No evidence for association between Amelogenesis imperefecta and candidate genes

Amelogenesis imperfecta [AI] is an inherited tooth disorder. Despite the fact that up to now, several gene mutations in MMP20, ENAM, AMELX and KLK4 genes have been reported to be associated with AI, many other genes suggested to be involved. The main objective of this study was to find the mutations in three major candidate genes including MMP20, ENAM and KLK4 responsible for AI from three Iranian families with generalized hypoplastic phenotype in all teeth. All exon/intron boundaries of subjected genes were amplified by polymerase chain reaction and subjected to direct sequencing. One polymorphisms was identified in KLK4 exon 2, in one family a homozygous mutation was found in the third base of codon 22 for serine [TCG>TCT], but not in other families. Although these base substitutions have been occurred in the signaling domain, they do not seem to influence the activity of KLK4 protein. Our results might support the further evidence for genetic heterogeneity; at least, in some AI cases are not caused by a gene in these reported candidate genes

Assessment of a low dose of IV midazolam used orally for conscious sedation in pediatric dentistry

Midazolam is preferably used in pediatric dentistry for quick onset of action and recovery. The aim of this prospective, observer-blind and placebo-controlled study was to assess the efficacy of a low dose of oral midazolam in modification of the behavior of young pediatric dental patients. Forty children aged 3 to 5 years who displayed ratings 1 or 2 on the Frankl Scale and were healthy by the American Society of Anesthesiologists-I status were randomly divided into two experimental and control groups of 20 each. All children required pulpotomy and restoration of D and E teeth and received either 0.25mg/kg of a 15mg/3ml IV midazolam mixed in black cherry syrup or the syrup alone. Subjects were continuously observed and monitored with pulse oximetry. Houpt's Behavioral Ratings was used to determine the overall behavior, the degree of crying and movement during treatment. Mann-Whitney U test was used for statistical analysis. Patients who received 0.25mg/kg of the prepared oral midazolam significantly behaved better during treatment than the placebo controls [P<0.05]. In comparison with the placebo group, reduced movement and crying were observed in the midazolam group [P<0.05]. No adverse effects were observed and treatments were completed successfully. A low dose of 0.25mg/kg of a 15mg/3ml IV midazolam mixed in black cherry syrup was found to be effective in conscious sedation of young pediatric dental patients

[Comparison of salivary fluoride rate between primary school children using Kimia and Shahre-Darou sodium fluoride mouthwashes]

Using fluoride mouthrinses is one of the most effective ways for prevention of dental caries. For obtaining this benefit, the ministry of health has started using sodium fluoride mouthrinse in primary school children. The aim of this study was evaluation and comparison of salivary fluoride after using Kimia and Share Daroo mouthrinse. In this experimental study, 42 physically and dentally healthy children, used 10 ml of 0.2% sodium fluoride mouthrinse for 1 minute and then expectorated it. Unstimulated whole saliva [in five minute intervals] was taken in baseline, and after 5, 15, 25 and 45 minutes. 7 days after taking the first test, the second test was taken by using the second mouthrinse. After the collection of all of samples, the content of fluoride and volume of samples was determined and the results were statistically analyzed by using the 2-way repeated measure ANOVA. Fluoride concentration of saliva after using Kimia mouthrinse was 0.95 +/- 0.17 and 0.198 +/- 0.18 after using Shahre Darou mouthrinse. Fluoride concentrations of saliva after using mouthrinse, was not statistically significant between the gender and the two ages. Results of this study showed that no statistically significant differences of fluoride retention in children's saliva exist between the two Iranian 0.2% sodium fluoride mouthrinses

[Effect of sugars and carbonated drinks consumption on anthropoinetric indices and dental health]

Carbohydrates are the main source of human diet. More than 60% of total needed energy is obtained from them. Many studies have shown that obesity and dental caries increase with high consumption of sugars and carbonated drinks. Some studies showed that this kind of diet has not any role on obesity and dental caries. The aim of this study was to assess the role of sugars and soft drinks on the anthropometric and dental health indices. By a descriptive cross-sectional study in year 1383, a total of 788 healthy 7-years old primary school children were selected via a cluster sampling in Tehran. Their general information was asked from their mothers. 24-hour frequency consumption of sugars including beverge was asked by the trained interviewers via a standard questionnaire. Then anthropometric measurements were also taken for each child. Dental health indices were measured by two trained dental hygienist. The Chi-square and Spearman tests were used for detection of statistical associations. Spearman statistical test did not show any significant relationship between dmft and consumption of sugars and soft drinks. Also consumption of sugars in children who had a problem with height for age and weight for height was higher but they did not show statistical difference. Also consumption of sugars in children who had problem with weight for age was significantly higher [P=0.002]. Consumption of sugar in low weight children was higher and there was not any significant relationship between sugar consumption and dmft

[ status of preventive dental services in Tehran]

The control and reduction of dental caries as well as oral health promotion can be expected only if proper preventive services are available to communities. Every dentist can play an important role in prevention of common oral diseases while providing routine dental services. The aim of this study was to evaluate the status of preventive dental care provided by dentists practicing in Tehran. One hundred and fifty five General dentists with at least two years of experience were selected through systematic random sampling, from twenty two districts of the capital city Tehran. A questionnaire was used to collect information about the type of patient visited and services rendered to them, such as dental health education, nutrition instruction, fluoride and sealant therapy as well as the level of dentist's satisfaction of preventive care provided. Five dentists [3.12%] didn't offer any preventive services. However, 61.2% of the dentists delivered dental health education to their patients, 81.3% provided fluoride therapy, and 80.6% fissure sealant therapy to their patients. Some 94.8% of dentists reported that they emphasized the role of personal preventive care to their patients. Only 12.9% of the dentists were satisfied from their preventive services provided to their patients. As the best possible resorts, 41.7% of the dentists suggested oral health education; and 34.6% recommended expansion of dental insurance coverage by insurance companies in order to cover the cost of preventive dental services. The preventive dental services provided by dentists in the city of Tehran are not sufficient yet. Oral health promotion in this population may be facilitated by 1] patient education, 2] changing dentists' attitude, and 3] dental insurance reform

Micronutrients Fe, Zn and Ca and their relationship with anthropometric indices and dental health among children

Proper nutrition has an important role in the physical and psychological development of children. The aim of this survey is to compare the nutrition of a community to the recommended daily amount [RDA] to determine deficiencies and present recommendations for improvement. In this cross-sectional study conducted in Tehran, Iran, 788 children, all seven years of age, were selected via cluster sampling and evaluated using standard questionnaires with a 24-hr recall regarding the frequency and type of food intake. Then by measurement of weight and height, their anthropometric and DMFT [decayed/missing/filled teeth] indices were determined using the Kruskal-Wallis one-way analysis of variance, and Mann-Whitney U and chi-square tests. Relative to the RDA, 23.6% of children had low intake of Ca, and 3.2% and 5.2% were deficient for Fe and Zn, respectively. Anthropometric measurements showed that 15.7% were malnourished based on weight for age, 10.5% based on height for age and 16.8% based on weight for height indices. The DMFT indices for children with dietary Ca levels under 75% of the RDA were significantly higher than those with sufficient Ca intake [P < 0.001]. The mean DMFT indices for dental development were 0.22 for permanent teeth [four molars; SD = 0.64] and 4.64 for primary teeth [SD = 3.24]. We found a significant correlation between DMFT indices and low Fe intake: the DMFT indices of children with iron deficiency were much higher than those with sufficient iron intake. Children in Tehran do not receive enough Ca Fe and Zn from their diets. This problem causes mild malnutrition and increases the risk of dental caries

Occlusal fissure caries and restorative treatment planning: variations among dentists

The dental treatment planning for occlusal caries is quite variable among dental clinicians. The objective of present study was to assess such variations among the general dental practitioners. A cross-sectional study design was used for this investigation. After oral examination of 8-1 0 years old children who were referred to the pediatric department, 6 first molar teeth with occlusal caries in Grades I, II and III [Espelid et. al., 1994] were selected. The cavity specifications for these teeth with fissure caries were confirmed by 5 specialists, members of dental faculty. The colored photographs of occlusal surfaces as well as bitewing radiographs of selected teeth were displayed for 150 randomly selected general dental practitioners. Dentists were asked to record their diagnosis and treatment plans for these conditions. The SPSS software was used for data analysis. The Kruskal-Wallis and ordinal regression tests were used to detect statistical significance level. As a gold standard treatment plan for restoration of occlusal caries, 36.1% suggested sealant therapy and 27.8% selected PRR procedure. Overall, four different procedures were suggested for non-carious fissures by dentists. They were included: 1] no treatment [36.4%], 2] better dental care plus fluoride therapy [33.1%] and 3] sealant therapy [22.3%]. For decayed fissures that were limited to enamel, 5 different treatment plans; and for more extended cavities 6 different treatment plans were suggested. Age, sex, place of graduation, experience with pediatric patients, were evaluated for possible correlation. Among others, sex was the only factor significantly related to treatment planning among dentists [P=0.013]. Based on this assessment, there are many variations among dentists in restorative treatment planning and they mostly choose the more invasive procedures. This evidence indicates that dentists should learn and apply more preventive procedures