International journal of paediatric dentistry最新文献

Background: Although dental fear and anxiety are common in children and adolescents, they are not well-defined constructs and may not capture critical clinical aspects. Dental phobia (DP) is more well-defined as a specific phobia that includes the criteria of functional impairment.

Aim: To investigate the prevalence and covariates of DP.

Design: A representative sample from two birth cohorts in Trondheim, Norway (n = 666) was assessed at age 16. A diagnostic interview using the Kiddie Schedule for Affective Disorders and Schizophrenia was conducted with both parent and adolescent. Personality traits, intelligence, and executive functioning were also assessed.

Results: The prevalence of DP was estimated to 3.7% (95% CI: 2.7%-5.1%), whereas 8.0% (95% CI: 6.5%-9.9%) had intra-oral injection phobia (I-OIP). Generally, DP was not associated with anxiety, depressive disorders, personality traits, or poor executive functioning. However, DP was comorbid with social anxiety disorder and had more symptoms of ADHD, hyperactivity-impulsivity, and lower verbal intelligence than those without DP.

Conclusions: Dental phobia is prevalent in adolescence and exists independently from other anxieties, although persons with DP more often experience social anxiety, hyperactivity, impulsivity, and difficulties understanding advanced language. These tendencies could lead to challenges with interaction and comprehension during dental visits.

Backgrounds: Maximum willingness to pay (WTP) for a health benefit is linked to perceived value.

Aim: This study assesses WTP for a service package in cleft lip and palate patients and identifies influencing factors.

Design: In this cross-sectional study, demographic, disease type, socioeconomic variables, and WTP for a service package reducing patients' problems were measured. A two-part regression model was used to identify factors influencing WTP.

Results: Among 491 participants, 57% were male. 320 (65.17%) patients were willing to pay for the package, with an average of 79.42 USD. The highest mean WTP was for cleft palate and lip (65.27 USD). Family monthly expenditure was the only significant model variable; spending 50-100 USD compared to < 50 USD increased the likelihood of WTP by 1.79 times. Heads of families were willing to pay more for girls and for patients over 2 years. Each increase in child order raised WTP by 8.44 USD, while each additional sibling reduced it by 6.02 USD.

Conclusion: WTP for cleft lip and palate services was lower than expected. Better family financial status increased the likelihood of WTP, while both financial and demographic factors influenced the amount.

Background: Children in rural and underserved communities face persistent barriers to oral health care, including limited access to providers. Teledentistry may offer a scalable strategy to improve access, education, and treatment adherence.

Aim: To evaluate the effectiveness of teledentistry interventions in improving oral health outcomes, treatment compliance, and educational engagement among pediatric populations in low-access settings.

Design: A systematic review was conducted following PRISMA 2020 guidelines. Eleven studies published between 2011 and 2025 were included, comprising randomized controlled trials, cohort studies, and school-based implementations. Interventions included synchronous video consultations, asynchronous data transmission, mobile apps, and social media-based education.

Results: Teledentistry interventions improved treatment adherence (66.7%-96.9%), reduced plaque and bleeding indices in orthodontic patients, and enhanced access to screening and referrals in schools. Mobile-based education promoted better hygiene behavior. Most studies reported high satisfaction and minimal technological issues. However, variability in intervention types and outcome measures precluded meta-analysis.

Conclusion: Teledentistry is a feasible and effective tool for addressing pediatric oral health disparities in underserved settings. It supports prevention, education, and early intervention. Future studies should emphasize standardized outcomes, long-term impact, and cost-effectiveness.

Trial registration: This systematic review is registered in PROSPERO under the registration number CRD420251066189.

Background: Molar incisor hypomineralization (MIH) often poses challenges in achieving effective anesthesia. The role of neuromodulation as a potential alternative to local anesthesia injections in managing MIH-affected teeth remains unexplored.

Aim: This study evaluated the efficacy of neuromodulation in providing pain relief during vital pulp therapy for MIH-affected permanent molars.

Design: A triple-blind, randomized clinical trial in 35 children (70 M) aged 6-12 assessed pulpotomy pain management. Teeth were randomly assigned to neuromodulation (Synapse Dental Pain Eraser) for 3 min and mock injection (experimental group), or to conventional infiltration of local anesthesia preceded by inactive control probes (control). Pain was evaluated using the Sound, Eye, Motor (SEM) scale, along with anesthesia need, patient satisfaction, and anesthesia duration. Data were analyzed using independent t-tests with significance set at p < 0.05.

Results: The experimental group reported higher no-pain scores (29%) compared to the control group (20%). Supplemental anesthesia was required in 11% of cases in the experimental group and 19% in the control group. Neither showed a statistically significant difference (p = 0.42 for pain scores; p = 0.36 for supplemental anesthesia).

Conclusions: Neuromodulation demonstrated comparable effectiveness to local anesthesia alone in managing pain during pulpotomy in MIH molars, and its use should be further studied.

Trial registration: ClinicalTrials.gov identifier: CTRI/2024/06/069004.

Background: Important psychometric approaches (structural validity, measurement invariance) remain underdeveloped in measuring oral health-related quality of life, particularly for preschool children across diverse contexts.

Aim: This study aimed to evaluate the structural validity of the child's self-reported version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) and test the measurement invariance from cultural and clinical/non-clinical comparison perspectives.

Design: Three datasets were analysed: two from Brazil and one from the United Kingdom (UK). One Brazilian dataset was derived from clinical data collection (n_br-cl. = 193), while the others were from non-clinical epidemiological school-based studies (n_br-ncl. = 768, n_uk-ncl. = 296). Dimensionality was tested through parallel analysis and confirmed by unidimensional indexes. Measurement invariance across datasets was tested via multi-group Confirmatory Factor Analysis (CFA).

Results: Unidimensionality was empirically confirmed for all three datasets. The multi-group CFA tests reached partial scalar invariance threshold between the Brazilian and UK non-clinical datasets. However, there was no scalar equivalence when comparing non-clinical with clinical datasets, neither within Brazil nor between countries.

Conclusion: The child's self-reported version of the SOHO-5 is a unidimensional oral health-related quality-of-life measure that is psychometrically comparable across different cultures (partial scalar invariance), but not between clinical and non-clinical groups.

Background: Gamified tools have shown promising improvements in health promotion. However, little is known about how mothers perceive their use in improving children's oral health.

Aim: This qualitative study explored the insights of mothers of school-aged children in Jeddah, Saudi Arabia, regarding gamification tools aimed at promoting oral hygiene.

Design: Participants were selected using purposive variation sampling to capture diversity. Data were collected through semi-structured individual interviews conducted in Arabic or English.

Results: Thematic analysis revealed six key themes: engagement and motivation to play, barriers related to prolonged use, perceived usefulness, parents' concerns and conflicts, desired features, and observed effects on children's behavior. These findings reflected the varied characteristics and experiences of the participants and highlighted both the learning potential and limitations of gamified tools for oral health education. While some mothers acknowledged the positive impact of gamified tools on increasing their children's knowledge and motivation in maintaining oral hygiene, others expressed concerns regarding excessive screen time, content, and linguistic needs.

Conclusions: Gamified tools appear effective in enhancing children's oral hygiene practices, as reflected by maternal observations of improved brushing habits. Nonetheless, concerns regarding screen exposure, content suitability, and cultural appropriateness emphasize the need for more customized and engaging solutions.

Background: Silver diamine fluoride (SDF) is a viable biological approach for arresting active dental caries in children. However, the resulting dark staining is a major concern for parents, often limiting its acceptance despite clinical benefits. Therefore, evaluating parental acceptability is crucial.

Aim: This study aimed to develop and validate a Malay version of the questionnaire on parental perception and acceptance of SDF treatment in children, based on the English version by Crystal et al., for use in Malaysia.

Design: The English questionnaire was modified and translated into Malay following standardised guidelines. Content validation was performed by an expert committee, followed by pilot testing with 134 participants. Construct validity was assessed using Exploratory Factor Analysis (EFA) with Kaiser-Meyer-Olkin (KMO) and Bartlett's test. Reliability was then measured through internal consistency (Cronbach's alpha) and test-retest reliability using intraclass correlation coefficient (ICC).

Results: Nineteen out of 22 items scored an I-CVI of 1.0; three scored 0.5. S-CVI/UA was 0.86 and S-CVI/Ave was 0.93. EFA confirmed construct validity (KMO = 0.74, Bartlett's test p < 0.001). Cronbach's alpha values ranged from 0.780 to 0.919, indicating high internal consistency. ICC values (0.528-0.802, p < 0.05) showed moderate to good reliability.

Conclusion: The Malay version of the questionnaire is both valid and reliable, supporting further nationwide studies to improve its stability.

Background: Asymmetrical occlusion in children may influence maxillofacial development and oral function, yet its clinical relevance remains underexplored.

Aim: To investigate the relationship between asymmetrical occlusion and oral/physical functions in schoolchildren during the mixed dentition period.

Design: A cross-sectional study of 374 (192 boys and 182 girls) schoolchildren (Hellman's dental age IIIA-IVA) was conducted. Asymmetry indices (AIs) were calculated using occlusal force/contact area data measured with the dental prescale. Oral and physical functions were assessed using masticatory performance, grip strength, and walking speed. Statistical analyses included Chi-squared test, Mann-Whitney U test, Spearman's rank correlation, Kruskal-Wallis test, and multiple regression analysis.

Results: AI, an indicator of unilateral occlusion, varied significantly across dental age groups (p = 0.011), peaking in stage IIIC. In IIIA, AI was correlated with age and masticatory performance; in IIIB and IIIC, it correlated with both oral and physical functions; and in IVA, with body size. Multiple regression revealed that lower occlusal force/area and slower chewing rates significantly explained greater asymmetry.

Conclusions: Asymmetrical occlusion in the mixed dentition showed weak but significant correlations with some oral functions, without consistent links to physical functions. Its cross-sectional design precludes causal inference, warranting further longitudinal studies.

Background: Clinical approaches for pediatric patients requiring endodontic treatment have been associated with specialty type.

Aim: The purpose of this study was to elucidate the nuanced clinical decision-making process for endodontic treatment of pediatric patients' permanent teeth.

Design: A qualitative design was used to explore the experiences and decision-making of general dentists, pediatric dentists, and endodontists. Clinicians practicing in the United States were recruited to interview using purposive sampling methods. A framework, thematic analytic approach was used to evaluate the data.

Results: In total, 26 dentists participated in the study: 7 general dentists, 11 pediatric dentists, 6 endodontists, and 2 dual-trained specialists. Overall, clinicians reported that caries on permanent first molars were the most common reason that pediatric patients required endodontic treatment. Access to care was influenced by practitioner clinical training and knowledge; patient behavior; and financial considerations. Treatment planning was influenced by parents, referrals, and clinical philosophy.

Conclusions: The findings explain how clinician decision-making and system-level factors influence access to care for pediatric patients in need of endodontic treatment and propagate oral health disparities. Barriers to accessing care were most limiting for children and adolescents from low-income households and were likely to result in premature tooth loss.