Oral health assessment in a sample of displaced people as a result of the war in Syria in Damascus city: results of non-profit initiative

Impact of war on oral health: a systematic review

AIM

To systematically review the evidence from published literature about the impact of war on oral health among children and adults.

METHODOLOGY

The electronic search was carried out in the following databases Pubmed, Cochrane, Scopus, Embase, Google Scholar. In vitro studies, cross-sectional, case control studies, and randomized controlled trials conducted during the war time were included. Cross-sectional and case control studies were assessed based on the Newcastle-Ottawa Scale, whereas randomized controlled trials were assessed based on the ROBINS-I tool. In-vitro studies included in this review were assessed using the United States national toxicology program tool.

RESULTS

The search strategy yielded a total of 5126 articles and finally 21 articles were included in the review. The influence of war on oral health was categorized among both the children and adult population. A total of 14 studies were carried out in children whereas the remaining seven studies were carried out in adults. A decrease in dental caries was observed in more war-prone areas due to the limited availability of carbohydrates and sugar. Severe periodontal disease in the adult population, mainly due to less availability of food and diminished oral hygiene habits, was also reported.

CONCLUSIONS

This review underscores the multifaceted impact of war on oral health, revealing a notable prevalence of periodontal problems, craniofacial injuries and varying rates of dental caries across affected populations.

Higher prevalence of dental caries and periodontal problems among refugees: A scoping review

Background

We assessed the prevalence data on oral health diseases, namely dental caries and periodontitis, among refugees and asylum seekers worldwide.

Methods

A systematic search of Scopus, Embase, and PubMed retrieved 1225 records; following title and abstract screening, 58 studies remained for full-text eligibility screening based on pre-defined inclusion criteria. Twenty-six studies were included in the review.

Results

Dental caries and tooth loss due to caries were high in refugee populations, regardless of their age, gender, or nationality. The adult population had a mean decayed, missing, and filled teeth (DMFT) index score of 9.2 (standard deviation (SD) = 2.3); children had a score of 3.1 (SD = 1.1) for deciduous teeth and 2.5 (SD = 1.1) for permanents. Caries prevalence among refugees ranged from 4.6% to 98.7%, and gingivitis from 5.7% to 100%, indicating a high heterogeneity in their oral health. Regarding oral health accessibility, 17% to 72% of refugees had never been to a dentist, showing a very low level of accessibility to dental health services.

Conclusions

Interventions and policies need to be designed to reduce oral health inequalities among refugee populations and asylum seekers, and host countries must implement strategies to increase their access to oral health care. Existing data should be used to set priorities for improving the oral health of refugees.

Registration

Open Science Framework: https://doi.org/10.17605/OSF.IO/SU59K.

Knowledge, perceptions, and behavior regarding children's oral health among Syrian pediatricians: a cross-sectional study

BACKGROUND

Oral health has a direct impact on health-related quality of life (HRQoL). Hence, general health and oral health cannot be separated. Pediatricians play a pivotal role in providing primary care for infants and are the first to interact with them since birth. Therefore, the aim of this study was to evaluate the knowledge, perceptions, and behavior of Syrian pediatricians regarding children's oral health.

METHODS

This was a cross-sectional study. The questionnaire consisted of six main sections and required answers regarding demographic characteristics, knowledge, behavior, perceptions, and training received in oral health. The association between categorical variables was tested with Pearson's chi-square tests and Fishers exact tests using SPSS ver. 23.

RESULTS

The response rate was 43.12% (229/531). Most of the participants (64.02%) got a poor level of knowledge and no significant association was found between knowledge level and years of experience (p = 0.270). The majority of the participants (99.13%) perceived that diet, bacteria, and sugar exposure time are the etiological factors of dental caries. The overwhelming majority of the participants (98.25%) acknowledged the need for further oral health training during residency.

CONCLUSIONS

Most pediatricians reported a poor level of knowledge. It is recommended to update the postgraduate and residency curriculum to equip pediatricians with adequate knowledge regarding children's oral health.

Caries-related and Preventive Dental Care of 5-, 12-, and 15-year-old Syrians in Bursa, Türkiye

Objectives

Türkiye has implemented an open-door policy for Syrians since the beginning of the Syrian crisis in 2011 and has been providing medical and dental services for Syrian asylum seekers. Bursa, being the 5th largest city in the Western region of the Turkish Republic, hosts 1,83,355 registered Syrians. The present study was designed to analyze the caries-related dental services and preventive applications among 5-, 12-, and 15-year-old Syrian patients admitted to a state-affiliated dental hospital in Bursa, Türkiye.

Design

This study comprises retrospective data analysis.

Place and duration of study

The data from 1st January 2016 to 1st September 2021 were derived from the Bursa Oral and Dental Health Training and Research Hospital.

Materials and methods

The dental records of Syrian patients aged 5, 12, and 15 years were reviewed for caries-related (restorations, extractions, and root canal treatments) and preventive applications (fissure sealants and topical fluoridation); others were excluded.

Results

A total of 3,388 dental records of 1,179 Syrian children aged 5 (N = 369), 12 (N = 498), and 15 (N = 312) years were analyzed. The highest percentages of dental services offered to 5-, 12-, and 15-year-old were "tooth extractions" (n = 369; 42.2%), "fissure sealants" (n = 555; 33.7%), and "restorative treatments" (n = 384; 44.4%), respectively (p < 0.001). Considering all years (2016-2021), male subjects [odds ratio (OR)-1.42, 95% confidence interval (CI) 1.09-1.85; p = 0.01] and 12-year-old (OR-1.87, 95% CI 1.31-2.66; p = 0.001) were more likely to visit a dentist more than once per year.

Conclusion

Caries-related dental services, which are an indicator of poor oral health, are common in 5-, 12-, and 15-year-old Syrian patients.

How to cite this article

Elbek Cubukcu C, Celik ZC, Dinc Ata G, et al. Caries-related and Preventive Dental Care of 5-, 12-, and 15-year-old Syrians in Bursa, Türkiye. Int J Clin Pediatr Dent 2023;16(1):64-67.