American Academy Of Pediatric Dentistry Research Articles

The Compliance of Dentists toward Prescribing Prophylaxis Antibiotic for Special Care Patients at Risk of Having Infective Endocarditis

Background: Prescribing antibiotics (Abs) as a prophylactic before dental procedures is recommended by the American Academy of Pediatric Dentistry (AAPD) in patients with cardiac diseases to prevent a potentially life-threatening infection of the cardiac valves or endocardium called “infective endocarditis (IE).” Aim: This study aimed to assess the compliance of dentists in Makkah city with the AAPD recommendations of prescribing prophylaxis Abs for special care pediatric patients at risk of having IE. Materials and Methods: This was an observational cross-sectional study among dentists who are working at the major hospitals in Makkah city, Saudi Arabia. Participants' perception regarding the prescription of prophylactic Abs was measured using validated and reliable questions. The reliability analysis was used with a model of alpha (Cronbach) to study the properties of measurement scales and the items that compose the scales and the average inter-item correlation. Results: One hundred and thirty-two dental practitioners were participated. Dental care providers would prescribe Abs with dental extraction (92.4%), periodontal surgery (89.4%), nonsurgical root canal treatment beyond apex (77.3%), supragingival scaling (67.4%), and retraction cord placement (46.2%). On the other hand, dental practitioners would not prescribe Abs for orthodontic appliance (87.9%), intraoral radiograph (87.1%), primary teeth shedding (81.8%), tooth preparation when taking an oral impression (76.5%), local anesthesia infiltration (68.2%), and restoration of Class II caries with matrix and wedge (56.8%). A significantly lower knowledge score was obtained by general dental practitioners when compared with consultant and specialists (P = 0.044). Consultants and specialists recorded significantly lower knowledge on the prescription of prophylaxis Abs for Class II caries with matrix and wedge (P < 0.001) when compared with general dental practitioners. Conclusions: Most dentists followed the AAPD recommendations of prophylactic Abs for children who have a high risk of developing IE. However, Class II dental restorations with matrix and wedge and placement of retraction cord have recorded more invalid responses. General dental practitioners had lower knowledge when compared with consultants and specialists when prescribing Abs for children who have a high risk of developing IE.

Pediatric Patients, Parenting and the Pandemic: Caring for Children in Modern Times

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsSharine V. ThenardSharine V. Thenard, DDS, MS, is a practicing pediatric dentist in the Bay Area. She earned her DDS from the University of California, San Francisco, and completed her MS degree and certificate in pediatric dentistry at The Ohio State University and Columbus Children’s Hospital (now Nationwide Children’s Hospital). Dr. Thenard has served as past president of the California Society of Pediatric Dentistry and the Alameda County Dental Society and as trustee of the California Dental Association and currently serves on the TDIC/TDICIS board. She is a diplomate of the American Board of Pediatric Dentistry and a fellow of the American Academy of Pediatric Dentistry and American College of Dentists. Conflict of Interest Disclosure: None reported.

Systematic Review of Clinical Practice Guidelines for Oral Health in Children With Cleft Lip and Palate.

Objective:Clinical practice guidelines (CPGs) exist to present recommendations and policies aimed at optimizing the oral health of children and adolescents born with cleft lip and/or palate. The aim of this review is to identify and assess the scope, quality, adequacy, and consistency of CPGs related to oral health in children and adolescents with clefts, along with reporting any differences and shortcomings.Methods:A systematic review of the literature of CPGs following Preferred Reporting Items for Systematic Reviews guidelines was conducted. Assessment of selected CPGs was performed using the Appraisal of Guidelines for Research & Evaluation II methodological quality instrument.Results:Only 7 CPGs fulfilled the criteria. Of these, 4 were from the American Cleft Palate-Craniofacial Association, and 1 each from the American Academy of Pediatrics, the Academy of Breastfeeding Medicine, and the American Academy of Pediatric Dentistry. The lowest overall mean scores were in the domain “Rigor of Development” (mean 29.58%, SD 17.11), revealing lower quality in methodology of the guideline. The domain “Clarity of Presentation” (mean 73.80%, SD 7.87) revealed the best score.Conclusions:Our review results reveal a lack of integrated high-quality CPGs that can be used as universal guidelines by health workers in a range of disciplines for improving oral health in children and adolescents with cleft problems.

Randomized trial of a photography-aided behavioural intervention to reduce risk factors for caries and malocclusion in high-risk infants.

To assess the efficacy of a photography-aided behavioural intervention in reducing risk factors for dental caries and malocclusion in high-risk infants. In this randomized trial conducted in a maternity hospital, 55 mothers of recently born infants at high risk of developing oral diseases were allocated to either the intervention (n=28) or usual care (n=27). The intervention arm received the same usual care plus an enhanced, behaviour-oriented, photography-aided, two-stage (0 and +6months) educational programme addressing nutritional, behavioural, lifestyle and familial factors that affect child's oral health. The primary outcome was the proportion of children classified as being at a 'low risk' of developing dental caries at the age of 12months using a modified score based on the Caries-risk Assessment Form of the American Academy of Pediatric Dentistry. Secondary outcomes included risk factors for malocclusion, such as duration of exclusive breastfeeding, pacifier use and bottle-feeding and/or sippy cup usage. At 12months, the proportion of children considered at low risk for dental caries was significantly higher in the intervention group compared to usual care (71% vs 15%, respectively, relative risk=4.82, 95% confidence interval=1.89-12.3, p<0.001). The median duration of exclusive breastfeeding in the intervention group was 1.7 times higher than in the control arm (5months vs 3months, p=0.03). Altogether, our findings provide evidence that a low-cost, two-stage preventive strategy using photographs to deliver a stronger visual impact might significantly reduce the incidence of risk factors for dental caries and malocclusion in 12-month-old children.

A Comparison of Four Caries Risk Assessment Methods.

Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions.Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0–6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups.Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.

State Medicaid Authorities' Policy Communications With Providers on Individualized Pediatric Dental Care.

Medicaid's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) pediatric benefit is designed to meet children's medically necessary needs for care. A 2018 Centers for Medicare & Medicaid Services (CMS) Bulletin advised Medicaid programs to ensure that their dental payment policies and periodicity schedules include language that highlights that medically necessary care should be provided even if that care exceeds typical service frequency or intensity. We assessed the extent to which Medicaid agencies' administrative documents reflect EPSDT's flexibility requirement. From August 2018 through July 2019, we retrieved dental provider manuals, periodicity schedules, and fee schedules in all 50 states and the District of Columbia; analyzed these administrative documents for consistency with the CMS advisory; and determined whether instructions were provided on how to bill for services that exceed customary frequencies or intensities. Dental-specific periodicity schedules were not evident in 11 states. Eighteen states did not include flexibility language, for example, as advocated by the American Academy of Pediatric Dentistry. Flexibility language was not evident in 24 dental provider manuals or in 47 fee schedules. Only 8 states provided billing instructions within fee schedules for more frequent or intensive services. Updating Medicaid agency administrative documents-including dental provider manuals and periodicity and fee schedules-holds promise to promote individualized dental care as ensured by EPSDT.

Envisioning forensic odontology under a new light

Forensic dentistry is an emerging field of science and it incorporates a wider scope for growth. It has developed itself as an important science in medical and legal matters and in the identification of the deceased person or an abuse victim. Forensic identification often requires an interdisciplinary approach. A pedodontist can help a forensic odontologist by applying their skills for recognition and reporting of child abuse and neglect, age assessment, bitemark analysis, and labeling of appliances that could provide vital clues for person identification. The American Academy of Pediatric Dentistry has prepared a guideline for record keeping that may provide pedodontist the information to accurately compile the records that will help the investigators. The aim of this article is to provide an overview of evolving trends in conventional methods and newer techniques and to discuss the role of pedodontist and how it can contribute to procedures needed for investigation in forensic odontology.

The Effect of Well Child Visit Location on Preventative Dental Visit

Recent emphasis has been placed on the integration of dental and medical primary care in an effort to promote recommendations from both American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD) that highlight the importance of preventing, intervening, and managing oral disease in childhood. The study aims to provide a population level insight into the role of location of service of medical well-child visit (WCV) and its association to preventative dental visit (PDV) for children between the ages of 0–20 years. Administrative claims data for 3.17 million Medicaid-enrolled children aged 0 to 20 years of age in 13 states in 2016 and 2017 were identified from the IBM Watson MarketScan Medicaid Database. Descriptive and survival analysis reveals most Medicaid enrolled children receive their WCV at an office and hospital, as compared to federally qualified health center, or rural or public health clinic. Further, this study demonstrates increased utilization of dental preventive services for children who receive a WCV. Hispanic children, female children, and children 5–9 years of age had a higher rate of PDV after a WCV at all three locations. This study contributes to the understanding of medical-dental integration among Medicaid-enrolled children and offers insight into the promotion of oral health prevention within medical primary care.

¿Porqué el trauma em la dentición decídua es importante?

El trauma de la dentición caduca puede causar un impacto físico, emocional y psicológico en los niños de cualquier edad, sin embargo, muchos acaban por no atribuirle la importancia adecuada. Teniendo en cuenta que a los 2 años ya se está formando el diente permanente, el primer aspecto que debe ser relevante es el impacto que puede causar en el diente permanente. Los niños ponen a prueba sus límites y muchas veces pueden sufrir traumas que son difíciles de prevenir, pero hay algunas precauciones que se pueden tomar para evitar estos traumas. Este trabajo destaca la importancia de los traumatismos en la dentición decidua para aclarar dudas sobre las diferentes secuelas y sus tratamientos, a partir de los testimonios de los profesionales presentes en el 17º Congreso de la Academia Latinoamericana de Odontopediatría y 6º Congreso de la APO, 2014. Para evaluar el tratamiento y las secuelas en el diente permanente, se debe valorar el tipo de traumatismo, la edad del niño, la evaluación clínica y radiográfica, y finalmente el seguimiento hasta la erupción del diente permanente.

Caries risk assessment of a sample of children attending preventive specialized dental center in Al Resafa, Baghdad

Background: Young children’s oral health maintenance and outcomes are influenced by their parent’s knowledge and beliefs, which affect oral hygiene and healthy eating habits. This study aims at assessing caries risk in children aged 6 months to 6 years attending the Specialized Center of Preventive and Pediatric Dentistry Center at Al-Resafa sector in Baghdad. Materials and Methods: A cross-sectional study was conducted from 15 May – 15 June 2018, all children attended the center (80 children) were assessed by using the standard caries risk assessment tool of the American Academy of Pediatric Dentistry (AAPD). Results: The highest percentage of children was as follows: no fluoride exposure 44(55%), did not brush 46(57.5%), had no special health care needs 77(96.25%), had no missed teeth due to caries 51(63.75%), had no-visible plaque 52(65%), frequent or prolonged between-meal exposure/day 55(68.75%), their mothers had carious lesions in last 7-23 months 34(42.5%); in visual caries: had carious lesions or restorations in last 24 months 67(83.75%), while the incipient carious lesions in last 24 months were 50(62.50%). Most of risk assessment score for the participants was moderate 57(71.3%), followed by low risk 16(20%), while the participants with high risk were 7(8.8%), with a statistically significant association between the risk assessment score and fluoride exposure (p=0.043), sugary foods or drinks(p=0.038), caries experience of the mothers (p=0.001), brushing (p=0.020) visual caries (p=0.000), incipient caries (p= 0.000), missing teeth due to caries (p= 0.001), but no statistical significance with special health care needs (p=0.533) and visible plaque (p=0.259). Conclusion: Moderate-risk of developing dental caries was predominant among the participants, followed by low-risk and less high-risk categories.&#x0D;

Assessment of Knowledge, Attitude, and Practice among Private Dental Practitioners toward Preventive Measures of Pediatric Patients in Durg-Bhilai City.

IntroductionThe old saying “prevention is better than cure” holds true when applied to preventive dental care. It is vitally important for the general health and well-being of the individual to take the necessary steps to prevent the occurrence of major dental problems. American Academy of Pediatric Dentistry (AAPD) emphasizes the importance of initiating professional oral health intervention in infancy and continuing through adolescence and beyond.Materials and methodsAround 109 available private general dental practitioners of Durg-Bhilai city (within city limits) made up the (convenient) sampling frame of the study. These entire dentists were identified and contacted. But, out of 109 dentists, only 92 were surveyed. BDS graduates and MDS (other than pedodontists) were included in the study. Dentists who were not willing to participate were excluded from the study. The sample size was calculated based on the total number of dentists practicing in Durg-Bhilai city limits.ConclusionA statistically significant correlation was found in-between the knowledge and practice score (0.368), knowledge and attitude (0.269); attitude and practice (−0.257).How to cite this articleTiwari J, Pattanshetti K, Doifode D, et al. Assessment of Knowledge, Attitude, and Practice among Private Dental Practitioners toward Preventive Measures of Pediatric Patients in Durg-Bhilai City. Int J Clin Pediatr Dent 2020;13(S-1):S78–S81.

COVID-19: General and Oral Manifestations in Children, Impact on Pediatric Dentistry and Future Perspective

(COVID-19) has spread rapidly across the globe, becoming a major public health concern for countries around the world. Despite worldwide efforts to contain viral spread, the outbreak has not shown any promising signs of containment yet. The coronavirus disease 2019 is a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It is mainly transmitted through respiratory droplets and close contact. As COVID-19 cases have been reported among children as well, there is an increased risk of acquiring the disease through these Silent Carriers who present as asymptomatic with mild or moderate clinical viral infection. The American Academy of Pediatric Dentistry (AAPD) is constantly revising their checklist for re-emergence in pediatric dental practice during the COVID-19 pandemic. Pediatric dentists should keep a high level of awareness to help patients, minimize risk and prevent viral spread. During this period of pandemic, management of child’s oral health presents specific difficulties related to the infectious spread of the disease. The aim of this article is to review the Covid-19 infection in children, its impact on pediatric oral health, challenges for pediatric dentistry and future perspective.

Inflammatory fibrous hyperplasia in pediatric dentistry due to deleterious habit: case report

This paper reports the clinical case of a pediatric dentistry patient, presenting a correlation between non-nutritive suction and inflammatory fibrous hyperplasia. A 10-year-old female patient attended the Pediatric Dentistry Clinic of the Araçatuba Dental School-Brazil (FOA/UNESP) with her mother, who reported a "little ball under the upper lip" of the daughter, observed three months before, with gradual increase. The clinical examination revealed poor positioning of tooth 21 and a fibrous hyperplasia at 2 cm from the upper region of the respective tooth. A presumptive diagnosis of inflammatory fibrous hyperplasia was established. The proposed treatment was lesion excision, fabrication of a Hawley appliance for repositioning of tooth 21 and counseling on the need to cease the deleterious digital sucking habit. We conclude that elimination of the traumatic agent is fundamental for therapeutic success, in addition to surgical removal.Descriptors: Hyperplasia; Fingersucking; Habits.ReferencesEspinoza-Zapata M, Loza-Hernández G, Mondragón-Ballesteros R. Prevalence of buccal mucosa lesions in pediatric patients. Preliminary report. Cir Cir. 2006; 74(3):153-57.Cawson R, Eveson J. Oral pathology and diagnosis: Color atlas with integrated text. Phipadelphia, USA: Saunders, 1995;1-128.Rodriguez AF, Sacsaquispe SJ. Hyperplasia Fibrosa Inflamatória y posibles factores asociados em adultos mayores. Rev Estomatol Heridiana.2005;15(2):139-44.American Academy of Pediatric Dentistry. Management considerations for pediatric oral surgery and oral pathology. Pediatr Dent 2018;40(6):373-82.Neville B, Damm DD, Allen C, Chi A. Oral and Maxillofacial Pathology, 4th ed. Elsevier; 2016.Góis EG, Ribeiro HC, Vale MP, Paiva SM, Serra-Negra JMC, Ramos-Jorge ML et al. Influence of nonnutritive sucking habits, breathing pattern and adenoid size on the development of malocclusion. Angle Orthod. 2008;78(4):647-54.Scarpelli BB, Berger SB, Punhagui MF, Oliveira CAZ, Ferelle A, Oltramari-Navarro PVP. Evaluation of a preventive educational program for malocclusions: 7-year study. Braz oral res. 2016;30(1):e119.Cavalvanti AL, Bezerra PKM, Moura C, Bezerra PM, Granville-Gracia AF. Relationship between malocclusion and deleterious oral habits in preschool children in Campina Grande, PB, Brazil. Stom Glass S. 2008;55:154-62.Montaldo L, Montaldo P, Cuccaro P, Caramico N, Minervini G. Effects of feeding on non-nutritive sucking habits and implications on occlusion in mixed dentition. Int J Paediatr Dent. 2011;21(1):68-73.Vasconcelos FMN, Massoni ACLT, Heimer MV, Ferreira AMB, Katz CRT, Rosenblatt A. Non-nutritive sucking habits, anterior open bite and associated factors in Brazilian children aged 30-59 months. Braz Dent J. 2011;22(2):140-45.Suhani RD, Suhani MF, Muntean A, Mesaros M, Badea ME. Deleterious oral habits in children with hearing impairment. Clujul Med. 2015;88(3):403-7.Bueno SB, Bittar TO, Vazquez FL, Meneghim MC, Pereira AC. Association of breastfeeding, pacifier use, breathing pattern and malocclusions in preschoolers. Dental Press J Orthod.2013;18(1):30e1-6.Gheno JN, Martins MAT, Munerato MC, Hugo FN, Sant'ana Filho M, Weissheimer C et al. Oral mucosal lesions and their association with sociodemographic, behavioral, and health status factors. Braz oral res. 2015;29(1):00289.Warren JJ, Bishara SE, Steinbock KL, Yonezu T, Nowak AJ. Effects of oral habit´s duration on dental characteristics in the primary dentition. J Am Dent Assoc. 2001;132(12):1685-93.Barros RMG, Campos KSM, Cabral LM. Relato de caso clínico de hiperplasia fibrosa inflamatória. Rev Odontol Araçatuba. 2014;35(2):15-18.Dutra KL, Longo L, Grando LJ, Riveiro ERC. Incidence of reactive hyperplastic lesions in the oral cavity: a 10 years’ retrospective study in Santa Catarina, Brazil. Braz J Otorhinolaryngol 2019; Braz j otorhinolaryngol. 2019;85(4):399-407.Palacios-Sánchez B, Cerero-Lapiedra R, Campo-Trapero J, Esparza-Gómez GC. Alteraciones gingivales no relacionadas con placa. RCOE. 2006;11(1):43-55.Coelho CM, Sousa YT, Daré AM. Denture-related oral mucosal lesions in a Brazilian school of dentistry. J Oral Rehabil. 2004;31(2):135-39.

The Modes of Dental Caries Prevention with Xylitol

The importance of dietary factors in the etiology of dental caries has been acknowledged, and the role of proper nutrition in improving the health of the population cannot be disputed [1]. The American Academy of Pediatric Dentistry (AAPD) acknowledges the benefits of sugar substitutes, particularly xylitol as caries preventive strategies on the oral health of infants, children, adolescents, and persons with special health care needs. Thus, the AAPD has intended a policy about the use of xylitol-based products in caries prevention [2].

BEBERAPA PENANDA (MARKER) PADA EARLY CHILDHOOD CARIES (ECC) DAN SAVERE EARLY CHILDHOOD CARIES (S-ECC)

Early childhood caries (ECC) is caries that affects children under the age of 6. According to the American Academy of Pediatric Dentistry (AAPD), ECC is defined as the presence of one or more teeth with caries (cavities or no cavities), missing teeth due to caries or the presence of restoration deciduous teeth in children under 71 months. If it occurred on the smooth surface of the tooth in children under 3 years of age, indicating severe early childhood caries (S-ECC). Streptococcus Mutans plays a role in the etiology of caries of preschool children, which is a contagious infectious disease, Streptococcus Mutans are acidogenic bacteria (can produce acid) and aciduric (can live in acidic environments). The occurrence of caries is a complex process of interaction between host factors (teeth), microorganisms, substrates (carbohydrates) and the environment, including saliva. Several markers related to ECC and S-ECC namely lysozyme, lactoferrin saliva, IL-8, CD36 salivary neutrophil.

Testing the efficacy of a brief-caries risk assessment form to evaluate the dental health status among preschool children, Bangkok, Thailand

PurposeThe study aims to test the efficacy of brief-caries risk assessment form with standard caries risk assessment form and to evaluate the application of caries risk assessment following American Academy of Pediatric Dentistry (AAPD) between brief and standard caries risk assessment on dental health status among preschool children.Design/methodology/approachBrief-caries risk assessment form was developed. Then, experimental study was conducted in public health center 54 among 70 patients (35 test and 35 control) from January to July 2019. Test group used brief-caries assessment form, and control group used standard form. Both groups received the same caries risk assessment criteria and management protocol from AAPD. At baseline, 3-month and 6-month follow-up, caries risk and dental health status (plaque index, cavitated caries lesion and non-cavitated caries lesion) were assessed. Data were analyzed by descriptive statistic, t-test, chi-square test, Fisher's exact test and repeated measures ANOVA.FindingsPercentage of high caries risk decreased from baseline (93.9%: test and 96.9%: control) to 6-month follow-up (66.7%: test and 65.6%: control) in both groups, with no statistically significant differences between groups. Plaque index, cavitated caries lesion and non-cavitated caries lesion were not statistically significant differences between groups. Brief-caries assessment decreased times/visit from 10-15 minutes to 5 minutes.Originality/valueBrief-caries assessment form decreased caries risk and prevented dental caries as the standard form. Using brief-caries assessment form could save time, is cost-effective and is appropriate for use in public health centers. However, a short follow-up time might have insufficient power to detect the differences between groups.

A survey on radiation exposure reduction methods including rectangular collimation for intraoral radiography by pediatric dentists in the United States

BackgroundThe authors conducted a survey of the American Academy of Pediatric Dentistry (AAPD) to determine awareness of the Image Gently Campaign in Dentistry (IGCD) and to ascertain radiologic practices, including radiation dose-reduction strategies such as rectangular collimation. MethodsAn institutional review board approved an electronic survey sent to 7,087 AAPD members covering practitioner demographic characteristics, radiographic techniques, and dose-reduction practices, including rectangular collimation. Responses were tabulated and analyzed using binomial tests, χ2 tests, and Fisher exact tests. ResultsA total of 1,124 pediatric dentists or residents in pediatric dentistry responded, (response rate 16%, margin of error ± 2.7%). The largest group (23.8%) graduated after 2010. More than 90% indicated that they followed American Dental Association (ADA)-AAPD radiation exposure guidelines, but only 33.5% were aware of IGCD. Almost all respondents used direct digital systems, storage phosphor plates, or both. Only 22.3% (n = 220) used rectangular collimation. Nonusers indicated that they were unfamiliar with collimation (33.3%) or concerned about potential for increased cone cuts (30.2%), 11.6% of respondents were unaware of any regulatory requirements for inspections of radiographic equipment recurring at regular intervals, and 4.1% of respondents considered use of lead aprons optional. ConclusionsAlthough the pediatric dentists surveyed believe they are in compliance with ADA-AAPD guidelines, most are unaware of IGCD recommendations. Use of digital radiography is almost ubiquitous, but use of rectangular collimation is limited. Practice ImplicationsDentists treating children should be familiar with ADA-AAPD radiation exposure guidelines and should consider using the dose-reduction strategies recommended by IGCD.

Occupational burnout and depression among paediatric dentists in the United States.

Paediatric dentists in the United States may be at greater risk for occupational burnout and/or depression because of chronic stress associated with provision of paediatric dental care and increasing prevalence of females in the workforce. To determine the prevalence of occupational burnout and/or depression among US paediatric dentists. A self-administered online anonymous survey was sent to members of the American Academy of Pediatric Dentistry (n=4735). The questionnaire consisted of seven demographic items, 22 items of Maslach Burnout Inventory (Three subscales: Emotional exhaustion, Depersonalization, and Personal accomplishment), and eight items of Patient Health Questionnaire-8. The survey had a response rate of 11.4% (females=53%). Twenty-three per cent of respondents had high emotional exhaustion while fewer respondents had high depersonalization (12%) or low personal accomplishment (10%). Nine per cent fulfilled the study's definition of occupational burnout (high emotional exhaustion+high depersonalization). Seven per cent of respondents had moderate-to-severe depression and showed significant correlations (P<.05) with high emotional exhaustion, high depersonalization and low personal accomplishment. Two out of five respondents with occupational burnout also had moderate-to-severe depression. There were no gender differences in prevalence of burnout or depression. Few paediatric dentists had occupational burnout and/or depression.

Pediatric Dentists' Educational Experiences, Attitudes, and Professional Behavior Concerning Resin Infiltration: Implications for Dental Education.

Minimally invasive dentistry (MID) is receiving increased attention. Resin infiltration (RI) is one micro-invasive technique for treating initial caries by sealing white spot lesions on tooth surfaces. The aims of this study were to assess pediatric dentists' RI-related educational experiences, attitudes, and professional behavior and to determine if their educational experiences were significantly related to their professional attitudes and behavior regarding RI. This cross-sectional study used an online survey to collect data from members of the American Academy of Pediatric Dentistry (AAPD) in March-April 2017. Of the 2,367 AAPD members invited to participate, 43 emails could not be delivered, and 273 surveys were completed, for a response rate of 11.8%. While only 9% of the 273 respondents reported that their classroom-based dental education had informed them about RI and only 1% that it had prepared them well to use RI with pediatric patients, higher percentages said they had been informed/prepared well by their classroom-based (24%) and clinical residency education (12%). The majority wanted to learn more about RI (71%) and would like to take a related CE course (59%). The respondents' average RI-related attitudes were positive (on five-point scale with 1=worst attitude: Mean=3.84). Regarding use of RI, 28% of respondents said they used RI sometimes and 4% often/very often, with 64% considering implementing RI in their clinics. Graduation year did not correlate with RI attitudes and use. However, the more education about RI the respondents had received during their residency (r=0.20; p<0.01) and in professional development after graduation (r=0.34; p<0.001), the more they used RI in their own work. This study found that the pediatric dentists' RI-related education was positively correlated with their professional behavior. Increasing predoctoral, resident, and continuing professional education about RI should therefore be considered.

Child dental neglect laws: Specifications and repercussions for dentists in 51 jurisdictions

BackgroundThe purpose of this study was to perform an interjurisdictional comparison of statutes and regulations (collectively laws) pertaining to the reporting of child dental neglect by dentists. Case law interpretation or enforcement of the laws was not included in this study. MethodsChild neglect laws were identified in 51 jurisdictions (50 states and the District of Columbia) by performing a Westlaw legal database search, conducting a systematic internet search, and engaging in direct communication with each jurisdiction. Laws on 2 domains relative to dentists were evaluated: protection from civil and criminal liability when reporting child neglect and sanctions for failing to report child neglect. ResultsAll jurisdictions have child neglect laws; however, only 8 specify failing to seek dental treatment as child neglect and none adopt the American Academy of Pediatric Dentistry’s definition. Although all jurisdictions protect dental professionals who report child dental neglect in good faith, sanctions for failing to report neglect include imprisonment from 6 months (49%) through 5 years (2%) and fines from $1,000 (61%) through $10,000 (6%). ConclusionsAlthough the laws vary across jurisdictions, dentists are protected when reporting child dental neglect but can be sanctioned for failing to report it. Practical ImplicationsDentists may not be aware of the current sanctions or interjurisdictional differences. Becoming informed about these laws may incentivize dentists to establish reporting protocols for child dental neglect.