Need For Treatment Of Children Research Articles

Perspective of pediatricians about early childhood caries (ECC) in lumbini province Nepal: A major virulent dental problem

Early childhood caries (ECC) is a significant worldwide oral health problem that needs to be looked after by parents. Some parents do not care about the oral health of their children, and they more frequently visit pediatricians. So, pediatricians are one of the most reliable profession for preventing children’s oral diseases, and promoting awareness. The aim of the study was to know the knowledge and awareness of pediatricians’ about early childhood caries (ECC) in lumbini province, Nepal.A total of 40 pediatricians were selected by using census sampling method and were requested to fill out an objective questionnaire pertaining to individual’s knowledge about ECC, without providing any oral health information taking duration of the study from March 2021 to September 2021.About 23(56.5%) of pediatricians understood the importance of pediatric dentistry. About 34(86.2%) of pediatricians performed oral examination regularly. Around 17% of pediatricians had knowledge of the ECC. Only 14(33.3%) of pediatricians acknowledged the cariogenicity of sugar containing medical syrups.The study shows poor knowledge regarding ECC, oral health, and dental treatment need in children among the surveyed pediatricians although having good knowledge about pediatric speciality and importance of primary dentition. Thus, there is a need to update the Pediatricians on recent recommendations about ECC and its early screening.

Characteristics prior to and at time of diagnosis in pediatric bipolar disorder

Objectives Describe symptoms before and at time of register-diagnosis in children and adolescents. Methods A random sample was selected for chart-review from a Danish nationwide cohort of patients <18 years registered with an incident ICD-10 register-diagnosis of single hypomanic/manic episode or bipolar disorder between 1995 and 2014. Patients with symptoms which adequately documented a BD diagnosis in the chart were included for analysis. Results 521 were diagnosed in the study period. A random sample of 25% were selected, and 106 charts were possible to retrieve, with 48 chart reviews resulting in confirmation of diagnosis. Time from first reported affective symptoms to diagnosis was 2.6 ± 2.7 years for depressive symptoms, 2.5 ± 2.9 years for mixed symptoms, 1.4 ± 1.6 years for hypomanic symptoms, and 0.4 ± 0.5 years for manic symptoms. A hierarchical clustering analysis revealed three patient-profiles: primarily hypomanic/manic, primarily depressive, and more rare, primarily mixed profile. Frequently reported symptoms prior to diagnosis include anhedonia (79%), irritability (71%), hyperactivity (62.5%), decreased energy (62.5%), and psychotic symptoms (52%). Symptoms of ADHD (19%), comorbid ADHD (15%), symptoms of anxiety (52%), comorbid anxiety (4%), suicidal thoughts (50%), suicide attempts (8%), cutting (23%), substance misuse (21%), and criminal activity (10%) were reported before incident BD diagnosis. Conclusion The observed patient-profiles leading to diagnosis were primarily manic or depressive, resembling presentations in adults. The presence of ADHD, anxiety, suicide attempts, cutting, and criminal activity prior to diagnosis emphasizes the need for treatment of children and adolescents with affective symptoms. The gap from appearance of the symptoms to diagnosis suggests a window for earlier treatment.

Malocclusion complexity and orthodontic treatment need in children with autism spectrum disorder

ObjectivesThis study aimed to investigate the malocclusion complexity and orthodontic treatment need among children with and without autism spectrum disorder (ASD) referred for orthodontic treatment by quantifying the Discrepancy Index (DI) and Index of Orthodontic Treatment Need (IOTN).Materials and methodsDental records of 48 ASD and 49 non-ASD consecutive patients aged between 9 and 18 years (median age 13.0 years) referred for orthodontic treatment were reviewed and compared. The Discrepancy Index (DI) was quantified to determine the malocclusion complexity, and the Index of Orthodontic Treatment Need (IOTN), including the Dental Health Component (IOTN-DHC) and Aesthetic Component (IOTN-AC), was quantified to determine the orthodontic treatment need. Statistical analysis included descriptive analysis, Pearson chi-square tests, Fisher’s exact test, Mann–Whitney U tests, and several univariate and multivariate regression analyses. The statistical analysis used descriptive analysis, Pearson chi-square test, Fisher’s exact test, and multivariate logistic regression.ResultsThe results show that both malocclusion complexity (DI, p = 0.0010) and orthodontic treatment need (IOTN-DHC, p = 0.0025; IOTN-AC p = 0.0009) were significantly higher in children with ASD. Furthermore, children with ASD had a higher prevalence of increased overjet (p = .0016) and overbite (p = .031).ConclusionsMalocclusion complexity and orthodontic treatment need are statistically significantly higher among children with ASD than children without ASD, independent of age and sex.Clinical relevanceChildren with autism may benefit from visits to a dental specialist (orthodontist) to prevent, to some extent, developing malocclusions from an early age.

Pediatric Acute Mastoiditis: Recent Evolutions in Clinical Presentation and Microbiology

Acute mastoiditis is a well-known complication of acute otitis media in children. Last year we noticed some changes: more virulent pathogens, a more fulminant course of the disease and an increased need for surgical treatment in children with acute mastoiditis admitted to our hospital. Recently, other authors have raised the same concerns. Based on the last 12 consecutive cases of pediatric acute mastoiditis admitted to our hospital and a review of recent literature, we discuss a possible change in presentation, complication rate and microbiology in order to raise vigilance to a possibly changing pathology.

The unmet need for treatment of children with musculoskeletal impairment in Malawi

BackgroundMore than a billion people globally are living with disability and the prevalence is likely to increase rapidly in the coming years in low- and middle-income countries (LMICs). The vast majority of those living with disability are children residing in LMICs. There is very little reliable data on the epidemiology of musculoskeletal impairments (MSIs) in children and even less is available for Malawi. Previous studies in Malawi on childhood disability and the impact of musculoskeletal impairment (MSI) on the lives of children have been done but on a small scale and have not used disability measurement tools designed for children. Therefore in this study, we aimed to estimate the MSI prevalence, causes, and the treatment need among children aged 16 years or less in Malawi.MethodsThis study was carried out as a national cross sectional survey. Clusters were selected across the whole country through probability proportional to size sampling with an urban/rural and demographic split that matched the national distribution of the population. Clusters were distributed around all 27-mainland districts of Malawi. Population of Malawi was 18.3 million from 2018 estimates, based on age categories we estimated that about 8.9 million were 16 years and younger. MSI diagnosis from our randomized sample was extrapolated to the population of Malawi, confidence limits was calculated using normal approximation.ResultsOf 3792 children aged 16 or less who were enumerated, 3648 (96.2%) were examined and 236 were confirmed to have MSI, giving a prevalence of MSI of 6.5% (CI 5.7–7.3). Extrapolated to the Malawian population this means as many as 576,000 (95% CI 505,000-647,000) children could be living with MSI in Malawi. Overall, 46% of MSIs were due to congenital causes, 34% were neurological in origin, 8.4% were due to trauma, 7.8% were acquired non-traumatic non-infective causes, and 3.4% were due to infection. We estimated a total number of 112,000 (80,000-145,000) children in need of Prostheses and Orthoses (P&O), 42,000 (22,000-61,000) in need of mobility aids (including 37,000 wheel chairs), 73,000 (47,000-99,000) in need of medication, 59,000 (35,000-82,000) in need of physical therapy, and 20,000 (6000-33,000) children in need of orthopaedic surgery. Low parents’ educational level was one factor associated with an increased risk of MSI.ConclusionThis survey has uncovered a large burden of MSI among children aged 16 and under in Malawi. The burden of musculoskeletal impairment in Malawi is mostly unattended, revealing a need to scale up both P&O services, physical & occupational therapy, and surgical services in the country.

Comparative Evaluation of Preventive and Interceptive Orthodontic Treatment Need in Children of 6-9 Years and 9.1- 12 Years

Introduction: Preventive and interceptive orthodontics, emphasizes on reduction of later need for complex orthodontic treatment. This thus increases the comprehensiveness of healthcare and help in strengthening the primary care. In literature, there is no comparison between the preventive and interceptive treatment needs in patients belonging to growing age (6-9 years) and those belonging to non-growing age (9.1-12 years). There is a need to compare these finding according to the age group.&#x0D; The present study aims to utilize the IPION to quantify the proportion of central Indian children who would gain from the preventive and interceptive orthodontics.&#x0D; Materials and Methods: The study will be conducted in the Department of Orthodontics, SPDC, Wardha in collaboration with Department of Public Health Dentistry, SPDC, Wardha. Total 383 patient in age group of 6 to 12 years, will be selected. All the features of the IPION-6 and IPION-9 will be recorded, and the variables will be multiplied by weighting factors according to the instructions of the original study by Coetzee. All the features of IPION-12 will be recorded, and the variables will be multiplied by weighting factors.&#x0D; Expected Results: There will be a decrease in the need of orthodontic treatment in patients who have completed the age of 9 years.

Prevalence of Malocclusion and Orthodontic Treatment Needs in Primary and Mixed Dentition Using Baby Roma Index and Index of Orthodontic Treatment Needs.

Aim and objectiveTo find the prevalence of malocclusion and orthodontic treatment need in children of East Lucknow city.Materials and methodsThe present study was conducted in the Department of Pedodontic and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow. The nursery and primary schools of East Lucknow were included in the study. Baby-ROMA Index and Index of Orthodontic Treatment Needs (IOTN) were tested on 400 children, which were divided into two groups of 200 in each group, referred from the Out Patient Department and school camps. A single operator who was trained and calibrated for the use of indices evaluated children.ResultsIntra-reliability test showed higher reproducibility of the index. It is shown that around 70% of the patient presented malocclusion from both indices.ConclusionBaby-ROMA Index and IOTN were helpful to assess the severity of malocclusion and the timing for orthodontic malocclusion in young patients (primary and mixed dentition).How to cite this articleSingh A, Rathore M, Govil S, et al. Prevalence of Malocclusion and Orthodontic Treatment Needs in Primary and Mixed Dentition Using Baby Roma Index and Index of Orthodontic Treatment Needs. Int J Clin Pediatr Dent 2021;14(S-1):S22–S28.

Assessment of awareness and need for interceptive treatment in children reporting for regular dental checkup- Institutional study

Assessment of awareness and need for interceptive treatment in children reporting for regular dental checkup- Institutional study

Assessment of pain and pain relief in children at a dental appointment

Relevance. Subjective assessment of pain in children is traditionally implemented using visual analogue scales. The need for comfortable dental treatment in children is obvious, therefore, in order to obtain the most reliable data, it is necessary to develop pain rating scales and the effectiveness of pain management in accordance with the age of the child.Purpose. Development of visual analogue scales designed to assess the effectiveness of pain relief when performing outpatient dental interventions in children, depending on the age of the child.Materials and methods. A visual analogue scale was designed to evaluate the effectiveness of pain relief in children at an outpatient dental appointment, in accordance with the age of the child. 100 patients aged 4 to 12 years were examined.Results. The reaction and behaviour of the child during dental treatment using local anesthesia were the basis of the designed pain rating scales. In the age group of 4-7 years, the visual analogue scale was filled in by the doctor, the child and the parent, and in the second group of patients aged 7 to 12 years, the scale was filled in by the child and the doctor, since in this age category children could independently correlate themselves with the picture on the scale.Conclusions. The designed scales of subjective assessment of the effectiveness of local anesthesia in children allow to determine the quality of the studied methods and means of local anesthesia in pediatric dental practice.

Çocuklarda Maloklüzyon ve Ortodontik Tedavi İhtiyacı

Çocuklarda Maloklüzyon ve Ortodontik Tedavi İhtiyacı

Pediatricians' view on early childhood caries and oral health in a north region of India: A cross-sectional study.

Background:The majority of oral diseases in children are preventable. The pediatricians owing to the unique position they occupy in child care are invaluable in achieving standard oral and dental healthcare in children. This study was aimed to assess pediatrician's knowledge, attitude, and awareness toward early childhood caries (ECC), oral health, and treatment needs of their patients.Methods:A total of 65 pediatricians were randomly selected for the study and were requested to fill out an objective questionnaire pertaining to individual details, approach toward pediatric dentistry, and knowledge level of oral health, without providing any oral health information.Results:About 58.5% of pediatricians acknowledged the importance of pediatric dentistry. About 72.7% of pediatricians perform oral examination regularly. Around 17% of pediatricians have knowledge of the ECC. Only 32.3% of pediatricians acknowledged the cariogenicity of medicated syrups.Conclusion:This study shows those pediatricians who were surveyed had poor knowledge regarding ECC, oral health, and dental treatment need in children. Pediatricians need to update themselves on recent recommendations.

Parental perceptions of dental health and need for treatment in children with epilepsy: a multicenter cross-sectional study.

BackgroundEpilepsy is a common neurological disorder in childhood. However, there have been limited studies on its impact on the oral health of affected children. Our study aimed to assess the oral health of children with epilepsy in the city of Jeddah, Saudi Arabia, as perceived by their mothers.MethodsWe conducted a cross-sectional study in three hospitals. We included children 2–18 years old with physician-confirmed epilepsy diagnosis. We assessed parental perception of dental status and need for dental care using a standardized questionnaire that was completed by the mothers. To adjust for potential confounding variables, we used univariate and multivariate logistic regression.ResultsWe included 96 children with epilepsy in our study. Their mean age was 6.4±3.4 years. In 55.2% (n=53), dental status was rated as bad, and in 84.4% (n=81) a need for dental care was expressed. Cerebral palsy (OR 5.06, 95% CI 1.28–19.99; P=0.021), motor disability (OR 6.41, 95% CI 1.12–36.73; P=0.037), referral from a pediatric neurology clinic to a dentist (OR 10.755, 95% CI 3.290–35.151; P<0.001), and irregular brushing of teeth (OR 5.397, 95% CI 1.536–18.961; P=0.009) were significantly associated with increased risk of perceived bad dental status. Perception of the child as being overweight (OR 0.117, 95% CI 0.034–0.400; P=0.001) was significantly associated with decreased risk of perceived bad dental status. Motor disability (OR 5.73, 95% CI 1.64–20.04; P=0.006) was significantly associated with increased parental expression of need for dental care.ConclusionIn most children with epilepsy, perceived dental status was bad and there was a high expressed need for dental care. Interventions to improve the dental health of children with epilepsy should focus on those with cerebral palsy and motor disability.

Correlation between oral-health related quality of life and orthodontic treatment need in children and adolescents - a prospective interdisciplinary multi centre cohort study

Correlation between oral-health related quality of life and orthodontic treatment need in children and adolescents - a prospective interdisciplinary multi centre cohort study

Caries in children with lactose intolerance and cow's milk protein allergy.

Dental caries in 5-to-8-year-old children with cow's milk protein allergy (CMPA) and lactose intolerance (LI), their treatment needs, and the consumption of milk-based products and milk derivatives by these patients were investigated. A cross-sectional study was undertaken with 200 children in southern Brazil in 2017. The clinical examination was based on the World Health Organization criteria and a questionnaire was sent to parents or legal guardians to collect information on the children's food intake, pre-existing systemic diseases, medication use, and CMPA and LI. Standardization was performed to verify concordance among examiners (kappa = 0.96). Caries prevalence was 67.50% in children with CMPA or LI, but 34.37% in those without these conditions. The mean dmft (decayed, missing, and filled teeth) index in children with CMPA or LI was 1.75 ± 1.84, significantly higher than among non-allergic or lactose-tolerant children (0.83 ± 1.60) (p < 0.001). In children with CMPA or LI, the mean for treatment needs was 1.58 ± 1.50. Lactose-free milk was the most frequently consumed food among allergic/intolerant children (65.00%), with a mean dmft of 2.00 ± 2.08, higher than that obtained for those without CMPA/LI (0.82 ± 0.87), showing no significant difference (p = 0.129). Although dental caries and treatment needs in primary dentition were associated with CMPA or LI, children's intake of replacement foods did not pose any risk for the development of carious lesions. Statistically significant differences were obtained for the prevalence and severity of dental caries. This shows the need for treatment of children with CMPA or LI, who had the worst caries prevalence and severity rates.

Correlation between oral health-related quality of life and orthodontic treatment need in children and adolescents-aprospective interdisciplinary multicentre cohort study.

Oral health-related quality of life (OHRQoL) is aconstruct for assessing the self-perceived oral health of patients. The aim of this study was to investigate the correlation between OHRQoL and orthodontic treatment need in consideration of demographic and psychological factors. This multicentre study included 250 patients with an indication for orthodontic diagnostics. In cooperation with the Institute of Clinical Psychology at the University of Würzburg, validated and internationally acknowledged questionnaires were selected to assess OHRQoL (COHIP-G19) and health-related quality of life (HRQOL). Self-esteem and behavioural problems were taken into consideration as possible psychological factors. Orthodontic treatment need was assessed using the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC), the Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC) and the Dental Aesthetic Index (DAI). Possible significant correlations between the collected parameters and OHRQoL were evaluated by means of linear regression analysis. Objective orthodontic treatment need (IOTN-DHC and DAI) was significantly correlated with OHRQoL. Further factors significantly influencing OHRQoL in children and adolescents were age, HRQOL, self-esteem and behavioural problems. Objective orthodontic treatment need significantly influences OHRQoL in children and adolescents. Further studies are required to investigate if OHRQoL may be improved by correcting misaligned teeth and jaws.

Perception of children and mothers regarding dental aesthetics and orthodontic treatment need: a cross-sectional study.

BackgroundThe normative orthodontic treatment need, established by dental professionals during the dental appointment, becomes ineffective when it does not evaluate all the factors that influence the decision-making process, including individuals’ perception and satisfaction with their dental appearance. Therefore, the purpose of this study was to investigate the perception of children and their mothers as regards orthodontic treatment need and satisfaction with dental aesthetics and test if these variables are associated with the objective orthodontic treatment needs, assessed by the Dental Aesthetic Index (DAI).MethodsA cross-sectional study was conducted on 308 children aged 12 years, and their mothers were randomly selected by cluster sampling (primary schools). The variables “orthodontic treatment need,” “satisfaction with chewing,” and “dental appearance” were assessed by means of a questionnaire. The questions were answered individually at school or home, in cases of children or mothers, respectively. DAI was assessed to make an objective clinical assessment. The variables were dichotomized and statistically analyzed by the chi-square and Fisher’s exact tests, contingency coefficient C, and logistic regression.ResultsThe results of the clinical evaluation (DAI) were statistically associated with the perception of orthodontic treatment need and satisfaction with dental appearance in children (p ≤ 0.01). However, no association was observed with regard to satisfaction with chewing and DAI (p = 0.10). The children’s perception of orthodontic treatment need and satisfaction with the appearance of their teeth was statistically associated (p ≤ 0.01) with their mothers’ perception. Maxillary overjet, maxillary and mandibular misalignment, and dental crowding were associated with the orthodontic treatment need by children and their mothers, with p value −0.05 and 5 % level of significance. Maxillary overjet was a significant predictor for the perception of orthodontic treatment need in children (OR 1.86, 95 % CI 0.98–3.55) and mothers (OR 3.02, 95 % CI 1.54–5.92).ConclusionsChildren and parents realize the need for orthodontic treatment according to the different types of malocclusion, as noted in the association between orthodontic treatment need and dental appearance perceived by children and their mothers, which was also observed—with low correlation—with regard to DAI.

Orthodontic treatment need of adolescents in the island community of Haida Gwaii, Canada

The aim of this study was to determine the prevalence of malocclusion and orthodontic treatment need according to the Index of Complexity, Outcome, and Need (ICON) among schoolchildren of the island community of Haida Gwaii in northwestern British Columbia, Canada. Two elementary and two high schools in Haida Gwaii were approached for census sampling. Out of 535 schoolchildren, 215 (90 boys and 125 girls) agreed to participate (40.2% response) in this cross-sectional epidemiological study. A trained examiner assessed orthodontic treatment need in children employing the ICON score and the ICON complexity grade. The mean age (N = 215) was 12.9 ± 2.8 years. Of the examined schoolchildren, 67% had Aboriginal ancestry (at least one Aboriginal parent). The mean ICON score (N = 215) was 43.5 ± 26.2. There were no statistically significant differences in ICON scores for gender (t test, p = 0.207), ethnicity (t tests: paternal ethnicity, p = 0.886 and maternal ethnicity, p = 0.389), or school (ANOVA with post hoc Bonferroni adjustment, p = 0.317). Overall, 43.7% of the surveyed Haida Gwaii adolescents needed orthodontic treatment (ICON &gt; 43). Based on the ICON complexity grade, 31% of the schoolchildren had moderate to very difficult malocclusions; therefore, specialty orthodontic services are recommended in this remote community.

A Basis for Creating a Reflective Network in Schools: Reflective Network Therapy in a Small Middle and High School

Expanding the utility of Reflective Network Therapy (RNT) schoolwide and to school pupils far beyond preschool age is now occurring. The process encouraged my integration of several psychoanalytic ...

Index of orthodontic treatment need in children from the Niš region.

The Index of Orthodontic Treatment Need (IOTN) is a scoring system for malocclusion that con- sists of the two independent components: Denal Health Component (DHC) and Aesthetic-Component (AC). IOTNs are usually used in the countries with dental healthcare financed by the government through the national healthcare system or healthcare insurance. The aim of the study was to determine IOTN in primary school children from the town of Niš and to asses percent of children with any kind of orthodontic treatment. The study involved 301 school children, 11-14 (12.4 ± 1.1) years old. The IOTN was used by the two examiners in order to evaluate the treatment need. The results of the study showed that 111 (37%) out of 301 examined children had orthodonic treat- ment (33.33% boys and 66.67% girls) and they were excluded from the study. Out of final sample of 190 school children, considering DHC of the IOTN, 27.4% of the children showed great (grades 4-5), 41.0% moderate (grade 3) and 31.6% slight or no treatment need (grade 1-2). Considering IOTN AC, 15.3% of the children showed great (grade 8-10), 24.3 % moderate (grade 5-7) and 60.4% slight or no treatment need (grade 1-4). The need for ortho- dontic treatment in school children in the town of Niš, Serbia, is similar to the need in most European countries, despite the fact that the number of children orthodontically treated is much higher compared to most of European countries.

History of dental caries and need for dental treatment of children with visual disabilities, Chile, 2014.

Objective: To determine the history of dental caries and the need for dental treatment among visually disabled children between 6 and 12 years old attending special Schools in Chile during 2014. Material and method: Descrip- tive and observational cross-sectional study. The target population was children with visual disabilities from special schools in Chile. A clinical examination was performed to obtain a dmft/DMFT index and know the need for treatment. Two calibrated examiners performed the visual clinical examination, according to the WHO criteria. Additionally, clinically detectable enamel lesions on cavitated and non cavitated surfaces were recorded. The recorded data were analyzed using des - criptive statistics. Results: Ninety-four children attending to seven special schools were examined. The average dmft index was 2.05 (SD±2.6) and DMFT index was 0.96 (SD±1.3). For 6 year olds, the dmft/DMFT index was 3/0, respectively. For 12 year olds, the dmft index was 0.17 and the DMFT index was 1.42. Caries pre- valence was 56.3%. From the total, 95% of children needed sealants, 50% needed at least one restoration of one face, and 29% restoration of 2 or more surfaces. As for enamel lesions, 34% of children had at least one non cavitated lesion and 48% of them had a cavitated lesion. Conclusion: History of dental caries is similar to that reported in the general population; however, there is a high need for preventi- ve treatment. Therefore, it is necessary to conduct more research to clarify whether these patients have a higher cariogenic risk due to their visual impairment in order