Dental needs and conditions of individuals with Lowe syndrome: An observational study.

INTRODUCTION: Lowe syndrome (LS) is an uncommon condition that affects the brain, kidneys, nervous system, and eyes, predominantly in males. The aim of this study was to examine dental conditions, dental treatments, and access and/or barriers to care for those with LS compared to healthy individuals. METHODS: Surveys assessing dental conditions, dental treatments, and access and/or barriers to care were administered to families in the Lowe Syndrome Association and families with healthy children who had dental appointments at the Tufts University School of Dental Medicine (TUSDM) pediatric dental clinic. One parent or a guardian of pediatric patients with LS or not at TUSDM was asked to complete an online survey. RESULTS: One hundred and eight surveys were obtained (n:58 from the LS group and n:50 from the healthy group). The LS group was significantly more likely (p < .05) to report "crooked/misaligned teeth," "difficult time chewing," "bad breath," and "mouth cysts" and was significantly less likely to report 6-month examination, "cleaning," and "filling." The LS group reported significantly greater difficulty locating a dentist. CONCLUSION: The findings of this study indicate that individuals with LS are more vulnerable to developing severe dental conditions and experiencing difficulties in accessing dental care than healthy individuals. Additionally, those who present with this syndrome may be less likely to receive specific necessary dental treatments. As a result, it is essential to offer appropriate dental care and support to individuals with LS to guarantee they achieve optimal oral health.

Attitudes and opinions of telehealth in the dental school environment: A survey study.

PURPOSE: The objective of this study was to assess provider attitudes and opinions regarding telehealth in the dental school environment. METHOD: A survey was developed and validated and was sent to 849 predoctoral students, postdoctoral students (residents), and faculty at a single dental school. It consisted of 13 questions regarding the participants' professional backgrounds, opinions, and attitudes toward telehealth. The survey opened on November 16, 2021, and remained open for 6 weeks. RESULTS: Of 849 survey recipients, 163 (19%) responded. Among 161 usable surveys, 90 (56%) were predoctoral students, 42 (26%) were postdoctoral students, and 29 (18%) were faculty. Fifty-four percent reported having completed at least one telehealth visit. Among this subset, 80% strongly agreed or agreed that telehealth is a good adjunct in providing care; 74% strongly agreed or agreed that telehealth has improved communication with patients. CONCLUSION: Most dental providers reported positive opinions and attitudes regarding telehealth's ability to improve communication and serve as an adjunct to providing care. PRACTICAL IMPLICATIONS: In the right circumstances, telehealth offers an alternative to traditional oral healthcare delivery methods. Based on the perceptions of dental providers, the use of telehealth may also be beneficial in combination with traditional approaches in the dental school environment.

Mandibular Regional Odontodysplasia in a Toddler.

Regional odontodysplasia (ROD) is a rare developmental anomaly with distinctive clinical, radiographical and histological findings, affecting both primary and permanent dentitions. The teeth with ROD have an atypical morphology and are usually discolored, with either delayed eruption or complete failure to erupt. Radiographically, the affected teeth have a "ghostly" appearance, with marked radiolucency and decreased radiodensity, showing a thin outline of enamel and dentin, which appear hypomineralized histologically, with poorly structured dentinal tubules and enamel prisms. Calcifications are frequently found in the pulp chambers of the affected teeth. This case report discusses a three-year-old girl who presented with ROD in her mandible as well as the clinical and radiographical features, and treatment of the condition.

Retention of Zirconia Crowns Compared to Stainless Steel Crowns: An Ex-Vivo Study.

PURPOSE: The purpose of this study was to compare the retention of 3M stainless steel crowns™ (SSCs), Kinder Krowns® zirconia crowns (ZCs), and EZCrowns ZCs on extracted primary mandibular second molars ex-vivo. METHODS: A total of 45 extracted primary mandibular second molars were allocated randomly to either of the three groups. All teeth were mounted in Dentsply acrylic molds and then prepared for crown cementation. Crowns were cemented with glass ionomer cement (GIC). Retention testing was performed using Instron 5566A. Differences in retention between the groups were tested via Welch's analysis of variance (ANOVA), and post hoc comparisons were performed with the Games-Howell test. RESULTS: Welch's ANOVA resulted in statistically significant differences between the three groups (P<0.001). The mean±SD force in Newtons (N) for the SSC group, Kinder Krowns® group, and EZCrowns group were 337.0±137.1 N, 89.4±53.6 N, and 106.5±77.7 N, respectively. Post hoc comparisons with the Games-Howell test presented that the SSC group had significantly higher retention than both the ZC groups (P<0.001). There was no significant difference between the ZC groups (P=0.76). CONCLUSIONS: Within the limitations of this ex-vivo study results, due to their statistically significant higher retention, stainless steel crowns should be selected over zirconia crowns when in need of a full coverage restoration. But if esthetics are a concern, dentists can choose freely between either of the ZCs tested in this study.

Shear Bond Strength of Different Restorative Materials to Primary Tooth Dentin Treated with Silver Diamine Fluoride.

Purpose: To investigate shear bond strength (SBS) of three restorative materials on primary dentin after silver diamine fluoride (SDF) application.
Methods: Thirty primary teeth were randomized into three groups of 10 teeth. Each tooth was split mesiodistally and randomized into experimental (artificial caries plus SDF) and control (sound dentine without SDF) groups. Glass ionomer cement (GIC), resin-modified bioactive resin (ACTIVA), and composite resin (CR) restorations were tested for SBS and mode of failure (MF).
Results: All SDF groups exhibited significantly lower SBS compared to the control (CR: P =0.001; ACTIVA: P =0.001; GIC: P =0.004). For the SDF group, the compa- rison of materials was statistically significant (P =0.006); posthoc tests showed significance only between CR and ACTIVA (P =0.009) and between ACTIVA and GIC (P =0.020). The lowest mean value was obtained for ACTIVA (1.4 MPa) and the highest mean value was obtained for CR (3.3 MPa). For the control group, Welch's F test was statistically significant (P =0.044), but all posthoc tests were not. For MF, SDF exhibited a significantly greater percentage of adhesive failures with ACTIVA and CR than with GIC. In the control group, a mixed MF was more dominant with no significant differences.
Conclusion : The SDF group had significantly lower SBS.

An In Vitro Pilot Study on the Effects of Silver Diamine Fluoride on Periodontal Pathogens and Three-Dimensional Scaffolds of Human Fibroblasts and Epithelial Cells.

Objective: The aims of this study were to investigate the antibacterial and cytotoxic effects of silver diamine fluoride (SDF) on periodontal pathogens and human skin constructs, respectively. Background: SDF has been proven to have bactericidal effects on cariogenic bacteria. No studies to date evaluated the bactericidal effects of SDF on periodontal pathogens nor its effect on epithelium and fibroblasts. Methods: Streptococcus mutans, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans were cultured in monospecies biofilms, exposed to increasing concentrations of SDF and inoculated on agar plates to assess viability. Human gingival fibroblasts in 2D cultures were exposed to 1 µL of 0.394% of SDF and viewed using real-time imaging. Finally, SDF was applied to human, 3D tissue scaffolds of fibroblasts and keratinocytes, and termed human skin equivalents (HSE). A clinical dose of 38% SDF was applied, and HSE were cultured for 12 hours, 1, 3, 5, and 10 days. The tissue was observed clinically and histologically with hematoxylin and eosin staining and TUNEL. Results: S. mutans and A. actinomycetemcomitans growth was completely inhibited using all dilutions of SDF, whereas P. gingivalis was still viable with 0.197% and 0.098% of SDF. Single-layer fibroblasts experienced immediate necrosis upon contact with SDF. Application of SDF to HSE showed maturation of a whitish lesion within 24 hours, followed by pigmented, crusted tissue after 3 days. Histological evaluation of treated tissues showed apoptotic cells in the epithelium and upper half of the connective tissue. Conclusion: Our data suggest that SDF has bactericidal properties against two periodontal pathogens: P. gingivalis and A. actinomycetemcomitans. SDF caused immediate necrosis of monolayer fibroblasts, but does not extend to the full extent of layered fibroblasts in HSE.

Effect of Light Curing on Silver Diamine Fluoride in Primary Incisors: A Microscopic Ex Vivo Study.

Purpose: To determine the effect of a dental curing light on the penetration depth of silver diamine fluoride (SDF), dentin hardness, and silver and fluoride ion precipitation into cavitated carious lesions. Methods: SDF was applied on 16 primary incisors extracted due to caries extending into dentin. Teeth were divided into two groups: (1) control group, was not light-cured; and (2) test group, was light-cured. A scanning electron microscope, and OmniMet software were used to measure penetration depth, dentin hardness, and ion precipitation. Wilcoxon's ranksum test was used for statistical analysis. Results: All samples in both groups showed SDF penetration beyond the carious lesion and into sound dentin. The penetration depth into sound dentin was 70 µm further without the dental curing light it (P<0.001). Silver precipitation in infected dentin with the dental curing light was approximately 2.6 times greater than without it (P=0.02). Dentin hardness of infected dentin was 26 percent more with the dental curing light (P=0.04). Conclusions: Applying a dental curing light during silver diamine fluoride treatment of carious lesions induces more silver ion precipitation in infected dentin, increases its hardness, and, perhaps because more silver stays in the infected dentin, less SDF penetrates into sound dentin.

Relationship of Lower Lingual Arch Appliance Use and Impaction of Second Molars: A Retrospective Study.

Purpose: The purpose of this study was to determine the prevalence of permanent mandibular second molar impaction in pediatric patients treated with a lower lingual holding arch (LLHA) to maintain lower arch perimeter. Methods: In this retrospective study, 259 radiographs of nine- to 17-year-old pediatric patients were examined for permanent mandibular second molar impaction. A total of 127 patients with LLHA were compared to a control group of 132 patients who had not received LLHA. Other independent variables (sex and treatment age) were also tested for their value as predictors of impaction difficulty. For statistical analysis, the chi-square test was used. Logistic regression analysis was used to determine the statistical significance of the possible predictors of second molar impaction. Results: The mean age of the subjects was 9.2±1.7 (standard deviation) years old. The prevalence of permanent mandibular second molar impaction was 7.1 percent in patients with LLHA compared to 1.5 percent in the control group. The LLHA group had a likelihood of second molar impaction 6.53 times higher than controls after controlling for age. The relationship was significant with P-value of 0.021. Conclusions: The lower lingual holding arch is associated with an increased risk of second molar impaction in patients nine to 17 years old.

Accuracy of Cone-beam Computed Tomography and Extraoral Bitewings Compared to Intraoral Bitewings in Detection of Interproximal Caries.

AIM AND OBJECTIVE: The purpose of this study is to evaluate the diagnostic accuracy of cone-beam computed tomography (CBCT) and extraoral bitewings in the detection of interproximal caries compared to intraoral bitewings. MATERIALS AND METHODS: Seven preserved cadaver heads with 106 teeth (molars, premolars, and canines) including 183 proximal surfaces were used. Five r adiographic modalities were studied: intraoral bitewings, extraoral bitewings, iCAT 3D, ProMax 3D high r esolution, and ProMax 3D low r esolution. Seven pediatric dental r esidents were r ecruited and calibrated as observers and asked to evaluate each proximal surface. Teeth were extracted, mounted, drilled, caries detection dye was applied, and the surfaces were examined under the light microscope. Interexaminer r eliability, sensitivity, specificity, and area under the curve values were compared. RESULTS: No significant differences were found in sensitivity, specificity, and area under the curve values between the five r adiographic modalities. R estorations may influence the accuracy of caries diagnosis. CONCLUSION: Cone-beam computed tomography radiographs and extraoral bitewings showed similar accuracies in detecting interproximal caries compared to intraoral bitewings. This suggests that with proper training and experience, CBCT and extraoral bitewings could be comparable to intraoral bitewings in detecting interproximal caries. CLINICAL SIGNIFICANCE: Cone-beam computed tomography and extraoral bitewings could potentially serve as alternatives to intraoral bitewings to diagnose proximal caries, especially when the CBCT study is needed for a specific diagnostic purpose.

Bottle-Weaning Recommendations Among Pediatricians and Pediatric Dentists.

Purpose: The purpose of this study was to determine how pediatricians (MDs) and pediatric dentists (PDs) interpret professional associations' guidelines for weaning of bottle-fed infants and assess ensuing provider recommendations. Methods: A survey was sent to 11,479 MDs and PDs. Results: 721 MDs and 1,005 PDs responded, yielding an overall response of 1,726 (15 percent). MDs (88 percent) and PDs (87 percent) responded that weaning is a transitional time period with both a start and a finish. Most MDs (76 percent) and PDs (62 percent) selected 12 and 15 months, respectively, for finishing weaning. Both MDs (91 percent) and PDs (89 percent) answered that complete bottle unavailability represented weaning cessation. MDs (71 percent) and PDs (84 percent) strongly agreed on importance for a pediatrician's weaning recommendations, with MDs more frequently giving recommendations (two to three visits) than PDs (one to two visits). Conclusions: Guidelines relating to bottle-fed infants are not uniformly understood by MDs and PDs. Bottle-weaning recommendations of MDs and PDs vary. There are well-documented risks of prolonged bottle use. Thus, development of clear, preventive guidelines that address the timely and complete removal of a bottle are warranted.

Effectiveness of interprofessional oral health program for pediatric nurse practitioner students at Northeastern University, United States.

BACKGROUND: Interprofessional education (IPE) is an important part of the landscape of modern education. However, there is a significant deficiency of studies that evaluate IPE in dentistry. The aim of this article is to evaluate the effects of an oral health educational program on the dental knowledge, awareness, attitude, confidence, and behavior of pediatric nurse practitioner (PNP) students and to emphasize the importance of IPE for PNP. METHODS: First-year pediatric nurse practitioners from Northeastern University participated in an IPE oral health education seminal and practical session as a pilot study. Several tests were used to evaluate the effectiveness of the educational program. The post-test assessed the knowledge, awareness, attitude, confidence, and behavior of the students immediately after attending the lecture; again immediately after hands on experience; and finally at a follow-up approximately a month after attending the training module. The training module consists of prevention and anticipatory guidance; caries process and management; trauma and dental emergencies. Differences in score items were evaluated between 4 time points. Friedman's, Wilcoxon signed-rank and McNemar's tests were used to analyze the results. RESULTS: Knowledge score was determined based on the number of correct responses to seven questions, while awareness score was based on the median of eight questions. Fifteen confidence, attitude, and behavior questions were used. The total sample size was 16 students with a mean age 33.31 ± 7.52. The majority were females (87.5%). Significant improvement was seen in all subjects' overall knowledge of oral health topics. The confidence, attitude, and behavior scores were differed by time of test (P < 0.01). It was the highest after post-test and the lowest in pre-test. CONCLUSION: Our study suggests that introducing an Interprofessional education program for pediatric nurse practitioner students can provide them with adequate knowledge, awareness, confidence, and attitude regarding oral health issues. It also can help them in changing behavior, prevention and ongoing dental surveillance.

Modifying dietary risk behaviors to prevent obesity and dental caries in very young children: results of the Baby Steps to Health pediatric dental pilot.

OBJECTIVES: To describe the design, feasibility, and acceptability of a theory-informed obesity and dental caries prevention pilot study, Baby Steps to Health, conducted in an academic dental clinic among a primarily Asian immigrant population. METHODS: Baby Steps used self-determination theory and behavioral motivation strategies for a caregiver/child (6-36 months) nutrition and oral health behavior change intervention implemented in a pediatric dental clinic. Caregivers completed a dietary practice assessment to identify risk behaviors and potential courses of action. With assistance from dental providers, caregiver responses were matched to customized dietary behavioral guidance and a behavior change goal to reinforce caregivers' autonomous motivation to improve feeding practices. A 1-month, post-visit phone caregiver interview assessed adherence to the behavioral goal(s) and solicited qualitative input for further program development. RESULTS: Fifty caregivers (82 percent Asian) participated in the initial visit, and 46 (92 percent) participated in the follow-up interview. Reported obesogenic/cariogenic risk behaviors were prevalent: 57 percent of bottle-fed children consumed non-water beverages in bottles to aid sleep and 38 percent of parents offered snacks ad libitum. At follow-up, 93 percent of caregivers who selected goals reported positive behavior change and 91 percent said they would participate in a similar future program. CONCLUSIONS: Tailored guidance delivered in a program that uses self-determination theory may represent a strategic use of the dental encounter to impart actionable information and motivate health-related behavior change for families with very young children. Partnerships between dental and nutrition professionals offer opportunities to address key dietary behaviors that may prevent obesity and improve oral health, particularly among at-risk children.

Radiographic Effectiveness of Resin Infiltration in Arresting Incipient Proximal Enamel Lesions in Primary Molars.

PURPOSE: The purpose of this split-mouth, randomized, prospective clinical trial was to evaluate radiographically the effectiveness of resin infiltration, as an adjunct to standard-of-care preventive measures compared to standard-of-care preventive measures alone, in arresting the progression of non-adjacent, incipient, proximal enamel lesions in primary molars 24 months after treatment. METHODS: The study included a total of 45 healthy five- to eight-year-olds who had been diagnosed radiographically with at least two non-adjacent, incipient, proximal enamel lesions in primary molars (90 lesions). Test group lesions were treated using resin infiltration followed by five percent topical sodium fluoride (NaF) application versus five percent NaF alone in the control group. The alpha level was set at 0.05. RESULTS: The children were examined after six, 12, 18, and 24 months. Twenty-five subjects were examined at the 24-month follow-up visit, At which time 10 of the 25 test lesions (40 percent) showed caries progression while 18 of the 25 control lesions (72 percent) showed caries progression (P=0.04). CONCLUSION: Resin infiltration as an adjunct to standard-of-care preventive measures is significantly more effective radiographically in reducing the progression of non-adjacent, incipient, proximal enamel lesions in primary molars compared with standard-of-care preventive measures alone after 24 months.

Treating Mucocele in Pediatric Patients Using a Diode Laser: Three Case Reports.

A mucocele is the most common minor salivary gland disease and among the most common biopsied oral lesions in pediatric patients. Clinically, a mucocele appears as a round well-circumscribed painless swelling ranging from deep blue to mucosa alike in color. Mucoceles rarely resolve on their own and surgical removal under local anesthesia is required in most cases. Different treatment options are described in the literature, including cryosurgery, intra-lesion injection of corticosteroid, micro-marsupialization and conventional surgical removal using a scalpel, and laser ablation. Therefore, the goal of this paper was to report three cases of mucocele removal in pediatric patients using a diode laser with a one-month follow-up. Mucoceles were removed by a pediatric dentist using a diode laser with a wavelength of 930 nm in continuous mode and a power setting of 1.8 Watts. In all cases, no bleeding occurred during or after the procedure and there was no need for suturing. On clinical examination during the one-month follow-up, in all three cases there was minimal or no scarring, minimal post-operative discomfort or pain, and no recurrence. Diode lasers provide an effective, rapid, simple, bloodless and well accepted procedure for treating mucocele in pediatric patients. Minimal post-operative discomfort and scarring was reported by all the three patients.

Effectiveness of an Oral Health Education Program for Obstetrician/Gynecologist Residents at Tufts Medical Center.

AIM AND OBJECTIVES: To assess Tufts Medical Center obstetrician/gynecologist (OB/GYN) residents' knowledge, beliefs, and previous training in oral health and to assess the effect of an oral health educational seminar on their knowledge and beliefs. MATERIALS AND METHODS: A preseminar questionnaire was distributed to the residents. The same questionnaire was distributed immediately after the seminar and 3 months later. SPSS Version 21 was used for the data analysis. RESULTS: Convenience sample of 25 residents were included in the study. The mean (standard deviation) age of participants was 29.08 (2.47) years. Only 1 (4%) participant reported receiving >8 h previous training in oral health and 7 (28%) reported receiving <1 h of training. The nonparametric Friedman test showed a statistically significant difference between administrations in terms of total score on knowledge-based questions (P < 0.001) and some of the belief-based questions. The post hoc Wilcoxon signed-rank test with Bonferroni correction showed statistically significant improvement in the knowledge-based questions between pre- and post-seminar questionnaire (P = 0.002) and between preseminar and 3-month follow-up (P = 0.003). CONCLUSIONS: OB/GYN residents at Tufts Medical Center received limited training in oral health. Their knowledge improved significantly following the oral health educational seminar. Similar training modules can be brought to other OB/GYN residencies and OB/GYNs in an effort to enhance the symbiotic relationship between medical and dental professionals.

Effectiveness of the D-TERMINED Program of Repetitive Tasking for Children with Autism Spectrum Disorder.

PURPOSE: The purpose of this study was to compare the effectiveness of the D-TERMINED Program with standard behavior guidance techniques (SBGTs) used for children with autism spectrum disorder (ASD) in a private dental setting. METHODS: A retrospective data analysis was performed from records of children with ASD who received treatment using either the D-TERMINED program or SBGTs at two private dental practices. Data were analyzed using chi-square, Fisher's exact, Wilcoxon Signed Rank, and Mann-Whitney U tests and logistic regression. RESULTS: Forty-four charts (22 in each group) were selected from office visits between 1999 and 2012. Children in the D-TERMINED group were significantly younger (P=0.01). There were no significant differences between groups regarding gender and dental care characteristics. Patients treated with the D-TERMINED program showed a significantly greater improvement in behavioral scores compared to the control group (P=0.03). Additionally, children treated with the D-TERMINED program had significantly lower referrals for dental treatment under general anesthesia (P=0.04). CONCLUSION: The D-TERMINED program may help children with ASD learn the cooperation skills necessary to receive treatment in a dental practice, which might impact health care cost effectiveness.

Efficiency and patient satisfaction with the Isolite system versus rubber dam for sealant placement in pediatric patients.

PURPOSE: The purpose of this clinical study was to compare the chair time and degree of patient satisfaction after use of the Isolite system (IS) versus rubber dam (RD) during the application of pit and fissure sealants. METHODS: The patients included in this study ranged from seven to 16 years old. In each subject, pit and fissure sealants were applied to one permanent molar in each quadrant. IS dental isolation was used on one side; RD isolation was used on the other side. Chair time was assessed using a stopwatch, and patient acceptance was evaluated using a questionnaire. RESULTS: Forty-two subjects (23 females and 19 males) were enrolled in the study. The average chair time was 19.36 minutes for the application of pit and fissure sealants on the RD side; average chair time was 10 minutes for the IS side (P<.001). Sixty-nine percent of the subjects were more comfortable using IS, while 31 percent found RD to be more comfortable (P=.02). CONCLUSION: Isolite is a viable alternative to the conventional rubber dam. The use of Isolite is associated with reduced chair time and greater patient satisfaction.

Saudi and U.S. dental student attitudes toward treating individuals with developmental disabilities.

This study was conducted to compare the attitudes of senior dental students at the Faculty of Dentistry at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia, and at Tufts University School of Dental Medicine (TUSDM) in Boston, Massachusetts, about providing dental care to individuals with developmental disabilities (DD). Two subsequent classes of senior dental students at both universities were surveyed using a pretested, validated, online questionnaire. The students' demographic and educational data were collected, along with information about their experience, training, and attitudes toward this population. Two hundred and fourteen students responded to the online survey, for a response rate of 35 percent (51 percent for KAU students and 21 percent for TUSDM students). Students at TUSDM had more training, more experience, and more positive attitudes toward individuals with DD compared to KAU students (p<0.05). Students who reported having previous experience with individuals with DD had more positive attitudes than students who reported no experience with these individuals (p<0.05). Students who reported being prepared to treat individuals with DD had more positive attitudes than students who reported not being prepared (p<0.05). These findings suggest an association between predoctoral education in the treatment of individuals with special needs and having positive attitudes toward providing oral health care to individuals with DD.

Effect of the DentalVibe injection system on pain during local anesthesia injections in adolescent patients.

PURPOSE: The purpose of this study was to compare the pain rating scale measurements from an exposure group (injections with the aid of DentalVibe Injection Comfort System) and control group (traditional injection without the aid of the DentalVibe) in adolescent patients using self-reported pain during administration of local anesthetic injections. METHODS: This was a randomized, controlled study. Subjects consisted of 36 10- to 17-year-old patients who required local anesthesia for dental treatment on both sides of the maxilla or mandible. All subjects received a conventional injection (control) and an injection using DentalVibe (experimental). A pain rating for each injection was obtained from subjects using the Wong-Baker FACES Pain Rating Scale. RESULTS: Statistical analysis using a Wilcoxon signed rank test found a significant reduction in pain ratings for injections with the DentalVibe when compared to control injections. There was a positive correlation between the pain rating for control injection and the difference between the two types of injection, indicating that subjects who reported a higher pain score with the control injection had a greater reduction when DentalVibe was used. CONCLUSION: When compared to a conventional approach, DentalVibe significantly lowered self-reported pain during local anesthesia injection for adolescent subjects in this study.

Inferior alveolar nerve block and third-molar agenesis: a retrospective clinical study.

BACKGROUND: Children often receive inferior alveolar nerve blocks (IANBs) when their third molars are just beginning to develop. The location of the third-molar follicle is close to where the needle penetrates during an IANB. The authors examined the possible association between IANBs and missing third molars. METHODS: The authors examined 439 potential sites of third-molar development for evidence of third-molar follicles on panoramic radiographs of randomly selected children 7 years and older. The authors conducted a statistical comparison of the incidence of missing third-molar follicles in a control group of children who had no history of receiving IANBs with children in a test group who had a definitive history of receiving IANBs by means of generalized estimating equations. RESULTS: The authors found a statistically significant greater incidence of missing third-molar follicles in mandibular quadrants that had a definitive history of receiving IANBs compared with mandibular quadrants that had no history of receiving IANB. CONCLUSION: IANBs administered to young children when the third-molar tooth bud is immature may stop third-molar development. Owing to the significant clinical implications, further research is needed to verify these results. PRACTICAL IMPLICATIONS: Dentists inadvertently may be stopping the development of third molars when administering IANBs to children.