The health network in the Islamic Republic (I.R.) of Iran is an integrated public health system with a four-level Dental Health Care System integrated into it by 1997. The first level is one of primary prevention at 'health houses', at the next, oral hygienists and dentists in health centres perform basic oral health care services such as fillings, scaling and extractions. At the third level, dentists manage and treat oral diseases in 'urban health centres, while the last level is for advanced treatment by specialists in university health centres in the big cities. There are about 13,000 dentists nationwide (1 dentist: 5,500 population) and nearly 1,200 specialists in universities and private practices. Data from surveys in the past two decades, show a marked decline in dental caries from DMFT of 4 to 1.5 in 12-year-old children. However, the general level of oral health is still not satisfactory, particularly among children. The percentage of caries-free children (deciduous and permanent teeth) among 6-and 9-year-olds is 13.8 and 11.5 respectively and more than 50% of 12-year-old children have caries experience, with the decayed component being the greatest component. The main objective would be to cope with the dental caries problem in primary teeth and, in this respect, the national oral health plan should be aimed at developing oral hygiene skills, reducing the frequency of sugar intake, instituting water fluoridation, improving access to fissure sealants and regular dental care, and finally promoting dental health services toward minimum treatment intervention and effective preventive strategies and health promotion.

This retrospective investigation was designed to compare tooth size discrepancies among subjects with different skeletal malocclusions in an orthodontic population. The study employed the pre-treatment models of 200 patients (100 males, 100 females, aged from 14 to 20 years) selected from the records of the Orthodontic Department, Shiraz Dental School. The subjects were from four malocclusion groups, Class I, Class II division 1, Class II division 2, and Class III, with the corresponding skeletal characteristics. Each group comprised 50 healthy individuals (25 males, 25 females). The mesio-distal dimensions of teeth were measured using digital electronic callipers (accurate to 0.01 mm) and the Bolton indices were determined. The data were statistically analysed using analysis of variance and Duncan's multiple range test, with the level of significance set at P < 0.05. The results revealed that the mean anterior ratio (79.01) for the whole sample was statistically significantly different from Bolton's (77.2) but no significant difference was found for the overall ratio. The posterior and overall ratios of the Class III malocclusion group were statistically greater than the other malocclusion groups (P < 0.05). The mean anterior ratio of the Class III group was greater than that of the Class II group. However, there was no difference when compared with the Class I malocclusion group. For the two types of Class II malocclusion, no significant ratio differences were observed.

BackgroundDifferent methods have been used for detecting developmental defects of enamel (DDE). This study aimed to compare photographic and replication methods with the direct clinical examination method for detecting DDE in children's permanent incisors.Methods110 8-10-year-old schoolchildren were randomly selected from an examined sample of 335 primary Shiraz school children. Modified DDE index was used in all three methods. Direct examinations were conducted by two calibrated examiners using flat oral mirrors and tongue blades. Photographs were taken using a digital SLR camera (Nikon D-80), macro lens, macro flashes, and matt flash filters. Impressions were taken using additional-curing silicon material and casts made in orthodontic stone. Impressions and models were both assessed using dental loupes (magnification=x3.5). Each photograph/impression/cast was assessed by two calibrated examiners. Reliability of methods was assessed using kappa agreement tests. Kappa agreement, McNemar's and two-sample proportion tests were used to compare results obtained by the photographic and replication methods with those obtained by the direct examination method.ResultsOf the 110 invited children, 90 were photographed and 73 had impressions taken. The photographic method had higher reliability levels than the other two methods, and compared to the direct clinical examination detected significantly more subjects with DDE (P = 0.002), 3.1 times more DDE (P < 0.001) and 6.6 times more hypoplastic DDE (P < 0.001). The number of subjects with hypoplastic DDE detected by the replication method was not significantly higher than that detected by direct clinical examination (P = 0.166), but the replication detected 2.3 times more hypoplastic DDE lesions than the direct examination (P < 0.001).ConclusionThe photographic method was much more sensitive than direct clinical examination in detecting DDE and was the best of the three methods for epidemiological studies. The replication method provided less information about DDE compared to photography. Results of this study have implications for both epidemiological and detailed clinical studies on DDE.

Before 1979, there were only 5 undergraduate dental schools in Iran with a total admission of 200 students per year, and only 2,000 dentists and about 50 specialists practicing in the country. Currently, there are 18 dental schools with a total admission of 750 undergraduate students, 5 postgraduate programs in 10 disciplines with a total of 100 students, more than 11,000 dentists (1 dentist per 5,500 population) and nearly 1,000 specialists in the country. Two new schools have recently begun offering specialty training courses in 2 disciplines. The length of the dentistry curriculum is 6 years. Students take general and basic science courses during the first 2 years, then continue on the predental and dental courses for the remaining 4 years. The curriculum has been revised over the past 20 years to establish intership and specialty programs and introduce courses reflecting current trends in the dental profession. Dental services in Iran are provided by both public and private sectors. Oral health care was integrated into the Public Health Care network by 1997, and 4 levels of a Dental Health Care Delivery System were established. The first level is concerned with primary prevention at ‘health houses’, where auxiliary health workers called ‘behvarzes’ provide periodic examinations, referrals, and oral health education. At the next level, oral hygienists and dentists in ‘health centers’ perform basic oral health care services such as fillings, scaling, and extraction. At the third level, dentists manage and treat oral diseases in ‘urban health centers’, while the last level is for advanced treatment by specialists in university health centers in the cities.

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