BackgroundIn Turkey, formal pre-primary education for children 5- 6 years old provides the ideal setting for school-based oral health promotion programs and oral health care services. To develop effective oral health promotion programs, there is a need to assess this target group's subjective oral health needs as well as clinical needs. The Early Childhood Oral Health Impact Scale (ECOHIS) is a well-known instrument for assessing oral health quality of life in children aged 0-5 years old and their families. This study aimed to adapt the ECOHIS for children 5-6 years old in a Turkish-speaking community and to undertake a preliminary investigation of its psychometric properties.MethodsThe Turkish version of the ECOHIS was obtained with forward/backward translations, expert panels and pre-testing and it was tested in a convenience sample of 121 parents of 5- 6 year-old children attending nursery classes of three public schools. Data were collected through clinical examinations and self-completed questionnaires. The main analyses were carried out on the imputed data set. The validity of content, face, construct, discriminant and convergent and as well as the reliability of internal and test-retest of the ECOHIS were evaluated. Sensitivity analysis was performed to examine the effect of the complete case analysis for managing "Don't know" responses on the validity and reliability of the ECOHIS.ResultsThe analysis of the imputed data set showed that Cronbach's alphas for the child and family sections were 0.92 and 0.84 respectively, and for the whole scale was 0.93. The intraclass correlation coefficient for test-retest was 0.86. The scale scores on the child and parent sections indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health, high caries experience, higher gingival index scores and problem-orientated dental attendance, supporting its construct, convergent and discriminant validity. Sensitivity analysis showed that the mean imputation method and the complete case analysis did not have differing effects on the validity and reliability of the ECOHIS.ConclusionsThis study provided preliminary evidence concerning validity and reliability of the Turkish version of the scale among 5-6-year-old children. Future studies should be conducted on the ECOHIS to evaluate fully its psychometric properties in both community- based and clinically-based studies among parents of children younger than five. This study provides initial evidence that the ECOHIS aimed at children aged 0-5 years may be a useful tool for assessing the oral health quality of life in 6 year - old preschool children.

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

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

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

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

Background: As patient-reported outcome, the Child Oral Impacts on Daily Performances (C-OIDP) has been commonly used for assessing children's oral health needs in order to facilitate oral health service planning. It was translated and cross-culturally adapted into Turkish in 2008. Since then, there is no study to assess its psychometric properties in Turkish child population. This cross-sectional study aimed to investigate the psychometric properties and factor structure of the Turkish version of the C-OIDP for use in Turkish primary school children. Methods: The Turkish translated version was tested on a convenience sample of primary school children aged 11 to 12 years attending two public schools in Istanbul. Data were collected by clinical examinations, face-to-face interviews and self-completed questionnaires. The internal consistency, test-retest reliability, construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), criterion related validity (concurrent and discriminant) were evaluated. Results: A total of 208 children were subjected to the tested the C-OIDP. Overall, 93.7% of them reported at least one oral impact in the last 3 months. The most frequently affected performances were "eating" (72.1%) and "cleaning mouth", while the performance with the lowest impact was "studying" (13%). The internal consistency and reproducibility of the C-OIDP were acceptable, with a Cronbach's alpha of 0.73 and an intra-class correlation coefficient of 0.83. The EFA yielded a two-factor model termed "functional limitation" and "psychosocial limitation". CFA identified the two-factor model which fit the data better than the previously proposed three-factor model, namely physical, psychological and social health. Having malocclusion, the presence of gum disease, reported history of oral problems in the mouth, dissatisfaction with oral health, bad self-rated oral health and having a problem-oriented pattern of dental attendance were found to be the most important factors related to worse oral health-related quality of life, supporting its criterion-related validity. Conclusion: This study provided preliminary evidence the psychometric properties of the C-OIDP index among Turkish school children aged 11-12 years. It may be applied to evaluate the oral health impact on quality of life in this population.