Is formocresol obsolete? A fresh look at the evidence concerning safety issues.

Concern has been expressed about the safety of formocresol use in pediatric dentistry. Formaldehyde, a primary component in formocresol, is a hazardous substance and is considered a probable human carcinogen by the International Agency for Research on Cancer, Health Canada, the Agency for Toxic Substances and Disease Registry in the U.S. Department of Health and Human Services, and the U.S. Environmental Protection Agency. Humans inhale and ingest formaldehyde daily, however, and produce formaldehyde during cellular metabolism. The human body is physiologically equipped to handle formaldehyde through multiple conversion pathways. The resultant single carbon atom released during metabolism is deposited in the "1-carbon pool," which, in turn, is used for the biosynthesis of macromolecules including DNA and RNA. Reevaluation of earlier research that examined potential health risks associated with formaldehyde exposure has shown that this research was based on flawed assumptions, which resulted in erroneous conclusions. The purpose of this review was to examine more recent research about formaldehyde metabolism, pharmacokinetics, and carcinogenicity. These results indicated that formaldehyde is probably not a potent human carcinogen under low exposure conditions. Extrapolation of these research results to pediatric dentistry suggests an inconsequential risk associated with formaldehyde use in pediatric pulp therapy.

Is formocresol obsolete? A fresh look at the evidence concerning safety issues.

Concern has been expressed about the safety of formocresol use in pediatric dentistry Formaldehyde, a primary component in formocresol, is a hazardous substance and is considered a probable human carcinogen by the International Agency for Research on Cancer, Health Canada, the Agency for Toxic Substances and Disease Registry in the U.S. Department of Health and Human Services, and the U.S. Environmental Protection Agency Humans inhale and ingest formaldehyde daily however, and produce formaldehyde during cellular metabolism. The human body is physiologically equipped to handle formaldehyde through multiple conversion pathways. The resultant single carbon atom released during metabolism is deposited in the "1-carbon pool," which, in turn, is used for the biosynthesis of macromolecules including DNA and RNA. Reevaluation of earlier research that examined potential health risks associated with formaldehyde exposure has shown that this research was based on flawed assumptions, which resulted in erroneous conclusions. The purpose of this review was to examine more recent research about formaldehyde metabolism, phormacokinetics, and corcinogenicity. These results indicated that formaldehyde is probably not a potent human carcinogen under low exposure conditions. Extrapolation of these research results to pediatric dentistry suggests an inconsequential risk associated with formaldehyde use in pediatric pulp therapy/

Risk factors for early childhood caries in Canadian preschool children seeking care.

PURPOSE: The purpose of this study was to determine family characteristics, beliefs, and habits that contribute to early and severe caries in young children in Canada. METHODS: A survey was administered to: (1) parents of 139 children diagnosed with early childhood caries (ECC) in 5 pediatric dentistry practices in Canada over a 33-month period (group 1); and (2) parents of all normal referrals (carious and noncarious children) in one of the practices over a 3 month period (group 2). Group 2 prevented studying an exclusive or polarized population, and allowed direct comparison between children with decoy and without decoy. The survey responses were compared with caries rates in the children, determined by dental examination, to detect important correlations of family and child factors with the disease level. Chi-square and logistic regression analyses described the strength of the relationships. RESULTS: Parent responses provided information on: (1) demographics; (2) economic status; (3) birth order; (4) parental education; (5) payment methods; (6) feeding and weaning history; (7) fluoride history; (8) food habits; (9) hygiene; (10) behavior; and (11) medication use. Caries presence and severe caries was linked to: (1) leaving the bottle with a child while sleeping; (2) having problems brushing a child's teeth; (3) prolonged holding of liquids in the mouth; and (4) being Caucasian. The authors did find that bottle use in general and having a difficult child were protective influences against decay. CONCLUSIONS: The factors providing the most caries risk are: (1) being left with a bottle while sleeping; (2) parents having problems brushing the child's teeth; (3) holding liquids in the mouth for prolonged times; and (4) ethnicity.

Persuasive evidence that formocresol use in pediatric dentistry is safe.

Concern has been expressed about the safety of formocresol use in pediatric dentistry. Formaldehyde, a primary component in formocresol, is a hazardous substance and is considered a probable human carcinogen by Health Canada. However, humans inhale and ingest formaldehyde daily and also produce this compound as part of normal cellular metabolism. The human body is physiologically equipped to handle this exposure through multiple pathways for oxidation of formaldehyde to formate and incorporation into biological macromolecules via tetrahydrofolate-dependent one-carbon biosynthetic pathways. Recent re-evaluation of earlier research that examined potential health risks associated with formaldehyde exposure has shown that the research was based on flawed assumptions, which resulted in erroneous conclusions. This review examines more recent research about formaldehyde metabolism, pharmacokinetics and carcinogenicity, the results of which indicate that formaldehyde is probably not a potent human carcinogen under conditions of low exposure. Extrapolation of these research results to pediatric dentistry suggests an inconsequential risk of carcinogenesis associated with formaldehyde use in pediatric pulp therapy. Areas for further investigation are suggested.

Intravenous procedural sedation: an alternative to general anesthesia in the treatment of early childhood caries.

Providing comprehensive dental treatment for preschool children with early childhood caries (ECC) is probably the greatest challenge facing most dentists; many elect to hospitalize a child with ECC and provide treatment under general anesthesia. However, as waiting lists for hospital admission are long, ECC continues to progress and can cause pain or acute infection. Hospital treatment also results in substantial costs beyond those for dental treatment. This paper describes a cost-effective intravenous sedation program being used in a pediatric dental practice in Kelowna, British Columbia. The program offers an alternative to general anesthesia that allows qualified dentists to provide comprehensive dental treatment to children with ECC safely and efficiently in the private practice setting.

Delivering supplemental oxygen during sedation via a saliva ejector.

Intraoperative oxygen supplementation to sedated children has been shown to prevent hemoglobin desaturations even in the presence of apnea during pediatric conscious sedation. Although many practitioners deliver supplemental oxygen via a nasal hood, this method is impractical and often unsuccessful if the child is a mouth breather, has moderate adenotonsillar hypertrophy or occasionally cries during treatment (at which time there will be mouth breathing). This paper describes a method in which the saliva ejector is used to deliver supplemental oxygen to sedated children while they are receiving dental treatment. The advantages of this method and suggestions for its successful application are also included.