervention (P<0.012).
Conclusion: The package of educational intervention for teachers in oral health-promoting schools improved the level of knowledge and practice, but slightly reduced the level of attitude. However, due to the importance of changing attitudes in teachers and the existence of structural and programmatic barriers to integrate the health issues into school education, other models need to be evaluated and compared.

Conclusion: Many elderly people avoid the treatment of oral diseases during coronavirus pandemic due to fear of coronavirus, high dental costs, lack of access to appropriate services, and this causes irreparable problems in their health. Therefore, it is recommended to provide practical solutions to facilitate the dental treatment of elderly patients.

Background and Aims: Studies have shown that dental anxiety may be caused by various factors such as child mood, age, maternal emotional maturity, previous dental anxiety and parenting styles. Therefore, the aim of this study was to investigate the possible relationship between the parenting styles and pediatric dental anxiety and the predictability of this variable through parenting styles.
Materials and Methods: The present study was a cross-sectional correlational study. The study population was children aged 7 to 12 years who had referred to the dental clinics of Tehran in 1400. Sampling from one of the clinics was done randomly. A total of 100 questionnaires of modified child dental anxiety scale and parenting style inventory were given to the children and their parents and 95 of them could have been analyzed. The questionnaires were analyzed using SPSS22 software and Pearson correlation and regression tests.
Results: The results showed that dental anxiety had a negative and significant relationship with authoritative parenting style (r=-0.286, P<0.01) and a positive and significant relationship with authoritarian parenting style (r=0.342, P<0.01). Authoritarian parenting style can be a predictor of dental anxiety.
Conclusion: Knowing the predictors of dental anxiety can help a pediatric dentist analysing who is most prone to dental anxiety. Based on this approach, a relationship based on trust can be established between the dentist and parents to make the necessary recommendations to parents in the office, reduce dental anxiety and improve oral health conditions in children.
 

Background and Aims: Today, academic stress and subsequent test anxiety is one of the most important problems for the last year of high school students. In addition to systemic effects, stress can affect the level of oral health by disrupting oral health behaviors. The aim of this study was to investigate the relationship between stress and variables related to oral health in the final year of high school students prior to University entrance exam.
Materials and Methods: In this descriptive-analytical study, the level of stress and variables related to oral health in 180 students of the final year of high school in Tehran, in three time periods during the academic year 2018-2019, were measured by a questionnaire and one clinical examination. Data were analyzed by Friedman, Bonferroni and Generalized Estimating Equations using SPSS software.
Results: As the exam approaches, some variables related to the oral health, such as toothbrush usage pattern, daily sleep, fast food frequency, and sweet snack consumption, changed (P<0.05). Daily sleep changes were significantly associated with the stress changes (P=0.022). According to the results of the Repeated Measures Analysis, significant changes were observed between the average score of the "Cognitive Error" aspect of three times (P<0.001). Also, according to the results of the Bonferroni Test, significant changes related to the difference in the average score of "cognitive error" 6 months and 3 months before the entrance exam (P<0.001), 6 months and 1 month before the entrance exam (P<0.001), and 3 months and 1 month before the entrance exam (P<0.001) were observed. In all three cases, as the time of the entrance exam approaches, the score of "cognitive error" had decreased significantly. Considering that the lower score in this index indicates a higher level of test anxiety, the closer we get to the entrance exam, the higher the level of test anxiety in the "cognitive error" dimension
Conclusion: The academic stress of the national university entrance exam can affect some oral health variables such as daily sleep, however, it is not related to other variables.

Background and Aims: Dental caries affects the quality of life of children and parents, oral health and overall health which can interfere with the childrens’ daily activities and growth. The purpose of this study was to investigate the relationship between the severity of dental caries and quality of life in pre-school children.
Materials and Methods: This cross-sectional descriptive study was conducted on 145 parents and preschool children aged 2-5 years old referring to Ahvaz dental school and a pediatric dentistry office in Ahvaz city. The convenient sampling method was used and participants were patients referred to the faculty of dentistry and one pediatric dentistry office in Ahvaz. Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was used to evaluate the oral health related quality of life. The demographic information and dmft index (decayed, missing, and filled teeth) was assessed for children. Statistical analyzes included descriptive statistics, Spearman and Pearson tests.
Results: The mean age of children was 4.12 ± 1.2 years. 72 children (49.65%) were boys and 73 of children (50.34%) were girls. Based on our results the mean ECOHIS score was 39.69 ± 18.95. There was a significant correlation between decreased quality of life and the lower age of the children (P=0.047), less parental education (P=0.018), more dmft score (P=0.000).
Conclusion: It can be concluded that severity of dental caries is effective on children's quality of life. The quality of life of children decreases with the increase in the dmft, lower socio-economic status of parents, and higher age of parents.

Background and Aims: Oral health is a necessity and part of general health and its importance in childhood is more than ever. The aim of this study was to investigate the knowledge, attitude, and practice of parents in Delfan city-Iran about oral health of their 6-12-year-old children in 2021.
Materials and Methods: The present study was a descriptive-analytical study that was performed on 365 parents of 6-12-year-old children in Delfan city. Convenience sampling was used. The questionnaires included four sections: demographic information, knowledge, attitude and practice about oral health. Data were entered in SPSS23. Independent t-test, analysis of variance and Pearson correlation were used to analyze the data. Significance level was considered 0.05.
Results: The mean age of the subjects was 36.5±7.1. 201 of parents were mothers. Parents' knowledge and attitude were good and their performance was fair. There was a statistically significant relationship between all three variables of knowledge, attitude, and practice (P<0.00). Also, there was a statistically significant relationship between the knowledge and education (P<0.00), mother job (P<0.04), father job (P<0.00), and economic status (P<0.00). There was a statistically significant relationship between the attitude with education (P<0.00), mother job (P<0.04), father job (P<0.01), and economic status (P<0.01), There was a statistically significant relationship between practice and education (P<0.00), mother job (P<0.01), father job (P<0.00), and economic status (P<0.00) of parents.
Conclusion: The results of this study showed that there was a significant relationship between the knowledge, attitude, and practice with education level, job and economic status. Therefore, oral health education for parents with low educational and economic level should be highly considered.

Background and Aims: The aim of this study was development and validation of a questionnaire measuring the pseudo-scientific unsupported of Iranians’ belief regarding oral health.
Materials and Methods: A list of 169 pseudo-scientific and invalid Iranian beliefs about oral health that was collected in the previous phase of the study were sent to a purposive sample of 13 professors at Mashhad dental school which resulted in extracting 34 beliefs being considered more common among Iranians. A list of 21 pseudo-scientific beliefs was obtained for preparing the questionnaire after receiving the sample opinions of 21 professors of Mashhad dental school about the invalidity and pseudoscientific propositions and their written revision. Finally, the questionnaire was completed by 44 participants to analyze the ease and clarity and to calculate Cronbach's alpha and Kuder Richardson measure as a homogeneity reliability index. It was completed in a group of 15 participants with a time interval of one month for test-retest analysis and consistency reliability evaluation.
Results: A questionnaire consisting of 21 beliefs was developed using four-point, three-point, or two-point Likert scales. The standardized Cronbach's alpha score and Kuder Richardson's measure score were 0.641 and 0.514, respectively, which indicated the moderate to good reliability of the homogeneity. The Interclass Correlation Coefficient (ICC) was calculated as 0.863, representing very good reliability of consistency of the questionnaire. Furthermore, the kappa coefficient of each of the 21 statements had a significant difference with zero (P<0.05) ranging between 0.605 and 1.
Conclusion: The result of the present study is a questionnaire measuring the level of Iranians’ belief in unsupported and invalid statements about oral health. Using this questionnaire would be helpful for dentists and oral health professionals to promote knowledge of Iranians about oral health.

Background and Aims: With the growth of elderly population, attention to their oral health status has become increasingly important. Most of the available studies have been conducted among dependent elders who usually have different oral health statuses and needs. Therefore, the aim of this study was to determine the oral health status of independent elderly attending municipal public centers and parks in Isfahan in 2020.
Materials and Methods: This is a descriptive-analytical cross-sectional study conducted among 195 elderly people attending Isfahan municipal centers in 2020. The oral health status and the oral health related quality of life (QOL) of elderly were evaluated using Geriatric Oral Health Assessment Index (GOHAI) and clinical examinations. The obtained data were analyzed using descriptive statistics (mean and standard deviation), correlation, independent T-test, Chi-squared and ANOVA using SPSS22 (α=0.05).
Results: 69% of the participants (n=133) were male and the mean age was 68.9± 3.5. Almost 20% of elderly (n=39) did not have any of their natural teeth. 63% (n=123) suffered from at least two chronic diseases and 38.5% (n=75) had a functional occlusion. The mean score of quality of life (QOL) of elderly and their DMFT was 51.7±6.4 and 20.5±6.3, respectively. A significant and negative relationship was found between the DMFT and GOHAI (P<0.001, r=-0.36). QOL scores were significantly higher in participants with dentures than those without dentures (P<0.001). There was a significant relationship between the frequency of brushing and the mean of DMFT (P<0.001). In people who did not brush, the DMFT score was higher than those who brushed at least once a day or even sometimes a week.
Conclusion: The results indicated that the oral health status of elderly was weak and it would reflect the need for more attention to taking more measures to both prevent the oral problems and to promote oral health.

Background and Aims: The evaluation of the results of health transformation plan in dentistry, which started in March 2016 with the aim of improving oral and dental health, is extremely important in order to improve planning for future actions. Therefore, the purpose of the present study was to evaluate the effect of the health transformation plan on common oral health indices in Guilan province in Iran.
Materials and Methods: This cross-sectional analytical study was performed using the Health Deputy of Guilan University of Medical Sciences data and results of the general population and housing census of the 2010 and 2015. Data analysis was done using Ordinary Least Squares regression method, considering dependent variables including DMFT, dmft and periodontal disease indices (CPI) and independent variables including gender, education, urban or rural residence, percentage of 13-year-old population, illiteracy rate, fertility rate and being or not in the transformation plan, to investigate the difference between the two groups before and after the implementation of the transformation plan in terms of variables and to examine the relationship between independent and dependent variables. Finally, data were analyzed by STATA SE software version 15.
Results: The health transformation plan did not have a significant relationship with the change of DMFT and CPI 2 to CPI 6 indices, but had succeeded in reducing dmft and CPI1 (P<0.05), which reduction in CPI1 index was not desirable.
Conclusion: It seems that despite the extensive activities of the health transformation plan in dentistry in the field of prevention and treatment, there is still a need for more changes, especially in terms of culture and education. Also, there is need to provide more facilities for access to services by all sections of the society, especially the weak sections for healthcare.

Background and Aims: Nowadays, the requirement of any policy-making at the national and regional level is to know the level of knowledge of people about oral health and ways to prevent dental caries.  This study examined the habits, actions and economic level of elementary school students in Qazvin city in 2017-2018.  Also, the effects of peer group social network on behaviors related to oral health and obesity was investigated in order to find the way for interventions making it more effective in this social group. Materials and Methods: In this descriptive-analytical study, 145 students participated. They were in the 3nd and 6th grades of elementary school in the academic year of 2017-2018. The questionnaire used in this study had 20 questions and 4 main sections. The main parts of this questionnaire included demographic characteristics, behavior and habits related to oral health, oral health knowledge of students and families, and socio-economic status. Data were collected through clinical examinations and through valid questionnaires and evaluated using SPSS and Excel software. Results: According to the results of Pearson's correlation analysis, a significant correlation was observed between the health knowledge scores of individuals and their friends between both groups of casual and close friends (P<0.01). The correlation between the knowledge of individuals and close friends was significantly stronger (P<0.01). Also, there was a significant relationship between socio-economic status and behaviors related to oral health (P<0.05). There was also a significant positive relationship between the number of times close friends brushing their teeth in a social network (P<0.001). This connection was not observed in the friends’ network. Conclusion: This study determined that close friends can be effective in determining the oral hygiene behaviors of elementary school students.

Background and Aims: Dental caries and periodontal disease are the most common chronic diseases. Health care workers specially “Behvarz” due to their wide range of duties, have the potential role in delivering education and prevention of dental caries. The purpose of the present study was to assess the perspective of “Behvarz” working in health care centers of Kordkooy city regarding oral health.
Materials and Methods: Focus group discussions was conducted with a convenient sample of “Behvarz” working in health centers of Kordkooy city.  Total number of 26 Behvarz with the mean work experience of 13 years took part in the study. After obtaining informed consent, group discussions performed in- person (2 groups of 7 and 2 groups of 6 participants) in health centers considering universal precautions. Two researchers coordinated the discussions. Five questions proposed on dental service utilization and oral health challenges and data collection continued until saturation obtained. The content of the discussion recorded and transcribed verbatim. For content analysis, two raters independently coded the content; sub-themes and themes were then extracted and consensus obtained.
Results: More than half of the participants were 34 years of age and older. Regarding the challenges related to dental care in health centers, the main themes were; resource limitation, workload, lack of awareness of “Behvarz” role, limited access, economic barriers to prevention and care. Regarding the challenges to prevention, the main themes were; poor knowledge of patients, limited oral health related knowledge of “Behvarz”, and human resources. The main suggestions were emphasizing on the role of schools, mothers and patient education.
Conclusion: Our research showed that despite the important role of “Behvarz” in delivering oral health promotion at the population level, this role is neglected and needs further attention.

Background and Aims: Numerous researches have been conducted in the field of dental public health in the country so far, and therefore the purpose of this study was to investigate the distribution of studies conducted in this field in terms of quantity and coverage of different subjects.
Materials and Methods: This study was conducted in 4 phases in Iran in 2023. The initial phase or the comparative study was to extract the doamins and sub-domains related to the dental public health studies, types of the research dissemination models, and the list of researchers in this field. The second phase included holding virtual Delphi meetings with researchers to finalize the information collecting checklists including the domains and sub-domains. In a virtual group of about 140 researchers, the domains and their proposed sub-domains were discussed and revisions continued until consensus was reached. In the third phase, the necessary data were collected and entered into the forms. The main source for data collection was google scholar profile. The final phase included the design of the system in the Access program for archiving and classifying information with the ability to search and report. Finally, the frequency and relative frequency of research titles were categorized according to the topic and the university conducting the research and the reports presented in the form of graphs and tables.
Results: Based on the first and second phases of the study, the selected model had 6 domains and 11 sub-domains. Epidemiology with the largest share (35%) was first rank, and the health system (30%) and health promotion (19%) ranked second and third, respectively. Ethics (1%) was at the lowest rank. Universities of Tehran (33%), Isfahan (25%) and Shahid Beheshti (22%) had the most publications in the field of community oral health. In the domian of epidemiology, oral health surveys with 204 articles (74%) and oral health risk factors with 69 articles (26%) were the highest number of published articles.
Conclusion: Some sub-domains of the community oral health filed are not well covered that might interrupt their application to improve the oral health situation in the country.

Background and Aims: Oral health literacy plays an important role in reducing oral health disparities. Evaluation of oral health literacy can be done at individual and population levels. This study was conducted with the aim of investigating oral health literacy among students of Shiraz University of Medical Sciences in 2023. Materials and Methods: This study was descriptive, applied and cross-sectional. The research population included the students of different academic levels of Shiraz University of Medical Sciences, except the final semester students. The sample size was calculated based on the total number of students studying at different levels at Shiraz University of Medical Sciences in the second half of the academic year in 2023 using an appropriate statistical formula. Sampling was done in a stratified-random manner according to faculty, field, and level of education. The oral health literacy of the participants based on education level, age, and gender was measured by the oral health literacy adult questionnaire (OHL Adults Questionnaire: OHL-AQ). Data analysis was done using SPSS 27 software and descriptive statistics (mean, standard deviation, percentage), independent t-test, Kruskal-Wallis, and Tukey test. Results: The findings indicated that the average oral health literacy score of students was 14.75±1.37. Also, there was a statistically significant relationship between the average oral health literacy score of students and the parameters of education level, gender, and age of students (P-value < 0.05). This indictaed that the oral health literacy of students increased in the doctoral level and also with increasing age. In addition, the female students had higher oral health literacy. Conclusion: Based on the results, the oral health literacy among Shiraz medical students was high. People with higher education level and age had higher level of oral and dental health literacy than people with lower education level and age. Oral and dental health literacy level was higher in girls than boys. It can be suggested that a 1) suitable platform be provided in order to improve the level of education of the society, leading to the improvement of the oral health literacy of the people; 2) regular dental examinations in order to increase the oral health literacy of the society is encouraged and promoted, especially in lower year students; and 3) research in effective training in the field of oral health literacy to increase the oral health literacy of people in the society.