BackgroundThe use of sealants as an effective measure for the prevention of pit and fissure caries in children has been well documented by several studies; either they are used on an individual or on a public health basis. In order to plan and establish a national preventive program with sealants in a community, it is mandatory to know the epidemiological pattern of caries along with other variables influencing their use and effectiveness. Aims: To assess the utilization and distribution pattern of pit and fissure sealants on the first and second permanent molars of Greek adolescents and to evaluate whether the existing usage of sealants and some socio-demographic factors are correlated to caries prevalence on the population examinedMethodsA stratified cluster sample of 2481 Greek adolescents was selected according to WHO guidelines (1224 twelve and 1,257 fifteen-year-old), living in urban and rural areas in 11 districts within the country. Five calibrated examiners carried out clinical examinations, recording caries experience at the dentine threshold (BASCD criteria) and presence or absence of sealants along with Socio-demographic indicators associated with oral health. Mann Whitney and Pearson's chi-square non parametric tests were utilized for assessing the data. The level of significance was p < 0.05.ResultsSealants utilization varied considerably within the different districts, with 8,3% of the 12 and 8,0% of the 15-year-old adolescents having at least one sealed molar. Sealants reduced DMFS scores by 11% in the 12-year-olds and by 24% in the 15-year-olds, while 15-year-old adolescents from rural areas had a statistically significant (p = 0.002) less chance of having sealants (71%) compared to children from urban areas. Girls had higher chance to receive sealants in both age groups (26% for the 12 and 19% for the 15-year-old) as well as patients that visited the dentist for prevention compared to those visiting the dentist because they thought they needed a restoration or because they were in pain.ConclusionsThe finding that sealants reduced DMFS scores despite their very low utilization, along with the high prevalence of dental caries found on the occlusal surfaces of the posterior teeth of Greek adolescents, is calling for a national preventive program with sealants which could eliminate caries to a larger extent.

Although there are several epidemiological studies on dental trauma internationally, there are not many studies that record, analyse and follow different kinds of dental trauma treated in a private office, and that evaluate how parameters such as type of dental trauma, as well as time lapse until treatment might influence the final outcome and the prognosis of the teeth. The sample consisted of 242 patients, 6-17 years of age, with 369 injured teeth treated within a period of 5 years. All the case were treated by the first author and were followed for at least 3 years. The treatment modalities used were based upon the clinical examination and the history of the case and included direct and indirect pulp capping, partial pulpotomy, pulpotomy, pulpectomy and splinting. The type of trauma was classified based on WHO classification partially modified. Seventy six percent of the teeth suffered only hard tissue injuries and 22% had only periodontal ligament PDL) trauma. Of the total number of teeth class I represented 3%, class II 59%, class III 20% and class IV 2%. Of the PDL injuries 14% of the teeth suffered concussion, 69% luxation and 17% exarticulation. The highest incidence of dental trauma was observed at the age of 10. Sixty eight percent of the patients sought treatment 3 days or more after the trauma had occurred delayed treatment), while only 32% within the first 3 days (immediate treatment). The main reasons for delayed treatment were neglect (50%) and unawareness 37%). Of the teeth with delayed treatment 43% became necrotic, while only 28% of the teeth that were treated on time needed pulpectomy. Luxations caused more pulp necrosis (46%) than Class I (0%) Class II (7%) or Class III (34%) type of trauma. The data from this study suggested that a most of the dental injuries on permanent teeth were class II or III type, b) a high percentage (68%) of the patients sought treatment more than 3 days after the injury (delayed treatment), c) delayed treatment caused more necrotic teeth, d) the public should be informed of the importance of immediate treatment in an effort to improve the prognosis of the pulp, e) dentists should be informed of the appropriate treatment of dental injuries since 10.3% of the cases were mistreated.

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