Characteristics and influencing factors of the first dental visit among children in Bangkok, Thailand: a cross-sectional study.

BACKGROUND: The first dental visit (FDV) is fundamental to good oral health. This study aimed to investigate the characteristics of FDV, including the influencing factors, in children attending the government dental hospital in Bangkok. METHODS: This study included 289 pairs of new patients (aged 0-12 years) and their parents. The questionnaires, consisting of three parts: socio-demographic, reasons for the child's FDV and for not having FDV earlier, and the children's oral health knowledge and attitude, were completed by parents. The Chi-square and Kruskal-Wallis tests were used to compare variables among age groups. The level of statistical significance was set at p < 0.05. A multiple linear regression analysis was performed to identify the factors that influence the age at FDV. The variables included in the analysis were the child's characteristics, the family's socio-demographic background, the presence of symptoms, and the parents' knowledge and attitude towards their child's oral health. RESULTS: The mean ages of children at FDV were 5.57 ± 2.88 (age range of 0.58-11.92) years. There were 2.42% who had FDV ≤ 12 months of age, and 76.5% of all children already had dental caries. A low attitude score among parents was significantly found in the older age group of children (p = 0.001). The influencing factors with the age at FDV were the parental age (p < 0.001), the presence of symptoms or chief complaints (p = 0.016), and the presence of dental caries (p < 0.001). CONCLUSIONS: Children in Bangkok had seriously delayed FDV compared to the recommended guidelines. The parental age strongly influenced the proper age at FDV, together with the presence of symptoms or chief complaints, and the presence of dental caries. Thus, an effective campaign to raise awareness about FDV is still needed, especially in advanced maternal age.

A retrospective comparison of dental treatment under general anesthesia versus non-pharmacological approach in patient with special health care needs.

Background/purpose: The unmet dental needs are still at the highest rate in patients with special health care needs (SHCN) owing to their physical conditions, lack of cooperation, anxiety and dental fear. This study was aimed to investigate the differences in characteristics and outcomes of dental treatment between general anesthesia (GA) and non-pharmacological approach (NP) in patients with SHCN. Materials and methods: This study reviewed the dental chart records of SHCN patients from 2005 to 2019. The dental chart records were divided into two subgroups: GA and NP groups. The demographic data, recall behavior and treatment outcomes were analyzed and compared between groups. The comparisons between groups were analyzed by Pearson's chi-squared test, Fisher's exact test and Mann-Whitney U test at a significant level of 0.05. Results: Two hundred and sixty-one patients aged 2.2-43.1 years with mean age 14.22 ± 8.64 years old were included. The proportion of cases treated under GA (62%) and NP (38%) was 1.6:1. General anesthesia group had significantly higher in mean ages, caries experience, definitely negative behavior and treatment needs than NP group (P < 0.001). Moreover, recall rates in GA group were significantly lower than NP group (P < 0.001) without a significant difference in regularity. New caries occurrence (P = 0.015) with faster rate (P = 0.035), and behavior changes was significantly found in GA group (P = 0.007) after 24 months of recall. Conclusion: Patients with SHCN who were at older age and had high caries experience with definitely negative behavior and numerous treatment needs were more justifiably for GA. A significant new caries occurrence with faster rate tended towards SHCN patients who underwent GA.

The Efficacy of Non-fluoridated Toothpastes on Artificial Enamel Caries in Primary Teeth: An In Vitro Study.

AIMS: The aim of this study was to evaluate the remineralizing effect among various non-fluoridated toothpastes on artificial caries in primary teeth. MATERIALS AND METHODS: Fifty sound primary incisor teeth were embedded in self-curing acrylic resin and immersed in demineralizing solution for 4 days forming artificial caries. All teeth were divided into five groups (10 teeth/group): Group I deionized water (control); Group II 1000 ppm F (Kodomo®); Group III non-fluoridated toothpaste containing calcium glycerophosphate and calcium lactate (Dokbuaku®); Group IV casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) paste (GC Tooth Mousse®), and Group V non-fluoridated toothpaste containing nanohydroxyapatite (NHA) (Apagard®). The specimens were subjected to pH-cycling and immersed in toothpaste slurry twice for 7 days. Baseline, before, and after pH-cycling surface microhardness (SMH) values were measured by Vickers hardness numbers, and the percentage recovery of SMH (%SMHR) was calculated. Data were analyzed by one-way analysis of variance and Tukey's multiple comparison at 95% confidence intervals. RESULTS: The SMH values of test groups were significantly higher than those of the control group (p = 0.00). The %SMHR was -5.72±7.03% in the control group, Group II was significantly higher than Group III but there were no significant differences among Groups II, IV, and V (p > 0.05). CONCLUSION: Non-fluoridated toothpastes containing CPP-ACP or NHA for young children had efficacy in remineralizing effect on primary teeth comparable with 1000 ppm fluoridated toothpaste.

The efficacy of dental sealant used with bonding agent on occlusal caries (ICDAS 2-4): A 24-month randomized clinical trial.

BACKGROUND: Bonding before sealant application enhances retention on saliva-contaminated sound teeth; however, there are few studies of bonding's efficacy on sealant retention on occlusal caries. AIM: To evaluate a bonding agent's efficacy on sealant retention on occlusal caries and caries transition. DESIGN: One hundred twenty pairs of first permanent molars with occlusal caries (ICDAS 2-4) from 98 children aged 7.3-9.9 years were included. One molar was randomly selected to use bonding (Adper™ Single Bond 2, 3M ESPE) applied before sealant application (Helioseal® clear, Ivoclar Vivadent). Bonding was not used on the contralateral tooth. Retention was determined using Simonsen's criteria; caries transition was evaluated using ICDAS scores, DIAGNOdent values, and bitewings at baseline, 6, 12, and 24 months. Data were analyzed with McNemar's and Fisher's exact tests. RESULTS: Bonding agent use significantly increased sealant retention rates (P < .001). Bonded (B) sealants had a higher retention rate (83.3%) than non-bonded (NB) sealants (53.7%). The difference in the caries-transition rate was not significant between the groups (P > .05). Three teeth (1.4%; NB:B = 2:1) were restored due to radiographic dentin-caries progression. CONCLUSIONS: Using a bonding agent before applying sealant on permanent molar occlusal caries (ICDAS 2-4) significantly enhanced sealant retention. Caries progression was rarely detected at the 24-month follow-up.