Türkiye'de Geçici Koruma Altındaki Suriyeli Ergen ve Genç Yetişkinlere sunulan Restoratif Diş Tedavileri: 5 Yıllık Karşılaştırmalı Retrospektif Araştırma

Year 2022, Volume: 7 Issue: 1, 51 - 62, 04.08.2022

Zeynep Ceren Çelik , Çiğdem Elbek Çubukçu , Güven Özkaya

Abstract

Amaç: Türkiye, Suriye Göç Krizi’nin başladığı 2011 yılından bu yana Suriyelilere açık kapı politikası uygulamakta ve geçici koruma kimlik belgesi ile ağız ve diş tedavisi hizmetleri sunmaktadır. Bu çalışma, Bursa ilinde 2017-2021 yılları arasında Suriyeli ve Türk ergenler ile genç yetişkinlerin restoratif diş tedavilerini değerlendirmeyi ve karşılaştırmayı amaçlamıştır.
Yöntemler: Mevcut retrospektif çalışmanın verileri, Ocak 2017 ile Eylül 2021 tarihleri arasında Bursa Ağız ve Diş Sağlığı Eğitim ve Araştırma Hastanesi'nden elde edilmiş ve tedavi kodları, yaş [erken ergenlik (10-15 yaş), geç ergenlik (16-19 yaş) ve genç yetişkinler (20-24 yaş)], cinsiyet, uyruk (Türk vatandaşları ve geçici koruma kimlik belgesine sahip Suriyeliler), diş hekimi randevu tarihi ve restoratif tedavi türleri analiz edilmiştir.
Bulgular: Tüm restoratif tedavilerin (n=174657) %4,26'sının Suriyeli hastalara (n=2993) uygulandığı tespit edilmiştir. Suriyelilere yönelik arka grup dişlerde (posterior) çok yüzlü amalgam (%33,4) ve ön grup (anterior) kompozitlerin (%25,3) grup içi yüzdeleri, Türklere kıyasla (sırasıyla %31,8 ve %18,5) anlamlı derecede yüksek bulunmuştur (p<0,001). Restoratif tedavilerin yaşa göre dağılımı Suriyeliler ve Türklerde benzer tespit edilmiştir (p=0,782). Suriyeliler ve Türklere sunulan restoratif tedaviler 2020 yılında (COVID-19 salgını sırasında) sırasıyla %76,5 ve %80,0 oranında keskin bir düşüş göstermiştir. Suriyeli ve Türk kadın hastalar (OR: 1,17, %95 GA: 1,13-1,20), geç ergenler ve genç yetişkinler (OR: 1,33, %95 GA: 1,27-1,38) diğer gruplara kıyasla yılda 1’den fazla diş hekimi ziyaretinde bulunmuştur (p<0.001).
Sonuç: Suriyelilere daha yüksek oranda sunulduğu tespit edilen posterior çok yüzlü amalgam ve anterior kompozit restorasyonlar, diş çürüğünün yaygın/geniş ve ilerlemiş olduğuna işaret etmekte ve kötü ağız hijyenini göstermektedir.

Keywords

Ağız ve Diş sağlığı araştırmaları, ergen, genç yetişkin, Suriye, mülteci

Restorative Dental Care of Syrian Adolescents and Young Adults with Temporary Protection Identity in Türkiye: A 5-Year Comparative Retrospective Survey

Abstract

Objectives: Türkiye has implemented an open-door policy for Syrians since the beginning of the Syrian crisis in 2011 and has been providing dental services via temporary protection identity. This study aimed to assess and compare the restorative dental treatments of Syrian and Turkish adolescents and young adults during 2017-2021 in Bursa City, Türkiye.
Methods: Data of present retrospective study were extracted from the Bursa Oral and Dental Health Training and Research Hospital between January 2017 and September 2021 and reviewed by procedure codes, age [early adolescence (10-15 years), late adolescence (16-19 years), and young adults (20-24 years)], sex, nationality (Turkish citizens and Syrians with temporary protection IDs), date of dental appointment, and type restorative treatments.
Results: Of all restorative treatments (n=174,657), 4.26% were administered to Syrian patients (n=2993). The intra-group percentages of posterior multi-surface amalgam (33.4%) and anterior composites (25.3%) delivered to the Syrians were significantly higher than those to the Turkish (31.8% and 18.5%, respectively) (p<0.001). Distribution of the restorative treatments by age was similar (p=0.782) in Syrians and Turkish. There was a sharp decrease of 76.5% and 80.0% observed in restorative treatments for Syrians and Turkish, respectively, in 2020. Syrian and Turkish female patients (OR: 1.17, 95% CI: 1.13-1,20), late adolescents, and young adults (OR: 1.33, 95% CI: 1.27-1.38) were more likely to have dental visit>1/year.
Conclusion: Posterior multi-surface amalgam and anterior composite restorations, which were found to be at a higher rate in Syrians, indicate extensive/severe dental caries and poor oral hygiene.

Keywords

dental health survey, adolescent, young adult, Syria, refugees

References

• REFERENCES 1. United Nations high commissioners for refugees. Asylumseekers (Available:22.02.2022) https://www.unhcr.org/syria-emergency.html?query=syrian
• 2. Ekmekci PE. Syrian refugees, health and migration legislation in Türkiye. J Immigr Minor Health. 2017;19(6):1434-1441.
• 3. Directorate general of migration management. TR/temporary-protection27 (Available: 10.02.2021). 2021. Temporary Protection https://en.goc.gov.
• 4. Annual Report, 2017 (2018) – WHO Health Emergencies in Türkiye: response to the crisis in the Syrian Arab Republic Available (22.02.2022): https://www.euro.who.int/__data/assets/pdf_file/0010/369919/Health-emergency-to-reponse-in-Syria-WHO-Türkiye.pdf.
• 5. Tayfur I, Günaydin M, Suner S. Healthcare service access and utilization among Syrian refugees in Türkiye. Ann Glob Health. 2019;85(1):42.
• 6. Agadayi E, Kucuk EO, Alsancak AD, Cakmak SG, Kahveci R. Retrospective analysis of electronic medical records of Syrian immigrants admitted to a training and research hospital in Türkiye. Turk J Clin Lab. 2018;4:307-312.
• 7. Sezen I, Turan M, Kaya AA. Syrian refugees in Türkiye and associated with infectious diseases (Turkish). GÜSBD. 2018;7(4):119-127.
• 8. Assi R, Özger-İlhan S, İlhan MN. Health needs and access to health care: the case of Syrian refugees in Türkiye. Public Health. 2019;172:146-152.
• 9. Çöl M, Bilgili Aykut N, Usturalı Mut AN, Koçak C, Uzun SU, Akın A, Say L, Kobeissi L. Sexual and reproductive health of Syrian refugee women in Türkiye: a scoping review within the framework of the MISP objectives. Reprod Health. 2020;17(1):99.
• 10. Survey on the health status, services utilization and determinants of health of the Syrian refugee population in Türkiye (2019) Available (15.02.2022): https://www.euro.who.int/__data/assets/pdf_file/0018/400581/who-health-survey-report_-25.04.19_with-cover.pdf.
• 11. Koparal M, Ege B, Keskinruzgar A, Yavuz GY, Erdogmus Z, Unsal MN. Dentist visits of Syrian refugees and the cost of their dental healthcare. Ann Med Res. 2019;26(12):2813-2817.
• 12. Donly KJ. Restorative dentistry for children. Dent Clin North Am. Dental Clinics. 2013;57(1):75-82.
• 13. Walmsley AD, et al. Restorative Dentisty. Elsevier Health Sciences. 2007.
• 14. WHO (World Health Organization). Health for the World’s adolescents (Available 22.02.2022 https://apps.who.int/adolescent/second-decade/section/section_2/level2_2.php.
• 15. Gültaç A, Yalçın BP, Sağlık Politikaları SSY. Sakarya Tıp Derg. 2018;8(2):193-204.
• 16. Association R. Number of Syrians in Türkiye January 2022 – refugees association (2022) (Available 22.02.2022) : https://multeciler.org.tr/eng/number-of-syrians-in-Türkiye/.
• 17. Bryant RA, Edwards B, Creamer M, O’Donnell M, Forbes D, Felmingham KL, Silove D, Steel Z, Nickerson A, Mcfarlane AC, Van Hooff M, Hadzi-Pavlovic D. The effect of post-traumatic stress disorder on refugees’ parenting and their children’s mental health: a cohort study. Lancet Public Health. 2018;3(5):e249-e258.
• 18. Pani SC, Al-Sibai SA, Rao AS, et al. Parental perception of oral health-related quality of life of Syrian refugee children. J Int Soc Prev Community Dent. 2017;7(4):191-196.
• 19. Khalaf ME, Alomari QD, Omar R. Factors relating to usage patterns of amalgam and resin composite for posterior restorations--a prospective analysis. J Dent. 2014;42(7):785-792.
• 20. Yadav RK, Verma UP, Tiwari R, Chaurasia A. Mercury or mercury free restorations in oral cavity. Int J Public Health Sci (IJPHS). 2018;7(3):201.
• 21. Lynch CD, McConnell RJ, Hannigan A, Wilson NH. Teaching the use of resin composites in Canadian dental schools: how do current educational practices compare with North American trends? J Can Dent Assoc. 2006;72(4):321.
• 22. Riatto SG, Montero J, Pérez DR, Castano A, Dib A. Oral Health Status of Syrian Children in the refugee Center of Melilla, Spain. Int J Dent. 2018(9):1-7.
• 23. Salim NA, Shaini FJ, Sartawi S, Al-Shboul B. Oral Health Status and Dental Treatment Needs in Syrian Refugee Children in Zaatari Camp, J Refugee Stud, 2021; 34(2): 2492–2507
• 24. Hoover J, Vatanparast H, Uswak G. Risk determinants of dental caries and oral hygiene status in 3-15 year-old recent immigrant and refugee children in Saskatchewan, Canada: A Pilot Study. J Immigr Minor Health. 2017;19(6):1315-1321.
• 25. Salim NA, Meyad SH, Sawair FA, Satterthwaite JD, Sartawi S. Satisfaction with healthcare services among refugees in Zaatari camp in Jordan. BMC Health Serv Res. 2021;21(1):507.
• 26. Ahmadi H, Ebrahimi A, Ghorbani F. The Impact of COVID-19 Pandemic on Dental Practice in Iran: A questionnaire-based report. BMC Oral Health. 2020;20(1):354.
• 27. Choi SE, Simon L, Basu S, Barrow JR. Changes in dental care use patterns due to COVID-19 among insured patients in the United States. J Am Dent Assoc. 2021;152(12):1033-1043.e3.
• 28. Duruk G, Gümüşboğa ZŞ, Çolak C. Investigation of Turkish dentists’ clinical attitudes and behaviors towards the COVID-19 pandemic: a survey study. Braz Oral Res. 2020;34:e054.
• 29. Budak F, Bostan S. The effects of Covid-19 pandemic on Syrian refugees in Türkiye: the case of Kilis. Soc Work Public Health. 2020;35(7):579-589.
• 30. Drachev SN, Brenn T, Trovik TA. Dental caries experience and determinants in young adults of the Northern State Medical University, Arkhangelsk, North-West Russia: a cross-sectional study. BMC Oral Health. 2017;17(1):136.
• 31. Demirci M, Tuncer S, Yuceokur AA. Prevalence of caries on individual tooth surfaces and its distribution by age and gender in university clinic patients. Eur J Dent. 2010;4(3):270-279.
• 32. Gökalp SG, Doğan BG, Tekçiçek MT, Berberoğlu A, Unlüer S. National survey of oral health status of children and adults in Türkiye. Community Dent Health. 2010;27(1):12-17.
• 33. Portero de la Cruz S, Cebrino J. Oral Health problems and utilization of dental services among Spanish and immigrant children and adolescents. Int J Environ Res Public Health. 2020;17(3):738.
• 34. Muñoz-Pino N, Vives-Cases C, Agudelo-Suárez AA, Ronda-Pérez E. Comparing Oral Health services use in the Spanish and immigrant working population. J Immigr Minor Health. 2018;20(4):809-815.