Pediatric Dental Patients Research Articles

Multicoloured Restorations for Pediatric Dental Patients

The purpose of this review is to discuss the viability of multicoloured dental restorations in children including possible technical, clinical and psychological aspects of multicoloured restorations. Multicoloured restorations utilizing different colours and glitter inclusions are a restorative option within the context of pediatric dentistry. Furthermore, custom shade guides involving different favourite cartoon characters also may improve a child’s positive interest in dental treatment. Multicoloured compomers have been available for use in the restoration of deciduous molars since 2002. In contrast to conventional poly-acid-modified resin composites, a small amount of glitter particles are included in order to produce colour effect shades of red, pink, blue, gold, etc. The filler content is similar to conventional compomers. Even though a coloured compomer is made to be decorative, it has physical properties that apparently are sufficient to hold up in the mouth until the restored deciduous tooth is lost. Short-term laboratory studies offer some information about the physical properties of new materials. Nevertheless, long-term clinical studies complement these studies and provide further information regarding the performance of these materials over an acceptable time period.

Comparative Evaluation of Different Radiographic Techniques in Pediatric Dentistry – An in vivo study

Radiographic imaging is an important diagnostic adjunct for clinical assessment of dental patients. Rapid advances in diagnostic imaging have major impact on dental radiology. Obtaining diagnostic radiographs in the paediatric dental patient is probably the most difficult to accomplish, because of fear and anxiety in children which is usually present during the first dental visit. So keeping this in mind few innovative radiographic techniques are used in this study, which can be used in paediatric dentistry to decrease the anxiety of children as well as parents. Intraoral periapical radiographs were taken in mandibular and maxillary arch with different techniques like using lollipop, snap-a-ray, bubblegum, desensitization and vertical holding of the film in pediatric patients. The efficacy of each technique was evaluated by Faces Pain Scale. The results revealed that the most accepted technique by paediatric patients was the lollipop technique.

Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study.

ABSTRACTAim: The purpose of the present study was to evaluate the eff-cacy of ‘audio distraction’ in anxious pediatric dental patients.Materials and methods: Sixty children were randomly selected and equally divided into two groups of thirty each. The first group was control group (group A) and the second group was music group (group B). The dental procedure employed was extraction for both the groups. The children included in music group were allowed to hear audio presentation throughout the treatment procedure. Anxiety was measured by using Venham's picture test, pulse rate, blood pressure and oxygen saturation.Results: ‘Audio distraction’ was found efficacious in alleviating anxiety of pediatric dental patients.Conclusion: ‘Audio distraction’ did decrease the anxiety in pediatric patients to a significant extent.How to cite this article: Singh D, Samadi F, Jaiswal JN, Tripathi AM. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study. Int J Clin Pediatr Dent 2014;7(3):149-152.

Analysis of tooth mortality among nigerian children in a tertiary hospital setting.

Background:Tooth mortality is important in evaluating dental care as tooth loss is a reflection of cumulative effects of past disease and treatment practices.Aim:The aim of this study is to analyze the pattern of tooth mortality among pediatric dental patients treated at the University of Benin Teaching Hospital, Benin City, Nigeria.Subjects and Methods:This was a retrospective study of patients treated at the Pediatric dental clinic of the University of Benin Teaching Hospital, Benin City between June 2007 and April 2012. Patients’ age, sex, indication for extraction and type of tooth were reviewed. Data analysis in the form of frequency, percentages, cross tabulation, Chi-square statistics were performed using the statistical package for the social sciences (SPSS) (Chicago IL, USA) version 17.0.Results:A total of 712 patients between the ages 0 and 16 years were seen and 1039 extractions were performed. Tooth extraction was performed more among females 53.4% (380/712) and those aged 6-12 years 54.1% (384/712). About one-third 33.1% (236/712) of the patients had two or more teeth extraction. The deciduous teeth were more frequently extracted 65.2% (677/1039) with second molars being the most frequently extracted deciduous teeth and first molars being the most frequently extracted permanent teeth. Permanent third molar accounted for the 0.7% (7/1039) of the extracted teeth in this study. The extractions were done more on the lower arch and on the right side of the mouth. In this study, dental caries was the leading reason for extraction of the deciduous and permanent teeth. Neonatal teeth and supernumerary accounted for 0.9% (4/438) and 0.7% (2/289) of deciduous and permanent dentition extractions respectively.Conclusion:Dental caries was the leading reason for extraction in both deciduous and permanent dentitions with female patients aged 6-12 years receiving the most tooth/teeth extractions. Stakeholder in child health need to pay adequate attention to dental caries preventive approaches to enable the pediatric population reach adulthood with a healthier dentition.

Overview of paediatric dental sedation: 2. nitrous oxide/oxygen inhalation sedation

The use of conscious sedation for the management of anxious paediatric dental patients is extremely beneficial. Inhalation sedation with nitrous oxide and oxygen remains the mainstay for paediatric sedation in the UK. Dentists carrying out inhalation sedation for dental treatment must be fully conversant with the technique and the principles of patient management.

Pediatric Dental Patients’ Attitudes to Rubber Dam

To explore young patients' experiences of rubber dam (RD) and determine how personal and clinical factors may influence opinions. A self-completed questionnaire was developed to capture pediatric patients' experiences of treatment under RD in a hospital setting. Patients' acceptance of RD and perceptions of how well it was explained to them were recorded on a 10cm Visual Analogue Scale (VAS), where zero represented the most negative score. The following clinical variables were also recorded: type of RD; procedure undertaken; use of local anaesthetic and procedure duration. One hundred children (52 male, 48 female) with a mean age of 11.8 years (SD = 2.29; range 7-17 years) participated Overall, acceptance of RD was satisfactory (mean VAS = 5.0). Patients were happy with the explanation of why RD was used (mean VAS = 7.7). The type of RD, use of local anaesthetic, procedure undertaken and duration of the procedure did not significantly influence acceptance levels. However RD was significantly less acceptable to patients who underwent radiographic examination whilst wearing the RD (P < 0.05, t-test). Nearly five times as many patients expressed concern at being seen wearing RD when taken to the radiography department (39.2%, n = 20/51), compared to those who were reportedly self-conscious about RD when treated only on the paediatric dentistry clinic (8.2%, n = 4/49). The use of RD appears acceptable physically and psychologically to most pediatric patients, however visibility of the RD to others was a potential concern to some children.

Treatment Under Dental General Anesthesia Among Children Younger than 6 Years in Lithuania

Dental general anesthesia (DGA) is an efficient treatment modality for young pediatric dental patients. The aim of this study was to identify the reasons for DGA, characteristics of patients receiving treatment under DGA, and treatment performed under DGA for children under school age in Kaunas, Lithuania. The study population comprised all patients younger than 6 years treated under GA for dental reasons (n=144) at the University Hospital during a 3-year period from 2010 to 2012. The data were collected by means of clinical dental examinations, a survey of the parents, and the patients' dental records and included personal background, reasons for DGA, dental status, and treatment provided. More than half (54%) of the children were younger than 4 years; 40% of them resided in cities. The dental caries experience was high: the mean dmft and d were 12.9 (SD, 3.5) and 12.1 (SD 3.9), respectively. The majority (81%) of the children had multiple reasons for DGA, with the need for excessive treatment (93%), followed by dental fear and uncooperativeness (66%), being the most common. The extent of treatment increased with age and was greater among patients from rural areas. Of the 1975 primary teeth treated under GA, 50% were restored, 32% extracted, and 18% targeted with preventive procedures. Young children with very high levels of untreated tooth decay are treated under DGA at the Lithuanian University of Health Sciences Hospital. The need for complex treatment as well as dental fear and uncooperativeness are the major reasons for DGA. Multiple caries treatments and extractions are performed for these patients. This study highlights a great need to develop the healthcare system with regard to the appropriate management of caries among young children and postoperative DGA care.

Asthma and the paediatric dental patient

Asthma is a common medical condition in children in the UK, and affected children generally have poorer oral health than their peers. Preventive care is important and specific considerations must be made for the safe and successful management of these patients

Cystic fibrosis in paediatric dental patients

Cystic fibrosis is a common genetic disorder and presents challenges to the dental team. This article reviews the necessary considerations for the successful management of paediatric dental patients with cystic fibrosis

Psychotropic drugs and their impact on the treatment of paediatric dental patients

In the past 10-15years, the diagnosis of mental diseases in the paediatric and adolescent population has risen significantly. This has resulted in paediatric dentists caring for a large number of children suffering from these conditions. For the safe care of these children, paediatric dentists need to be aware of not only the characteristics of mental diseases but also the medications used for their treatment. Becoming familiar with the plethora of psychoactive agents and their complex pharmacological properties and interactions poses a daunting but necessary challenge as they are likely to influence dental treatment. To help with this understanding, the present paper provides a comprehensive but simplified review of the major paediatric psychotropic drugs in terms of basic pharmacology, common indications, general and oral health-related adverse effects and interactions with other medications which may be prescribed in the course of dental treatment.

Sedative effects of Oral Midazolam, Intravenous Midazolam and Oral Diazepam in the Dental Treatment of Children

To evaluate and compare the behavioral changes and effect of sedative techniques in pediatric dental patients using Oral Midazolam, Intravenous Midazolam and Oral Diazepam as sedative agents. Triple blind randomized control trial with 40 patients aged between 2-10 years, exhibiting definitely negative behavior was considered. Patients were randomly assigned to one of the four treatment groups. Group I received midazolam 0.5 mg/kg orally, Group II received 0.5 mg/kg diazepam orally, Group III received 0.06 mg/kg midazolam intravenously and Group IV received oral placebo. Behavioral changes (sleep, crying, movement, and overall behavior) and effect of sedative techniques on pediatric patients were assessed. All the patients in group 3 were significantly better in post administrative behavior viz. sleep, crying and movement. Over all behavior scores for group 3 patients were significantly better than other three groups (p < 0.001). Positive behavior of patients in group 2 and 3 did not show significant difference but positive behavior in group 3 was significantly (p < 0.05) more than group 2. Placebo group showed the highest negative behavior Sedative effects of oral midazolam and oral diazepam were comparable, where as intravenous midazolam produced more sedation. Anxiolysis was found to be more in both the midazolam groups than the diazepam group. Most number of positive changes were observed in midazolam groups as compared to diazepam group.

Methemoglobin Levels in Generally Anesthetized Pediatric Dental Patients Receiving Prilocaine Versus Lidocaine

The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3-6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1:100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P < .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure.

A Retrospective Study of Paediatric Dental Patients Treated under General Anesthesia

Dental care under general anesthesia (DGA) was found to be a safe, efficient and effective quality treatment for children. Purpose: To describe the characteristics of child dental patients treated under DGA and describe the indications of the treatments and types of treatments provided. Method: The sample consisted of 40 patients treated under DGA at Department of Paediatric Dentistry of school and Hospital of Stomatology of Wuhan University between June 2011 and December 2012. Detailed information was collected from dental records. SPSS software package was used for statistical analysis. Results: The age of the patients ranged from 2.5 years to 24.1 years. Males were more common than females M:F 1.5:1 .The mental retardation patients accounted for (5%) of the sample. The most common indication was inability to cooperate and accept dental treatment under local anesthesia (95%). The treatments rendered included: caries restorations (37%), root canal treatments (34%), extractions (7%), fluoride application (6%), fissure sealants (6%), indirect pulp capping (5%), stainless steel crowns (4%), pulpotomies (0.8%) and labial frenectomy (0.1%). In the follow-up visit fillings were found to be lost in 3 patients, with 2 anterior teeth and one posterior tooth. Conclusion: Caries restoration and root canal treatments were the most common treatments provided. Preventive strategies should be targeted toward children to reduce the number of healthy children receiving treatment under general anesthesia. Clinical significance: This study provides baseline information regarding the types of treatments for paediatric dental patients inWuhanand it is hoped that the data from this study will be useful for other researchers.

Salivary Markers of Oxidative Stress and Their Relation to Periodontal and Dental Status in Children

Background: Previous studies have shown that salivary thiobarbituric acid reactive substances are related to the periodontal status in adults. Such an analysis has not been done on children yet. The aim of our study was to analyze salivary markers of oxidative stress in relation to periodontal and dental status in children.Methods: The periodontal and dental status of 82 consecutive pediatric dental patients was assessed. The oral hygiene index (OHI), the papillary bleeding index (PBI) and the caries index (CI) were assessed as clinical parameters. Markers of oxidative stress and antioxidant status were measured in whole saliva samples.Results: Multivariate analysis of covariance showed that the variability of PBI explains 10.9% of the variance of salivary thiobarbituric acid reacting substances (TBARS). Advanced oxidation protein products (AOPP) were related to CI (eta 8.6%). Measures of antioxidant status (total antioxidant capacity and ferric reducing ability of saliva) were partially determined by OHI (13.6% and 7.2%) and PBI (16.9% and 7.9%).Conclusions: Antioxidant status in saliva is related to oral hygiene and periodontal status. Salivary TBARS are a potential sensitive marker of periodontitis in children, similarly to adults, at least on a population level. Salivary AOPP are related to caries. Potential diagnostic value of the analyzed markers should be analyzed in further interventional studies.

An update on local anesthesia for pediatric dental patients.

Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients.

Salivary markers of oxidative stress and their relation to periodontal and dental status in children.

Background: Previous studies have shown that salivary thiobarbituric acid reactive substances are related to the periodontal status in adults. Such an analysis has not been done on children yet. The aim of our study was to analyze salivary markers of oxidative stress in relation to periodontal and dental status in children. Methods: The periodontal and dental status of 82 consecutive pediatric dental patients was assessed. The oral hygiene index (OHI), the papillary bleeding index (PBI) and the caries index (CI) were assessed as clinical parameters. Markers of oxidative stress and antioxidant status were measured in whole saliva samples. Results: Multivariate analysis of covariance showed that the variability of PBI explains 10.9% of the variance of salivary thiobarbituric acid reacting substances (TBARS). Advanced oxidation protein products (AOPP) were related to CI (eta 8.6%). Measures of antioxidant status (total antioxidant capacity and ferric reducing ability of saliva) were partially determined by OHI (13.6% and 7.2%) and PBI (16.9% and 7.9%). Conclusions: Antioxidant status in saliva is related to oral hygiene and periodontal status. Salivary TBARS are a potential sensitive marker of periodontitis in children, similarly to adults, at least on a population level. Salivary AOPP are related to caries. Potential diagnostic value of the analyzed markers should be analyzed in further interventional studies.

Moderate Sedation in Paediatric Dental Patients

Moderate Sedation in Paediatric Dental Patients

Moderate Sedation in Paediatric Dental Patients: Author's Reply

Moderate Sedation in Paediatric Dental Patients: Author's Reply

La sedazione cosciente inalatoria con protossido d’azoto e ossigeno in odontoiatria

ObjectivesTo examine the existing possibilities of controlling anxiety in the dental office practice. While pain control is not a problem with the current techniques of regional anesthesia and with the modern local anesthetics, control anxiety and fear is still a limit to the treatment of categories of patients such as children, disabled, psychiatric patients however, who have a strong emotional component. The use of sedation and anxiolysis also reduces the risk of medical complications in dental treatment of patients “at risk” for systemic diseases. Materials and methodsThe technique of inhalation analgesia and sedation with nitrous oxide and oxygen is described in detail, after analyzing the current classification of sedation: pharmacokinetics and toxicity of two gases, indications and contraindications, operative technique in the adult and pediatric dental patient using dedicated equipment, possible adverse effects and complications. The scientific literature on the safety aspects of the methodology and forensic in dentistry is then revised. ResultsThe review confirms the efficacy and the absolute safety of the sedative technique inhaled nitrous oxide and oxygen, provided that it is not associated with other hypnotic or sedative drugs. The dental practitioner is considered suitable for inhaled conscious sedation in outpatient environment, even at a higher rate of 50% nitrous oxide. Although the technique does not present risks of cardiovascular and respiratory, current legislation requires dental practitioner adequate training in cardiopulmonary resuscitation (BLS-D). ConclusionsThe inhaled sedation with nitrous oxide and oxygen sedation technique is considered the first choice in dental outpatient environment, as it ensures fast action and equally rapid elimination of the effects, safety and clinical efficacy.

Screening and detection of human papillomavirus (HPV) high-risk strains HPV16 and HPV18 in saliva samples from subjects under 18 years old in Nevada: a pilot study

BackgroundHuman papillomaviruses (HPV) are oncogenic and mainly associated with cervical cancers. Recent evidence has demonstrated HPV infection in other tissues, including oral epithelia and mucosa. Although a recent pilot study provided new information about oral HPV status in healthy adults from Nevada, no information was obtained about oral HPV prevalence among children or teenagers, therefore, the goal of this study is to provide more detailed information about oral prevalence of high-risk HPV among children and teenagers in Nevada.MethodsThis retrospective study utilized previously collected saliva samples, obtained from pediatric dental clinic patients (aged 2 – 11) and local school district teenagers (aged 12-17) for high-risk HPV screening (n=118) using qPCR for quantification and confirmation of analytical sensitivity and specificity.ResultsA small subset of saliva samples were found to harbor high-risk HPV16 (n=2) and HPV18 (n=1), representing a 2.5% of the total. All three were obtained from teenage males, and two of these three samples were from White participants.ConclusionsAlthough this retrospective study could not provide correlations with behavioral or socioeconomic data, this project successfully screened more than one hundred saliva samples for high-risk HPV, confirming both HPV16 and HPV18 strains were present in a small subset. With increasing evidence of oral HPV infection in children, this study provides critical information of significant value to other dental, medical, oral and public health professionals who seek to further an understanding of oral health and disease risk in pediatric populations.