7^thGlobal Dentists and Pediatric Dentistry Annual meeting March 30-31, 2016 Valencia, Spain

N Akerzoul obtained her Doctorate of Dental Surgery (DDS) from Mohammed V University, Morocco. She is the General Practitioner Dentist in Oral Health Center of Guelmim City, Morocco. She is currently a 3rd year Resident Oral Surgeon in Center of Consultation of Dental Treatments of Rabat, Faculty of Dentistry of Rabat, Mohammed V University, Morocco. She also obtained Universitary Diploma of Biostatistics and Research Methodology. She is the author of many International Publications in the field of Oral Surgery and Oral Oncology. She is the International Presenter (Oral & Poster Presenter) in different meetings of Oral Surgery and Head & Neck Oncology in Turkey and the USA. She serves as the Editorial Board Member in Department of Oral and Maxillofacial Surgery of the International Journal of Oral Health and Medical Research (IJOHMR) and also Journal of Cosmetology and Orofacial Surgery. She is a Reviewer in OMICS GROUP Biomedical Journals.

Purpose: Study the epidemiological and histopathological profile of the oral cancers in children in care at the Pediatric Hemato-Oncology, Stomatology and Maxillofacial Surgery departments at the 20 August Hospital in Casablanca and at the Hospital of children in Rabat. Our aim is to define the importance of the pediatric oncology, especially the one affecting the oral cavity and also to describe the oral cancers in children, their frequencies and their histo-pathological characteristics. We collected 71 patients’ consultation records and files between 2004- 2012. Materials & Methods: This is a retrospective study of 126 children hospitalized between 2010 and 2013 of the Pediatric Hemato-Oncology Department, Stomatology and Maxillofacial Surgery department at the 20 August hospital in Casablanca and also in the Pediatric Hemato-Oncology Department at the hospital of children in Rabat and in which we diagnosed a confirmed cancer of the oral cavity. Results: In our sample, all age groups were affected by the disease process, but ages between [0-4] years and [13-16] were the most affected with an average age of 8 years and extremes ranging from 4 months to 16 years. In our population sex sample, we noted a slight female predominance with 50.7% of cases. Non-Hodgkin lymphoma Burkitt was the most common histological type with 35.2% of cases. Cheeks represented the most frequent localization with 37.9% of cases, while the maxillary represented 19.7% of cases. Chemotherapy has been the exclusive therapeutic strategy most used in our sample in 67.6% of cases. Conclusion: Epidemiological, clinical and pathological characteristics of cancers of the oral cavity in our population are not different from the literature data. However, the parents’ lack of awareness and late diagnosis of these lesions appear to be responsible for the dramatic profile of oral cancers.

Dr. Seon-mi Kim has graduated in 1992, has completed master's degree in 1995, and has completed her PhD in 1998 from the dental school in Chonnam National University, South Korea. She has published large number of papers in renounced journals, and she is actively involved in clinical pediatric dentistry.

Propolis has been widely used as a traditional medicine for broad purposes including infection and inflammation control and recently used as an alternative capping materials. However, the potential of propolis as an odontogenic inducer in dental pulp cells has not yet been studied. Therefore, this study aimed to evaluate effects of propolis or combined propolis and mineral trioxide aggregate (MTA), used as an effective pulp-capping material, on odontoblastic differentiation in dental pulp cells and their possible mechanism. Dental pulp cells were isolated from the extracted teeth for orthodontic purposes. Cell viability was monitored for any toxicity of MTA and propolis, based on tetrazolium salts. The odontoblastic differentiation was assayed by alkaline phosphatase (ALP) staining and expression of odontoblast-specific cell differentiation marker genes using real time PCR. Mineralization was identified with Alizarin Red staining. To observe the involvement of ERK signaling in their effects, western blot analysis was performed. MTA and propolis upregulated expression of dentin sialophosphoprotein (DSPP) and dentin matrix protein 1 (DMP-1), odontoblast differentiation markers, and facilitated mineral nodule formation, indication of calcium deposits required for dentin formation. The treatment of MTA, propolis or combination increased the phosphorylation of ERK, known to odontoblast differentiation mediator. However, increased calcium deposits in combined MTA and propolis were attenuated by U0126, an inhibitor of ERK. Taken together, this study suggested that combined propolis and MTA promoted dental pulp cell differentiation and mineralization in human pulp cells via ERK signaling pathway.

Huda Alrakaf has completed her Masters on Pediatric Dentistry in the year 1998 from King Saud University, Riyadh, Saudi Arabia. She also has obtained specialized certificate on High Risk Pediatric Dentistry (2002); as well as, completed her training in Pediatric Dentistry for Special Need Children (2003) from La Universidad Complutense de Madrid, Spain. She is now a consultant in pediatric dentistry in Prince Sultan Medical City. Two of her publications are in the International Journal for Pediatric Dentistry.

Background: COACH is an acronym that outlines a syndrome ¬linked with: C - cerebellar vermis defect (Joubert syndrome), O–oligophrenia, A–ataxia, C–coloboma, H-hepatic fibrosis. Joubert Syndrome (JS) is characterized as a rare brain malformation by the absence or underdevelopment of the cerebellar vermis - an area of the brain that controls balance and coordination as well as a malformed brain stem in which the obligatory hallmark is the molar tooth sign through magnetic imaging. Objective: This poster will present the orodigital facial manifestation of JS and related disorders and present the experience in providing dental care. Case Reports: This poster reported two cases of Saudi pediatric male and female patients with growth retardation. Parents are first cousins supporting an autosomal recessive mode of inheritance. Male and female are equally affected and occurs in 1 to 100,000 live births. Optimal management requires a multidisciplinary approach with particular attention to feeding problems, ataxia and episode tachypnea. These factors should always be considered when dental treatment will be required for patient with JS. Decision was taken by group consultation for extraction of the anterior teeth under O2 supporting and LA. Two weeks later, tongue and lip healed with scar. Patient improved good sleeping habits, had stopped lip biting and improved psychologically. Conclusion: It was concluded that early dental treatment for patient’s diagnosed with Joubert Syndrome is necessary to avoid possible future complications such as eating or feeding difficulties and dehydration.

Dr. Jiiang-Huei Jeng is a specialist in both Endodontics and Periodontics. He got IADR Hatton Award and his Doctor of Dental Surgery degree in 1994. Dr Jiiang-Huei Jeng practiced endodontic, periodontic, and implant dentistry in the National Taiwan University Hospital since 1991 and the chair in Department of Endodontics. He is also a professor, researcher and teaching staff in the National Taiwan University Dental School. He has published many papers in scientific journals including Biomaterials, Acta Biomaterialia, J Endod, Int Endod J, Carcinogenesis, J Periodontol etc. He received International Association of Dental Research (IADR) distinguish scientist award of PTT group in Brazil (2012). He also served as a reviewer and editorial board member of many journals.

Introduction: In Taiwan, a combination of betel quid (BQ) chewing, alcohol consumption and cigarette smoking habits may increase the oral cancer risk by 123-folds higher than persons without any habits. During the pathogenesis of oral cancer, lymphocyte phenotypes in the peripheral blood of patients may potentially influence the cancer progression and prognosis of oral cancer. As we know, poor oral habits will easily initiate and promote the cell to malignant transformation. Over 90% of oral cancer patients have the bad oral habits, so oral cancer is still the fourth highest cause of death in Taiwan. We try to know the immunological changes of lymphocytes populations in different stage of oral carcinogenesis and their relation to survival of oral cancer patients. Materials and methods: Totally 86 oral cancer patients and 80 healthy men were enrolled in this study. Their lymphocyte populations (expression of CD4+, CD8+, CD19+, CD56+ cells) data were analyzed by flow cytometry and collected from 2002 to 2004. After 10+years follow-up to Dec. 2014, cancer patients with/without expire were recorded and evaluated their relation to oral habits and the percentage of initial lymphocyte markers by Student’s t-test, Chi-square and Fisher exact test. Results: 50 cancer patients were expired and showed a significant decrease in percentage of CD19+ lymphocytes (10.13 ± 3.51, n=50), relatively lower than patients that still survive (12.95 ± 4.05, n=36) (P<0.05). Difference in CD56+ lymphocyte populations was also considered to have statistically significant. Alcohol consumption also showed an association with the survival rate of oral cancer patient (P=0.05), whereas BQ and smoking showed little effect. Conclusions: These results suggest that alcohol consumption, CD19+ B cells and CD56+ Natural Killer cells expression may be the factor to long-term affect the survival rate of oral cancer patients. (This study is supported by a grant from Ministry of Science and Technology, Taiwan and National Taiwan University Hospital, Taiwan).

Dr. Me-Chi Chang received her master and Ph.D degree in Department of Pharmacology, National Taiwan University Medical College (1995). Currently she is a professor, researcher and teaching staff in the Chang Gung University of Science and Technology. She has published many papers in scientific journals including Blood, Thrombosis & Haemostasis, BBA, Biomaterials, Acta Biomaterialia, J Endod, Int Endod J, Carcinogenesis etc. She also served as a reviewer and editorial board member of many journals such as Toxicology, J Dent Res, Carcinogenesis, Int Endod J, Austin Dent J.

Introduction: Betel quid (BQ) chewing is popular in India, Sri Lanka, Taiwan and many other countries. There are about 600 million BQ chewers in the world. BQ usually comprises of areca nut (AN), tobacco, lime with/without betel leaf. This oral habit increases the incidence of oral cancer and oral submucous fibrosis (OSF), possibly due to the induction of toxicity and inflammatory mediators’ release of oral mucosal cells. AN components have been shown to stimulate cyclooxygenase-2 (COX-2) expression and PGE2 production of gingival keratinocytes (GKs). However, the role of TGF-1-activated kinase-1(TAK1) in mediating these events is not clear. Materials and methods: In this study, human GKs were incubated with AN extract (ANE) with/without pretreatment and co-incubation with 5z-7oxozeaenol (a TAK1 inhibitor). Cytotoxicity was estimated by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl- tetrazolium bromide (MTT) assay. The level of COX-2 mRNA and protein expression was studied by reverse transcriptase-polymerase chain reaction (RT-PCR) and western blotting. PGE2 production was quantified by enzyme-linked immunosorbent assays. Results: ANE stimulated COX-2 expression and PGE2 production of GK. ANE-induced COX-2 mRNA and protein expression can be attenuated by 5z-7oxozeaenol. Similarly, ANE-induced PGE2 production of GK was also prevented by 5z-7oxozeaenol. However, pretreatment and co-incubation by 5z-7oxozeaenol was not able to suppress the ANE-induced intracellular vacuoles formation as well as cytotoxicity to GKs as analyzed by MTT assay. 5z-7oxozeaenol further prevented the ANE-induced hemeoxygenase-1 and phosphor-cytosolic phospholipase A2 (p-cPLA2) expression of GKs. Conclusions: These results indicate that TAK1 signaling pathway plays an important role in the ANE-induced pathogenesis of inflammatory response in oral cancer and OSF. Inhibition of TAK1 may be potentially used for targeting therapy for prevention and treatment of ANE-induced oral cancer and other related diseases. (This study is supported by grants from Ministry of Science and Technology, Taiwan and Chang Gung University of Science and Technology, as well as Chang Gung Memorial Hospital, Taiwan).

Seoyoun Shim has graduated in 2009 from Yonsei University. She completed her master's degree in 2014 and is currently in doctorate program at the school of dentistry in Chonnam National University, South Korea. She enjoys to spend working hours in the dental office with children in regards of the field of pediatric dentistry

Mineral trioxide aggregate(MTA) materials have been used for many years as a pulp therapy material. Proroot wMTAⓇ has a major drawback that it causes tooth discoloration. Alternatives have recently been developed such as BiodentineⓇ, EndocemⓇand RetroMTAⓇ. This study assessed discoloration of crown when these various MTA-based materials were placed in the coronal aspect of the root canal. The teeth (n=75) were randomly assigned to four experimental group, each of Biodentine (n = 15), Proroot wMTA (n = 15), Endocem (n = 15), RetroMTA (n = 15) and one negative control groups (n = 15). Teeth were sectioned in the coronal third of the root complex and each of materials were placed into the pulp chambers. Color was assessed using spectrophotometer at 8 time points: initial, 1 day, 1 week, 2, 4, 8, 12 and 16 weeks. Statistical analysis was performed by using 2-way repeated analysis of variance and a Bonferroni’s method with P < 0.05. Proroot wMTA induced significant decreases in L* values. The total color change caused by Proroot wMTA exceeded the perceptible threshold for the human eye( 3.7≤⊿E*) after 16 weeks. The Biodentine and RetroMTA showed color stability. Tooth samples from the Endocem group presented indistinct grayish color changes during the course of the 16 weeks. Less discoloration was observed with Biodentine and RetroMTA than with Proroot wMTA. The Endocem group showed the largest ⊿E* value after the 1 day but after that, the contant ∆E* change showed for the rest of period. The application of Proroot wMTA induced a decrease in lightness in teeth.

Abdulhameed G Albeshr earned his BDS degree from King Saud University in Riyadh, Saudi Arabia in 2010. In 2015, he completed his Master of public health in Community and Environmental Health in King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia.

Introduction: Periodontal disease is more prominent in developing countries. It is common in all ages and affects both genders. Unhealthy periodontium cause serious problems for the individual and lead to tooth loss. Objective: Determine prevalence of periodontal disease and its risk factors. Method: Electronic search conducted on Pub-Med using Inclusion criteria; articles in English about prevalence of periodontal disease and its risk factors from 1990 to 2014. 47 articles were identified initially and after applying exclusion criteria only nine articles were selected for this review. Results: Prevalence of periodontal disease effect 63%-68%. In the patients above 40 years old, an average of 76% of extracted teeth was due to periodontal disease. The main risk factor for periodontal disease is poor oral hygiene. The role of smoking in developing of periodontal disease was clear. Diabetic patients have the highest prevalence of periodontal disease compared with other diseases, which is 21%. Conclusion: The prevalence of the periodontal disease is high and more studies needed in different cities and in rural areas. Proper sampling and longitudinal studies should be considered to ensure representativeness and confirm the causality. The direct relation between poor oral hygiene and periodontal disease is clear. This review provides convincing evidence about effect of tobacco smoking on oral health. The review shows high prevalence of periodontal disease among diabetic patients. Better understand the full extent and characteristics of periodontal disease in our population beside public health programs will diminish the effects of the disease.

Mahsa Sahraneshin Samani has completed her education at age of 30 years from Isfahan University of medical science in restorative and cosmetic dentistry. She is a specialist in operative & cosmetic dentistry and assistant Professor in the department of Operative Dentistry at Shahrekord University of Medical Science. She published 4 papers in journals and has lectured in more than 10 dental congresses.

Introduction: Demands for aesthetic restorations are increased, on the other hand, for achieving a long-term high performance composite restoration, a good isolation especially at the gingival margin is needed. The aim of the present study was to evaluate the effect of the various hemostatic agents on the gingival margin microleakage of class V composite resin restorations. Material and methods: Class V cavities were prepared at the cemento-enamel junction in both buccal and lingual surfaces of 48 sound human premolars. Following preparation all specimens were randomly assigned into 8 groups as follows: In groups 1 to 4, Adper Single Bond, ASB (3M ESPE) and Z250 composite resin (3M ESPE) were used to restore the cavities; In Group 1 (control) no hemostatic agent was used for restoring cavities. Before the application of adhesive resin, ViscoStat, VS (ferrous sulfate, Ultradent) ViscoStat Clear, VSC (Aluminum Chloride, Ultradent) and Trichloracetic acid, TCA; hemostatic agents were applied respectively in Group 2,3 and 4. In groups 5 to 8, silorane system adhesive, SSA (3M ESPE) and Filtek P90 silorane based composite resin (3M ESPE) were used to restore the cavities. In group 5 (control) no hemostatic agent was used for restoring cavities. In Groups 6 to 8 respectively VS,VSC and TCA hemostatic agents were used. Following water storage and thermocycling, teeth were immersed in 2% basic fuschin and then was sectioned, and evaluated with a stereomicroscope at ×36. Results: Data were evaluated using Kruskal-Wallis and Mann-Whitney tests (α=0.05). P-value=0.019 showed statically significant difference between groups. Conclusion: Application of hemostatic agents (except TCA) have not statically significant difference on microleakage of either methacrylate based or silorane based resin composites. Microleakage was less in self etch groups (SSA+P90) groups in comparison with total each (ASB+Z250) groups. Application of TCA increased microleakage in P90 in comparison to control group.

Yazeed A Alhabdan earned his BDS degree from King Saud University in Riyadh, Saudi Arabia in 2010. In 2015, he completed his Master of public health in Community and Environmental Health in King Saud bin Abdul-Aziz University for Health Sciences in Riyadh, Saudi Arabia.

Introduction: Dental caries is a common cause of tooth loss in young people. Different individuals will be susceptible to different degrees depending on the shape of their teeth, oral hygiene behavior, dietary behavior and socioeconomic status. Objective: Determine prevalence of dental caries among 6-8 years old school children and examine the association between dental caries and socioeconomic status, oral health practices and other health practices (diet and feeding practices). Method: This is a cross-sectional study among 578 male children aged 6-8 years old from 12 primary schools. Students were screened for clinically evident caries using the DMFT index. A parent questionnaire was administered to collect information on socioeconomic indicators, child oral health behavior, child feeding practices and dietary habits. Results: The prevalence of caries was 83.13%. Presence of dental caries is significantly associated with poor oral heath behavior (P<0.001), low socioeconomic status (P<0.001), consumption of cariogenic food (P<0.001) and the practice of sending the child to bed with a bottle (p<0.001). Difficulty to get an appointment (62.6%) was the main reason for not visiting the dentist. Logistic regression analysis revealed that low maternal education, low family income, not brushing teeth and high consumption of flavored milk were independent predictors for dental caries. Conclusion: Prevalence of caries was high and significantly associated poor oral hygiene and socioeconomic status. Preventive programs should target families with low socioeconomic status and give them assistance and cues to action for prevention.

Sunmi Yang has graduated in 2008 from Chonnam National University. She completed her master's degree in 2013 and is currently in doctorate program at the school of dentistry in Chonnam National University, South Korea. She is eagerly engaged in the field of pediatric dentistry.

School nurses can play an important role in improving the prognosis of traumatized teeth of school children after they are informed about the immediate and proper dental first aid steps to be taken at the time of an accident. The purpose of this study were: (i) to assess the awareness of school nurses concerning the management of traumatized teeth and (ii) to determine if a short lecture about dental trauma management could improve school nurses' knowledge on this topic. School nurses in Gwangju and Jeon-nam province replied twice before and after the lecture using a questionnaire about first-aid knowledge with particular focus on the following three categories. Part I was composed of questions asking general information and whether they received education about dental trauma or not. Part II include questions about dental emergency education and prevention. Part III was composed of questions asking knowledge and proper attitude in case of the specific dental trauma situation. According to previous studies, school nurses' knowledgement tend to be higher compare with the teachers. Improvement of school nurse knowledge was observed after the lecture in most of answers. In conclusion, it is recommended that continuous and regular education is needed for improvement of school nurses' knowledge about proper management of dental trauma emergency.

Graduated from the University of Geneva in 2010 and since she has been working simultaneously in a private practice as a general dentist and at the University of Geneva (Division of cariology, endodontlogy and pediatric dentistry) teaching students and conducting research. In 2013 at the age of 29 years ,Marwa Abdelaziz started a PhD Project supervised by the University of Amsterdam (ACTA) and the University of Geneva, the subject of the research is focused on non-invasive diagnostic methods and non-invasive treatment options of initial carious lesions like infiltration and sealing.

This in vitro study evaluated the pulpal and subsurface temperatures during tooth surface irradiation with different settings of a 810 nm diode laser. The elevation of pulpal and dentinal temperature during irradiation was measured with the aid of thermocouples positioned in the centre of the pulp chamber (n=30) and in the centre of a prepared 1.5 mm deep coronal cavity (n=30). Irradiation was performed three times on each sample with different exposure settings. A temperature increase of 3.5°C was regarded as critical value for pulpal heath. Results were analysed with one-way ANOVA and Duncan post-hoc tests. In addition, micromorphological investigation by digital microscopy was carried out for the irradiated and non-irradiated tooth surface. Measurable temperature increase within the pulp chamber (∆PT) and the subsurface dentin (ΔDT) were observed with all laser settings tested. The highest recorded ∆PT & ΔDT were 3.1°C and 8.5°C, respectively. Delivery mode, beam diameter, and exposure time were of influence on temperature rise. Digital microscopy did not show any alteration of the dental surface structure by all parameters tested. From the thermal point of view, under the conditions of the present study the application of a 810 nm diode laser on the outer surface of the tooth at 1 W in the continuous mode and at 5 W in the pulsed mode for two cycles of 30 s each proved to be safe.

Dr. Ajay Rao has completed his Bachelors in Dental Surgery in 2000 and his Masters in Dental Surgery in Pediatric Dentistry in 2006. He is presently serving as a Professor and a Post Graduate guide in the Dept. of Pediatric & Preventive Dentistry in Yenepoya Dental College Mangalore. He has around six national and international publications and has attended various workshops and conferences. He has his own private practice in Mangalore city and is also a consultant for various clinics in and around Mangalore.

This study evaluated the remineralization produced by CALCIUM SODIUM PHOSPHOSILICATE (NOVAMIN) and CPP-ACP (GC TOOTH MOUSSE) on artificially produced demineralized lesions and also compared their remineralization efficacy. 120 caries free extracted premolars were included in the study. Teeth were divided into 3 groups of 40 teeth in each group . Teeth were painted with nail varnish exposing a window of 2x2 mm on buccal and lingual surfaces and assigned into experimental group I (Novamin) , positive control group II ( GC Tooth mousse ) and negative control group III (Artificial saliva). The samples were subjected to a daily treatment regimen ( pH cycling ) alternating between demineralization and remineralization solution for a period 21 days . Samples were evaluated for the amount of remineralization by laser fluorescent device (DIAGNOdent) and by observing the surface topography of enamel surface under scanning electron microscope at 21 days. The laser fluorescent readings of the samples belonging to the experimental group , positive control group and negative control group from their baseline , demineralization and remineralization were analyzed using paired t test. The comparative remineralization component seen in positive control II GC Tooth mousse was higher compared to that of experimental group I Novamin . Both laser fluorescence and the scanning electron microscope observations proved that application of Novamin and GC Tooth Mousse significantly remineralizes the demineralized enamel samples in vitro .

Yong Jin Lee has graduated in 2009 from the University of North Alabama in the United States. He completed his master's degree in 2014 and is currently in doctorate program at the school of dentistry in Chonnam National University, South Korea. He thinks of children not only as beings to care for and give learning to but also as someone to learn something from

Neuroblastoma is a common malignant tumor of the sympathetic nervous system in childhood, arises from embryonic neural crest cells. The period of tooth development is matched with peak times of diagnosis and treatment of neuroblastoma. The intensive multimodality treatment including radiotherapy and chemotherapy is used in patients with neuroblastoma has been shown to have late adverse effects and disturbances in dental development like tooth agenesis, microdontia, enamel hypoplasia and short roots. A 8-year old girl had been on medication and radiotherapy for neuroblastoma since she was 15 months old at Department Pediatrics, Chonnam National University Hospital. Oligodontia, microdontia, and short root formation was notable in clinical and radiological examination. Mobility of lower permanent incisor was detected and measured at about degree 2. Resin wire splint using mini-screw implantation on buccal alveolar bone was conducted for maintenance of mandibular incisors and alveolar bone. Excessive mobility has been eliminated and maintained well so far. Further treatment is planned for re-evaluation of mobility, preventing dental caries and regular oral hygiene management. Although we need further evaluation, this treatment could be one of alternative therapy for those who have similar dental anomalies.

Ahlem BAAZIZ is graduated from Monastir University (Tunisia) since 1996, she has begun teaching in 2001, pediatric dentistry and oral prevent at the dentistry school of Monastir. She conducted many studies about oral health in children. She published some papers about pediatric dentistry. She is member of Tunisian section of IADR and of dento facial biological and clinical approach laboratory. Since 2014, she was elected chief of department.

Introduction: Despite the considerable progress in the field of oral health, dental troubles remain a major public health problem. The objective of this study was to measure the importance of malocclusion spread and dental troubles prevalence among pupils aged 15 in Mahdia. Material and Methods: It is a cross-sectional survey conducted on a representative sample. Clinical data was collected through an oral examination. Results: Based on a sample of 900 pupils aged 15, the study revealed that malocclusion prevalence was high (62,3%). The most common malocclusion trait was the midline deviation (53%). An association on one hand between malocclusion and mucous membranes status and on the other hand between malocclusion and orofacial dysfunction has been proven. The parafunctions and functional disorders were common (48.5% and 30.2 %).The prevalence of dental anomalies was found to be very high (74.7 %). Conclusion: The oral health status of pupils aged 15 in Mahdia especially that of malocclusion is worrying. Establish a national strategy for malocclusion like interesting decay, to offer the best solutions according to the particularities of our country.

Dr. Arwa Hamed Alaujan (BDS) was born in 1972. She was raised in Kuwait. In 1990, she moved back with her family to Riyadh, Saudi Arabia where she joined College of Dentistry, King Saud University. In 1996 she graduated and earned Bachelor of Dental Surgery (BDS) degree with GPA of 3,92. After she completed one year as intern, she was chosen to work as a researcher in KSU, where she did a research with two prosthodontists titled: Retention of cast posts cemented with zinc phosphate cement using different cementing techniques. The article was published in Journal of prosthodontics in Mar 2001. In 1999, she joined King Abdulaziz Medical City in Riyadh where she worked as a staff dentist. In 2002 she joined a two-year postgraduate program in Advanced Education in General Dentistry (AEGD). After completion of the program on 2004, she earned AEGD certificate and worked as an assistant consultant in advanced general dentistry section. In 2012, she was promoted to a consultant in advanced general dentistry. In 2004 she did a literature review with Dr. Abdullah Alzahem (her husband) titled: Stress among dentists. It was published in General dentistry Journal. This is beside two other publications with Dr. Alzahem. One was titled: Stress amongst dental students, published in European Journal of dental education, the other one was: Stress management in dental students published in advanced medical education practice. Dr. Arwa is interested in medical education and stress among dental students as well as dentists as she herself and many colleagues affected by stress in their practice. She do believe that managing stress as early as the time students join dental college will have a great impact on their quality of lives as practicing dentists’ later on and on their psychological wellbeing. She hope that she can in collaboration with Dr. Abdullah Alzahem to develop a more humanistic dental education environment in which the dental students can gain not only an excellent skills and knowledge that will enable them to work as a successful dentists, but also to minimize and manage stress while studying and continue practicing it after graduation to be a happy satisfied dentists by taking care of their mental health and managing stress in their lives. She do believe that making changes in dental education curricula by incorporating educational courses about stress, its effect and teaching stress management and various coping techniques will have a positive impact on dental students’ lives at present and in future beside improving the quality of dental care delivered to their patients.

Dentists are faced every day with many stressors; as a result, they are subjected to many symptoms of stress that must be identified and managed in the early stages before serious physical and psychological consequences develop. This article reviews the literature concerning stress among dentists. Many stressors are identified and coping techniques are explained.