The use of cone beam computed tomographic imaging in a paediatric dentistry department

Abstract Cone beam computed tomography (CBCT) is an emerging radiographic imaging modality. The diagnostic benefit must exceed the individual detriment that its generally higher radiation exposure may cause. Since limited studies exist on the use and impact of CBCT in paediatric dentistry, a service evaluation was carried out to explore the reasons for CBCT referral and to identify its impact on the treatment plan and/or management in a paediatric dentistry department. Clinical records for all paediatric patients who underwent a CBCT were reviewed, to identify the reason for referral and its influence on diagnosis or management, by comparing the provisional treatment plan with the definitive treatment plan, post-CBCT. A total of 130 paediatric patients underwent CBCT in a 12-month period, of which 52 satisfied the inclusion criteria. CBCTs were most commonly requested for the localisation of unerupted/impacted teeth 14/52 (27%), assessment of supernumerary teeth 12/52 (23%), and to investigate root resorption 9/52 (17%). All CBCTs provided additional information that assisted treatment planning, diagnosis, or management and, most significantly, 16/52 (31%) of treatment plans were changed based on CBCT findings. All CBCTs requested in this study were justified and confirmed or influenced the management of paediatric patients, ultimately reducing the risk of complications and further treatment

To extract or not to extract? Management of infraoccluded second primary molars without successors

Infraocclusion is a term used to describe a tooth which has stopped its relative occlusal growth into the arch after the period of active eruption; as a result, the tooth becomes depressed below the occlusal plane. Although many aetiological mechanisms have been proposed, ankylosis is considered the primary cause of infraocclusion. Complex cases benefit from multidisciplinary management. This paper concentrates on the diagnosis and management of infraoccluded second primary molars, without permanent successors and without significant malocclusion, and provides clinicians with a treatment decision tree to aid in treatment planning

A questionnaire-based study of Paediatric Dentists’ knowledge of teething signs, symptoms and management

Introduction Signs and symptoms attributed to erupting primary teeth are commonly known as “teething”. Its existence is controversial with concern that overusing this term might mask other illnesses and some treatments may be unnecessary or harmful. Parents/carers can access over-the-counter remedies and may seek professional advice. This survey-based investigation explored gaps in knowledge, training, perceptions and experiences of UK Paediatric Dentists (PDs) regarding teething in young children. Method Cross-sectional study with a convenience sample of PDs with different training levels, accessed through the British Society for Paediatric Dentistry membership lists. A 10-item questionnaire explored participants’ knowledge of teething-related issues and management. Responses are presented using descriptive statistics. Results Of 80 responding PDs (response rate 27%), 62–74% suggested drooling, irritability, oral fixation and flushed cheeks were attributed to primary tooth eruption. Fifty-eight (72%) participants were unaware of guidelines, yet 53 (66%) felt guidance was needed. Conclusion Signs and symptoms of teething might mask underlying conditions so it should be a diagnosis of exclusion. PDs attributed similar signs and symptoms to teething, as have been reported in the literature, although some commented that they did not think teething was a condition. There was a lack of awareness over guidelines

Reducing anxiety for dental visits

This work addresses children’s (under 6 years of age) fear and apprehension to visit dental clinics. We present a bespoke interactive Virtual Reality reproduction of the physical dental clinic, augmented with virtual characters and enriched with gamification style information for a richer user experience. The experience allows the user to navigate and familiarise themselves with the location and the procedures they will undertake before visiting the clinic. The experience is now being piloted at the Dental Public Health at the University Hospital of Wales

The dental management of a patient with Nager syndrome: a case report

Patients with Nager syndrome have extensive craniofacial involvement resulting in restricted mouth opening. This case report is of a child with Nager syndrome who also had extensive dental caries. This patient required dental treatment to be carried out under general anaesthesia, due to her restricted mouth opening. Preventive advice is of vital importance