[Non-restorative cavity treatment: from guidelines to the practice]. / Niet-restauratieve caviteitsbehandeling: van richtlijn naar de praktijk.

The new KIMO guidelines 'Oral Health Care for Children' approach caries as a behavioural related disease and unequivocally assign priority to causal caries treatment, emphasising lifestyle and behavioural changes. The 5-step concept of non-restorative caries treatment (NRCT) is recommended as treatment of choice for cavitated dentine lesions in primary dentition. Communicative aspects of NRCT are supported by limited technical interventions, for the purpose of effective oral care. A balance between aetiological and symptomatic treatment is sought for each child individually, in close cooperation with the parents. Technical aspects per tooth range from limited interventions like making cavities accessible for brushing, applying fluoride varnish or SDF, covering the cavity with a layer of glass ionomer cement to treatment like ART restoration or the Hall technique, in cases of necessity. Lifestyle changes lead to sustainable treatment results and enhance the quality of life of the child or young person.

Prevalence of molar-incisor-hypomineralisation among children participating in the Dutch National Epidemiological Survey (2003).

AIMS: This was to determine the prevalence of Molar-Incisor-Hypomineralisation (MIH) among children participating in the Dutch National Epidemiological Survey of 2003 and to compare the prevalence data with that found in the previous survey of 1999 when MIH was found in 9.7% of 11-year-old Dutch children. METHODS: The survey took place in the same four cities as the previous survey in 1999. In 442 9-year-old children born in 1994, first permanent molars and all permanent incisors were examined for demarcated opacities, post-eruptive enamel breakdown, atypical restorations and extractions due to MIH. Children were considered as having MIH, when at least one molar was affected, with or without involvement of the incisors. RESULTS: Of the children examined 63 or 14.3% had at least one affected molar with hypomineralisation defects. Of those children with MIH only demarcated opacities were present in 35 (55.6%), while 13 (20.6 %) had at least one tooth with occlusal breakdown in addition to opacities, and in 15 (23.8%) atypical restorations were found. No teeth had been extracted due to MIH. Of the children with MIH there were 36 (57.1%) who had both molars and incisors affected. CONCLUSIONS: A significantly higher prevalence of MIH has been found in Dutch 9 year-old children in the last National Epidemiological Survey of 2003 as compared with to the Survey of 1999.

Molar incisor hypomineralization: review and prevalence data from the study of primary school children in Kaunas/Lithuania.

AIMS: These were to determine the prevalence of MIH in a group of primary school children in Kaunas, Lithuania and to compare the prevalence of MIH in Lithuania with the prevalence in other countries using published data. METHODS: First permanent molars and all permanent incisors were examined in 1277 children, aged 7 to 9 years and having at least one erupted permanent molar, for demarcated opacities, post-eruptive enamel breakdown, atypical restorations and extractions due to MIH, according to the criteria, provided by the EAPD experts. Examinations were performed by two calibrated observers (k=0.829). RESULTS: Of all the children 190 (14.9%) had hypomineralization defects in at least one index tooth, 124 (9.7%) had at least one affected molar and were considered as having MIH. Only demarcated opacities were present in 68 (54.8%) of children with MIH, 35 (28.2 %) had at least one tooth with breakdown, 21 (16.9%) had atypical restorations. No teeth had been extracted due to MIH. Children with 3-6 affected teeth were 3.5 times more likely to have enamel breakdown and/or atypical restorations when compared with the children having only one or two affected teeth. Of the 124 children with MIH 96 (77.4%) had lesions only in molars, 28 (22.6%) had both - molars and incisors - affected. CONCLUSIONS: MIH was common among 7-9 years old Lithuanian children; majority of the affected children were affected mildly. Severity of the lesions was increasing with the number of affected teeth. Compared to the other studies MIH in Lithuania was moderately prevalent.