Oral Health Implications of Risky Behaviors in Adolescence.

Adolescence is a time for new discoveries, which may lead teens to engage in impulsive behaviors. Although social media and the Internet have brought great benefits to the world, they can also have a negative influence on adolescents, facilitating their engagement in risky behaviors. Positive parenting and healthy friendships in adolescence have a protective effect against sensation-seeking behaviors. Dental practitioners also have a significant role in steering young patients toward healthy behaviors. They play an essential role in the early recognition, initiation of appropriate interventions, and referrals for treatment of youth at risk.

Hospital Inpatient Admissions of Children and Adolescents for Nontraumatic Dental Conditions in Florida.

Purpose: Barriers to regular dental care may lead to children being hospitalized for dental problems. The purpose of this study was to examine trends related to pediatric hospital inpatient admissions for nontraumatic dental conditions (NTDCs) in Florida between 2006 and 2016. Methods: Data were from the Florida Department of Health inpatient admission database and included zero- to 19-year-old patients. The authors calculated age-specific and age-adjusted rates of inpatient admission for NTDCs and the proportion of all hospitalizations they comprise. Results: There were 6,217 inpatient admissions for NTDCs of zero- to 19-year-olds in Florida between 2006 and 2016. The median charge was $21,654 per admission, and total charges were $196,220,470. Medicaid was the primary payer. Admission rates increased in all age groups, and age-adjusted rates increased by 62 percent during that period. The two most common NTDC diagnoses were periapical abscess without sinus tract and cellulitis of the mouth. Conclusions: The rate and cost for hospital inpatient admissions to treat nontraumatic dental conditions increased significantly for children and adolescents in Florida during the past decade. Establishment of a dental home at an early age and removing barriers to receiving regular and periodic dental care may result in more effective and efficient use of health care resources and better patient outcomes.

Silver Diamine Fluoride Helps Prevent Emergency Visits in Children with Early Childhood Caries.

Purpose: Early childhood caries remains a worldwide disease and often requires treatment under sedation or general anesthesia, with long waitlists. Silver diamine fluoride has been shown to arrest caries lesions. The purpose of this study was to determine whether silver diamine fluoride (SDF) application reduces emergency visits by waitlisted patients with early childhood caries (ECC). Methods: Waitlisted patients aged zero to 71 months with ECC who were treated with SDF were enrolled at the University of Florida's NCEF Pediatric Dental Center; their cumulative incidence of dental emergencies were compared with children who were waitlisted during the 16 months preceding the introduction of SDF. Data from patient records on demographics, dental visits, SDF placement, and caries arrest were abstracted. Bivariate analyses and multiple logistic regression modeling were performed. Results: Participants included 97 patients treated with SDF and 216 not treated with SDF. The cumulative incidence of dental emergencies was approximately 80 percent lower in the SDF group than in the comparison group (4.1 percent versus 17.6 percent; adjusted odds ratio equals 0.18; 95 percent confidence interval equals 0.06 to 0.54); 81 percent of SDF-treated surfaces were arrested at a follow-up visit. Conclusions: Silver diamine fluoride helps reduce emergency visits for children with early childhood caries while on treatment waitlists and confirms the effectiveness of SDF for caries arrest in primary teeth.

Molar-incisor malformation: Eight new cases and a review of the literature.

BACKGROUND: Molar-incisor malformation (MIM) is a recently described dental abnormality. While MIM mimics dentin dysplasia, it presents in a localized pattern. Furthermore, it is speculated that MIM is caused by significant early-life medical history. AIM: The purpose of this study is to present a series of MIM cases and compare the findings with the literature. DESIGN: An extensive search of all published cases of MIM in the English-language literature was conducted. Additionally, an institutional review board-approved retrospective search was performed within the University of Florida oral pathology biopsy service archives. Radiographic consultation cases were also included. Cases lacking radiographs were excluded. RESULTS: Seventy-nine cases were identified in the literature, and eight cases were identified in our retrospective search. All but one case involved the permanent first molars. The average age at diagnosis was 9 years. Many patients reported significant early-life medical histories. CONCLUSIONS: MIM usually affects the permanent first molars and may be linked to early-life medical conditions or interventions. Oral healthcare providers, especially paediatric dentists, should be aware of MIM to avoid misdiagnosing it as dentin dysplasia. Long-term follow-up studies with thorough medical history documentation are essential to understand the pathogenesis and aetiology and to create treatment guidelines.

A Multi-Institutional Study of Dental Student Readiness to Address Adolescent Risk Behaviors.

The aim of this replication study was to determine if prior findings at one U.S. dental school about dental students' comfort discussing and perceptions of the relevance of 15 risk behaviors to adolescent patient oral health care would be observed at other institutions. All first- and fourth-year dental students (n=414) at three U.S. dental schools in fall 2017 were invited to participate, and 218 completed the survey (52.7% response rate). These students reported feeling comfortable to uncomfortable discussing risk behaviors with adolescent patients, yet perceived those risk behaviors as relevant to their oral health. There were significant differences in student comfort discussing risk behaviors with adolescents and their perceptions of relevance by gender, age, class status, and school location. Males were more comfortable than females discussing oral health risk behaviors. There were no significant differences by race/ethnicity. Fourth-year students had higher levels of comfort discussing risk behaviors than first-year students. Compared to students in the South and Midwest schools, students at the West school were more comfortable discussing selected topics and had higher perceptions of their relevance to adolescent oral health care. These results suggest there is room for improvement in this area of dental education. Dental schools should aim to strengthen students' knowledge of and comfort in discussing oral health risk behaviors with adolescent patients with the use of educational activities and clinical experiences.

Dental Students' Readiness to Address Adolescent Risk Behaviors: A Pilot Study.

Adolescents' engagement in risk-taking behaviors is well documented. However, the role of the dental practitioner in helping teenage patients understand and avert those behaviors is relatively unknown. The aim of this pilot study was to assess dental students' familiarity with adolescent risk behaviors, comfort level in discussing adolescent risk behaviors with teenage patients, and ratings of the relevance of these topics in dental education. Of the 373 University of Florida dental students across all four years who were invited to participate in 2017, 151 (40.5%) completed the survey. Among these respondents, 66% were female, 53% were from an underrepresented minority (URM) group, 40% were above the age of 25, 53% were in their preclinical years of education, and 47% were in their clinical years. In the results, the males had higher levels of comfort discussing adolescent risk behavior topics than the females, and the non-URM students had higher levels of comfort than the URM students. The clinical students showed statistically significant higher levels of comfort and ratings of the relevance of adolescent risk behaviors than the preclinical students. This pilot study assessed these students' comfort in discussing adolescent risk behaviors with patients and their level of agreement about the relevance of those topics in dental education across groups (age, gender, minority status, and educational level). Future studies are needed to examine pre- and posttest changes following interventions aimed at enhancing students' knowledge and comfort in discussing adolescent risk behaviors.

Dental Students' Knowledge of Resources for LGBT Persons: Findings from Three Dental Schools.

Recently, there has been increased attention to including cultural diversity in the education of health professionals, including concern for lesbian, gay, bisexual, and transgender (LGBT) inclusion and visibility. Studies regarding cultural exposure and acceptance of LGBT populations have been concentrated in medicine, with findings showing that medical providers often graduate having missed the preparation required to care for LGBT persons. A visible, comprehensive, culturally competent environment in dental schools would help ensure that all oral health professionals and students are aware of services available to address the particular needs of LGBT students. The aims of this survey-based study conducted in 2015-16 were to determine dental students' perceptions regarding LGBT students' needs and to assess dental students' knowledge of resources for LGBT persons at three U.S. dental schools, one each in the Midwest, West, and South. Of the 849 students invited to participate, 364 completed the survey (338 dental, 26 dental hygiene), for an overall response rate of 43%. The response rate at individual schools ranged from 30% to 55%. The results showed perceptions of insufficient LGBT information, resources, and support at these institutions, especially at the Western school. There were significant differences among the three schools, with students at the Western school more than the other two schools perceiving that their institution was less aware of whether it met the academic, social support, and spiritual needs of LGBT students. There were no significant differences between LGBT and non-LGBT students' perceptions. The authors urge dental school administrators to explore the degree to which their programs teach respectful and caring behavior towards LGBT students and, by extension, LGBT patient populations.

The tooth as a monitor of cholestatic liver disease in rats.

OBJECTIVE: Measure, noninvasively, the deposition of bilirubin in the tooth by using DIAGNOdent and correlate it to liver dysfunction. STUDY DESIGN: After confirming the capacity of DIAGNOdent to measure varying bile concentrations in plaster blocks, a cholestatic liver disease model was studied to detect increasing bilirubin impregnation in the teeth of rats. Wistar-EPM rats (n = 50) were divided into three groups: (1) BDL: rats submitted to bile duct ligation (BDL); (2) Naïve: rats without procedure; and (3) Sham: rats submitted to laparotomy without BDL (n = 10/period/group). The rats' teeth were monitored with the use of DIAGNOdent before the procedure and at days 10 and 50 following surgery. Serum bilirubin was also monitored. RESULTS: Tests in vitro showed that DIAGNOdent detected bile in plaster blocks according to its concentration. BDL promoted progressive liver dysfunction, with death occurring approximately 50 days later. DIAGNOdent values obtained on teeth showed correlation with the progression of serum hyperbilirubinemia. CONCLUSIONS: The tooth was found to be a good tissue for noninvasively monitoring the progression of bilirubinemia in cholestatic liver disease in rats by using DIAGNOdent.

The Impact of an Infant Oral Health Program on Dental Students' Knowledge and Attitudes.

The high prevalence of early childhood caries and many general dentists' reluctance to treat young children and pregnant women demand new educational programs to foster delivery of oral health services. The aim of this study was to evaluate the impact of an Infant Oral Health Program (IOHP) at the University of Florida College of Dentistry on dental students' knowledge about and willingness to provide dental care for infants, children up to three years of age, and pregnant women. A total of 233 dental students in the first through fourth years and recent graduates completed a survey that assessed the educational outcomes of the IOHP; only the fourth-year students had received IOHP training. The results showed that females were more likely than males to provide counseling to caregivers about dental and physical development (p=0.024) and to offer restorative treatment to young children (p=0.021). Older students were more likely than younger students to provide restorative treatment (p=0.013). A greater percentage of IOHP-trained students (96%) reported knowing how to use the lap examination technique compared with untrained students (71%; p<0.001). IOHP-trained students were the most uncomfortable dealing with a crying child in the dental chair (p=0.0175). The graduates and fourth-year students were significantly more likely than the other cohorts to provide preventive (p=0.001) and restorative (p<0.001) care for pregnant women. The graduates were least likely to use some form of caries risk assessment (p<0.001). These findings highlight the need for earlier and greater exposure to the IOHP and the importance of promoting awareness about risk assessment and oral disease management.

Enxerto ósseo em bloco autógeno na maxila: relato de caso clínico / Autogenous block bone graft in the upper jaw: report of case

A instalação de implantes em áreas com perda óssea pode estar associada a uma relação coroa-implante desfavorável, resultado estético insatisfatório e dificuldades de higienização, prejudicando o prognóstico do tratamento. O enxerto ósseo possibilita a instalação de implantes em uma posição tridimensional favorável. Alguns métodos têm sido estudados e propostos para a reconstrução do osso alveolar perdido: enxertos ósseos autógenos, homógenos, substitutos ósseos alógenos, xenógenos e aloplásticos. Ainda existe a regeneração óssea guiada, distração osteogênica, fatores de crescimento e as combinações destas referidas metodologias. Dentre os materiais disponíveis, o osso autógeno é tido como primeira opção para a reconstrução óssea,tido como padrão ouro em enxertia óssea, pois fornece as condições mais favoráveis de reparo pós-cirúrgico, por apresentar as propriedades de osteocondução, osteoindução e osteogênese,auxiliando na correção de defeitos de espessura, desde que haja um bom suprimento vascular no local. Neste trabalho é demonstrada uma técnica de enxertia óssea em bloco autógeno, através da realização de um caso clínico, para a reconstrução de maxila atrófica, visando o aumento do volume ósseo disponível para a instalação de implantes dentais.

The installation of implants in areas of bone loss may be associated with an unfavorable ratiocrown-implant, unsatisfactory aesthetic result and cleaning difficulties, impairing treatment prognosis. The bone graft allows the installation of implants in a favorable three-dimensional position. Some methods have been studied and proposed for the reconstruction of lost alveolar bone: autogenous bone grafts, homogeneous bone, allogenic, xenogenous and alloplasticbone substitutes. There is still the guided bone regeneration, distraction osteogenesis, growth factors and combinations of these referred methodologies. Among the materials available, the autogenous bone is considered as the first option for bone reconstruction, considered the gold standard in bone grafting because it provides the most favorable conditions for post-surgical repair, presenting the properties of osteoconductive, osteoinductive and osteogenesis, helping the correction of the defects of thickness, since there is a good blood supply in the area. Thiswork shows a bone grafting technique in autogenous block by performing a case for the reconstruction of atrophic maxilla, in order to increase bone volume available for the installation of dental implants.

Oral, radiographical, and clinical findings in Weaver syndrome: a case report.

Weaver syndrome is a rare condition characterized by accelerated growth, advanced osseous maturation, and distinct craniofacial features that can occur in both males and females. Etiology is unknown and no definitive oral characteristics have been established. The objective of this case report is to describe the oral and radiographic findings of a 14-year-old male with Weaver syndrome. A comprehensive dental examination was performed under general anesthesia. The clinical findings were: severe generalized heavy plaque with subgingival calculus, gingival edema, malocclusion and maxillary atresia, mild micrognathia of the mandible, enlarged tongue, and bifid uvula. Clinical and radiographic caries were not found. Out of over 40 possible cases of Weaver syndrome previously reported in the literature, only two were related to the oral cavity. Bifida uvula was not mentioned until now as clinical findings associated with the syndrome. Autism, macroglossia, and cleft palate were seldom mentioned. The oral manifestations in Weaver syndrome are not yet well known. Future studies will be required to improve the subject matter.

Geriatric dentistry: a new specialty in Brazil.

OBJECTIVE: To present the current status of geriatric dentistry in Brazil. BACKGROUND: In 2001, the Brazilian Dental Council established a new specialty: geriatric dentistry. This decision was based on the increase in both the elderly population and the demand for dental treatment of this cohort. MATERIALS AND METHODS: Data were obtained through online searches of the Brazilian Dental Council and the Brazilian Institute of Geography and Statistics. RESULTS: Brazil has 170 dental schools offering around 14 000 undergraduate vacancies every year. At the postgraduate level, there are 19 recognised dental specialties, one of which is geriatric dentistry, comprising 18 certificate programmes, with the potential to produce 216 new specialists every 18 months. The dentist/habitant ratio was 1:870, higher than that recommended by the Word Health Organization. The Brazilian population consists of around 14.5 million elderly people (8.6%). There were 124 specialists in geriatric dentistry distributed irregularly throughout the country. The specialist/elderly population rate was 1:117 249. At the undergraduate level, this new specialty is not included in the curricula of most dental schools in Brazil. CONCLUSIONS: Geriatric dentistry should be included in the undergraduate curricula of dental schools in Brazil. Postgraduate degree courses should be developed to produce more clinical academics and researchers in this field.

Special care dentistry: a new specialty in Brazil.

In 2001, the Brazilian Dental Council established a new specialty: Special Care Dentistry (SCD). This decision was based on the increase of both the number of people with disabilities and their demand for dental treatment. The aim of this study was to present the current status of SCD in Brazil. Data was obtained through online searches from the Brazilian Dental Council and the Brazilian Institute of Geography and Statistics. There are 11 SCD training programs which have the potential to produce 132 new specialists every 18 months. There are currently 292 specialists in SCD unevenly distributed throughout the country. The ratio of specialists to the number of people with disabilities was 1:82,247. At the undergraduate level, this new specialty was not included in most dental schools in Brazil. Special Care Dentistry should be included in the undergraduate curriculum of dental schools in Brazil. Master's and PhD postgraduate degree courses should be developed to produce more teachers, consultants, and researchers in this field.

Manifestações bucais em um paciente portador de rubéola congênita - Relato de caso clínico / Oral manifestations in patient with congenital rubella - Clinical case report

Este trabalho aborda as possíveis alterações na dentição decídua de pacientes portadores de rubéola congênita com o relato de um caso clínico. O feto pode ser infectado pelo vírus da rubéola em qualquer estágio gestacional . Porém, as conseqüên-cias desta infecção fetal estão relacionadas ao período de gestação onde as oito primeiras semanas são as que mais ocasionam alterações de ordem geral e local, no caso, os dentes em formação...

Intrauterine infections: a literature review.

During gestation, many microorganisms can infect the fetus, causing severe birth defects. Such organisms and the resulting clinical syndromes have been categorized as TORCH infections, a useful acronym referring to Toxoplasma gondii, other microorganisms (like syphilis), rubella virus, cytomegalovirus, and herpesviruses. Since dental patients typically report pregnancy or previous infections as part of their health history, and TORCH infections can manifest oral symptoms, the dentist is in a position to act as an educator and screener for these infections. This article reviews TORCH agents for dentists to help the clinician in educating pregnant patients about the risks these infections pose to the fetus. The authors also note oral symptoms related to these infections.

Motivação e educação odontológica em pacientes especial / Dental health education and the special patient

O presente trabalho relata o caso clínico de um paciente portador de deficiência mental e auditiva atendido na Disciplina de Paciente Especiais da Faculdade de Odontologia da UNIBAN, apresentando higiene bucal precária, em que a utilização de figuras como meio para movimentacao imposta pelas patologias melhorando a condição imposta pelas patologias bucal do paciente

Metodologia de diagnóstico para o tratamento de maloclusöes e disfunçöes através de ortopedia funcional dos maxilares em pacientes especiais no Núcleo Integrado de Atendimento Preventivo ao Paciente Especial (NIAPE) do Curso de Odontologia da Universidade Paulista (UNIP) / Methodology of maxillary functional orthopedics for malocclusion and disfunctions treatment for hadicapped patients at the Integrated Nucleous of Preventive Treatment for the Handicapped (NIAPE) of the School of the Dentistry at Paulista University (UNIP)

Os autores descrevem uma metodologia desenvolvida para a fase de diagnóstico do tratamento das maloclusöes e disfunçöes reflexo-vegetativas de pacientes portadores de desvios dos padröes de normalidade, de ordem física, mental, intelectual, sindrômicos ou näo, atendidos pelos alunos do 4§ ano de graduaçäo de 1997 do Núcleo Integrado de Atendimento Preventivo ao Paciente Especial (NIAPE) - Disciplina de Clínica Integrada do Curso de Odontologia do Instituto de Ciências da Saúde da Universidade paulis (UNIP)

Homeopatia na odontologia para pacientes especiais: momento atual / Homeopathy in dental treatment for handicapped patients: actual moment

Foi pesquisado o quanto a Homeopatia é utilizada pelos pacientes atendidos no Núcleo Integrado de Atendimento Preventivo Especial (NIAPE) do Departamento de Odontologia do Instituto de Ciências da Saúde da Universidade Paulista (UNIP). Dos 110 pacientes pesquisados, o percentual de utilização da Homeopatia foi de 5,44 por cento. Apesar deste percentual ser considerado pequeno, os resultados obtidos com o tratamento homeopático foram avaliados pelos pacientes de forma satisfatória, justificando assim o uso da Homeopatia como um método terapêutico complementar que pode ser utilizado como uma terapia auxiliar no tratamento odontológico de pacientes especiais