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Objective: Health professionals who work with women in pregnancy and postpartum are rarely educated in psychosocial aspects of body image and mental health, despite this being a time of significant bodily change for women. This study presents the results of a needs assessment to determine the extent, nature, and format of health professional education in relation to body image and perinatal mental health. Method: Participants were N = 257 health professionals (89% female) from 16 European countries, recruited through the authors professional networks, who completed an online survey about their existing knowledge and experience, and preferences for further education. Results: Current knowledge about body image was low, and open-ended comments indicated that body image was integrated into pregnancy and postpartum care within the context of encouraging weight loss. Health professionals saw opportunities for the inclusion of conversations about body image and mental health within their clinical care and a need for training about ‘what to say’ to mothers, as well as recommendations for diagnostic and referral pathways, and more general information about postpartum body image and mental health that could inform their practice. Discussion: This research indicates the need for health professional education in relation to perinatal body image and mental health., peer-reviewed

Objective: The aim of this study was to test the efficacy of long-term, daily intake of erythritol and xylitol candy, compared with sorbitol candy, on the development of enamel and dentin caries lesions. Methods: The study was a double-blind randomized controlled prospective clinical trial. Altogether 485 primary school children, first- and second-graders at baseline, from southeastern Estonia participated in this 3-year intervention. Each child consumed four erythritol, xylitol or sorbitol (control) candies three times per school day. The daily intake of polyol was about 7.5 g. The International Caries Detection and Assessment System (ICDAS) was used in the clinical examinations by four calibrated examiners at baseline and at 12, 24 and 36 months. Results: The annual examination analyses and the follow-up analyses confirmed that the number of dentin caries teeth and surfaces at 24 months follow-up and surfaces at 36 months follow-up was significantly lower in the mixed dentition in the erythritol group than in the xylitol or control group. Time of enamel/dentin caries lesions to develop and of dentin caries lesions to progress was significantly longer in the erythritol group compared to the sorbitol and xylitol groups. Also the increase in caries score was lower in the erythritol group than in the other groups. Conclusions: In the follow-up examinations, a lower number of dentin caries teeth and surfaces was found in the erythritol group than in the xylitol or control groups. Time to the development of caries lesions was longest in the erythritol group. Trial registration: ClinicalTrials.gov Identifier NCT01062633.

The objective of the present paper is to report results from oral biologic studies carried out in connection with a caries study.Samples of whole-mouth saliva and dental plaque were collected from initially 7- to 8-year-old subjects who participated in a 3-year school-based programme investigating the effect of the consumption of polyol-containing candies on caries rates. The subjects were randomized in three cohorts, consumed erythritol, xylitol, or sorbitol candies. The daily polyol consumption from the candies was approximately 7.5 g.A significant reduction in dental plaque weight from baseline (p0.05) occurred in the erythritol group during almost all intervention years while no changes were found in xylitol and sorbitol groups. Usage of polyol candies had no significant or consistent effect on the levels of plaque protein, glucose, glycerol, or calcium, determined yearly in connection with caries examinations. After three years, the plaque of erythritol-receiving subjects contained significantly (p0.05) lower levels of acetic acid and propionic acid than that of subjects receiving xylitol or sorbitol. Lactic acid levels partly followed the same pattern. The consumption of erythritol was generally associated with significantly (p0.05) lower counts of salivary and plaque mutans streptococci compared with the other groups. There was no change in salivary Lactobacillus levels.Three-year consumption of erythritol-containing candies by initially 7- to 8-year old children was associated with reduced plaque growth, lower levels of plaque acetic acid and propionic acid, and reduced oral counts of mutans streptococci compared with the consumption of xylitol or sorbitol candies.

Manuscript. Published version available at http://dx.doi.org/10.1159/000450762 Objective: Assess the effect of daily consumption of erythritol, xylitol, and sorbitol candies on caries development in mixed dentition during a three-year intervention and three years after the intervention. Methods: 485 Estonian first and second grade primary school children participated. Children were randomly allocated to an erythritol, xylitol, or sorbitol (control) group. Polyol-containing candies were administered on school days with a daily polyol consumption of 3x2.5 g. Yearly, caries development was assessed by calibrated dentists using the ICDAS criteria. Six years after initiation of the study and three years after cessation of daily polyol consumption, 420 participants were re-examined to identify potential long-term effects of polyol consumption. Survival curves were generated at the end of the intervention period and three years post intervention. The model included age of the subjects, schools, tooth surface ages and years of surface exposure to intervention. ICDAS scoring system based events included enamel/dentine caries development, dentine caries development, increase in caries score, and dentist intervention. Results: At the end of the intervention, time to enamel/dentine caries development, dentine caries development, increase in caries score, and dentist intervention was significantly longer in the erythritol group as compared to the sorbitol group. Except for increase in caries score, all effects persisted three years after cessation of daily polyol consumption. Conclusions: A caries preventive effect of three-year erythritol consumption as compared to sorbitol was established in children with mixed dentition. The effect persisted up to three years after the end of the intervention. Trial registration: ClinicalTrials.gov Identifier NCT01062633.

The aim was to (1) assess the proportion of children with dental fear, to (2) compare results obtained by a single fear question to those obtained by using a set of 11 fear questions, to (3) study associations between children's dental fear and their dental health, and to (4) compare children's dental fears to those of their parents.A cross-sectional sample of 344 8-10-year-old schoolchildren from South Estonian primary schools participated. Children's fears were measured with the modified Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). The scale includes 11 fear items amongst which five represent less invasive (noninvasive items), another five invasive aspects of dental treatment (invasive items), and one question represents general dental fear of the child. In addition, two questions were included to assess parental dental fear. The dental health of children was examined using the International Caries Detection and Assessment System (ICDAS) criteria.The proportion of children with general dental fear was 6.1%. The mean score of noninvasive fears was higher among the youngest than among the oldest age group (p0.02). Children whose dmft/DMFT-scores were0 had higher fear scores than those whose dmft/DMFT-scores were =0 (p0.01). A total of 16.8% and 15.7% of mothers and fathers afraid of dentistry in general. There were strong correlations between children's dental fears and maternal (p0.01), and paternal (p0.01) dental fear.Children's fears were strongly associated with untreated caries and experience of dental treatment, and with parental fears.

This study aims to assess the caries experience among first- and second-grade children in the elementary schools of southeastern Estonia.A representative sample of 485 children was studied. The mean age of children in the first grade was 7.8 years (SD = 0.35) and in the second grade 8.8 years (0.38). The clinical examinations using ICDAS criteria were completed by four calibrated examiners. The inter- and intra-examiner consistency of the examiners was high (surface and tooth-based kappa0.9).The mean caries experience of dentinal caries lesions was 0.8 (D 4-6 MFT) and 1.6 (D 4-6 MFS) among the first graders and 1.1 (D 4-6 MFT) and 1.6 (D 4-6 MFS) among the second graders. The mean caries enamel lesions among the first graders was 1.6 (D1-3T) and 2.2 (D1-3S) and among the second graders 2.1 and 3.0, respectively. The most affected surfaces were the occlusal surfaces of the lower first molars. The prevalence of sealants was very low-only 2.4% of the first molars were sealed among the first graders and 3.9% among the second graders. There were no statistically significant differences in caries experience or in the provision of restorative treatment between the schools.Caries experience is high in southeastern Estonia. Preventive programs are urgently needed.

Caries has traditionally been assessed with WHO criteria including only obvious caries lesions. ICDAS has been developed to detect also the enamel caries lesions. This study aims to study caries and the associations of the number of caries lesions between the permanent and primary molars with ICDAS in the mixed dentition of the first and second grade primary school children. The clinical examinations of 485 children were conducted by four examiners with high reproducibility (inter- and intraexaminer kappas >0.9). The mean number of caries lesions—especially dentine caries—seemed to be higher in the second primary molars than in the first permanent molars. There were significant correlations between the number of lesions on occlusal and lingual surfaces between the primary and permanent molars. Enamel caries lesions, restorations, and caries experience did not increase according to age. Therefore, caries might be increasing in this population. As a conclusion, ICDAS recording seems to give appropriate information from the occurrence of caries lesions and its correlations between the primary and permanent teeth and surfaces.

Health is a critical dimension of human well-being and flourishing, and oral health is an integral component of health: one is not healthy without oral health. Significant barriers exist to ensuring the world's people receive basic healthcare, including oral healthcare. Amongst these are poverty, ignorance, inadequate financial resources and lack of adequate numbers of educated and trained (oral) healthcare workers. Emerging economies are encouraged to develop a national strategic plan for oral health. International organizations have developed goals for oral health that can be referenced and adapted by emerging economies as they seek to formulate specific objectives for their countries. Demographic data that assess the nature and extent of oral diseases in a country are essential to sound planning and the development of an oral healthcare system that is relevant, effective and economically viable. Prevention should be emphasized and priority consideration be given to oral healthcare for children. The types and numbers of members of the oral healthcare team (workforce) will vary from country to country depending on the system developed. Potential members of the workforce include: generalist dentists, specialist dentists, dental therapists, dental hygienists, denturists, expanded function dental assistants (dental nurses) and community oral health workers/aides. Competences for dentists, and other members of the team, should be developed to ensure quality care and developed economies should cooperate with emerging economies. The development, by more advanced economies, of digital, virtual curricula, which could be used by emerging economies for educating and training members of the oral healthcare team, should be an important initiative. The International Federation of Dental Educators and Associations (IFDEA) should lead in such an effort.