Effect of Modified Bioceramic Mineral Trioxide Aggregate Cement with Mesoporous Nanoparticles on Human Gingival Fibroblasts.

The ion doping of mesoporous silica nanoparticles (MSNs) has played an important role in revolutionizing several materials applied in medicine and dentistry by enhancing their antibacterial and regenerative properties. Mineral trioxide aggregate (MTA) is a dental material widely used in vital pulp therapies with high success rates. The aim of this study was to investigate the effect of the modification of MTA with cerium (Ce)- or calcium (Ca)-doped MSNs on the biological behavior of human gingival fibroblasts (hGFs). MSNs were synthesized via sol-gel, doped with Ce and Ca ions, and mixed with MTA at three ratios each. Powder specimens were characterized using Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and scanning electron microscopy (SEM). Biocompatibility was evaluated using a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay following hGFs' incubation in serial dilutions of material eluates. Antioxidant status was evaluated using Cayman's antioxidant assay after incubating hGFs with material disc specimens, and cell attachment following dehydration fixation was observed through SEM. Material characterization confirmed the presence of mesoporous structures. Biological behavior and antioxidant capacity were enhanced in all cases with a statistically significant increase in CeMTA 50.50. The application of modified MTA with cerium-doped MSNs offers a promising strategy for vital pulp therapies.

Do Maternal Beliefs, Knowledge and Practices for Own and Young Child Oral Care Reflect on Actual Child Oral Health?

AIM: The aim of the present study was to evaluate whether mother's oral health habits and knowledge for child oral care actually reflect on her young child's oral health and hence sought for direct evidence for this association. MATERIALS AND METHODS: One hundred mothers accompanied their children, aged 2-5 years to a University Pediatric Dentistry Clinic and completed a three-arm questionnaire. Child dental caries (decayed, missing, filled surfaces-dmfs) and gingival bleeding index (GBI) were recorded. Correlations were sought by the analysis of variance (ANOVA). RESULTS: A negative correlation was observed between maternal education and family income with child dmfs (p < 0.01). Additionally, other maternal factors such as age and correct knowledge of the appropriate age for a child's first dental visit, the initiation of toothbrushing, and fluoride exposure were positively associated with lower dmfs and GBI. Additionally, some maternal practices also contributed to these results. CONCLUSION: Maternal practices and knowledge are predictors of child oral health. CLINICAL SIGNIFICANCE: Mothers-to-be, especially those with low socioeconomic characteristics, should be involved in dental education and motivation interventions in order to practice proper oral hygiene for their children.

Assessment of Young Mothers' Oral Hygiene Practices during Pregnancy and Their Knowledge of Children's Oral Health in Northern Greece.

AIM: The aim of the study was to assess maternal knowledge about oral health practices for children along with oral hygiene perceptions of mothers during pregnancy in the city of Thessaloniki, Greece. MATERIALS AND METHODS: This cross-sectional study was conducted among 300 newly delivered mothers who were admitted to the obstetrician/gynecological (OB/GYN) University Clinic in Thessaloniki, Greece, to give birth. A three-part, self-reported, 40-item questionnaire was designed, collecting socioeconomic data, perceptions, and practices regarding maternal oral hygiene during pregnancy and their knowledge in relation to children's oral health. Collected data were recorded, tabulated, and statistically analyzed with SPSS (Version 24.0), and p < 0.05 was accepted as statistically significant. RESULTS: The sample consisted of mainly Greek, married, university alumni mothers less than 35 years of age. Self-reports of oral hygiene practices during gestation were sufficient but an inadequate level of regular dental visits was recorded. Poor knowledge was equally noted, regarding children's oral health, in the domains of fluoride toothpaste usage, the age of the first dental visit, supervised toothbrushing, nighttime breastfeeding, potential hazards of pacifier use, and thumb sucking. All factors were significantly associated with the mothers' education level (p < 0.05). CONCLUSION: Newly-delivered mothers presented with a lack of knowledge regarding mother/caregiver-related risk factors associated with early childhood caries (ECC), the timing of establishing a dental home, and misconceptions about the safety of dental visits during pregnancy. CLINICAL SIGNIFICANCE: Healthcare professionals interacting with pregnant women or young mothers are a vital element to bridge the existing gap in knowledge and assist those socially and educationally deprived.

Presentation of a Case of Short Root Anomaly in an 11-Year-Old Child.

Short root anomaly (SRA) is a developmental anomaly in which the affected teeth present morphologically normal crowns and short, round roots. The exact cause of SRA is unknown. A case of an 11-year-old female patient with SRA is described. The patient presented short, round roots of all permanent teeth but first molars. Maxillary lateral incisors presented severe root resorption and mobility. Treatment plan included preservation of the maxillary lateral incisors by splinting them to their adjacent teeth using a stainless steel coaxial wire. A custom mouthguard for dental trauma protection was also constructed using a computer-aided design - computer-aided manufacturing (CAD-CAM) system in order to fabricate 3D-printed dental casts. At 2-year follow-up, the mobility of maxillary lateral incisors decreased, and the patient's dentition remained stable. Considerations regarding differential diagnosis, orthodontic management, and treatment options after an eventual loss of teeth are thoroughly discussed.

Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists.

Background: In recent years, breastfeeding has been largely promoted due to health benefits for the children and the mothers and social, economic, and environmental advantages. World Health Organization (WHO) recommends breastfeeding for at least 2 years and to be continued for as long as this is desired by the mother-child dyad.Despite its advantages, including protection against caries in the 1st year of life, prevention of malocclusions, and development of more normal breathing patterns, there is a great controversy in the literature regarding breastfeeding involvement in elevated risk for early childhood caries (ECC).Breastfeeding and oral health are strongly related. Breastfeeding can influence oral health and development, but oral findings, such as tethered tissues and natal/neonatal teeth, may negatively affect lactation. Conclusion: A healthy collaboration between the oral health care provider and the lactation specialist is important in order to identify those oral findings and prevent breastfeeding implications, but also in order to facilitate uneventful breastfeeding by emphasizing oral health care prevention strategies. Clinical significance: Information on the advantages of certain lactation aspects and the potential risks for ECC is important for the pediatric dentist to be able to form an individualized treatment/prevention plan that will benefit and promote the oral and general health of young patients. How to cite this article: Papadopoulou P, Boka V, Arapostathis K. Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists. Int J Clin Pediatr Dent 2023;16(S-3):S306-S310.

Dental treatment of a Seven-Year-Old Child with Mastocytosis.

AIM: Mastocytosis is a rare disorder characterized by pathologic mast cell degranulation. This paper aims to present the dental management of a seven-year-old girl diagnosed with mastocytosis, in a hospital setting, yet without general anesthesia. CASE REPORT: A seven-year-old girl, diagnosed with urticaria pigmentosa, was referred to a dental practice. Her parents' main concern was a possible allergic reaction to local anesthetics and antibiotics. It was decided to perform treatment in the operating theatre of a clinic without general anesthesia. Eight primary teeth were restored. The patient was monitored, and no complications occurred throughout the procedure. Follow-ups performed every three months for two years after treatment. Patient's oral hygiene was improved significantly. CONCLUSION: Collaboration between medical experts, patient's family and the pediatric dentist was crucial. The dentist must be aware of the medical history and potential triggering factors. Due to high probability for life-threatening emergencies, dental treatment in a hospital setting is recommended.

Occlusal features of 5-year-old Greek children: a cross-sectional national study.

BACKGROUND: Occlusal characteristics of the primary dentition are crucial in predicting and determining permanent tooth alignment and occlusion. The aim of our study was to determine the occlusal characteristics of the primary dentition of 5-year-old children in Greece through a national pathfinder survey. METHODS: A stratified cluster sample of 1222 5-year-old children was selected according to the WHO guidelines for national pathfinder surveys. Five occlusal traits were registered clinically in centric occlusion, separately for the left and right sides: sagittal relationships of the second primary molars and primary canines, overjet, overbite, crossbite, and maxillary and mandibular spacing. RESULTS: Most children showed a flush terminal plane of primary second molars (44.8%), a class I primary canine relationship (52.2%) and normal overjet (46.4%), but a high prevalence of Class II canine relationship (25.6%) and overjet (37.8%) were also observed. A normal overbite was found in 40% of the children and 40% had a deep overbite. Spacing was apparent in both maxilla (71.1% of children) and mandible (56.4%). The prevalence of open bite and distal step molar relationship significantly rose in children with non-nutritive sucking habits. CONCLUSIONS: Νon-nutritive habits were associated to altered occlusal features. No sex significant differences were found in either the sagittal relationships of second primary molars and primary canines, or overjet, overbite, crossbite and spacing.

Orthodontic Status and Orthodontic Treatment Need of 12- and 15-Year-Old Greek Adolescents: A National Pathfinder Survey.

The purpose of this research was to assess the orthodontic status and orthodontic treatment needs of 12- and 15-year-old schoolchildren in Greece, in relation to sociodemographic factors and parental education level. A total of 1102 12-year-old children and 1131 15-year-old adolescents across Greece were assessed using the Modified Dental Health component (DHC) of the Index of Orthodontic Treatment Need (IOTN). An amount of 38.7% of 12-year-olds and 33.7% of 15-year-olds were in definite need of orthodontic treatment. The most common etiologic factors were tooth eruption and position anomalies. A higher rate of orthodontic treatment need was recorded among subjects with lower parental education level. Class I malocclusion was found in 50.9%, Class II in 38.4% and Class III in 10.8% of the total sample. A higher incidence of dental trauma was found in the 12-year-olds presenting with a Class II molar relationship and >3 mm overjet. The need for orthodontic treatment in Greece was higher, in comparison to other European countries, with one out of two children presenting a severe overjet associated with a high incidence of dental trauma. One out of three adolescents were still judged as having a need for orthodontic treatment by the age of 15.

Cytotoxic Evaluation and Determination of Organic and Inorganic Eluates from Restorative Materials.

Over the last years, diverse commercial resin-based composites have dominated as dental filling materials. The purpose of the present study was to determine organic and inorganic eluates from five restorative materials using GC/MS and ICP-OES and to compare the effect on cell survival of human gingival fibroblasts of a conventional and a bioactive resin. Five commercially available restorative materials were employed for this study: ActivaTM Bioactive Restorative, ENA HRi, Enamel plus HRi Biofunction, Fuji II LC Capsule, and Fuji IX Capsule. Disks that were polymerized with a curing LED light or left to set were immersed in: 1 mL methanol or artificial saliva for GC/MS analysis, 5mL deionized water for ICP-OES, and 5mL of culture medium for cell viability. Cell viability was investigated with a modified staining sulforhodamine B assay.The following organic substances were detected: ACP, BHT, BPA, 1,4-BDDMA, CQ, DBP, DMABEE, HEMA, MCE, MeHQ, MOPA, MS, TMPTMA, and TPSb and the ions silicon, aluminum, calcium, sodium, and barium. Activa Bioactive Restorative was found to be biocompatible. Elution of organic substances depended on material's composition, the nature of the solvent and the storage time. Ions' release depended on material's composition and storage time. The newly introduced bioactive restorative was found to be more biocompatible.

Dental Neglect in Children: A Comprehensive Review of the Literature.

AIM: The purpose of this review is to present the most recent bibliography regarding the etiology, risk factor indicators, types of dental neglect, and the epidemiological studies, showing the relationship between neglect and dental caries indices. Moreover, the review will focus on the role of oral healthcare professionals in evaluating such conditions. BACKGROUND: Untreated oral diseases, like dental caries, can lead to a variety of negative impacts on children including pain and infection. However, such complications can be prevented if a child's basic oral health needs are fulfilled. In addition, it is important to be aware that there are significant inequalities in accessing dental care and poverty, and such cases have to be distinguished from neglect. However, when there is adequate access to oral healthcare services and the parent or the guardian persistently fails to ensure appropriate medical care or treatment for his/her child, the possibility of dental neglect has to be seriously considered. REVIEW RESULTS: Dental neglect can be apart of a child's general neglect with short-term complications, such as caries, as well as long-term consequences that extend to adulthood, such as poor growth and impaired quality of life. CONCLUSION: Early diagnosis of dental neglect plays an important role in avoiding adverse impacts on children. Signs and risk factors for dental neglect should alert the dental team in order to intervene in time and prevent suspected cases. CLINICAL SIGNIFICANCE: Diagnosis of dental neglect can be difficult. However, identifying dental neglect at an early stage and making a child protection referral may safeguard the child and prevent further harm. For this reason, dentists should be informed about dental neglect and they should know how to deal with these cases. Effective education is necessary to increase knowledge and awareness of all aspects of child neglect.

Jet or conventional local anaesthesia? A randomized controlled split mouth study.

OBJECTIVES: To compare the efficacy, acceptance and preference of conventional infiltration technique with a needleless jet anaesthetic device (Comfort-In). MATERIALS AND METHODS: Non-fearful healthy adult volunteers, aged 19-40 years, were recruited in the Dental School of Aristotle University of Thessaloniki, Greece. Intact maxillary premolars were selected for local anaesthesia. Both techniques were applied sequentially with 35 min time gap on either buccal side on the same day by the same operator. The quadrant and the order of administration were randomly assigned using an online randomization generator. Immediately after administration, at 1, 3, 5, 10, 15, 20, 25 and 30 min, pulp vitality and soft tissue pain reaction tests were performed. Each participant was asked 6 questions in order to assess acceptance. At the end of the session, at 24 h and 7 days, all participants were asked to report any adverse events and their preference. RESULTS: In 63 volunteers who were successfully followed, 63 teeth received conventional local infiltration and 63 the Comfort-In. Both techniques presented with similar anaesthetic efficacy at 1, 3, 5, 10 and 15 min, whereas the conventional technique was more efficacious at 20 min (p < 0.005). Both presented similar acceptance apart from higher pain/discomfort during administration of Comfort-In (p = 0.002). Significantly higher preference was reported for the conventional technique immediately after the session, at 24 h and at 7 days (p < 0.0005); 19 (30.2%) reported the presence of ecchymosis or lacerations at the Comfort-In site as opposed to 5 (7.9%) with the conventional method (p < 0.0001). CONCLUSION: Both techniques showed similar effectiveness. Conventional infiltration was preferred to needleless anaesthesia by non-fearful adult volunteers and was associated with less adverse events. CLINICAL RELEVANCE: This study enhances the advantages of conventional local anaesthesia. TRIAL REGISTRATION: ISRCTN17400733.

Caries prevalence and caries experience (ICDAS II criteria) of 5-, 12- and 15-year-old Greek children in relation to socio-demographic risk indicators. Trends at the national level in a period of a decade.

PURPOSE: To study the caries status of 5, 12 and 15-year-old Greek children, assess how disease parameters are related to socio-demographic indicators and identify relevant trends at the national level. METHODS: A stratified cluster sample of 3702 children in total was randomly selected and examined clinically for caries (ICDAS II criteria). Caries experience was outlined by adapting ICDAS0-6 criteria to the d/D component of the WHO dmf/DMF index configuration. Percentages (%) of caries experience-free children, of children with initial caries (ICDAS1-2), and the mean d1-2t/D1-2T, d3-6mft/D3-6MFT and d3-6mfs/D3-6MFS indices were calculated. The probability of presenting with d1-2t/D1-2T ≥ 1 was assessed by binary logistic regression analysis, whereas negative binomial regression models examined the effect of socio-demographic parameters on d3-6mfs/D3-6MFS indices (level of significance: p ≤ 0.05). RESULTS: 60.1%, 48.1%, and 34.7% of the 5, 12, and 15-year-old children, respectively, had no caries experience at the defect level (d3-6mft/D3-6MFT = 0). Initial lesions (ICDAS1-2) were detected in 17.7%, 19.3% and 17.4% of the 5, 12 and 15-year-olds, accordingly. Mean d1-2t/D1-2T was 0.93, 1.70, and 2.51, whereas mean d3-6mft/D3-6MFT was 1.48, 1.61, and 2.46 for the 5, 12, and 15-year-olds, respectively. Children with higher educated parents and 15-year-old urban residents exhibited significantly less caries experience at the defect level. Initial caries lesions presented a significantly higher probability of being detected in urban-residing 5- and 15-year-olds, while no consistent trend could be identified for parental education level. Caries prevalence and experience levels declined for all age groups in ten years. CONCLUSION: Although the dental health of Greek children has improved disparities remain, calling for organised primary and secondary preventive interventions.

Dental Caries Prevalence and Experience (ICDAS II Criteria) of 5-, 12- and 15-Year-Old Children and Adolescents with an Immigrant Background in Greece, Compared with the Host Population: A Cross-Sectional Study.

Evidence regarding disparities in oral health among native and immigrant child and adolescent populations in Europe is scarce. The present study aimed to determine the caries status of 5-, 12-, and 15-year-olds with an immigrant background in Greece in relation to their sociodemographic characteristics and compare their caries levels with those of their native Greek peers. A sample of 707 immigrants underwent clinical examination for caries (ICDAS II criteria), followed by a calculation of caries prevalence and experience estimates (2013-2014). Multivariable regression models assessed the effect of ethnic background on the caries experience (d3-6mfs/D3-6MFS) of the total (707 immigrants and 3702 Greeks) population, and the association between parental education level and the immigrants' d3-6mfs/D3-6MFS. Among the 5- and 12-year-olds, those with an immigrant background demonstrated higher caries rates and had unfulfilled treatment needs at higher proportions. Among 15-year-old adolescents, no considerable differences in caries status were observed according to ethnic background (native Greek or immigrant). The strength of the association between immigrant background and caries experience levels attenuated gradually with increasing age (IRR = 1.61, 1.27 and 1.10, and p = 0.001, p = 0.006 and p = 0.331 for 5-, 12- and 15-year-olds, respectively). Among the immigrants, adolescents with less educated mothers exhibited elevated caries levels. Public health strategies should prioritize immigrant children and early adolescents in order to reduce the existing ethnic disparities in oral health.

Enamel opacities in all other than Molar Incisor Hypomineralisation index teeth of adolescents.

BACKGROUND: There are scarce data on the hypomineralisation of other permanent teeth (HOPT) than the index teeth of Molar Incisor Hypomineralisation (MIH). AIM: To report on the prevalence and surface pattern of HOPT and seek associations with MIH. DESIGN: Representative samples of urban Greek 14-year-olds were examined in classroom with a dental mirror. Their enamel defects were recorded using EAPD criteria for MIH. Descriptive statistics and correlation tests for HOPT vs previously reported MIH findings in the same samples were applied. RESULTS: HOPT prevalence in 1156 consented adolescents was 22.9%. 148 (16.2%) of 912 no-MIH children had HOPT; 117 (48.1%) of the 244 MIH children had HOPT too (OR 3.0, 95% CI 2.4-3.6). There were more HOPT teeth per child in the MIH vs no-MIH children (P < .001). HOPT tooth frequency was as follows: second molar 33.7%, canine 25.7%, first premolar 23.6%, and second premolar 17.0%. Enamel breakdown was seen in 5.3% HOPT children. Vestibular to intraoral surface defect ratio differed between jaws (maxilla 187/88, mandible 149/17, P < .05). CONCLUSIONS: Hypomineralisation defects in the MIH non-index teeth collectively had comparable prevalence and tooth surface patterns to MIH, but much lower severity. MIH was predictor for HOPT.

When a pedodontic examination leads to the diagnosis of osteopetrosis: A case report.

BACKGROUND/AIM: Osteopetrosis is an inherited disease characterized by increased bone density. Its genetic variability results in various phenotype expressions, whereas clinically are classified in three types: malignant infantile, intermediate and adult. The various oral manifestations of the disease give a crucial role to the pediatric dentists in diagnosis. CASE PRESENTATION: A 7-year-old girl with persistent swelling on right cheek visited a pedodontic clinic. After extra- and intra-oral examination/findings, the patient was referred for further investigation concerning a possible general pathological background. An extraction, included in the initial dental treatment plan, led to the diagnosis of osteopetrosis. Various medical examinations co-led to the diagnosis of osteopetrosis but without genetic identification. Extractions of carious teeth, under general anesthesia, and full cover or sealants, on chair, of unaffected teeth were conducted respectively to minimize the microbial load and to prevent from osteomyelitis relapse and new caries. Two more general anesthesia sessions took place due to relapse of lower jaw osteomyelitis. Follow-up was conducted every 3 months for 2 years. CONCLUSION: Osteopetrosis' diagnosis can be triggered by its oral manifestations (rampant caries, osteonecrosis, enamel defects, malformed roots/crowns, missing teeth), for which the pediatric dentist could be the first observer. Management of these patients needs multidisciplinary approach and follow-up appointments should be very frequent.

Gagging prevalence and its association with dental fear in 4-12-year-old children in a dental setting.

AIM: The aims were to determine the prevalence of gagging in children in the dental setting, detect any association between gagging and dental fear in that setting, and determine if the association varied by type of setting. DESIGN: A total of 734 children (4-12 years old), seeking dental care either at a University paediatric dental clinic (UC) or at a private paediatric practice (PP), filled out the Greek version of the Gagging Assessment Scale (GAS, subjective assessment) and the Greek version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The shorter form of the Gagging Problem Assessment-dentist part for children (GPA-de-c/SF, dentist's objective measurement) was used to assess their gag reflex. RESULTS: A total of 209 children (28.47%) gagged according to the GPA-de-c/SF. There was no significant difference in gagging between UC and PP children. Children rated as gaggers on the GPA-de-c/SF reported significantly higher GAS and CFSS-DS scores (U = 33 629.000; P < 0.001, U = 31 955.500, P < 0.001, respectively). Also, there was a significant association between GAS and CFSS-DS (rho = 0.307, P < 0.001). CONCLUSIONS: In the dental setting, there were significant relationships between dental fear, the dentist's objective measurement of gagging severity, and the child's subjective gagging assessment.

Biological interactions of a calcium silicate based cement (Biodentine™) with Stem Cells from Human Exfoliated Deciduous teeth.

OBJECTIVE: To investigate the biological interactions of a calcium silicate based cement (Biodentine™) with Stem Cells from Human Exfoliated Deciduous teeth (SHED), focusing on viability/proliferation, odontogenic differentiation, biomineralization and elemental release/exchange. METHODS: Biodentine™ specimens were used directly or for eluate preparation at serial dilutions (1:1-1:64). SHED cultures were established from deciduous teeth of healthy children. Viability/proliferation and morphological characteristics were evaluated by live/dead fluorescent staining, MTT assay and Scanning Electron Microscopy. Odontogenic differentiation by qRT-PCR, biomineralization by Alizarin red S staining, while ion elution by Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES). RESULTS: SHED effectively attached within the crystalline surface of Biodentine™ specimens acquiring a spindle-shaped phenotype. Statistically significant stimulation of cell proliferation was induced at day 3 by eluates in dilutions from 1:16 to 1:64. Differential, concentration- and time-dependent expression patterns of odontogenic genes were observed under non-inductive and inductive (osteogenic) conditions, with significant up-regulation of DSPP and Runx2 at higher dilutions and a peak in expression of BMP-2, BGLAP and MSX-2 at 1:8 dilution on day 7. Progressive increase in mineralized tissue formation was observed with increasing dilutions of Biodentine™ eluates. ICP-OES indicated that Biodentine™ absorbed Ca, Mg and P ions from culture medium, while releasing Si and Sr ions from its backbone. SIGNIFICANCE: Biodentine™ interacts through elemental release/uptake with the cellular microenvironment, triggering odontogenic differentiation and biomineralization in a concentration-dependent manner. These results reveal a promising strategy for application of the calcium silicate based cement (Biodentine™) for vital pulp therapies of deciduous teeth in Paediatric Dentistry.

Periodontal Impact of Preformed Metal Crowns on Permanent Molars of Children and Adolescents: A Pilot Study.

PURPOSE: When treating an early permanent molar with coronal malformation in children, as in severe molar incisor hypomineralization (MIH) cases, preformed metal crowns (PMCs) are a successful mid- to long-term restorative option. The purpose of this study was to evaluate possible changes in periodontal tissues and subgingival microbiota after PMC placement by way of a split-mouth study. METHODS: Fourteen healthy patients with a mean age of 10.6 (±4.2) years old, attending a university dental clinic, had one MIH severely affected permanent first molar restored with a PMC (study side), while the contralateral relatively healthy tooth was the control. The Turesky plaque index, gingival index (GI), and pocket depth (PD) were assessed, and counts of periodontal pathogens were determined by checkerboard DNA-DNA hybridization at baseline and at the six-month recall. RESULTS: There were no defective PMCs at either examination time. GI and PD significantly increased statistically in the permanent molars under study from baseline to follow up, as did Porphyromonas gingivalis and Tannerella forsythia counts. CONCLUSION: The changes found in periodontal status and specific periodontal pathogens six months after preformed metal crown placement on permanent first molars warrant long-term follow-up to ascertain if these are reversible.

The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear.

BACKGROUND: No studies assessing the association between gagging and dental fear are available in pediatric samples. AIM: To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. DESIGN: A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. RESULTS: A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). CONCLUSIONS: The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment.

Relationship between Child and Parental Dental Anxiety with Child's Psychological Functioning and Behavior during the Administration of Local Anesthesia.

OBJECTIVES: The aims of this study were to determine: 1) the relationship between children's psychological functioning, dental anxiety and cooperative behavior before and during local anesthesia, 2) the relationship of parental dental anxiety with all the above child characteristics. STUDY DESIGN: There was a convenient sample of 100 children (4-12 years). Child dental anxiety and psychological functioning were measured using the "Children's Fear Survey Schedule" (CFSS-DS) and the "Strengths and Difficulties Questionnaire" (SDQ) respectively. Parental dental anxiety was measured using the "Modified Dental Anxiety Scale" (MDAS). All questionnaires were completed by parents. Before and during local anesthesia, the child behavior was scored by one experienced examiner, using the Venham scale. Non-parametric tests and correlations (Mann-Whitney, Spearman's rho) were used for the analysis. RESULTS: The mean SDQ score was 10±5.6 for boys (n=60) and 8.3±4.8 for girls (n=40) (p=0.038), but there was no correlation with children's age. The mean CFSS-DS score was 33.1±11.86 and there was no correlation with age or gender. Children with higher levels in the pro-social subscale of the SDQ had significantly less anxiety and better behavior before local anesthesia. Higher mean CFSS-DS scores were significantly associated with uncooperative behavior during local anesthesia (p=0.04). There was no correlation between parents' and their children's dental anxiety, psychological functioning and behavior. 46% of the children had previous dental experience in the last 6 months. As time since the last dental treatment increased, an improvement was found in children's behavior during local anesthesia. CONCLUSIONS: Child psychological functioning was related to dental anxiety and behavior during dental appointment involving local anesthesia.