The Impact of Climate Change on Paediatric Dentistry

The effects of global warming and climate change are happening at a faster rate than expected, and they are going to get worse. Global climate change has already started to show the effects on environment—fast melting glaciers, accelerated sea level rise and base shifting of native flora and fauna. There has been an increase in temperature globally with a few countries already showing intense heat waves and extreme cold temperatures. The interrelation between dentistry, environmental impact and human health is still in its nascent stage, but studies in medicine show that the healthcare industry contributes to greenhouse gas emissions and climate change, poor air quality, food and water insecurity, extreme weather events and vector?borne illnesses. The concept of eco?friendly dentistry has evolved in this context for providing environmentally feasible dental solutions. Paediatric dentistry is no exception. The concept of prevention has to be promoted more in paediatric dentistry to provide a positive impact on environment. The prevention of oral diseases will lead to less travel to paediatric dental clinics, less use of dental materials, lesser energy usage, minimal use of single?use plastics and less use of nitrous oxide/general anaesthesia for behaviour management. The greenhouse gases have an effect on teeth of children in relation to early childhood caries (ECC). Here, we discuss the impact of climate change on paediatric dentistry and what changes can be made to provide environment?friendly solutions

Attitudes of dental students towards paediatric dental behaviour guidance

Aim: To compare the pre-clinical and clinical students` perceptions about the non-pharmacological behaviour management techniques in paediatric dentistry and to investigate the influence of the dental curriculum on the students` knowledge regarding this issue. Methods: A total of 283 students from the IV-and X-semester completed a questionnaire, consisted of 12 statements, describing the nonpharmacological behaviour management techniques for the treatment of paediatric dental patients. The acceptability rate was evaluated with a Likert scale ranging from 1 to 5. Results: The students from all courses demonstrated high acceptance for Reinforcement and Desensitization techniques and low for the Negative reinforcement and Physical restraint. The comparison between the perceptions of the pre-clinical and clinical students demonstrated a statistically significant increase in the acceptance of the physical restraint, along with Nonverbal communication, Modelling and Parental presence/absence (p<0.05). Conclusion: The results provide information about the students' knowledge and skills in behaviour management techniques together with some insights about how the educational process can modify the students` perceptions and views in dealing with paediatric dental patients

Patterns of Paediatric Dental Treatment Under General Anaesthesia: A Retrospective Study

ABSTRACT@#This retrospective study aimed to evaluate patterns of comprehensive dental treatment under general anaesthesia (GA) for healthy children in Universiti Teknologi MARA, Malaysia. The treatment records of healthy paediatric patients who received dental treatment under GA from February 2017 to January 2021 were reviewed. The patients were divided into two groups: (1) less than 6 years old and (2) 6 to 16 years old. Patients’ characteristics were summarised using descriptive statistics while an independent t-test was applied to investigate the influence of “age group” on treatment duration, number of procedures and use of various restorative materials. A total of 125 paediatric patients (67 boys and 58 girls) were included. The patients’ mean age at the time they underwent GA was 5.77 ± 1.94 years old and the average duration of dental treatment was 62.58 minutes. There was a significant difference in the duration of treatment between the two age groups (p < 0.05). Tooth extraction was the most dental procedure performed (63.31%). The 6 to 16 years old group had a significantly shorter treatment duration (p < 0.05). However, no significant differences were found in all procedures (extraction, restoration, preventive and pulp therapy) and the utilisation of composite, glass ionomer cement (GIC) and compomer in both groups. The use of stainless steel crown (SSC) restorations was significantly higher in the less than six years old group (p < 0.05). Most of the dental procedures performed under GA on healthy children were extraction procedures. Children less than six years of old had a longer treatment duration under GA. Composite restorations and SSC were more frequently used in primary dentition.

Sobre técnicas y estrategias para el manejo y guía de la conducta en odontología pediátrica: análisis de la literatura / Techniques and strategies for the management and guidance of behavior in pediatric dentistry: analysis of the literature

El objetivo de esta revisión narrativa es analizar críticamente las publicaciones sobre las diferentes estrategias y técnicas que la literatura odontológica mundial recomienda para la atención de los niños que rechazan el tratamiento (AU)

The purpose of this narrative review is to do a critically analysis of all the papers currently published on different strategies and techniques recommended by the world dental literature for the management of children who refuse dental treatment or non-compliant child patients (AU)

The Extent of Parents Acceptance with Regard to Usage of General Anaesthesia for Their Children during Dental Procedure in Riyadh City

Investigators have begun to assess the parental acceptance on General Anaesthesia (GA) in pediatric dentistry. Patient satisfaction and knowledge has an essential role in determining the utilization of the healthcare services. Physiologic and functional outcomes can affect completion of the treatment process that is one of the Factors that influence parental decision for seeking care. METHODSIn this survey, a structured self-administered and close ended questionnaire, was used to assess parents’ acceptance for dental treatments under general anaesthesia for their child. Parents whose children were going to undergo dental treatments in Riyadh Elm University, were approached with this questionnaire. All parents fulfilling inclusion criteria were explained about the purpose of the study and a total of 452 parents provided informed consent during the aforementioned period was included in the survey. RESULTSA total of 452 parents of the children participated in the study. The educational level of the parents was found to be significantly associated with the effectiveness of the comprehensive dental care for their child under GA. Child age showed significant association with the parental refusal of dental treatment under GA. Educational level of the parents and residence were found to be significantly associated with the perception that the dental treatment under GA is indicated for a specific class of patients. (P < 0.05) CONCLUSIONSEducation level of parent’s have important role in knowlage and awareness to treat their children under GA. Regular dental check up is important. Educating parents about oral health and diseases is important to increase the awareness about prevention rather than intervention.

Oral health-related quality of life of pre-school children: review and perspectives for new instruments

Abstract This study aimed to describe different approaches for the evaluation of the Oral health-related quality of life (OHRQoL) of preschool children and to discuss perspectives for future instruments. The OHRQoL is a concept that surpasses an exclusively clinical perception and includes functional, social, emotional, and environmental issues. The measure of OHRQoL represents a holistic approach for researchers and clinicians extending their visions beyond the mouth and understanding the entire context of the patient. Negative impacts of oral conditions on OHRQoL in childhood can reflect on health development, especially in a life stage marked by social and cognitive maturation. Instruments have been developed and cross-culturally adapted to evaluate the impact of oral conditions on the OHRQoL of preschool children and their families. Some features distinguish these instruments and influence their selection, such as: self- or proxy-report; generic- or specific-condition; long- or short-form, and less or more established used in literature. Moreover, theoretical framework, construct validation and availability should also be considered. Nine OHRQoL instruments for preschool children were included in the present literature review. They were created between 2003 and 2017 by developed countries in most cases. The shorter instrument has five items, and the larger has 31 items. Most of them are proxy-reported, generic-condition, and have been relatively well established in the literature. The diversity of instruments indicates the evolution of OHRQoL studies, but there are methodological issues still in need to be improved in future developments or cross-cultural adaptations, according to current psychometric evidence.

Resumo Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) é um conceito que extrapola uma percepção exclusivamente clínica ao incluir questões funcionais, sociais, emocionais e ambientais. A avaliação da QVRSB representa uma abordagem holística para a pesquisa e prática clínica. O impacto negativo das condições bucais na QVRSB durante a infância pode refletir no desenvolvimento saudável, especialmente em um estágio da vida marcado pela maturação social e cognitiva. Instrumentos vêm sendo desenvolvidos e adaptados transculturalmente para avaliar o impacto das condições bucais na QVRSB de pré-escolares e seus familiares. Algumas características distinguem esses instrumentos e influenciam na seleção, tais como: autorrelato ou relato proxy; condição genérica ou específica; formas longas ou curtas, mais ou menos estabelecidos na literatura. Além disso, a base teórica, a avaliação do construto e a disponibilidade do instrumento também devem ser consideradas. A diversidade de instrumentos indica a evolução dos estudos em QVRSB, mas ainda há questões metodológicas que precisam ser avançadas em futuros desenvolvimentos ou adaptações desses instrumentos, seguindo as atuais evidências psicométricas. O presente estudo objetiva descrever as diferentes abordagens para avaliar a QVRSB de pré-escolares e discutir as perspectivas para futuros instrumentos.

Use of Formocresol by the Paediatric Dentists across Chennai - A Questionnaire Study

Formocresol is used as medicament for non-vital teeth and primary teeth. In the composition of formocresol, formaldehyde is a primary component which is the hazardous substance. Studies have proved that the use of low dose of formaldehyde in the composition of formocresol would not be carcinogenic. There is a controversy about formocresol in paediatric dentistry for more than 20 years. We wanted to assess the application of formocresol for deciduous teeth and permanent teeth pulpotomy and understand the awareness towards the diluted form of formocresol and its adverse effect among Chennai paediatric dentists. METHODSA questionnaire was given to 50 paedodontists from Chennai city. The questions were based on the usage of original strength or diluted form of Formocresol by the practitioners, the brand and formula that was applied and in case they use diluted form of formocresol, by what method they diluted it and formulation was achieved and the knowledge about the adverse effects. Data was analysed statistically to achieve the results. RESULTSMost of the dentist were aware of the fact that the formocresol has carcinogenic effect. Higher number of dental practitioner were using diluted form of formocresol. Many dentist weres using commercially available formocresol. 64 % of the dentists were using formocresol as intracanal medicament. 24 % of the dentists were using full concentration of formocresol and 54% were using dilute form of formocresol. CONCLUSIONSThis survey concluded that formocresol is a widely used medicament and it is used as commercially available diluted form by most of the practitioners.

Prevalence of Molar Incisor Hypomineralisation Among School Children aged 7-12 years in Tunis, Tunisia

Abstract Objective: To evaluate the prevalence and the characteristics of Molar Incisor Hypomineralisation (MIH) in 7-12-year-old children in Tunis, Tunisia. Material and Methods: This study was designed as a cross-sectional study, in which school children aged 7 to 12 years were included. A total of 510 children (257 girls and 253 boys) who had their first permanent molar and incisors were evaluated using the 2003 European Academy of Paediatric Dentistry (EAPD) recommendation criteria were examined. Descriptive data analysis and Pearson's chi-squared test were performed (p<0.05). Results: A total of 510 children were included in the study. MIH was present in 35.4 % of our study population. Boys exhibited slightly higher MIH (19,4%) and Post Eruptive Breakdown (PEB) (7,3%) prevalence compared to girls, but the difference was not statistically significant (p=0.07). Moreover, demarcated opacities were more prevalent than PEB. More precisely, the main prevalence without PEB was MIH with white/creamy demarcated opacities, which was more frequent than yellow/brown demarcated opacities (p<0.05). Conclusion: The prevalence of MIH in Tunis was 35.4%, with no difference between girls and boys. The main MIH type prevalence was white/creamy demarcated opacities without PEB.

Tratamiento conservador de un adolescente con amelogénesis imperfecta / Conservative treatment for an adolescent with amelogenesis imperfecta

RESUMEN: La amelogénesis imperfecta es un trastorno hereditario que afecta la formación del esmalte presentándose en dentición decidua y permanente. Existen numerosas clasificaciones, donde la amelogénesis imperfecta hipoplásica presenta las siguientes características clínicas: reducción del espesor del esmalte, coloración entre amarillo y marrón, superficie rugosa y falta de contacto interproximal. Estos pacientes reportan niveles más altos de evitación social y angustia por lo que es imperativo realizar un buen tratamiento rehabilitador. El presente artículo tiene como objetivo describir la secuencia terapéutica de un paciente adolescente diagnosticado con amelogénesis imperfecta hipoplásica utilizando la técnica modificada clear matrix con resinas compuestas.

ABSTRACT: Amelogenesis imperfecta is an inherited disorder affecting enamel formation in deciduous and permanent dentition. There are a large number of classifications, where hypoplastic amelogenesis imperfecta has the following clinical features: reduced enamel thickness, yellowish brown coloration, rough surface and lack of interproximal contact. These patients report the highest levels of social avoidance and distress, and it is therefore imperative to perform a good rehabilitative treatment. The objective of this paper is to describe the therapeutic sequence of an adolescent patient diagnosed with hypoplastic amelogenesis imperfecta, using the modified clear matrix technique with composite resins.

Ansiedade odontológica autorrelatada pelas crianças atendidas na Faculdade de Odontologia da Universidade Federal de Minas Gerais: fatores associados e correlação com o medo dos pais / Self-reported dental anxiety by children attended in the Dental School of the Universidade Federal de Minas Gerais: associated factors and correlation with parents' dental fear

Objetivo: Avaliar a correlação da ansiedade odontológica das crianças atendidas nas clínicas de Odontopediatria da Faculdade de Odontologia da Universidade Federal de Minhas Gerais (FAO-UFMG) com o medo odontológico de seus pais/responsáveis. Além disso, avaliar a associação entre a presença de ansiedade dessas crianças com tipo de tratamento necessário, o tempo em que faz tratamento na FAO-UFMG e com seu comportamento. Métodos: Foi realizado um estudo transversal com uma amostra de conveniência de 65 crianças de 4 a 11 anos de idade atendidas nas clínicas de Odontopediatria da FAO-UFMG e seus pais/responsáveis. Os Questionários Venham Picture Test Modificado e Dental Fear Survey foram utilizados para mensurar a ansiedade e medo autorrelatados frente o tratamento odontológico das crianças e dos responsáveis, respectivamente. Tipo de tratamento odontológico, tempo em tratamento nas clínicas (FAO-UFMG) e comportamento da criança (escala de Frankl) foram obtidos através da ficha clínica. Sexo e idade (criança) sexo, grau de parentesco e escolaridade (responsável) através de um questionário. Os dados foram analisados através da correlação de Spearman e teste Kruskal-Wallis. Resultados: Não houve correlação significativa entre a ansiedade das crianças e o medo dos pais/responsáveis (r = -0,029; p = 0,820). A ansiedade odontológica foi maior em crianças submetidas à exodontia (média = 3,17; DP = 2,639) do que naquelas submetidas à procedimentos restauradores/endodônticos (média = 0,96; DP = 2,021; p = 0,013) ou sem necessidade de tratamento (média = 0,30; DP = 0,483; p = 0,032). Crianças com 4-21 meses em tratamento apresentaram maior ansiedade comparada àquelas com mais de 21 meses em tratamento (p = 0,045). Não houve associação significativa entre ansiedade odontológica e comportamento da criança (p = 0,221). Conclusão: A ansiedade odontológica das crianças não foi associada ao medo de seus pais/responsáveis. Entretanto, a necessidade de procedimentos mais complexos e o tempo em que a criança estava sob tratamento na clínica foram associados à presença de ansiedade odontológica. (AU)

Aim: To evaluate the presence of dental anxiety in children who receive dental care in the Pediatric Dentistry Clinic of the School of Dentistry at Universidade Federal de Minas Gerais (FAO-UFMG) and their correlation with their parents'/guardians' dental fears. This study also seeks to evaluate the association between these children's dental anxiety with the type of necessary dental treatment, the time needed for treatment at FAO-UFMG, and their behavior. Methods: A cross-sectional convenience study was conducted with 65 children of 4 to 11 years of age who received dental care in the Pediatric Dentistry Clinic of the FAO-UFMG and their parents/guardians. The questionnaires "Modified Venham Picture Test" and "Dental Fear Survey" were used to measure the self-reported dental anxiety and fear concerning the dental treatment of the children and their parents, respectively. The type of dental treatment, length of treatment (FAO-UFMG), and the child's behavior (Frankl scale) were obtained from the clinical record. Gender and age (child), gender, kinship, and education level (responsible) were obtained through a questionnaire. The data were analyzed using Spearman correlation and Kruskal-Wallis tests. Results: There was no significant correlation between children's anxiety and the fear of parents/caregivers (r = -0.029; p = 0.820). Dental anxiety was higher in children undergoing extraction (mean = 3.17; SD = 2.639) than in children undergoing restorative/endodontic procedures (mean = 0.96; SD = 2.021; p = 0.013) or without treatment (mean = 0.30; SD = 0.483; p = 0.032). Children who had been undergoing treatment for 4-21 months presented higher anxiety when compared to children who had been undergoing treatment for more than 21 months (p = 0.045). No significant association was observed between dental anxiety and the child's behavior (p = 0.221). Conclusion: Children's dental anxiety was not associated with their parents'/guardians' dental fear. However, the need for more complex procedures and the time the child had been undergoing treatment at the clinic were associated with the presence of dental anxiety. (AU)

Enfermedad periodontal en niños y adolescentes. A propósito de un caso clínico / Periodontal disease in children and adolescents. Case report

RESUMEN: Dentro de las enfermedades gingivales en niños y adolescentes el cuadro clínico más prevalente es la gingivitis asociada a la placa bacteriana; más aún, es la afección más prevalente dentro de todas las enfermedades periodontales. El progreso de la gingivitis a la periodontitis implica la interrelación de una serie de factores de riesgo y factores contribuyentes que progresarán en la pérdida de la inserción periodontal. El presente artículo tiene como objetivo resumir las principales características de la enfermedad periodontal en niños, así como mostrar la secuencia clínica del diagnóstico y tratamiento de un paciente niño con enfermedad periodontal localizada a quien se realizó el tratamiento periodontal básico para revertir los efectos causados en el periodonto de inserción y de soporte. Resultados: El seguimiento del caso clínico mostró una reducción del índice de sangrado, índice de placa bacteriana e índice de higiene oral. Conclusión: Se concluye que la evaluación periodontal de pacientes pediátricos y adolescentes debe ser parte rutinaria del examen odontológico, y que un tratamiento conservador permite revertir los efectos de la enfermedad periodontal en este tipo de pacientes.

ABSTRACT: Gingivitis is the most prevalent clinical condition in the gum diseases presented in children and adolescents, as well as being the most prevalent of all periodontal diseases. The progression of gingivitis to periodontitis involves the interplay of a number of risk and contributing factors that will progress into loss of periodontal attachment. This article aims to summarise the main characteristics of periodontal disease in children and to present the clinical diagnosis and treatment of a patient with localised periodontal disease on whom the basic periodontal treatment was performed to reverse the effects caused by the loss of periodontal attachment. Results: The monitoring of the case showed a reduction in bleeding index, plaque index, and oral hygiene index. Conclusion: It is concluded that periodontal evaluation of children and adolescents should be part of the routine dental examination as a conservative treatment can reverse the effects of periodontal disease in these patients.

Clinical efficacy of a two-year oral health programme for infants and toddlers in Singapore

INTRODUCTION@#Dental caries, which is prevalent in Singapore preschoolers, is a disease that has a major impact on children's health and places a high cost on the society and health services. Oral health programmes for young children implemented in some parts of the world have been shown to be effective in the prevention of dental caries. We aimed to examine the clinical efficacy of a two-year oral health programme for infants and toddlers in Singapore.@*METHODS@#90 children and their caregivers participated in the programme, and 64 children, who were 24 months older than the intervention group at the initial visit, were recruited as controls in a quasi-experimental study design. We evaluated the presence of severe early childhood caries (SECC) and dmfs in the control group at the initial visit and in the intervention group after the completion of the two-year programme.@*RESULTS@#Some children in the intervention (7.8%) and control (31.3%) groups (p < 0.001) had SECC (difference 23.5%, 95% confidence interval 11%-36%). A higher percentage of children in the intervention group had dmfs = 0 and habits associated with low risk for caries. The odds of SECC in the control group were three times higher than that for the intervention group, and the effect was significant (p = 0.037) after adjustment for other significant risk factors.@*CONCLUSION@#The preventive oral health programme in Singapore was successful in reducing SECC among infants and toddlers when targeted behaviour modifications were implemented.

Técnicas de manejo comportamental não farmacológicas na odontopediatria / Behavioral management techniques non-pharmacological in pediatric dentistry

É habitual, na vivência odontológica, deparar-se com variados tipos de comportamentos indesejados, gerados principalmente pelo medo, ansiedade, birra ou dor, interferindo no atendimento odontológico. Nesses casos, o odontopediatra poderá utilizar técnicas de manejo comportamental não farmacológicas, auxiliando, assim, no tratamento do paciente infantil. Entretanto, para que tais técnicas sejam mais efetivas, é necessário conhecer suas possíveis restrições quanto à faixa etária e perfil de cada criança, de modo a promover e estabelecer segurança e qualidade ao atendimento. Este trabalho tem como objetivo revisar e discutir por meio de literaturas as técnicas de controle comportamental em odontopediatria

It is customary in the dental experience to face different kinds of unwanted behaviors, and these are generated mostly by fear, anxiety, tantrums or pain, thus interfering with dental care. In these cases, the dentist can use behavioral management techniques non-pharmacological, thereby assisting in the treatment of child patient. However in order to such techniques be more effective, it is necessary to know their potential restrictions on the age and profile of each child in order to promote and establish safety and quality service. This work aims to review and discuss through the literatures the behavioral control techniques in pediatric dentistry