Infant oral mutilation (IOM) related to traditional practices among inner city pre-school children in Sudan.

BACKGROUND: The term Infant Oral Mutilation (IOM) refers to the aggressive cultural rituals where primary canine tooth germs of infants are enucleated for therapeutic reasons. OBJECTIVES: To determine the prevalence and risk factors for IOM among inner city pre-school children in Khartoum. METHODS: In this cross-sectional study, 212 randomly selected children from twelve government pre-schools in Khartoum were examined for the presence of IOM. Socio-demographic, feeding and teething-related data were collected by self-administered questionnaires. RESULTS: The mean age of the sample was 4.7 years. The prevalence of clinical IOM was 10.8%. Multivariable regression analysis revealed that children who suffered from diarrhea during teething were 7.15 times more likely to have clinical IOM over their counterparts (p<0.0001). Mothers who were educated below elementary school level were 2.69 times more likely to have children showing clinical IOM (p= 0.0369). CONCLUSION: The present study showed that the practice of IOM is common among inner city children. Certain teething-related symptoms especially diarrhea and maternal education could be strong determinants of the malpractice of IOM.

Traumatic injuries of permanent teeth among 6- to 12-year-old Iraqi children: a 4-year retrospective study.

PURPOSE: The purpose of this retrospective study was to identify the types, causes, and other factors associated with traumatic dental injuries (TDIs) in the permanent teeth of children in Mosul, Iraq. METHODS: Data were collected from the dental records of 6- to 12-year-old children with TDIs who attended the Pediatric Dental Clinic at the Mosul University School of Dentistry between October 2006 and October 2010. The gathered data included: demographic information, when and where the injury occurred, type of dental injury, cause of injury, and the time elapsed between the TDI and dental care. Data were evaluated using the chi-square test. RESULTS: A total of 294 children with TDIs were examined and treated. The highest frequency of TDIs was among 12-year-old children (29%), with more males being affected (P<.001). The most common type of injury was enamel-dentin fracture (56%). The most frequent cause of TDIs was falls (53%). The majority of the injuries happened outdoors (55%), and 37% of the cases occurred in the Fall. Only 5% of patients sought dental care within 24 hours of the injury. CONCLUSION: This 4-year retrospective study showed that the majority of children with TDIs sought dental treatment after one month of the injury. Educating parents and teachers about the benefits of trauma prevention and immediate treatment of injuries is a must.

Total IgA and IgA reactivity to antigen I/II epitopes in HLA-DRB1*04 positive subjects.

Bacterial adherence to the acquired dental pellicle, important in dental caries (caries), is mediated by receptor-adhesins such as salivary agglutinin binding to Streptococcus mutans antigen I/II (I/II). Ten selected I/II epitopes were chosen to determine their reactivity to human salivary IgA. Previous studies suggested that a specific HLA biomarker group (HLA-DRB1*04) may have differential influence of immune responses to I/II. However, it was not known whether secretory IgA (SIgA) responses to the selected epitopes from HLA-DRB1*04 positive subjects were different compared to controls, or across other caries-related factors such as total IgA (TIgA). Thirty-two total subjects were matched according to HLA type, gender, ethnicity and age. HLA genotyping, oral bacterial, immunoglobulin and antibody analyses were performed. A large observed difference emerged with regard to the natural immune reservoir of TIgA in HLA-DRB1*04 positive subjects, specifically, a 27.6% reduction compared to controls. In contrast to all other epitopes studied, HLA-DRB1*04 positive subjects also exhibited reduced reactivity to I/II epitope 834-853. HLA-DRB1*04 positive subjects exhibited lower specific SIgA activity/TIgA to 834-853 and also a lower specific reactivity to 834-853/whole cell S. mutans UA159. Furthermore, HLA-DRB1*04 positive subjects exhibited lower responses to I/II in its entirety. The large observed difference in TIgA and the 834-853 reactivity pattern across multiple measures suggest potentially important connections pertaining to the link between HLA-DRB1*04 and caries.

Contamination of handpieces during pulpotomy therapy on primary teeth.

PURPOSE: The purpose of this in vivo study was to determine the potential for internal bacteriol contamination of low-speed handpiece/ contraangle systems. METHODS: Clinical contamination was measured for 24 pulpotomies on primary first or second molar teeth from 20 subjects. The investigators used microbiologic analysis to determine the extent of bacterial contamination from the patient's saliva using enriched trypticase soy agar (ETSA) plates. Analysis for the presence of blood also occurred. RESULTS: Microbial analysis indicated aerobic and anaerobic bacterial contamination at all 3 culturing sites from all 24 handpieces (100% contamination, 95% confidence intervals [CI] = 86%-100%). Aerobic and anaerobic bacteria levels (CFU/mL) were not significantly different (P = .43 overall, P > .25 for each of the 3 evaluated sites). The sites also did not have significantly different CFU/mL levels (P = .13 overall, P = .63 for aerobic, P = .14 for anaerobic). The analysis showed no blood contamination at any of the 3 culturing sites for any of the 24 handpieces (0% contamination, 95% CI = 0%-14%). CONCLUSIONS: The in vivo data suggest that low-speed handpiece/contraangle systems can become bacterially contaminated during the performance of pulpotomies and, unless properly sterilized between patients, there is the potential for pathogenic micro-organisms to enter, adhere, and then emit during use on subsequent patients.

Internal contamination of air-driven low-speed handpieces and attached prophy angles.

BACKGROUND: In an in vitro crossover study, the authors investigated whether the interior of low-speed handpiece/prophy-angle systems becomes contaminated during operation and submersion into Geobacillus stearothermophilus. METHODS: This study involved two types of handpieces attached to eight brands of prophy angles. The researchers operated angles attached to sterile handpieces for 60 seconds. They then analyzed the inside surfaces of the angle, nosecone and motor. They tested each prophy angle and handpiece 10 times. RESULTS: In the 160 tests of handpieces contaminated at the prophy cup end, the spores traveled into the motor gears 32 times (20 percent). In the other 160 tests in which the motor gears were contaminated, the test bacterium traveled through the prophy cup in 75 instances (47 percent). CONCLUSIONS: The in vitro data suggest that low-speed handpiece motors can become contaminated internally during use with prophy angles. Also, internal contaminants appear to have been released from the handpiece. CLINICAL IMPLICATIONS: The results suggest that low-speed hand-pieces can become contaminated internally during use. Unless low-speed handpieces are sterilized properly between patients, they may become cross-contaminated.