International journal of paediatric dentistry最新文献

Background

Understanding the viewpoints of parents of children regarding dental interventions can enhance clinical practices and play a pivotal role in evaluating the acceptability of treatment recommendations.

Aim

To explore the experiences and perceptions of parents regarding minimally invasive dentistry and invasive dental interventions for caries prevention and management in their children.

Design

A systematic search strategy was performed to identify qualitative studies that assessed the phenomenon of interest in October 2022, updated in April 2024. The studies' methodological quality was evaluated, and the final synthesised findings were graded (ConQual). Data were analysed using a meta-aggregative approach.

Results

Sixteen studies were included. There were four synthesised key findings: family-centred care components identified in the dental attendance, aspects of interventions and settings that facilitated their acceptability, influence of oral health conversations and instructions on parents' behaviour, and barriers that persist. Confidence in the synthesised findings was rated as moderate–high. Parents mentioned aspects concerning the professionals, the impact of information on behavioural changes, the acceptability of dental interventions, expectations, criticisms and difficulties.

Conclusion

The dentist's attitude is a crucial aspect of parents' experience and can influence the acceptability of interventions and the change in behaviours related to oral health.

Background

Grandparental influences on child feeding practices that impact oral health remain under-investigated.

Aim

Explore perspectives and influences of intergenerational caregivers on cariogenic feeding practices in children.

Design

This qualitative study is based on phenomenological approach. Data collection involved in-depth interviews with parent(s) and grandparent(s) from the same family.

Results

Thematic saturation was achieved after 26 interviews (13 families) with 13 mothers, 13 grandmothers and one grandfather. Three themes were generated: (1) Intergenerational differences in milk feeding practices—Grandparents had strong preference for formula milk. They advocated formula milk feeding beyond infancy and sometimes encouraged cariogenic comfort feeding habits; (2) Transgenerational influences on snacking practices—Parents' and grandparents' own cariogenic snacking habits encouraged the child's cariogenic snack intake. Grandparents occasionally used sugary treats to reinforce their special identity as grandparents; and (3) Impact of new information sources versus grandparental input—Information sources influencing child feeding practices differed between generations; parents relied on social media (rather than grandparental advice) while grandparents drew from past experiences. However, grandmothers who were actively involved in food preparation had considerable influence on child feeding practices.

Conclusion

Practitioners and policymakers should actively engage grandparents to provide them with appropriate information on avoiding cariogenic feeding practices.

Background

Early childhood caries (ECC) impacts both children and their families.

Aim

To characterise improvement in oral-health-related quality of life (OHRQoL) among young children undergoing treatment for ECC under general anaesthesia (GA) and its association with family functioning.

Design

Pre-test/post-test design, with OHRQoL measured before treatment and then at 1, 6, and 12 months post-treatment, using the P-CPQ8 and the FIS8. Family functioning was measured before treatment, using the 12-item General Functioning (GF12) subscale of the McMaster Family Assessment Device.

Results

Of the 353 recruited participants, 300 (85.0%) underwent comprehensive dental treatment, with the remainder undergoing extractions only. Just over half were reassessed after 1 month, with that falling to 42.8% and 35.4% at 6 and 12 months, respectively. Only one in five participated in all four assessments. Improvements in P-CPQ8 and FIS8 scores from baseline showed large effect sizes. Those with poorer family functioning did not have higher P-CPQ8 and FIS8 scores after treatment, but younger children did.

Conclusion

Treating cases of ECC under GA leads to marked OHRQoL improvements that remain detectable 1 year later, but those do not tend to be greater in better-functioning families.

Background

Vertical bitewing radiographs (VBWs) are often used in paediatric dentistry but no clinical studies have been conducted to evaluate the feasibility or effectiveness of their use.

Hypothesis/Aim

To evaluate the quality of VBWs taken in children by undergraduate dental students.

Design

VBWs were taken for high-caries-risk children using two types of vertical holders: Snap-A-Ray and Red Rinn XCP. Trained and calibrated examiners assessed VBW quality including positioning errors, visibility of crown and furcation area of primary molars and presence of permanent successor. Association between VBW quality scores and independent variables was investigated using ordinal logistic regression (α = 5%).

Results

A total of 150 VBWs were evaluated. Radiographs were rated as excellent (10.67%), diagnostically acceptable (72%) and diagnostically compromised (17.33%). VBWs allowed the visualisation of the entire primary molar crown (80.55%), furcation (90.54%) and permanent successors (86.37%).

Common positioning errors included horizontal errors (48.67%) and coning off (38.67%). Use of the Red Rinn XCP holder was significantly associated with improved VBW quality compared to Snap-A-Ray (p = 0.045).

Conclusions

The use of vertical bitewings allowed visualisation of the primary molars crown, furcation area and presence of permanent successors. The use of a Red Rinn vertical holder can improve the quality of the bitewing radiographs by avoiding positioning errors.

Background

The International Caries Classification and Management System (ICCMS) advocates for nonsurgical approaches in early carious lesions and minimally invasive restorations in advanced cases.

Aim

This study investigated Thai dentists' adherence to ICCMS guidelines for managing caries in children and adolescents and explored factors influencing their decisions.

Design

A web-based questionnaire collected demographic information and routine treatment preferences for various stages of carious lesions from participants. Descriptive statistics and regression analyses were employed to examine relationships between management strategies and demographics.

Results

A total of 442 dentists participated. Their agreement with ICCMS guidelines for occlusal caries ICDAS 2, 3, and 4 in primary dentition was 39.6%, 53.9%, and 42.5%, respectively, and in permanent dentition was 34.4%, 46.8%, and 39.6%, respectively. The agreement rate with ICCMS guidelines for approximal caries RA1, RA2, RA3, and RB4 in primary dentition was 69.6%, 78.0%, 12.4%, and 99.5%, respectively, and in permanent dentition was 70.8%, 68.3%, 19.0%, and 97.7%, respectively. Factors associated with restorative treatment decisions included years since graduation, postgraduate education, and practice type.

Conclusions

Participants did not comply well with ICCMS recommendations for occlusal caries, some employed destructive techniques instead of noninvasive approaches. However, most participants followed ICCMS guidelines for approximal caries, except for RA3 stage.

Background

Dental impressions are crucial in pediatric dentistry, but exaggerated gagging can obstruct this process. Various methods have been proposed to manage the gag reflex (GR).

Aim

This study aimed to evaluate and compare the effectiveness of laser acupuncture and electroacupuncture in controlling children's GR.

Design

A three-armed randomized controlled trial was conducted with 63 patients aged 6–9, with excessive GR, scheduled for dental impressions. Participants were assigned to one of three groups: low-level laser (n = 21), microcurrent stimulation with a Meridian pen (n = 21), and a control group with a deactivated pen (n = 21). Gag preventive index (GPI) was taken, and dental anxiety was assessed using the Facial Image Scale (FIS), pulse rate (PR), and blood oxygen saturation (SaO₂). Significance was set at p < 0.05.

Results

All interventions influenced GPI scores. The Meridian pen and laser groups achieved better GPI scores (p < 0.001) than the control group. FIS scores between the Meridian pen and laser groups were comparable, differing significantly from the control group (p < 0.001). The Meridian pen and laser groups showed greater reductions in PR (p < 0.001) and higher SaO₂ post-intervention (p < 0.001).

Conclusion

The Meridian pen and laser outperformed the control group, demonstrating effectiveness in enhancing physiological and subjective measures.

Trial Registration

ClinicalTrials.gov identifier: NCT06422286