Background For patients with hereditary coagulopathies such as hemophilia, the most common dental problem is spontaneous oral bleeding caused by daily oral hygiene habits like tooth brushing. Because of fear of bleeding, children with hemophilia often skip routine oral hygiene procedures, which can lead to dental caries and periodontal diseases. This case control study aimed to evaluate the oral hygiene awareness and hygiene practices of children with hemophilia from 6 to 18 years of age in Bulgaria. Material/Methods This study was conducted over 4 years and included 31 patients (children). A sociological approach was used, with direct individual questionnaires for self-assessment of dental habits. Statistical analyses were performed using SPSS. Results There was no significant difference between groups in methods of oral hygiene. The duration of oral hygiene procedures was 1 min (n=5, 16.13±6.61%) or 2 min (n=13, 41.94±8.86%), which was considered insufficient for proper oral hygiene. Children who had received oral hygiene advice by a dentist brushed their teeth significantly longer (n=9, 69.23±12.80%) than those who had not. There was a considerable difference between the reasons for the last dental visit between the groups of children (χ 2 =5.18, P <0.05). Conclusions Children with hemophilia have high awareness of oral hygiene methods; however, more attention should be focused on additional individual educational methods at the dental office. Frequent professional and self-assessment of the oral hygiene routine of children with hemophilia could identify the factors compromising dental status in this vulnerable population.
BACKGROUND: Dentophobia (DF) is unreasonable, irrational, excessive, and socially limiting fear of specific situations related to dental care. The condition is part of the ultimate and pathological cluster of dental anxiety. AIM: Objectives of the present study are: (1) Identification of latent factors in the psychological manifestation of dental fear, anxiety, and phobia and (2) comparison of these factors with the degree of manifestation of the psychological construct and gender differences. METHODS: A cross-sectional online-based survey was conducted. The primary sociological information is collected through a direct individual survey including 32 items divided into four sections. Statistical data processing includes descriptive statistics, non-parametric hypothesis tests, exploratory and confirmatory factor analysis for detection and verification of latent factors, internal validity analysis. DISCUSSION: The presence of a latent factor conditionally describing “pain related fear” is a possible reason for the overlap of DF with other panic disorders related to medical care described in the literature. A study performed for a wider and diverse population sample would produce more credible findings from which to draw more accurate conclusions. CONCLUSION: This study provides a better understanding of how to identify patients who are prone to, or already suffer from dental anxiety and allows dentists and health-care professionals to provide better health. The analysis of this study discovered a significant difference between latent factors from the construct encompassing the pain related fear and social fear.
Preconception care (PC) is relatively new area of practice. While the volume and quality of PC activities depend on local settings, the awareness of women is critical for the successful promotion of PC services. The aim of this study was to examine the preconception-health-related attitudes and experiences of Bulgarian women of reproductive age. A qualitative study conducted among 20 women aged 18 to 49 years was performed between May and July 2022. Two focus groups were used with mixed samples of nulligravida, pregnant, and postpartum women. The participants thought that the Internet and their obstetrician-gynecologist were the only places where they could learn about getting pregnant. Only two of them discussed their PC plans with their physicians. Women pointed out that general practitioners (GPs) need to be more proactive in promoting PC. All respondents outlined the need for a web-based educational platform that could serve as a primary source of health information for future families. The role and functions of GPs in the continuum of PC should be reconsidered. We recommend targeted educational measures for all stakeholders, including women and GPs. In this regard, an easily accessible, knowledge-based web platform could enhance Bulgarian women’s awareness and perceptions of PC.
BACKGROUND: Hemophilia is the most common inherited coagulopathy, but its diagnosis and treatment are still a challenge for healthcare professionals. Collaborative efforts between National bleeding disorder agencies, World Federation of Hemophilia, Ministries of Health, educational institutions, and non-governmental organizations aim to improve access to care and the quality of life of people with coagulopathies AIM: The aim of this study was to analyze and critically evaluate the oral health policy for children with hemophilia in Bulgaria. MATERIALS AND METHODS: A sociological survey is conducted among dentists in Bulgaria during the period 2019 - 2020 about their attitude toward the oral health policy regarding children with hemophilia in Bulgaria. The oral health legislation of Bulgaria and international guidelines for dental care of people with hemophilia is critically evaluated. Data is revised and synthetized for implementation in the Bulgarian health policy. RESULTS: In 2013, the first European guidelines for the certification of Hemophilia Centers are published, which is the only document accrediting centers for rare diseases. According to the recommendations of the World Federation of Hemophilia, dental and medical care for people with hemophilia should be provided in hemophilia treatment centers. According to the latest guidelines from 2020, dental care for people with hemophilia should be provided by every dentist, regardless of their specialty. Most of the dentists (n = 88; 84.62 ± 3.54%) would be more confident in treating a patient with hemophilia in their practice if they are part of an organized team. In need of a consultation with another doctor, dentists prefer to refer the case to a specialist clinical hematologist (n = 74; 71.15 ± 4.44%), pediatric oncohematologist (n = 60; 57.69 ± 4.84%), or oral surgeon (n = 35; 33.65 ± 4.63%). DISCUSSION: Improvement can be achieved through programs for management of specific dental conditions, targeted at rare disease groups, and successfully implemented in health policy at the local level. CONCLUSION: Potential new policies may offer more dental treatment options for people with hemophilia. In-depth clinical and sociological studies are needed to determine the optimal effect in the current state and situation.
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