Natalia Wanczewska
5 year, group 15ORAL HEALTH ATTITUDES AND KNOWLEDGE
AMONG PEDIATRIC PATIENTS RECEIVING
ORTHODONTIC TREATMENT.A CROSS-SECTIONAL
STUDY.
Master`s Thesis
LITHUANIAN UNIVERSITY OF HEALTH SCIENCES MEDICAL ACADEMY
FACULTY OF ODONTOLOGY
CLINIC FOR PREVENTIVE AND PEDIATRIC DENTISTRY
ORAL HEALTH ATTITUDES AND KNOWLEDGE AMONG PEDIATRIC PATIENTS RECEIVING ORTHODONTIC TREATMENT.A CROSS-SECTIONAL STUDY.
Master`s Thesis
The thesis was done
by student ... Supervisor ...
(signature) (signature)
... ...
(name surname, year, group) (degree, name surname)
... 20…. ... 20….
(day/month) (day/month)
EVALUATION TABLE OF CLINICAL–EXPERIMENTAL MASTER’S THESIS
Evaluation: ...
Reviewer: ...
(scientific degree, name and surname)
Reviewing date: ...
Compliance with MT
No. MT parts MT evaluation aspects requirements and
evaluation Yes Partially No
1
Summary (0.5 point)
Is summary informative and in compliance with the
thesis content and requirements? 0.3 0.1 0
2 Are keywords in compliance with the thesis essence? 0.2 0.1 0 3 Introduction, aim and tasks (1 point)
Are the novelty, relevance and significance of the
work justified in the introduction of the thesis? 0.4 0.2 0
4 Are the problem, hypothesis, aim and tasks formed
clearly and properly? 0.4 0.2 0
5 Are the aim and tasks interrelated? 0.2 0.1 0
6
Review of literature (1.5 points)
Is the author’s familiarization with the works of
other authors sufficient? 0.4 0.2 0
7
Have the most relevant researches of the scientists discussed properly and are the most important results and conclusions presented?
0.6 0.3 0
8 Is the reviewed scientific literature related enough
to the topic analysed in the thesis? 0.2 0.1 0
9 Is the author’s ability to analyse and systemize the
scientific literature sufficient? 0.3 0.1 0
10
Material and methods (2 points)
IS the research methodology
explained comprehensively? Is it suitable to achieve the set aim?
0.6 0.3 0
11
Are the samples and groups of respondents formed and described properly? Were the selection criteria suitable?
12
Are other research materials and tools (questionnaires, drugs, reagents, equipment, etc.) described properly?
0.4 0.2 0
13
Are the statistical programmes used to analyse data, the formulas and criteria used to assess the level of statistical reliability described properly?
0.4 0.2 0
14 Results (2 points)
Do the research results answer to the set aim and
tasks comprehensively? 0.4 0.2 0
15 Does presentation of tables and pictures satisfy the
requirements? 0.4 0.2 0
16 Does information repeat in the tables, picture and
text? 0 0.2 0.4
17 Is the statistical significance of data indicated? 0.4 0.2 0
18 Has the statistical analysis of data been carried
out properly? 0.4 0.2 0
19
Discussion (1.5 points)
Were the received results (their importance, drawbacks) and reliability of received results assessed properly?
0.4 0.2 0
20
Was the relation of the received results with the latest data of other researchers assessed
properly?
0.4 0.2 0
21 Does author present the interpretation of results?
0.4 0.2 0
22
Do the data presented in other sections (introduction, review of literature, results) repeat?
0 0.2 0.3
23
Conclusions (0.5 points)
Do the conclusions reflect the topic, aim and
tasks of the Master’s thesis? 0.2 0.1 0
24
Are the conclusions based on the analysed material? Do they correspond to the research results?
0.2 0.1 0
26
References (1 point)
Is the references list formed according to the
requirements? 0.4 0.2 0
27
Are the links of the references to the text correct? Are the literature sources cited correctly and precisely?
0.2 0.1 0
28 Is the scientific level of references suitable for
Master’s thesis? 0.2 0.1 0
29
Do the cited sources not older than 10 years old form at least 70% of sources, and the not older than 5 years – at least 40%?
0.2 0.1 0
Additional sections, which may increase the collected number of points
30 Annexes Do the presented annexes help to understand the
analysed topic? +0.2 +0.1 0
31 Practical
recommendations
Are the practical recommendations suggested
and are they related to the received results? +0.4 +0.2 0 General requirements, non-compliance with which reduce the number of points
32 General
requirements
Is the thesis volume sufficient (excluding annexes)?
15-20 pages (-2 points)
<15 pages (-5 points)
33 Is the thesis volume increased
artificially?
-2 points -1 point
34 Does the thesis structure satisfy the
requirements of Master’s thesis? -1 point -2 points
35
Is the thesis written in correct
language, scientifically, logically and laconically?
-0.5 point -1 points
36 Are there any grammatical, style or
computer literacy-related mistakes? -2 points -1 points
37
Is text consistent, integral, and are the volumes of its structural parts
balanced?
-0.2 point -0.5 points
38 Amount of plagiarism in the thesis. >20%
39
Is the content (names of sections and subsections and enumeration of pages)
in -0.2 point
-0.5 points compliance with the thesis structure
and aims?
40
Are the names of the thesis parts in compliance with the text? Are the titles of sections and sub-sections distinguished logically and correctly?
-0.2 point -0.5 points
41 Was the permit of the Bioethical
Committee received (if necessary)? -1 point
42 Are there explanations of the key
terms and abbreviations (if needed)? -0.2 point
-0.5 points
43
Is the quality of the thesis typography (quality of printing, visual aids, binding) good?
-0.2 point -0.5 points
*In total (maximum 10 points):
*Remark: the amount of collected points may exceed 10 points.
Reviewer’s comments: ___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _________________________________________ ___________________________
TABLE OF CONTENTS
SUMMARY………..9
INTRODUCTION………....10
REVIEW OF LITERATURE………...12
MATERIAL AND METHODS………...15
RESULTS………....17 DISCUSSION………...24 ACKNOWLEDGEMENT………...26 CONFLICT OF INTERESTS………..26 CONCLUSION………27 PRACTICAL RECOMMENDATIONS………...27 REFERENCES………....28 ANNEXES………...34
Oral health attitudes and knowledge among pediatric patients receiving orthodontic treatment. A cross-sectional study.
SUMMARY
Aim: To assess oral health attitude and knowledge of adolescents receiving orthodontic treatment.
Materials and methods: A cross -sectional study was conducted among patients aged 10-17 years attending Clinic of orthodontics and Clinic for preventive and pediatric dentistry at Lithuanian University of Health Sciences (LSMU, Kaunas) during autumn semester 2017/2018 study year. A self-administered questionnaire was answered by 289 patients (164 receiving and 125 non-receiving orthodontic treatment) with a response rate of 97%. SPSS 19 program was used for statistical analysis. The significance level was set at p<0.05.
Results: 62% of all participants brushed the teeth 2 times a day or more. The most preferred type of toothbrush was manual (94.4%) with soft bristles (45.2%). More patients receiving orthodontic treatment used interdental aids than control group patients (56% vs. 40.8%) (p<0.001). The most common interdental aid was floss among patients receiving orthodontic treatment (38.8%).
Majority of patients consumed fast food occasionally and used sweetened beverages daily. 88.4% of patients receiving orthodontic treatment were introduced to oral hygiene recommendations by their orthodontists. 80.1% of patients receiving orthodontic treatment claimed that changed their oral hygiene habits a bit during orthodontic treatment.
Conclusion: Oral hygiene habits of adolescents receiving orthodontic treatment did not statistically significantly differ from those not receiving orthodontic treatment. Significantly more orthodontic patients receiving orthodontic treatment used interdental measures. Moreover, place of living and gender played a role on oral health behavior (patients from urban areas and males attended more regularly for dental visits).
Keywords: oral hygiene, orthodontic treatment, fixed orthodontic appliance, attitude, knowledge, adolescents
INTRODUCTION
Malocclusion as a common oral disorder is not only associated with functional and aesthetic consequences but also with psychosocial consequences, especially in adolescents. Studies showed that malocclusion directly affects oral health related quality of life (OHQoL), therefore orthodontic treatment is necessary to improve the quality of life as related to oral health [1].
Improvement in facial aesthetics, self-confidence and social acceptability are the main reasons motivating young people to orthodontic treatment [2].
World Health Organisation (WHO) states that adolescents are in a group age between 10 and 19 years old [3]. Adolescence period is a good time to begin orthodontic treatment because eruption of secondary dentition is completed even though craniofacial structures are still growing.
Unfortunately, in some cases due to poor patient compliance with oral hygiene, treatment is interrupted and complications may occur [4].
Fixed orthodontic appliances significantly alter oral cavity environment by expanding plaque
retention sites and thus lead to increased biofilm formation [5]. Braces also disturb natural cleansing activity provided by tongue, cheeks and lips muscles which result in foods and bacteria
accumulation [6]. As a result, harmony of microbial flora is agitated and may lead to hard and soft tissues diseases [7].
Dental caries and periodontal diseases are contemplated to group of behavioral diseases, as they are controlled mainly by persons good oral habits; such as diet and hygiene routine [8]. Individual’s lifestyle is essential factor in oral diseases development. Hence, excellent oral hygiene regime is fundamental while undergoing orthodontic treatment [8].
Substandard habits during orthodontic treatment may lead to hard tissues demineralization [6]. White spot lesions are result of highly acidic and sugary diet which significantly drops oral environment pH. White spot lesions are first sign of enamel caries lesion [9].
Generally, it takes half of the year for carious tissue to be established in patients undergoing orthodontic therapy, while white spot lesions may appear around brackets already within a first month of treatment [10]. The occurrence of white spot lesions in post orthodontic patients ranges from 0 to 97% [11]. Patients wearing the braces are more likely to develop white spot lesions which later may cause aesthetic troubles [12].
There are many different preventive measures to stop demineralization process, such as fluoride gels, varnishes and foams applications, drinking high in fluoride water or using fluoridated mouthwash and toothpaste [13].
One of the most common adverse effects caused by orthodontic therapy are periodontal problems [14]. In one of the studies soft plaque accumulation was up to three times higher in patients
receiving orthodontic treatment than in patients not receiving orthodontic treatment [6]. It has been noted that after first 3 months of orthodontic therapy there was significant rise in number of bacteria associated with periodontal disease [15]. Those microfloral changes are reversible among
adolescent whom have well-functioning immune system. Constant gingival inflammation may result in chronic hyperplastic gingivitis or recessions [4].
Excellent brushing technique, regular use of dental floss, decent diet and regular dental check-ups are fundamental in oral disease prevention [16].
Daily fluoride rinses and use of fluoridated toothpaste are very commonly advocated by
orthodontists [7]. In one of the studies, it has been shown that fluoride varnish applications every six weeks in orthodontically treated patients presented moderate evidence of being effective preventive measure [7].
It is crucial that every patient undergoing orthodontic treatment should be fulfilling with oral disease preventive strategy and significance of rigorous oral hygiene and regular dental
examinations [17]. Orthodontists and patient’s regular dentist should re-assess oral hygiene status and discuss diet during regular recall visits. Teeth also should be professionally cleaned if there is need for that [18]. Every patient should be explained about appropriate brushing techniques and its frequency. Knowledge regard to right toothbrush type, interdental cleaning tools and auxiliary measures (adequate toothpaste and mouthwash) are crucial [19].
Dental care professionals, especially orthodontists are under obligation for regular evaluation of patient’s plaque control and advise in spite to prevent periodontal disease development.
Unfortunately, numerous patients fail in satisfactory plaque control standards shortly after treatment begins [17].
The aim of this study was to evaluate attitude and knowledge of adolescents with and without orthodontic appliances.
Objectives of the study:
1.To collect and analyze data about knowledge and attitudes toward oral health among patients receiving orthodontic treatment.
2. To describe knowledge and attitude toward oral health among patients receiving orthodontic treatment and to compare with control group.
3.To analyze literature related to the topic of the study and to compare results of this study with other studies results.
The hypothesis is that pediatric patients receiving orthodontic treatment have better knowledge and attitude towards oral hygiene than patients non-receiving orthodontic treatment.
REVIEW OF LITERATURE
In the literature, various studies have been carried out to assess knowledge and attitude of patients seeking orthodontic treatment, however they mainly focused on patients receiving fixed orthodontic appliances. In this review were included patients with different types of orthodontic appliances. Some studies were conducted to determine the oral hygiene awareness among orthodontic patients with fixed appliances and results showed poor oral hygiene behavior and both authors concluded that there is a need for better education and motivation which will be helpful to the patients in maintaining good oral hygiene [8,17]. Another study carried out by Khraist et al. assessed a self-reported oral hygiene practices and compared the results according to gender. The results of this study showed that females have better oral hygiene practices than males with statistical significance in the frequency of toothbrushing [20].
Oral hygiene practices in the study carried out by Lee et al. were assessed through questions on the type and frequency use of toothbrush, other cleaning measures used daily and professional
mechanical tooth cleaning (PMTC) during the orthodontic treatment. It was observed that all patients used toothbrush and most of them brushed at least twice daily, the most preferred toothbrush is soft one and more than half of the patients did not go for PMCT [21].
Findings of the study showed that most of the orthodontic patients used fluoride toothpaste, however results revealed, that use of adjuncts must be reinforced. Authors concluded that
orthodontists and dental assistants should increase their awareness for instructing their patients in oral hygiene to prevent caries and periodontal diseases [22].
The other study investigated oral hygiene status among patients with fixed orthodontic appliances using a simplified Oral Hygiene Index (OHI-S) by Greene and Vermillion; and a self-administered questionnaire was administered to determine tooth brushing practices. This study revealed a satisfactory oral hygiene status among Nigerian orthodontic patients [23].
Oral hygiene level of children in early school age was assessed in Poland. Study included patients undergoing orthodontic treatment with removable and fixed orthodontic appliance, living in the urban and rural region and questionnaires were answered by parents/ guardians. The authors were trying to assess relationship between oral hygiene procedures and occurrence of diseases and infections of the mouth and they concluded that in the most cases oral hygiene was satisfactory and did not contribute to the deterioration of oral health [24].
In some study approximal plaque index (API), plaque pH, DMF-T index, proper hygiene and dietary habits were evaluated and results did not show any statistically significant differences in
oral hygiene between children wearing removable appliances and those not wearing such appliances [25].
Pandey et al. commenced a study to assess dental negligence and oral health status among patients undergoing orthodontic treatment using dental neglect scale (DNS) questionnaire. A study
comprised of two questionnaires, one was close-ended questionnaire and other questionnaire comprised of DNS followed by examination of oral hygiene status using Oral Hygiene Index Simplified. The authors found that less frequency of brushing, rinsing mouth, and eating sticky and hard food can be attributed to self-neglect of the orthodontic patients [26].
A study performed by Mazzoleni et al. compared the efficiency of the electric versus manual
toothbrush in terms of oral hygiene achieved by patients wearing rapid maxillary expanders (RPEs). The authors concluded that electric toothbrush is statistically more efficient in performing an
adequate level of oral hygiene in children wearing RPE [27]. In another study, 3 toothbrush treatments were compared in adolescents and young adults with fixed orthodontic appliances. Digital plaque imaging analysis (DPIA) methodology was used to determine plaque removal efficacy of an oscillating-rotating electric toothbrush with a specially designed orthodontic brush head compared with regular brush head and a regular manual toothbrush. It was concluded that the electric toothbrush with either brush head, demonstrated significantly greater plaque removal over the manual brush and the orthodontic brush head was superior to the regular head [28].
Cardoso et al. compared the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets. The subjects received material and instructions for oral hygiene and Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30,60 and 180 days later [29].In some studies, self-ligating brackets (SLBs) were compared with conventional brackets (CBs) and compared whether SLBs promote oral hygiene. In both studies, no significant differences were found between passive self-ligating brackets and conventional brackets with regard to plaque control and both authors concluded that SLBs do not outperform CBs in promoting oral health [30]. The purpose of the study carried out by Abbate et al. was to explore the microbiological and periodontal changes occurring in adolescents during 12 months of orthodontic therapy with
Invisalign aligners and fixed appliances. Subgingival microbiological samples, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were obtained from the mesiovestibular
subgingival sulcus of the upper right first molar and left central incisor at the beginning of treatment and 3, 6 and 12 months later. Full mouth plaque score (FMPS) and full mouth bleeding score
none of patients was positive for the periodontal anaerobes analyzed. The all indexes scores were significantly lower and compliance with oral hygiene was significantly higher in the group treated with Invisalign than in the group treated with fixed brackets [31].
MATERIALS AND METHODS
A cross-sectional survey of oral health attitude and knowledge among pediatric patients receiving orthodontic treatment was carried out in the Lithuanian University of Health Sciences (Kaunas, Lithuania) during autumn semester 2017/2018 study year. The study was approved by the Bioethics Center of the Lithuanian University of Health Sciences (No. BEC-OF-14).
The questionnaires were shared during October- January period. The principle investigator (NW) asked all pediatric patients (N=289) attending Clinic of Orthodontics and Clinic for preventive and pediatric dentistry to complete an anonymous self-administered questionnaire during the dental appointment. The examiner explained to the participants the purpose of the study and written consent was obtained from the parents of participants. Participation was voluntary and anonymous, thus return of completed questionnaire was considered as acceptance to participate.
The sample size was calculated using the Paniott's formula with the error of 0.05% based on the number of patients (10-17-year-old) attending Orthodontic Clinic and Clinic for preventive and pediatric dentistry for first time. By using this formula, it was determined that not less than 300 10-17year-old adolescents had to be included in the study.
Subjects
Subjects were pediatric patients attending Clinic of Oral Health and Pediatric Dentistry and Clinic of Orthodontics at Lithuanian University of Health Sciences (LSMU).
The participants were adolescents and their age ranged from 10 to 17 years old. Participants regarding to age were dichotomized into two groups 10-12 and 13-17 years. The prevalence of patients of both age groups (10-12 and 13-17-year-old) were almost equal (50.2% vs. 49.8%). Mean of age was 12.98 (2.36) years (Table 1).
All participants were asked about received orthodontic treatment and options of answers were the following -do not receive any orthodontic treatment, braces, removable appliance, functional appliance and retention appliance.
Later all participants were grouped into two groups non-receiving orthodontic treatment and patients with retention appliance (control group) and patients receiving orthodontic treatment including removable, fixed, functional orthodontic appliances (study group).
A total 289 patients participated 164 receiving orthodontic treatment (42 with fixed appliances (30 with braces and 12 with functional appliances)), 122 with removable appliances) and 125 non-receiving orthodontic treatment in this study.
Participants were grouped regarding to living place to urban and rural areas. A majority of patients were living in urban area (72.9%) (p=0.285).
Overall more girls than boys (56.8% vs. 43.2%) participated in the study (p=0.397) (Table 1). Response rate was 97%.
The questionnaire
An anonymous self-administered questionnaire consisted of 26 multiple choice questions which covered background information (gender, age, living place), oral hygiene and dietary habits; and seeking professional dental care. Oral hygiene practices were assessed through questions on the frequency and duration of toothbrushing, type of used toothbrush, and other auxiliary measures used daily and regular professional oral hygiene. Patients of control group were asked to answer to the 21 questions, since patients receiving orthodontic treatment were asked to answer additionally 5 questions including type and care of orthodontic appliance, source of information. Additionally, orthodontic patients were asked to assess their change of oral habits during orthodontic treatment.
Statistical analysis
Statistical data analysis was carried out by using SPSS (Statistical Package for the Social Sciences for Windows) 19 version.
To establish relationships between categorical variables, the Pearson chi-squared test (χ2) was used. The significance level was set at p<0.05.
Table 1.Demographic characteristics of participants.
Control group N(%)
Patients receiving orthodontic treatment N(%) Total N(%) p-value
Fixedappliance Removableappliance Gender Girls 68(23.5) 24(8.3) 71(25) 163(56.4) P=0.397 Boys 57(19.7) 17(5.9) 51(17.6) 131(45.3) Total n(%) 125(43.2) 41(14.2) 122(42.6) 289(100) Age 10-12 65(22.5) 7(2.4) 72(24.9) 144(49.8) P<0.001 13-17 60(20.8) 35(12.1) 50(17.3) 145(50.2) Total n(%) 125(43.3) 42(14.5) 122(42.2) 289(100)
Living place (missing N=4)
Urban 92(32.3) 30(10.5) 89(31.2) 211(74) P=0.285
Rural 31(10.9) 12(4.2) 31(10.9) 74(26)
RESULTS
Oral hygiene habits
The results showed that the majority of the patients brushed the teeth twice a day or more often (62%) including both control and study groups (p=0.467).More than half of the adolescents (55.6%) reported brushing their teeth 2min, one-fourth (25.4%) of patients brushed >2 min. Hence, similar number of patients (45.2% vs. 38.1%) wearing fixed orthodontic appliances chose the following options brushed their teeth 2 min and >2 min, whereas most of the patient (56.6%) wearing removable appliances brushed the teeth 2 min (p=0.117) (Table 2).
Considering type of toothbrush, largest proportion of patients (94.4%) preferred manual toothbrush, while only 5.6% of patients used electric toothbrush, however differences were not statistically significant between control group and patients receiving orthodontic treatment (p=0.995). Furthermore, the most common hardness of toothbrush bristles among patients was soft (45.2%) and medium (39.6%) (p=0.893). Almost a half of the participants (48.6%) used the toothbrush unchanged shorter than 3 months, 45.5% of patients used the toothbrush 3-6 months and 5.9% of patients used the toothbrush more than 6 months (p=0.711) (Table 2).
Almost a half (47.9%) of patients did not know about the type of toothpaste they used. 37.2%of patients reported that used fluoridated toothpaste, while 14.9% used fluoride-free toothpaste (p=0.926) (Table 2).
57.4% of participants did not use tongue brush, besides most often orthodontic patients wearing fixed orthodontic appliances 57.1% reported that they clean the tongue (p=0.06) (Table 3). A half of the patients (50.4%) declared that did not use interdental measures. A majority of orthodontic patients used interdental aids in comparison to non-orthodontic patients (56% vs. 40.8%). Although, the use of floss was reported as the most common cleaning aid for oral
preventive measure among the study population (38.8%), followed by interdental brush (13%) and irrigator (0.6%). The differences were statistically significant (p<0.001) (Table 3).
In this survey, more girls (54.6%) than boys (42.7%) reported that used interdental measures, however there were no statistically significant differences by gender (p=0.133). Considering place of living, the use of interdental measures was significantly higher (p<0.05) among patients from urban area (50.9%) in comparison to patients from rural area (44.4%). The use of interdental measures between patients receiving orthodontic treatment (40.8%) and patients non-receiving orthodontic treatment (40.8%) differed significantly(p<0.05) (Table 3).
Table 2. Oral hygiene habits of participants.
Control group N(%)
Patients receiving orthodontic treatment N(%) Total N(%) P-value Fixedappliance Removableappliance Frequency of toothbrushing Irregularly 16(5.5) 1(0.3) 11(3.8) 28(9.6) 0.467 Once a day 37(12.8) 9(3.1) 36(12.5) 77(28.4) ≥2 times a day 72(24.9) 32(11.1) 75(26) 168(62) Total N(%) 125(43.2) 42(14.5) 122(42.3) 289(100)
Duration of toothbrushing (missing N=1)
<1min 19(6.6) 7(2.4) 29(10) 55(19) 0.117 2 min 72(25) 19(6.6) 69(24) 160(55.6) >2min 33(11.5) 16(5.6) 24(8.3) 73(25.4) Total N(%) 124(43.1) 42(14.6) 122(42.3) 289(100) Type of toothbrush Manual 117(40.5) 40(13.8) 116(40.1) 273(94.4) 0.995 Electric 8(2.8) 2(0.7) 6(2.1) 16(5.6) Total N(%) 125(43.3) 42(14.5) 122(42.2) 289(100)
Hardness of bristles (missing N=1)
Do not know 19(6.6) 7(2.4) 14(4.9) 40(13.9) 0.893
Hard 3(1) 1(0.3) 0(0) 4(1.3)
Medium 51(17.7) 14(4.9) 49(17) 114(39.6)
Soft 52(18.1) 19(6.6) 59(20.5) 130(45.2)
Total N(%) 125(43.4) 41(14.2) 122(42.4) 288(100)
Duration of toothbrush using (missing N=1)
> 6 months 9(3.1) 2(0.7) 6(2.1) 17(5.9) 0.711
3-6 months 54(18.8) 19(6.6) 58(20.1) 131(45.5)
<3 months 62(21.5) 21(7.3) 57(19.8) 140(48.6)
Total N(%) 125(43.4) 42(14.6) 121(44) 288(100)
Type of toothpaste (missing N=1)
Do not know 61(21.2) 19(6.6) 58(20.1) 138(47.9) 0.926
Fluoride-free 17(5.9) 5(1.7) 21(7.3) 43(14.9)
With fluoride 46(16) 18(6.3) 43(14.9) 107(37.2)
Table 3. Auxiliary measures used of participants.
Control group N(%)
Patients receiving orthodontic treatment N(%) Total N(%) P-value Fixedappliance Removableappliance Tonguebrushing Yes 42(14.6) 24(8.3) 57(19.7) 116(42.6) 0.060 No 83(28.7) 18(6.2) 65(22.5) 157(57.4) Total N(%) 121(43.3) 42(14.5) 122(42.2) 289(100)
Interdental aids (missing N=3)
Do not use 72(25.2) 12(4.2) 60(21) 144(50.4) <0.001 Irriagtor 3(1.1) 1(0.3) 0(0) 4(1.1) Interdentalbrush 7(2.4) 12(4.2) 9(3.1) 28(9.7) Floss 40(14) 13(4.5) 50(17.5) 103(36) >one method 2(0.7) 3(1.1) 2(0.7) 7(2.5) Total N(%) 124(43.4) 41(14.3) 121(42.3) 286(100) Use of mouthwash Yes 49(17) 25(8.6) 48(16.6) 122(42.2) 0.131 No 76(26.3) 17(5.9) 74(25.6) 167(57.8) Total N(%) 125(43.3) 42(14.5) 122(42.2) 289(100) Dietary habits
The consumption of fast food occasionally was the most common in both genders, males and females (89.7% vs. 93%), whereas only low percentage of boys and girls (0.8% vs. 1.2%) answered that never consumed fast food, respectively. There were no statistically significant differences between males and females with respect to frequency of fast food consumption (p=0.218). Most of the patients from both rural and urban area consumed fast food occasionally (91.9% vs. 91.5%), although those who never eat fast food are patients from urban area (2.4%) (p=0.605). There were no statistically significant differences between frequency of fast food consumption and presence of orthodontic treatment as well (p=0.933) (Table 4).
Considering sweetened beverages consumption, more common both boys and girls used daily (65.9% vs. 51.8%) than occasionally (32.5% vs. 47.6%). More girls tended to consume sweetened beverages more occasionally in comparison to boys, although the differences were not statistically significant different (p=0.07). A majority of patients from both rural and urban area used to
and non-orthodontic patients drink beverages daily (55.4% vs. 61.2%) and occasionally (44% vs. 37.2%) (p=0.971). Only 1% of patients reported who never drink beverages (Table 4).
A majority of patients consumed snacks. There were no statistically significant differences between consumption of snacks, gender, living place and presence of orthodontic appliance (p>0.05) (Table 4).
Professional care
Results showed that a higher proportion of both girls and boys (54.1%vs. 53.5%) attended dental office once a year. While, regarding to gender 33.6% of male and 24.2% of female visited dentist 2 times a year. Girls used to go for a dental visit more irregularly (22.3%) then boys (12.3%)
(p=0.05). Considering the living place, a majority of patients from urban area attend for dental visits once a year (58.5%), while 25.6% attend 2 times a year and 15.9 % attend irregularly. There is an insignificant difference between patients living in rural area attending for dental visits once a year (40.6%) and 2 times a year (37.7%). Patients from rural area who visited dentist irregularly constitute of 21.7% (p<0.0.05). No differences were found between frequency of dental appointment and presence of orthodontic treatment (p=0.270). Most of receiving orthodontic treatment and non-receiving orthodontic treatment attended for dental visits once a year (57.3 %vs. 49.1%) (Table 4).
Most of the participants avoided visiting a dental hygienist. Lower number of patients reported visiting dental hygienist once a year and the least number of patients attend 2 times a year or more often. The differences were not found between frequency of visiting to dental hygienist,
gender(p=0.783) and living place(p=0.430). Moreover, there was no statistically significant difference considering presence of orthodontic treatment (p=0.092) (Table 4).
Table 4. Dietary habits, dental visit and auxiliary measures according gender, living place and presence of orthodontic treatment.
Gender* Area** Orthodontic treatment*** P-value
Boys Girls Rural Urban Yes No
Auxiliary measures
Yes 53(18.5) 89(31) 32(11.3) 108(38) 93(32.5) 49(17.2) P*=0.133
P**=0.017
P***<0.001
No 71(24.7) 74(25.8) 40(14.1) 104(36.6) 73(25.5) 71(24.8)
Frequency of fast food consumption
Never 3(1) 2(0.7) 0(0) 5(1.8) 2(0.7) 3(1) P*=0.218
P**=0.605
P***=0.933
Occasionally 113(39.1) 153(52.9) 68(23.8) 194(67.8) 154(53.5) 111(38.6)
Daily 10(3.5) 8(2.8) 6(2.1) 13(4.5) 11(3.8) 7(2.4)
Frequency of sweetened beverages consumption
Never 2(0.7) 1(0.3) 1(0.3) 2(0.7) 1(0.3) 2(0.7) P*=0.07 P**=0.105 P***=0.971 Occasionally 41(14.1) 78(26.9) 22(7.6) 94(32.8) 74(25.6) 45(15.6) Daily 83(28.7) 85(29.3) 51(17.8) 117(40.8) 93(32.2) 74(25.6) Consumption of snacks Yes 113(39.1) 141(48.8) 61(21.3) 190(66.4) 152(52.8) 101(35.1) P*=0.271 P**=0.224 P***=0.565 No 12(4.1) 23(8) 13(4.6) 22(7.7) 16(5.5) 19(6.6) Dental visits Irregularly 15(5.4) 35(12.5) 15(5.4) 33(12) 27(9.7) 23(8.3) P*=0.05 P**=0.035 P***=0.270 2 times a year 41(14.7) 38(13.6) 26(9.4) 53(19.2) 43(15.5) 35(12.6) Once a year 66(23.7) 84(30.1) 28(10.2) 121(43.8) 94(33.8) 56(20.1)
Visits to dental hygienist
Do not attend 74(26.5) 86(30.8) 41(14.9) 116(42) 87(31.1) 74(26.4) P*=0.783 P**=0.430 P***=0.092 Once a year or less 34(12.2) 49(17.6) 16(5.8) 67(24.3) 54(19.3) 29(10.3) 2 times a year or more 17(6.1) 19(6.8) 11(4) 25(9) 26(9.3) 10(3.6)
p*-comparison between gender
p**-comparison between living place
Source of information
Majority of patients undergoing orthodontic treatment (88.4%) received oral hygiene instructions from their orthodontist. Smaller number of patients were tough about oral hygiene by parents (8.6%), following by friends (1.2%) and oral hygienist (0.6%). Equal number (0.6%) of patients claimed that did not receive any oral hygiene instructions and found information through media (internet, TV). The differences were statistically significant (p<0.001) (Fig. 1).
P<0.001
Figure 1.Source of information regarding oral hygiene during orthodontic treatment period. 0.6 %
Did not receive
0.6 % Media 0.6% Oral hygienist 1.2% Friends 8.6% Parents 88.4% Orthodontist
Change of habits
Most of the patients (59%) claimed that their oral hygiene habits changed a bit during orthodontic treatment period. 21.1% of participants changed their habits a lot, however 15.1% did not observe any changes and 4.3% could not answer to this question. The differences were found to be
statistically significant (p<0.001) (Fig. 2).
P<0.001
Figure 2.Changes of oral hygiene habits during orthodontic treatment period. 4.80% 15.10% 59.00% 21.10% 0.00% 15.00% 30.00% 45.00% 60.00% 75.00%
DISCUSSION
Nowadays, in the society one can notice increased acceptance and popularity of orthodontic treatment among adolescents [25]. The main motivating factor to undertake orthodontic therapy is desire to improve facial and dental aesthetics [19]. Good knowledge and oral hygiene attitude is tremendously important factor to patients having orthodontic treatment. Obtaining this information can be useful to understand patient’s oral health needs and patient’s compliance to oral hygiene instructions [17].
Therefore, the present study assesses awareness of oral hygiene employed by orthodontic patients. Currently, in Lithuania there is a limited data about oral hygiene habits among orthodontic patients. Various studies demonstrated unsatisfactory oral hygiene regime of orthodontically treated patients and suggested enhancement in frequency of oral hygiene prophylaxis, introduction of appropriate methods of cleaning and use of adjunct products improved treatment results [8,17,19,20,25]. Meanwhile, other studies did not observe any effects on orthodontic treatment with deterioration in oral hygiene status [23]. In this study statistically significantly more patients receiving orthodontic treatment used more interdental aids then non-orthodontic patients.
The findings of other studies showed that quite similar results like in this study toward recommendations about frequency and duration of tooth brushing among patients receiving orthodontic treatment [8,23,25]. The results were that 65.3% of the patients reported to brush their teeth twice daily or even more, where 53.6% brush their teeth for 2 min and 24.4% for more than 2min. Similar results were seen in study from Poland [25], where majority of patients brushed twice daily or more, but in contrary to response of participants in study from India where majority
brushed once daily [19].
Recent studies proved better effectiveness of electric toothbrush over conventional toothbrush in plaque removal in patients wearing orthodontic appliances [27,28,]. While some reasons of manual toothbrush popularity over electric toothbrush might be cheaper price and availability. A manual toothbrush was a first choice for almost all participants of this study and only 5.6% admitted using electric toothbrush. Furthermore, another study showed very low using of electric brushes among subjects (1.4%) [25].
Toothbrushes with hard bristles are strongly not recommended by dental health care professionals due to risk of being too aggressive on tooth structure and soft tissue [21]. Our findings revealed that only 0.6% of patients used toothbrushes with hard bristles and more patients reported use of soft toothbrush than in study by Baheti et al.[17], but less than in study from Malaysia [21].
Mouthwash containing fluoride is an essential adjunct recommended during fixed appliance treatment helping to maintain better oral health and reducing risk of demineralization [7]. In this study most (59.5%) of orthodontic patients with fixed appliance reported use of mouthwash as an adjunct to their daily oral hygiene, surprisingly control group reported higher use (64.5%). This percentage is similar to result obtained by Lee et al., [21] although higher than result obtained by another study from Jordan [20].
Fluoride toothpaste is essential while brushing and helps prevent tooth decay by strengthening tooth enamel [18]. Results of this study showed that patients did not pay attention on used tooth paste, because 47.9% participants didn’t know which type of toothpaste they use. This might be price driven or due to family traditions and routine, who provides goodies for home. Also 15.8% of participants used fluoride free toothpaste which is strongly not recommended due to lack of caries control [22]. This might be because of new popular trends rising through internet and social media. The use of interdental aids such as floss or interdental brushes helps patients with braces to
maintain good oral hygiene and it is a very crucial factor as toothbrushing alone is not effective enough in soft plaque removal [23]. Nonetheless, the use of auxiliary measures such as interdental floss and brushes is not a ,golden rule’ followed by patients. Results of some studies revealed that patients are not familiar with use of interdental aids and majority reported to not use them at all [19,25]. This study brought a reason for optimism since over 56% of participants receiving orthodontic treatment reported use of auxiliary measures. Flossing under arch wires can be very challenging so patients found that interdental brushes are easier to use [21]. In the study from Sudan, for instance, results indicated that more patients (51%) preferred use of interdental brush then in our study but lesser number of patients used dental floss (12%) [32].
Various studies suggest that females are better in maintaining oral hygiene [8,16]. The differences between genders in oral hygiene practices can be explained by fact that females are more concerned about their appearance and losing their teeth more frequently than males [20].Similar to other studies [20], girls used auxiliary measures more often than boys (54.6% vs. 42.7%), although the differences were not significant.
Results suggest that participants living in the urban areas use auxiliary measures more often than people living in country sides. It could be related to their accessibility in local stores supply.
This study revealed that frequency of fast food and sweetened beverages consumption did not differ between control group and patients receiving orthodontic treatment. This might be due to a lack of appropriate information provided by health care professionals, trend among adolescents and cultural factors where it is relatively cheap to consume these types of food. Moreover, girls (without
significant differences) were consuming more often fast foods and beverages than boys. Participants living in the urban areas were consuming sweet beverages and fast food more often than people from rural area, and this might be because of accessibility. Although, adolescents never consuming fast foods were from urban areas, this might be because of very precise education and leading a healthy lifestyle in family. A study performed in India showed a higher percentage of patients receiving orthodontic treatment avoided fast food [19].
Last but not least, 59% of patients receiving orthodontic treatment claimed that they changed oral hygiene habits a bit and 21.1% changed a lot. It might be connected that they were better informed by their orthodontists (88.4% of patients receiving orthodontic treatment). Likewise, it was
observed in another study around 50% of orthodontic patients do not attend for professional oral hygiene at all [21]. Only (15.6%)of orthodontic patients attend to oral hygienist regular. This may be due to insufficient motivation and knowledge to go for professional oral hygiene, but also cost and time constrains may be the contributing factors. Important factor related to patients’ oral health and overall success rate of treatment is how well the patients was paying attention to what has said to him/her. A mixed-method case-note study reflect on patient adherence and observe that not many clinicians note it down regarding adherence [33].
ACKNOWLEDGEMENT
I would like to thank my supervisor Doctor Sandra Žemgulytė, to staffs of Clinic for Preventive and Pediatric Dentistry and to Clinic of Orthodontics and to all patients who participated and
contributed to the development of this research.
CONFLICT OF INTERESTS
The author has not encountered any conflict of interests.CONCLUSION
Oral hygiene habits of adolescents receiving orthodontic treatment did not statistically significantly differ from those not receiving orthodontic treatment despite that majority orthodontic patient received information from orthodontist. Although significantly more orthodontic patients used interdental measures. Moreover, place of living and gender played a role on oral health behavior (patients from urban areas and males attended more regularly for dental visits). There were no significant differences in dietary habits between patients receiving orthodontic treatment and patients not-receiving orthodontic treatment.
PRACTICAL RECOMMENDATIONS
Clear repeated instructions how to maintain good oral hygiene should be given to the patient at every visit in oral and written form. Demonstration of oral hygiene technique by patients under supervision and video tape can produce better effect. Using technologies such as mobile phone applications and/or having known idols of adolescents give recommendations in social media might increase patient’s compliance and motivation. Regular dental check-ups and professional oral hygiene throughout the treatment.
REFERENCES
1. Foster Page LA, Thomson WM, Ukra A, Baker SR. Clinical status in adolescents: is its impact on oral health-related quality of life influenced by psychological characteristics?Eur J Oral Sci. 2013;121(3 Pt 1):182-7.
2. Fawzan AA. Reasons for seeking orthodontic treatment in Qassin region: a Pilot Study. International Dental Journal of Student’sReaserch. 2013;1:58-62.
3. Health for the world’s adolescents: a second chance in the second decade [Internet]. Geneva: World Health Organization; 2014, http://apps.who.int/adolescent/second-decade/Accessed 22 March 2018.
4. Eid HA, Assiri HA, Kandyala R, Togoo RA, Turakhia VS. Gingival enlargement in different age groups during fixed Orthodontic treatment. J Int Oral Health. 2014;6(1):1-4.
5. Koopman JE, van der Kaaij NC, Buijs MJ, Elyassi Y, van der Veen MH, Crielaard W et al. The Effect of Fixed Orthodontic Appliances and Fluoride Mouthwash on the Oral Microbiome of Adolescents - A Randomized Controlled Clinical Trial.PLoS One. 2015;10(9):e0137318.
6. Terri T. Oral health maintenance in orthodontics. Dimens Dent Hyg. 2014;12:19-22.
7. van derKaaij NC, van derVeen MH, van derKaaij MA, ten Cate JM. A prospective, randomized placebo-controlled clinical trial on the effects of a fluoride rinse on white spot lesion
development and bleeding in orthodontic patients.Eur J Oral Sci. 2015;123(3):186-93. 8. Nadar S, Saravana Dinesh S P. A questionnaire study about oral hygiene awareness among
orthodontic patients. Int J Orthod Rehabil 2016;7:97-100.
9. Sundararaj D, Venkatachalapathy S, Tandon A, Pereira A. Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: A meta-analysis. J IntSocPrev Community Dent. 2015;5(6):433-9.
10. Harrell RE. Promote oral hygiene during orthodontic treatment. Dimensions of Dental Hygiene. 2014;12:67-71.
11. Julien KC, Buschang PH, Campbell PM. Prevalence of white spot lesion formation during orthodontic treatment. Angle Orthod. 2013;83(4):641-7.
12. Maxfield BJ, Hamdan AM, Tüfekçi E, Shroff B, Best AM, Lindauer SJ. Development of white spot lesions during orthodontic treatment: perceptions of patients, parents, orthodontists, and general dentists. Am J Orthod Dentofacial Orthop. 2012;141(3):337-44.
13. Chi DL, Dinh MA, da Fonseca MA, Scott JM, Carle AC. Dietary Research to Reduce Children's Oral Health Disparities: An Exploratory Cross-Sectional Analysis of Socioeconomic Status, Food Insecurity, and Fast-Food Consumption. J Acad Nutr Diet. 2015;115(10):1599-604.
14. Singh G, Batra P. The orthodontic periodontal interface: A narrative review. J IntClin Dent Res Organ. 2014;6:77-85.
15. Dhami B, Shrestha P, Shrestha RM, Dhakal J. Assessment of periodontal health in Nepalese orthodontic patients. Orthodontic Journal of Nepal. 2013;3(1):26-30.
16. Oberoi SS, Mohanty V, Mahajan A, Oberoi A. Evaluating awareness regarding oral hygiene practices and exploring gender differences among patients attending for oral prophylaxis.J Indian SocPeriodontol. 2014;18(3):369-74.
17. Baheti MJ, Toshniwal NG. Survey on oral hygiene protocols among orthodontic correction-seeking individuals. J Educ Ethics Dent. 2015;5:8-13.
18. Khoroushi M, KachuieM. Prevention and Treatment of White Spot Lesions in Orthodontic Patients.ContempClin Dent. 2017;8(1):11-9.
19. Pandey V, Chandra S, Dilip Kumar HP, Gupta A, Bhandari PP, Rathod P. Impact of dental neglect score on oral health among patients receiving fixed orthodontic treatment. A cross-sectional study. J IntSocPrev Community Dent.2016;6(2):120-4.
20. Khraist HM, Al-Shideifat NA, Al-Alawaneh AM, Al-Zyood AI, Al-Maani MO. Oral hygiene practices among fixed orthodontic patients in Az-Zarqua, Jordan. Pakistan Oral and Dental Journal. 2016;36(3):404-7.
21. Lee JH, Abdullah AAA, Yahya NA. Oral Hygiene Practices among FixedOrthodontic Patients in a University Dental Setting.Int J Oral Dent Health. 2016;2(2):027.
22. Anuwongnukroh N, Dechkunakorn S, Kanpiputana R. Oral Hygiene Behavior during Fixed Orthodontic Treatment. Dentistry 7. 2017;7:457.
23. Ajayi EO, Azodo CC. Oral hygiene Status Among Orthodontic Patients AttendingUniversity of Benin Teaching Hospital, Benin City, Nigeria. J Dent Health Oral DisordTher.
2014;1(4):00023.
24. Słomska J, Kamińska A, Szalewski L, Skórzyńska H, Błaszczak J, Borowicz J. Higiena jamy ustnej dzieci leczonych ortodontycznie z terenu miasta i wsi. Med. Og Nauk Zdr.
2015;21(2):152-7.
25. Krupińska-Nanys M, Zarzecka J. An assessment of oral hygiene in 7-14 year-oldchildren undergoing orthodontic treatment. J Int Oral Health. 2015;7(1):6-11.
26. Pandey V, Chandra S, Dilip Kumar HP, Gupta A, Bhandari PP, Rathod P. Impact of dental neglect score on oral health among patients receiving fixed orthodontic treatment. A cross-sectional study. J IntSocPrev Community Dent.2016;6(2):120-4.
27. Mazzoleni S, Bonaldo G, Pontarolo E, Zuccon A, De Francesco M, Stellini E. Experimental assessment of oral hygiene achieved by children wearing rapid palatal expanders, comparing manual and electric toothbrushes. Int J Dent Hyg. 2014;12(3):187-92.
28. Erbe C, Klukowska M, Tsaknaki I, Tsaknaki I, Timm H, Grender J, Wehrbein H. Efficacy of 3 toothbrush treatments on plaque removal in orthodontic patients assessed with digital plaque imaging: a randomized controlled trial. Am J Orthod Dentofacial Orthop. 2013;143(6):760-6.
29. Cardoso Mde A, Saraiva PP, Maltagliati LÁ, Rhoden FK, Costa CC, Normando D, Capelozza Filho L. Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets. Dental Press J Orthod. 2015;20(2):35-41.
30. Yang X, Su N, Shi Z, Xiang Z, He Y, Han X, Bai D. Effects of self-ligating brackets on oral hygiene and discomfort: a systemic review and meta-analysis of randomized controlled clinical trials. Int J Dent Hyg. 2017;15(1):16-22.
31. Abbate GM, Caria MP, Montanari P, Mannu C, Orrù G, Caprioglio A, Levrini L. Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances. J OrofacOrthop. 2015;76(3):240-50.
32. Abuaffan AH, Elamin LT. Oral hygiene performance among a sample of Sudanese orthodontic patients. Pyrex Journal of Dentistry and Oral Hygiene. 2015;(1):1-8.
33. Al Shammary N, Asimakopoulou K, McDonald F, Newton JT, Scambler S. How is adult patient adherence recorded in orthodontists’ clinical notes? A mixed- method case-note study. Patient Prefer Adherence.2017;20(11):1807-14.
EVALUATION FORM OF THE MASTER’S THESIS FOR THE MEMBER OF DEFENCE COMMITTEE
Graduate student ___________________________________________________________________,
of the year ______, and the group _____ of the integrated study programme of Odontology
Master’s Thesis title: ………...……….………...………… ………...….………...……...
No. MT evaluation aspects
Evaluation
Yes Partially No
1 Has the student’s presentation lasted for more than 10 minutes?
2 Has the student presented the main problem of the Master’s thesis, its aim and tasks?
3 Has the student provided information on research methodology and main research instruments?
4 Has the student presented the received results comprehensively?
5 Have the visual aids been informative and easy to understand?
6 Has the logical sequence of report been observed?
7 Have the conclusions been presented? Are they resulting from the results?
8 Have the practical recommendations been presented?
9 Have the questions of the reviewer and commission’s members been answered correctly and thoroughly?
10 Is the Master’s thesis in compliance with the essence of the selected study programme?
Remarks of the member of evaluation committee of Master’s Thesis
______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
Evaluation of the Master’s Thesis
_____________________________________________________________________________
Member of the MT evaluation committee:
________________ ___________________________ _____________________
(scientific degree) (name and surname) (signature)
Member of the MT evaluation committee:
________________ ___________________________ _____________________
ANNEXES
Annex No.1 VAIKŲ, KURIEMS TAIKOMAS ORTODONTINIS GYDYMAS, POŽIŪRIS Į BURNOS
SVEIKATĄ IR JŲ ĮPROČIAI
Šis klausimynas yra sudarytas siekiant išsiaiškinti pacientų, nešiojančių fiksuotus ir nuimamus ortodontinius aparatus, požiūrį į burnos priežiūrą ir jų įpročius bei palyginti su vaikų, kuriems nėra taikomas ortodontinis gydymas, įpročiais.
Tyrimą atlieka Lietuvos Sveikatos Mokslų Universiteto 5 kurso studentė Natalia Wanczewska.
Maloniai prašome užpildyti šį anoniminį klausimyną. Dalyvavimas yra savanoriškas. Šis tyrimas visiškai anoniminis. Tyrimo rezultatai bus naudojami tik moksliniams tikslams ir vėliau visos anketos bus sunaikintos.
Dėkojame už Jūsų pastangas ir sugaištą laiką!
Sandra Žemgulytė Gyd. vaikų odontologė
LSMU Burnos priežiūros ir vaikų odontologijos klinika, Lukšos-Daumanto 6
51106 Kaunas
sandra.zemgulyte@lsmuni.lt tel. 8 37 388192
1. Lytis: Moteris Vyras 2. Amžius: ... metai
3.Kur jūs gyvenate? Mieste Kaime 4. Kaip dažnai valote dantis?
1 kartą per dieną 2 kartus per dieną arba dažniau Nereguliariai 5.Kiek laiko trunka dantų valymas?
Trumpiau nei 1 min 2 min Ilgiau nei 2 min 5.Kokį dantų šepetėlį naudojate?
Paprastą Elektrinį
6. Kokio šerelių kietumo dantų šepetėlį naudojate?
Minkštą Vidutinio kietumo Kietą Nežinau 7. Kiek laiko naudojate tą patį dantų šepetuką?
Trumpiau nei 3 mėn. 3-6 mėnesius Ilgiau nei pusę metų 8. Kokią dantų pastą naudojate?
Su fluoru Be fluoro Nežinau Kita (įrašykite)... 9. Ar valote liežuvį?
Taip Ne
10. Kokia papildomas priemones naudote valant dantis?
Tarpdančių siūlą Tarpdančių šepetėlį Irigatorių Nenaudoju papildomų priemoniu
11. Ar naudojate burnos skalavimo skystį? Taip Ne
12. Ar skundžiatės nemaloniu burnos kvapu? Taip Ne
13. Ar kraujuoja dantenos dantų valymo metu? Taip Ne
14. Kaip dažnai valgote „greitąjį maistą”?
Kasdien Kartą per savaitę Iki poros kartų per mėnesį Retai Niekada 15. Kaip dažnai geriate saldžius gėrimus (gazuotus, sultis ir kt.)?
Kasdien Pora kartų per savaitę Pora kartų per mėnesį ar rečiau Niekada nevartoju 16. Ar mėgstate užkandžiauti (ne pagrindinių valgių metu)?
Taip Ne
17. Ar skalaujate burną pavalgius?
Visada Dažnai Kartais Niekada 18. Kaip dažnai lankotės pas gydytoją odontologą?
1 kartą per metus 2 kartus per metus ir dažniau Lankausi nereguliariai 19. Kaip dažnai lankotės pas burnos higienistą (-ę)?
Kas 3 mėnesius Kas 6 mėnesius Kartą per metus ar rečiau Nesilankau 20. Ar nešiojate ortodontinį aparatą
Taip Ne
Į šiuos klausimus atsakykite, jei nešiojate ortodontinį aparatą: 21. Kokį ortodontinį aparatą nešiojate?
Breketų sistemą Ortodontinę plokštelę Funkscinį aparatą Retencinius Aparatus
22. Kas Jums suteikė informacijos apie burnos ir ortodontinių aparatų priežiūrą? Gyd. Burnos Tėvai Draugai Radau informaciją Televizija - ortodontas (-ė) higienistas(-ė) -internete
23. Kaip prižiūrite išimamus ortodontinius aparatus, jei turite?
Išvalau su Peteliu Nuplaunu vandeniu Pamerkiu Išvalau su Nuvalau ir nuplaunu vandeniu į specialų servetėle
tirpala
24.Kaip elgiatės po valgio ( atsakykite į šį klausimą, jei turite breketų sistemą)?
Išsivalau dantis Išsivalau dantis Išsiskalauju vandeniu Nieko nedarau su pasta ir dantų su dantų šepetėliu,
šepetėliu pasta ir tarpdančių
siūlu ar šepetėliu
25. Ar pasikeitė dantų priežiūros įpročiai ortodontinio gydymo metu?
TIRIAMOJO ASMENS IR TĖVŲ, GLOBĖJŲ SUTIKIMO FORMA
Aš sutinku dalyvauti LSMU Odontologijos fakulteto studentės Natalia Wanczewska atliekamoje apklausoje, skirtoje įvertinti pacientų, nešiojančių fiksuotus ir nuimamus ortodontinius aparatus, požiūrį į burnos priežiūrą ir jų įpročius bei palyginti su vaikų, kuriems nėra taikomas ortodontinis gydymas, įpročiais.
Tiriamojo ar tėvų parašas_____________________ Nr._______________ Data ____________
