Cognitive-behavioral interventions are a general name for psychotherapy practices based on evidence and cognitive psychology. Cognitive psychology is used to help children identify negative thoughts through behavioral exercises. Cognitive Behavioral Therapy (CBT) is a non-pharmacological approach that incorporates both behavioral and cognitive strategies to help manage behavior during dental treatments for children. This structured psychological method involves behavior analysis, psychoeducation, exposure therapy, cognitive restructuring, assertiveness training, and home exercises. The cognitive-behavioral therapy is a psychological intervention that has been applied to various health-related issues including psychiatric illnesses such as depression and anxiety, various phobia as well as physical symptoms such as pain. It has been applied to help children overcome dental phobia. The therapy focuses on personalized techniques that help children develop healthier emotional and mental responses to stress during dental visits.

Accurate identification of cariogenic bacteria is crucial for understanding caries development in children. Classical culture methods often underestimate microbial diversity, while polymerase chain reaction (PCR) can detect species that are difficult to cultivate. The aim of this study was to compare culture-based and PCR-based methods for detecting key cariogenic microorganisms in the carious dentin of pediatric patients. Thirty dentin samples were collected from the permanent teeth of children aged 8–14 years. Parallel analyses were performed using standard culture techniques and PCR targeting the gtfB gene of S. mutans and the 16S rRNA gene of Lactobacillus spp. Culture results were quantified as colony-forming units, while PCR results were classified as negative, low-positive, or positive. The results show that culture-based methods identified S. mutans in 16.7% of the samples and Lactobacillus spp. in 3.3%, while PCR identified a signal for S. mutans in 43.3% and Lactobacillus spp. in 100% of the samples. PCR-based methods provide higher sensitivity for detecting key cariogenic bacteria, including S. mutans and Lactobacillus spp. However, PCR detects bacterial DNA and does not indicate bacterial viability or activity. Combining molecular and culture-based approaches allows a more comprehensive assessment of the cariogenic microbiota, supporting accurate microbiological evaluation in pediatric caries research.

Oral health education is a fundamental component of preventive dentistry, but children’s engagement across different educational approaches remains an important area of investigation. This study aimed to comparatively evaluate observed behavioural engagement associated with interactive, demonstrational, and game-based educational approaches among school-age children. A pilot, school-based comparative observational study was conducted among 60 second-grade students at a primary school in Sofia, Bulgaria. A standardized 40 min educational session included three approaches: interactive PowerPoint presentations, demonstrations with dental models and visual tools, and game-based activities emphasizing toothbrushing skills and dietary habits. Children’s engagement was assessed using three indicators: active participation and willingness to engage, confidence, and interaction with the educational materials. The game-based approach demonstrated the highest proportion of children classified in the “Very High” engagement category across all indicators. The average proportion of “very high” performance was 63.4% for the game-based approach, compared with 27.8% for the demonstrational approach and 22.8% for the interactive approach. Children participating in game-based activities demonstrated higher observed levels of participation, confidence, and interaction with educational materials. Game-based educational activities were associated with higher observed engagement during oral health education. These findings highlight the potential value of game-based activities for engaging children in oral health education. Further research using randomized designs, validated assessment instruments, and independent observers is needed to determine whether these differences in observed engagement are reproducible.

Lymphangioma is a benign rare congenital malformation of the lymphatic system, which commonly occurs inthe dorsum of the tongue, lips, buccal mucosa, soft palate, followed by the floor of the mouth. Histologic classifications do not align with therapeutic responses or clinical behavior. A classification system based on morphological characteristics has become more widely used. This system categorizes lymphangiomas into three types based on their response to sclerotherapy: macrocystic, microcystic, and mixed. Lymphangioma simplex of the tongue is an uncommon occurrence, with only isolated case reports mentioned in the literature.A 4 yaers old boy was admitted to the Departmet of Pediatric Dentistry - Sofia. The patient had been diagnostic with mixed lymphangioma of the tongue (microcystic, macrocystic). Reduction in the tongue movements without any loss of sensory or motor function. There were previous accidental traumas which commonly enlarge the lymphatic malformation and worsen the swelling. Early and accurate differential diagnosis of the condition is crucial for achieving optimal results in preventive and treatment outcomes.

Understanding children's emotional responses during dental treatment is essential for improving their experience and the effectiveness of care. The aim of this study is to investigate how preschool-aged children recognize and define their emotions during dental treatment. The study included 150 children aged 4 to 6 years, treated at the Faculty of Dental Medicine in Sofia. Using an adapted version of the Facial Expression Emotional Scale (FEES) and six questions derived from a modified version of the Children Fear Survey Scale – Dental Subscale, the emotional responses of the participants were assessed in relation to common dental procedures. The results showed that non-invasive procedures elicited predominantly positive emotions, such as happiness, while invasive interventions like tooth extractions and dental drilling triggered fear and anger in a significant portion of the children. Anger was the least reported emotion, except in cases involving extractions. Age-based analysis revealed that six-year-olds demonstrated the widest emotional range, while four-year-olds primarily expressed sadness. The study highlights the importance of emotional development during early childhood and the role of dental professionals in recognizing and managing emotions to reduce anxiety and ensure a positive treatment experience. Understanding how children perceive and express emotions through facial cues not only supports their emotional regulation but also improves dentist-patient communication. The collected data offer a useful foundation for future research and may assist clinicians in predicting emotional responses and applying appropriate behavioural strategies to improve outcomes in pediatric dental care.