Parental preferences for dental caries treatment in preschool children according to socio-demographic conditions and beliefs about the primary dentition.

AIM: To assess parental preferences for dental caries treatment and its association with socio-demographic conditions and beliefs about the primary dentition. METHODS: Study design: Cross-sectional study. This study was conducted among 512 parents of 2- to 5-year-old children in the State of Tocantins, in the North Region of Brazil. A self-administered questionnaire on preferences for dental caries treatment, socio-demographic conditions and beliefs about the primary dentition was responded by parents considering two hypothetical clinical scenarios: if their child had one or more asymptomatic caries lesions (without pain), one or more symptomatic caries lesions (toothache). Poisson regression models fitted the association between explanatory variables and the preference to conservative interventions. CONCLUSION: It can be concluded that parental preferences for dental caries treatment in preschool children depend on mother's age and education level, as well as on beliefs about the primary dentition.

Long-term evaluation of primary teeth molar pulpotomies with Biodentine and MTA: a CONSORT randomized clinical trial.

BACKGROUND: Calcium silicate-based materials have become widely used in recent years due to their positive effect on pulp cells, which stimulate tertiary dentin formation. AIM: The aim of the present study was to evaluate and compare clinically and radiographically the performance of MTA and Biodentine as pulp-dressing materials following pulpotomy in primary molars at 24-month follow-up. DESIGN: Molars from patients aged 4-9 years scheduled for pulpotomy were treated with either MTA or Biodentine followed by a stainless-steel crown. These molars were clinically and radiographically followed up at 6, 12, 18, and 24 months. Statistical analysis was performed to detect differences between the two groups. RESULTS: A total of 84 pulpotomies were performed obtaining a total success rate of 99.4 and 97.2% for Biodentine and MTA, respectively, at 24 months, showing no statistically significant differences between the two groups. CONCLUSION: 24-month follow-up showed that Biodentine and MTA have similar effectiveness.

Effect of audiovisual distraction on children's behaviour, anxiety and pain in the dental setting.

AIM: To evaluate whether the parental perception of the patient's anxiety, children's anxiety, pain, behaviour and heart rate of paediatric patients improves when an audiovisual technique is used as a distraction method during dental treatment. MATERIALS AND METHODS: This non-randomised crossover trial was performed with 34 patients aged 6-8 years, who required a minimum of two treatment visits for restorative therapy. During the last visit, the patient was shown a cartoon film. RESULTS: There was a significant improvement in the global behaviour when children were shown a cartoon film (P < 0.001). A significant increase in heart rate was recorded in both visits (P = 0.0001) when the anaesthetic was injected. A 97% of the sample would like to continue seeing their chosen film during subsequent visits. No statistically significant differences were found (P > 0.05) between the visits in terms of parental perception of the patient's anxiety, or the patient's self-reported anxiety, pain and heart rate. CONCLUSIONS: The use of the audiovisual material used as a method of distraction produces a global improvement in patient behaviour, but not in parental perception of the patient's anxiety, self-reported anxiety, pain or heart rate according to the measurement scales used. This material is also highly accepted by paediatric patients.

Oral rehabilitation of a 4-year-old child with early childhood caries under general anaesthesia: a case report on long-term outcome.

BACKGROUND: Young patients with early childhood caries (ECC) commonly undergo oral rehabilitation under general anaesthesia (GA), often because of problems with behaviour management. Children with a history of ECC are highly susceptible to the development of new caries, even after comprehensive oral rehabilitation. CASE REPORT: The present paper reports the case of a female patient, aged 4.1 years, with ECC who was referred for treatment to the Department of Paediatric Dentistry of the Universitat Internacional de Catalunya. On account of the requirement for extensive dental treatment, and because of behaviour management problems, her dentition was restored under GA. A combination of restorative approaches and techniques was used, including the placement of composite resins, preformed metal crown restorations, extractions, and space maintainers. The patient was followed for 24 months, both clinically and radiographically. Conclusion This case reflects the need to provide adequate support to children at high risk for ECC, together with their families by developing more acceptable and effective biological and behavioural interventions in order to reduce caries relapse after oral rehabilitation under GA.

Objective and subjective measures for assessing anxiety in paediatric dental patients.

AIM: Anxiety has been defined as a nonspecific feeling of apprehension towards a concrete situation that does not necessarily involve a previous experience. Dental anxiety can prevent patients from cooperating fully during dental treatment. Given that there is a connection between dental anxiety and uncooperative behaviour, it is important for dentists to be able to assess anxiety in their patients. There are many methods for such assessment, and in children they depend on age and intellectual development. These measures can be objective or subjective, depending on the method used to quantify the degree of anxiety. The aim of this literature review was to analyse the objective and subjective scales that are used most commonly to assess the degree of anxiety of children in a dental setting. CONCLUSION: Knowing the degree of anxiety of dental children is important in order to guide them through their dental experience. Their level of cooperation will also improve and anxiety will be reduced as well.

Temperature changes caused by light curing units on dentine of primary teeth.

AIM: This was to determine the temperature changes produced in dentine discs of primary teeth placed below a glass ionomer, microhybrid flow resin or microhybrid resin during the photocuring process with conventional halogen lamps and LEDs at different distances. STUDY DESIGN: Experimental design. MATERIALS AND METHODS: This in vitro study was carried out in the research laboratory of the Universitat International de Catalunya. We cut 1 mm thick dentine discs with the IsoMet 1000 cutting machine. Thereafter, we cut stainless steel rings of different heights. Subsequently, to facilitate the temperature measurement, we prepared silicone moulds, in which the dentine disc, stainless steel ring and the digital thermometer/ thermocouple were positioned. Once the silicone mould was finished, a 2 mm thick layer of the restorative material was placed on the dentine disc. Finally, the polymerisation process was conducted according to the times recommended by the manufacturers, and the temperature produced was recorded at the end of the procedure. STATISTICAL EVALUATION: Replies were analyzed using the STATGRAPHICS® Plus Version 5.0 statistics software system, in order to obtain comparative diagrams and graphs using the ANOVA multifactorial system. RESULTS: The photocuring lamps used on the restorative materials produced statistically significant differences in temperature, with p = 0.00001. CONCLUSION: Halogen lamps cause a greater temperature rise in materials than LEDs lamps, and the greatest rise is produced when microhybrid flow resin is photocured with the Optilux 501 halogen lamp.

Acceptance by Spanish parents of behaviour-management techniques used in paediatric dentistry.

AIM: This was to examine the attitude of a group of Spanish parents towards behaviour-management techniques used in paediatric dentistry. METHODS: A video with 8 different behaviour-management techniques used in paediatric dentistry was shown to 50 parents whose children were being treated at the International University of Catalonia (Barcelona, Spain). The techniques shown were: tell-show-do, nitrous-oxide sedation, passive restraint, voice control, handover- mouth (HOM), oral premedication, active restraint and general anaesthesia. Parents gave an acceptance rating of each of these techniques according to a scale of 0 to 10, with 0 being the lowest level of acceptance and 10 the highest. RESULTS: The technique rated as most acceptable was the tell-show-do technique, while the least accepted was the HOM technique. An association was found between acceptance of the different techniques and the socioeconomic status and gender of the parent, and the differences were statistically significant. No statistically significant differences were found regarding the age or gender of the child treated, or the previous dental experiences of those interviewed or of their children, with acceptance of each of the techniques. CONCLUSIONS: The techniques were well accepted by all those surveyed with the exception of HOM technique and the use of the papoose board. On comparing this study to other studies previously carried out in other areas of the world, similar results were found.

Effects of xylitol chewing gum on salivary flow rate, pH, buffering capacity and presence of Streptococcus mutans in saliva.

AIM: The first studies on the use of chewing gum in dentistry were done in the 1970s. The Turku Sugar Studies, carried out between 1970 and 1973, showed the excellent anticaries properties of xylitol chewing gums. Since then, many dentists, particularly in Scandinavian countries, have studied the role of chewing xylitol-sweetened chewing gums as another preventive strategy in the control of dental caries. OBJECTIVE: To compare variations in salivary flow rate, pH, buffering capacity, and levels of Streptococcus mutans in baseline conditions and after chewing paraffin pellets or xylitol chewing gum in children between the ages of 6 and 12 years who eat lunch in a school canteen. MATERIALS AND METHODS: The study sample consisted of 90 children divided into 2 study groups, and a control group. The children ate lunch at the canteen of the Escultor Ortells state school in the town of Vila-real (Castellón, Spain). The baseline data recorded in the first phase of the study were compared with the data recorded in the second phase, after 15 minutes of chewing xylitol- sweetened chewing gums or paraffin pellets, depending on the study group. Salivary flow rate was measured by collecting the stimulated saliva in a graduated beaker. Levels of pH were measured using a Cyberscan pH 110 pH meter (Eutech Instruments). CRT buffer strips and the CRT bacteria test (Ivoclar-Vivadent) were used to measure buffering capacity and levels of S. mutans, respectively. RESULTS: The data obtained after sample collection were compared by means of a 1-way analysis of variance using the StatGraphics Plus statistical software package, version 5.0. Statistically significant differences were found (p<.05) when pH, buffering capacity and levels of S. mutans were compared between the 3 groups. Comparison of salivary flow rates revealed no statistically significant differences (p>.05), though salivary flow rates were higher in the groups where gum was chewed. CONCLUSION: The effect of chewing is essential to the stimulation of salivary flow and the resulting recovery of pH levels and reduction of levels of S. mutans in saliva.

Short communication. Frequency of dispensing paediatric medicines with high sugar content by pharmacists in Barcelona.

AIM: To determine which high sugar cough syrups sell most frequently in pharmacies in Barcelona. METHODS: 300 pharmacies in 10 districts of Barcelona (Spain) were visited and data collected on the type of syrup-based medicines dispensed most often over a 3-month period in 2008. RESULTS: Data was collected in 142 out of 300 pharmacies. The percentage of the medicines sold by group of antibiotics (sweetener) were: Augmentine (aspartame) 5.72%; Clamoxyl (sucrose) 3.28%; Ceclor (sucrose) 3.66%. In the anti-inflammatory group: Junifen 2.0% (saccharine sódic); 3.59%, Junifen 4.0% (sodic sucrose); 4.35%, Apiretal Codeine (sucrose); 0.31%, Dalsy (sucrose) 39.35%; Febrectal (sodic saccharine): 0.89%. CONCLUSIONS: It is very important to advise parents, pharmacists, paediatricians, and paediatric dentists about low-sweetener paediatric medicine alternatives to control the high content sucrose medicines. The aim should be to reduce the intake of over the counter medication.