An overview of dental caries-preventives approaches for children

Dental caries is biofilm-induced acid demineralization of enamel and dentin, which is mediated by saliva. Given time, the interaction of cariogenic microorganisms and fermentable carbohydrates on the tooth surface may induce demineralization and progress to loss of tooth structure and cavitations. Despite the implementation of community water fluoridation and the widespread use of fluoride toothpastes, dental caries remains a significant problem in Hong Kong preschool children. Of great concern, dental caries is unequally distributed among the population and heavily concentrated in socially disadvantaged children, who are least likely to have adequate access to dental care. Dental caries in children is a preventable and reversible infectious disease process. In children, prevention improves their overall quality of life, reduces the cost of restorative treatment, and promotes a positive attitude towards oral health. The objective of the paper was to provide an overview of the effectiveness of various caries-preventive agents which can be applied to the teeth of children in Hong Kong. These include the use of chlorhexidine, xylitol, fluorides, fissure sealant, and remineralizing products. Increased emphasis on caries prevention by the dental profession could bring about more favorable oral health outcomes for children in Hong Kong.published_or_final_versio

A Retrospective Review of Outcomes of Dental Treatment Performed for Special Needs Patients under General Anaesthesia: 2-Year Follow-Up

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Developing clinical practice guidelines for caries prevention and management for pre-school children through the ADAPTE process and Delphi consensus

Background This study aims to develop consensus evidence-based clinical guidelines for caries prevention and management by caries risk assessment for pre-school children in Hong Kong. Methods Employing the ADAPTE process, guidelines for caries prevention and management by caries risk assessment for pre-school children with a preliminary list of 91 recommendations was complied. External review of the guidelines was conducted by a panel of 41 reviewers from the Hong Kong Society of Paediatric Dentistry using a two-round web-based Delphi process. The reviewers were invited to contribute any comments on the draft-adapted guidelines and rated their agreement with each recommendation using a 9-point Likert scale. During the second round, 36 participants received anonymous feedback from the first round and assessed a narrowed list of 28 recommendations. Recommendations were retained and classified according to the median score and rating percentages by the reviewers. Results A total of 70 out of 91 recommendations were retained (five reached high consensus, 65 reached consensus), and 21 recommendations were discarded. Recommendations and guidelines were outlined. Conclusions Caries prevention and management guidelines for pre-school children were developed for use in Hong Kong using the ADAPTE process and Delphi consensus to develop evidence-based recommendations. This can facilitate the translation of guidelines into dental practice.published_or_final_versio

Bonding of Resin-modified glass ionomer-based adhesive to dentine

This journal suppl. entitled: Special Issue: Abstracts of the 2012 FDI Annual World Dental CongressTheme: Preventive dentistry - Public Health (Oral Presentation)OBJECTIVES: To compare the effect of conditioning dentine with either 37% phosphoric acid for 5 s or 10% polyacrylic acid (PAA) for 10 s on microtensile bond strength (lTBS) of resin-modified glass ionomer based-adhesive to dentine and micro-morphology of the bonded interface. METHODS: Twenty sound perma...postprin

Caries Management: A Journey between Black’s principals and Minimally Invasive Concepts

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Evaluating the impact of caries prevention and management by caries risk assessment guidelines on clinical practice in a dental teaching hospital

Background Clinical practice guidelines on ‘Dental caries prevention and management by caries risk assessment for pre-school children in Hong Kong’ were developed using ADAPTE process and Delphi consensus technique. This study aimed to evaluate the feasibility of disseminating and implementing the guidelines, and to evaluate their effectiveness in changing clinical practice. Methods The study was conducted in two phases, examining clinical records of pre-school aged patients being treated by non-academic clinical staff in the Paediatric Dentistry Clinic of a dental teaching hospital in Hong Kong. The clinical guidelines were introduced to the staff in a departmental seminar at the end of pre-intervention phase. Post-intervention phase began one month after the introduction of guidelines. Clinical records for three consecutive months were reviewed against standards and recommendations derived from the newly developed clinical guidelines in both phases. The results were assessed by Chi-square test, ANOVA and regression analyses. Results A total of 237 and 147 clinical records were reviewed in pre-intervention and post-intervention phases, respectively. Guideline adherence percentage increased significantly on almost all aspects of the guidelines in the post-intervention phase (P < 0.05). There were a significant difference in the mean overall guideline adherence score (pre-intervention phase: x⎯⎯⎯x¯ = 14.86 ± 6.11; post-intervention phase: x⎯⎯⎯x¯ = 28.88 ± 8.75) and sub-domain adherence scores between the two phases (P < 0.001). The training grade of the clinicians was the factor associated with changes in evidence-based practice (P < 0.001). Conclusions The developed guidelines were effective in translating evidence into best practice. The findings have implication for widespread implementation.published_or_final_versio

Effect of moist and dry bonding on interfacial failure modes after microtensile bond-testing

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Oral health of Hong Kong children: a historical and epidemiological perspective

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Bonding to hypomineralized enamel – A systematic review

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Fractographic analysis of dentin bonded with a moist or dry technique after microtensile bone testing

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