Evaluation of the predictors of oral health-related quality of life among 3-5-year-old children with dental trauma

This study evaluated the influence of socio-demographic, clinical, and parental psychological factors on oral health-related quality of life (OHRQoL) and determined their predictors in preschool-aged children with traumatic dental injury (TDI). The study sample consisted of 324 dyads of children and their parents attending the Clinics of Pediatric Dentistry at Istanbul University. After clinical examination, the Sense of Coherence (SOC), Generalized Self-Efficacy Scale, Early Childhood Oral Health Impact Scale, and Multidimensional Health Locus of Control Scale-MHLC questionnaires were administered to the parents. The statistical analyses included Spearman correlation coefficients, Mann-Whitney U tests, Kruskal-Wallis tests, multiple linear regression, and confirmatory factor analysis. Having mixed TDI, a non-nuclear family, fewer children, and weak parental SOC were important predictors of worse overall OHRQoL and its sections of child and family. Lower internal health locus of control and dental pain due to TDI were predictors of worse overall OHRQoL and child impact, respectively. Consideration of these predictors may help oral health professionals to develop prevention and treatment programs for TDI and oral health literacy programs for families.

Factors affecting the parental knowledge, beliefs, and attitudes towards pediatric dental X-rays

OBJECTIVES

To investigate the knowledge, beliefs, and attitudes towards pediatric dental radiography and its associated factors among Turkish parents seeking dental care for their children.

MATERIALS AND METHODS

This cross-sectional study enrolled 483 parents of children aged 6-15 years. Data were collected using the questionnaire including socio-demographic characteristics, knowledge, beliefs, and attitudes based on The Health Belief Model and planned behavior theory. Descriptive, bivariate, and multivariate statistics were performed.

RESULTS

More than half of parents had correct knowledge on their rights to access health information, the radiation risk and exposure from dental X-rays, children's vulnerability to radiation, and using lead apron. Most parents (70.4%) perceived dental X-rays as valuable. They had limited knowledge regarding the permanent damage and negative attitudes regarding its safety and goodness. There were positive correlations between knowledge-attitudes, knowledge-perceived benefits, and attitudes-perceived benefits (all p values < 0.01). Having a previous dental X-ray (p = 0.014) and not having parents' information needs (p = 0.007) were associated with higher attitudes. Increasing education levels, having a educational need and higher perceived benefit were found to be predictors of higher parental knowledge.

CONCLUSION

Turkish parents had some knowledge and positive attitudes towards pediatric dental X-rays but not at optimum levels. Parents' education levels, information needs, and beliefs were the most important factors affecting parental knowledge. Attitudes towards radiation safety and goodness should be improved.

CLINICAL RELEVANCE

These findings may provide useful insight to clinicians when developing theory-driven health education interventions on pediatric dental X-rays and identifiying the parents with low knowledge.

Association of socio-demographic, behavioral, and comorbidity-related factors with severity of periodontitis in Turkish patients

Objective: To assess the prevalence of comorbidities and periodontal diseases severity in dental patients and to determine the socio-demographic, behavioral, and comorbidity-related predictors of periodontal diseases severity.Material and methods: This retrospective study sample consisted of 2458 patients who referred to faculty dentistry clinic. Socio-demographic, behavioral, and comorbidity characteristics of study participants were collected using hospital database and self-reported questionnaire. Descriptive, bivariate, and multivariate analyses were used to analyze study data.Results: Of these patients, 55.2% had mild-to-moderate periodontitis and 44.8% had severe periodontitis. The severity of periodontal disease was significantly associated with the presence of comorbidity, the number of comorbidities, age, gender, income level, smoking, and alcohol consumption. Patients with severe periodontitis were more likely being a current smoker, to report drinking alcohol sometimes or every day, to be a male, to have a pulmonary disease, to have an endocrinological and metabolic disorder, to have a cardiovascular disorder and to have a neurological disorder than those with mild/moderate periodontitis. Having a hematological disorder, having a muscle, skeletal and connective tissue disorder, to be a current smoker and lower age were found to be predictors of moderate periodontitis whereas being a female and lower number of comorbidities were predictors of mild periodontitis.Conclusions: The severity of periodontitis was associated with socio-demographic, behavioral, and comorbidity characteristics of periodontal patients.

Psychometric evaluation of the child oral impacts on daily performances (C-OIDP) for use in Turkish primary school children: a cross sectional validation study

BACKGROUND

As patient-reported outcome, the Child Oral Impacts on Daily Performances (C-OIDP) has been commonly used for assessing children's oral health needs in order to facilitate oral health service planning. It was translated and cross-culturally adapted into Turkish in 2008. Since then, there is no study to assess its psychometric properties in Turkish child population. This cross-sectional study aimed to investigate the psychometric properties and factor structure of the Turkish version of the C-OIDP for use in Turkish primary school children.

METHODS

The Turkish translated version was tested on a convenience sample of primary school children aged 11 to 12 years attending two public schools in Istanbul. Data were collected by clinical examinations, face-to-face interviews and self-completed questionnaires. The internal consistency, test-retest reliability, construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), criterion related validity (concurrent and discriminant) were evaluated.

RESULTS

A total of 208 children were subjected to the tested the C-OIDP. Overall, 93.7% of them reported at least one oral impact in the last 3 months. The most frequently affected performances were "eating" (72.1%) and "cleaning mouth", while the performance with the lowest impact was "studying" (13%). The internal consistency and reproducibility of the C-OIDP were acceptable, with a Cronbach's alpha of 0.73 and an intra-class correlation coefficient of 0.83. The EFA yielded a two-factor model termed "functional limitation" and "psychosocial limitation". CFA identified the two- factor model which fit the data better than the previously proposed three-factor model, namely physical, psychological and social health. Having malocclusion, the presence of gum disease, reported history of oral problems in the mouth, dissatisfaction with oral health, bad self-rated oral health and having a problem-oriented pattern of dental attendance were found to be the most important factors related to worse oral health- related quality of life, supporting its criterion-related validity.

CONCLUSION

This study provided preliminary evidence the psychometric properties of the C-OIDP index among Turkish school children aged 11-12 years. It may be applied to evaluate the oral health impact on quality of life in this population.

Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world

Background

The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow‐up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL).

Methods

Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias.

Results

There were 2136 patients with a median total number of PCI items selected of 5 (2‐10). “Fear of the cancer returning” (39%) and “dry mouth” (37%) were most common. Twenty‐five percent (524) reported less than good QOL.

Conclusion

There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case‐mix variables. There was a strong progressive association between the number of PCI items and QOL.

Relationship between healthy lifestyle behaviors and health related quality of life in turkish school-going adolescents

Background

The aim of this study is to determine the relationship between healthy lifestyles behaviours and health-related quality of life (HRQOL) among Turkish school-going adolescents.

Subjects and Methods

This cross-sectional study was conducted among 413 students studying in a secondary school of Istanbul, Turkey. Data were collected using a questionnaire containing socio-demographic characteristics, health promoting lifestyle behaviors and the Turkish generic health-related quality of life questionnaire for children (Kid-KINDL). Data were analyzed using descriptive statistics, t-test, Pearson's product-moment correlation, and a hierarchical multiple regression analysis.

Results

Univariate statistics showed that gender, school grade, parental education level, monthly income, and all healthy lifestyles behaviours except for fruit and vegetable intake were associated with adolescents' HRQOL. Multivariate statistics indicated that participation in social activities and talking about their problems were the most important predictors of better HRQOL. Healthy lifestyles behaviours, especially talking about their problems to close friends and/or family members and participation in leisure-time social activity were related to better HRQOL of Turkish adolescents, independently of socio-demographic factors.

Conclusion

Collaborative efforts among providers of school health and counseling services are urgently needed to improve all aspects of adolescent health.

Predictors of obturator functioning and satisfaction in Turkish patients using an obturator prosthesis after maxillectomy

OBJECTIVE

The aim of this study was to determine the sociodemographic, behavioral, and clinical factors affecting obturator function and satisfaction using the obturator functioning scale (OFS) in maxillectomy patients rehabilitated with obturator prostheses.

STUDY DESIGN

The study sample consisted of 41 maxillectomy patients. The OFS was translated into Turkish and adapted for assessing obturator functioning and patient satisfaction among Turkish patients. Data were collected from patients' medical records and self-completed questionnaires, including the Turkish version of the OFS, sociodemographic and behavioral characteristics. Descriptive statistics, Mann-Whitney U test, Spearman's correlation coefficient, and backward stepwise multiple linear regression were used for data analysis.

RESULTS

Internal consistency (Cronbach's alpha = 0.85) and test-retest reliability (intraclass correlation coefficient = 0.86) were acceptable for the OFS. The most frequently reported problem was "difficulty chewing." Bivariate analysis revealed significant differences in total OFS scores in terms of surgery type, defect size, and education level, except for the other clinical and sociodemographic characteristics and behavioral factors. Education level and surgery type were found to be the most important predictors of patient satisfaction and functioning of the obturator.

CONCLUSIONS

The Turkish version of the OFS might be a useful tool for clinicians to identify patients who are at risk for poor functioning of the obturator, lack of satisfaction, and unmet needs.

Reliability and validity of the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30)

OBJECTIVE

To culturally adapt the Turkish version of Rapid Estimate of Adult Literacy in Dentistry (TREALD-30) for Turkish-speaking adult dental patients and to evaluate its psychometric properties.

MATERIAL AND METHODS

After translation and cross-cultural adaptation, TREALD-30 was tested in a sample of 127 adult patients who attended a dental school clinic in Istanbul. Data were collected through clinical examinations and self-completed questionnaires, including TREALD-30, the Oral Health Impact Profile (OHIP), the Rapid Estimate of Adult Literacy in Medicine (REALM), two health literacy screening questions, and socio-behavioral characteristics. Psychometric properties were examined using Classical Test Theory (CTT) and Rasch analysis.

RESULTS

Internal consistency (Cronbach's Alpha = 0.91) and test-retest reliability (Intraclass correlation coefficient = 0.99) were satisfactory for TREALD-30. It exhibited good convergent and predictive validity. Monthly family income, years of education, dental flossing, health literacy, and health literacy skills were found as stronger predictors of patients'oral health literacy (OHL). Confirmatory factor analysis (CFA) confirmed a two-factor model. The Rasch model explained 37.9% of the total variance in this dataset. In addition, TREALD-30 had eleven misfitting items, which indicated evidence of multidimensionality. The reliability indeces provided in Rasch analysis (person separation reliability = 0.91 and expected-a-posteriori/plausible reliability = 0.94) indicated that TREALD-30 had acceptable reliability.

CONCLUSION

TREALD-30 showed satisfactory psychometric properties. It may be used to identify patients with low OHL. Socio-demographic factors, oral health behaviors and health literacy skills should be taken into account when planning future studies to assess the OHL in both clinical and community settings.

Soft Tissue Response and Survival of Extraoral Implants: A Long-Term Follow-up

Maxillofacial defects may be reconstructed by plastic surgery or treated by prosthetic mean rehabilitation. In case of large defects, prosthetic rehabilitation rather than surgical reconstruction is preferred due to the insufficient esthetic results of surgical interventions. However, retention of the craniofacial prosthesis is a great problem despite the satisfactory esthetic results. With the presentation of extraoral implants, the retention of maxillofacial prostheses was improved, and osseointegrated craniofacial implants have become indispensable for retention and stability. However, there are conflicting results regarding the success rates of osseointegrated implants used at the craniofacial region. A total of 24 patients with 64 implants (30 in auricular region of 13 patients, 24 in nasal region of 8 patients, and 10 in orbital region of 3 patients) ranging in age from 16 to 83 years (mean age = 45.45 years) were evaluated. One patient among 13 patients (1/13) has lost his implants in the auricular area, 1 patient among 8 patients (1/8) lost his implants, and 1 patient among 3 patients (1/3) has lost all of her implants. Peri-implant soft tissue response was evaluated for a 60-month period and a total of 654 visits/sites recorded. Grade 0 (no irritation) was present in 72.8% (476/654) of the visits/sites. Grade 1 (slight redness) was observed for 18.8% (123/654). Grade 2 (red and slightly moist tissue) was scored in 6.9% (45/654). Grade 3 (red and slightly moist tissue with granulation) was noted in 1.5% (10/654) and grade 4 (infection) could not be found. Ossseointegrated implants provide reasonable support and show successful results when used with maxillofacial prostheses.

Comparison between dexmedetomidine and remifentanil infusion in emergence agitation during recovery after nasal surgery: A randomized double-blind trial

BACKGROUND

Postoperative emergency agitation (EA) is a common problem. Dexmedetomidine and remifentanil may be used to prevent this problem. Our primary aim was to compare dexmedetomidine, remifentanil, and placebo with respect to their effectiveness in preventing postoperative EA.

MATERIAL AND METHODS

Ninety patients undergoing nasal surgery were randomized into three groups. The dexmedetomidine group (group D, n = 30) received dexmedetomidine infusion at a rate of 0.4 μg kg(-1 ) h(-1); the remifentanil group (group R, n = 30) received remifentanil infusion at a rate of 0.05 μg kg(-1) min(-1) from induction of anesthesia until extubation; and the control group (group S, n = 30) received a volume-matched normal saline infusion as a placebo. Propofol (1.5-2 mg kg(-1)) and fentanyl (1 μg kg(-1)) were used to initiate anesthesia, and desflurane was used to maintain anesthesia. The incidence of agitation, hemodynamic parameters, and recovery characteristics were evaluated during emergence.

RESULTS

The incidence of EA was significantly higher in group S (46.7%) compared with groups R and D (3.3 and 20%, respectively; p < 0.001). The lowest incidence of EA was detected in group R (p = 0.046). Residual sedation in the post-anesthesia care unit (PACU) was similar in all groups (p = 0.947). The incidence of nausea or vomiting was significantly lower in group D than in groups R and S (p = 0.043). Administration of analgesics in the PACU was higher in group R than in groups S and D (p = 0.015).

CONCLUSION

Anesthetic maintenance with either remifentanil or dexmedetomidine infusion until extubation provided a more smooth and hemodynamically stable emergence, without complications after nasal surgery. While remifentanil was superior to dexmedetomidine with regard to avoiding EA, dexmedetomidine was more effective than remifentanil regarding vomiting and pain.

Validation of the Turkish version of the Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) in prosthetically rehabilitated patients with head and neck cancer

BACKGROUND

The Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) is a measure assessing the impact of oral rehabilitation on patients' health-related quality of life (HRQOL).The aims of the study were to adapt culturally the LORQv3 for Turkish-speaking head and neck cancer patients who had undergone prosthetic rehabilitation and to undertake an initial investigation of its psychometric properties.

METHODS

The Turkish version of the LORQv3 was translated and culturally adapted into Turkish, and tested on a sample of 46 head and neck cancer patients who had undergone prosthetic rehabilitation at a university clinic. Patients were categorized into three groups: Patients with maxillary obturator prostheses treated by surgery alone (n = 15); Patients with maxillary obturator prostheses treated by surgery plus radiotherapy, with or without chemotherapy (n = 23); and, Nasopharyngeal cancer patients without maxillary defects wearing conventional dental prostheses who had been treated by radiotherapy with or without chemotherapy (n = 8). Data were collected through clinical examinations and self-reported questionnaires, including socio-demographic characteristics, the LORQv3, and the University of Washington Quality of Life questionnaire version 4 (UW-QOLv4). The psychometric evaluation included validity (content, face, construct, and criterion) and reliability (internal consistency and test-retest).

RESULTS

All sections of the LORQv3 showed satisfactory internal consistency, with Cronbach's alpha between 0.71 to 0.82. Kappa statistics showed moderate to perfect test-retest reliability for the 33 LORQv3 items. We found significant negative correlations between the LORQv3 and the UW-QOL v4 for some related items. The LORQv3 also identified differences in responses among patient groups, supporting its construct and criterion validity.

CONCLUSIONS

This study provides initial evidence in support of the validity and reliability of the Turkish version of LORQv3 in prosthetically rehabilitated patients with head and neck cancer; it could be used in clinical practice in Turkey.

Identifying potential predictors of pain-related disability in Turkish patients with chronic temporomandibular disorder pain

Background

The aims of this study were to examine whether patients’ psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6 months in duration.

Methods

The Research Diagnostic Criteria of TMD (RDC/TMD) data for Axis I and II were obtained for 104 consecutive patients seeking treatment.

Data were analyzed using descriptive statistics, t-test, Mann–Whitney U-test, chi-square test, One-way ANOVA, Kruskal-Wallis test, and binary multiple logistic regression tests. Patients were classified into two groups according to Graded Chronic Pain Scale scores: Grade III and IV were scored for patients with high levels of pain-related disability, whereas Grade I and II were scored for patients with low disability.

Results

Muscle and joint pain were found in 64.9% and 31.8% of the patients, respectively, and 27.3% of the patients suffered from both muscle and joint pain.

Psychosocial disability was found in 26% of patients. There were no statistically significant differences among the diagnostic subgroups with regards to the demographic, behavioral, psychological, and psychosocial characteristics. Patients with high levels of pain-related disability had significantly higher depression, somatization, pain intensity and jaw disability scores than those with low levels of pain-related disability.

Patients with high levels of pain-related disability were more likely to have higher pain intensity, to report higher somatization symptoms and functional impairment, and were less likely to have joint pain than those with low levels of pain related disability.

Conclusion

In conclusion, the Turkish version RDC/TMD, based on a dual axis system, may be used to screen chronic TMD patients at high-risk for pain-related disability who need comprehensive care treatment program.

Assessment of health-related quality of life in Turkish patients with facial prostheses

Background

Facial prostheses are intended to provide a non-operative rehabilitation for patients with acquired facial defects. By improving aesthetics and quality of life (QOL), this treatment involves reintegration of the patient into family and social life. The aim of this study was to evaluate the perception of QOL in adult patients with facial prostheses and to compare this perception with that of a control group.

Methods

The study participants consisted of 72 patients, who were divided into three equal-sized groups according to the type of prosthesis (OP- orbital prosthesis, AP- auricular prosthesis, NP - nasal prosthesis) and 24 healthy control participants without any congenital or acquired deformity of face or body. Clinical and socio-demographic data were gathered from each person’s medical chart. Participants completed the Turkish version of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF). Descriptive statistics, independent sample t-tests, Pearson's chi-square test, ANOVA, ANCOVA, and Pearson correlation were used to analyse the data.

Results

Compared with the control participants, patients with NP scored lower on the all domains of QOL and all three patient groups had lower scores on overall QOL and its domains of physical and environmental health. Patients with OP reported significantly lower physical health scores than those with AP, while patients with NP reported significantly lower overall QOL and psychological health scores than those with AP. Female patients had lower environmental domain scores than did male patients. The patient’s age and income correlated with social relationships QOL, while the patient’s income and the age of facial prosthesis were correlated with environmental QOL.

Conclusion

Patients with facial prostheses had lower scores in overall QOL, physical and environmental health domains than the control participants. Socio-demographic and clinical characteristics such as age, gender, income, localization of the defect, and age of facial prosthesis were associated with patients’ QOL. These findings may provide valuable information about the specific health needs of these patients that may affect their well-being. Further studies are needed to confirm these results. Use of the WHOQOL-BREF may provide valuable information for determining patients’ needs and priorities as well as for planning and developing comprehensive prosthetic rehabilitation programs.

Factors related to sense of coherence among dental students at Istanbul University

The salutogenic model suggests that generalized resistance resources (GRRs) promote the development and maintenance of a strong sense of coherence (SOC), which is a health-promoting factor. This study examined associations between GRRs (sociodemographic characteristics, social support, stress, health practices, and self-rated health) and a strong SOC among dental students at Istanbul University. Data were collected from a convenience sample of 566 students using questionnaires including a sociodemographic section, the SOC scale, the Perceived Stress Scale, the Multidimensional Scale of Perceived Social Support, self-rated health, and health practices. Data were analyzed using descriptive statistics, t-test, chi-square test, and binary multiple logistic regression. Students were classified into a low or strong SOC group by a median split procedure, based on their total score on the SOC scale (median=56, range=22 to 91). Univariate statistics showed that students with a strong SOC reported lower stress levels, higher social support levels, better self-rated health, brushing their teeth more frequently, lower sugar intake between meals, and less frequent smoking than students with a low SOC. Multivariate statistics indicated that being a nonsmoker and having better self-rated health, higher social support levels, lower stress levels, and lower sugar intake between meals were the most important predictors of strong SOC. Taking into account the factors that reinforce a strong SOC may help dental educators develop health promotion programs and create supportive environments for maintaining dental students' health.

Cross - cultural adaptation and preliminary validation of the Turkish version of the early childhood oral health impact scale among 5-6-year-old children

Background

In Turkey, formal pre-primary education for children 5- 6 years old provides the ideal setting for school-based oral health promotion programs and oral health care services. To develop effective oral health promotion programs, there is a need to assess this target group's subjective oral health needs as well as clinical needs. The Early Childhood Oral Health Impact Scale (ECOHIS) is a well-known instrument for assessing oral health quality of life in children aged 0-5 years old and their families. This study aimed to adapt the ECOHIS for children 5-6 years old in a Turkish-speaking community and to undertake a preliminary investigation of its psychometric properties.

Methods

The Turkish version of the ECOHIS was obtained with forward/backward translations, expert panels and pre-testing and it was tested in a convenience sample of 121 parents of 5- 6 year-old children attending nursery classes of three public schools. Data were collected through clinical examinations and self-completed questionnaires. The main analyses were carried out on the imputed data set. The validity of content, face, construct, discriminant and convergent and as well as the reliability of internal and test-retest of the ECOHIS were evaluated. Sensitivity analysis was performed to examine the effect of the complete case analysis for managing "Don't know" responses on the validity and reliability of the ECOHIS.

Results

The analysis of the imputed data set showed that Cronbach's alphas for the child and family sections were 0.92 and 0.84 respectively, and for the whole scale was 0.93. The intraclass correlation coefficient for test-retest was 0.86. The scale scores on the child and parent sections indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health, high caries experience, higher gingival index scores and problem-orientated dental attendance, supporting its construct, convergent and discriminant validity. Sensitivity analysis showed that the mean imputation method and the complete case analysis did not have differing effects on the validity and reliability of the ECOHIS.

Conclusions

This study provided preliminary evidence concerning validity and reliability of the Turkish version of the scale among 5-6-year-old children. Future studies should be conducted on the ECOHIS to evaluate fully its psychometric properties in both community- based and clinically-based studies among parents of children younger than five. This study provides initial evidence that the ECOHIS aimed at children aged 0-5 years may be a useful tool for assessing the oral health quality of life in 6 year - old preschool children.

Predictors of health-promoting behaviors among freshman dental students at Istanbul University

The aim of this cross-sectional study was to determine the predictors of health-promoting behaviors among freshman dental students at Istanbul University. Data were collected from a convenience sample of 111 students using questionnaires including a sociodemographic section, the Health-Promoting Lifestyle Profile II, the Health Value Scale, the Generalized Self-Efficacy Scale, the Perceived Stress Scale, and the Multidimensional Scale of Perceived Social Support. Data were analyzed using descriptive statistics, t-test, Pearson's correlation, and stepwise multiple linear regression. The overall health-promoting lifestyle behaviors among these students were at a moderate level, indicating that they engaged in health-promoting behaviors sometimes to often. They scored highest on the spiritual growth but lower on the health responsibility subscales. Females reported having engaged more in health responsibility behaviors and lower in physical activity than did males. Students from high-income families reported more physical activity. Significant correlations were found between overall health-promoting lifestyle behaviors, self-efficacy, health value, stress, and social support. Among all the related factors, self-efficacy was the most strongly predictive factor: it explained 61 percent of the variance in overall health-promoting behaviors. Thus, self-efficacy as a cognitive-perceptual factor should be considered by dental educators when planning educational interventions to promote students' healthy lifestyle.

Oral health: locus of control, health behavior, self-rated oral health and socio-demographic factors in Istanbul adults

OBJECTIVES

To determine oral health control beliefs of Istanbul adults using the Multidimensional Oral Health Locus of Control Scale (MOHLCS) after confirming its factorial validity and to examine the relationships between these beliefs, self-rated oral health, oral health behaviors and socio-demographic factors.

MATERIAL AND METHODS

The MOHLCS was administered to a sample of 1200 subjects aged ≥18 years in Istanbul chosen using a quota-sampling method (response 88%). The relationship between the MOHLCS and oral health behaviors, self-rated oral health and socio-demographic factors was assessed after confirming the factorial validity of the MOHLCS.

RESULTS

The MOHLCS demonstrated satisfactory internal reliability. Factor analysis results showed a new four-factor solution, namely Internal, Dentist, Chance, and Socialization agents. Multivariate analysis showed that female gender, younger age, higher socioeconomic status, more frequent daily toothbrushing, and regular dental check-ups were associated with higher Internal beliefs, while older age, lower educational level, lower socioeconomic status, low toothbrushing frequency, and symptom-orientated dental attendance were associated with higher Chance beliefs. Being unmarried and low toothbrushing frequency were associated with lower Dentist beliefs. Males and older subjects had lower Socialization agents beliefs. Internal, Dentist and Chance beliefs were significantly associated with self-rated oral health.

CONCLUSIONS

Compared with the original factor structure, the new factor structure had better goodness of fit for this sample. Self-rated oral health, socio-demographic factors, and oral health behaviors were significantly associated with oral health control beliefs. These beliefs may be useful for planning oral health promotion programs and for formulating advice given by oral health professionals about their patients' oral health behaviors.

Dental training and changes in oral health attitudes and behaviors in Istanbul dental students

The aim of this study was to examine the changes that occur in the oral health attitudes and behaviors of dental students in Istanbul, Turkey, during their dental education. The Turkish version of the Hiroshima University-Dental Behavioral Inventory (HU-DBI) was distributed among 757 dental students at the Dental Faculty, Istanbul University. The response rate was 72 percent. Chi-square and logistic regression models were used for statistical analysis. The mean HU-DBI score of the clinical students was significantly higher than that of the preclinical students. Preclinical students significantly more often believed that it was impossible to prevent gum disease with toothbrushing alone and worried about the color of their teeth and bad breath. Most of them brushed their teeth with strong strokes, thought the condition of their teeth was getting worse despite daily toothbrushing, and would seek dental care only when symptoms arise. Clinical students more often used disclosing solutions to see how clean their teeth were and complained of bleeding gums. The variation in favorable oral health attitudes/behaviors appeared to reflect the students' educational training experience. The findings of this study highlight the relatively poor oral health behaviors of Turkish dental students, which should be improved by means of comprehensive programs that aim to promote their own dental hygiene practices and preventive oral health knowledge from the start of dental training.

Spontaneous rupture of hepatocellular carcinoma: a case report and review of literature

Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive haemorrhage. A 64-year-old man presented with sudden, severe epigastric pain for 6 h. Systolic blood pressure was 80/50 mmHg, and pulse rate was 100/min. The patient's history did not reveal any operation or disease up to date. Contrast enhancement-axial computed tomography (CT) scan showed a tumoral lesion with a necrotic centre measuring 6 x 5 cm within 6th segment of the liver and a fluid collection (haemoperitoneum) at the periphery of the liver. At exploratory laparotomy, the liver was found to be cirrhotic, and an actively bleeding tumour confirmed in 6th segment of the liver. The tumour was resected. Post-operative recovery was unremarkable, and the patient was discharged on the 14th post-operative day. Ruptured HCC should be included in the differential diagnosis of non-traumatic intra-abdominal haemorrhage.

Acinic cell carcinoma originating in the nasal septum

Acinic cell carcinoma represents approximately 2.5% to 4% of all salivary gland tumors and 13% of all malignant parotid tumors. The nasal septum is a rare site of an acinic cell carcinoma. We have treated such a tumor in a 47-year old man who had been asymptomatic for the past 1.5 year. This is the second reported case of acinic cell carcinoma at the nasal septum.