Prevalence of Obesity and Dental Caries in High School Adolescents during the First Decade of Saudi Vision 2030: A Cross-Sectional Study.

Saudi Vision 2030 was launched in 2016. Obesity and dental caries are both highly prevalent in Saudi adolescents and have been targeted by the Vision's health initiatives. The aim is to assess their prevalence in adolescents during the first decade since the launch of the Vision. This cross-sectional study was conducted in Jeddah, Saudi Arabia using a stratified sample of 571 high school students, with an average age of 16.7 (0.6). Their height and weight were measured, and their body mass index (BMI) was calculated. The decayed, missed, and filled scores (DMFTs) were recorded after an oral examination. Non-parametric tests were used to assess the associations of DMFT with BMI, sex, and school type; and its predictors were assessed. One-third of males were overweight/obese compared with 22% of females. Males exhibited higher DMFTs than females. DMFTs were higher among public school students than among their private school counterparts. No significant association was observed between DMFT and BMI. Sex and school type were significant predictors of DMFT. The prevalence of obesity has slowly decreased in adolescents, but the prevalence of dental caries has not. There was no significant relationship between these conditions. Saudi Vision 2030's current preventive/educational initiatives may be more effective in combating obesity than dental caries.

Timing, reasons, and predictors for first dental visits among children seen at two university hospitals.

BACKGROUND: Dental caries is the most common chronic childhood disease. The recommended age for the first dental visit (FDV) is 1 year, yet a minority of children visit before the age of 3 years. AIM: The aim of the study was to estimate the patterns of and predictors for dental visits among a sample of children. DESIGN: Parents of children between the ages of 6 months and 18 years, who attended the paediatric dentistry clinics and the well-baby clinics, were recruited. A validated questionnaire was used to collect data. Logistic regression was utilized to assess the predictors of ever visiting a dentist. RESULTS: The mean age at FDV was 5.8 ± 2.1 years. Parents' belief of not needing to see a dentist was the most common barrier to visiting a dentist (33%). Among the reasons for FDV, caries and pain were the most common (45% and 20%, respectively). Predictors of ever visiting a dentist were children who are not an only child and children of parents who visited a dentist themselves. CONCLUSION: Children visited the dentist at an age older than that recommended, and the reasons for FDV were mainly caries and its consequences.

Are parents' willing to vaccinate their children against COVID-19? A qualitative study based on the Health Belief Model.

In response to the COVID-19 pandemic, several countries have started implementing voluntary or involuntary mass vaccination programs. Although vaccine acceptance is high among adults, uncertainty about whether to vaccinate children against COVID-19 remains a controversial theme. To date, few qualitative studies have explored parents' views on this topic. A qualitative descriptive study design was used to collect data and individual in-depth interviews were conducted with 50 parents in the Makkah region of Saudi Arabia. The Health Belief Model (HBM) was used as a guide in developing the interview guide. Each question was related to a construct of the HBM. The data were then analyzed using thematic content analysis and interpreted using NVivo software. Two major themes emerged: motivation to vaccinate children, which was influenced by perceived benefits, perceived severity, perceived suitability, collective responsibilities, confidence, and cues to action; and barriers to vaccination in children, which included complacency, rapid vaccine development, and uncertainty about the long-term side effects of the vaccine. The findings of this study revealed that the public is not sufficiently informed about the efficacy or side effects of the COVID-19 vaccine, increasing the awareness of which will help parents make informed decisions regarding vaccinating their children and potentially increase vaccine acceptance.

Currently, the debate about whether children should be vaccinated for COVID-19 is ongoing worldwide. This research explored the thoughts of Saudi Arabian parents in this regard through in-depth interviews. The viewpoints were grouped into two themes: motivators and barriers toward vaccination. The motivators included factors such as parents' beliefs that the vaccine would help protect their children and the aged against the severity of the disease, especially those with existing conditions such as obesity. They also felt that the vaccination would help develop the society's herd immunity against the virus and felt an obligation to have their children vaccinated. Barriers toward vaccination included factors such as concerns about the long-term side effects of the vaccine on children, and the belief that children's immune systems are strong enough to fight the virus and that the vaccine might negatively affect their immune systems. This study showed that parents need to be educated on the benefits and side effects of COVID-19 vaccination for children. The results of this study will help health authorities and the government to increase the uptake and acceptability of the COVID-19 vaccine for children.

Oral Health Knowledge, Attitudes, and Clinical Practices of Pediatricians and Pediatric Residents: A Cross-Sectional Study.

Background Pediatricians are the first line in the provision of healthcare for children. They can make an important contribution to the oral health of their patients because they usually see children and parents early and frequently in life. This study aims to assess the pediatricians' and pediatric residents' oral health knowledge, attitudes, and practices with patients. Methods A structured English survey was developed based on previous surveys in the literature. It collected data on oral health knowledge, attitudes, and practices. Pediatricians were visited and invited to take the survey. A link to the survey was sent via email to all pediatric residents. An oral health practice score was created based on participants' responses to the practice questions, and a linear regression assessed its predictors. Frequencies of oral health knowledge, attitudes, and practices were presented and compared between both groups by the chi-square test. Results A total of 218 pediatricians and residents were surveyed. The oral health knowledge was low overall, but it was higher among pediatricians, 10.0±1.9, compared to the residents, 8.2±2.5 (P<0.001). The attitude ranged from 66.3% agreeing with the statement "Limited time with patients makes it difficult to integrate oral health into primary care practice" to 87.4% agreeing with the statement "Primary healthcare physicians should know their local dentists to facilitate dental referral and treatment." Overall, pediatricians practice positive oral health behaviors more than pediatric residents, and higher knowledge levels predicted more positive oral health practices. Conclusion Despite acknowledging their important role in promoting oral health, pediatricians' and future pediatricians' knowledge is poor, and their participation in oral health continues to be limited. The potential for the non-dental workforce to greatly improve children's oral health is underexploited. The healthcare system should seek to integrate medical and dental practices better. Incorporating oral health into residency programs and providing continuous education courses are strongly encouraged.

The accuracy of teledentistry in caries detection in children - A diagnostic study.

Introduction: : The increasing burden of dental caries and the lack of effective dental caries screening protocols in non-dental settings, such as schools, demand an innovative and cost-effective approach. Teledentistry is the field of dentistry that combines telecommunication with health records and digital imaging to improve access to dental care and help in epidemiological surveys. This study aimed to assess the accuracy of non-dentist teledentistry in caries detection compared with the clinical dental examination of a sample of 5-10-year-old schoolchildren. Methods: A calibrated dentist examined schoolchildren aged 5-10 years old. The dentist and two teachers took intraoral photographs for each child, using a smartphone. The photographs were concealed; therefore, the dentist assessed the three sets of photographs blindly two weeks after the clinical examination. Accuracy was measured to compare the teledentistry examination with the clinical dental examination. Results: The mean DMFT of primary teeth was 3.38, 3.42, and 3.17 upon clinical examination, dental-teledentistry examination (findings of photographs taken by a dentist), and non-dental teledentistry (findings of photographs taken by teachers), respectively. The mean DMFT of permanent teeth was 0.75, 0.69, and 0.65 upon clinical examination, dental-teledentistry examination, and non-dental teledentistry examination, respectively. In primary teeth, dental teledentistry and non-dental teledentistry examinations showed 95 and 98.3 sensitivity and 94.3 and 91.4 specificity, respectively. In permanent teeth, dental teledentistry and non-dental teledentistry examinations showed 80.8 and 88.5 sensitivity and 94.1 and 96.1 specificity, respectively. Conclusions: Teledentistry has acceptable accuracy for caries detection in schoolchildren compared to a clinical dental examination.

Social Media and Health Care (Part II): Narrative Review of Social Media Use by Patients.

BACKGROUND: People are now connected in a borderless web-based world. The modern public, especially the younger generation, relies heavily on the internet as the main source of health-related information. In health care, patients can use social media for more tailored uses such as telemedicine, finding a provider, and for peer support. OBJECTIVE: The aim of this narrative review is to discuss how social media has been used in the health care industry from the perspective of patients and describe the main issues surrounding its use in health care. METHODS: Between March and June 2020, a review of the literature was conducted on PubMed, Google Scholar, and Web of Science for English studies that were published since 2007 and discussed the use of social media in health care. In addition to only English publications that discussed the use of social media by patients, publications pertaining to ethical and legal considerations in the use of social media were included. The studies were then categorized as health information, telemedicine, finding a health care provider, peer support and sharing experiences, and influencing positive health behavior. In addition, two more sections were added to the review: issues pertaining to social media use in health care and ethical considerations. RESULTS: Initially, 75 studies were included. As the study proceeded, more studies were included, and a total of 91 studies were reviewed, complemented by 1 textbook chapter and 13 web references. Approximately half of the studies were reviews. The first study was published in 2009, and the last was published in 2021, with more than half of the studies published in the last 5 years. The studies were mostly from the United States (n=40), followed by Europe (n=13), and the least from India (n=1). WhatsApp or WeChat was the most investigated social media platform. CONCLUSIONS: Social media can be used by the public and patients to improve their health and knowledge. However, due diligence must be practiced to assess the credibility of the information obtained and its source. Health care providers, patients, and the public need not forget the risks associated with the use of social media. The limitations and shortcomings of the use of social media by patients should be understood.

Global Scenario of Teledentistry during COVID-19 Pandemic: An Insight.

With the advent of the coronavirus pandemic, dentistry has faced a halt as it involves face-to-face interaction with patients which had to be suspended for quite some time. Teledentistry (TD) can offer an innovative solution to resume dental practice during this pandemic. This paper gives an insight into the practice of TD being used in various countries to aid in the management of dental problems arising during the coronavirus disease 2019 (COVID-19) era. It also reviews the utilization of TD for academic institutions to facilitate educating dental students across the globe. How to cite this article: Kumar G, Rehman F, Al-Muzian L, et al. Global Scenario of Teledentistry during COVID-19 Pandemic: An Insight. Int J Clin Pediatr Dent 2021;14(3):426-429.

Mothers' Knowledge, Attitudes, and Fears About Dental Visits During the COVID-19 Pandemic: A Cross-sectional Study.

OBJECTIVES: This study aimed to assess mothers' knowledge of coronavirus disease 2019 and to evaluate their attitudes and fears about dental visits during the pandemic. MATERIALS AND METHODS: A structured questionnaire, developed in English and Arabic, adapted from previous questionnaires was remotely applied to a sample of 833 mothers of children aged 17 years and younger, from different socioeconomic backgrounds. Eligible participants were encouraged to invite others. The questionnaire collected information on knowledge about COVID-19, dental visit patterns, willingness of mothers to take their children to the dentist, and factors affecting it during the pandemic. Frequencies and percentages of categorical variables were presented, and predictors of willingness to visit a dentist during the pandemic were examined by logistic regression. RESULTS: Mothers who perceived the dental clinic to be of less or similar danger to public places were more willing to take their children to the dentist during the pandemic than were those who perceived it to be more dangerous (odds ratio [OR] = 2.9, 95% confidence interval [CI]: 1.2-7.0; OR = 2.3, 95% CI: 1.1-4.8, respectively). Mothers who were willing to go to the dentist during the pandemic were more likely to take their children to the dentist compared with mothers who were not willing to go themselves, OR = 16.9 (6.0-47.1). The most commonly reported barrier to visiting the dental clinic was fear of contracting the virus from someone there (80%). Most parents did not take their child to the dentist during the pandemic (83%), and 24% of those who had an appointment did not allow their children to attend. CONCLUSION: Mothers were unlikely to take their children to the dentist except for an emergency and perceived the dental clinic as a risky place for contracting the virus. More reassuring information about infection control measures at dental clinics should be delivered to this population.

Social Media and Health Care, Part I: Literature Review of Social Media Use by Health Care Providers.

BACKGROUND: As the world continues to advance technologically, social media (SM) is becoming an essential part of billions of people's lives worldwide and is affecting almost every industry imaginable. As the world is becoming more digitally oriented, the health care industry is increasingly visualizing SM as an important channel for health care promotion, employment, recruiting new patients, marketing for health care providers (HCPs), building a better brand name, etc. HCPs are bound to ethical principles toward their colleagues, patients, and the public in the digital world as much as in the real world. OBJECTIVE: This review aims to shed light on SM use worldwide and to discuss how it has been used as an essential tool in the health care industry from the perspective of HCPs. METHODS: A literature review was conducted between March and April 2020 using MEDLINE, PubMed, Google Scholar, and Web of Science for all English-language medical studies that were published since 2007 and discussed SM use in any form for health care. Studies that were not in English, whose full text was not accessible, or that investigated patients' perspectives were excluded from this part, as were reviews pertaining to ethical and legal considerations in SM use. RESULTS: The initial search yielded 83 studies. More studies were included from article references, and a total of 158 studies were reviewed. SM uses were best categorized as health promotion, career development or practice promotion, recruitment, professional networking or destressing, medical education, telemedicine, scientific research, influencing health behavior, and public health care issues. CONCLUSIONS: Multidimensional health care, including the pairing of health care with SM and other forms of communication, has been shown to be very successful. Striking the right balance between digital and traditional health care is important.

Sustainability of Improvement in Oral Health-Related Quality of Life in Children After Dental Treatment.

PURPOSE: Dental treatment has been associated with improvement in the oral health-related quality of life (OHRQoL) in children. There is little evidence of whether the effect of treatment is sustainable over time or not. The aim of this study was to determine whether the effect of dental treatment on OHRQoL is maintained or diminishes over time. MATERIALS AND METHODS: A consecutive sample of parents of 47 children between 2 and 6 years who received comprehensive dental treatment at a postgraduate dental clinic were recruited. Parents completed the Early Childhood Oral Health Impact Scale (ECOHIS) prior to treatment and at 1 and 4 months after treatment. Parents were also asked three global questions. Score changes (overall and for each section) between time points were analyzed by a repeated-measures analysis of variance and Bonferroni tests. RESULTS: The children's mean age was 4.7 ± 1.1, and 60% were females. ECOHIS scores were significantly improved from baseline (22.2 ± 6.9) to 1 month after treatment (8.7 ± 6.8) and were further improved at 4 months after treatment (1.9 ± 2.7), P < 0.001, with large effect sizes (2.8 for the child impact section and 2.2 for the family impact section). Parents' perception of changes in the OHRQoL of their children obtained from a global question indicated an improvement in OHRQoL that was sustained over the follow-up period; at 1-month and 4-month follow-up, 89% and 94% of mothers reported that their child's oral health improved a lot after dental treatment, respectively. CONCLUSION: The impact of dental treatment on OHRQoL continued to remarkably improve during the 4 months following dental treatment.

Impact of Dental Rehabilitation on Oral Health-related Quality-of-life in Healthy Children and Those with Special Health Care Needs.

Aim: The aim of this study is to compare the effect of dental rehabilitation on oral health-related quality-of-life (OHRQoL) in children with special health care needs (CSHCN) and healthy children. Materials and methods: The prospective study's sample consisted of 213 parents of caries-affected children, who were aged 6 years or younger and were scheduled for dental rehabilitation under general anesthesia (DRGA). The parent-child dyads were recruited from three public hospitals in Jeddah between October 2014 and May 2016. They comprised healthy children (n = 133) and CSHCN (n = 80). Parents self-completed the early childhood oral health impact scale (ECOHIS) before and 1 month after DRGA. The parents also rated the overall oral health status of their children by answering a global question before and after DRGA. Results: At baseline, the CSHCN had significantly worse OHRQoL in most of the scale domains at 25.9 [standard deviation (SD) 11.3] and 19.9 (SD 10.3) respectively. The OHRQoL significantly improved in both groups postoperatively (p = 0.005, Wilcoxon rank-sum test). The effect size of the improvement in the CSHCN group (+1.8) was greater than that in the healthy group (+1.5) in all domains, except for the family impact and parental distress sections. Conclusion: The DRGA markedly improves OHRQoL in children aged 6 years or younger, and the improvement is even greater in CSHCN. Clinical significance: The substantial improvement in OHRQoL after DRGA highlights the importance of oral health care in young children, which should receive higher priority than it has been done to date. Keywords: Children with special health care needs, Dental caries, Early childhood oral health impact scale, General anesthesia, Oral health-related quality-of-life.

Responsiveness of the Arabic version of the ECOHIS to dental rehabilitation under general anaesthesia.

BACKGROUND: The Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) has been validated, but its ability to detect change was not tested. AIM: To evaluate the responsiveness of the A-ECOHIS to dental rehabilitation under general anaesthesia (DRGA). DESIGN: A consecutive sample of 131 parents of children aged 6 years or younger, scheduled for DRGA were recruited from three public hospitals. The parents completed the A-ECOHIS before and 4 weeks following DRGA. The responsiveness of the A-ECOHIS was assessed by evaluating changes in scores before and after DRGA, and by measuring the change in scores in relation to the global question. RESULTS: The A-ECOHIS scores were higher among parents who reported poor oral health on the global question than those reporting better oral health (P = 0.001). There was a significant reduction in the scores at follow-up (P < 0.001). The effect size was 1.5 for the total scale, and 1.3 and 1.6 for the child and family impacts, respectively. After DRGA, the child and family impact section scores decreased by 78.6% and 77.9%, respectively. The majority of parents reported improvement in children's overall oral health-related quality of life post-operatively (94%). CONCLUSION: The A-ECOHIS was responsive to DRGA.

The prevalence of overweight/obesity in high school adolescents in Jeddah and the association of obesity association with dental caries.

BACKGROUND: The prevalence of overweight/obesity in children in Saudi Arabia is among the highest in the world. The prevalence of dental caries is also high in Saudi children. Studies on the relationship between caries and obesity in Saudi adolescents are lacking. OBJECTIVES: To study the prevalence of overweight/obesity in adolescents, and determine any association between obesity and caries. DESIGN: An analytical cross-sectional study. SETTING: Private and public schools in Jeddah. PATIENTS AND METHODS: The study sample comprised high school children from public and private schools selected by multistage stratified random sampling. Height, weight, waist circumference (WC), and body mass index (BMI) were measured for all children, who were then classified as underweight/normal, overweight, or obese according to their BMI values, and nonobese or obese according to their WC values. The presence of caries was assessed using the Association of State and Territorial Dental Directors criteria. MAIN OUTCOME MEASURE(S): The prevalence of overweight/obesity and the association of obesity with the number of decayed permanent teeth. RESULTS: 801 high school children (48% boys, 49% from public schools) with a mean (SD) age of 16.5 (0.9) years. When the BMI classification was used, 24%, 16%, and 60% adolescents were obese, overweight, and underweight/normal, respectively. When the WC classification was used, 19% and 81% were obese and nonobese, respectively. Obesity was more prevalent in boys and in students attending private schools (P < .05). The number of decayed permanent teeth showed a very weak and insignificant correlation with BMI and WC. CONCLUSION: One in every four adolescents residing in Jeddah was obese, with a high obesity prevalence in boys and in children attending private schools. The prevalence of caries in the permanent dentition was not associated with BMI or WC. LIMITATIONS: It was difficult to establish temporality in this cross-sectional study. Data on common risk factors were not adjusted for in the analyses.

Validation of the Arabic Version of the Early Childhood Oral Health Impact Scale (ECOHIS).

BACKGROUND: Assessment of the adverse effects of oral health problems on oral health-related quality of life (OHRQoL) is essential to ensure the well-being of children. The Early Childhood Oral Health Impact Scale (ECOHIS) is an instrument that was designed to assess caregivers' perceptions of OHRQoL in preschool children. Although it has been translated into many languages, it has yet to be validated in Arabic. Therefore, this study aimed to translate this questionnaire to Arabic (A-ECOHIS) and test its psychometric properties. METHODS: Questionnaire responses from three samples of caregivers of preschool children ≤ 6 years of age were collected: (i) community-based (n = 422), from preschools selected as a stratified random sample; (ii) clinic-based, from those seeking pediatric dental care at a university clinic (n = 246); and (iii) a test-retest sample (n = 68), a clinic-based group of caregivers who completed questionnaires twice about siblings who were not receiving dental care. Children received a dental examination to assess their decayed, missed, filled teeth (dmft) scores. Convergent validity was evaluated by assessing the A-ECOHIS scores in relation to the response to a global question. Discriminant validity was evaluated by comparing the scores of children with varying levels of oral disease. Internal consistency was assessed by calculating Cronbach's alpha, and the test-retest reliability was assessed using intra-class correlation coefficients (ICCs). RESULTS: The A-ECOHIS scores of the questionnaire sections and the global oral health rating were significantly correlated; Spearman correlation coefficients were, r = 0.55, P ≤ 0.01 (overall score), r = 0.54, P ≤ 0.01 (child section), and r = 0.51, P ≤ 0.01 (family section). The mean A-ECOHIS scores were also statistically significantly higher in children with higher dmft scores compared with lower dmft, and in the clinic-based sample compared with the community sample. The Cronbach's alpha value of the the child, family sections and overall questionnaire were, 0.80, 0.78, and 0.85, respectively. The intra-class correlation coefficient (ICC) of A-ECOHIS was 0.86. CONCLUSION: The A-ECOHIS performed well on all psychometric tests to which it was applied. Thus, it is a valid and reliable instrument that can be used in Arabic-speaking caregivers of preschoolers aged 2 to 6 years.

Children Undergoing Chemotherapy: Is It Too Late for Dental Rehabilitation?

Children undergoing cancer therapy encounter a diverse spectrum of oral changes that generally are attributed to immunosuppression and bleeding tendencies caused by the therapeutic agents. Therefore, providing oral health instructions and dental rehabilitation before the initiation of cancer therapy is encouraged. In this article, we discuss the general dental management of pediatric patients with cancer actively undergoing cancer therapy, or for whom it is planned. We also describe the dental rehabilitation performed on a child while he was undergoing chemotherapy for neuroblastoma, using an unconventional approach that varied from the standard management protocol used by King Abdulaziz University Hospital. The importance of close collaboration between the medical and dental teams is highlighted.

Prevalence of obesity in elementary school children and its association with dental caries.

OBJECTIVES: To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage. Methods: This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child's caries experience was assessed using the decay score in the primary and permanent teeth. Results: Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p less than 0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p less than 0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p less than 0.05). Conclusion: The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC.

In vitro Resistance Testing of Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia to Triclosan.

AIM: To determine the sensitivity of Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia to triclosan, and determine if these bacteria develop resistance to triclosan upon prolonged exposure. MATERIALS AND METHODS: Susceptibility to triclosan was tested against three periodontal pathogens P. gingivalis, P. intermedia, and T. forsythia. Escherichia coli strains sensitive and resistant to triclosan were used as biological controls to confirm the efficacy of triclosan in the assays. Agar plates were prepared locally with vitamin K and hemin-supplemented medium. RESULTS: Porphyromonas gingivalis and P. intermedia did not grow on plates containing ≥ 2 µg/ml triclosan, while T. forsythia did not grow on ≥ 1.66 µg/ml. Colonies of P. intermedia resistant to triclosan developed after prolonged incubation at 2 µg/ml, but this resistance disappeared during subculture in the absence of triclosan. CONCLUSION: No significant resistance to triclosan was detected for these species. CLINICAL SIGNIFICANCE: Dental products containing triclosan can be beneficial in controlling periodontal disease.

Sealing Ability of Four Calcium Containing Cements used for Repairing Furcal Perforations in Primary Molars: An in vitro study.

AIM: The aim of this study was to compare the sealing ability of mineral trioxide aggregate (MTA), Portland cement (PC), Biodentine(TM) and Tech biosealer in repairing furcal perforations in primary molars using the fluid-filtration technique. MATERIALS AND METHODS: Fifty freshly extracted maxillary second primary molars were sectioned horizontally at the furcation region to create dentin disks of 1.5 mm (+ 0.1 mm) thickness. Five disks were not perforated and served as negative controls. In the remaining 45 disks, furcation perforations were prepared. Five disks did not receive furcation repair and served as positive controls. The remaining 40 disks were then randomly divided into four equal groups (10 disks in each group). Perforations were repaired with: MTA, PC, Biodentine(TM) or Tech Biosealer. The sealing ability of the tested materials was evaluated by measuring microleakage for each disk after four different storage periods: 24-hour, 1-month, 6-month and 1-year storage using fluid-filtration. Comparisons between the four materials and the four time periods were done using the two-way analysis of variance and the Scheffe multiple comparisons test. RESULTS: There was no significant difference between the mean microleakage values obtained in the four tested materials after 24 hours, 1, 6 month and 1 year. However, microleakage values for each individual material were significantly higher at 24 hours than at the other time intervals. CONCLUSION: Mineral trioxide aggregate, PC, Biodentine(TM) and Tech biosealer showed similar capabilities in sealing the furcal perforations of the primary molars, where the sealing ability improved over time for each individual material.

Sodium Hypochlorite Versus Formocresol and Ferric Sulfate Pulpotomies in Primary Molars: 18-month Follow-up.

PURPOSE: This study's purpose was to compare the clinical and radiographic success rates of 5.25 percent Sodium Hypochlorite (NaOCl) pulpotomies to Formocresol (FC) and Ferric Sulfate (FS) in decayed primary molars. METHODS: Eighty-one primary molars, randomly divided into three groups, were treated with one of three different pulpotomy materials; NaOCl, FC and FS. The outcomes of the different groups were assessed clinically and radiographically every six months over 18 months. Chi-square test was used to detect differences in outcome measures in all groups. RESULTS: At six months, clinical and radiographic success rates were 100 percent for each group (27/27). At 12 months, clinical success was 100 percent (24/24), 96 percent (24/25), and 95.7 percent (22/23) for NaOCl, FC, and FS respectively. The radiographic success was 95.8 percent (23/24) for NaOCl group, and 100 percent for FC (25/25), and FS (23/23). At 18 months, the clinical success was 83.3 percent (20/24), 96 percent (24/25), and 87 percent (20/23) for NaOCL, FC, and FS respectively. The 18 month radiographic success was 91.7 percent (22/24), 100 percent (25/25), and 95.7 percent (22/23) for NaOCl, FC, and FS respectively. No significant differences were found in clinical or radiographic outcomes between the three groups at six, 12 and 18 months. CONCLUSION: The three pulpotomy medicaments yielded similar outcomes.

Natal and neonatal teeth.

Natal teeth (teeth present at birth) and neonatal teeth (teeth observed in the first 30 days of life) are uncommon. They may cause feeding problems and ulcerations on the ventral surface of the tongue. They can also be alarming to parents and cause discomfort with breastfeeding. A review of literature was conducted to review their etiology, significance, and clinical features with special emphasis on the complications and management. The opportunity of establishing a dental home through the early dental visits was highlighted. Furthermore, this case report details the examination and management of a 24-hour old neonate with 2 neonatal teeth. Natal teeth, although uncommon, are best referred to pediatric dentists for investigation and management.