A brain abscess of probable odontogenic origin in a child with cyanotic heart disease.

The purpose of the present report was to present a rare case of a brain abscess in a child with heterotaxy syndrome, severe cardiac anomalies, and extensive dental caries. The pathogen was Streptococcus intermedius isolated from the cerebrospinal fluid. The source of the pathogen was probably an infection of a primary molar with a dentoalveolar abscess involving the bud of the permanent successor. After a long course of antibiotic regimens followed by a craniotomy with abscess drainage, a shunt, and comprehensive dental treatment, the patient was discharged from the hospital without any neurological sequel. At home, she completed an additional 3 months of oral antibiotics. This is the only known documented case of a toddler with a brain abscess of probable odontogenic origin without previous dental intervention. It emphasizes the importance of collaboration between cardiologists and pediatric dentists, especially in referring children with congenital heart defects for early dental checkups.

Effects of frequent oral hygiene instructions on microbial levels and salivary buffer capacity in orthodontic patients and their parents.

AIM: To assess whether parental involvement can improve children's oral health as a strategiy to reduce caries risk in children undergoing orthodontic treatment. METHODS: The study population consisted of 40 healthy children aged 7 to 15 years (mean 10.93 ± 2.78) and their accompanying parents (mother or father). Oral hygiene instructions were given simultaneously to all children and accompanying parents every 6 weeks at their regular orthodontic appointments. Levels of Streptococcus mutans and salivary buffer capacity were assessed for both children and parents before and 9 months into orthodontic treatment. RESULTS: The majority of children (74%) and parents (92%) expressed unchanged levels of Streptococcus mutans and stable salivary buffer capacity throughout the study. When analyzing child-parent pairs with respect to Streptococcus mutans and salivary buffer capacity, no significant differences were found prior to treatment. Nine months into treatment, 57% of the children and parents still showed similar Streptococcus mutans counts and buffer capacity. CONCLUSION: The child-parent approach succeeded in preventing deterioration of children's oral hygiene. Parental involvement has an essential part in maintaining children's oral health. Oral health care professionals should partner with parents when implementing any kind of health behavior.

Dental treatment of a 2-year-old victim of a suicide bomb attack.

The purpose of this report was to describe the diagnosis and dental treatment of a 2-year-old girl that was involved in a suicide bomb attack. A 14-months-old infant was severely injured when a suicide bomber detonated an explosive device inside a crowded bus. Her injury was 'multi-system', mainly burns and fragments in her face, eyes and other parts of the body. Fifteen months later, she was brought to the Department of Pediatric Dentistry of the Hadassah School of Dental Medicine and the clinical and radiographic examination showed that she was caries free but there were dental trauma injuries to many teeth. Due to her non-cooperative behavior and the extent of treatment the girl was scheduled for a one appointment treatment under deep sedation. Three days later, she was brought to the Emergency Room of the Department of Pediatric Dentistry complaining of pain on the lower left side of the mouth and a swollen vestibule and face could clinically be observed. The lower left first molar that apparently revealed only an enamel fracture and cracks at the time of treatment, actually revealed a necrotic pulp as a result of the blast. As this girl was caries free, and with no history of dental trauma due to any accident, the only explanation for the response of the pulp was the impact of the blast. In conclusion, the reaction of the dental pulp to the blast of an explosion is different than the reaction to other kind of insult and this should be taken in consideration when treating children after this kind of dental trauma.

Pulp canal obliteration in an unerupted permanent incisor following trauma to its primary predecessor: a case report.

Trauma to a primary tooth may result in damage to the underlying developing permanent tooth bud because of the close proximity between the root of the primary tooth and its permanent successor. We report an unusual case where injury to the primary dentition resulted in pulp canal obliteration (PCO) of a permanent maxillary central incisor prior to its eruption. The other permanent maxillary central incisor was diagnosed as malformed because of trauma to the primary dentition at an earlier age. The occurrences of PCO or crown malformation dose not routinely disrupt the eruption of those teeth. Periodic assessment is required to determine the need for endodontic intervention.