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Veselina K Kondeva

Bio: Veselina K Kondeva is an academic researcher. The author has contributed to research in topics: Dental fluorosis & Permanent teeth. The author has an hindex of 3, co-authored 4 publications receiving 46 citations.

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TL;DR: In this country there is no established practice for children to make their first dental visit before they turn one year of age, and the predominant cause to make the first visit is caries and its complications.
Abstract: Introduction The ideal time for the first dental visit of a child as recommended by many professional dental organizations across the world is by the age of one year. The aim of this study was to survey the age and the most common causes for the first visit to the dental office, as well as the recommendations of dentists regarding this visit. Patients and methods The present study included 289 children visiting a dentist for the first time. The children were divided into 5 age groups and the reasons for the visit were categorized into 9 groups. The variables we assessed were the percentages of children in each age group and the reasons for the first visit to the dentist. Respondents to a questionnaire were 145 dentists. The survey included questions on gender, years of professional experience, specialty, ability to work with children and recommendations concerning the age of the first visit to the dentist. Results The greatest number of children making their first dental visit were in the 3-6 year-olds (51.90 percent) and the smallest number were the children younger than 1 year (1.73%). The most common reason for making this visit was caries and its complications (59.86%). The second most common reason was parents' decision to have a prophylactic examination of their child (26.99%). The number of dentists in this country that recommended that the first visit should be before the age of 1 year is small (17.93%). 39.31% of the respondents recommended that the first dental visit should take place between 1 and 2 years of age, and 31.03 percent between 2 and 3 years. It was only pediatric dentists that recommended a dentist appointment in the first year of life - 47.37%. This study found that it was the female dentists that predominantly admit and treat children in their dental practices. Conclusions The results of the study show that in this country there is no established practice for children to make their first dental visit before they turn one year of age. The predominant cause to make the first visit is caries and its complications. It is necessary to work out recommendations on the age for the first visit to the pediatric dentist and related prophylactic measures.

33 citations

Journal Article
TL;DR: The prevalence of ECC is high in the studied populations and the analysis of the questionnaire data shows that the knowledge of mothers about the appropriate feeding of their children is insufficient, and frequent consumption of quickly soluble carbohydrates is not the only risk factor for developing caries.
Abstract: INTRODUCTION Available data show that Early Childhood Caries (ECC) has a very wide range of prevalence (5% to 55%). Contemporary studies investigate the specific etiologic factors contributing to the appearance of ECC. As these questions are inadequately addressed in the stomatological literature in Bulgaria, we decided to investigate them in the present study. AIM To determine the prevalence of ECC and the risk factors in children aged 12 to 47 months in Plovdiv. METHODS The study is representative by design and is conducted in compliance with the requirements of World Health Organization. It includes 370 children 1 to 3 years of age, selected randomly. The dental caries was diagnosed by the visual-tactile method with a dental explorer and mirror at the cavitation level. A survey for determining the risk factors for ECC is carried out among the mothers of all affected children. RESULTS The results of the study demonstrate high prevalence of ECC in the studied populations--20.82% in 1-year-old children, 40.0% in 2-year-old children and 56.15% in 3-year-old children. The analysis of the questionnaire data shows that the knowledge of mothers about the appropriate feeding of their children is insufficient. The use of baby's comforter with honey is not the only risk factor for developing caries. It is ascertained that frequent consumption of quickly soluble carbohydrates, as well as their prolonged contact with the tooth surface is highly significant risk factors too. CONCLUSIONS The prevalence of ECC is high in the studied populations. The results of the questionnaire survey demonstrate the need for recommending adequate feeding practices of children till the age of 3 years to their mothers.

11 citations

Journal Article
TL;DR: The results of the study showed excessive fluoride intake during tooth development and suggested a need for further research of risk factors.
Abstract: INTRODUCTION There has been no study on the prevalence of dental fluorosis in Bulgaria of today where people have free access to some fluoride-containing products. AIM The aim of the study was to investigate the prevalence of dental fluorosis among children 4 to 14 years old from the town of Dimitrovgrad, where due to unsatisfactory qualities of tap water people consume bottled water including such with fluoride levels higher than 1.5 mg/l. PATIENTS AND METHODS The study included 1504 randomly selected children. We analysed subjects with dental fluorosis according to Dean's modified criteria. The following severity levels were defined: 0 - normal; 0.5 - suspicious; 1 - very mild; 2 - mild; 3 - moderate; 4 - severe. Data were analyzed separately for the different types of dentitions. RESULTS Results showed that 54.52% of all children included in the study had dental fluorosis in different degrees. Primary teeth were affected by dental fluorosis less frequently than permanent teeth (P < 0.001). In mixed dentition cases 41.41% of the children had fluorosis of permanent teeth only, 1.64% had dental fluorosis of primary teeth only and 12.50% had both their primary and permanent teeth affected. The proportion of individuals with the lowest degree of severity - 0.5, was the greatest both for the primary and permanent teeth. Comparison with the proportions of children with more severe degrees of fluorosis revealed significant differences (P < 0.001). CONCLUSION The results of the study showed excessive fluoride intake during tooth development and suggested a need for further research of risk factors.

4 citations

Journal Article
TL;DR: A comparative analysis of three epidemiological studies carried out in Plovdiv and Dimitrovgrad in 2004, 2005 and 2008 found that the higher prevalence of dental fluorosis does not necessarily lead to low prevalence of dentist caries and low DMFT values in the specific population.
Abstract: INTRODUCTION There is evidence that the prevalence of dental fluorosis in many countries has increased over the last three decades along with a noted decrease of dental caries. To date no comparative studies of dental caries and dental fluorosis have been conducted in Bulgaria reflecting the present-day conditions of life. AIM To study comparatively the prevalence of dental fluorosis and dental caries and to establish what relationship, if any, there is between them. MATERIAL AND METHODS We performed a comparative analysis of three epidemiological studies carried out in Plovdiv and Dimitrovgrad in 2004, 2005 and 2008. The hypothesis tested was that dental caries was less frequent in populations with higher prevalence of dental fluorosis (with predominance of mild fluorosis cases). Dental fluorosis was diagnosed using Dean's criteria, and dental caries was scored using the WHO criteria. The results were analysed using the alternative analysis and analysis of variance at a level of significance P < 0.05. RESULTS The prevalence of dental fluorosis in the studied populations in Dimitrovgrad in 2004 was 56.99%, in Plovdiv in 2005--7.80%, and in 2008--23.18%. The comparison of the studies in Dimitrovgrad and Plovdiv in 2005 showed lower prevalence of dental caries and lower DMFT values in all age groups (P < 0.001) in Dimitrovgrad, where the prevalence of dental fluorosis was greater than that in Plovdiv (P < 0.001). The comparison between the studies in Plovdiv alone in 2005 and 2008 showed an increase in dental fluorosis in 2008 (P < 0.001). The prevalence of dental caries was higher in almost all groups, but the differences failed to reach statistical significance (P < 0.001). The DMFT index was higher in 2008 (P < 0.001) with the exception of some age groups. CONCLUSION The higher prevalence of dental fluorosis does not necessarily lead to low prevalence of dental caries and low DMFT values in the specific population.

3 citations


Cited by
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TL;DR: The results from the caries severity data indicate that the initiation of water fluoridation results in reductions in dmft and DMFT compared to the median control group mean values, and the initiated programme results in the proportion caries free between the fluoridated and control groups.
Abstract: BACKGROUND: Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community water fluoridation was initiated in the USA in 1945 and is currently practised in about 25 countries around the world; health authorities consider it to be a key strategy for preventing dental caries. Given the continued interest in this topic from health professionals, policy makers and the public, it is important to update and maintain a systematic review that reflects contemporary evidence. OBJECTIVES: To evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries.To evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis. SEARCH METHODS: We searched the following electronic databases: The Cochrane Oral Health Group's Trials Register (to 19 February 2015); The Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2015); MEDLINE via OVID (1946 to 19 February 2015); EMBASE via OVID (1980 to 19 February 2015); Proquest (to 19 February 2015); Web of Science Conference Proceedings (1990 to 19 February 2015); ZETOC Conference Proceedings (1993 to 19 February 2015). We searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization's WHO International Clinical Trials Registry Platform for ongoing trials. There were no restrictions on language of publication or publication status in the searches of the electronic databases. SELECTION CRITERIA: For caries data, we included only prospective studies with a concurrent control that compared at least two populations - one receiving fluoridated water and the other non-fluoridated water - with outcome(s) evaluated at at least two points in time. For the assessment of fluorosis, we included any type of study design, with concurrent control, that compared populations exposed to different water fluoride concentrations. We included populations of all ages that received fluoridated water (naturally or artificially fluoridated) or non-fluoridated water. DATA COLLECTION AND ANALYSIS: We used an adaptation of the Cochrane 'Risk of bias' tool to assess risk of bias in the included studies.We included the following caries indices in the analyses: decayed, missing and filled teeth (dmft (deciduous dentition) and DMFT (permanent dentition)), and proportion caries free in both dentitions. For dmft and DMFT analyses we calculated the difference in mean change scores between the fluoridated and control groups. For the proportion caries free we calculated the difference in the proportion caries free between the fluoridated and control groups.For fluorosis data we calculated the log odds and presented them as probabilities for interpretation. MAIN RESULTS: A total of 155 studies met the inclusion criteria; 107 studies provided sufficient data for quantitative synthesis.The results from the caries severity data indicate that the initiation of water fluoridation results in reductions in dmft of 1.81 (95% CI 1.31 to 2.31; 9 studies at high risk of bias, 44,268 participants) and in DMFT of 1.16 (95% CI 0.72 to 1.61; 10 studies at high risk of bias, 78,764 participants). This translates to a 35% reduction in dmft and a 26% reduction in DMFT compared to the median control group mean values. There were also increases in the percentage of caries free children of 15% (95% CI 11% to 19%; 10 studies, 39,966 participants) in deciduous dentition and 14% (95% CI 5% to 23%; 8 studies, 53,538 participants) in permanent dentition. The majority of studies (71%) were conducted prior to 1975 and the widespread introduction of the use of fluoride toothpaste.There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels.There is insufficient information to determine the effect of stopping water fluoridation programmes on caries levels.No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria.With regard to dental fluorosis, we estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12% (95% CI 8% to 17%; 40 studies, 59,630 participants). This increases to 40% (95% CI 35% to 44%) when considering fluorosis of any level (detected under highly controlled, clinical conditions; 90 studies, 180,530 participants). Over 97% of the studies were at high risk of bias and there was substantial between-study variation. AUTHORS' CONCLUSIONS: There is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation.

262 citations

Journal ArticleDOI
TL;DR: Results of the study demonstrate that even in Western countries ECC and S-ECC represent a significant burden in preschool children, particularly in those disadvantaged, and that most of the known modifiable associated factors regarding feeding practices and oral hygiene are still very spread in the population.
Abstract: This survey was intended to investigate prevalence and severity of early childhood caries (ECC) in a sample of children in Southern Italy and to identify factors that may be related to this condition The study was designed as a cross-sectional survey The study population (children aged 36–71 months) attending thirteen kindergartens was randomly selected through a two-stage cluster sampling procedure Parents/guardians of all eligible children were invited to participate filling out a structured self-administered questionnaire, and after having returned the informed consent form an oral examination of the child was performed at school The questionnaire included information on: socio-demographics about parents/guardians and child, pregnancy and newborn characteristics, oral hygiene habits of child, eating habits particularly on consumption of sweets, access to dental services, and infant feeding practices The WHO caries diagnostic criteria for deciduous decayed, missing and filled teeth (dmft) and surfaces (dmfs) were used to record ECC and severe-ECC (S-ECC) Univariate and multiple logistic regression analyses were conducted to evaluate statistical associations of social demographics, infant feeding practices, oral hygiene habits, and access to dental services to ECC, S-ECC, dmft and dmfs 515 children participated in the study 19% had experienced ECC, and 27% S-ECC, with a mean dmft and dmfs scores of 051 and 099, respectively Mean dmft was 268 in ECC subjects, and 686 in S-ECC subjects Statistical analysis showed that prevalence of ECC significantly increased with age (OR = 195; 95% CI = 13-291) and duration of breastfeeding (OR = 126; 95% CI = 101-157), whereas it was significantly lower in children of more educated mothers (OR = 064; 95% CI = 042-096), and higher in those who had been visited by a dentist in the previous year (OR = 329; 95% CI = 172-633) Results of our study demonstrate that even in Western countries ECC and S-ECC represent a significant burden in preschool children, particularly in those disadvantaged, and that most of the known modifiable associated factors regarding feeding practices and oral hygiene are still very spread in the population

85 citations

Journal ArticleDOI
TL;DR: For children younger than 2 years, caregivers' assessments correlated poorly with clinical needs, which routinely were underestimated, underscore the importance of preventive dental visits at a young age and the early establishment of a dental home.
Abstract: Background Caregivers' perceptions of their young children's oral health status (OHS) are a strong determinant of whether the children visit a dentist. Our aims were to quantify the correlation between caregivers' assessments and their children's clinically determined restorative treatment needs, while investigating factors related to this association.

58 citations

Journal ArticleDOI
10 Apr 2017
TL;DR: This review article highlights different microbiological perspectives of dental caries in broader sense and its update will help to upgrade the recent trends of microbiology in dental carie and also formulating various developmental programs towards oral hygiene.
Abstract: Tooth decay, also known as dental caries is an epidemic, microbiological contagious disease of the teeth that ends in localized dissolution and damage of the calcified structure of the teeth. This disease occurs due to multiple factors such as interactions within the plaque community, host physiology, diet, fluoride, pH and the nature of the tooth enamel, and dominance of Streptococcus mutans . The time factor is significant for the commencement and development of caries in teeth. The main instigation and progress of dental caries involves acidogenic and aciduric Gram-positive bacteria such as Streptococcus, Lactobacillus and Actinomycetes colonizing the supragingival biofilm which impede with usual nutrition intake, verbal communication, self-worth and daily habitual behavior. Nutritional influences on craniofacial development, oral cancer and other oral infectious diseases are expensive to treat. In spite of development in science of oral diseases, dental caries extend to be a global health concern affecting human being of different age groups. With this concern, this review article highlights different microbiological perspectives of dental caries in broader sense and its update will help to upgrade the recent trends of microbiology in dental caries and also formulating various developmental programs towards oral hygiene.

58 citations