Comparison of dmft and Behavior Rating Scores Between Children with Systemic Disease and Healthy Children at the First Dental Visit

Purpose: To evaluate and compare oral health and behavior scores at the first dental visit and dental treatment need using general anesthesia/sedation (GA/S) of children with systemic diseases (SD) and healthy children. Methods: Data were obtained from healthy children (n = 87) and children with SD (n = 79), aged 4 to 6 years, presenting to a hospital dental clinic for a first dental examination. The total number of decayed, missing and filled teeth (dmft), dental behavior score using Frankl Scale, and dental treatment need using GA/S were recorded. Chi-square / Fisher’s exact test and Mann–Whitney U tests were used for statistical analyses. Results: The patients with SD were diagnosed with cardiac disease (61%), renal disease (9%), and pediatric cancers (30%). The median dmft values of the SD group (3.00) were significantly lower than those of healthy children (5.00) (p = 0.02) and healthy children exhibited significantly more positive behavior (90.8%) than children with SD (73.4%) (p = 0.002). The number of patients needing GA/S for dental treatment did not differ significantly between the two groups (p = 0.185). There was no relationship between dental treatment need with GA/S and dental behavior scores of the patients (p = 0.05). A statistically significant relationship was found between the patients’ dmft scores and the need for dental treatment using GA/S; and the cut-off value was found to be dmft \u3e 4 for the overall comparisons. Conclusion: The presence of chronic disease in children appeared to affect the cooperation negatively at the first dental visit compared to healthy controls, however, it did not affect the oral health negatively. Having a negative behavior score or SD did not necessitate the use of GA/S for dental treatment

An Evaluation of 10 Percent and 20 Percent Benzocaine Gels in Patients With Acute Toothaches: Efficacy, Tolerability and Compliance With Label Dose Administration Directions

Background The authors evaluated the efficacy and tolerability of 10 percent and 20 percent benzocaine gels compared with those of a vehicle (placebo) gel for the temporary relief of toothache pain. They also assessed the compliance with the label dose administration directions on the part of participants with toothache pain. Methods Under double-masked conditions, 576 participants self-applied study gel to an open tooth cavity and surrounding oral tissues. Participants evaluated their pain intensity and pain relief for 120 minutes. The authors determined the amount of gel the participants applied. Results The responders’ rates (the primary efficacy parameter), defined as the percentage of participants who had an improvement in pain intensity as exhibited by a pain score reduction of at least one unit on the dental pain scale from baseline for two consecutive assessments any time between the five- and 20-minute points, were 87.3 percent, 80.7 percent and 70.4 percent, respectively, for 20 percent benzocaine gel, 10 percent benzocaine gel and vehicle gel. Both benzocaine gels were significantly (P ≤ .05) better than vehicle gel; the 20 percent benzocaine gel also was significantly (P ≤ .05) better than the 10 percent benzocaine gel. The mean amount of gel applied was 235.6 milligrams, with 88.2 percent of participants applying 400 mg or less. Conclusions Both 10 percent and 20 percent benzocaine gels were more efficacious than the vehicle gel, and the 20 percent benzocaine gel was more efficacious than the 10 percent benzocaine gel. All treatments were well tolerated by participants. Practical Implications Patients can use 10 percent and 20 percent benzocaine gels to temporarily treat toothache pain safely

Dental Quality Improvement in an Integrated Health Care Setting: Pedal Faster

ABSTRACTBackground Quality measurement is new to dentistry but will become part of dental care within a short period of time due to governmental and public pressure and medicolegal requirements.Description This article describes challenges and opportunities for a dental department to: (1) participate in overreaching organizational quality and safety efforts with non-dental colleagues, and (2) establish a discipline-specific continuous quality improvement program. The article will propose advancing both dental and general health care through measures specific to different institutions and their unique environments, such as hospitals and community-based clinics. Steps and strategies leading to success are suggested for beginning a meaningful program, engaging and educating dental staff, and moving the quality needle forward in dentistry

Pediatric Dentistry: Infancy Through Adolescence

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A 3-Year Retrospective Study of Traumatic Dental Injuries to the Primary Dentition

Background/Aims Traumatic dental injuries (TDIs) in the primary dentition are a significant public health problem, which has been neglected worldwide. Despite its high prevalence, limited studies address this injury. The aim of this study was to determine the characteristics and treatment modalities of TDIs affecting primary teeth, along with accompanying medical co-morbidities and attendance at follow-up appointments. Material and Methods This retrospective analysis included all TDIs affecting primary teeth from January 2014 to January 2017. Data abstraction included demographics, time lapse prior to arrival at hospital, trauma etiology, classification of TDIs, soft tissue and supporting bone injuries, medical co-morbidities, emergency treatment, follow-up appointments and prognosis. Results Records of 283 children with 536 traumatized primary teeth were reviewed. The median age was 2 years and the maxillary right central incisor (35.1%) was the most frequently injured tooth. Almost half the patients, 46.3%, sought treatment after 24 h. Periodontal tissue injuries (97.2%) predominated TDIs for which fall accidents (82.0%) were the most encountered cause. Most patients (177/283) had accompanying soft tissue/supporting bone injuries and 67.2% had multiple traumatized teeth. Seventy percent of the patients were examined only or were prescribed medication. Survival time following TDIs was unknown in 67.7% of traumatized teeth due to non-attendance at follow-up appointments. Most patients (55.1%) did not attend the follow-up appointments. Conclusions TDIs occurred in the primary dentition with the predominance of periodontal tissue injuries. When TDI was the presenting problem to hospital, accompanying systemic injury was rare. Treatment modalities were mostly limited to examination or extraction. The follow-up appointments were poorly attended

Oral health in America 2021: Making a case for curricular change

BackgroundThe NIH Oral Health in America: Advances and Challenges report is the most recent evidence-based review of the status of oral health in North America since Oral Health in America: A Report of the Surgeon General, which was published in 2000. This article aims to synthesize and discuss information from the report pertinent to improving dental education to positively impact oral health. Calls for action and suggestions for implementation are presented.MethodsThe authors reviewed each section from the report and identified key messages relevant to dental education. These were then combined into a framework based on the NIH report’s three main “call to action” items. A matrix for calls to action and implementation recommendations was developed using the findings from the 2021 NIH report and a previous 2018 report on Advancing Dental Education in the 21st Century.ConclusionThe information discussed in the report related to dental education has the potential to improve oral health, and educators, schools, professional organizations, state, and federal agencies are called to develop and/or implement action plans focused on curriculum, competencies, workshops, guidelines, and policies based on the summary framework presented in this study.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/172994/1/jdd12929.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/172994/2/jdd12929_am.pd

Pediatric dentistry: infancy through adolescence

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