In Vitro Study of Laser-Assisted Prefabricated Ceramic Crown Debonding as Compared to Traditional Rotary Instrument Removal.

This study compared the laser and rotary removals of prefabricated zirconia crowns in primary anterior and permanent posterior teeth. Sixty-two extracted teeth were prepared for prefabricated zirconia crowns cemented with resin-modified glass-ionomer cement. Specimens underwent crown removals by a rotary handpiece, or erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. Pulpal temperatures, removal times, and scanning electron microscopy (SEM) examinations were compared. The average crown removal time for rotary and laser methods was 80.9 ± 19.36 s and 353.3 ± 110.6 s, respectively, for anterior primary teeth; and 114.2 ± 32.1 s and 288.5 ± 76.1 s, respectively, for posterior teeth (p < 0.001). The maximum temperature for the rotary and laser groups was 22.2 ± 8.5 °C and 27.7 ± 1.6 °C for anterior teeth, respectively (p < 0.001); and 21.8 ± 0.77 °C and 25.8 ± 0.85 °C for the posterior teeth, respectively (p < 0.001). More open dentinal tubules appeared in the rotary than the laser group. The rotary handpiece removal method may be more efficient than the laser with lower pulpal temperature changes. However, the laser method does not create noticeable tooth or crown structural damage compared to the rotary method.

Oral Health Knowledge, Barriers to Dental Care, and Awareness of a Medicaid Pregnancy Dental Coverage Among Reproductive-Age Women.

Objectives: Oral health is an integral part of women's health, yet many women face barriers and go without necessary dental care. The objectives of this study were to (1) examine and compare pregnancy-related oral health knowledge and barriers to dental care access during pregnancy among women with private and public insurance and (2) estimate awareness of available Medicaid pregnancy dental benefit among Medicaid-enrolled women and explore associated factors. Methods: A cross-sectional survey was administered to a convenience sample of 21- to 45-year-old women (n = 187) visiting a large urban academic health center in Virginia. Data on pregnancy-related oral health knowledge, barriers to dental care access, Medicaid dental benefit awareness, health insurance, socio-demographics, health information source, and last dental visit were collected. Chi-square tests, t-tests, and multivariable regression were used to examine associations at p ≤ 0.05. Results: More than half of the women reported private insurance (52.4%), 40.3% reported Medicaid, and 8.3% reported being uninsured. Medicaid-enrolled women reported a lower prevalence of a routine dental checkup in the past year (44% vs. 71%, p = 0.002), lower knowledge scores (2.9 vs. 3.6, p < 0.001), and more barriers to accessing dental care during pregnancy compared with privately insured women. One in every three Medicaid-enrolled women (34%) was unaware of the Medicaid pregnancy dental benefit. Benefit awareness was associated with the receipt of health information from a health care source (p = 0.030) and a high oral health knowledge score (p = 0.018). Conclusions: There was a significant gap in dental care use and knowledge between Medicaid-enrolled and private-insured women in our study sample. Targeted programs should be developed to educate women about the importance of oral health and share information about available Medicaid dental coverage to reduce barriers to dental care during pregnancy.

Association between Vitamin D and Dental Caries in a Sample of Canadian and American Preschool-Aged Children.

BACKGROUND: Inadequate vitamin D levels may increase the risk of caries during childhood. The purpose of this study was to investigate the association between 25-hydroxyvitamin D (25(OH)D) status and severe early childhood caries (S-ECC) in preschool children. METHODS: Data were obtained from children <72 months of age in two case-control studies in Winnipeg, Manitoba and Richmond, Virginia. Serum analysis assessed 25(OH)D, calcium and parathyroid concentrations. Data on demographics, dental history and oral hygiene were obtained via questionnaires. Bivariate and multiple logistic regression analyses were performed to assess the relationships between demographic and biological variables and S-ECC. A p-value of ≤0.05 was significant. RESULTS: Data were available for 200 children with S-ECC and 144 caries-free controls. Children with S-ECC had significantly lower 25(OH)D levels than those who were caries-free (p < 0.001), and children with deficient 25(OH)D levels were 10 times more likely to have S-ECC (p < 0.001). Multiple logistic regression revealed that having higher 25(OH)D and calcium concentrations (p = 0.019 and p < 0.0001, respectively), as well as being breastfed in infancy (p < 0.001), were significantly and independently associated with lower odds of S-ECC, while dental insurance (p = 0.006) was associated with higher odds of S-ECC. CONCLUSIONS: This study provides additional evidence of an association between nutritional status, specifically vitamin D and calcium levels, and S-ECC.