Comparative evaluation of the oral and dental health status and dental care services of children aged 0-3 years living in Trabzon center (Ortahisar) and surrouding districts through a database

Dental caries is an infectious health problem caused by the combination of biological factors (plaque, saliva, systemic conditions, etc.), individual habits (nutrition, oral hygiene, etc.), and environmental factors (socioeconomic-sociocultural status, geographical factors, etc.). It is a common condition in early childhood and has a significant impact on the quality of life of families. Early childhood caries (ECC) is influenced by social factors such as parents' education level, income status, and place of residence. Additionally, there are differences in oral health status and access to dental services between individuals living in urban areas and those living in surrounding districts. This thesis study aims to evaluate the oral health status, prevalence of ECC, treatment needs, and costs of these treatments for children living in the Central district (Ortahisar) and surrounding districts (peripheral) of Trabzon Province. Additionally, it aims to examine the differences in oral health between urban and rural areas and to provide recommendations for improving healthcare services in this field. The research is based on a retrospective database analysis of 447 patients, 205 from the central district (Ortahisar) and 242 from surrounding districts, aged 0-3 years, who applied to the Department of Pediatric Dentistry at Karadeniz Technical University Faculty of Dentistry for dental treatment between 2022 and 2024. The demographic information, oral health status, treatments performed, and costs of these treatments for the included individuals were examined in detail. The data were evaluated in accordance with the criteria of the World Health Organization (WHO), and dmft scores were calculated. Chi-square and Mann-Whitney U tests were used for statistical analyses and a p-value of <0.05 was considered statistically significant. The study findings showed that the dmft scores of children living in peripheral districts (6.14±6.06) were higher compared to those living in the central district (5.97±6.25). Overall, the ECC rate of the included individuals was found to be quite high (74.4%), and it was more common in the peripheral area (42.5%) compared to the central area (31.9%). Additionally, it was determined that ECC rates increased with age, rising from 23.4% in the 0-2 age group to 51% in the 3 year old group. Dental trauma complaints were particularly common in the 0-2 age group (11.2%). The need for fluoride was generally low (10.1%), and it was found to be even lower in peripheral regions. Restorative treatments were among the most needed procedures in the 0-3 age group, followed by root canal treatments and tooth extractions. It was determined that invasive procedures such as root canal treatment and tooth extractions were more frequently performed in children living in peripheral districts. Cost analyses revealed that treatment costs in peripheral areas were higher compared to central areas. While the average treatment cost in the peripheral region was 4 385.57±4 643.43 TL (0-33 500.00 TL), it was calculated as 4 216.42±4 362.21 TL (0-18 980.04 TL) in the central region. It was determined that the costs of all treatments other than fluoride applications were higher in peripheral regions. In conclusion, the high ECC rates and the significant need for restorative dental treatment among individuals aged 0-3 years included in the study are noteworthy. It was observed that children living in peripheral districts had higher caries rates, increased treatment needs, and costs. Additionally, it is thought that measures such as expanding fluoride applications, increasing preventive health services, and implementing awareness-raising education programs will play an important role in improving oral health. It has been stated that digital health systems and artificial intelligence-supported data analyses can be effective tools in planning oral health services and reducing disparities. Keywords: Early Childhood Caries (ECC), Oral and Dental Health, Urban (Central) and Rural (Peripheral) Areas, Types of Treatments and Costs, Digital Health Systems