Adverse Events in Pediatric Dental Practice: Survey of Pediatric Dentists in the United States.

Purpose: To survey pediatric dentists in the United States regarding adverse events during dental care for children. Methods: A self-administered, anonymous online survey was sent to American Academy of Pediatric Dentistry members (N equals 6,327) using REDCap® software (between October and December 2019). The questionnaire (all items with radio-button numerical categories) included five items surveying pediatric adverse event occurrence and seven demographic items. Annualized occurrences of adverse events in US pediatric dental practices were extrapolated from the data collected. Results: The survey response was 11 percent (n equals 704), with 91 percent of respondents reporting that at least one child experienced an adverse event during dental treatment. The two most prevalent adverse events, each reported by 82 percent of respondents, were self-inflicted trauma to soft tissues after local anesthesia and nausea and vomiting, with annualized estimates of 7,816 and 7,003, respectively. Major adverse events (respiratory depression, cardiovascular depression, neurological damage, death) during pediatric dental treatment were reported by 14 percent of respondents (annualized estimate equals 443). "Wrong" errors (wrong tooth/wrong procedure/wrong patient) were reported by 24 percent of respondents (annualized estimate equals 600). Conclusions: Adverse events during pediatric dental care are of noticeable concern with some (wrong tooth/wrong procedure/wrong patient errors) that can be procedurally mitigated.

High caries prevalence and risk factors among young preschool children in an urban community with water fluoridation.

BACKGROUND: Singapore is unique in that it is a 100% urban community with majority of the population living in a homogeneous physical environment. She, however, has diverse ethnicities and cultures as such; there may be caries risk factors that are unique to this population. AIM: The aims were to assess the oral health of preschool children and to identify the associated caries risk factors. DESIGN: An oral examination and a questionnaire were completed for each consenting child-parent pair. RESULTS: One hundred and ninety children (mean age: 36.3 ± 6.9 months) were recruited from six community medical clinics. Ninety-two children (48.4%) were caries active. The mean d123 t and d123 s scores were 2.2 ± 3.3 and 3.0 ± 5.6, respectively. Higher plaque scores were significantly (P < 0.0005) associated with all measures of decay (presence of decay, dt, ds). The risk factors for severity of decay (i.e., dt and ds) include child's age, breastfeeding duration, and parents' ability to withhold cariogenic snacks from their child. CONCLUSIONS: The high caries rate suggests that current preventive methods to reduce caries in Singapore may have reached their maximum effectiveness, and other risk factors such as child's race, and dietary and breastfeeding habits need to be addressed.