احمد حائریان

Oral health can prepare such activities as eating, speaking, and  convenient social encounters as well as increased quality of life. Quality of life related to oral and dental health measures the effect of body and mind on oral health, and the effect of oral and dental disabilities on daily life. This study was carried out to evaluate the relationship between oral health indices and quality of life in 14-18 year-old boy students in Yazd.

In this cross- sectional and descriptive study, three high schools were selected randomly and 273 students were evaluated. They were examined with dental mirror and explorer in natural light. We used standard questionnaire called Short Form 36 (SF36) for evaluation of life quality and DMFT and Oral Health Index-simplified (OHI-S) for evaluation of oral hygiene. Kruskal-Wallis, ANOVA test and Spearman’s correlation coefficient were used for data analysis at a confidence interval of 0.95.

In this study, mean and standard deviation of DMFT and OHI-S respectively, were (3.07±2.18) and (1.89±1.3). The quality of life in the field of physical functioning was the most and in the field of role limitation due to physical functioning was the least. Correlation between DI-S (Debris Index- simplified) with social functioning, between CI-S (Calculus Index- simplified) with the age and the educational degree of student was statistically signicant.

The results of this study showed the relation of life quality and oral hygiene, among oral health indices, CI-S and age has the highest correlation.

Regarding special physiological conditions of pregnant women, training the rules of oral and dental care are required to be more emphasized. Most of health problems are associated with human behavior and, therefore, the theories of behavior can help with prevention of oral and dental health problems. The present study was conducted to determine predictors of oral and dental care in pregnant women based on the theory of planned behavior.
Material: This was a descriptive correlational study in which 208 pregnant women referring to four health centers in the city of Yazd were selected using multistage random sampling. The questionnaire was designed according to the theory of planned behavior which consisted of demographic and background information, theoretical questions, and oral and dental health status. It was completed through interview while the validity was confirmed by the expert opinions and the reliability by Cronbach's alpha of 0.83-0.64.
59.1% of the studied women brush their teeth once a day and only 30.8% used dental floss daily. The average number of healthy teeth of the pregnant women was 23.56 ± 7.65. Attitude toward behavior, subjective norms, and perceived behavioral control predicted 66% of behavioral intension. Health behavior predicted 12% of the changes of oral and dental health condition. Perceived behavioral control was the strongest predictor of behavioral intention.
Concentrating on perceived behavioral control, the theory of planned behavior could result in optimum behaviors of oral and dental health. This model can be used as an appropriate model in promoting oral and dental health status.

In periodontal pockets, the exposed root surfaces are contaminated with an accumulation of plaque and calculus. Usually, in the initial phase of periodontal therapy, debridement of the diseased root surface is non surgically. However, complete removal of plaque and calculus is not always achieved with only the use of conventional mechanical therapy. The outcome of other studies showed that adding diode laser therapy to the initial phase of periodontal therapy significantly improved treatment results. The aim of this study was the evaluation of the effects of diode (980 nm) laser on clinical periodontal parameters after nonsurgical periodontal therapy.
Twenty-one patients with moderate to severe chronic periodontitis (11 men and 10 female with mean age of 42.2) were selected and divided into the control group (SRP) and test group (SRP laser). Two months after the last scaling and laser radiation, clinical parameters were recorded and compared with baseline. This clinical trial study was in splint mouth design which was done on randomized selection in two quadrant (Maxilla and Mandible) in test group. the data were entered in computer and analysed bying SPSS 16 and Mannywhitny and Wilcoxon test.
After two months, clinical parameters improved in both groups. There were statically significant difference between two groups in PI and PD (0-3) mm, however in CAL and PPD (3-5) mm, (>5) mm no statically significant difference were seen.
According to an overall improvement in clinical parameters, usage laser as an adjunctive treatment besides common methods could be suggested.

The role of inappropriate thoughts in preventing an access to desirable level of oral health in society seems to be undeniable. Therefore, this study intends to investigate the patients’ attitude referred to health centers of Yazd in regard with inappropriate beliefs about dentistry in 2012.
In this descriptive cross-sectional study, 300 patients referred to oral health centers of Yazd were selected via a two-stage cluster random sampling method. In order to obtain data, a questionnaire was used which its validity was substantiated by a team of specialists and its reliability was confirmed utilizing re-testing via the correlation coefficient of 95%. The questionnaire consisted of two parts: the first part involved the demographic information and the second part entailed the most common beliefs about dentistry. The collected data were analyzed by SPSS ver.16, applying ANOVA, T-test, turkey test and Pearson correlation coefficient.
The average score of attitude was 2.87 ±0.63 out of 5. Half of the patients (50%) revealed a moderate attitude towards dental care and only 14.7% had a high level of attitude. The mean score of inappropriate beliefs demonstrated no significant statistical difference between males and females (P.Value=0.363), though there was a significant relationship among age, education level and career with inappropriate beliefs (P.value= 0.001).
The study results revealed that the level of inappropriate beliefs about dentistry was in moderate level in the studied society, which such beliefs belonged to half of the population. Therefore, in order to reach appropriate results regarding oral health, enhancing the knowledge level of individuals seems to be necessitated prior to any planning for health education and preventive cares.

The present study aimed to explore the impact of preventive dimensions of a dentistry education program on the behavior, oral hygiene, and gingival health of a group of dentistry students of Yazd province.
51 junior and senior dentistry students of Shahid Sadoughi University of Medical Sciences volunteered to participate in the study. Participants were asked to fill in the Hiroshima University-Dental Behavioral Inventory (HU-DBI). Also, clinical examinations to assess Gingival Bleeding Index and Oleary Index were conducted.
Comparison of junior and senior participants’ responses to the HU-DBI items indicated a statistically significant difference between the two groups on items 1, 8, 10, 15, 17, 18, 20, and 21. While the senior group showed lower Gingival Bleeding and Oleary indexes in comparison to its junior counterpart, the junior group showed a higher HU-DBI mean score in comparison to the junior group. Furthermore, participants with higher HU-DBI mean scores were found to show lower Gingival Bleeding and Oleary indexes.
Findings of the study indicate that junior dentistry students, in comparison to senior ones, had better gingival health and oral hygiene.

Oral malodor can be used as a motivational tool to improve oral health-related behaviors. The present study aimed to compare oral health training on the dental plaque index.
In the current study, 161 ( 76 females, 85 male) grade-one high school students from public schools of Yazd were divided into three groups : 1 – Oral health training oral malodor training ( halitosis group), 2– oral health training training of dental caries and periodontal diseases ( traditional groups), 3- oral health training (control group ). Two weeks and two months after the intervention, plaque index was measured. Positive and negative changes were recorded over time, and then, the study data were analyzed using Chi-square (bonferroni adjustment), McNemar, Kruskal-Wallis and Paired t-Test.
The study results revealed no significant differences between the halitosis group and the traditional group, though both had a significant difference with the control group. Positive changes in halitosis group especially within girls were held to be more durable compared to the other groups.
Oral health training accompanging training of oral malodor, tooth decay and periodontal disease seems to be more effective on health promotion of senior high school students in Yazd. Furthermore, oral malodor training produces more durable effects. As a result, this training style is recommended in regard with eductional programs of schools.

Oral health related quality of life - United Kingdom (OHQoL-UK) questionnaire is one of the instrument which measure both positive and negative aspect of Oral Health related Quality of Life (OHQoL) at the same time. The aim of this study is to evaluate OHQoL with remaining teeth and other variable using OHQoL-UK questionnaire. Method and Material: This cross-sectional study was done on 150 patients referring to Yazd dental university and Khatamolanbia clinic; They were randomly asked to complete OHQoL-UK questionnaire. Number of teeth, present or absence of dental prosthesis (partial or fixed) was examined by the clinician. Then patients completed the OHQoL-UK questionnaire. Sixty one male and 84 female completed the questionnaire. Male have higher mean quality of life score than female (68.8 in male and 67.9 in female) although it was not statistically significant (p=0.519). Increasing age was associated with lower mean quality of life score (p=0.214). Patients with more teeth have higher mean quality of life score (p= 0.002, rs=0.253). Mean quality of life score in patients with partial prosthesis was less than other patients but this relationship was not statistically significant (p=0.563). Patients with fixed prosthesis had higher mean quality of life score than others (p=0.05). According to the effect of dental condition on quality of life and effect of tooth loss on decreasing quality of life, required intervention should be done to improve dental condition and quality of life as a result.

Dental abscesses and periodontal disease can be regarded as the common causes of odontogenic sinusitis. Apical periodontitis, periodontal disease, implant treatment and teeth extraction lead to the increase risk of maxillary sinus mucositis. The maxillary sinuses are usually well visualized on panoramic images. Therefore, this study aimed to explore the association between mucosal thickening of the sinuses and periodontal bone loss(PBL) on the digital panoramic images. In this cross-sectional descriptive study, a total of 200 digital panoramic images related to patients at least suffering from mild periodontal bone loss were reviewed. Type and severity of PBL of posterior teeth were assessed, and the presence of mucosal thickening was recorded. The study data were analyzed via SPSS software (version17) applying Chi-square test. Moreover, significant level of P –value of less than. 005 was determined. Mucosal thickening was significantly correlated with the bone loss and pattern type of the bone loss. Moreover, the prevalence of sinus mucosal thickening was 12.10% in patients with mild bone loss, 27.45% in patients with moderate bone loss, 63.15% in patients with severe bone loss. No statistically significant relationship was detected between Maxillary sinus mucositis with patients’ age and sex (p =0.05). In patients suffering from the bone loss, increased severity of the bone loss can lead to an increase in the prevalence of sinus mucosal thickening. The maxillary sinus mucositis was reported to be more prevalent in the bone loss with a vertical pattern rather than the bone loss with a horizontal pattern. Moreover, based on the results of the present study, the periodontal disease may increase the risk of sinus mucosal thickening.

Almost 40% of cancer patients undergo the radiation therapy during their treatment. Therefore, the present study aimed to evaluate the knowledge of patients referring to Shahid Ramazanzade radiotherapy center concerning oral side effects of head and neck radiation therapy in 2014.

In this descriptive cross-sectional study, 180 patients who referred to Shahid Ramazanzade radiotherapy center, were selected by a simple random sampling method. The study data were gathered via a researcher-made questionnaire that its and reliability and validity have been confirmed. This questionnaire included 10 questions related to the patient’s knowledge with the maximum and minimume scores of “0” and “2” respectively. Scores of 0-6.99, 7-13.99, 14-20, respectively, demonstrated a poor, moderate and good levels of knowledge. The study data were analyzed using SPSS software (ver 17),  using ANOVA and T-test.

One hundred-eighty 21-88 years old patients with the mean age of 51.42±3.44 and age range of 21-88 attended in this study, of whome 110 (61.10%) were men and 70 (38.89%) were women. The knowledge mean score was 9.24±3.94  out of 20. Moreover, a significant statistical relationship was observed between the knowledge score of patients with their age (P=0.005) and education (P=0.0001), whereas no significant relationship was detected between the knowledge score and  gender of patients (P=0.502).

The findings of the present study revealed a moderate level of patients’ knowledge regarding the effects of radiotherapy on oral cavity. As a matter of fact, the knowledge level of patients was held to be lower in older patients, and patients with higher level of education gained a higher knowledge score.

Oral hygiene instruction performed by different personnel in various manners is a necessity for prevention and treatment of dental caries and periodontal diseases. Since dentists are the majority of personnel who deliver oral hygiene instruction to patients, this study was designed to evaluate dentist's attitude towards oral hygiene instruction in their private office in Yazd. A questionnaire including demographic information and various oral hygiene instruction methods was prepared and delivered to 151 dentists who were working in their private office in Yazd. Data were analyzed with SPSS 16 software and Fisher exact test was performed. Results revealed that 95.3% of dentists gave oral hygiene instruction to their patients. This training included dental flossing techniques followed by tooth brushing. Therefore, using an oral model was the most common way of patient’s instruction. Results obtained from this study showed that the majority of dentists in Yazd gave oral hygiene instruction to their patients through various methods.

Dental caries and periodontal disease are probably the most common oral chronic diseases in worldwide, and their prevalence is progressively increasing from day to day. Therefore, this study was conducted to investigate the relationship between caries and periodontal disease. In this cross sectional study, 237 panoramic radiographies of patients aged 10 to 65 years (110males and 127 females) were selected utilizing convenience sampling. In order to measure the variables, a graduate caliper with 0/2 mm accuracy and Negatoscope with optimum light were used. Moreover, in order to diagnose the caries and minimize the errors, “calibration” method was selected. There was no significant relationship between crown caries and mean of alveolar bone loss. (p=0/19). As the age increased in patients, the mean of alveolar bone loss also increased and a significant association was detected between the severity of caries, alveolar bone loss and male gender. Generally, no relationship was observed between dental caries and periodontal disease in this study.

Although Chlorhexidine mouthwash involves the most effective antiseptic in order to control the plaque as well as to prevent gingivitis, the incidence of some side effects has made an obstacle to use this substance permanently. Persica herbal mouthwash has recently been introduced to Iran’s market demonstrating no side effects of chemical substances consumption. Therefore, this study aimed to compare the effects of two Persica and Chlorhexidine mouthwashes on gingiva bleeding after scaling in order to determine an appropriate mouthwash to improve gingival bleeding after the priodental treatment.

In this clinical trial, 39 patients participated referring to periodontics department of Yazd dentistry school who had slight to moderate gingival inflammation and were randomly classified into three groups by parallel and double blind research design. Normal saline was given to the first group, chlorhexidine 0.2% was provided to the second group and persica was presented to the third group. The gingival bleeding index was evaluated at the beginning of study, precisely immediately and one week after mouthwash use. The collected data were analyzed by SPSS software (ver. 18) via Kruskal-Willis, Mann-Whitney, Wilcoxon and Chi-square tests.

The study results demonstrated the higher effect of persica on lowering gingival bleeding index compared to chlorhexidine which this difference proved to be statistically significant (p<0.05).

Using persica mouthwash can lead to a significant decrease in gingival bleeding. The study findings revealed that it seems persica mouthwash can be utilized in treatments of gingival diseases.

Dental fear is a major factor in postponing and cancelling a dental appointment. The studies in this field are still limited. The current study was conducted to examine dental fear in patients going to dentists in Mashhad, Iran. In this descriptive study, 400 patients were selected randomly from 20 dental offices in Mashhad. The data were collected, using Dental Fear Scale. The reliability and validity of the questionnaire have been measured and confirmed in previous studies. The data were analyzed, using the SPSS software to perform t-test, ANOVA, Spearman’s rank-order correlation coefficient, and Pearson’s product-moment correlation coefficient. Nearly 20.8% of the participants had mild, 57.5% had moderate, and 21.8% had severe dental fear. The mean score of fear was statistically higher in females (49.95±13.3) compared to males (39.69±14.7). In terms of marital status, the highest mean score of fear was observed among the divorced and widows (51.82 ± 14.2). In terms of occupation, the highest mean score of fear was observed among the housewives (52.63±12.89). Correlational analysis showed the following inverse relationship between dental fear score and age(r=-0.18,p<0.001), education level(ρ=-0.28,p<0.001)and income level (ρ=-0.39,p< 0.001). females, particularly housewives, have a significantly higher level of dental fear, and it had an inverse correlation with age, education level and level of income and they should be considered in interventional and educational programs aimed decreasing dental fear level.

The external margins of restorations involve appropriate places for plaque accumulation which assist in the creation or exacerbation of periodontal disorders. Since there are different materials and techniques for restorations, the present study aimed to determine the effect of restorative materials in correct class II restorations on the gingival health in patients referring to Shahid Sadoughi Dental School of Yazd in 2013.

In this study, 60 patients were selected via convenient sampling and classified into two groups of class II restored with amalgam and composite. Four surfaces of each tooth were examined and gingival status indices, plaque, bleeding on probing and the depth of probing were applied to check the periodontal status. In order to compare the two groups statically, SPSS software (ver.16) was utilized via applying non-parametric Man-Whitney test due to the ordinal nature of the variables.

The study results demonstrated that the mean score of MGI, PI, BI and PDI indices were more in the composite restored teeth. The difference was statically significant in the level of 0.05 (P.value= 0.001). Although the mean score of PDI index was a little more in the group of composite restored teeth, there was no statically significant difference between the two groups (P.value=0.470).

The findings revealed that even correctly restored teeth have a role in causing periodontal diseases, though in this case the negative impact of composite material seems to be more than amalgam.

It is possible to spread pathogens while working with ultra-sonic device through aerosol's dispersion so, it is necessary for dentists to have knowledge about infection control and the way of using it . this study was accomplished with the aim of evaluation of level of student's awareness of Yazd dental school about contamination during working with ultra-sonic device in the year 2012-2013

In this descriptive-sectional study, 80 students of Yazd dental school, which had passed periodontics, were included by census method. In order to evaluate the level of students’ knowledge about the possibility of infection's spread by working with ultra-sonic device and the way of controlling it, a questionnaire was used which consisted of 12 questions and its validity and reliability was confirmed. The data were analyzed by SPSS ver.17 and T-test.

From 80 students 43 were female (53.75%) and 37 were male (46.25%). The most correct answer was related to the sentence "mandatory of disinfecting the room which scaling has been done in". the average students score about the possibility of infection spread during working with ultra-sonic device and the way of controlling it was 6.76±0.620 that was evaluated in a moderate level. There was not a significant difference in the level of knowledge (P.value=0.062), however, female students awareness was more than male students.

According to the moderate level of students’ knowledge about infection control during working with ultra-sonic device, it is recommended to provide more education in this field.

The aim of this study was to compare the effect of a dental student’s education and health volunteers'' education on the knowledge، attitude، performance of housewives. In this study first a questionnaire and a booklet containing oral health instructions were prepared. Then 80 women attending two health centers were chosen for the study. Health volunteers received oral health instructions. Women were allocated into 2 groups; group A received oral health education from a dental student، while group B was trained by health volunteers. Both groups completed the questionnaire and the plaque index scores were recorded. After this step all participant were supplied by the oral health instruction booklet. The filling of the questionnaires and recording the plaque index scores were repeated after 3 months. Using Wilcoxon ranks test and Mann-Whitney test the data were then analyzed. The results of this study showed a significant increase in knowledge، attitude and performance while the plaque index decreased after 3 month. Comparing the effect of oral health education there was no significant difference between a dental student and health volunteers. The finding of this study indicated that health volunteers could serve as oral health trainers in the community.

Increasing demands for health care's services on one hand and limited resources on the other hand brings about pressure over governments to find out a mechanism for fair and appropriate distribution of resources. Economic analysis is one of the appropriate tools for policy making on this priority. The aim of this study was to assess capital and consumption of oral health units of health care centers in Yazd city and comparing it with revenue of these centers and determining of cost effectiveness. In this descriptive cross sectional study, all health care centers of Yazd city with active dentistry department were evaluated. The data has been extracted from current documents in health care center of county based issued receipts and daily information registers. Expended cost for providing of oral hygiene services in second half of 2008 in 13 medical health centers of Yazd included active dentistry section was 557.887.500 Rials and revenue to cost ratio was about 34%. The most provided service was related to tooth extraction and the average of tooth restoration in each working day was 0.48. With attention to low tariffs of dentistry services in medical health centers and paying subsidy to target groups, expenses of oral hygiene are always more than its revenue.

Patient's anxiety and thus not referring to detal offices for receiving dental services may inappropriately affect inadequately on community development indicators. There are limited studies in this area, and the results are usually inconsistent. This study was then carried out with the aim of determining the dental anxiety among patients referred to private offices in Mashhad. In this descriptive study, a total number of 400 patients who had referred to private dental offices in Mashhad entered in the study. Data were then collected using Dental Anxiety Scale. Validity and reliability of the scale was determined and approved in the previous studies. Data were analyzed through SPSS software using T-Test, ANOVA, Pearson Correlation Coefficient, and Spearman Correlation Coefficient.Of all the participants, 16.8% of participants had mild, 58.8% moderate and 24.8% severe dental anxiety. Mean score of dental anxiety was higher in women (12.4±3.91) than men (9.19±3.89) (p<0.001). Divorced and dead couple subjects (13.39±4) had a higher level of dental anxiety than the married and singles. Regarding the job, the highest level of dental anxiety was observed in the housewives (12.89±3.77). Dental anxiety was negatively correlated with age (r=-0.125, p= 0.013), number of dental visit (r=-0.143, p=0.004), education level (ρ= -0.319, p<0.001) and income level (ρ= -0.415, p<0.001). As the rate of dental anxiety was higher among women especially housewives and also it was negatively correlated with age, education level and income, people with such characteristics should be addressed in educational programs in this area.

Evaluation is an important part of all educational activities and considering of these evaluations help us to improve all educational institutes.The aim of this study was evaluation of face validity of multiple choice questions in faculty of dentistry in second semester of 1385-1386 at Shahid Sadughi University of medical sciences. In this study, for evaluating of face validity, all of the multiple choice questions were examined with a check list which were considered and the percentage of face validity established. Then data were analyzed. Introduction page, time of the exam and name of the professor(s) were written in all of the exams. The independency of the questions and the lack of vague words in the question's stem were 100%. The percentage of each professor's contribution in the exam and the length of the choices for each question were 8.7% and 27.7% respectively. Face validity of the questions was 92-99.7%. According to this investigation it is concluded that some of the professors need to pass the question plan courses.

Teeth and mouth diseases encompass about 5-10% of the total health care costs. Transtheoretical Model (TTM) explains when individuals will adopt changes in their behaviors, how they change their behaviors, and which factors affect the changes in their behaviors. Processes of change is an important component of the model which include covert and overt activities that people use to progress through the stages. The purpose of this study was to determine the stages of change of inter-dental cleaning behavior and its relationship with the process of changes based on TTM in Yazd, Iran. This analytical cross-sectional study was performed on 361 students from 8 pre-university schools who were selected via cluster sampling. Appropriate standard instrument were used to measure the stages of inter-dental cleaning behavior, and the process of change questionnaire was developed by the researchers. The reliability and validity of questionnaires were examined and approved using expert panel and cronbach's α coefficient. Data were analyzed with SPSS software and using ANOVA and Binary Logistic Regression tests. 49% of students were in pre-contemplation stage, 5.3% in contemplation, 24.1% in preparation, 6.8% in action and 12.5% were in maintenance stage. The subjects earned 73.98% scores of cognitive processes of change, 63.59% scores of behavioral processes of change and 59.77% of scores of total processes of change. According to binary logistic regression analysis, In order to transfer from pre-action stages to action stages, the students used consciousness raising (Odd Ratio=1.061) and Self- liberation (Odd Ratio =1.155), and social liberation (Odd Ratio =1.204). Majority of students was in pre-contemplation stage and most of them used cognitive processes of change to move from primary to final stages. So, interventional strategies which include programs with the aim of increasing cognitive process of change may be useful for transferring the students from primary stages of inter-dental cleaning behaviors to final stages.

The purpose of this cross- sectional study was to evaluate the prevalence of dental caries in 15 year old high school students of Yazd. A total of 295 boy students with mean age of 15 years± 6 month in 2002 and 180 boy students in 2009 were selected randomly and after necessary examination, the obtained data was recorded and evaluated. The over all mean DMFT was 4.8± 3.13 and 11.5% of the subjects(34 cases) were caries free. 4.4% of the population had DMFT> 10 and 6.92% of DMFT was due to extracted teeth. Meanwhile, 77.5% of the DMFT was due to decayed teeth. Also, the percentage of teeth with fillings was 15.53%. Of the total, 93.08% had all the teeth present in their mouth that is a little higher than the 2000 WHO criteria which is 85%. Preventive and therapeutic dentistry services in Yazd city are far from the standard levels and therefore the results of this study could be utilized for systematic planning of preventive and therapeutic affairs.

Orodental diseases have harmful outcomes in children and adults and encompass 5-10% of the total cost of health care. Trans-theoretical model predicts change and time of behavior. The purpose of this study was to determine stages of inter-dental cleaning behavior based on trans-theoretical model in male and female students in Yazd, Iran. This cross-sectional study included 361 pre-university students from 8 schools by cluster sampling method. Data were collected and recorded in a valid and reliable questionnaire consisted of demographic characteristics, self-efficacy questions, and decisional balance (perceived advantages and perceived obstacles) and stages of change in inter-dental cleaning behavior. The data were analyzed by using SPSS software. 54.8% of the subjects were female and 45.2% male with a mean age of 17.35 ±.55 years. %50 of students (n=179) were in pre-contemplation, 5.3 % (n=19) in contemplation, 24.1% (n=87) in preparation, 8.6% (n=31) in action and 12.5% (n=5) in maintenance stages of inter-dental cleaning behavior. There was a positive significant relationship among stages of change with self-efficacy (r=0.33) and perceived benefits (r=0.19) also existed negative significant relation between stages of change and perceived barriers (r= -0.19). Constructs of the model were statically significant predictors of stages of change and accounted for 0.15% of the variation, so that self efficacy was the most important predictor (β=0.212). In this study, most students were in pre contemplation stage. They will be probably exposed to dental caries in the future. Trans-theoretical model can be used to determine strategies for every stage of change of teeth-mouth self-care behavior and also for educational interventions and programs.