Pattern of management of oro-facial infection in children: A retrospective.

BACKGROUND: The purpose of this study was to determine the distribution and management of orofacial infection in children treated at one of the major hospitals in Jeddah City, Saudi Arabia over a 12-month period during the year 2014. METHODS: Data from the clinical records of 94 children (33 girls, 61 boys; aged 2-14 years) who presented for treatment of orofacial infection at the emergency dental department of the military hospital in Jeddah during a 12-month period. Patients were treated with antibiotic therapy. A favorable outcome was determined based on length of hospital stay. RESULTS: The results indicated that the most common cause of odontogenic infection in Saudi children was dental caries (88%). The primary posterior teeth (84%) were considered to be a major source of infection. The most commonly affected teeth were the primary first molars (34%), followed by the primary second molars (31%). Six children were hospitalized; four of these stayed less than 4 days, which was considered a short hospital stay. The most common treatment was antibiotics as 93% received a type of antibiotic. CONCLUSIONS: The most common cause of odontogenic infection was dental caries which has been treated with antibiotic prescription and dental procedures.

Intranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double-blinded randomized controlled trial.

BACKGROUND: This prospective, randomized, double-blind study was designed to evaluate the use of intranasally administered dexmedetomidine vs intranasal midazolam as a premedication in children undergoing complete dental rehabilitation. METHODS: Seventy-two children of American Society of Anesthesiology classification (ASA) physical status (I & II), aged 3-6 years, were randomly assigned to one of two equal groups. Group M received intranasal midazolam (0.2 mg·kg(-1)), and group D received intranasal dexmedetomidine (1 µg·kg(-1)). The patients' sedation status, mask acceptance, and hemodynamic parameters were recorded by an observer until anesthesia induction. Recovery conditions, postoperative pain, and postoperative agitation were also recorded. RESULTS: The median onset of sedation was significantly shorter in group M 15 (10-25) min than in group D 25 (20-40) min (P = 0.001). Compared with the children in group M, those in group D were significantly more sedated when they were separated from their parents (77.8% vs 44.4%, respectively) (P = 0.002). Satisfactory compliance with mask application was 58.3% in group M vs 80.6% in group D (P = 0.035). The incidences of postoperative agitation and shivering were significantly lower in Group D compared with group M. Thirteen children (36.1%) in group M, showed signs of nasal irritation with teary eyes, and none of these signs was seen in the children in group D (P = 0.000). There were no incidences of bradycardia, hypotension, in either of the groups during study observation. CONCLUSION: Intranasal dexmedetomidine (1 µg·kg(-1)) is an effective and safe alternative for premedication in children; it resulted in superior sedation in comparison to 0.2 mg·kg(-1) intranasal midazolam. However, it has relatively prolonged onset of action.

Bond strength of 4 sealants using conventional etch and a self-etching primer.

PURPOSE: The purpose of this study was to determine and compare the shear bond strength of 4 fissure sealant systems (Dyract Seal, Concise, Visio-Seal, Helioseal) to enamel using conventional etch and self-etching primer (Prompt-L-Pop). METHODS: Fifty-six newly extracted noncarious first permanent molars were used and embedded in a Teflon mold (3-mm height, 3-mm internal diameter). Mesial surfaces were exposed to a flattened area of enamel and then dried and washed. The teeth were divided into 8 groups, each consisting of 7 specimens stored in 37 degrees C distilled water for 24 hours. Then specimens were tested in a shear mode (Instron) at a crosshead speed of 0.5 mm/minute. The mean and standard deviations were subjected to an analysis of variance. RESULTS: The average bond strengths using Prompt-L-Pop were: (1) Dyract Seal=20.61 MPa; (2) Concise=23.42 MPa; (3) Visio-Seal=2.94 MPa; and (4) Helioseal=11.83 MPa. These values were higher than and statistically different from those of Dyract Seal (10.18 MPa) and Concise (9.17 MPa) when the conventional etch system was used (student t test, P<.001). CONCLUSION: The bond strengths of Prompt-L-Pop, in conjunction with Dyract Seal and Concise fissure sealant materials, exceeded those of conventional etch.

Evaluation of shear bond strength and SEM observation of all-in-one self-etching primer used for bonding of fissure sealants.

OBJECTIVES: To evaluate and compare enamel shear bond strength of an all-in-one self-etching primer (Prompt L-Pop) to regular acid etch material when bonded to two-fissure sealant systems (Concise and Dyract Seal). METHOD AND MATERIALS: Forty newly extracted non-carious first permanent molars were embedded in a Teflon mold. The teeth were divided into four groups and each consisted of ten specimens. The bonding surfaces were treated with either Prompt L-Pop as recommended by the manufacturer or etched with phosphoric acid. After 24 hours of water storage, the specimens were evaluated for shear bond strength using an Instron testing machine. Scanning electron microscope (SEM) examinations were carried out to evaluate the failure sites of the sealants. RESULTS: The mean shear bond strengths using Prompt L-Pop were Concise: 23.46 MPa and Dyract Seal: 20.34 MPa. These values were higher than and statistically different from those of Dyract Seal (9.99 MPa) and Concise (8.85 MPa) when phosphoric acid was used. The failure was predominantly of the adhesive type. The SEM examination showed the failure of debonding was predominantly related to the type of etching systems used rather than the type of fissure sealants. CONCLUSION: The use of the all-in-one self-etching adhesive Prompt L-Pop improves the mean enamel shear bond strength of fissure sealants.

Comprehensive dental care of pediatric patients treated under general anesthesia in a hospital setting in Saudi Arabia.

The aims of this study were to determine the characteristics of patients and type of dental treatment carried out using dental general anesthesia (DGA) during two years in a following three year period. A total of 182 patients received treatment between 1999 and 2001. The mean age was 4.9 years. The main indication for DGA was behavior management problems. Complete oral rehabilitation including complex restorative treatment and extractions was provided under DGA at a single visit. Failure to return for recalls was common; 83% of patients returned for the post-operative recall but only 26% after a three year period. Most of the patients requiring further treatment accepted it in the dental chair. Only one patient received a second DGA during the three years following treatment.

Feeding habits of children with Down's syndrome living in Riyadh, Saudi Arabia.

The aim of the study was to investigate the breastfeeding and introduction of solid foods among children with Down's syndrome. Mothers of 225 children attending three institutes providing education for children with Down's syndrome were asked to complete a questionnaire. Data were collected on knowledge of feeding procedure, pattern of feeding, and introduction of solid food. Although 66.7% of mothers commenced breastfeeding, 30% of them discontinued breastfeeding at 3-6 months of the child's age. Overall, mothers of children with Down's syndrome started weaning between 6 and 9 months of age and the formula most used was Similac 'yellow'. In conclusion it was observed that Saudi mothers with Down's syndrome children frequently breastfed their children and introduced solid food comparatively late.

The views and attitudes of parents of children with a sensory impairment towards orthodontic care.

A questionnaire was sent to the parents of 77 visually impaired (VI), 210 hearing impaired (HI) and 494 control children seeking their views on their child's dental appearance, orthodontic treatment need and issues that might influence the child undertaking treatment. The parents' views were compared with a dentist's assessment of treatment need using the Index of Orthodontic Treatment Need (IOTN). There was disagreement between the dentist's assessment and the parents' perceptions in all groups. However, the least disagreement was seen in the HI group. There was a statistically significant (P < 0.05) association between control and HI parents' views of their children's treatment needs and their opinion on their dental appearance. Most parents thought that orthodontic treatment was difficult to obtain and expensive and that their child would find difficulty coping with the treatment. Furthermore, parents of VI children considered that treatment was unlikely to be undertaken due to their child's reduced concern for their appearance. The study indicates that the awareness of treatment need for VI and HI children differs between their parents and dentists.

Occupational exposures and hepatitis B vaccination statues in dental students in Central Saudi Arabia.

OBJECTIVE: To assess the nature of occupational exposures occurring to students and to assess the rate of reporting of incidents. METHODS: A self-administrated questionnaire was circulated to third, fourth and final year undergraduate dental students in Dental College of King Saud University, Riyadh, Kingdom of Saudi Arabia from April 2004 to May 2004. The questionnaire was consisted of 4 domains: personal details, hepatitis B vaccination, occupational exposures and reporting of the exposure incident. RESULTS: Significantly more incidents occurred among final year students than third year students. Through the students there was no correlation between ages, gender, and dominate hand; however, more exposures occurred in female students. A significant decrease in exposures (p<0.05) occurred when an assistant was employed. Some students with one or more exposures during their training were percutaneous injuries predominated. Seventy-seven (28.9%) students stated that they have not been vaccinated against hepatitis B virus and that was notice among male students. CONCLUSION: Dental teaching colleges are faced with the unique challenge of protecting the student and populations against blood-borne infections. Efforts must go beyond teaching of universal precaution, which should include safer products and clinical procedures that can reduce the risks associated with occupational exposures.