Maxillofacial infections in lithuanian hospitalised children and adolescents: a 17-years retrospective study.

PURPOSE: To analyse the epidemiology, treatment, and microbiological findings of hospitalised Lithuanian children and adolescents admitted due to maxillofacial infections over a 17-years period. METHODS: 428 medical records of paediatric (under the age of 18) patients hospitalised at Vilnius University Hospital from 2003 to 2019 due to a maxillofacial infection were reviewed. The data concerning patient sociodemographic characteristics, aspects related to a hospital stay, treatment modalities, microbiological findings, and sensitivity to antibiotics, were collected and analysed. RESULTS: The most prevalent condition was odontogenic maxillofacial space infection (28.7%), followed by lymphadenitis (21.7%). The mean (sd) age was 10.86 (4.8) years and the male-to-female ratio was 1.37:1. The majority of patients (83.4%) underwent surgical treatment. The mean (sd) hospital stay was 5.49 (2.9) days. The longest hospital stay was observed in the case of odontogenic maxillofacial space infections. A longer period of hospitalisation was generally associated with the presence of anaerobes and their resistance to antibiotics as well as multiple space involvement in deep neck space infections and a permanent causative tooth in odontogenic cases. The most commonly isolated microbiological species was Staphylococcus aureus spp. CONCLUSION: The most common origin of maxillofacial infection was odontogenic among investigated Lithuanian children and adolescents. In the majority of cases, a penicillin group antibiotic was prescribed. Streptococci were the predominant bacteria in the cases of odontogenic infection, while Staphylococci were the most prevalent among non-odontogenic cases. Nearly 40.0% of isolated microorganisms were resistant to penicillin. High resistance to metronidazole was identified among anaerobic bacteria.

A cluster randomized theory-guided oral hygiene trial in adolescents-A latent growth model.

OBJECTIVES: (i) To test whether theory-guided interventions are more effective than conventional dental instruction (CDI) for changing oral hygiene in adolescents and (ii) to examine whether such interventions equally benefit both genders and different socio-economic (SES) groups. METHODS: A total of 244 adolescents were recruited from three schools, and cluster randomization allocated adolescents to one of the three types of interventions: two were theory-based interventions (Precaution Adoption Process Model or Authoritative Parenting Model) and CDI served as an active control. Oral hygiene levels % (OH) were assessed at baseline, after 3 months and after 12 months. RESULTS: A complete data set was available for 166 adolescents (the total follow-up rate: 69%). There were no significant differences in baseline OH between those who participated throughout the study and those who dropped out. Bivariate and multivariate analyses showed that theory-guided interventions produced significant improvements in oral hygiene and that there were no significant gender or socio-economic differences. CONCLUSIONS: Theory-guided interventions produced more positive changes in OH than CDI, and these changes did not differ between gender and SES groups.

Dental health and disease in patients with haemophilia--a case-control study.

Management of patients with hereditary bleeding disorders in dentistry causes considerable problems. This study examined different aspects of dental health or disease of Lithuanian children and adults with haemophilia and compared them with the general population. Two study groups of cases and controls were formed. Cases were recruited through census sampling and controls were randomly chosen from the general population matched for gender, age and place of residence. Dental health of permanent and deciduous dentitions was assessed by one examiner employing the WHO Criteria for Oral Health Surveys. The following aspects of dental health/disease were considered: overall caries experience, treatment experience, unmet dental treatment needs and the presence of functional dentition. Data were collected from 76 patients with haemophilia among which 27 were children and 49 were adults and a control group of 76 subjects comprising 30 children and 46 adults. Children with haemophilia had a significantly lower overall caries experience and less unmet dental treatment needs in deciduous teeth as compared to healthy children. In permanent dentitions, overall caries experience, unmet dental treatment needs or treatment experience did not differ between cases and controls either in older children or adult cohorts. There were no differences between the study groups regarding the functional dentition-related indices. Healthier deciduous teeth were observed in children with haemophilia than in children without haemophilia, but other dental health or disease-related outcomes did not differ between cases and controls.

Oral hygiene education in adolescence based on the Precaution Adoption Process Model.

OBJECTIVE: The present study hypothesised that interventions based on the Precaution Adoption Process Model (PAPM) are more effective than the conventional approach in modifying oral hygiene behaviour in adolescents. METHOD: A stratified random sampling method was used with subject groups (classrooms) randomly allocated to a control or to one of intervention groups (conventional instruction or PAPM). Short-term and long-term results were assessed after 3 and 12 months. The study sample comprised 254 12-13 year olds whose plaque levels were assessed by two outcome measures, namely the Quantitative Plaque Percent Index and its derivative the Ratio of Plaque % Change. RESULTS: Subject retention rate was 69%. The most substantial decrease in plaque scores was in the PAPM group (12% after 3 months, 18% after 12 months), while the smallest reduction was in the control group (4% after 3 months and 12% after 12 months). There was a trend of reduction in plaque levels (p < 0.001) in all study groups from baseline to the 12 month follow-up. CONCLUSIONS: The intervention based on the Precaution Adoption Process Model was only slightly more effective in changing adolescent oral hygiene behaviour as compared to the conventional approach. The positive change in the control group was unexpected and needs further exploration.

Balancing the role of the dental school in teaching, research and patient care; including care for underserved areas.

Inequalities within dentistry are common and are reflected in wide differences in the levels of oral health and the standard of care available both within and between countries and communities. Furthermore there are patients, particularly those with special treatment needs, who do not have the same access to dental services as the general public. The dental school should aim to recruit students from varied backgrounds into all areas covered by the oral healthcare team and to train students to treat the full spectrum of patients including those with special needs. It is essential, however, that the dental student achieves a high standard of clinical competence and this cannot be gained by treating only those patients with low expectations for care. Balancing these aspects of clinical education is difficult. Research is an important stimulus to better teaching and better clinical care. It is recognized that dental school staff should be active in research, teaching, clinical work and frequently administration. Maintaining a balance between the commitments to clinical care, teaching and research while also taking account of underserved areas in each of these categories is a difficult challenge but one that has to be met to a high degree in a successful, modern dental school.