Renata Grzic

Background and Objectives: Global research has shown that 60–90% of school children have caries, and that oral health care is of great public health significance. We present the data of an oral health promotion Program conducted in the Primorje-Gorski Kotar County (PGC), Croatia, from 2008 to 2019. The Program includes comprehensive preventive oral status assessments of first- and fifth-grade elementary school students, as well as oral health promotional and preventative activities for preschool children, pregnant women, and new mothers. Here, we aimed to analyze the Program data and determine its applicability and sustainability. Materials and Methods: We assessed the changes in caries prevalence in first- and fifth-grade PGC students by comparing the 2008–2019 dental registry data on decayed, missing, and filled teeth for primary teeth (dmft)/decayed, missing, and filled teeth for permanent teeth (DMFT) index means. We also analyzed the data from the administrative Program reports. Results: We analyzed the dental registry data of 44,422 children in the PGC (21,714 first and 22,708 fifth grade). The average Program response rate was 83%. We noted a dmft/DMFT index decrease from 4.66 to 3.73 (first graders) and from 2.50 to 1.00 (fifth graders). The 2017–2019 dmft was significantly smaller than that of 2008–2009. There were 2336 workshops conducted in kindergartens, 1240 in first grades, and 1015 in fifth grades; health visitors educated 26,559 women. There was an increasing trend in the number of insured people under the age of six using pediatric oral health care. Conclusions: The Program improved the behavior and oral health of children and included various stakeholders, avoided additional financial expenses, increased the number of children in care, and proved its necessity and sustainability. It has been recognized on a national level and has led to the creation of two oral health care programs.

Background and objective: Research shows that 60–90% of school children have caries, representing a serious public health issue. Here, we present a model of oral health promotion that has been conducted in the Primorje-Gorski Kotar County (PGC), Croatia, from 2008 to 2019. We assessed the oral status of first and fifth grade elementary students and determined the sustainability and influence of our model on the status and behavior regarding the children’s oral status. Additionally, during the observed period, promotional and preventative activities aiming to improve oral health were conducted. Since 2014, the Program has begun to be continuously, comprehensively, and systematically introduced into preschools as well. Material and methods: We assessed the number of children with caries by analyzing the changes in the decayed, missing, and filled teeth for primary teeth (dmft)/decayed, missing, and filled teeth for permanent teeth (DMFT) index mean during the observed period. Results: From 2008 to 2019 we assessed 44422 children in the PGC (21714 first grade and 22708 fifth grade students). The average response rate throughout the Program has been 83%. We have noted a dmft/DMFT index decrease from 4,66 to 3,73 (first graders) and from 2,50 to 1,00 (fifth graders). Conclusions: The Program has improved the behavior and oral health of children; stakeholders from various professions have been included, such as health visitors, school medicine teams, and pediatricians, avoiding additional financial expenses, increasing the number of children in care, and proving the sustainability of our oral health improvement model.

Background: Tooth extraction, changing dentition and malocclusion can decrease area of occlusal contact and negatively affect masticatory efficiency. Aim of this study was to evaluate difference in masticatory efficiency in association with previously named factors. Materials and methods: In this cross-sectional study masticatory efficiency parameters (number of particles, mean diameter and mean surface of particles) determined with optical scanning method were compared between children with healthy dentition (12 girls, 12 boys, age 3 to 14) and children with lost antagonistic contacts due to tooth extraction, changing dentition and malocclusions (12 girls, 12 boys, age 3 to 14). Results: Number of chewed particles is significantly higher in a group of children with healthy dentition (p < 0.001), and chewed particles’ mean diameter and surface are significantly higher in the Group 2 (p < 0.001; p < 0.001). Number of lost occlusal contacts is not in correlation with masticatory efficiency parameters (p= 0.464; p= 0.483; p= 0.489). Conclusions: Children with lost antagonistic contacts have an impaired masticatory efficiency in comparison to children with complete dentition, but there is no difference regarding the aetiology of contact loss.

The aim of this cross-sectional research was to investigate how the COVID-19 pandemic affected the activity of dental medicine in the Republic of Croatia in 2020. It included 136 doctors of dental medicine who completed an online survey regarding their personal and professional information; work in dental offices; and level of fear for their own health, the health of others, and financial existence; and their attitude about vaccination. There was a significantly higher decrease in patient visits in dental offices that do not have a contract with public health insurance (70% vs. 37%; p < 0.001) and in dental offices that have a higher percentage of profit from dental tourism (32% vs. 14%; p < 0.001). Fear of financial existence was significantly higher in the group of dentists who do not have a contract with public health insurance (p = 0.0) and is positively correlated with the percentage of profit from dental tourism (r = 0.299; p < 0.001). Dentists with a higher level of fear that they or their loved ones would get infected due to the nature of their job are more likely to get vaccinated (p ≤ 0.007). The decision to get vaccinated and wearing a disposable coat/apron was related to fear when all other parameters were controlled for (R = 0.44; p = 0.037). In conclusion, the COVID-19 pandemic had a minimal impact on the profession of dental medicine in Croatia but represented a larger financial stress for dentists working in dental offices that do not have a contract with public health insurance and have a higher percentage of income from dental tourism.