Localized aggressive periodontitis in a six-year-old: a case report.

The purpose of this report was to describe an approach to diagnose and effectively treat a pediatric patient with localized aggressive periodontitis. A 6-year-old female presented with clinical and radiographic evidence of severe attachment loss around several primary teeth. She had no history of systemic disease, periodontal disease, or caries prior to the periodontal abscess that prompted her referral. Routine immunological tests did not reveal any functional defects, but DNA testing for periodontal pathogens revealed the presence of all 8 aggressive periodontal pathogens assayed. Treatment consisted of the extraction of 2 severely affected primary teeth, increased frequency of recall appointments, and administration of systemic antibiotics. The patient's periodontal condition was stabilized 18 months post-treatment, and the 8 pathogens were no longer at detectable levels. With a treatment goal of preventing disease progression into the erupting permanent dentition, this treatment regimen provides an effective alternative to more aggressive strategies.

Do pediatric dentists practice the orthodontics they are taught?

PURPOSE: The purpose of this study was to determine whether the orthodontic treatment provided by pediatric dentists reflects the orthodontic training received in pediatric dental residency programs. METHODS: Five questions from a survey of the American Academy of Pediatric Dentistry (AAPD) diplomates in August 2002 and a survey of pediatric dental residency program directors in June 2002 were statistically analyzed to compare the orthodontic treatment provided by diplomates to that provided within pediatric dental residency programs. RESULTS: Patient populations differed financially between pediatric dental residencies and diplomates of the AAPD. Residents treated significantly more public assistance patients. The residents were more likely than diplomates to use most orthodontic appliances and treat most stages of dental development and most conditions/malocclusions with orthodontics. Diplomates anticipated a decrease in the amount of orthodontic treatment provided in the next 5 years, while program directors anticipated an increase. CONCLUSIONS: The majority of the orthodontic treatment provided by pediatric dental residents and diplomates was similar, although the residents were exposed to more diverse orthodontic treatment modalities than those used by diplomates. The residencies were also more likely than the diplomates to increase the amount of orthodontic treatment provided in the next 5 years.

Adolescent pregnancy: a review of dental treatment guidelines.

More than 6% of adolescent females become pregnant in the United States per year, yet there is no concise guide for their dental treatment. The principles for medical management of these patients are not unlike those used for adult females, but the higher incidence of complications coupled with social and consent issues make their overall management more complex. Whether treating a pregnant adolescent or an adult, the primary goal is to maintain a safe environment for both the fetus and mother. Untreated dental disease can compromise the health of the mother and unborn child; therefore, dental treatment should not be withheld. In complicated pregnancies, dental practitioners should contact the patient's obstetrician prior to providing treatment or prescribing medication. With proper technique, dental radiographs do not place the fetus at risk and should be taken if they are of potential benefit. Preventive care should be delivered throughout pregnancy, and elective routine care is best delivered during the second trimester.

Orthodontic training in pediatric dental residencies.

The purpose of this study was to determine the amount and types of orthodontic training in pediatric dental residencies. A twenty-one-item survey was mailed to sixty directors of pediatric dental residencies. Follow-up surveys were sent to those who had not responded. Fifty-two surveys were returned for a response rate of 87 percent. Most programs provided forty-eight formal orthodontic course hours, one-half to one day of clinical orthodontic experience per week, and six to ten case starts for each resident. Most program directors anticipated this amount of experience would increase or stay the same in the future. Though most programs had an affiliated graduate orthodontic program, fewer than half of the programs had an orthodontist on faculty from the affiliated program (43 percent). As expected, orthodontic training varies with different program characteristics. The faculty members teaching orthodontics in pediatric dental residencies are often not from affiliated graduate orthodontic programs. Most program directors do not anticipate a decrease in the didactic or clinical components in the next five years.