Factors associated with toothbrushing performance among children: An observational cohort study.

BACKGROUND: Effective removal of dental plaque is essential factor for prevention of caries, gingival, and periodontal diseases in children and adults. AIM: To evaluate factors associated with improving toothbrushing performance (TB-P) among children. DESIGN: An observational cohort study analyzed all paediatric patients receiving regular examinations in a single dental clinic between 2009 and 2017 and regularly brushing their teeth with a triple-headed toothbrush (TH-TB). At every periodic follow-up, the TB-P of the child/parent was evaluated using the TB-P Skill Index (TB-PS-I); that is, did the child reach all five teeth segments within each arch and did he/she perform 10 back-and-forth stocks in each segment. When not optimal, they received instructions for improving TB-P and subsequently were asked to re-demonstrate. TB-PS-I was calculated and analyzed for correlation with other explanatory variables. RESULTS: A total of 1737 children with 7399 follow-up appointments were analyzed. Older age, female gender, higher number of follow-up appointments, and compliance with twice-daily toothbrushing significantly improved TB-P. The most typical mistakes in their performance were not reaching the canine segments and not performing enough strokes in each segment. Instructions given after imperfect TB-P significantly improved the TB-P. The magnitude of improvement, however, did not correlate with the performers' age, gender, or the number of follow-up visits. CONCLUSIONS: A significant percentage of children >8 years did not perform optimal toothbrushing even when using TH-TB.

The prevalence of dental developmental anomalies among childhood cancer survivors according to types of anticancer treatment.

Survival following childhood cancer has increased considerably. In an observational cross-sectional study, we assessed the prevalence of dental developmental anomalies (DDA) among childhood cancer survivors according to types of anticancer treatment. Permanent teeth were examined clinically and radiographically in 121 adolescents with a history of childhood malignancies, to identify DDA, namely hypomineralization or hypoplasia, microdontia, root changes and hypodontia. DDA were observed in 56/121 individuals (46%), in 309/3388 teeth (9%). Hypomineralization or hypoplasia of enamel appeared in 21 (17%) patients. Altered root development appeared in 26 patients and hypodontia affected 13 (10%). Dental anomalies were observed in 36 (43%) individuals who received chemotherapy and not radiation, in 20 (52%) who received radiotherapy, and in 15 (60%) of those who received head and neck radiotherapy. Among patients who received only chemotherapy, young age (6 years or younger) was associated with a higher number of malformed teeth. In conclusion, antineoplastic treatment that combines chemotherapy and radiotherapy appears to increase the risk of DDA. Radiation to the head and neck area was shown to particularly increase the risk of DDA. No specific chemotherapy agent was found to be associated more than the others with DDA.

Outcomes of Calcium Hydroxide with Iodoform Pulpectomies in Primary Teeth.

Purpose: To assess retrospectively the success rate of calcium hydroxide with iodoform as a filling material in pulpectomies of primary molars with irreversible pulpitis or pulp necrosis, and to evaluate factors that affect outcomes.
Methods: This study consisted of records of 73 patients with primary molars treated with pulpectomy with high quality radiographs. Treatment was considered successful clinically if the tooth was not extracted and radiographs showed a decrease or no change in preexisting pathologic radiolucent defects.
Results: Follow-up ranged from three to 39 months (median: 21.5 months). The success rate of teeth restored with a stainless steel crown (SSC) on the same appointment (88.9 percent) was higher than for teeth that received a temporary restoration (P =0.001). There was no statistically significant difference between the success rate and the extent of resorption of root canal filling material. Primary second molars had a higher success rate than first molars (P =0.018). No difference was found between the level of pulpectomy filling and treatment success (P =0.17).
Conclusion: Pulpectomies done with calcium hydroxide and iodoform had an overall success rate of 74 percent. If restored with an SSC, the success rate increased to 88.9 percent. Resorption of the paste did not affect the success rate.

Compliance of children and youngsters in the use of mouthguards.

The purpose of the study was to examine the compliance of children wearing their mouthguards, and to evaluate socio-environmental factors that impact upon the usage of the device. Eighty children attending the student clinic of the Hadassah School of Dental Medicine received mouthguards free of charge. One year later, 69 participants and their parents answered a survey aimed at gaining information regarding compliance and comfort when wearing the mouthguard correlated with gender, ages of parents and child, number of siblings, position of child in the family, socio-economic status, education of parents and past dental injuries of siblings or parents. Twenty-nine percent of the children never wore the mouthguard, 32% wore it sometimes, 15.9% wore it when necessary at the beginning but stopped after one month and 23.2% wore the mouthguard whenever needed. About 68% of the participants still possessed the mouthguard one year after receiving it, 44.9% reported that they did not wear the mouthguard because they forgot and 42% reported that the reason for not wearing the appliance was because it was not comfortable. Seventy-seven percent of the parents were not aware of the existence of this appliance prior to this study. In addition, 47.9% stated that dentists had not offered such treatment to them in the past, 20.8% indicated that their child had never possessed a mouthguard before due to its significant expense and 39.6% stated that they would not invest in this treatment in the future because their child would not wear the appliance. Boys were more comfortable wearing the mouthguard than girls. The younger the child and the later s/he was in the sibling order of the family, the more likely s/he was to lose the mouthguard.