Adolescents' Awareness of E-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and E-Cigarette Use Impact on Health.

PURPOSE: The purposes of this study were to: (1) examine adolescents' knowledge regarding e-cigarettes and e-cigarette or vaping product use-associated lung injury (EVALI), and (2) describe common misconceptions regarding e-cigarette use. METHODS: Adolescents aged 13 to 19 years were recruited in pediatric dental clinics and completed a survey questionnaire regarding their knowledge of e-cigarettes. RESULTS: A total of 66 adolescents participated. Forty-seven adolescents indicated knowledge of e-cigarettes. Forty adolescents recognized that most e-cigarettes contain nicotine, and 49 adolescents reported knowledge of EVALI cases. Adolescents had knowledge of possible lung damage from e-cigarette use. Adolescents also had misconceptions about e-cigarettes containing nicotine and them being less addictive than other tobacco products. CONCLUSIONS: Adolescents were aware of e-cigarette or vaping product use-associated lung injury cases, and the majority of them viewed e-cigarette use as harmful to their health. However, some adolescents had misconceptions regarding the safety of e-cigarette use. Oral health providers should recognize that they play an important role in identifying risky behaviors amongst adolescents, incorporate adolescent-specific risk assessments into their clinical practice, and be comfortable providing anticipatory guidance about e-cigarette and nicotine use.

Effect of Caregiver's Race and Ethnicity on Acceptance of Passive Immobilization for Their Child's Dental Treatment.

Purpose: To determine if caregivers' race and ethnicity impact their willingness to accept passive immobilization for their child's dental treatment and to determine if a detailed description of passive immobilization will make caregivers more likely to accept the technique.
Methods: Caregivers of one- to 11-year-old patients were recruited in a university pediatric dental clinic. They completed two surveys and reviewed a written and pictorial description of passive immobilization.
Results: A total of 266 caregivers participated. Subjects were willing to accept passive immobilization at the following percentages by race/ethnicity: Hispanic (84 percent); African American (66 percent); Asian (50 percent); and non-Hispanic Caucasian (24 percent). There was a significant association between a caregiver's race and ethnicity and the willingness to consent to passive immobilization (P =.000), and in willingness to accept passive immobilization after reviewing its detailed description (P =.000).
Conclusion: Differences in acceptance of passive immobilization were observed based upon race and ethnicity. African American and Hispanic caregivers were more willing to accept the technique than their Asian and non-Hispanic Caucasian counter- parts. Caregivers were more likely to accept the use of passive immobilization after they were given more information about the technique. (J Dent Child 2019;86(1):3-9) Received May 30, 2018; Last Revision August 3, 2018; Accepted August 7, 2018.

Acceptance and Use of Protective Stabilization Devices by Pediatric Dentistry Diplomates in the United States.

PURPOSE: To assess acceptance and use of protective stabilization devices (PSD) by Pediatric Dentistry Diplomates. METHODS: Surveys were electronically mailed in 2013 to 2922 members of the American Board of Pediatric Dentistry's (ABPD) College of Diplomates. Bivariate (assessing provider personal and practice characteristics) and multivariate analyses were performed on reported acceptance and use of PSD. RESULTS: Response rate was 28 percent. Providers more likely to report acceptance and use of PSD were those in practices with lower SES patient base, where there was the perception that patients' parents were more accepting of PSD, and those with low patient volume. Provider who were more likely to report acceptance and use of PSD were female, not working solely in private practice, and from Southeast or North Central regions of the U.S. Neither PSD use during residency nor ABPD Board cohort (<2009 versus 2009-2013) was associated with current acceptance or PSD use. Upon multivariate assessments of practice and personal characteristics, only perception of parent acceptance was associated with provider acceptance whereas perception of parental acceptance, practitioner sex and practice setting were associated with provider use of PSD. CONCLUSIONS: Practitioner sex, practice setting, region, and perception of parental acceptance are all important factors related to PSD acceptance and use.

Oral Health-related quality of life in pediatric patients with cystic fibrosis.

PURPOSE: To compare the oral health-related quality of life (OHRQoL) of 8- to 12-year-old children and 13- to 17-year-old adolescents diagnosed with cystic fibrosis (CF). MATERIALS AND METHODS: Participants were recruited from a Midwest CF center. Parents provided demographic information and their assessment of the child's health. Patients completed the Child Oral Health Impact Profile (COHIP). RESULTS: Thirty-nine child-parent pairs participated. Fifty four percent of the patients were male, 87% Caucasian, and 56% adolescent, with 66% of families reporting an annual income of over $100,000. Excellent or very good health, including oral health, was reported by 67% of the patients. Individuals taking 10 or more medications reported better OHRQoL while Caucasians reported better oral health and total scores than other races. Adolescents had poorer total COHIP, social-emotional well-being, and self-image scores. CONCLUSION: Although most patients reported good or excellent oral health, adolescents reported a poorer OHRQoL than younger patients.

Occlusal Characteristics of Individuals with Growth Hormone Deficiency, Idiopathic Short Stature, and Russell-Silver Syndrome.

PURPOSE: The purpose of this study was to assess the occlusal characteristics of individuals with growth hormone deficiency (GHD), idiopathic short stature (ISS), and Russell-Silver syndrome (RSS), and compare them to the means of a normal population. METHODS: Data about the stage of dentition, diastema, maxillary transverse deficiency, overjet, overbite, molar classification, and maxillary and mandibular crowding were obtained from orthodontic screening notes and standardized clinical exams of children with growth disorders seen at screening events. The prevalence of these occlusal characteristics was calculated and compared to the pooled mean of a normal population as determined by the National Health and Nutrition Examination Survey studies. RESULTS: Twenty RSS subjects and 16 subjects with GHD or ISS were studied. The RSS cohort presented statistically significant greater mean overbite as well as mandibular and maxillary crowding compared to the general population. Descriptive statistics were performed for the GHD and ISS group. CONCLUSION: Occlusal abnormalities are prevalent in children with growth disorders.

Are state child care regulations meeting national oral health and nutritional standards?

PURPOSE: The purpose of this study was to review of US state child care center regulations on oral health and nutrition as related to early childhood caries (ECC). METHODS: Child care center regulations for the 50 states and the District of Columbia, as of April 2010, were audited for their inclusion of 8 oral health and 11 nutrition topics related to the development of or care for ECC. The topics are based on selected recommended standards from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Out-of-Home Child Care Programs. RESULTS: On average, states had 2.6 (±1.7 SD; range=0-6) of the oral health standards and 5.9 (±2.5; range=1-11) of the nutritional standards included in their regulations. States varied greatly on the content covered. Seven states did not include any of the reviewed oral health topics. The 2 least covered regulations for oral health were "toothbrush maintenance" (4 states) and "oral health screening" (5 states). CONCLUSIONS: The weakness of coverage in child care center regulations for early childhood caries prevention calls to strengthen these policies for their potential to improve the oral health and obesity status of US children.

An association of premature loss of primary maxillary incisors with speech production of bilingual children.

PURPOSE: Early childhood caries is prevalent in the United States, especially among Hispanic children. One consequence may be premature loss of primary teeth, raising concern about developmental challenges. This study examined speech sound articulation errors association with premature loss of the primary maxillary incisors of bilingual children (Spanish/English). METHODS: Hispanic children were assessed with a speech sound articulation test at 7 to 10 years of age against their history of primary maxillary anterior incisor loss. The exposed group (N =25) experienced premature extraction of these incisors, and the unexposed group (N =8) had normal dental exfoliation. RESULTS: The groups were similar regarding: age at speech assessment; gender; language spoken at home; socioeconomic status; caries prevalence; mean number of decayed, missing, filled and sealed teeth. Higher values for the dental articulation errors (P=.04) were revealed among exposed vs unexposed. Exposed boys had more total speech articulation errors (P=.03), dental-related errors (P=.048), and other errors (P=.04) than the unexposed boys, although of small sample size. DISCUSSION: Bilingual children who experienced early primary tooth loss exhibited differences in speech sound production vs those who did not. Further research is warranted to determine the extent early tooth loss in bilingual children predicts speech problems.

Oral intubation in premature infants with and without stabilizing devices.

PURPOSE: This study evaluated the effects of palatal stabilizing devices (PSDs) on accidental extubations (AEs) and other intubation complications in infants with breathing tubes at a neonatal intensive care unit (NICU) of a university hospital. PSDs are individually crafted acrylic oral devices for stabilizing breathing tubes in neonates. METHODS: Charts of all first admission NICU neonates weighing less than 1,500 g were reviewed (N =733); 548 were intubated and had information available on birth weight, gender, transfer status, gestational age, length of admission, ventilator type, sedation, dates of intubations and extubations, number of accidental extubations, dates of PSD placement, and complications. RESULTS: 153 subjects received PSDs, with 19 AEs; 395 received no PSDs, with 31 AEs. Non-PSD neonates were intubated for a median of 3 and PSD neonates for 26 days. PSDs were associated with sedation, male gender, longer admissions, longer intubation periods, being on a high-frequency ventilator, and low birth weight (P<.05). 0.4 accidental extubations over 100 intubated patient days were recorded for the PSD vs 0.79 for the non-PSD group. CONCLUSIONS: Palatal stabilizing devices were not related to other complications of breathing tubes. The PSD group had fewer accidental extubations per days of intubation vs the non-PSD group.

Survey of oral health knowledge and behavior of pregnant minority adolescents.

PURPOSE: This study's purpose was to compare dental visits and oral health knowledge of African American (AA) and Hispanic American (HA) pregnant adolescents in a community health clinic. METHODS: Demographics, oral health knowledge, oral hygiene, and dental visits during pregnoncy were surveyed by anonymous questionnaire to adolescents who were pregnant at the time of the study or within the last year. RESULTS: Responses from 50 AA and 61 HA adolescents between 12 and 20 years old were analyzed. Fourteen percent of AAs and 26 percent of HAs saw a dentist during pregnancy, while 26 percent of AAs and 16 percent of HAs reported regular 6-month visits when not pregnant. Fifty-two percent of AAs and 43 percent of HAs knew that oral health problems could affect the pregnancy or growth of the baby. Thirty-four percent of AAs and 56 percent of HAs knew that pregnancy was related to gum problems (P = .02). Logistic regression revealed the predictors of a dental visit during pregnancy, including living with a boyfriend/husband (P = .02, odds ratio = 4.4, confidence interval = 13-153) and dental visits when not pregnant (P < .001, OR = 13.6, CI = 3.7-50.5). CONCLUSIONS: Minority pregnant adolescents had only limited dental visits whether or not they were pregnant and possessed limited knowledge of oral health and pregnancy outcomes.

Pediatric oral health knowledge of African American and Hispanic of Mexican origin expectant mothers.

PURPOSE: This study assessed the impact of a lecture on children's oral health knowledge of pregnant women from vulnerable African American (AA) and Hispanic of Mexican origin (HM) populations utilizing the same urban community health center prenatal education program. METHODS: Participants heard one 45-minute lecture in English or Spanish on children's oral health, and completed a survey (English or Spanish) before and after the lecture. RESULTS: Seven sessions provided 60 participants: (a) 30 AA; and (b) 30 HM. These two groups differed on: (1) educational attainment; (2) preferred language; (3) country of origin; and (4) baseline scores. They were similar in: (1) age; (2) frequency of first mothers; and (3) final scores. Oral health knowledge significantly rose from baseline to the end of the lecture (ANOVA, P < .001). Educational attainment was associated with HM baseline scores (P = .04), whereas age was associated with AA final scores (P = .01). CONCLUSIONS: An oral health lecture within a prenatal program improved oral health knowledge for African American and Hispanic of Mexican origin pregnant women, though associated factors varied between the two groups. Further study is needed to explore long-term knowledge retention and effect on the future babies' oral health.

Assessing the American Board of Orthodontics objective grading system: digital vs plaster dental casts.

INTRODUCTION: The purposes of this study were to determine whether the American Board of Orthodontics objective grading system (ABO OGS) can be assessed accurately from digital dental casts and whether there are statistical differences between digital and plaster dental casts in scoring the ABO OGS. METHODS: Thirty posttreatment plaster dental casts were selected and scanned by OrthoCAD (Cadent, Carlstadt, NJ) to produce 30 corresponding digital dental casts. The plaster and digital casts were compared by using the criteria of the ABO OGS. Because the data were ordinal, a nonparametic statistical analysis was used. RESULTS: The Wilcoxon test for paired samples showed significant differences between the plaster and digital casts for occlusal contacts, occlusal relationships, and total scores (P <.05). No significant differences were found for alignment, marginal ridges, overjet, and interproximal contacts. Buccolingual inclination was not included in this study because of inability to perform proper measurements with the OrthoCAD program. Mean differences of points deducted ranged from .03 point for marginal ridges to 5.07 points for the total score. The variable with the most points deducted related to occlusal relationships, and the fewest points were deducted for interproximal contacts. CONCLUSIONS: Based on this study, the current OrthoCAD program (version 2.2) was not adequate for scoring all parameters as required by the ABO OGS.

Dental and medical students' knowledge and opinions of infant oral health.

Primary care providers' involvement with and perceptions of the epidemic of early childhood caries could be related to attitudes and knowledge of the disease as well as to differences in discipline-based recommendations. A cross-sectional survey of demographics, opinions on infant oral health care visits and importance of infant oral health care, knowledge of tooth eruption, and knowledge of health care guidelines of the American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD) was administered by several methods to first- and fourth-year dental and medical students at two University of Illinois campuses. Some expected variations were found among dental and medical students pertaining to perceptions and knowledge of infant oral health. Higher proportions of dental students responded correctly or considered the issues very important. However, Rockford medicine students were more likely to know when children should be weaned, yet less likely to agree with recommendations for time of first dental visit. Furthermore, fourth-year dental students were less likely than first-year dental students to give the recommended answer for age of first dental visit. Variances of opinions and basic knowledge of infant oral health of dental and medical students showed inconsistencies with desired outcomes of educational and clinical experiences. Further research is needed to understand the role of experience and other factors to effectively educate primary care providers in this area.

Nasal versus oral midazolam sedation for pediatric dental patients.

PURPOSE: The purpose of this study was to evaluate and compare intranasal (IN) and oral (PO) midazolam for effect on behavior, time of onset, maximum working time, efficacy, and safety for patients requiring dental care. METHODS: Forty anxious subjects (20 IN, 20 PO, Frankl Scale 3 and 4, ages 2-6 years, ASA I and II) were sedated randomly with either IN (0.3 mg/kg) or PO (0.7 mg/kg) midazolam. The dental procedure under sedation was videotaped and rated by a blinded and calibrated evaluator using Houpt's behavior rating scale. RESULTS: There was no statistical difference for overall behavior (F3,27 = 0.407; P = .749). The planned contrasts showed significant interactions between time and route (IN vs PO) between 25 and 30 minutes after starting sedation. The time of onset (P = .000) and the working time (P = .007) were significantly different between IN and PO midazolam. There were no statistically significant differences in vital signs (O2 sat, HR, RR, BP) between PO and IN (P = .595). IN subjects showed more movement and less sleep toward the end of the dental procedures, and faster onset time but shorter working time than PO. Vital signs were stable throughout the procedures with no significant differences. CONCLUSIONS: Mean onset time was approximately 3 times faster with IN administration compared to PO administration. Mean working time was approximately 10 minutes longer with PO administration than it was with IN administration. Overall behavior under PO and IN was similar. However, more movement and less sleep were shown in subjects under IN than those under PO toward the end of the dental session. All vital signs were stable throughout the procedures and showed no significant differences between PO and IN administration.

Management of early childhood caries.

Even though the rate of dental caries in American children decreased dramatically throughout the 20th century, it still is the most prevalent childhood disease. As with general health, oral health status tends to vary in the United States on the basis of sociodemographic factors. Caries risk assessment is one of the most important goals of a child's initial oral examination. This manuscript will provide readers with general information regarding early childhood caries, its pattern, and the restorative and preventive needs of children affected by it.

Glass ionomer microleakage from preparations by an Er/YAG laser or a high-speed handpiece.

OBJECTIVE: The purpose of this study was to compare microleakage of glass ionomer materials (GIC) using two different modes of cavity preparation: a high-speed hand piece and an erbium/yttrium-aluminum-garnet (Er/YAG) laser. METHODS: Eighty caries free permanent molar teeth had class V preparations cut on both the buccal and lingual surfaces. The high-speed hand piece was used to prepare a class V cavity preparation on the buccal surface and an Er/YAG laser was used to prepare a class V cavity preparation on the lingual surface. GIC or resin modified GIC was used as the restorative material. The teeth were thermocycled for 7000 cycles, placed in 2% basic fushin for 24h, sectioned in the center of each restoration, and analyzed under a stereomicroscope. RESULTS: There was no statistical difference in microleakage between the two modes of cavity preparations. The gingival margins had more microleakage than the occlusal margins for both GIC materials and the resin modified GIC showed significantly more leakage than the conventional GIC. CONCLUSIONS: The Er/YAG laser provided an equivalent method of tooth removal when evaluated for microleakage of GIC materials compared to a high-speed hand piece.