Year 2025,
Volume: 52 Issue: 2, 63 - 70, 31.08.2025
Eser Rengin Nalbantoglu
,
Şule Kavaloğlu Çıldır
,
Nüket Sandallı
References
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Petersen PE, Baez RJ, Ogawa H. Global application of oral disease prevention and health promotion as measured 10 years after the 2007 World Health Assembly statement on oral health. Community Dent Oral Epidemiol. 2020;48(4):338–348. doi:10.1111/cdoe.12538.
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Fraihat N, Madae’en S, Bencze Z, Herczeg A, Varga O. Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019;16(15). doi:10.3390/ijerph16152668.
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Gökalp SG, Doğan BG, Tekçiçek MT, Berberoğlu A, Unlüer S. National survey of oral health status of children and adults in Turkey. Community Dent Health. 2010;27(1):12–7. doi:10.1922/CDH_2365Gökalp06.
-
Orhan AI, Alkan A, Orhan K, Tezel A, Karaoglanoglu S, Oztas D. Dental caries and associated factors among Turkish children and adults: Findings from the 3rd National Oral Health Survey. Community Dent Oral Epidemiol. 2024;52(4):499–508. doi:10.1111/cdoe.12943.
-
Schwendicke F, Dörfer CE, Schlattmann P, Foster Page L, Thomson WM, Paris S. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res. 2015;94(1):10–8. doi:10.1177/0022034514557546.
-
Engelmann JL, Tomazoni F, Oliveira MD, Ardenghi TM. Association between Dental Caries and Socioeconomic Factors in Schoolchildren–A Multilevel Analysis. Braz Dent J. 2016;27(1):72–8. doi:10.1590/0103-6440201600435.
-
Piovesan C, Mendes FM, Antunes JL, Ardenghi TM. Inequalities in the distribution of dental caries among 12-year-old Brazilian schoolchildren. Braz Oral Res. 2011;25(1):69–75. doi:10.1590/s1806-83242011000100012.
-
Chung SY, Chung SY, Hwang YH, Kim EK, Choi YH, Song KB. Socioeconomic inequalities in dental behaviors among Korean adults. Dental and Medical Problems. 2017;54(3):235–240. doi:10.17219/dmp/76082.
-
Amudha S, Moses J, Vijayakumar M, Shankar P. Prevalence of Dental Caries among Different Socioeconomic Status and their Treatment Needs among 5-15-year-old School-going Children in Maduravoyal Area, Chennai. Int J Clin Pediatr Dent. 2021;14(3):403–411. doi:10.5005/jp-journals-10005-1963.
-
Nilima T, Rutuja W, Pramod Bane S. Evaluation of co-relation between maternal behavior characteristics and early childhood caries in children of Wardha District. J Pharm Res Int. 2021;33(47A):245–253. doi:10.9734/jpri/2021/v33i47A33010.
-
Ramakrishnan M, Banu S, Ningthoujam S, Samuel VA. Evaluation of knowledge and attitude of parents about the importance of maintaining primary dentition-A cross-sectional study. J Fam Med Prim Care. 2019;8(2):414–418. doi:10.4103/jfmpc.jfmpc_371_18.
-
Rughani R, Ondhia A. They’re not ‘just baby teeth’. Bdj Team. 2023;10(1):10–13. doi:10.1038/s41407-023-1709-5.
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Clark MB, Keels MA, Slayton RL. Fluoride Use in Caries Prevention in the Primary Care Setting. Pediatrics. 2020;146(6). doi:10.1542/peds.2020-034637.
-
Beil H, Rozier RG, Preisser JS, Stearns SC, Lee JY. Effects of early dental office visits on dental caries experience. American Journal of Public Health. 2014;104(10):1979–1985. doi:10.2105/AJPH.2013.301325.
-
Brusius CD, Alves LS, Maltz M. Association between toothbrushing frequency and dental caries and tooth loss in adolescents: a cohort study. Braz Oral Res. 2023;37:e127. doi:10.1590/1807-3107bor-2023.vol37.0127.
-
Hamilton K, Cornish S, Kirkpatrick A, Kroon J, Schwarzer R. Parental supervision for their children’s toothbrushing: Mediating effects of planning, self-efficacy, and action control. Br J Health Psychol. 2018;23(2):387–406. doi:10.1111/bjhp.12294.
-
Khodke S, Naik S, Agarwal N. Infant Dietary Pattern and its Association with Early Childhood Caries in Preschool Children: A Cross-sectional Study. Int J Clin Pediatr Dent. 2023;16(3):421–425. doi:10.5005/jp-journals-10005-2356.
-
Mohd Khairuddin AN, Bogale B, Kang J, Gallagher JE. Impact of dental visiting patterns on oral health: A systematic review of longitudinal studies. BDJ Open. 2024;10(1):18. doi:10.1038/s41405-024-00195-7.
-
Soofi M, Pasdar Y, Karami Matin B, Hamzeh B, Rezaei S, Kazemi Karyani A, et al. Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study. BMC Oral Health. 2020;20(1):63. doi:10.1186/s12903-020-1036-6.
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Al Agili DE, Bhayat A, Farghaly M. Oral health knowledge and behavior among male Saudi schoolchildren. Saudi Dent J. 2012;24(4):195–200. doi:10.1016/j.sdentj.2012.07.002.
-
Vanagas G, Milasauskiene Z, Grabauskas V, Mickeviciene A. Associations between parental skills and their attitudes toward importance to develop good oral hygiene skills in their children. Medicina (Kaunas). 2009;45(9):718–23. doi:10.3390/medicina45090094.
-
Pieper K, Dressler S, Heinzel-Gutenbrunner M, Neuhauser A, Krecker M, Wunderlich K, et al. The influence of social status on pre-school children’s eating habits, caries experience and caries prevention behavior. Int J Public Health. 2012;57(1):207–15. doi:10.1007/s00038-011-0308-x.
-
Akyildiz M, Olmez S, Gungor O, Sonmez IS. Evaluation of caries experience, oral hygiene status, and parental attitudes in autistic children. Niger J Clin Pract. 2022;25(12):1652–1659. doi:10.4103/njcp.njcp_2053_21.
-
Saied-Moallemi Z, Virtanen JI, Ghofranipour F, Murtomaa H. Influence of mothers’ oral health knowledge and attitudes on their children’s dental health. Eur Arch Paediatr Dent. 2008;9(2):79–83. doi:10.1007/bf03262612.
-
Chou R, Cantor A, Zakher B, Mitchell JP, Pappas M. Preventing dental caries in children <5 years: systematic review updating USPSTF recommendation. Pediatrics. 2013;132(2):332–50. doi:10.1542/peds.2013-1465.
-
Kay E, Locker D. Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol. 1996;24(4):231–5. doi:10.1111/j.1600-0528.1996.tb00850.x.
-
Kay EJ, Locker D. A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dent Health. 1998;15(3):132–44.
-
Naidu R, Nunn J, Irwin JD. The effect of motivational interviewing on oral healthcare knowledge, attitudes and behaviour of parents and caregivers of preschool children: an exploratory cluster randomised controlled study. BMC Oral Health. 2015;15:101. doi:10.1186/s12903-015-0088-1.
-
Gao X, Lo EC, Kot SC, Chan KC. Motivational interviewing in improving oral health: a systematic review of randomized controlled trials. J Periodont Res. 2014;49(5):550–9. doi:10.1111/jre.12126.
-
Colvara BC, Faustino-Silva DD, Meyer E, Hugo FN, Hilgert JB, Padilha DMP. Motivational Interviewing in preventing early childhood caries in primary healthcare: A community-based randomized cluster trial. J Pediatr. 2018;201:190–195.e1. doi:10.1016/j.jpeds.2018.05.045.
-
Harrison R, Benton T, Everson-Stewart S, Weinstein P. Effect of motivational interviewing on rates of early childhood caries: a randomized trial. Pediatr Dent. 2007;29(1):16–22.
-
Weinstein P, Harrison R, Benton T. Motivating parents to prevent caries in their young children: One-year findings. J Am Dent Assoc. 2004;135(6):731–8. doi:10.14219/jada.archive.2004.0297.
-
Ismail AI, Ondersma S, Jedele JM, Little RJ, Lepkowski JM. Evaluation of a web-based parent education program to prevent early childhood caries. Community Dent Oral Epidemiol. 2011;39(5): 381–96. doi:10.1111/j.1600-0528.2010.00607.x.
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Ismail AI, Pitts NB, Tellez M, et al. The International Caries Classification and Management System (ICCMS™) An Example of a Caries Management Pathway. BMC Oral Health. 2015;15 Suppl 1(Suppl 1):S9. doi:10.1186/1472-6831-15-S1-S9.
-
Pitts NB, Ekstrand KR, ICDAS Foundation. International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS) – methods for staging of the caries process and enabling dentists to manage caries. Community Dent Oral Epidemiol. 2013;41(1):e41–52. doi:10.1111/cdoe.12025.
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Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal intervention dentistry for managing dental caries – a review: report of a FDI task group. Int Dent J. 2012;62(5):223–43. doi:10.1111/idj.12007.
-
Splieth CH, Banerjee A, Bottenberg P, Breschi L, Campus G, Ekstrand KR, et al. How to intervene in the caries process in children: A Joint ORCA and EFCD Expert Delphi Consensus Statement. Caries Res. 2020;54(4):297–305. doi:10.1159/000507692.
-
Mejàre I, Axelsson S, Dahlén G, Espelid I, Norlund A, Tranæus S, et al. Caries risk assessment. A systematic review. Acta Odontol Scand. 2014;72(2):81–91. doi:10.3109/00016357.2013.822548.
-
Tellez M, Gomez J, Pretty I, Ellwood R, Ismail AI. Evidence on existing caries risk assessment systems: are they predictive of future caries? Community Dent Oral Epidemiol. 2013;41(1):67–78. doi:10.1111/cdoe.12003.
-
American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent. 2016;38(6):52–4.
-
American Academy of Pediatric Dentistry. Policy on Dietary Recommendations for Infants, Children, and Adolescents. Pediatr Dent. 2016;38(6):57–8.
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American Academy of Pediatric Dentistry. Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. Pediatr Dent. 2018;40(6):60–2.
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American Academy of Pediatric Dentistry. Policy on dietary recommendations for infants, children, and adolescents. Pediatr Dent. 2018;40(6):64–6.
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American Academy of Pediatric Dentistry. Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. Pediatr Dent. 2021;43(6):49–51.
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Dental Caries and Oral Health Practices in Children of High-Income Families from Central Areas in Non-Fluoridated Istanbul, Türkiye
Year 2025,
Volume: 52 Issue: 2, 63 - 70, 31.08.2025
Eser Rengin Nalbantoglu
,
Şule Kavaloğlu Çıldır
,
Nüket Sandallı
Abstract
OBJECTIVES: This study aimed to determine the prevalence of dental caries and assess oral health practices among children from affluent families in central Istanbul without community water fluoridation. The associations between parental education and fluoride supplementation with caries occurrence were also assessed.
METHODS: A cross-sectional study was conducted with 350 children aged 6–11 years enrolled in a private school representative of high socioeconomic status in Istanbul. Oral examinations followed WHO criteria and were performed by two calibrated examiners (Kappa>0.7). Questionnaires regarding fluoride exposure, toothbrushing frequency, dental visits, and parental education were completed by 250 parents (71.4% response rate). Data analysis included chi-square and independent samples t-tests (p<0.05).
RESULTS: Dental caries prevalence was 75.1%; only 24.9% of children were caries-free. Mean dft and dfs scores were 2.37 ± 2.47 and 3.97 ± 4.93; DMFT and DMFS scores were 1.54 ± 1.79 and 2.03 ± 2.71, respectively. The mean total caries experience was 3.91 (95% CI: 3.58–4.24). Fluoride supplementation was reported by 24.4% of parents until age 3, 4.4% until age 6, and 57.6% never supplemented; no significant link was found between supplementation and caries (p>0.05). Regular toothbrushing (≥2 times/day), routine dental visits, and higher maternal education significantly correlated with lower caries prevalence (p<0.05). Parental supervision and age at brushing initiation were not significantly associated with caries occurrence (p>0.05).
CONCLUSIONS: Dental caries remain highly prevalent in central Istanbul despite high socioeconomic status. Preventive strategies emphasizing maternal education and consistent oral hygiene behaviors may yield greater improvements than fluoride supplementation alone.
References
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Petersen PE, Baez RJ, Ogawa H. Global application of oral disease prevention and health promotion as measured 10 years after the 2007 World Health Assembly statement on oral health. Community Dent Oral Epidemiol. 2020;48(4):338–348. doi:10.1111/cdoe.12538.
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Fraihat N, Madae’en S, Bencze Z, Herczeg A, Varga O. Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019;16(15). doi:10.3390/ijerph16152668.
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Gökalp SG, Doğan BG, Tekçiçek MT, Berberoğlu A, Unlüer S. National survey of oral health status of children and adults in Turkey. Community Dent Health. 2010;27(1):12–7. doi:10.1922/CDH_2365Gökalp06.
-
Orhan AI, Alkan A, Orhan K, Tezel A, Karaoglanoglu S, Oztas D. Dental caries and associated factors among Turkish children and adults: Findings from the 3rd National Oral Health Survey. Community Dent Oral Epidemiol. 2024;52(4):499–508. doi:10.1111/cdoe.12943.
-
Schwendicke F, Dörfer CE, Schlattmann P, Foster Page L, Thomson WM, Paris S. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res. 2015;94(1):10–8. doi:10.1177/0022034514557546.
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Engelmann JL, Tomazoni F, Oliveira MD, Ardenghi TM. Association between Dental Caries and Socioeconomic Factors in Schoolchildren–A Multilevel Analysis. Braz Dent J. 2016;27(1):72–8. doi:10.1590/0103-6440201600435.
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Piovesan C, Mendes FM, Antunes JL, Ardenghi TM. Inequalities in the distribution of dental caries among 12-year-old Brazilian schoolchildren. Braz Oral Res. 2011;25(1):69–75. doi:10.1590/s1806-83242011000100012.
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Chung SY, Chung SY, Hwang YH, Kim EK, Choi YH, Song KB. Socioeconomic inequalities in dental behaviors among Korean adults. Dental and Medical Problems. 2017;54(3):235–240. doi:10.17219/dmp/76082.
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Amudha S, Moses J, Vijayakumar M, Shankar P. Prevalence of Dental Caries among Different Socioeconomic Status and their Treatment Needs among 5-15-year-old School-going Children in Maduravoyal Area, Chennai. Int J Clin Pediatr Dent. 2021;14(3):403–411. doi:10.5005/jp-journals-10005-1963.
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Nilima T, Rutuja W, Pramod Bane S. Evaluation of co-relation between maternal behavior characteristics and early childhood caries in children of Wardha District. J Pharm Res Int. 2021;33(47A):245–253. doi:10.9734/jpri/2021/v33i47A33010.
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Ramakrishnan M, Banu S, Ningthoujam S, Samuel VA. Evaluation of knowledge and attitude of parents about the importance of maintaining primary dentition-A cross-sectional study. J Fam Med Prim Care. 2019;8(2):414–418. doi:10.4103/jfmpc.jfmpc_371_18.
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Rughani R, Ondhia A. They’re not ‘just baby teeth’. Bdj Team. 2023;10(1):10–13. doi:10.1038/s41407-023-1709-5.
-
Clark MB, Keels MA, Slayton RL. Fluoride Use in Caries Prevention in the Primary Care Setting. Pediatrics. 2020;146(6). doi:10.1542/peds.2020-034637.
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Beil H, Rozier RG, Preisser JS, Stearns SC, Lee JY. Effects of early dental office visits on dental caries experience. American Journal of Public Health. 2014;104(10):1979–1985. doi:10.2105/AJPH.2013.301325.
-
Brusius CD, Alves LS, Maltz M. Association between toothbrushing frequency and dental caries and tooth loss in adolescents: a cohort study. Braz Oral Res. 2023;37:e127. doi:10.1590/1807-3107bor-2023.vol37.0127.
-
Hamilton K, Cornish S, Kirkpatrick A, Kroon J, Schwarzer R. Parental supervision for their children’s toothbrushing: Mediating effects of planning, self-efficacy, and action control. Br J Health Psychol. 2018;23(2):387–406. doi:10.1111/bjhp.12294.
-
Khodke S, Naik S, Agarwal N. Infant Dietary Pattern and its Association with Early Childhood Caries in Preschool Children: A Cross-sectional Study. Int J Clin Pediatr Dent. 2023;16(3):421–425. doi:10.5005/jp-journals-10005-2356.
-
Mohd Khairuddin AN, Bogale B, Kang J, Gallagher JE. Impact of dental visiting patterns on oral health: A systematic review of longitudinal studies. BDJ Open. 2024;10(1):18. doi:10.1038/s41405-024-00195-7.
-
Soofi M, Pasdar Y, Karami Matin B, Hamzeh B, Rezaei S, Kazemi Karyani A, et al. Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study. BMC Oral Health. 2020;20(1):63. doi:10.1186/s12903-020-1036-6.
-
Al Agili DE, Bhayat A, Farghaly M. Oral health knowledge and behavior among male Saudi schoolchildren. Saudi Dent J. 2012;24(4):195–200. doi:10.1016/j.sdentj.2012.07.002.
-
Vanagas G, Milasauskiene Z, Grabauskas V, Mickeviciene A. Associations between parental skills and their attitudes toward importance to develop good oral hygiene skills in their children. Medicina (Kaunas). 2009;45(9):718–23. doi:10.3390/medicina45090094.
-
Pieper K, Dressler S, Heinzel-Gutenbrunner M, Neuhauser A, Krecker M, Wunderlich K, et al. The influence of social status on pre-school children’s eating habits, caries experience and caries prevention behavior. Int J Public Health. 2012;57(1):207–15. doi:10.1007/s00038-011-0308-x.
-
Akyildiz M, Olmez S, Gungor O, Sonmez IS. Evaluation of caries experience, oral hygiene status, and parental attitudes in autistic children. Niger J Clin Pract. 2022;25(12):1652–1659. doi:10.4103/njcp.njcp_2053_21.
-
Saied-Moallemi Z, Virtanen JI, Ghofranipour F, Murtomaa H. Influence of mothers’ oral health knowledge and attitudes on their children’s dental health. Eur Arch Paediatr Dent. 2008;9(2):79–83. doi:10.1007/bf03262612.
-
Chou R, Cantor A, Zakher B, Mitchell JP, Pappas M. Preventing dental caries in children <5 years: systematic review updating USPSTF recommendation. Pediatrics. 2013;132(2):332–50. doi:10.1542/peds.2013-1465.
-
Kay E, Locker D. Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol. 1996;24(4):231–5. doi:10.1111/j.1600-0528.1996.tb00850.x.
-
Kay EJ, Locker D. A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dent Health. 1998;15(3):132–44.
-
Naidu R, Nunn J, Irwin JD. The effect of motivational interviewing on oral healthcare knowledge, attitudes and behaviour of parents and caregivers of preschool children: an exploratory cluster randomised controlled study. BMC Oral Health. 2015;15:101. doi:10.1186/s12903-015-0088-1.
-
Gao X, Lo EC, Kot SC, Chan KC. Motivational interviewing in improving oral health: a systematic review of randomized controlled trials. J Periodont Res. 2014;49(5):550–9. doi:10.1111/jre.12126.
-
Colvara BC, Faustino-Silva DD, Meyer E, Hugo FN, Hilgert JB, Padilha DMP. Motivational Interviewing in preventing early childhood caries in primary healthcare: A community-based randomized cluster trial. J Pediatr. 2018;201:190–195.e1. doi:10.1016/j.jpeds.2018.05.045.
-
Harrison R, Benton T, Everson-Stewart S, Weinstein P. Effect of motivational interviewing on rates of early childhood caries: a randomized trial. Pediatr Dent. 2007;29(1):16–22.
-
Weinstein P, Harrison R, Benton T. Motivating parents to prevent caries in their young children: One-year findings. J Am Dent Assoc. 2004;135(6):731–8. doi:10.14219/jada.archive.2004.0297.
-
Ismail AI, Ondersma S, Jedele JM, Little RJ, Lepkowski JM. Evaluation of a web-based parent education program to prevent early childhood caries. Community Dent Oral Epidemiol. 2011;39(5): 381–96. doi:10.1111/j.1600-0528.2010.00607.x.
-
Ismail AI, Pitts NB, Tellez M, et al. The International Caries Classification and Management System (ICCMS™) An Example of a Caries Management Pathway. BMC Oral Health. 2015;15 Suppl 1(Suppl 1):S9. doi:10.1186/1472-6831-15-S1-S9.
-
Pitts NB, Ekstrand KR, ICDAS Foundation. International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS) – methods for staging of the caries process and enabling dentists to manage caries. Community Dent Oral Epidemiol. 2013;41(1):e41–52. doi:10.1111/cdoe.12025.
-
Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal intervention dentistry for managing dental caries – a review: report of a FDI task group. Int Dent J. 2012;62(5):223–43. doi:10.1111/idj.12007.
-
Splieth CH, Banerjee A, Bottenberg P, Breschi L, Campus G, Ekstrand KR, et al. How to intervene in the caries process in children: A Joint ORCA and EFCD Expert Delphi Consensus Statement. Caries Res. 2020;54(4):297–305. doi:10.1159/000507692.
-
Mejàre I, Axelsson S, Dahlén G, Espelid I, Norlund A, Tranæus S, et al. Caries risk assessment. A systematic review. Acta Odontol Scand. 2014;72(2):81–91. doi:10.3109/00016357.2013.822548.
-
Tellez M, Gomez J, Pretty I, Ellwood R, Ismail AI. Evidence on existing caries risk assessment systems: are they predictive of future caries? Community Dent Oral Epidemiol. 2013;41(1):67–78. doi:10.1111/cdoe.12003.
-
American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent. 2016;38(6):52–4.
-
American Academy of Pediatric Dentistry. Policy on Dietary Recommendations for Infants, Children, and Adolescents. Pediatr Dent. 2016;38(6):57–8.
-
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