International journal of paediatric dentistry最新文献

Background: Erosive tooth wear is a multifactorial and common condition in children.

Aim: This systematic review and meta-analysis aimed to determine the prevalence and key risk factors for erosive tooth wear in the primary dentition of children up to 7 years of age.

Design: Electronic databases (PubMed, Embase, Scopus, and Web of Science) were searched in February 2023 for observational studies reporting prevalence and anamnestic risk factors. Additionally, a manual hand search was performed. Meta-analyses were conducted for the prevalence and odds ratios of identified risk factors. Risk of bias was assessed using the Newcastle-Ottawa scale modified for cross-sectional studies.

Results: A total of 26 sources, reporting on 23 studies, were included in the systematic review. The overall estimated prevalence of children with erosive tooth wear in the primary dentition amounted to 35.6% (95% CI: 24.8-48.1). Anamnestic factors were structured into domains. Meta-analyses revealed gastroesophageal reflux disease (GERD; p_adj. = .008; OR = 1.98, 95% CI: 1.37-2.87), consumption of acidic food (p_adj. < .001; OR = 5.14, 95% CI: 3.56-7.42) and acidic drinks (p_adj. < .001; OR = 6.90, 95% CI: 4.64-10.25), holding beverages in the mouth while drinking (p_adj. = .035; OR = 1.82, 95% CI: 1.26-2.63), and snacking regularly (p_adj. = .041; OR = 1.58, 95% CI: 1.18-2.10) to be significantly associated with erosive tooth wear.

Conclusion: Future research should use standardized questionnaires to assess erosive tooth wear and its underlying risk factors (PROSPERO: CRD4202339776).

Background: Common etiological factors have been reported in the development of molar-incisor hypomineralisation (MIH) and dental anomalies (DA).

Aim: To assess the association between MIH and DAs.

Design: A cross-sectional study was performed to evaluate the presence of MIH and other six DAs in a sample of 415 pretreatment records from patients aged 9-18 years. Statistical analyses were performed using the chi-squared and Fisher's exact tests, and logistic regressions.

Results: There was statistically significant association between the prevalence of DAs and MIH (CI: 1.43-2.43, φ-coefficient: 0.204, PR: 1.87). Higher percentage of tooth agenesis (CI: 1.37-1.68, φ-coefficient: 0.271, PR: 1.50), maxillary premolar agenesis (CI: 1.70-3.65, φ-coefficient: 0.125, PR: 2.49), mandibular second premolar agenesis (CI: 1.68-3.16, φ-coefficient: 0.172, PR: 2.30) and distoangulation of the mandibular second premolars (CI: 1.31-3.47, φ-coefficient: 0.103, PR: 2.13) was observed among children who had MIH-affected teeth. Individuals with MIH had a 2.95 times greater chance of having DAs (R² = .153). The number of patients with DAs was higher when the first molar showed severe defects (OR = 4.47; R² = .149).

Conclusion: There is a weak association between MIH and DAs. Patients with severe MIH lesions have a slightly higher risk of presenting DAs.

Background: Effective removal of dental plaque is essential factor for prevention of caries, gingival, and periodontal diseases in children and adults.

Aim: To evaluate factors associated with improving toothbrushing performance (TB-P) among children.

Design: An observational cohort study analyzed all paediatric patients receiving regular examinations in a single dental clinic between 2009 and 2017 and regularly brushing their teeth with a triple-headed toothbrush (TH-TB). At every periodic follow-up, the TB-P of the child/parent was evaluated using the TB-P Skill Index (TB-PS-I); that is, did the child reach all five teeth segments within each arch and did he/she perform 10 back-and-forth stocks in each segment. When not optimal, they received instructions for improving TB-P and subsequently were asked to re-demonstrate. TB-PS-I was calculated and analyzed for correlation with other explanatory variables.

Results: A total of 1737 children with 7399 follow-up appointments were analyzed. Older age, female gender, higher number of follow-up appointments, and compliance with twice-daily toothbrushing significantly improved TB-P. The most typical mistakes in their performance were not reaching the canine segments and not performing enough strokes in each segment. Instructions given after imperfect TB-P significantly improved the TB-P. The magnitude of improvement, however, did not correlate with the performers' age, gender, or the number of follow-up visits.

Conclusions: A significant percentage of children >8 years did not perform optimal toothbrushing even when using TH-TB.

Background: There is limited evidence of succinic acid release from amber necklace that justifies its biological plausibility.

Aim: This study aimed to evaluate the release of succinic acid from Baltic amber beads in the presence of Staphylococcus epidermidis.

Design: The Baltic amber beads from the necklace were stratified according to their weight (average 0.05 g ± 0.067). Subsequently, the beads (n = 8) were submerged in 0.9% buffered saline (Control) or brain-heart infusion culture medium in the presence of a commercial strain of S. epidermidis, a resident skin bacterium incubated at 37°C for 24 h or 7 days. The samples were centrifuged, and the supernatants were analyzed by ¹H Nuclear Magnetic Resonance. Multivariate analyses were adopted using the sparse partial least squares discriminant analysis method (p < .05).

Results: The group incubated with saline solution showed small release of succinic acid only after 7 days. In the groups with S. epidermidis, the release of succinic acid was observed in the both presence and absence of amber beads, indicating that succinic acid is a product released by bacteria.

Conclusions: It was found that amber beads do not exhibit the ability to release expressive succinic acid, especially in a short period of time, which does not justify their use in infants. The most production of succinic acid is tributed to S. epidermidis.

Background: Pain and anxiety can be considerable obstacles while treating paediatric dental patients. Moderate sedation is needed to treat uncooperative patients.

Aim: This study aimed to compare the effectiveness of buccal administration of dexmedetomidine-ketamine combination versus dexmedetomidine.

Design: Fifty-six uncooperative children were randomly assigned into two groups: Group I received buccal dexmedetomidine (2 μg/kg) and ketamine (2 mg/kg) (DEX-KET), whereas Group II received buccal dexmedetomidine (4 μg/kg) (DEX). The effects of drugs were evaluated based on changes in vital signs, onset and duration of sedation, sedation level, analgesia, ease of treatment and procedural adverse effects.

Results: There were no significant differences in vital signs or sedation onset between the two groups. DEX-KET group showed shorter recovery time than DEX group (p < .0001). There were no statistically significant differences between both groups regarding sedation level at optimum sedation and during operative procedure (p = .064, p = .069 respectively). The ease of treatment was significantly better in DEX-KET group than in DEX group (p = .048). Procedural side effects and analgesic effects of the sedative drugs were comparable between both groups.

Conclusion: The combination of dexmedetomidine and ketamine delivered buccally provided a better method of delivering care to uncooperative children with more rapid recovery than dexmedetomidine.

Background: Dental practitioners desire non-pharmacological methods to alleviate anxiety, fear, and pain in children receiving dental care; high-quality evidence, however, is required to evaluate methods' efficacy.

Aim: This study aimed to develop and validate an observation-based coding approach (paediatric dental pain, anxiety, and fear coding approach [PAFCA]) to evaluate non-pharmacological behavior management techniques for anxiety, fear, and pain.

Design: Objective (video-based) and subjective (self-reported) anxiety, fear, and pain data were collected from a pilot clinical trial evaluating animal-assisted therapy (AAT) in paediatric dentistry, in which 37 children aged 7-14 were assigned to AAT or control before dental treatment (restorations or extractions). A coding approach utilizing a codebook, a gold standard calibration video, and a user training guide was developed. Trained examiners coded the gold standard video for inter-rater agreement, and masked, calibrated examiners analyzed videos using the Noldus Observer XT software.

Results: A novel, software-based coding approach was developed, with moderately high inter-rater agreement. Using PAFCA, we found children reporting higher levels of pain, fear, and anxiety exhibited treatment-interfering behaviors, including crying/moaning, attempts to dislodge instruments, and more upper and lower body movements.

Conclusion: PAFCA shows promise as a reliable tool for assessing anxiety, pain, and fear in behavioral research for paediatric dentistry.

Background: Children with special healthcare needs (SHCN) often require specialized interventions due to their disabilities. Dental general anesthesia (DGA) is a treatment modality, which improves their access to care but concerns about repeated DGAs persist.

Aim: This study investigated DGA utilization in children with SHCN and identified factors associated with multiple DGAs in Alberta, Canada (2010-2020).

Design: This retrospective population-based study used administrative data encompassing all children (<18 years) undergoing DGA in publicly funded facilities. Children were identified as SHCN based on their diagnosis codes and categorized into behavioral/psychiatric disorders, mental/intellectual disabilities, physical disabilities, systemic conditions, syndromes/congenital anomalies, physical-mental disabilities, and disabilities with medical conditions.

Results: This study analyzed 3884 DGA visits for children with SHCN, predominantly males aged 6-11 and from low-income families. Mental/intellectual disabilities were prevalent (31.8%), and autism was the leading disease. Caries was the primary dental diagnosis across all groups, whereas pulp problems were higher in psychiatric/behavioral disorders (23.6%), and periodontal problems were more common in physical-mental disabilities (13.2%). 28.7% had multiple DGAs, with younger age, disabilities with medical conditions, mental/intellectual disabilities, and initial pulp treatments, increasing the likelihood of multiple DGAs.

Conclusion: This study highlights the importance of individualized prevention and less conservative treatments for younger children to reduce oral health disparities.

Background: Dental caries remains prevalent among children in Bhutan, despite an increasing number of oral health professionals (OHPs). Insights into caries preventive practices among OHPs can identify areas for capacity building.

Aim: This cross-sectional descriptive study assessed the knowledge, attitude and practice of caries prevention in children among OHPs in Bhutan.

Design: A self-administered online questionnaire was sent to all active registered OHPs.

Results: The respondents included 73 dentists and 61 dental hygienists (88% response rate) with a mean experience of 8.4 ± 7.1 years. Many practitioners rarely saw children; most of them, however, exhibited a positive attitude towards caries prevention in children, yet lacked knowledge and practice, especially in younger children. Caries risk factors were not all recognized, and assessment was not practised. Many forms of fluoride were available, but their efficacy was underestimated. Fluoridated toothpaste was underutilized in younger children. Preventive practice relied mainly on giving advice. The most common limitations on preventive practice were the unavailability of materials and treatment prioritized over prevention.

Conclusion: Caries prevention in Bhutanese children requires a systematic approach in the oral healthcare system and further education of OHPs. Proactive strategies, time management and efficient distribution of preventive materials could promote better practice.

Background: Surgical intervention for tongue-tie, or ankyloglossia performed by paediatric dentists can alleviate symptoms and improve functional abilities in infants and children. Despite widespread practice, there are currently no established clinical guidelines or consistent approaches for pre- and post-operative care of children.

Aim: The aim of this study was to explore approaches to pre- and post-operative care for children with ankyloglossia having frenum surgery.

Design: A scoping review of peer-reviewed articles in four electronic databases was conducted. Intervention studies that reported on pre- or post-operative regimens for infants, children and adolescents (0 to 18 years) with a diagnosis of tongue-tie or ankyloglossia, who had surgical intervention such as frenotomy or frenectomy, were included and quality assessments performed.

Results: Twenty-three studies were identified, with seven studies incorporating both pre- and post-operative care, and 16 studies focussing solely on post-operative care. Tongue exercises were commonly prescribed, and only three studies examined the relationship between post-operative care and recovery outcomes. Considerable variability existed in study design, prescribed care and outcome measures.

Conclusion: There was substantial variability in pre- and post-operative care protocols, including dosage, frequency and duration of exercises and other care regimens for infants and children having frenum surgery. Further research is needed to determine the most effective course of pre- and post-operative care for children undergoing frenum surgery.

Background: Given the relationship between overweight and obesity (OV/OB) and poor oral health in children, paediatric dentists are uniquely positioned to provide educational interventions to children with OV/OB during dental visits.

Aim: To assess how an educational nutrition intervention delivered by dentists affected dental-nutritional behaviors and body mass index (BMI) percentile in children with OV/OB.

Design: Retrospective analysis was performed using data collected on 217 patients with OV/OB aged 6-11 years who received nutritional counseling during dental visits at a Federally Qualified Health Center from September 1, 2021, through September 30, 2022. Data were collected on sociodemographic variables, oral health, and BMI percentile. Participants and their guardians were surveyed to measure the frequency of behaviors related to oral health and weight. Multivariable generalized estimating equations were constructed to determine the effect of the intervention on BMI percentile and reported dental-nutritional behaviors.

Results: The intervention had no effect on the BMI percentile (p = .35). There were statistically significant reductions in the reported average number of sugar-sweetened beverages consumed daily (p < .001), reported average daily water intake (p < .001), and the reported frequency of brushing teeth (p < .001), the clinical significance of these reductions remains unclear.

Conclusion: Further research is needed to establish the efficacy of behavioral interventions at reducing weight and changing health behaviors.