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ارزیابی تاثیر رفتار بهداشتی والدین روی شاخص هایSiC (پوسیدگی‌های قابل توجه) وپلاک دندانی Assessment of parents’ oral health behavior on SiC and plaque indices 1 1 سابقه و هدف : پوسیدگی دندانی یکی از شایع ترین بیماری های مزمن دوران کودکی است. والدین نقش مهمی در کنترل بروز پوسیدگی در کودکان خود دارند. هدف از مطالعه حاضر ارزیابی تاثیر  رفتار بهداشتی والدین روی شاخص های  SiC (پوسیدگی های قابل توجه) و پلاک دندانی کودکان دبستانی آنها بوده است. مواد و روشها : این مطالعه از نوع مقطعی توصیفی-تحلیلی است که بر روی 200 دانش آموز دختر کلاس اول دبستان شهر کرمان انجام شد. روش جمع آوری داده ها پرسشنامه شامل وضعیت رعایت بهداشت دهان والدین و کودکان و اطلاعات دموگرافیک و معاینه بالینی کودکان شامل معاینه دندان از نظر پوسیدگی براساس معیارهای WHO و شاخص پلاک دندانی  بود. از آزمون t-test و رگرسیون خطی در سطح معناداری 5% برای آنالیز داده ها استفاده شد. یافته ها: پاسخ دهندگان در این مطالعه 89% (179نفر)،  والدین  مادر  و بقیه پدران بودند . میانگین سنی والدین33/6±00/34 سال بودند. 126 نفر از پدران (63%) و 100 نفر از مادران (52.5%) تحصیلات دانشگاهی داشتند. میانگین و انحراف معیار دو شاخص SiC و dmft به ترتیب3.25±6.29 و 27/3 ± 25/5 به دست آمد. میانگین شاخص پلاک در گروه  با پوسیدگی بیشتر بطور معنی داری بیشتر بود (0.003p=)میانگین نمره ی عملکرد بهداشتی دریک سوم افرادی که بالاترین dmft را داشتند 1.742±6.87 و در دو سوم بقیه 1.84±7.14بود. بین این دوگروه تفاوت آماری معنی داری وجود داشت(0.036p=). بین سن والدین و شغل مادران با عملکرد بهداشتی کودکان ارتباط آماری معنی دار مشاهده شد(0.050p=)و(0.008p=). بین شغل پدران با عملکرد بهداشتی خودشان ارتباط آماری معنی دار مشاهده شد.( 0.020p=) نتیجه گیری: نتایج حاصل از این تحقیق نشان داد که عملکرد بهداشتی والدین رابطه مستقیمی با میزان شیوع پوسیدگی در فرزندانشان دارد. 2 Background and purpose: Dental caries is one of the most common chronic diseases in childhood. Parents have an important role in the control of caries in their children .The aim of present study was to assess of parents oral health behavior on Sic and plaque indices of their 7 years old children. Methods: This cross-sectional study was conducted on 200 girls, first grade students in Kerman, Iran. Data were collected by questionnaire consist of demographic data and oral health behavior and clinical examination according to by WHO criteria and plaque index. T-test and regression were used to analyze data .P value at 0.05 was considered statistically significant. Results: 89.5% of parents were mothers (179 people). The mean age of parents was 34.00 ± 6.33. 63% of fathers and 52.5% of mothers had university education. The mean of Sic and dmft indices were 6.29 ± 3.25 and 5.25 ± 3.27 respectively. The mean of plaque index in the one third of the population with highest dmft was 94.5313 ± 10.10731 and 90.8862 ± 12.54252 for the other two third. There was a significant difference between two groups (p=0.003). The mean score in oral health behavior with highest dmft was 6.87 ± 1.742 and 7.14 ±1.846. There was a statistically significant difference between these two groups. There was a significant correlation between mothers’ job and parents’ age with the oral health behavior of the children (p=0.008, p=0.050). There was a significant correlation between fathers’ job with their oral health behavior (p=0.020). Conclusion: According to the study, the low level of education of parents, especially the mother and the habitat in the village, affect the oral health of children. Due to the young population of the country, planning for the prevention and treatment of children's oral teeth is essential 1 10 2018/05/8 1397/2/18 2018/05/8 1397/2/18 مهرناز کریمی افشار m Karimi afshar iran ایران ملوک ترابی m Torabi iran ایران جهانگیر حقانی j Haghani iran ایران حمیدرضا پوراسلامی h Poureslami iran ایران علی طاهری a Taheri iran ایران منصوره سالاری m Salari iran ایران Children oral health status education employment. پوسیدگی دندانی dmft SiC عملکرد بهداشتی والدین کودکان 7 ساله. 1-Castilho ARFd, Mialhe FL, Barbosa TdS, Puppin-Rontani RM. Influence of family environment on children's oral health: a systematic review. Jornal de Pediatria (Versao en Portugues). 2013;89(2):116-123.##2-Bozorgmehr E, Hajizamani A, Malek Mohammadi T. Oral health behavior of parents as a predictor of oral health status of their children. ISRN dentistry. 2013; 5(4):768-779.##3-Chu C-H, Ho PL, Lo EC. Oral health status and behaviours of preschool children in Hong Kong. BMC public health. 2012;12(1):767.##4-Mitrakul K, Laovoravit V, Vanichanuwat V, Charatchaiwanna A, Charatchaiwanna A, Bunpradit W, et al. Factors associated with parent capability on child's oral health care. Southeast Asian Journal of Tropical Medicineand Public Health. 2012;43(1):249.##5-Ravera E, Sánchez GA, Squassi AF, Bordoni N. Relationship between dental status and family, school and socioeconomic level. Acta odontologica latinoamericana: AOL. 2011;25(1):140-149.##6-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):718-723.##7-Saied-Moallemi Z, Vehkalahti MM, Virtanen JI, Tehranchi A, Murtomaa H. Mothers as facilitators of preadolescents’ oral self-care and oral health. Oral Health Prev Dent. 2008;6(4):271-277.##8-Costa C, Pereira M, Passadouro R, Spencer B. [Children's oral hygiene: healthy mouth, families supervise?]. Acta medica portuguesa. 2007;21(5):467-474.##9-Poutanen R, Lahti S, Tolvanen M, Hausen H. Parental influence on children's oral health-related behavior. Acta Odontologica. 2006;64(5):286-292.##10-Rong WS, Bian JY, Wang WJ, De Wang J. Effectiveness of an oral health education and caries prevention program in kindergartens in China. Community Dentistry and Oral Epidemiology. 2003;31(6):412-416.##11-Bratthall D. Introducing the Significant Caries Index together with a proposal for a new global oral health goal for 12‐year‐olds. International dental journal. 2000;50(6):378-384.##12-Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Oontologica. 1963;21(6):533-551.##13-Ramos-GomezF. Early maternal exposure to children’s oral health may be correlated with lower early childhood caries prevalence in their children. Journal of Evidence Based Dental Practice. 2012;12(2):113-115.##14-Vallejos-Sánchez A, Medina-Solís C, Minaya-Sanchez M, Villalobos-Rodelo J, Marquez-Corona M, Islas-Granillo H, et al. Maternal characteristics and treatment needs as predictors of dental health services utilisation among Mexican school children. European journal of paediatric dentistry: official journal of European Academy of Paediatric Dentistry. 2012;13(4):307-310.##15-Nanjappa S, Hector M, Marcenes W. Mother's Perception of General Family Functioning and Sugar Consumption of 3- and 4-Year-Old Children: The East London Family Study. Caries Res. 2015;49(5):515-22. ##16-Naidu R,Nuun J,Forde M.Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers .BMC Oral Health .2012;12:27.##17-El Tantawi M, Bakhurji E, Al-Ansari A, Al-Khalifa KS, Al -Subaie A .Influences of parents, close friends and classmates on four co-existing oral health practices in Saudi male teenagers. Acta Odontol Scand. 2017 Mar;75(2):137-143.##18-Sariba S,Bereger C,Fernando L,Saliba C.Social aspects of dental caries in the context of mother-child pairs.J Appl Oral Sci.2014;22(1):73-8.##19-Litsue L,Candelaria M,Bighetti T,Valden,Seichi R,Rosario M.Relationship Between Dental Caries Andsocio-Economic Factors In Adolescents .J Appl Oral Sci 2005; 13(3):305-11.##1-Castilho ARFd, Mialhe FL, Barbosa TdS, Puppin-Rontani RM. Influence of family environment on children's oral health: a systematic review. Jornal de Pediatria (Versao en Portugues). 2013;89(2):116-123.##2-Bozorgmehr E, Hajizamani A, Malek Mohammadi T. Oral health behavior of parents as a predictor of oral health status of their children. ISRN dentistry. 2013; 5(4):768-779.##3-Chu C-H, Ho PL, Lo EC. Oral health status and behaviours of preschool children in Hong Kong. BMC public health. 2012;12(1):767.##4-Mitrakul K, Laovoravit V, Vanichanuwat V, Charatchaiwanna A, Charatchaiwanna A, Bunpradit W, et al. Factors associated with parent capability on child's oral health care. Southeast Asian Journal of Tropical Medicineand Public Health. 2012;43(1):249.##5-Ravera E, Sánchez GA, Squassi AF, Bordoni N. Relationship between dental status and family, school and socioeconomic level. Acta odontologica latinoamericana: AOL. 2011;25(1):140-149.##6-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):718-723.##7-Saied-Moallemi Z, Vehkalahti MM, Virtanen JI, Tehranchi A, Murtomaa H. Mothers as facilitators of preadolescents’ oral self-care and oral health. Oral Health Prev Dent. 2008;6(4):271-277.##8-Costa C, Pereira M, Passadouro R, Spencer B. [Children's oral hygiene: healthy mouth, families supervise?]. Acta medica portuguesa. 2007;21(5):467-474.##9-Poutanen R, Lahti S, Tolvanen M, Hausen H. Parental influence on children's oral health-related behavior. Acta Odontologica. 2006;64(5):286-292.##10-Rong WS, Bian JY, Wang WJ, De Wang J. Effectiveness of an oral health education and caries prevention program in kindergartens in China. Community Dentistry and Oral Epidemiology. 2003;31(6):412-416.##11-Bratthall D. Introducing the Significant Caries Index together with a proposal for a new global oral health goal for 12‐year‐olds. International dental journal. 2000;50(6):378-384.##12-Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Oontologica. 1963;21(6):533-551.##13-Ramos-GomezF. Early maternal exposure to children’s oral health may be correlated with lower early childhood caries prevalence in their children. Journal of Evidence Based Dental Practice. 2012;12(2):113-115.##14-Vallejos-Sánchez A, Medina-Solís C, Minaya-Sanchez M, Villalobos-Rodelo J, Marquez-Corona M, Islas-Granillo H, et al. Maternal characteristics and treatment needs as predictors of dental health services utilisation among Mexican school children. European journal of paediatric dentistry: official journal of European Academy of Paediatric Dentistry. 2012;13(4):307-310.##15-Nanjappa S, Hector M, Marcenes W. Mother's Perception of General Family Functioning and Sugar Consumption of 3- and 4-Year-Old Children: The East London Family Study. Caries Res. 2015;49(5):515-22. ##16-Naidu R,Nuun J,Forde M.Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers .BMC Oral Health .2012;12:27.##17-El Tantawi M, Bakhurji E, Al-Ansari A, Al-Khalifa KS, Al -Subaie A .Influences of parents, close friends and classmates on four co-existing oral health practices in Saudi male teenagers. Acta Odontol Scand. 2017 Mar;75(2):137-143.##18-Sariba S,Bereger C,Fernando L,Saliba C.Social aspects of dental caries in the context of mother-child pairs.J Appl Oral Sci.2014;22(1):73-8.##19-Litsue L,Candelaria M,Bighetti T,Valden,Seichi R,Rosario M.Relationship Between Dental Caries Andsocio-Economic Factors In Adolescents .J Appl Oral Sci 2005; 13(3):305-11.## ##

مقایسه تغییرات قند خون حین بیهوشی با پروپوفول و ایزوفلوران در کودکان کاندید درمان دندانپزشکی تحت بیهوشی عمومی Compare blood glucose changes in intravenous anesthesia by Propofol and inhalation anesthesia by Isoflurane in children between 4-6 years old that candidate for dentistry treatment under general anesthesia 1 1 سابقه و هدف: در بیهوشی عمومی از داروهای زیادی استفاده می شود، که از بین آنها پروپوفول اثرات متابولیکی بیشتری دارد. هدف مطالعه مقایسه تغییرات قند خون هنگام بیهوشی با استفاده از پروپوفول و ایزوفلوران در کودکان سالم کاندید کار دندانپزشکی تحت بیهوشی می باشد. روش بررسی: در این مطالعه کار آزمائی بالینی آینده نگر، تصادفی، 27 کودک سالم کاندید کار دندانپزشکی تحت بیهوشی عمومی بررسی شدند. القا و نگهداری بیهوشی در یک گروه با پروپوفول و در گروه دیگر با تیوپنتال سدیم و ایزوفلوران انجام شد. قند خون با استفاده از گلوکومتر قبل از عمل، پس از القا بیهوشی، در پایان عمل و قبل از ترخیص در دو گروه اندازه گیری و با کمک آزمونهای آماری T تست جفتی (زوج)، تحلیل واریانس و توکی، من ویتنی و تحلیل های رگرسیونی، در نرم افزار SPSS تحلیل شدند. یافته­ها: میانگین قند خون قبل از عمل دو گروه تفاوت معنی داری نداشت. بعد از القای بیهوشی قند خون در هر دو گروه افزایش داشت، ولی تفاوت معنی داری با یکدیگر نداشتند (11/0=p). در پایان عمل قند خون در گروه پروپوفول به 64/148 رسید، که بطور معنی داری بیشتر از قند خون در گروه ایزوفلوران (58/124) بود(029/0=p). قند خون پایان ریکاوری در دو گروه نسبت به پایان عمل کاهش داشت، ولی تفاوت معنی داری بین دو گروه دیده نشد(651/0=p). نتیجه­گیری: بیهوشی عمومی با ایزوفلوران و پروپوفول باعث افزایش قند خون می شوند، ولی افزایش قند خون در گروه پروپوفول بیشتر است؛ لذا توصیه می شود، در کودکانی که افزایش قند خون در آنان خطرناک است، هنگام بیهوشی از پروپوفول استفاده نشود 2 Background and aims: in General anesthesia many group of drugs can be used. Propofol have high metabolic effect. The purpose of this study was to compare blood glucose change during anesthesia by Propofol and Isoflurane in healthy child candidate for dentistry procedure under general anesthesia. Methods: In this prospective Randomized clinical trial study, blood glucose change was survey in 27 healthy children that candidate for dentistry procedure under general anesthesia. Induction and maintenance of anesthesia was done in one group by Propofol and other group by thiopental and Isoflurane. Blood glucose was measure by glucometer before anesthesia, after induction, after operation and before discharge and analysis by T.test, Mann-Whitney test, regression analyses, variance analyse and Tukey in SPSS. Results: No significant difference was seen in two groups before anesthesia. After induction, blood glucose was increase in two groups but had not significant difference (p=0.11). After finishing the operation blood glucose in propofol group (148.64 mg/dl) was significantly higher than Isoflurane (124.58 mg/dl) (p=0.029). Blood glucose after recovery in two group was decrease but no significant difference was seen between two groups (p=0.651). Conclusion: General anesthesia with Isoflurane and Propofol can increase blood glucose but in Propofol group increase blood glucose was higher than Isoflurane. So recommend in children that increase blood glucose was dangerous, Propofol was contraindicated 11 20 2018/05/82018/05/9 1397/2/19 2018/05/82018/05/9 1397/2/19 ناصر کاویانی N Kaviani iran ایران ندا احمدی N Ahmadi iran ایران هاجر محبی نیا H Mohebinia iran ایران General anesthesia blood glucose propofol isoflurane pediatric dentistry. بیهوشی عمومی قند خون پروپوفول ایزوفلوران دندانپزشکی اطفال. 1. Mayer J, Bolt J, Rohm DK, et.al. Desflurane anesthesia after sevoflurane inhaled induction reduces severity of emergence agitation in children undergoing minor ear-nose-throat surgery compared with sevoflurane induction and maintenance. Anesth Analg 2006; 102:400-4.##2. Bong CL, NG AS. Evaluation of emergence delirium in Asian children using the pediatric anesthesia emergence delirium scale. Pediatric anesthesia 2009; 19:593-600.##3. Uezono S, Goto T, Terui k, et al. Emergence agitation after seviflurane versus propofol in pediatric patients. Anesth Analg 2009; 91:563-6.##4. Ronald D Miller. Miller's Anesthesia. 8th Ed. Philadelphia:Saunders, 2014:56-163.##5. Hanna AH, Mason L J. Challenges in pediatric ambulatory anesthesia. Curr Opin Anaesthesiol 2012; 25(3):315-20.##6. Katzung BG, Trevor AJ. Basic and Clinical Pharmacology.13th ed. McGraw-Hill, 2015:421-440.##7. Godoy DA, Di Napoli M, Rabinstein AA. Treating hyperglycemia in neurocritical patients: benefits and perils. Neurocritical Care 2010;13(3):425–438.##8. Nylen E S, Muller B. Endocrine changes in critical illness. Journal of Intensive Care Medicine 2004;19(2):67–82.##9. Moghissi ES, MT Korytkowski, DiNardo M. American association of clinical endocrinologists and American diabetes association consensus statement on inpatient glycemic control. Diabetes Care 2009;32(6):1119–1131.##10. Srinivasa G, Jain R, Pildes RS, Kannan CR. glucose homeostasis during anesthesia and surgery in infant. J Pediatr Surg 1986; 21(8):718-21.##11. Myles PS, Buckland MR, Morgan DJ, Weeks AM. Serum lipid and glucose concentrations with a propofol infusion for cardiac surgery. J cardiothorac vasc anesth 1995; 9(4): 373-8.##12. Oztekin I, Gokdogan S, Oztekin DS, Issver H, Goksed O. Effects of propofol and midazolam on lipids, glucose and plasma osmolality during and in the early postoperative period following coronary artery bypass graft surgery: a randomized trial. Yakugakuzasshi 2007; 127(1):173-82.##13. Schricker T, klubienk, Carli F. The independent effect of propofol anesthesia on whole body protein metabolism in humans. Anesthesiol 1999; 90(6): 1636.##14. Kitamura T, Kawamura G, Ogawa M, and Yamada Y. Comparison of the changes in blood glucose levels during an esthetic mangment using sevoflurane and propofol. Masui 2009; 58(1):81-4. ##15. Cok OY, Ozkose Z, Pasaoglu H, Yardim S. Glucose response during craniotomy: propofol-remifentanil versus isoflurane-remifentanil. Minerva Anestesiol 2011; 77(12):1141-8.##16. Kaviani N, Koosha F, Shahtusi M. Comparison of the Changes in Blood Glucose Level During Sedation with Midazolam and Propofol in Implant Surgery: A Prospective Randomized Clinical Trial. J Dent Shiraz Univ Med Sci 2014; 15(3):135-139.##17. Sato Y, Onozawa H, Fujiwara C, Kamide M, Tanifuji Y, Amaki Y. Propofol anesthesia for a patient with insulinoma. Masui 1998; 47(6):738-41. ##18. Mitterschiffthaler G, Theiner A, Hetzel H, Fuith LC. Safe use of propofol in patient with acute intermittent Porphyries. Br Anaesth 1989; 60:109-111.##1. Mayer J, Bolt J, Rohm DK, et.al. Desflurane anesthesia after sevoflurane inhaled induction reduces severity of emergence agitation in children undergoing minor ear-nose-throat surgery compared with sevoflurane induction and maintenance. Anesth Analg 2006; 102:400-4.##2. Bong CL, NG AS. Evaluation of emergence delirium in Asian children using the pediatric anesthesia emergence delirium scale. Pediatric anesthesia 2009; 19:593-600.##3. Uezono S, Goto T, Terui k, et al. Emergence agitation after seviflurane versus propofol in pediatric patients. Anesth Analg 2009; 91:563-6.##4. Ronald D Miller. Miller's Anesthesia. 8th Ed. Philadelphia:Saunders, 2014:56-163.##5. Hanna AH, Mason L J. Challenges in pediatric ambulatory anesthesia. Curr Opin Anaesthesiol 2012; 25(3):315-20.##6. Katzung BG, Trevor AJ. Basic and Clinical Pharmacology.13th ed. McGraw-Hill, 2015:421-440.##7. Godoy DA, Di Napoli M, Rabinstein AA. Treating hyperglycemia in neurocritical patients: benefits and perils. Neurocritical Care 2010;13(3):425–438.##8. Nylen E S, Muller B. Endocrine changes in critical illness. Journal of Intensive Care Medicine 2004;19(2):67–82.##9. Moghissi ES, MT Korytkowski, DiNardo M. American association of clinical endocrinologists and American diabetes association consensus statement on inpatient glycemic control. Diabetes Care 2009;32(6):1119–1131.##10. Srinivasa G, Jain R, Pildes RS, Kannan CR. glucose homeostasis during anesthesia and surgery in infant. J Pediatr Surg 1986; 21(8):718-21.##11. Myles PS, Buckland MR, Morgan DJ, Weeks AM. Serum lipid and glucose concentrations with a propofol infusion for cardiac surgery. J cardiothorac vasc anesth 1995; 9(4): 373-8.##12. Oztekin I, Gokdogan S, Oztekin DS, Issver H, Goksed O. Effects of propofol and midazolam on lipids, glucose and plasma osmolality during and in the early postoperative period following coronary artery bypass graft surgery: a randomized trial. Yakugakuzasshi 2007; 127(1):173-82.##13. Schricker T, klubienk, Carli F. The independent effect of propofol anesthesia on whole body protein metabolism in humans. Anesthesiol 1999; 90(6): 1636.##14. Kitamura T, Kawamura G, Ogawa M, and Yamada Y. Comparison of the changes in blood glucose levels during an esthetic mangment using sevoflurane and propofol. Masui 2009; 58(1):81-4. ##15. Cok OY, Ozkose Z, Pasaoglu H, Yardim S. Glucose response during craniotomy: propofol-remifentanil versus isoflurane-remifentanil. Minerva Anestesiol 2011; 77(12):1141-8.##16. Kaviani N, Koosha F, Shahtusi M. Comparison of the Changes in Blood Glucose Level During Sedation with Midazolam and Propofol in Implant Surgery: A Prospective Randomized Clinical Trial. J Dent Shiraz Univ Med Sci 2014; 15(3):135-139.##17. Sato Y, Onozawa H, Fujiwara C, Kamide M, Tanifuji Y, Amaki Y. Propofol anesthesia for a patient with insulinoma. Masui 1998; 47(6):738-41. ##18. Mitterschiffthaler G, Theiner A, Hetzel H, Fuith LC. Safe use of propofol in patient with acute intermittent Porphyries. Br Anaesth 1989; 60:109-111.## ##

بررسی میزان آگاهی والدین از مرحله تکاملی دندانی کودکان 4 تا 9 ساله Evaluation of knowledge of dental developmental stage of 4-9 years old children among parents 1 1 سابقه و هدف : آگاهی والدین از مرحله تکاملی دندانی کودک تاثیر بسزایی در کیفیت و کمیت فراهم آوری مراقبت­های بهداشتی خانگی، مراقبت­های پیشگیرانه حرفه­ای و همچنین نیازهای درمانی کودک از طرف والدین دارد. هدف از این مطالعه بررسی میزان آگاهی والدین از مرحله تکاملی دندانی کودکان 4 تا 9 ساله در مشهد می­باشد. مواد و روشها: این مطالعه به شکل مقطعی صورت گرفت. تعداد 218 والد (به همراه یک فرزند) با پرکردن پرسشنامه و پاسخ به سوالات بالینی در خصوص مرحله تکاملی دندانی کودک خود در این مطالعه شرکت کردند. داده­ها توسط نرم افزار SPSS مورد تحلیل قرار گرفت. جهت آنالیز داده­ها از میانگین،  درصد و ضریب همبستگی اسپیرمن و پیرسون استفاده­شد. یافته­ها : حدود 80% از والدین سیستم دندانی را به درستی تشخیص دادند. در رابطه با آگاهی والدین از لزوم افتادن دندان شیری برای رویش هر دندان دائمی، یافته ها نشان داد که تنها 45% از والدین به پرسش مطرح شده پاسخ صحیح دادند.  طبق آزمون آنالیز واریانس، بین آگاهی والد از نوع سیستم دندانی و سن کودک رابطه معناداری وجود داشت(p= 0.02). علاوه بر این، بین آگاهی والد از لزوم افتادن دندان شیری قبل از دندان رویش دائمی و سطح در آمد خانوار نیز رابطه معناداری وجود داشت (p= 0.022). در خصوص تشخیص شیری یا دائمی بودن دندان­ها، بالاترین درصد اشتباه مربوط به دندان های مولر اول دائمی فک پایین (37.5 درصد)، بود. سن کودک ارتباط معنادار و همبستگی مثبتی با تشخیص نادرست نوع دندان توسط والد داشت (p= 0.06). همچنین سطح تحصیلات والدین رابطه معناداری با تشخیص نادرست نوع دندان­ها نشان داد (p= 0.042).  نتیجه­گیری: درصد قابل توجهی از والدین اطلاعات ناکافی از نوع سیستم دندانی کودک و شیری یا دائمی بودن هریک از دندان­ها داشتند و نیاز به تلاش­های بیشتری در زمینه آموزش والدین توسط دندانپزشکان و نهادهای مربوطه را مطرح می­سازد 2 Background and purpose: Parental knowledge about child’s dental developmental stage affects their performance greatly in providing domestic hygienic care, professional preventive care and meeting child’s needs for treatment. The aim of this study was to evaluate of knowledge of dental developmental stage of 4-9 years old children among parents in Mashhad, Iran. Method: Two hundred eighteen parents (with one child) participated in this cross sectional study, filling questionnaires and answering clinical questions about their child’s dental developmental stage. The results were analyzed using SPSS software, using spearman and Pearson correlation, means and percentiles. Results: Around 80% of parents correctly named the dental system type of their children. Considering the question about the need for a primary tooth exfoliation before eruption of each permanent tooth, only 45% of parents gave the right answer. Variance analysis declared that there was significant relationship between knowing about type of dental system and child’s age (p= 0.02). There was also significant relationship between parental knowledge about the need for a primary tooth exfoliation before eruption of each permanent tooth and family income (p= 0.022). Parents could not correctly recognize the type of tooth (primary or permanent) for 11.01% of teeth. The most miss recognized teeth was related to lower first permanent molar (37.5 %). There was significant relationship and positive correlation between child’s age and miss recognizing the tooth type by parents (P= 0.06). There was also a significant relationship between parental academic education and miss recognizing the tooth type by parents (P= 0.042). Conclusions: A significant percentage of parents had inadequate knowledge about type of dental system and type of each tooth (primary or permanent). More effort should be put on educating parents by dentists and authorities. 21 32 2018/05/82018/05/92018/05/11 1397/2/21 2018/05/82018/05/92018/05/11 1397/2/21 مجتبی فاضل m Fazel iran ایران الهام افشاری e Afshari iran ایران Dental system primary teeth permanent teeth. سیستم دندانی- دندان شیری- دندان دائمی 1. Dean J. Turner E. Eruption of the teeth:local, systemic and congenital factors that influence the process. In: McDonald R E. Dentistry for the child and adolescent. 10th ed. Mosby Elsevier; 2016. P.349.##2. Hilton I V, Stephen S, Barker JC, Weintraub J A. Cultural factors and children's oral health care: a qualitative study of carers of young children. Community dentistry and oral epidemiology 2007; 35(6): 429-438.##3.Massignan C, Cardoso M, Porporatti A L, Aydinoz S, Canto G L, Mezzomo L A.M, Bolan M. Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis. Pediatrics peds 2016.##4.Zouashkiani T, Mirzakhan T. Parental knowledge about presence of the first permanent molar and its effect on health of the tooth in 7-8 years old children .J Mashad Dent Sch 2006; 30: 225-32##5. Luca R, Stanciu I, Ivan A, Vinereanu A. Knowledge on the first permanent molar - audit on 215 Romanian mothers. OHDMBSC 2003; 2(4): 27-32.##6. Dean J. Turner E. Development and morphology of the primary teeth. In: McDonald R E. Dentistry for the child and adolescent. 10th ed. Mosby Elsevier; 2016. P.83.##7. MO I. Impact of health education on maternal perception and practices about teething at a pediatric outpatient clinic in Lagos state.Edorium .Journal of Health Education 2016; 6:1-10.##8.Bereșescu L, Coșa L, Pop M, Kovacs M, Csilla B. knowledge of parents of preschoolers regarding eruption and caries preservation of the first permanent teeth. Debates on globalization. Approaching national identity through intercultrul dialogue, 284.##9.Petersen PE. Sociobehavioural risk factors in dental caries. International perspectives. Community Dent Oral Epidemiol 2005; 33: 274–9.##10. Arantes R, Frazão P.Income as a Protective Factor for Dental Caries among Indigenous People from Central Brazil. Journal of health care for the poor and underserved.2016; 27(1): 81-89.##11 Qajar S .Evaluating the knowledge of parents with 3-6 year old children from the Qaqazan rural areas in Qazvin, on the importance of primary teeth maintenance in 2006.[Doctoral dissertation], Qazvin university of Medical Sciences, 2006. (Persian)##12. Faezi M, Farhadi S ,NikKerdarH. Correlation between dmft, Diet and Social Factors in Primary School Children of Tehran-Iran in 2009-2010. JMDS 2012; 1(36):141-148.‎##13. Zare'ei, T. Evaluating parents knowledge on oral hygiene in elementary schools of Qazvin.[Doctoral dissertation], Qazvin Univerity of Medical Sciences,2000. (Persian)##14. Torabi M, Shojaee Poor R, Karimi Afshar S, Shojaat M, Karimi Afshar M, Moshrefian S. Evaluation of Parental Knowledge and Practice of Oral Hygiene Status in 7 Years Old Children in Kerman . Iranian Journal of Pediatric Dentistry 2013; 9 (1) :21-28##15. Haghnegahdar A A, Bronoosh P, Aidenlou S. Assessment of mothers' knowledge of sequence and time of deciduous and permanent teeth eruption in children. Sadra Medical Sciences Journal 2014. 2(1 Jan).##16. Butani Y, Weintraub J A, Barker J C. Oral health-related cultural beliefs for four racial/ethnic groups: assessment of the literature. BMC Oral Health 2008; 8(1); 26.##17. Hooley M, Skouteris H, Boganin C, Satur J, Kilpatrick N. Parental influence and the development of dental caries in children aged 0–6 years: a systematic review of the literature. Journal of dentistry 2012; 40(11): 873-885.ral Sci 2005; 13(3): 305-11.##1. Dean J. Turner E. Eruption of the teeth:local, systemic and congenital factors that influence the process. In: McDonald R E. Dentistry for the child and adolescent. 10th ed. Mosby Elsevier; 2016. P.349.##2. Hilton I V, Stephen S, Barker JC, Weintraub J A. Cultural factors and children's oral health care: a qualitative study of carers of young children. Community dentistry and oral epidemiology 2007; 35(6): 429-438.##3.Massignan C, Cardoso M, Porporatti A L, Aydinoz S, Canto G L, Mezzomo L A.M, Bolan M. Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis. Pediatrics peds 2016.##4.Zouashkiani T, Mirzakhan T. Parental knowledge about presence of the first permanent molar and its effect on health of the tooth in 7-8 years old children .J Mashad Dent Sch 2006; 30: 225-32##5. Luca R, Stanciu I, Ivan A, Vinereanu A. Knowledge on the first permanent molar - audit on 215 Romanian mothers. OHDMBSC 2003; 2(4): 27-32.##6. Dean J. Turner E. Development and morphology of the primary teeth. In: McDonald R E. Dentistry for the child and adolescent. 10th ed. Mosby Elsevier; 2016. P.83.##7. MO I. Impact of health education on maternal perception and practices about teething at a pediatric outpatient clinic in Lagos state.Edorium .Journal of Health Education 2016; 6:1-10.##8.Bereșescu L, Coșa L, Pop M, Kovacs M, Csilla B. knowledge of parents of preschoolers regarding eruption and caries preservation of the first permanent teeth. Debates on globalization. Approaching national identity through intercultrul dialogue, 284.##9.Petersen PE. Sociobehavioural risk factors in dental caries. International perspectives. Community Dent Oral Epidemiol 2005; 33: 274–9.##10. Arantes R, Frazão P.Income as a Protective Factor for Dental Caries among Indigenous People from Central Brazil. Journal of health care for the poor and underserved.2016; 27(1): 81-89.##11 Qajar S .Evaluating the knowledge of parents with 3-6 year old children from the Qaqazan rural areas in Qazvin, on the importance of primary teeth maintenance in 2006.[Doctoral dissertation], Qazvin university of Medical Sciences, 2006. (Persian)##12. Faezi M, Farhadi S ,NikKerdarH. Correlation between dmft, Diet and Social Factors in Primary School Children of Tehran-Iran in 2009-2010. JMDS 2012; 1(36):141-148.‎##13. Zare'ei, T. Evaluating parents knowledge on oral hygiene in elementary schools of Qazvin.[Doctoral dissertation], Qazvin Univerity of Medical Sciences,2000. (Persian)##14. Torabi M, Shojaee Poor R, Karimi Afshar S, Shojaat M, Karimi Afshar M, Moshrefian S. Evaluation of Parental Knowledge and Practice of Oral Hygiene Status in 7 Years Old Children in Kerman . Iranian Journal of Pediatric Dentistry 2013; 9 (1) :21-28##15. Haghnegahdar A A, Bronoosh P, Aidenlou S. Assessment of mothers' knowledge of sequence and time of deciduous and permanent teeth eruption in children. Sadra Medical Sciences Journal 2014. 2(1 Jan).##16. Butani Y, Weintraub J A, Barker J C. Oral health-related cultural beliefs for four racial/ethnic groups: assessment of the literature. BMC Oral Health 2008; 8(1); 26.##17. Hooley M, Skouteris H, Boganin C, Satur J, Kilpatrick N. Parental influence and the development of dental caries in children aged 0–6 years: a systematic review of the literature. Journal of dentistry 2012; 40(11): 873-885.ral Sci 2005; 13(3): 305-11.## ##

بررسی میزان آگاهی پزشکان کودکان درخصوص پوسیدگی های زودرس دندان کودکان Evaluation of the knowledge and awareness of pediatricians about the early childhood caries 1 1 سابقه و هدف : با توجه به این که متخصصین کودکان اولین گروه کادر پزشکی هستند که با کودک و والدین وی تماس دارند می توانند  با تشخیص زودرس ضایعات پوسیدگی وارجاع به موقع بیمار به متخصصین دندانپزشکی کودکان در پیشگیری از عوارض احتمالی آینده این بیماری در کودک نقش بسزایی ایفا کنند. مطالعه حاضر با هدف تعیین میزان آگاهی متخصصین کودکان شاغل در شهر یزد در سال 1395 در خصوص پوسیدگی های زودرس دندان کودکان انجام  شد. مواد و روشها : در این مطالعه توصیفی مقطعی،  53 نفر از متخصصین کودکان شاغل در شهر یزد در سال 1395 شرکت کردند. جهت گردآوری داده ها از پرسشنامه روا و پایا استفاده شد .این پرسشنامه در دو قسمت اطلاعات فردی و سوالات مربوط به آگاهی تنظیم گردیده بودکه براساس پرسشنامه های قبلی بعد از روایی سنجی مورد تأیید قرار گرفت. جهت تجزیه و تحلیل داده ها ازآزمون های آماری t-test و ANOVA استفاده شد.(05/0=α) یافته ها : از 53 متخصص (میانگین سنی (04/9±11/46)) 36 نفر (9/67%) مرد و 17 نفر (1/32%) زن بودند. میانگین نمره آگاهی کلی متخصصین در خصوص پوسیدگی های زودرس دندان کودکان 39/3 ± 71/19 بود. ارتباط آماری معنی داری بین میانگین نمره آگاهی بر حسب گروه های سنی مورد مطالعه (479/0=(P value ، جنس(560/0=(P value و پیشینه کار طبابت (749/0=P value )مشاهده نشد. نتیجه گیری: بر اساس یافته های این مطالعه آگاهی متخصصین کودکان شهر یزد در خصوص پوسیدگی های زودرس دندان کودکان درسطح مطلوبی قرار داشت. 2 Background and aims: Since pediatricians are the first group of medical staff who has contact with children and parents, they can play a significant role with early detection of caries lesions and referring the patient to a dentist or pediatric dental specialists to prevent the future possible complications. The aim of this study was to evaluate the knowledge and awareness of pediatricians at Yazd city about the early-onset tooth decay in the children in 2016. Methods: In this descriptive, cross-sectional study 53 pediatricians who worked at Yazd in 2016 were included. Data were collected by valid and reliable questionnaires. The questionnaires were included two parts: demographic Information and the knowledge questions. Data were analyzed by ANOVA and T-test while α=0.05. Results: Of 53 pediatricians (mean age 34.6 ± 9.49), 36 ones (67.9%) were male and 17(32.1%) were female. The mean value of pediatricians’ knowledge in this regard was recorded as 19.71±3.39. The mean value of pediatricians’ knowledge was no statistically significant according to the demographic factor like age (P-value=0.479), the gender (P-value=0.560), and the previous professional experience (P-value=0.749(. Conclusion: Based on the results of this study pediatricians’ knowledge about the early-onset tooth decay in the children at Yazd should be inceased. 33 44 2018/05/82018/05/92018/05/112018/05/11 1397/2/21 2018/05/82018/05/92018/05/112018/05/11 1397/2/21 مهدی جعفرزاده m Jafarzadeh iran ایران رویا غفوری فرد r Ghafourifard iran ایران دانا تحریریان d Tahririyan iran ایران علی غفوری فرد a Ghafourifard iran ایران Early Childhood caries Pediatrician knowledge پوسیدگی های دندان؛پوسیدگی زودرس کودکان؛متخصصین کودکان؛کودکان پیش دبستانی؛ آگاهی 1. Mcdonald RE, Avery DR, Dean JA. Dentistry for the child and adolescent. St.Louis: Mosby; 2011.##2. Qin M, Li J, Zhang S, Ma W. Risk factors for sev Dental Research center, Assistant professor, Department of Pedodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran ere early childhood caries in children younger than 4 years old in Beijing, China. Pediatr Dent 2008;30(2):122-8.##3. Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc 2009;140(6):650-7.##4. Kawashita Y, Kitamura M, Saito T. Early childhood caries. Int J Dent 2011;2011:725320.##5. Tang C, Quinonez RB, Hallett K, Lee JY, Whitt JK. Examining the association between parenting stress and the development of early childhood caries. Community Dent Oral Epidemiol 2005;33(6):454-60.##6. Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, et al. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital Health Stat 11 2007(248):1-92.##7. Mohebbi SZ, Virtanen JI, Murtomaa H, Vahid-Golpayegani M, Vehkalahti MM. Mothers as facilitators of oral hygiene in early childhood. Int J Paediatr Dent 2008;18(1):48-55.##8. Tiberia MJ, Milnes AR, Feigal RJ, Morley KR, Richardson DS, Croft WG, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dent 2007;29(3):201-8.##9. Tinanoff N, O'Sullivan DM. Early childhood caries: overview and recent findings. Pediatr Dent 1997;19(1):12-6.##10. Caufield PW, Li Y, Dasanayake A. Dental caries: an infectious and transmissible disease. Compend Contin Educ Dent 2005;26(5 Suppl 1):10-6.##11. Tinanoff N, Reisine S. Update on early childhood caries since the Surgeon General's Report. Acad Pediatr 2009;9(6):396-403.##12. Nammalwar RB, Rangeeth P. Knowledge and attitude of pediatricians and Family Physicians in Chennai on Pediatric Dentistry: A survey. Dent Res J (Isfahan) 2012;9(5):561-6.##13. Broderick E, Mabry J, Robertson D, Thompson J. Baby bottle tooth decay in Native American children in Head Start centers. Public Health Rep 1989;104(1):50-4.##14. Shiboski CH, Gansky SA, Ramos-Gomez F, Ngo L, Isman R, Pollick HF. The association of early childhood caries and race/ethnicity among California preschool children. J Public Health Dent 2003;63(1):38-46.##15. Murthy GA, Mohandas U. The knowledge, attitude and practice in prevention of dental caries amongst pediatricians in Bangalore: a cross-sectional study. J Indian Soc Pedod Prev Dent 2010;28(2):100-3.##16. Gonzalez E, Perez-Hinojosa S, Alarcon JA, Penalver MA. Knowledge of Andalusian pediatricians and parents about early-onset tooth decay. An Pediatr (Barc) 2015;82(1):19-26.##17. Poornima P, Bajaj M, Nagaveni NB, Roopa KB, Neena IE, Bharath KP. Evaluation of the knowledge, attitude and awareness in prevention of dental caries amongst paediatricians. Int J Community Med Public Health 2015;2(1):64-70.##18. Ismail AI, Nainar SM, Sohn W. Children's first dental visit: attitudes and practices of US pediatricans and family physicians. Pediatr Dent 2003;25(5):425-30.##19. Di Giuseppe G, Nobile CG, Marinelli A, Angelillo IF. Knowledge, attitude and practices of pediatricians regarding the prevention of oral diseases in Italy. BMC Public Health 2006;6:176.##20. Douglass JM, Douglass AB, Silk HJ. A practical guide to infant oral health. Am Fam Physician 2004;70(11):2113-20.##21. Douglass JM, Douglass AB, Silk HJ. Infant oral health education for pediatric and family practice residents. Pediatr Dent 2005;27(4):284-91.##22. Lewis CW, Grossman DC, Domoto PK, Deyo RA. The role of the pediatrician in the oral health of children: A national survey. Pediatrics 2000;106(6):E84.##23. Prakash P, Lawrence HP, Harvey BJ, McIsaac WJ, Limeback H, Leake JL. Early childhood caries and infant oral health: Paediatricians' and family physicians' knowledge, practices and training. Paediatr Child Health 2006;11(3):151-7.##24. Sanchez OM, Childers NK, Fox L, Bradley E. Physicians' views on pediatric preventive dental care. Pediatr Dent 1997;19(6):377-83.##25. Tsamtsouris A, Gavris V. Survey of pediatrician's attitudes towards pediatric dental health. J Pedod 1990;14(3):152-7.##26. Sakakibara Y. A study on bond strength to dentin irradiated by erbium: YAG laser. JAPANESE JOURNAL OF CONSERVATIVE DENTISTRY 1998;41:207-219.##27. Douglass AB, Douglass JM, Krol DM. Educating pediatricians and family physicians in children's oral health. Acad Pediatr 2009;9(6):452-6.##28. Krol DM. Dental caries, oral health, and pediatricians. Curr Probl Pediatr Adolesc Health Care 2003;33(8):253-70.##29. Sezer RG, Paketci C, Bozaykut A. Paediatricians' awareness of children's oral health: Knowledge, training, attitudes and practices among Turkish paediatricians. Paediatr Child Health 2013;18(4):e15-9.##30. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent 2008;30(7 Suppl):40-3.##31. Caspary G, Krol DM, Boulter S, Keels MA, Romano-Clarke G. Perceptions of oral health training and attitudes toward performing oral health screenings among graduating pediatric residents. Pediatrics 2008;122(2):e465-71.##32. Brickhouse TH, Unkel JH, Kancitis I, Best AM, Davis RD. Infant oral health care: a survey of general dentists, pediatric dentists, and pediatricians in Virginia. Pediatr Dent 2008;30(2):147-53.##33. Koch G, Poulsen S. Pediatric dentistry- A clinical approach. 2nd ed. Kent: Wiley-Blackwell; 2009.##34. Chandiwal S, Yoon RK. Assessment of an infant oral health education program on resident physician knowledge. J Dent Child (Chic) 2012;79(2):49-52.##35. Bruerd B, Jones C. Preventing baby bottle tooth decay: eight-year results. Public Health Rep 1996;111(1):63-5.##36. Grenby TH, Andrews AT, Mistry M, Williams RJ. Dental caries-protective agents in milk and milk products: investigations in vitro. J Dent 2001;29(2):83-92.##37. Iida H, Auinger P, Billings RJ, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics 2007;120(4):e944-52.##38. Salone LR, Vann WF, Jr., Dee DL. Breastfeeding: an overview of oral and general health benefits. J Am Dent Assoc 2013;144(2):143-51.##39. Weerheijm KL, Uyttendaele-Speybrouck BF, Euwe HC, Groen HJ. Prolonged demand breast-feeding and nursing caries. Caries Res 1998;32(1):46-50.##40. White V. Breastfeeding and the risk of early childhood caries. Evid Based Dent 2008;9(3):86-8.##41. Amiri-TehraniZadeh N, Asgarizadeh N, Kamel V. A literature review of the relationship between breastfeeding and early childhood caries. J Dent Med 2012;25(2):142-50.##42. Judit S. Fissure sealing. A review. Fogorv Sz 2008;101(4):137-46.####1. Mcdonald RE, Avery DR, Dean JA. Dentistry for the child and adolescent. St.Louis: Mosby; 2011.##2. Qin M, Li J, Zhang S, Ma W. Risk factors for sev Dental Research center, Assistant professor, Department of Pedodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran ere early childhood caries in children younger than 4 years old in Beijing, China. Pediatr Dent 2008;30(2):122-8.##3. Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc 2009;140(6):650-7.##4. Kawashita Y, Kitamura M, Saito T. Early childhood caries. Int J Dent 2011;2011:725320.##5. Tang C, Quinonez RB, Hallett K, Lee JY, Whitt JK. Examining the association between parenting stress and the development of early childhood caries. Community Dent Oral Epidemiol 2005;33(6):454-60.##6. Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, et al. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital Health Stat 11 2007(248):1-92.##7. Mohebbi SZ, Virtanen JI, Murtomaa H, Vahid-Golpayegani M, Vehkalahti MM. Mothers as facilitators of oral hygiene in early childhood. Int J Paediatr Dent 2008;18(1):48-55.##8. Tiberia MJ, Milnes AR, Feigal RJ, Morley KR, Richardson DS, Croft WG, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dent 2007;29(3):201-8.##9. Tinanoff N, O'Sullivan DM. 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بررسی دیدگاه های دندانپزشکان عمومی در خصوص درمان پوسیدگی های اکلوزالی عمیق عاجی بدون درگیری پالپ در دندان های دائمی جوان Evaluation of general practitioners' treatment choices of deep occlusal caries without pulpal involvement in young permanent teeth 1 1 سابقه و هدف : اولین مولر دائمی به سادگی دچار پوسیدگی می شود ولی عواملی مثل پذیرش درمان توسط بیمار، سن پایین آنها، نبود گایدلاین واضح و عدم اطمینان از نتیجه درمان، دندانپزشکان را برای انتخاب طرح درمان قاطع مردد می کند.هدف این طرح، شناسایی طرح درمان های منتخب از سوی دندانپزشکان عمومی تهران برای درمان پوسیدگی های عمیق در دندان های زنده دائمی جوان است. مواد و روشها : در این مطالعه توصیفی-مقطعی، که بر روی 401 دندانپزشک عمومی انجام شد، یک پرسشنامه‌ی اختصاصی به منظور بررسی عملکرد دندانپزشکان عمومی هنگام مواجه با بیمار خردسال که دارای پوسیدگی عمیق اکلوزالی بر روی دندان دائمی نابالغ خود بود، طراحی گردید. این پرسشنامه از طریق ارسال لینک پرسشنامه در تلگرام و یا به صورت حضوری در اختیار دندانپزشکان قرار داده شد. پس از مطالعه پاسخ های تشریحی انواع درمان تاج، وپالپ و پیگیری بیمار بعد از انجام درمان های مورد نظر، بررسی شد. به منظور بررسی داده های به دست آمده از نرم افزار SPSS و آنالیز رگرسیون multinominal استفاده شد. پاسخ های دندانپزشکان با درمان های تایید شده بر اساس گایدلاین ها و مقالات مختلف مقایسه گردید تا میزان تطابق آن با این گایدلاین هاسنجیده شود.داده ها به صورت توصیفی استخراج گردید. یافته ها : 50% دندانپزشکان در صورت اکسپوز شدن پالپ در حین درمان، Root canal therapy، و در صورت عدم اکسپوز، 80% دندانپزشکان درمان پالپ کپ غیر مستقیم را برگزیدند. نتیجه گیری: اکثر طرح درمان هایی که توسط دندانپزشکان به عنوان درمان بیمار مورد سوال قرار گرفته  مطرح شد با طرح درمان های تایید شده توسط رفرنس های معتبر همخوانی نداشت که این امر بر لزوم تدوین ودر اختیار قرار دادن یک راهنمای بالینی تاکید می کند. 2 Background and aim: The first permanent molar is easily decayed, especially at early years of eruption. Some factors such as avoid of treatment by very young patients, their low age, the lack of clear guideline, and the uncertainty of the outcome of the treatment undermine the dentists to choose a decisive treatment plan. The purpose of this study was identification of selected treatment plans by Tehran general dentists for the treatment of deep caries in young permanent teeth. Methods: This was a descriptive cross-sectional study, which was performed on 401 general dentists. A specific questionnaire was designed to assess the performance of general dentists when dealing with a young patient with deep occlusal caries of young permanent teeth. This questionnaire sent to dentists by social network. Data were analyzed using SPSS software and multinominal regression analysis. Dentists' responses were compared with approved therapies based on the references and the various articles to measure their compliance with these guide lines. Results: Around 50% of dentists in the event of pulp exposure during treatment, selected the root canal therapy, and in the absence of exposure, 80% of dentists chose indirect pulp therapy. Conclusion: Most of the treatments that were discussed by dentists as patient treatment were not consistent with the design of approved therapies by valid references, which emphasizes the need for a clinical guide to be compiled. 45 56 2018/05/82018/05/92018/05/112018/05/112018/05/12 1397/2/22 2018/05/82018/05/92018/05/112018/05/112018/05/12 1397/2/22 احمد جعفری a Jafari iran ایران فریماه پورجواد f Pourjavad iran ایران روشنک منتظری r Montazeri iran ایران Function deep caries young permanent teeth general dentists open apex apexogenesis direct pulp capping clinical guidelines. عملکرد پوسیدگی عمیق دندان های دائمی نابالغ دندانپزشکان عمومی اپکس باز اپکسوژنزیس پوشش مستقیم پالپ راهنمای بالینی 1. Badri Gargari R, Salek Hadadian N. The role of factors related to perceived self-efficacy and health behavior brushing and flossing pull the visitors to the private office of Tabriz. Int J Res Med Sci. 2011;9:130-8.##2. Shayegh S, Nasr Esfahani M. Knowledge and attitudes of dental students at universities across the country to provide oral health services, and health care networks in the nation. Daneshvar J. 2007;15:53-6.##3. Bader JD, Shugars DA. Understanding dentists' restorative treatment decisions. Journal of public health dentistry. 1992;52(2):102-10.##4. Weber CM, Alves LS, Maltz M. Treatment decisions for deep carious lesions in the Public Health Service in Southern Brazil. Journal of public health dentistry. 2011;71(4):265-70.##5. Çağlaroğlu M, Kilic N, Erdem A. Effects of early unilateral first molar extraction on skeletal asymmetry. American Journal of Orthodontics and Dentofacial Orthopedics. 2008;134(2):270-5.##6. Risse G. The angulation of upper 1st permanent molars, the key to functional occlusion. Artikel Fach J. 2005;1:1-9.##7. Fazeli A, Fazeli A. First-molar caries in primary school children of a northern city of Iran. Pakistan Oral & Dent. 2005;25(1):93-6.##8. Motlagh MG, Kohestani A. An investigation on DMFTand DMFS of first permanent molars in 12-year-old blind children in residential institutes for blinds in Tehran (2000-2001). Journal of Dentistry of Tehran University of Medical Sciences. 2004;1(3):56-61.##9. Rebellato J, editor Asymmetric extractions used in the t reatment of patients with asymmetries. Seminars in orthodontics; 1998: Elsevier.##10. Luca R, Stanciu I, Ivan A, Vinereanu A. Knowledge on the first permanent molar-audit on 215 Romanian mothers. OHDMBSC. 2003;2(4):27-32.##11. Zouashkiani T, Mirzakhan T. Parental knowledge aboutpresence of the first permanent molar and its effect on health of the this tooth in 7-8 years-old children (2006). Journal of Mashhad Dental School. 2006;30(Issue):225-32.##12. Ong DV, Bleakley J. Compromised first permanent molars: an orthodontic perspective. Australian dental journal. 2010;55(1):2-14.##13. Chen JW, Leggitt VL. Pulp treatment for young first permanent molars: To treat or to extract? Endodontic Topics. 2010;23(1):34-40.##14. Handbook of clinical techniques in pediatric dentistry. .2015.##15. Barbizam JVB, Ribeiro RG, Tanomaru Filho M. Unusual anatomy of permanent maxillary molars. Journal of endodontics. 2004;30(9):668-71.##16. El Meligy O, Al Nowaiser A, Al Sheikh L, Caliwag N. Decision-making in the Management of Badly Decayed First Permanent Molars in Children and Adolescents. J Dent Oral Care Med. 2016;2(3):302.##17. Tsilingaridis G, Malmgren B, Andreasen JO, Malmgren O. Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome. Dental Traumatology. 2012;28(6):416-22.##18. Andreasen FM. Histological and bacteriological study of pulps extirpated after luxation injuries. Dental Traumatology. 1988;4(4):170-81.##19. Chala S, Abouqal R, Rida S. Apexification of immature teeth with calcium hydroxide or mineral trioxide aggregate: systematic review and meta-analysis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;112(4):e36-e42.##20. Katebzadeh N, Dalton BC, Trope M. Strengthening immature teeth during and after apexification. Journal of Endodontics. 1998;24(4):256-9.##21. Favieri A, Barros FGBd, Campos LC. Root canal therapy of a maxillary first molar with five root canals: case report. Brazilian dental journal. 2006;17(1):75-8.##22. Nygaard-Östby B. Caries profunda. Nor Tannlaegeforen Tid. 1951;61:96-105.##23. Langeland K. Tissue response to dental caries. Dental Traumatology. 1987;3(4):149-71.##24. Torneck CD. Changes in the fine structure of the dental pulp in human caries pulpitis. Journal of Oral Pathology & Medicine. 1974;3(2):83-99.##25. Pitts N. " ICDAS"--an international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management. Community dental health. 2004;21(3):193.##26. Stangvaltaite L. The" deep caries" challenge. Prevalence and management of deep carious lesions in Northern Norway. 2015.##27. Massler M. Pulpal reactions to dental caries. International dental journal. 1967;17(2):441-60.##28. Massler M, Pawlak J. The affected and infected pulp. Oral Surgery, Oral Medicine, Oral Pathology. 1977;43(6):929-47.##29. Dentistry AAoP. Guideline on pulp therapy for primary and immature permanent teeth, Revised 2014. Pediatric dentistry Reference Manual. 2014;2015:242-50.##30. Murray P. Treatments for Traumatized and Diseased Immature Teeth: Pulpotomy, Cvek Partial Pulpotomy, Apexification, Apexogenesis, and Regenerative Endodontics. A Concise Guide to Endodontic Procedures: Springer; 2015. p. 73-97.##31. Oen KT, Thompson VP, Vena D, Caufield PW, Curro F, Dasanayake A, et al. Attitudes and expectations of treating deep caries: a PEARL Network survey. General dentistry. 2007;55(3):197-203.##32. Schwendicke F, Meyer-Lueckel H, Dörfer C, Paris S. Attitudes and behaviour regarding deep dentin caries removal: a survey among German dentists. Caries research. 2013;47(6):566-73.##33. McQuistan MR, Kuthy RA, Daminano PC, Ward MM. General dentists' referrals of 3-to 5-year-old children to pediatric dentists. The Journal of the American Dental Association. 2006;137(5):653-60.## ##1. Badri Gargari R, Salek Hadadian N. The role of factors related to perceived self-efficacy and health behavior brushing and flossing pull the visitors to the private office of Tabriz. Int J Res Med Sci. 2011;9:130-8.##2. Shayegh S, Nasr Esfahani M. Knowledge and attitudes of dental students at universities across the country to provide oral health services, and health care networks in the nation. Daneshvar J. 2007;15:53-6.##3. Bader JD, Shugars DA. Understanding dentists' restorative treatment decisions. Journal of public health dentistry. 1992;52(2):102-10.##4. Weber CM, Alves LS, Maltz M. Treatment decisions for deep carious lesions in the Public Health Service in Southern Brazil. Journal of public health dentistry. 2011;71(4):265-70.##5. Çağlaroğlu M, Kilic N, Erdem A. Effects of early unilateral first molar extraction on skeletal asymmetry. American Journal of Orthodontics and Dentofacial Orthopedics. 2008;134(2):270-5.##6. Risse G. The angulation of upper 1st permanent molars, the key to functional occlusion. Artikel Fach J. 2005;1:1-9.##7. Fazeli A, Fazeli A. First-molar caries in primary school children of a northern city of Iran. Pakistan Oral & Dent. 2005;25(1):93-6.##8. Motlagh MG, Kohestani A. An investigation on DMFTand DMFS of first permanent molars in 12-year-old blind children in residential institutes for blinds in Tehran (2000-2001). Journal of Dentistry of Tehran University of Medical Sciences. 2004;1(3):56-61.##9. Rebellato J, editor Asymmetric extractions used in the t reatment of patients with asymmetries. Seminars in orthodontics; 1998: Elsevier.##10. Luca R, Stanciu I, Ivan A, Vinereanu A. Knowledge on the first permanent molar-audit on 215 Romanian mothers. OHDMBSC. 2003;2(4):27-32.##11. Zouashkiani T, Mirzakhan T. Parental knowledge aboutpresence of the first permanent molar and its effect on health of the this tooth in 7-8 years-old children (2006). Journal of Mashhad Dental School. 2006;30(Issue):225-32.##12. Ong DV, Bleakley J. Compromised first permanent molars: an orthodontic perspective. Australian dental journal. 2010;55(1):2-14.##13. Chen JW, Leggitt VL. Pulp treatment for young first permanent molars: To treat or to extract? Endodontic Topics. 2010;23(1):34-40.##14. Handbook of clinical techniques in pediatric dentistry. .2015.##15. Barbizam JVB, Ribeiro RG, Tanomaru Filho M. Unusual anatomy of permanent maxillary molars. Journal of endodontics. 2004;30(9):668-71.##16. El Meligy O, Al Nowaiser A, Al Sheikh L, Caliwag N. Decision-making in the Management of Badly Decayed First Permanent Molars in Children and Adolescents. J Dent Oral Care Med. 2016;2(3):302.##17. Tsilingaridis G, Malmgren B, Andreasen JO, Malmgren O. Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome. Dental Traumatology. 2012;28(6):416-22.##18. Andreasen FM. Histological and bacteriological study of pulps extirpated after luxation injuries. Dental Traumatology. 1988;4(4):170-81.##19. Chala S, Abouqal R, Rida S. Apexification of immature teeth with calcium hydroxide or mineral trioxide aggregate: systematic review and meta-analysis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;112(4):e36-e42.##20. Katebzadeh N, Dalton BC, Trope M. Strengthening immature teeth during and after apexification. Journal of Endodontics. 1998;24(4):256-9.##21. Favieri A, Barros FGBd, Campos LC. Root canal therapy of a maxillary first molar with five root canals: case report. Brazilian dental journal. 2006;17(1):75-8.##22. Nygaard-Östby B. Caries profunda. Nor Tannlaegeforen Tid. 1951;61:96-105.##23. Langeland K. Tissue response to dental caries. Dental Traumatology. 1987;3(4):149-71.##24. Torneck CD. Changes in the fine structure of the dental pulp in human caries pulpitis. Journal of Oral Pathology & Medicine. 1974;3(2):83-99.##25. Pitts N. " ICDAS"--an international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management. Community dental health. 2004;21(3):193.##26. Stangvaltaite L. The" deep caries" challenge. Prevalence and management of deep carious lesions in Northern Norway. 2015.##27. Massler M. Pulpal reactions to dental caries. International dental journal. 1967;17(2):441-60.##28. Massler M, Pawlak J. The affected and infected pulp. Oral Surgery, Oral Medicine, Oral Pathology. 1977;43(6):929-47.##29. Dentistry AAoP. Guideline on pulp therapy for primary and immature permanent teeth, Revised 2014. Pediatric dentistry Reference Manual. 2014;2015:242-50.##30. Murray P. Treatments for Traumatized and Diseased Immature Teeth: Pulpotomy, Cvek Partial Pulpotomy, Apexification, Apexogenesis, and Regenerative Endodontics. A Concise Guide to Endodontic Procedures: Springer; 2015. p. 73-97.##31. Oen KT, Thompson VP, Vena D, Caufield PW, Curro F, Dasanayake A, et al. Attitudes and expectations of treating deep caries: a PEARL Network survey. General dentistry. 2007;55(3):197-203.##32. Schwendicke F, Meyer-Lueckel H, Dörfer C, Paris S. Attitudes and behaviour regarding deep dentin caries removal: a survey among German dentists. Caries research. 2013;47(6):566-73.##33. McQuistan MR, Kuthy RA, Daminano PC, Ward MM. General dentists' referrals of 3-to 5-year-old children to pediatric dentists. The Journal of the American Dental Association. 2006;137(5):653-60.## ## ##

آگاهی وعملکرد مرتبط با سلامت دهان در مادران باردارمراجعه کننده به مراکز بهداشتی درمانی Knowledge and practice related to oral health in pregnant women referring to health centers 1 1 سابقه و هدف: مادران باردار به سبب تغییرات فیزیولوژیک و رفتاری از ریسک افزایش یافته ای برای بیماری های دهان و دندان برخوردار هستند. مطالعه حاضر با هدف ارزیابی آگاهی و عملکرد مادران باردار مراجعه کننده به مراکز بهداشتی درمانی کمتر برخوردار شهر تهران در رابطه با سلامت دهان و دندان انجام شد. مواد و روشها : این مطالعه به صورت مقطعی بر روی مادران باردار مراجعه کننده به ۱۰ مرکز بهداشتی درمانی در شهر تهران صورت گرفت. در میان افراد شرکت کننده پرسشنامه ای توزیع گردید که سوالات آن در سه دسته ی اطلاعات دموگرافیک، عملکرد مادران و دانش مادران  طبقه بندی شده بود. پرسشنامه ها توسط خود افراد تکمیل گردید. در نهایت داده ها با آزمون های آماری توصیفی ، همبستگی و رگرسیون توسط نرم افزار IBM SPSS (نسخه ۲۴) مورد تجزیه تحلیل قرار گرفتند.  یافته ها : تعداد ۱۶۶ مادر باردار در مطالعه شرکت کردند میانگین نمره دانش مادران در رابطه با سلامت دهان در دوران بارداری، نمره ۳.۳۲ از ۹ بود.. نتایج آنالیز های رگرسیونی نشان داد، بین دانش عمومی مادران باردار در زمینه سلامت دهان و میزان تحصیلات افراد ارتباط وجود داشت  (065/0 p=)  و با قومیت، نژاد، سطح تحصیلات همسر، سطح درآمد، وضعیت محل سکونت ارتباط نداشت (‏1/0‏p<).  در حالی که میزان دانش مادران باردار در مورد سلامت دهان و دندان در دوران بارداری با سطح تحصیلات (07/0p=) ، وضعیت محل سکونت (042/0p=) و تعداد افراد خانوار مادران (069/0p=) ارتباط معنی­داری برقرار بود. رفتارهای عمومی سلامت دهان مادران تنها با میزان تحصیلات افراد ارتباط داشت (03/0p<) و با سایر متغییرها ارتباط معنی­داری نداشت (‏1/0‏p<). در حالی که بین رفتار های سلامت در دوران بارداری توسط مادران باردار با هیچ یک از متغیرهای مورد مطالعه ارتباط معنی داری وجود نداشت (‏1/0‏p<). نتیجه گیری: نتایج پژوهش حاضر نشان داد جامعه ی مورد مطالعه از سطح آگاهی و دانش کافی در زمینه ی مراقبت از سلامت دهان و دندان برخوردار نبوده و لازم است در این زمینه به مادران باردار آموزش های متناسب در مورد مهارت های عملی مراقبت از سلامت دهان و دندان داده شود و این افراد از اهمیت حفظ سلامت دهان در این دوران و اثرات بالقوه نامطلوب بیماری های پریودنتال آگاه گردند. 2 Background and purpose: Pregnant women have increased risk for oral and dental diseases due to their ‎physiological and behavioral changes. The aim of this study was to evaluate the awareness and ‎performance of pregnant women referred to non-affluent health centers in Tehran about oral and ‎dental health. Methods: This cross-sectional study was conducted on pregnant women attended to ‎‎10 health centers in Tehran. A questionnaire was distributed among the participants in which ‎questions were categorized into three categories of demographic information, mothers' ‎performance and their knowledge. Finally, the data were analyzed by IBM SPSS software (version 24) using descriptive, correlation and regression tests. Results: Totally, 166 pregnant women participated in the study. The average ‎score of people was 3.32 out of nine. The results of regression analysis showed ‎that there was a relatively significant relationship between the general knowledge of pregnant ‎women about oral health and the level of education (P = 0.065) but there was no correlation ‎between general oral health knowledge and ethnicity, husband education, income and resident ‎status (p>0.1). While oral health knowledge of pregnant women during pregnancy with education ‎‎(p=0.07), resident status (p=0.042) and the number of mother roommates (p=0.069) had relatively significant correlation. General Oral health behavior had significant statistical correlation with ‎education (p=0.03), but there was no correlation with other variables (p>0.1). Oral health behavior ‎during pregnancy was not significantly correlated with any of the variables (P> 0.1). Conclusion: The ‎results of this study showed that the study population had no acceptable knowledge about oral and ‎dental health care and it is necessary to train pregnant women on practical skills of oral health care ‎and they will be aware of the importance of maintaining oral health during this period and the ‎potential adverse effects of periodontal diseases.‎ 57 72 2018/05/82018/05/92018/05/112018/05/112018/05/122018/05/12 1397/2/22 2018/05/82018/05/92018/05/112018/05/112018/05/122018/05/12 1397/2/22 سیمین زهرا محبی s Mohebi iran ایران کتایون سرگران k Sargeran iran ایران سمانه رازقی k Razeghi iran ایران شاداب خراسانی زاده sh Khorasanizadeh iran ایران هدی بهرامیان h Bahramian iran ایران Oral Health pregnant women knowledge practice. سلامت دهان مادران باردار آگاهی عملکرد 1. Bahramian H, Mohebbi SZ, Khami MR, Asadi-Lari M, Shamshiri AR, Hessari H. Psychosocial determinants of dental service utilization among adults: Results from a population-based survey (Urban HEART-2) in Tehran, Iran. European journal of dentistry. 2015;9(4)542-550.##2. Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. American Family Physician. 2008;77(8).##3. Thomas NJ, Middleton PF, Crowther CA. Oral and dental health care practices in pregnant women in Australia: a postnatal survey. BMC pregnancy and childbirth. 2008;8(1):13.##4. Gaffield ML, GILBERT BJC, MALVITZ DM, ROMAGUERA R. Oral health during pregnancy: an analysis of information collected by the pregnancy risk assessment monitoring system. The Journal of the American Dental Association. 2001;132(7):1009-16.##5. Mamatha B RR, G Radha. ORAL HEALTH STATUS AND TREATMENT NEEDS FOR PREGNANT WOMEN: A REVIEW. International Journal of Dental and Health Sciences. 2015;02(03):619-27.##6. Xiong X, Buekens P, Fraser W, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. 2006;113(2):135-43.##7. George A, Johnson M, Blinkhorn A, Ajwani S, Bhole S, Yeo A, et al. The oral health status, practices and knowledge of pregnant women in south‐western Sydney. Australian dental journal. 2013;58(1):26-33.##8. Byanaku Ak RD. ORAL HEALTH OF PREGNANT WOMEN; Knowledge, attitude and practice at antenatal care clinic in Morogoro Municipal, Tanzania. Professional Med Journal. 2016;20(3):365-73.##9. Council O. Guideline on Perinatal Oral Health Care.##10. Shamsi M, Hidarnia A, Niknami S. Self-reported oral hygiene habits and self-care in the oral health in sample of Iranian women during pregnancy. World Applied Sciences Journal. 2013;22(5):647-56.##11. Kazemi HH, Zeinal Zadeh M, Farsam F, Khafri S, Matloubi N. Pregnant women's self-report of oral health condition and its relation with oral clinical status. Iran J Obstet Gynecol Infertil 2016; 18(186):9-16.##12. HajiKazemi E, Mohseni SH, Oskouie F, Haghani H. The association between knowledge, attitude and performance in pregnant women toward dental hygiene during pregnancy. Iran Journal of Nursing. 2005;18(43):31-8.##13. Shamsi M, Hidarnia A, Niknami S. A survey of oral health care behavior in pregnant women of Arak: Application of Health Belief Model. Journal of Mazandaran University of Medical Sciences. 2012;22(89):103-115. (Persian)##14. Bayat F, Karimi-Shahanjarini A, Bashirian S, Faradmal J. Assessment of Dental Care and its Related Barriers in Pregnant Women of Hamadan City. JECH. 2016; 3 (1) :20-27##15. Shamsi M, Hidarnia A, Niknami S, Rafiee M, Karimi M: Oral health during pregnancy: A study from women with pregnancy. Dent Res J (Isfahan). 2013;10:409-410.##16. Boggess KA, Urlaub DM, Massey KE, Moos M-K, Matheson MB, Lorenz C. Oral hygiene practices and dental service utilization among pregnant women. The Journal of the American Dental Association. 2010;141(5):553-61.##17. Saddki N, Yusoff A, Hwang YL. Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia. BMC Public Health. 2010;10(1)75 ##18. Hullah E, Turok Y, Nauta M, Yoong W. Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London. Archives of gynecology and obstetrics. 2008;277(5):405-9.##19. Al Habashneh R, Guthmiller JM, Levy S, Johnson GK, Squier C, Dawson DV, et al. Factors related to utilization of dental services during pregnancy. Journal of clinical periodontology. 2005;32(7):815-21.##20. Özen B, Özer L, Başak F, Altun C, Açıkel C. Turkish women’s self-reported knowledge and behavior towards oral health during pregnancy. Medical Principles and Practice. 2012;21(4):318-22.##21. Bamanikar S, Kee LK. Knowledge, attitude and practice of oral and dental healthcare in pregnant women. Oman medical journal. 2013;28(4):288.##22. Hom JM, Lee JY, Divaris K, Baker AD, Vann WF. Oral health literacy and knowledge among patients who are pregnant for the first time. The Journal of the American Dental Association. 2012;143(9):972-80.####1. Bahramian H, Mohebbi SZ, Khami MR, Asadi-Lari M, Shamshiri AR, Hessari H. Psychosocial determinants of dental service utilization among adults: Results from a population-based survey (Urban HEART-2) in Tehran, Iran. European journal of dentistry. 2015;9(4)542-550.##2. Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. American Family Physician. 2008;77(8).##3. Thomas NJ, Middleton PF, Crowther CA. Oral and dental health care practices in pregnant women in Australia: a postnatal survey. BMC pregnancy and childbirth. 2008;8(1):13.##4. Gaffield ML, GILBERT BJC, MALVITZ DM, ROMAGUERA R. Oral health during pregnancy: an analysis of information collected by the pregnancy risk assessment monitoring system. The Journal of the American Dental Association. 2001;132(7):1009-16.##5. Mamatha B RR, G Radha. ORAL HEALTH STATUS AND TREATMENT NEEDS FOR PREGNANT WOMEN: A REVIEW. International Journal of Dental and Health Sciences. 2015;02(03):619-27.##6. Xiong X, Buekens P, Fraser W, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. 2006;113(2):135-43.##7. George A, Johnson M, Blinkhorn A, Ajwani S, Bhole S, Yeo A, et al. The oral health status, practices and knowledge of pregnant women in south‐western Sydney. Australian dental journal. 2013;58(1):26-33.##8. Byanaku Ak RD. ORAL HEALTH OF PREGNANT WOMEN; Knowledge, attitude and practice at antenatal care clinic in Morogoro Municipal, Tanzania. Professional Med Journal. 2016;20(3):365-73.##9. Council O. Guideline on Perinatal Oral Health Care.##10. Shamsi M, Hidarnia A, Niknami S. Self-reported oral hygiene habits and self-care in the oral health in sample of Iranian women during pregnancy. World Applied Sciences Journal. 2013;22(5):647-56.##11. Kazemi HH, Zeinal Zadeh M, Farsam F, Khafri S, Matloubi N. Pregnant women's self-report of oral health condition and its relation with oral clinical status. Iran J Obstet Gynecol Infertil 2016; 18(186):9-16.##12. HajiKazemi E, Mohseni SH, Oskouie F, Haghani H. The association between knowledge, attitude and performance in pregnant women toward dental hygiene during pregnancy. Iran Journal of Nursing. 2005;18(43):31-8.##13. Shamsi M, Hidarnia A, Niknami S. A survey of oral health care behavior in pregnant women of Arak: Application of Health Belief Model. Journal of Mazandaran University of Medical Sciences. 2012;22(89):103-115. (Persian)##14. Bayat F, Karimi-Shahanjarini A, Bashirian S, Faradmal J. Assessment of Dental Care and its Related Barriers in Pregnant Women of Hamadan City. JECH. 2016; 3 (1) :20-27##15. Shamsi M, Hidarnia A, Niknami S, Rafiee M, Karimi M: Oral health during pregnancy: A study from women with pregnancy. Dent Res J (Isfahan). 2013;10:409-410.##16. Boggess KA, Urlaub DM, Massey KE, Moos M-K, Matheson MB, Lorenz C. Oral hygiene practices and dental service utilization among pregnant women. The Journal of the American Dental Association. 2010;141(5):553-61.##17. Saddki N, Yusoff A, Hwang YL. Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia. BMC Public Health. 2010;10(1)75 ##18. Hullah E, Turok Y, Nauta M, Yoong W. Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London. Archives of gynecology and obstetrics. 2008;277(5):405-9.##19. Al Habashneh R, Guthmiller JM, Levy S, Johnson GK, Squier C, Dawson DV, et al. Factors related to utilization of dental services during pregnancy. Journal of clinical periodontology. 2005;32(7):815-21.##20. Özen B, Özer L, Başak F, Altun C, Açıkel C. Turkish women’s self-reported knowledge and behavior towards oral health during pregnancy. Medical Principles and Practice. 2012;21(4):318-22.##21. Bamanikar S, Kee LK. Knowledge, attitude and practice of oral and dental healthcare in pregnant women. Oman medical journal. 2013;28(4):288.##22. Hom JM, Lee JY, Divaris K, Baker AD, Vann WF. Oral health literacy and knowledge among patients who are pregnant for the first time. The Journal of the American Dental Association. 2012;143(9):972-80.## ##

ارتقاء سلامت دهان و دندان در زنان باردار: یک مرور نقلی Oral health promotion in pregnant women: a narrative review 1 1 مقدمه و هدف: سلامت دهان و دندان مادران باردار به دلیل پیامدهای آن بر سلامت خود و جنین آن ها اهمیت دارد. مقاله حاضر با هدف ارزیابی نوع و میزان موفقیت مداخلات ارتقاء سلامت دهان در مادران باردار تهیه شده است. مواد و روشها: جستجوی الکترونیکی در پایگاه‌های اطلاعاتی ProQuest، PubMed ،Biomed Central ، Google Scholar، بانک اطلاعات علمی(SID)  و بانک اطلاعات نشریات کشور Magiran  با استفاده از کلید واژه­های بهداشت دهان، مادران باردار، دانش سلامت دهان، ارتقاء سلامت دهان، برنامه سلامت دهان وoral health, promotion, program, prevention, knowledge education  و pregnant women, pregnant mother, pregnancy از 1990 تا 2017 انجام و تعداد 9653 مقاله یافت شد. بعد از خارج شدن مقالات تکراری و غیر مرتبط در بررسی عنوان و سپس چکیده، ٨٨ مقاله با متن کامل مورد بررسی قرار گرفت، و در نهایت بیست و چهار مطالعه انتخاب و مورد بررسی قرار گرفت. یافته­ها: از 24 مقاله انتخاب‌ شده، 10 مطالعه تجربی و 14 مطالعه نیمه تجربی بودند. مداخله در 21 مطالعه به صورت برنامه آموزشی، در دو مطالعه به صورت ترکیبی (ارائه خدمات پیشگیرانه و برنامه آموزشی) و در یک مطالعه، مداخله تنها به صورت ارائه خدمات پیشگیرانه بود. مداخلات به شکل برنامه ‌های آموزشی با جلسات پیگیری، معاینه و خدمات پیشگیرانه در مدت زمان مختلف انجام شده بود. نتایج مطالعات حاکی از افزایش معنی دار آگاهی، نگرش و عملکرد در خصوص انجام مراقبتهای بهداشت دهان و دندان در کوتاه مدت بود. نتیجه­گیری: آموزش رفتارهای ارتقاء دهنده سلامت دهان و دندان مادران باردار و خدمات پیشگیرانه در کوتاه مدت (چند ماه) بخصوص مداخلات مبتنی بر نظریه ها و مدل های تغییر رفتار اثرات مثبتی بر سلامت دهان و دندان زنان باردار دارد.     2 Background and purpose: Oral health behaviors in pregnant mothers are important owing to their impact on mother’s and child’s general health. The present study is designed to evaluate the type and success rate of interventions in oral health promotion programs. Methods: A search of published papers in ProQuest, Pubmed, Biomed Central, Google Scholar, and Iran Scientific Information Database (SID) and Iran Press Information Bank (Magiran), was done using the keywords oral health promotion (program, prevention, knowledge, education) and pregnant women (pregnancy) from 1990 to January 2017. Out of 9653 titles, and excluding repeated and irrelevant papers in title and abstracts, 88 relevant full test papers in second step were evaluated, and finally, 24 papers were finally selected for review. Results: Ten of the evaluated studies were experimental and 14 semi-experimental. Interventions in 21 studies were educational, in two were combined, and in one study was only in form of preventive services. Interventions were in form of educational programs alone, and with follow-up sessions, oral examination, preventive services, in different time intervals. Results indicated to a significant improvement in intervention groups in short term. Theory and model-based interventions were effectively improved oral health behaviors in pregnant women.  Conclusion: Education of oral health promoting behaviors and preventive services have positive effects on the oral health of pregnant women in short term, especially through theory and model-based interventions.  73 90 2018/05/82018/05/92018/05/112018/05/112018/05/122018/05/122018/05/12 1397/2/22 2018/05/82018/05/92018/05/112018/05/112018/05/122018/05/122018/05/12 1397/2/22 رضا یزدانی r Yazdani iran ایران دهناد ساسان فر d Sasanfar iran ایران حسین حصاری h Hessari iran ایران Oral health promotion prevention intervention pregnancy بهداشت دهان و دندان ارتقای سلامت دهان خدمات پیشگیرانه بارداری 1- Kheirollai H, Mazloomi SS, Haerian Ardakani A, Ahmadieh MH. Evaluation of knowledge and attitude of Yazd dental students toward oral hygiene. J Shahid Sadoughi Univ Med Sciences Health Services 1998;6:83-78. (Persian)##2- Radnai M, Gorzo I, Nagy E, Urban E, Eller J, Novak T, et al. Caries and periodontal state of pregnant women. Part I. Caries status. Fogorv Sz 2005;98(2):53-7.##3- Bakhshi M, Sabet MS, Hashemi ES, Bakhtiari S, Tofangchiha M, Marhabi SA, et al. Evaluation of biochemical changes in unstimulated salivary, calcium, phosphorous and total protein during pregnancy. Afr J Biotechnol 2012;11(8):2078-83.##4- Newman MG, Takei HH, Carranza FA: Carranza’s Clinical Periodontology. 9th Ed. W B. Saunders Co. 2002; Chaps13,37:238-240,516-517.##5- Dasanayake AP: Poor periodontal health of the pregnant women as a risk factor for Low birth weight. Ann Periodontol 1998;3(1):206-12.##6- Thomas NJ, Middleton PF, Crowther CA. Oral and dental health care practices in pregnant women in Australia: A postnatal survey. BMC Pregnancy Childbirth 2008;21:8:13.##7- Diaz-Romero RM, Martinez-Sanchez C. Education for dental health in pregnancy. Dia Salud Publica Mex 1989; 31(4):530-5.##8- Kay EJ, Locker D. Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol 1996; 24(4):231-5 .##9- Kay E, Locker D. A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dent Health 1998; 15(3): 132-44.##10- Vamos CA, Thompson EL, Avendano M, Daley EM, Quinonez RB, Boggess K. Oral health promotion interventions during pregnancy: a systematic review. Community Dent Oral Epidemiol 2015; 1;43(5):385-96.##11- Ebrahimipour S, Ebrahimipoiur H, Alibakhshian F, Mohamadzadeh M. Effect of education based on the theory of planned behavior on adoption of oral health behaviors of pregnant women referred to health centers of Birjand in 2016. J Int Soc Prev Community Dent 2016;6(6):584–589.##12- Emami Moghadam Z, Aemmi SZ, Dadgar S, Sardar Abadi F. Improving the performance of pregnant women in oral and dental health based on the Health Belief Model. The Iranian J Obstet Gynaecol Infert 2015;18(176):11-6. (Persian)##13- Emami sigarody AH, Nickbin poshtamsari S. The effect of educational program based on Health Belief Model on oral health behavior of pregnant women. Iranian registry of clinical trials. http://en.search.irct.ir/view/24734 [Accessed 26th July 2017].##14- Mohammadi Zeidi I, Pakpour HajiAgha A, Karbord A, Mohammadi Zeidi B. Effect of an Educational Intervention Based on the Trans-Theoretical Model on Oral Health Behaviors in Pregnant Women. J Isfahan Dent Sch 2015; 11(4):329-345.##15- Bahri N, Tohidinik HR, Bahri N, Iliati HR, Moshki M, Darabi F. Educational intervention to improve oral health beliefs and behaviors during pregnancy: a randomized-controlled trial. J Egypt Public Health Assoc 2015;1;90(2):41-5.##16- Shahnazi H, Hosseintalaei M, Ghashghaei FE, Charkazi A, Yahyavi Y, Sharifirad G. Effect of Educational Intervention on Perceived Susceptibility Self-Efficacy and DMFT of Pregnant Women. Iran Red Crescent Med J 2016;18(5): e24960.##17- Ramazani N, Ladez MA, Zareban I, Bagheri E. Oral health care education regarding the gingival health, knowledge, attitude, and behavior of the pregnant women. Health Scope 2014;3(4):e19446.##18- Ebrahimipour H, Mohamadzadeh M, Niknami S, Ismaili H, Vafaii Najjar A. The effect of educational programs based on the theory of planned behavior to improve the oral health behavior of pregnant women attending urban health facilities Ashkhaneh city in 2014. J North Khorasan Univ Med Sciences 2015;7(1):7-18. ##19- Ramazani N, Zareban I, Ahmadi R, ZadSirjan S, Daryaeian M. Effect of anticipatory guidance presentation methods on the knowledge and attitude of pregnant women relative to maternal, infant and toddler’s oral health care. J Dent (Tehran) 2014;11(1): 22–30.##20- Shamsi M, Hidarnia A. Niknami S. The survey of oral health in women with pregnancy in Arak city apply health belief model. J Mazandaran Univ Med Sci 2012; 22(89):104-15. (Persian).##21- Bahri N, Iliati HR, Sajjadi M, Boloochi T, Bahri N. Effects of oral and dental health education program on knowledge, attitude and short-time practice of pregnant women (Mashhad-Iran). J Mash Dent Sch 2012;36(1):1-2. (Persian)##22- Adams SH, Gregorich SE, Rising SS, Hutchison M, Chung LH. Integrating a nurse‐midwife‐led oral health intervention into centering pregnancy prenatal care: J Midwifery Women’s Health 2017;62(4):463-469. ##23- Al Khamis S, Asimakopoulou K, Newton T, Daly B. The effect of dental health education on pregnant women's adherence with toothbrushing and flossing—A randomized control trial. Community Dent Oral Epidemiol 2017;45(5):469-477. ##24- Chawla RM, Shetiya SH, Agarwal DR, Mitra P, Bomble NA, Narayana DS. Knowledge, attitude, and practice of pregnant women regarding oral health status and treatment needs following oral health education in Pune District of Maharashtra: A longitudinal hospital-based study. 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Changing knowledge and beliefs through an oral health pregnancy message. J Public Health Denti 2012;1;72(2):104-11.##29- Lin DL, Harrison R, Aleksejuniene J. Can a prenatal dental public health program make a difference. J Can Dent Assoc 2011;24;77(32):7.##30- Cardenas LM, Ross DD. Effects of an oral health education program for pregnant women. J Tenn Dent Assoc 2010;90(2):23-6##31- Anderson C, Harris MS, Kovarik R, Skelton J. Discovering Expectant Mothers' Beliefs about Oral Health: An Application of the Centering Pregnancy Smiles® Program. Int Q Community Health Educ 2010 Jul;30(2):115-40.##32- Cibulka NJ, Forney S, Goodwin K, Lazaroff P, Sarabia R. Improving oral health in low‐income pregnant women with a nurse practitioner‐directed oral care program. J Am Assoc Nurse Pract 2011;1;23(5):249-57.##33- Vasiliauskiene I, Milciuviene S, Bendoraitiene E, Narbutaite J, Slabsinskiene E, Andruskeviciene V. Dynamics of pregnant women’s oral health status during preventive programme. Stomatologija 2007;9(4):129-36.## ##