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.

Objectives Oral health in children is additionally burdened with the presence of dental fear and anxiety (DFA). These clinical psychologic entities in their progressive stages inevitably lead to avoidance of dental appointments, which makes prevention and therapy of oral diseases more difficult. Upon the onset of DFA in general, as one of the emotional outcomes of stress in a dental office, most children patients could define the specific stressors that were most intense for them, which could predict the presence of DFA. Aim To examine the predictors of DFA presence in 9-12-year-old children, and investigate how they could explain the DFA occurrence in study participants. Material and Methods The sample consisted of 200 children aged from 9 to 12 years. The DFA presence was determined by the modified version of the CFSS-DS scale. The child's behavior in the dental office during the treatment was evaluated by the trained observer using Venham anxiety and behavior rating scales. Socioeconomic status, characteristics of dental office visits, and previous caries experience were also analyzed. Results The main DFA predictors were related to invasive dental treatments, where the behavior during dental treatment was the most accurate expression of the DFA appearance. Conclusions Invasive dental procedures are the main stressful factor for DFA occurrence. Predisposing factors could strengthen the DFA occurrence.

Background: As the pandemic time went by in Bosnia and Herzegovina (B&H), various patterns toward COVID-19 itself and its impacts, implementation of prescribed preventive measures among the team members, and those of their patients, including immunization process, have been revealed. These patterns were of both empirical and evidence-based kind and consequently formed dental personnel behavior. The aim was to evaluate and compare the COVID-19 status of dentists in B&H, implementation of prescribed preventive measures, and usage of various kinds of PPE, at the beginning of the pandemics and now, 2.5 years later, including dentists’ current vaccination status, and their opinions and attitudes toward the national COVID-19 economic impact on dental practice. Methodology: Study research was in a form of a cross-sectional longitudinally designed online survey and was conducted in two parts. Results and conclusions: Dental professionals in B&H had a high frequency of COVID-19 symptoms in the second pandemic year. The vaccination status of dentists in B&H was in line with the global average values of vaccinated professionals. Dentists used patient management preventive measures and PPE recommended by WHO, but some preventive measures have been changed and prioritized recently. The economic impact of pandemics on dentistry was predominantly negative.

Background: The most commonly used diagnostic tests for evaluation of the dental fear and anxiety (DFA) presence in children were psychometric scales, where interpretation in determining and using of their cut-off scores sometimes was not completely exact. Also, several studies have been conducted where the results were conflicting in terms of who better assessed the DFA presence - the children, their parents, or dentists. Objective: To determine the normative values in the child and parental versions of the Modified version of the CFSS-DS scale (CFSS-DS-mod scale) and to compare the ways in which children, their parents, and the dentist assessed the DFA presence in the dental office. Methods: Survey sample consisted of 200 children aged from 9 to 12 years, whose DFA presence was determined by the CFSS-DS-mod scale. Child parents answered to their version of this scale, and the dentist observed the child behavior in the dental office during the treatment using Venham Anxiety and Behaviour Rating Scales. Results: Parental version of the CFSS-DS-mod scale found to be reliable (Cronbach alpha = 0.955) and valid (67.87% of variance explained) instrument for assessment of the DFA presence in children. Two cut-off scores were determined in a child (37 and 43), as well as in a parental version of CFSS-DS-mod scale (36 and 44), respectively. Dentists assessed the DFA presence in child patients most accurately. Conclusion: The normative values of psychometric instruments should be considered prior to their use. The borderline area of DFA presence should also be taken into account in the future studies. Children could underestimate DFA existence by themselves while interviewing.

We developed measures of relational beliefs and expectations among single young gay and bisexual men (YGBM). Data come from an online cross-sectional study YGBM, which ran from July 2012 until January 2013. There were 50 items on relational beliefs and 25 items on relational expectations. We used random split samples and a priori analysis to group items together and applied principal axis factoring with varimax orthogonal rotation. We had a total N = 1582 in our analytical sample and identified six constructs of relational expectations (restrictions, negative break up, masculine and gender norms, optimism, cheating, immediacy) and two constructs of relational beliefs (sex beliefs, equality). Our findings highlight specific relational cognitions among YGBM and offer insight into the beliefs and expectations that may inform their relationships. Findings may be useful for health professionals to help YGBM reflect and understand the health implications of their beliefs and expectations about same-sex relationships to promote healthy decision-making as they seek future partners.

Objectives Demarcated opacities (DO) on teeth affected by Molar Incisor Hypomineralisation (MIH) were observed to investigate if parameters of DO existence and the number of teeth affected could be used to predict the progression of disease. Material and methods In 2009, the MIH prevalence was 11.5% (n=51) among 446 subjects in Sarajevo, aged from 6 to 9 years. In subjects with MIH who gave consent for further participation (n=25), the teeth with DO were observed after a 12-month period. Results our sample included 29 permanent incisors and 14 first permanent molars with DO. The number of teeth with light opacities was significantly higher than the number of teeth with dark opacities. Opacities were more numerous on surfaces which were not exposed to masticatory pressure. The size of tooth surface affected by DO occurrence ranged from 1.33% to 56.56%. The number of affected teeth ranged from two to six. A strong positive correlation between MIH progression and dark colored opacities located on the occlusal/incisal surface of teeth was noted. Larger part of tooth surface was affected by hypomineralisation in the case of dark-colored opacities. The DO presence on incisors was more likely to be located on vestibular surfaces and on the first permanent molars on their occlusal surfaces. Conclusions The color of DO occurrence was the best predictor for MIH progression both independently and in combination with the number of affected teeth. Location of DO occurrence was a good independent predictor for MIH progression. It is important to collect information about color and location of DO presence.

AIM Research aimed to gather aepidemiological parameters of MIH from a sample of Sarajevo children born between the years 1999 and 2003. Prevalence of MIH, distribution according to severity (mild vs. moderate/severe cases) and distribution according to phenotypes (MIH vs MH) were investigated. MATERIALS AND METHODS Study design: This was a cross-sectional, observational, aepidemiological study that was conducted on a sample of 446 children aged 6 to 9 years. It was conducted as a part of regular dental screening of children attending a randomly selected primary school in the Bosnian capital city of Sarajevo. RESULTS The overall prevalence of MIH was 11.5%. MIH prevalence varied between 19.9% of examinees born in year 2002 to 8.4% among those born in 2003. Number of teeth affected varied from 1 to 7. The average number of affected teeth was 3.82 ± 1.46. Demarcated opacities were recorded on 13.89%, post-eruptive enamel breakdown on 11.28% and atypical filling on 6.2% index teeth. Mild cases of MIH were rare in our sample, 18% of subject had only demarcated opacities present. A smaller percentage of examinees (35.3%) had hypomineralisation present only on first permanent molars (MH group). Out of 64.7% of subjects in MIH group, 37.25% had one incisor affected and 21.57% had two incisors affected. CONCLUSION Over 80% of study subjects with MIH were categorised as moderate/severe case of MIH and they represent a major problem with regards to dental treatment. It is necessary to plan a multi-disciplinary approach for dental care of this population. It is necessary to educate primary care dentists to recognise this condition and provide recommended treatment to patients with mild clinical picture, while directing those with more severe problems to specialised doctors.

Abstract Objective The aim of this research was to examine the attitudes and perceptions of dentofacial aesthetics among different age groups. Materials and Methods The sample consisted of elementary-school students from the city of Sarajevo, Bosnia and Herzegovina, and their parents. This study included 314 subjects: 157 children and 157 parents. The children’s group consisted of 85 (54.14%) males and 72 (45.85%) females, aged 9 to 15 years. Statistical Analysis Descriptive statistics were used to determine frequency distribution and percentages for all variables. A chi-squared (x 2) test was used to determine the association between variables and a p-value < 0.05 was considered significant for all the differences and associations. Results For the dentofacial appearance with no teeth irregularity or with severe teeth irregularity, an analysis of variance (ANOVA) (post-hoc tests—Tukey’s HSD) indicated that the difference is not statistically significant (p = 0.06) relative to rank matching between all three subject groups. For dentofacial appearance with mild teeth irregularity, an ANOVA (post-hoc tests—Tukey’s HSD) showed statistical difference (p = 0.07) between the teenage group of subjects relative to pre-teenage group of subjects and adult group of subjects. Conclusion Attitudes about desirable and acceptable dental aesthetics differ in younger children compared with older children and parents. Ten years old children find good function with poor aesthetics more pleasing, while 14 years old children find aesthetics with bad function as more pleasing.

Background: Compared to heterosexual women, lesbian women experience higher rates of many chronic diseases, including depression, obesity, hypertension, and diabetes. Lesbian women report higher rates of risky health behaviors such as hazardous drinking and cigarette smoking. However, little longitudinal research has been done to examine changes in disparities between lesbian and heterosexual adult women. Methods: A total of 1,084 women were initially recruited from Pittsburgh, PA to participate in the Epidemiologic Study of HEalth Risk in Women (ESTHER) study and completed a baseline survey between 2003 and 2006. In 2015 or 2016, N = 483 women, 270 of whom were lesbian, completed a follow-up survey. Participants completed a questionnaire at both baseline and follow-up and completed a clinic visit for the baseline study to provide biometric data. Results: At baseline, lesbian participants reported higher rates of obesity (p = 0.03), depression (p = 0.02), and smoking (p = 0.04). Lesbian participants had elevated measured C-reactive protein levels (p = 0.05). By the time of the follow-up survey 10 years later, lesbian women continued to have higher rates of smoking (p = 0.04), but the disparity in depression (p = 0.53) and obesity (p = 0.24) rates had resolved. We found no differences in any other outcomes of interest. Conclusions: To our knowledge, this is the first study to report a resolution in obesity or depression disparities between lesbian and heterosexual women. Future research is necessary to determine if other disparities, such as respiratory conditions, appear over time and how lesbian women's health may continue to improve relative to heterosexual women and stem this public health inequity.

BACKGROUND Adverse life experiences (ALE; eg, discrimination and sexual abuse) may contribute to cardiovascular disease (CVD) risk in sexual minority women (SMW), but few studies have tested whether ALE explain the association of sexual identity with cardiovascular health (CVH) markers in women. OBJECTIVE The aim of this study was to examine sexual identity differences in CVH among women and the role of ALE. METHODS In the Epidemiologic Study of Risk in Women, we used multinomial logistic regression to assess sexual identity differences (SMW vs heterosexual women [reference group]) in CVH markers (ideal vs poor, intermediate vs poor) using the American Heart Association's Life's Simple 7 metric and the total score. Next, we tested whether the association of sexual identity with the total CVH score was attenuated by traditional CVD risk factors or ALE. RESULTS The sample consisted of 867 women (395 heterosexual, 472 SMW). Sexual minority women were more likely to have experienced discrimination (P < .001) and lifetime sexual abuse (P < .001) than heterosexual women. Sexual minority women were also less likely to meet ideal CVH criteria for current tobacco use (adjusted odds ratio, 0.43; 95% confidence interval, 0.24-0.73) or intermediate CVH criteria for body mass index (adjusted odds ratio, 0.60; 95% confidence interval, 0.40-0.92). Sexual minority women had a lower cumulative CVH score (B [SE] = -0.35 [0.14], P < .01) than heterosexual women. This difference was not explained by traditional CVD risk factors or ALE. CONCLUSIONS Smoking, body mass index, and fasting glucose accounted for much of the CVH disparity due to sexual identity, but those differences were not explained by ALE. Health behavior interventions tailored to SMW should be considered.

ABSTRACT HIV Pre-Exposure Prophylaxis (PrEP) has shown great promise in reducing HIV transmission among affected populations; however, PrEP uptake among Black men who have sex with men (BMSM) has stalled. This study compares BMSM using PrEP and BMSM at risk for HIV not using PrEP based on differences in behavior, psychosocial conditions and the presence of a syndemic (n = 1,411). BMSM reporting PrEP use were significantly more likely to report three of five HIV risk behaviors and three of four psychosocial conditions. Odds of reporting PrEP use increased as the number of psychosocial conditions increased such that BMSM with three psychosocial conditions (AOR = 5.65, 95% CI: 3.17, 10.08) and four conditions (AOR = 18.34, 95% CI: 5.01, 67.20) demonstrated significantly greater odds of PrEP use compared to BMSM reporting one or less conditions. While BMSM at greatest risk are using PrEP, strategies are still needed for men at varying risk levels.