Developmental and Acquired Abnormalities of the Teeth.

This review aims to present a detailed analysis of the most common developmental and acquired dental abnormalities, including caries, resorptive lesions, and congenital anomalies of teeth number, size, form, and structure. This review highlights how diagnostic imaging can aid in the accurate identification and management of these conditions.

The Impact of Minimal Intervention Dentistry on Patient-Reported and Observation-Based Outcomes in the Pediatric Population: A Systematic Review and Meta-Analysis.

This review aimed to systematically investigate the effect of minimal intervention dentistry on patient-reported and observation-based outcomes of anxiety, pain and patient cooperation in the pediatric population. Microinvasive treatments (MITs) were compared to conventional treatments, home-based and professionally applied non-invasive treatments (NITs), and between MITs. Two reviewers independently screened studies from four electronic databases, extracted data, assessed the risk of bias and certainty of evidence with the GRADE approach. Ultimately, 26 studies were included for qualitative synthesis, with the data from 12 studies being incorporated into the meta-analysis. No statistically significantly differences in terms of anxiety were noted between MITs and conventional treatments, or between MITs from the meta-analyses. The treatment durations of MITs were not necessarily shorter than conventional treatments but varied with the use of local anesthesia, behavioral and clinical approach, and other confounding factors. The certainties of evidence were deemed low due to high risk of bias of the included studies. NITs evoked less anxiety and pain compared to MITs. Minimal intervention dentistry is an alternative treatment to manage dental caries among children and does not arouse different levels of dental anxiety and pain compared to other treatment modalities. However, further well-designed studies are required to draw an evidence-based conclusion.

Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review and Meta-Analysis.

Antiretroviral therapy (ART) increases the survival of HIV-infected children, but might also bring in oral health-related side effects and increase their risks of oral diseases. The review compared the oral health status of children living with HIV (CLWH) undergoing ART with healthy controls. Dual independent screening and study selection from four electronic databases and manual searches, data extraction, risk of bias assessment, and quality-of-evidence evaluation with Grading of Recommendations Assessment Development and Evaluation were performed. Twelve studies were included in qualitative and quantitative analysis. CLWH taking ART had a significantly higher prevalence of periodontal diseases (OR = 3.11, 95% CI 1.62-5.97), mucosal hyperpigmentation (OR = 20.35, 95% CI 3.86-107.39), and orofacial-related opportunistic infections than healthy controls. No significant differences regarding caries prevalence and tooth development were identified. Those with CD4+ T-cell counts below 250 cells/mm3 were more likely to manifest opportunistic infections, while medication duration had minimal influence on the prevalence of orofacial opportunistic infections. The current findings did not identify HIV and antiretroviral status as predisposing factors to dental caries, but affirmed the associated increased risk of periodontal diseases, mucosal hyperpigmentation and candidiasis.

Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and Meta-Analysis.

Oral health is an integral component of general health and well-being but might be undermined among children living with HIV (CLWH) due to the condition itself or the antiretroviral therapy (ART) received. This review summarises the current evidence and compares the oral health status of the CLWH who were treatment-naïve with those undergoing different ART medications. Fourteen studies were included in the final qualitative and quantitative analyses. This review identified no significant difference in the prevalence of caries, periodontal conditions, and tooth development between both groups. Orofacial opportunistic infections were more prevalent in the CLWH without ART. Children undergoing ART with a duration longer than 3 years had a significantly lower prevalence of oral candidiasis and CD4+ T-cell counts. However, due to the insufficient number of well-administered case-control studies with adequate sample size, the quality of the evidence in all outcomes was of very low certainty.

Does Early Childhood Caries Increase Caries Development among School Children and Adolescents? A Systematic Review and Meta-Analysis.

The aim of this paper is to systematically review the literature to determine whether early childhood caries (ECC) is significantly associated with caries development in permanent teeth among school children and adolescents, and to identify the association of other risk factors over 24 months. A systematic literature search was performed in four electronic databases and via a manual search from inception to 28 July 2022. Independent study selection and screening, data extraction, evaluation of risk of bias using ROBINS-I tool and certainty of evidence with GRADE were performed. Ten cohort studies were included, all of which identified that ECC significantly increased the risk of caries in permanent teeth. Meta-analysis suggested children with ECC were three times more likely to develop caries in their permanent teeth (OR, 3.22; 95% CI 2.80, 3.71; p < 0.001), especially when the lesions were in primary molars and progressed to dentine. However, the certainty of evidence was substantially compromised by serious risk of bias and inconsistency between studies. There were inconsistent findings between socioeconomic or behavioural factors on caries development, which could not be pooled for meta-analyses. ECC significantly increases the likelihood of caries development in permanent teeth. Evidence on the association of socioeconomic and oral health behavioural factors is weak.

Prevalence and Associated Factors of Erosive Tooth Wear among Preschool Children-A Systematic Review and Meta-Analysis.

The prevalence of dental erosion among preschool children and its associated factors range widely between studies. The aims of this review are to evaluate the literature and to determine the prevalence and associated factors of dental erosion among children below 7 years old. An electronic search was undertaken to identify observational studies evaluating the prevalence of dental erosion and its associated factors in children below 7 years old. Dual independent screening, data extraction, risk of bias assessment, meta-analysis, meta-regression, and evaluation of quality of evidence were performed. Twenty-two papers were included. The overall estimated prevalence of dental erosion in children was 39.64% (95% CI: 27.62, 51.65; I2 = 99.9%), with very low certainty of evidence. There was also low-quality evidence suggesting that the likelihood of (1) boys having dental erosion was significantly higher than girls (p < 0.001) and (2) children with digestive disorders having dental erosion was significantly higher than those without such digestive disorders (p = 0.002). Qualitative synthesis identified that more frequent intake of fruit juices and soft drinks correlated with erosive tooth wear. Dental erosion is prevalent among over one-third of preschool children. Digestive disorders and dietary factors are the main potential contributing factors.

Developing a Toothbrushing Visual Pedagogy (TBVP) for Preschool Children with Autism Spectrum Disorder.

Visual pedagogy and social stories have been widely used to assist children with Autism Spectrum Disorder (ASD) in learning various skills. A toothbrushing visual pedagogy (TBVP) was developed adapting existing toothbrushing social stories for children with ASD. This TBVP consists of 13 toothbrushing steps with scripts describing the toothbrushing technique. To evaluate its feasibility, a review panel was formed to provide feedback on the TBVP and three other published toothbrushing social stories. Effectiveness of the TBVP was further evaluated among 119 preschool children with ASD with significant improvements in toothbrushing skills observed at 3-month and 6-month follow-ups. It is concluded that TBVP is a feasible and an effective educational means that assists children with ASD in learning toothbrushing skills.

Evaluation of visual pedagogy in improving plaque control and gingival inflammation among preschool children with autism spectrum disorder: An interventional study.

BACKGROUND: Visual pedagogy (VP) is a behavioural intervention used to facilitate learning among autistic children. Limited studies have evaluated VP when applied to dentistry. AIM: To evaluate the effectiveness of VP in improving oral hygiene and gingival health status of autistic children. DESIGN: The interventional study was conducted among 122 autistic preschool children and their parents in Hong Kong. Toothbrushing visual pedagogy (TBVP) was provided to parents for supervising their children with toothbrushing at home. The children's sociodemographic background, developmental profile, and clinical parameters were obtained via parental questionnaire, standardised assessment form, and clinical examination, respectively. The change in plaque and gingival indices over time and potential confounding factors were evaluated with Friedman's two-way analysis of variance and logistic regressions, respectively. RESULTS: Significantly lower level of plaque and gingival inflammation was found at 3 months and 6 months than baseline. The oral health status of children with poorer baseline oral hygiene status and gingival health was more likely to improve with TBVP. Other developmental and socio-economic backgrounds had insignificant associations on the improvement of these clinical parameters. CONCLUSION: The findings suggest TBVP is effective in promoting oral hygiene maintenance and improving the periodontal conditions among individuals diagnosed with ASD.