Dental Care For Children Research Articles

치위생과 학생들의 임상실습관련 불안과 피로 조사

Objectives : The aim of the study is to investigate anxiety, fatigue and stress of dental hygiene students in clinical practice and to improve the psychological support program. Methods : A self-reported questionnaire was filled out by 428 dental hygiene students in 4 universities in Gwagju and Jeonnam. Data were analyzed for anxiety, stress and fatigue, general characteristics using SPSS 18.0 program for descriptive statistics, ANOVA, and correlation. Results : Saliva suction showed the most high score in treatment(<TEX>$mean{\pm}SD=2.92{\pm}1.13$</TEX>) and was followed by children dental care(<TEX>$2.79{\pm}1.21$</TEX>), preventive dental care(<TEX>$2.38{\pm}1.04$</TEX>), maxillofacial radiology(<TEX>$2.35{\pm}1.15$</TEX>). During the clinical practice, students felt uneasy when they stayed in relative home(p<0.05). Poor interpersonal relation(p<0.001), poor health condition(p<0.01), low satisfaction with major(p<0.01), the other cause of major choice(p<0.01) influenced on their stress. Satisfaction with major was closely related to clinical practice performance, anxiety, physical fatigue and mental fatigue. Conclusions : In order to reduce physical, mental, neuro sensory fatigue of students in clinical practice, it is recommended to reinforce the patient care etiquettes in curricula.

A gestão em saúde bucal na linha de cuidado materno infantil: Análise do Programa ‘Sorria Bombeirinho’ da Policlínica Odontológica do Corpo de Bombeiros Militar do Distrito Federal, Brasil.

Oral health can not be separated from general health and directly influences the quality of life and self-esteem of the individual. Preventive programs accompanying children from birth are fundamental to the development of a healthy dentition without caries or other sequelae due to para- functional habits. Moreover, it is very important that the manager understands the user’s view in relation to the health service, so that it feels safe and welcomed. This study aimed to examine the program of maternal and child dental care Dental Polyclinic line in the Fire Brigade of the Federal District (PODON - CBMDF). Thus, we evaluated the perception of those responsible for children 0-2 years attending the first phase of the program in the period 2011-2013 and oral health conditions thereof. This research was exploratory, using a quantitative approach, the applied nature, where there was a field study, occurring in 2 steps: a questionnaire to managers and analysis of medical records of patients. Microsoft Excel 2007 software was used for statistical analysis. After tabulation and interpretation thereof, a report was made, and the same was delivered to program management. The questionnaire to parents identified that they are very satisfied with the actions and services of the program and the institution. The analysis of the records showed that of the 75 children studied, 67 (89 %) had oral disease during follow-up. Thus, the program appears to be effective in preventing early childhood caries in early childhood.

Responsiveness of the Child Perceptions Questionnaire11-14for Cambodian children undergoing basic dental care

Oral-Health-Related Quality of Life (OHRQoL) instruments are useful outcome measures in dental health services research; however, there are no reports of the use OHRQoL measures in evaluating the outcome of basic dental care in children anywhere. The aims of this study are to evaluate the responsiveness of the Khmer version of the Child Perceptions Questionnaire11-14 (CPQ11-14) and to describe changes in OHRQoL associated with the provision of basic dental care. A pre-test/post-test design, with a clinical convenience sample of children aged from 8 to 14 years of age who received basic dental care from a local nongovernmental organisation (NGO). Of the 140 children in the baseline sample, 116 (82.9%) were followed up. The mean change in CPQ11-14 overall score for those with caries was 1.7, representing a small improvement in OHRQoL. There was a moderate (one in three) statistically significant reduction in the prevalence of impacts across the whole sample (P < 0.001; McNemar test), and one in five improved by the minimally important difference (MID) of five-scale points. The Khmer version of the CPQ11-14 appears to be a valid and responsive measure for assessing treatment-associated changes in OHRQoL in children with dental caries in Cambodia.

The role of parental education and socioeconomic status in dental caries prevention among Lithuanian children

Background and objectiveThe aim of this study was to disclose parental attitudes toward their children's dental care and preventive measures used as well as to evaluate their associations with parental education and socioeconomic status. Materials and methodsA total of 1248 parents of 7-, 9-, and 12-year-old children from 5 largest Lithuanian cities were enrolled in the study. The questionnaire comprised 34 items, which were grouped into 4 clusters. ResultsThe parents with a high educational level scored better than those who had a low educational level (2.13 [SD, 0.39] vs. 2.2 [0.43], P=0.002). The parents who reported sufficient-family income scored their child's and their own health significantly better than those reporting insufficient-family income (2.02 [SD, 0.37] vs. 2.27 [SD, 0.41], P<0.001). The parents cared about their child's health more than about their own (1.53 [SD, 0.51] vs. 2.15 [0.61], P<0.001). The parents with a high educational level and those receiving sufficient income cared about education on oral hygiene and regular preventive dental check-ups more than those with a low educational level and insufficient income (36.7% and 40.8% vs. 30.2% and 28.7%, P<0.01 and P<0.001, respectively). The children whose parents had a high educational level brushed their teeth 2 times a day more frequently than those of the parents with a low educational level (48.5% and 42.4%, respectively, P<0.001). ConclusionsGreater attention to children's dental care as well as keeping their teeth healthy was paid by the parents with a high educational level and sufficient income.

Viewpoint: Early childhood caries: a New Zealand perspective

Dental caries, primarily a preventable disease, remains the most common chronic disease of childhood and one of the most common reasons for hospital admissions for children in New Zealand. The most vulnerable children are shouldering the burden of the disease, with Maori and Pacific children having greater experience and severity of dental caries. Early childhood caries has deleterious effects on a child’s oral and general health and significant numbers of preschool-aged children experience pain and infection. Early identification by primary health care providers of children at high risk of developing early childhood caries can ensure these children are referred to the appropriate oral health services to receive appropriate and timely management. KEYWORDS: Dental care for children; dental caries; New Zealand; preschool child

Behavioral changes in preschoolers treated with/without rotary instruments.

Background:Behavioral dentistry is an interdisciplinary science which needs to be learned, practiced, and reinforced in order to provide quality dental care in children.Aim:To assess the anxiety experienced during dental treatment in preschool children with/without rotary instruments using behavioral scale.Study and Design:Sixty pediatric patients of preschool age with bilateral occlusal carious lesions extending into dentin were selected for the study. Carious lesions were removed using conventional rotary instruments on one side and Papacarie – chemomechanical caries removal of approach on contra lateral side. Both cavities were restored with glass ionomer cement (Fuji IX). Anxiety scores were determined using ‘Modified Child Dental Anxiety Scale’ (Wong et al, 1998) during the various clinical stages of the treatment course.Results:Children experienced relaxed behavior when subjected to Papacarie method of caries removal compared to conventional method using rotary instruments.Conclusion:This study helped us to provide behavioral measures and introduce children to dentistry in a nonthreatening setting.

A parent motivational interviewing program for dental care in children of a rural population.

Objectives: To determine the effectiveness of a motivational interviewing-based educational program in reducing the number and intensity of new caries and bacterial dental plaque levels at 6 months post randomization. Study Design: A randomized and single blind clinical trial in 100 schoolchildren between 6-10 years of age presenting the highest risk score of caries according to the Caries Management by Risk Assessment (CAMBRA) criteria was performed. These patients were randomized to two groups: control (in which the mothers initially received an oral prevention informative session) and experimental (in which the mothers received the initial informative session, followed by individual motivational interviewing sessions during a period of 6 months). The International Caries Detection and Assessment System (ICDAS) scores and bacterial plaque were evaluated at baseline, at 6 and 12 months. Results: After 12 months, children in the experimental group had 2.12 ± 0.8 new caries versus 3.5 ± 0.9 in the control group (t=7.39; p<0.001). Caries in the experimental group was seen to be limited to the enamel, with a median intensity of 2 (range 0-3) versus 3 (0-6) in the control group (U=1594; p<0.0001). Bacterial plaque determined by the O’Leary index decreased in both groups; however, it decreased more in the experimental than in the control group (34.3 vs. 20.6; t=-3.12, p= 0.002) respectively. Conclusions: Motivational interviewing is better than traditional educational programs in preventing caries and decreasing bacterial plaque. Key words:Health educational, motivational interviewing, caries risk.

Reimbursement rates and policies for primary molar pit-and-fissure sealants across state Medicaid programs

Little is known about Medicaid policies regarding reimbursement for placement of sealants on primary molars. The authors identified Medicaid programs that reimbursed dentists for placing primary molar sealants and hypothesized that these programs had higher reimbursement rates than did state programs that did not reimburse for primary molar sealants. The authors obtained Medicaid reimbursement data from online fee schedules and determined whether each state Medicaid program reimbursed for primary molar sealants (no or yes). The outcome measure was the reimbursement rate for permanent tooth sealants (calculated in 2012 U.S. dollars). The authors compared mean reimbursement rates by using the t test (α = .05). Seventeen Medicaid programs reimbursed dentists for placing primary molar sealants (34 percent), and the mean reimbursement rate was $27.57 (range, $16.00 [Maine] to $49.68 [Alaska]). All 50 programs reimbursed dentists for placement of sealants on permanent teeth. The mean reimbursement for permanent tooth sealants was significantly higher in programs that reimbursed for primary molar sealants than in programs that did not ($28.51 and $23.67, respectively; P = .03). Most state Medicaid programs do not reimburse dentists for placing sealants on primary molars, but programs that do so have significantly higher reimbursement rates. Medicaid reimbursement rates are related to dentists' participation in Medicaid and children's dental care use. Reimbursement for placement of sealants on primary molars is a proxy for Medicaid program generosity.

Oral health care in children with haemophilia in Helsinki, Finland

The bleeding tendency and fear of bleeds may have a negative effect on preventive dental care of patients with haemophilia both at home and at dental appointments. To describe the clinical practice of dental care in children with haemophilia in Helsinki, Finland. This study evaluated retrospectively the medical records of 28 paediatric patients with haemophilia (aged 5.3-17.4years) from dental visits during 2009-2010. Decayed, missing and filled teeth in the primary (dmft) and permanent dentition (DMFT), Community Periodontal Index (CPI), signs of developmental dental defects in enamel and the number of preventive and restorative procedures were gathered. Dmft+DMFT scores were compared with those of 17,079 non-haemophiliac boys. The Mann-Whitney U-test was used to compare the data between the groups of different severity of haemophilia. The median number of dental visits per patient was three (range 1-11). Twenty-two patients (79%) had dmft+DMFT-scores within the 95% reference range for age. None of the children had a CPI >2. Twelve (43%) patients had developmental enamel defects. Half had received restorative dental care and three out of four preventive procedures. Dental care during hospital visits in children with haemophilia may enhance confidence in the preventive dental care and help minimise bleeding during dental procedures.

The traditional practice of canine bud removal in the offspring of Ethiopian immigrants

BackgroundThe custom of canine bud removal has detrimental consequences on children’s general health and dental care. The objective of this study was to assess whether the prevalence of missing primary canines and dental defects in offspring of emigrants from Ethiopia is greater than in offspring of native Israeli parents of similar socioeconomic class.Methods477 children of Ethiopian descent and 317 offspring of native Israeli parents, from 21 nursery schools and kindergartens, underwent dental examinations aimed to determine the presence or absence of primary canines and of developmental enamel defects on adjacent teeth to the primary canines. For purposes of analysis, children were classified into two age groups: younger (ages 18–48 months) and older (ages 49–82 months).ResultsCanines were present in more Israeli than Ethiopian younger children, 87.5% vs. 42.3%, p=0.0001; and in more Israeli than Ethiopian older children, 92.6% vs. 40.4%, p=0.0001. More dental defects were detected in Ethiopian than in Israeli younger children, 32% vs. 3.9%, p=0.0001; and in more Ethiopian than Israeli older children, 31.2% vs. 5.8%, p=0.0001.ConclusionsThe prevalence of missing primary canines and dental defects was greater among offspring of parents who had emigrated from Ethiopia 15–20 years earlier than among offspring of native Israeli parents living in the same low socioeconomic neighborhoods.

Faktor yang berhubungan dengan partisipasi orang tua dalam perawatan kesehatan gigi anak di Puskesmas Tegallalang I

Abstrak: Laporan Puskesmas Tegallalang I menunjukkan bahwa tingkat partisipasi orang tua dalam perawatan kesehatan gigi dan mulut anak di wilayah kerja puskesmas masih kurang (31,7%-35,1%). Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan, sikap, motivasi orang tua dan ketersediaan alat transportasi dengan tingkat partisipasi orang tua dalam perawatan kesehatan gigi dan mulut anak di Puskesmas Tegallalang I. Penelitian dilakukan secara cross sectional pada 100 orang tua yang anaknya dirujuk untuk melakukan perawatan kesehatan gigi dan mulut di Puskesmas Tegallalang I yang dipilih secara random. Data pengetahuan, sikap, motivasi dan ketersediaan alat transportasi dikumpulkan menggunakan pedoman wawancara, sedangkan partisipasi orang tua didapat dari register pelayanan gigi. Data dianalisis dengan regresi logistik. Hasil penelitian menunjukkan bahwa tingkat partisipasi orang tua dalam perawatan kesehatan gigi dan mulut anak masih kurang (41%). Variabel yang berhubungan secara signifikan dengan tingkat partisipasi orang tua dalam perawatan kesehatan gigi dan mulut anak adalah pengetahuan [OR=7.35; p=0.001], motivasi [OR=4.89; p=0.028], dan sikap [OR=4.19; p=0,039]. Ketersediaan alat transportasi tidak terbukti berhubungan [OR=2.35; p=0.123]. Berdasarkan hasil penelitian dapat disimpulkan bahwa partisipasi orang tua dalam perawatan kesehatan gigi dan mulut anak dipengaruhi oleh pengetahuan orang tua tentang kesehatan gigi dan mulut, sikap dan motivasi orang tua terhadap perawatan kesehatan gigi dan mulut anak. Diharapkan kepada puskesmas untuk meningkatkan penyuluhan tentang kesehatan gigi dan mulut serta manfaat perawatannya untuk meningkatkan partisipasi orang tua dalam perawatan kesehatan gigi dan mulut anak.

Factors related to parent’s participation in child dental health care in Tegallalang I Public Health Centre

Factors related to parent’s participation in child dental health care in Tegallalang I Public Health Centre

Dental neglect as a marker of broader neglect: a qualitative investigation of public health nurses' assessments of oral health in preschool children.

BackgroundChild neglect is a pernicious child protection issue with adverse consequences that extend to adulthood. Simultaneously, though it remains prevalent, childhood dental caries is a preventable disease. Public health nurses play a pivotal role in assessing oral health in children as part of general health surveillance. However, little is known about how they assess dental neglect or what their thresholds are for initiating targeted support or instigating child protection measures. Understanding these factors is important to allow improvements to be made in care pathways.MethodsWe investigated public health nurses’ assessment of oral health in preschool children in relation to dental neglect and any associations they make with child neglect more broadly. A qualitative study was conducted in Scotland during 2011/12. Sixteen public health nurses were recruited purposively from one health region. Individual, semi-structured interviews were undertaken and data were analyzed inductively using a framework approach. Categories were subsequently mapped to the research questions.ResultsPublic health nurses assess oral health through proxy measures, opportunistic observation and through discussion with parents. Dental neglect is rarely an isolated issue that leads on its own to child protection referral. It tends to be other presenting issues that initiate a response. Threshold levels for targeted support were based on two broad indicators: social issues and concerns about child (and parental) dental health. Thresholds for child protection intervention were untreated dental caries or significant dental pain. Barriers to intervention are that dental neglect may be ‘unseen’ and ‘unspoken’. The study revealed a communication gap in the care pathway for children where a significant dental problem is identified.ConclusionsPublic health nurses take their child protection role seriously, but rarely make a link between dental caries and child neglect. Clear guidance on oral health assessment is required for public health nurses. Establishing formal communication pathways between child dental care providers and public health nurses may help close gaps in care pathways. However, further research is required into how these communication mechanisms can be improved.

Knowledge of preventive child oral healthcare among expectant mothers in Port Harcourt, Nigeria

This study was carried out to assess the perception of preventive oral care in children among expecting mothers at the antenatal clinic of University of Port Harcourt Teaching Hospital, Nigeria. Women who already had one or more children were selected; participants were drawn from among them by consent and a structured questionnaire was administered. Information obtained included sociodemographic information (age, educational level, employment status, and the parity of the women) and participants' perception of child dental care. Data collection spanned a period of four weeks. Three hundred and eighty two respondents participated and they had a mean age of 30.6 (±4.3 SD) years. The majority of the participants were 26–35 years old (76%) and were primiparous (49.5%) with tertiary education (67%). Toothache was their reported reason for a child's first visit to the dentist (47.4%) while routine dental check-up accounted for (42.7%). A third (35.3%) of the participants agreed that tooth cleaning should begin as soon as the first tooth erupts; 20.7% opined that soft toothbrush and toothpaste are choice materials for cleaning. There were statistically significant associations between parity and (i) child's visit to the dental clinic (p = 0.00); and (ii) the material used in cleaning the baby's teeth (p = 0.00). Also, educational status and knowledge of routine dental check-ups were significantly associated (p = 0.04). The perceptions of dental visits, cleaning of teeth, and commencement of unassisted tooth brushing in children were poor. Pediatric oral health education should be incorporated into ante- and post-natal clinics.

Effectiveness of audiovisual modeling on the behavioral change toward oral and dental care in children with autism

Background/aimThe purpose of this study was to evaluate the effectiveness of audiovisual modeling on behavioral change of Autistic children toward oral and dental care. MethodThis prospective study was performed on 36 autistic children aged from 6 to 12 years old attending The “Egyptian Autistic Society (EAS).” Children participated in tooth brushing intervention program. They were randomly divided in to 3 different groups according to modeling methods of tooth brushing. Children in the first group were subjected to demonstration of tooth brushing steps using model representing upper and lower jaws, children in the second group were subjected to specific colored pictures explaining tooth brushing steps (pictorial Activity schedule (PAS)) and children in the third group were subjected to video modeling (Peer model brushing his teeth). Behavior of the children toward tooth brushing before and after running the program and the dental health knowledge and attitudes of parents toward dental care were assessed using a special questionnaire completed by parents and teachers of the children. Final evaluation was done after one month. ResultsThe result of the study showed that: no statistically significant change in behavior of the children after the program in group A there was a statistically significant change in behavior of the children after program in Group B (PAS model) and Group C (video model). ConclusionVisual pedagogy and Technology-based intervention is useful tool for helping Autistic children to improve their oral hygiene.

Study of the psychological preparation on the dental care of children with special needs

The psychology in Dentistry is a great challenge for the clinicians during the care of their patients. The conditioning of a patient to achieve a behavior meeting the professional’s needs for developing a procedure within the quality standards is necessary. When this conditioning focuses on the child patients the challenge is even greater because the child will use all ways to make difficult the action of the clinician due to fear or discomfort. The ability of the dentist to condition the patient will be directly proportional to the training and theoretical knowledge acquired. Considering the Patients with Special Needs (PSN), this training should be differentiated because there is the physical, cognitive, and the previous dental/medical history in addition to the psychological and emotional difficulties. The aim of this study was to evaluate the profile of the patient to be conditioned satisfactorily and which conditioning techniques would be more efficient to ambulatory dental care of PSN. Thirty patients, both genders, aged from 20 months to 11 years-old who were enrolled at the ambulatory treatment of NEAPE were observed. It was concluded that when there is the cognitive development of the individual, they are able to be conditioned for the ambulatory care; the use of auxiliary methods is important in the conditioning for the ambulatory care of the individuals; the syndromic patients had the best results for the conditioning aiming to the ambulatory care; there was a significant improvement in the behavior of individuals between the first and last appointments.

Life course experiences and lay diagnosis explain low‐income parents' child dental decisions: a qualitative study

This study aimed to better understand low-income parents' child dental care decisions through a life course approach that captured parents' experiences within the social context of poverty. We conducted 43 qualitative life history interviews with 10 parents, who were long-term social assistance recipients living in Montreal, Canada. Thematic analysis involved interview debriefing, transcript coding, theme identification and data interpretation. Our interviews identified two emergent themes: lay diagnosis and parental oral health management. Parents described a process of 'lay diagnosis' that consisted of examining their children's teeth and interpreting their children's oral signs and symptoms based on their observations. These lay diagnoses were also shaped by their own dental crises, care experiences and oral health knowledge gained across a life course of poverty and dental disadvantage. Parents' management strategies included monitoring and managing their children's oral health themselves or by seeking professional recourse. Parents' management strategies were influenced both by their lay diagnoses and their perceived ability to manage their children's oral health. Parents felt responsible for their children's dental care, empowered to manage their oral health and sometimes forgo dental visits for their children because of their own self-management life history. This original approach revealed insights that help to understand why low-income parents may underutilize free dental services. Further research should consider how dental programs can nurture parental empowerment and capitalize on parents' perceived ability to diagnose and manage their children's oral health.

Multidisciplinary treatment in children with ectodermal dysplasia

Oral habilitation in children with ectodermal dysplasia (ED) necessitates consideration of the special dental and oral conditions as well as of the growing child’s physical and psychological development. The severity of ED symptoms varies and is for some families a source of daily worries and complications. The paediatric dentist may be the first professional to suggest the diagnosis of ED since delayed eruption of teeth, aberrant tooth shape and oligodontia are distinct symptoms. Oligodontia may affect chewing ability, speech and aesthetics, so early treatment is often favourable in order to give the child good oral function and appearance. Prevention of dental fear and anxiety is important, since the individual with ED is likely to need dental treatment repeatedly during childhood, adolescence and young adulthood. Therefore, behaviour management methods in combination with an adequate use of sedation and pain control measures are essential. Due to the complexity of treatment planning for children with oligodontia, a multidisciplinary team approach is beneficial and the team should preferably include the disciplines of paediatric dentistry, orthodontics, prosthetic dentistry, and maxillofacial surgery. The patient and the parents should always be involved in the treatment planning and be informed about short- and long-term treatment options. Aesthetic improvement of existing teeth should be done early if requested. Removable dentures at an early age may also be beneficial for some children. Treatment with fixed dental prostheses should be evaluated at early school age according to individual needs and indications. Examples of multidisciplinary treatment in three children with ED treated in the framework of free dental care for children in Sweden will be presented.

Dental care for children

Dental care for children

Caring for children: little teeth, big challenges

Dental care for young children with carious primary teeth may pose a number of challenges in terms of assessment and diagnosis, behaviour management and treatment planning. These challenges, together with some misconceptions about the value of restoring the primary dentition, have led to a reduction in the proportion of restorations provided for young children in primary care settings. The aim of my presentation at the forthcoming BDA conference is to provide an overview of current practices for caries management in young children. It will particularly focus on restorative interventions, including preformed metal crowns (using the Hall technique), and will consider the evidence-base for a variety of restorative options. In addition, the child's perspective of restorative care will be considered.