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    Association of health-promoting behaviors with oral health status among Turkish dental students: A cross-sectional study
    (Springer Nature Link, 2026) Ballı Akgöl, Beyza; Bayram, Merve; Üstün, Nilüfer; Aksaka, Nurcan
    Background: Oral health is an essential component of overall well-being, and dentistry students are expected to model healthy behaviors. However, their lifestyle habits may not always reflect this role. This study explores the relationship between oral health status and health-promoting behaviors among fourth-year dental students. While the Health-Promoting Lifestyle Profile II (HPLP II) has been widely applied, its use alongside objective oral health indices in this population remains limited. Methods: This cross-sectional study assessed health-promoting behaviors using the Health-Promoting Lifestyle Profile II (HPLP II) and evaluated oral health status using clinical indices, including Decayed, Missing, and Filled Teeth (DMFT) index, Gingival Index (GI), and Plaque Index (PI), among fourth-year dental students. Results: Students with better gingival health exhibited higher overall health-promoting lifestyle scores, particularly in the domains of nutrition and health responsibility. Similarly, participants with better plaque control demonstrated more favorable stress management behaviors. In addition, weak inverse associations were observed between dental caries experience and spiritual growth, as well as between plaque accumulation and overall health-promoting lifestyle behaviors. Conclusion: This study revealed significant links between key health promoting lifestyle domains—nutrition, stress management, and health responsibility—and oral health indicators. These findings underscore the need to integrate structured health promotion modules into dental curricula to improve students’ well-being and clinical competence.
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    Cartoon-assisted visual/auditory distraction usage in paediatric dental care, assessment of effects on patient anxiety, pain, and behaviour: A randomised crossover clinical trial
    (Springer Nature, 2025) Üstün, Nilüfer; Ballı Akgöl, Beyza; Bayram, Merve
    Objectives This randomized crossover clinical trial designed to evaluate the impact of visual and auditory distraction techniques on pediatric patients’ anxiety, pain perception, and behavior during dental treatment. The study specifically focuses on children, aiming to determine whether distraction methods can effectively reduce anxiety levels, alleviate pain experiences, and improve cooperative behavior in a clinical setting. Method and materials Children aged 4 to 9 years receiving routine dental care at the Pediatric Dentistry Clinic, Istanbul Medipol University, were randomly assigned to Group 1 (distraction first, then tell-show-do) or Group 2 (tell-show-do first, then distraction), with a two-week washout period before switching interventions. Anxiety was assessed using the Venham Picture Test and pulse rate, pain perception with the Sounds, Eyes, and Motor Scale during local anesthesia and the Wong-Baker FACES Pain Rating Scale during treatment, while cooperation and behavior were evaluated using the Houpt Scale. Statistical analysis was conducted using Mann-Whitney U, Student’s t-test, Paired t-test, and Wilcoxon test, with the significance level set at 0.025 using the Bonferroni correction. Results Sixty-eight patients (37 female, 31 male) with a mean age of 6.69±1.08 years completed the study (Group 1: n=32, Group 2: n=36). The cartoon-assisted distraction technique did not significantly reduce anxiety compared to the tell-show-do method. A non-significant reduction in pain perception was observed during local anesthesia with distraction. However, this technique significantly reduced self-reported pain during treatment (p<0.025) and improved child cooperation and behavior. Conclusion Cartoon-assisted visual and auditory distraction can alleviate pain perception and improve behavior during pediatric dental procedures. However, it does not appear to reduce dental anxiety or pain perception during local anesthesia. Integrating this technique with the traditional tell-show-do approach may enhance the pediatric dental experience.
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    Effect of plaque-disclosing agents on biofilm removal: Single-center randomized trial in fourth-year dental students
    (BioMed Central, 2026) Ballı Akgöl, Beyza; Bayram, Merve; Üstün, Nilüfer; Aksaka, Nurcan
    Background To assess whether plaque-disclosing agents (PDA) improve self-performed mechanical plaque removal and gingival health compared with standard instruction alone in dental students. Design/Setting Single-center, parallel-group randomized controlled trial (1:1), Istanbul Medipol University (Oct 2023–Jan 2024). Participants 124 fourth-year dental students (age 20–30 years) randomized to test (n=62) or control (n=62). Interventions Both groups received standardized oral-hygiene instruction (Modified Bass; interdental cleaning guidance). The test group additionally received PDA before brushing as a visual aid; all outcomes were measured after triple rinsing. Primary outcome (prespecified) Between-group difference in change (Δ) in Plaque Index (PI) from baseline to week 1. Secondary outcomes ΔPI baseline→post-brushing and baseline→month 1; ΔGingival Index (GI) baseline→week 1 and baseline→month 1. Masking Outcome assessor blinded at the time of measurement (after rinsing). Results All 124 randomized participants completed follow-up and were analyzed. Both groups showed short-term improvement (immediate reduction in PI post-brushing; GI improvement at week 1). The primary outcome showed no significant between-group difference in ΔPI from baseline to week 1. Secondary analyses similarly found no significant between-group differences in ΔPI or ΔGI at month 1. Conclusions In a population with high baseline oral-hygiene proficiency, adding PDA did not confer a measurable advantage over standardized instruction alone on PI or GI change. PDA may be more informative in lay populations with lower oral-health literacy. Trial registration ClinicalTrials.gov, NCT06080672, registered on October 12, 2023.