Background: The aim of the present study was to determine whether differences exist in the expression of the multidimensional components of DF A among school-aged children in Bosnia and Herzegovina. Subjects and Methods: This cross-sectional observational study included mentally and physically healthy participants of both sexes, aged 8-15 years, attending a scheduled dental appointment involving either invasive or non-invasive procedures. Prior to treatment, participants completed IDAF-4C core module and the IDAF-S stimulus module independently. Behavioral responses during treatment were assessed using the Frankl Behavior Rating Scale by an independent observer. Results: The findings were presented descriptively in tables. Differences were identified in the expression of the multidimensional components of DF A assessed with the IDAF-4C module. The behavioural component demonstrated the lowest level of expression, followed by the cognitive and physiological components, whereas the emotional component demonstrated the highest level of expression (Friedman test = 238.963; p < 0.0005). Differences were also observed according to the invasiveness of dental procedures, with all components demonstrating higher (more negative) scores during invasive dental treatments: emotional component (Mann-Whitney U = 21,894.000; p = 0.004), behavioural component (Mann-Whitney U = 21,211.500; p = 0.009), physiological component (Mann-Whitney U = 23,570.500; p < 0.0005), and cognitive component (Mann-Whitney U = 20,749.500; p = 0.048). Conclusion: There were no statistically significant differences in the expression of the multidimensional components of the DF A among school-aged children in BiH between the younger and older age groups of respondents. A statistically higher level of DF A components was observed in association with invasive treatments, indicating a link between the intensity of dental fear and the presence of specific stimuli.

Background/Aim: The aim of this study was to conduct a comparative analysis of the oral health promotion programmes in the Balkan countries, to compare key measures and activities in the implementation of the programme, and to analyse the results achieved after the implementation of the programme. Material and Methods: Data were obtained through an electronic search of publicly available documents published in the field of dental healthcare in the Balkan countries. The search terms were: "national programme", "strategy", "action plan", "project", and "oral health". The search was conducted in English and in the native languages of the Balkan Peninsula countries. A comparative analysis of valid documents and those whose validity period has expired was carried out. Results: This study illuminates the information on preventive programmes for each country and discusses the challenges faced in the Balkans region. While countries in the Balkan Peninsula have made progress in improving the oral health of their inhabitants, the absence of national oral health promotion programmes is striking. Greater involvement of the community in activities to maintain and improve oral health is needed, as is more comprehensive dental care for vulnerable populations. Conclusions: The findings of this study may be employed to enhance oral health in the delineated regions, and to confer benefits upon the population of the region and beyond. The findings from this analysis provide valuable insights for policymakers and public health professionals aiming to strengthen oral health initiatives and ensure more equitable access to dental care across the Balkan Peninsula. This paper (Part II) describes specifics of oral health promotion programmes, dental health care, and key epidemiological indicators in each Balkan country.

Aim: The aim of the work is to examine the possibility of perception of dental aesthetics and satisfaction with one's own appearance in children of different ages. Materials and methods: In this research, 80 children, aged 3-16 years, participated, none of whom were orthodontic patients. The research consisted of an interview, in which the children were asked questions, and a drawing on the topic of what is a "beautiful and ugly" tooth for them. The questions were designed to reflect children's perception and attitude related to dental aesthetics, as well as satisfaction with their own appearance in the context of dental aesthetics. The drawings and answers were classified according to Piaget's classification of cognitive development, according to the age of the subjects. The questions for the parents were related to the parents' practice related to visits to the dentist and previous caries experience in children. Results: The results of the research showed that all respondents, regardless of gender and age, showed the ability to perceive and express their attitudes regarding the concepts of "beautiful" and "ugly" in the context of dental aesthetics, as well as to express their attitude, knowledge and satisfaction/dissatisfaction with one's own appearance. Conclusion: The research results suggest that the experience of beauty and the feelings associated with dental aesthetics are universal, independent of gender and age. Children have the ability to distinguish what they consider beautiful or ugly, regardless of age, and are able to clearly express attitudes related to satisfaction with their own appearance.

Background/Aim: The aim of this study was to conduct a comparative analysis of the national oral health programmes in the Balkan countries, to compare key measures and activities in the implementation of the general and specific objectives of the programme, and to analyse the results achieved after the implementation of the programme. Material and Methods: The data were obtained through an electronic search of publicly available documents published by the relevant institutions in the field of dental health care in the Balkan countries. The search terms were: "national programme", "strategy", "action plan", "project", and "oral health". The search was conducted in English and in the native languages of the Balkan Peninsula countries. A comparative analysis of valid documents and those whose validity period has expired was carried out. Results: Bulgaria and the Republic of North Macedonia have valid national preventive programmes. In Cyprus, a strategic plan for the provision of dental services is described. An oral health promotion programme for elementary school children and universal preventive programme for children ("dentist pass") have been implemented in Greece. Serbia has a national preventive programme that has expired, but the programme activities still apply. Albania, Bosnia and Herzegovina, Montenegro, Romania, and Turkey do not have national oral health preventive programmes. Countries in the region with no oral health promotion programmes have poorer oral health indicators compared to countries with existing programmes. Conclusions: While countries in the Balkan Peninsula have made progress in improving the oral health of their inhabitants, the absence of national oral health promotion programmes is striking in many countries in the region. Greater involvement of the community in activities to maintain and improve oral health is needed, as is more comprehensive dental care for vulnerable populations. This paper (Part I) compares national oral health promotion programmes of the Balkan countries, the key measures and activities, and general and specific objectives of the programme.

Aim To investigate the frequency of consumption of sweet and salty snacks among children aged 2-18 years in relation to their mothers' education level. Methods A descriptive epidemiological study was conducted in five dental practices at the School of Medicine of the University of Mostar from May to October 2022. The data were collected from medical records. Results: Out of a total of 477 children, 172 (36.1%) had mothers with a high school education, while 305 (63.9%) had mothers with a university degree. In the group of preschool children (aged 2-6 years), there were 42 mothers with high school education and 105 with university degree. In the group of school children (age 7-18 years) there were 130 mothers with high school education and 200 with university degree. The difference in the consumption of sweetened beverages among children of mothers with high school and university was not statistically significant. Similar results were found for the consumption of salty snacks, lollipops, caramels and candies. The frequency of the consumption of biscuits, chocolate and cakes (several times a day) was statistically significantly higher among the children of mothers with high school education (p=0.04), especially among school children. Eating habits of children, regardless of the level of education of their mothers, differed significantly only in the consumption of lollipops, caramels, and candies (p=0.03), which were consumed once a day by 79 (63.7%) schoolchildren and 45 (36.3%) of pre-schoolers. Conclusion A higher level of education among mothers does not necessarily equate to proper nutritional knowledge.

Objectives Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day’s busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well. Aims To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers. Methods The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits. Results ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%); dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children’s parents (CI=10.55%, RI=10.80%, TI=12.98%). Conclusion Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions.

Background/Aim: The aim of the research was to examine the general attitude, knoweledge and practice of pediatricians about caries in children of preschool age. Material and Methods: The research was conducted from November 2019 to the end of January 2020. The research consisted of a survey of pediatricians. The questionnaire consisted of 4 modules and 37 questions, which related to the attitude, knowledge and practice of pediatricians on the prevention of early childhood caries. Results: The majority of pediatricians (84.9%) stated that they assess the nutrition of their patients, while 32.1% of them always do oral health assessment, and half of them in the second month of the child's life; and 39.6% assess oral health only if there is a problem. The majority of pediatricians (86.8%) recommended the first dental examination, most often in the first year of the child's life (79.5%), and then every 6 months (43.5%). The majority of respondents did not required information about the dental health of their patients' mothers, fluoride toothpastes and topical application of fluoride as well (62.3-75.5%). The majority of pediatricians (79.2%) have never provided or sometimes provided educational material on caries prevention and control to the parents of their patients. The most accurate answers and the highest percentage of correct answers that the pediatricians had were about attitudes (Z=8.98, 66.63%), while the fewest correct answers and the lowest percentage of correct answers regarding the practices on the prevention of early childhood caries (Z=11.91, 58.90%). Conclusions: The research showed that pediatricians have the good attitudes and knowledge, but do not implement prevention of early childhood caries in practice. The basic deficiency of attitude, knowledge and perception of the importance of prevention is a consequence of insufficient education of pediatricians.

Background/Aim: Deep carious lesions on primary teeth usually have been causing infectious dental pulp changes. If indicated, traditional endodontic root canal treatment for these kinds of pulpal infections in primary teeth usually should involve the performing of pulpectomy methods, but often with questionable prognosis. The lesion sterilization and tissue repair (LSTR) approach is one of the good endodontic therapeutic alternatives for affected primary teeth with a poor prognosis, which could otherwise be condemned to premature extraction. Aim was to evaluate the medium-term clinical success in everyday practice of the LSTR method applied in affected primary teeth with irreversible pulpal tissue infections by observation of reduction/absence of their clinical symptoms. Material and methods: The study sample included child patients who had one or more of their affected primary molars with irreversible pulpal tissue changes of poor prognosis treated with the LSTR method. For each patient whose primary molar tooth was endodontically treated with the LSTR method a clinical evaluation of treated tooth was performed at intervals of 1 and 12 months afterwards. Results: Study sample was consisted of 40 child patients aged 4 to 9 years, with 45 primary molars included in total. It was obvious that the symptoms related to affected sample teeth have already been decreased almost immediately after initial action of triple antibiotic paste. Final outcome after 12-months follow-up period was success of applied LSTR method in 43 (95.6%) affected sample teeth in a way that initial clinical symptoms completely decreased and disappeared. Conclusions: LSTR method has been shown as successful pulpotomy technique for noninstrumental endodontic approach in non-vital pulp treatment of primary molar teeth in a 12-months follow-up period.

Introduction: Dental fear and anxiety (DFA) is a ubiquitous entity among dental patients in terms of their prevalence and incidence. It is among the major clinical problems in dentistry. In addition, the differences in DFA prevalence were present considering the age and gender of patients and over time, but with some opposite reports. The aim of this study is to examine the prevalence of DFA presence in children concerning their age, gender, and over time. Methods: The survey sample comprised 200 of 9–12-year-old children. The DFA presence was determined twice by the modified version of the CFSS-DS scale (CFSS-DS-mod scale) during a 6-months long period between the first and the subsequent dental appointment due to the need for restorative dental treatment. The scale was applied before the restorative treatment started on both occasions. Results: The prevalence of DFA was 17.5% in the study sample and decreased over time. It was slightly higher in girls. Conclusions: The DFA prevalence in 9–12-year-old children is decreasing over time. Latent manifestations of DFA presence should be considered for evaluation in the future.