Parents' perceptions of oral health, general health and dental health care for children with Down syndrome in Sweden.

AIM: To describe parental perceptions of general health, oral health and received dental health care in Swedish children with Down syndrome (DS). METHODS: Online questionnaire, quantitative data analysis (Chi-square test). RESULTS: Parents of 101 children with DS (52 boys, 49 girls, mean age: 9.6 years) participated. Seventy percent rated their child's general health and 74% their child's oral health as good or very good. Parents, who rated their child's oral health as poor (8%), also reported that dental procedures were difficult. Children received dental care at general (55%) and specialist clinics (53%). Ninety-four percent of parents of children receiving specialist dental health care were satisfied compared to 70% of parents with children in general clinics. The parents most valued characteristics of dental professionals were patience (63%) and their ability to engage the child (68%). Parents wanted multidisciplinary collaboration. CONCLUSION: Most parents rated their child's general and oral health as good or very good. Children with poor oral health were also reported to have difficulties coping with dental procedures. Parents wanted dental care to be tailored to meet their child's unique needs. They wanted dental professionals to have knowledge about children with a need for special care. Lastly, they requested multidisciplinary collaboration.

Developing communication support for interaction with children during acute radiographic procedures.

INTRODUCTION: The Convention on the Rights of the Child will be absorbed into Swedish law by 2020, which highlights the need to promote equality in communication between health care professionals and communicatively vulnerable children. In this regard, participation and person-centredness is important in the interaction with each child to provide adequate information on the peri-radiographic process in a way that the child can understand. Hence, the aim was to develop communication support for interaction with children during acute radiographic procedures. METHOD: The study has a qualitative design adapting a multiphase structure. A participatory design was used which included four phases conducted in succession to each other. Interviews were conducted with children from Elementary School and Special School. Questionnaires were collected from their parents and from radiographers in four different Radiology Departments. RESULTS: The analysis of the data highlighted the need for information in the peri-radiographic process. Parents and children wanted material that is easy to use and could be adapted in a person-centred way. CONCLUSION: A prototype of the ICIR (interactive communication support in radiology settings), with illustrations and accompanying text was developed that can be useful as information sharing in interaction between children, parents and health care professionals in the radiographic context. IMPLICATIONS FOR PRACTICE: The ICIR can be a usable tool for information sharing in the interaction between children, parents and health care professionals during radiographic procedures.

Oral administration of Lactobacillus reuteri during the first year of life reduces caries prevalence in the primary dentition at 9 years of age.

The aim of this study was to evaluate the effect on oral health, at age 9 years, of daily oral supplementation with the probiotic Lactobacillus reuteri, strain ATCC 55730, to mothers during the last month of gestation and to children through the first year of life. The study was a single-blind, placebo-controlled, multicenter trial involving 113 children: 60 in the probiotic and 53 in the placebo group. The subjects underwent clinical and radiographic examination of the primary dentition and carious lesions, plaque and gingivitis were recorded. Saliva and plaque were sampled for determination of mutans streptococci (MS) and lactobacilli (LB) in saliva and plaque as well as salivary secretory IgA (SIgA). Forty-nine (82%) children in the probiotic group and 31 (58%) in the placebo group were caries-free (p < 0.01). The prevalence of approximal caries lesions was lower in the probiotic group (0.67 ± 1.61 vs. 1.53 ± 2.64; p < 0.05) and there were fewer sites with gingivitis compared to the placebo group (p < 0.05). There were no significant differences between the groups with respect to frequency of toothbrushing, plaque and dietary habits, but to intake of fluoride supplements (p < 0.05). There were no intergroup differences with respect to L. reuteri, MS, LB or SIgA in saliva. Within the limitation of this study it seems that daily supplementation with L. reuteri from birth and during the first year of life is associated with reduced caries prevalence and gingivitis score in the primary dentition at 9 years of age.

Caries prevalence, caries-related factors and plaque pH in adolescents with long-term asthma.

The aim of the present case-control study was to investigate dental caries, various caries-related factors as well as gingival condition, in 12- to 16-year-olds with long-term asthma (n = 20) and a matched healthy control group (n = 20). Data on dietary and oral hygiene habits, numbers of mutans streptococci and lactobacilli in saliva were also obtained. The plaque pH drop after a sucrose rinse was measured up to 40 min at 2 approximal tooth sites. A lower salivary flow rate was found in the asthma group compared to the control group (p < 0.05). The mean (± SD) of DFS, including manifest and initial caries, was 4.9 ± 5.5 in the asthma and 1.4 ± 2.3 (p < 0.01) in the control group. Only 1 adolescent in the asthma group was caries free compared to 13 in the control group. Concerning pH in plaque, adolescents with asthma had a lower initial value (p < 0.01) and final pH (p < 0.05) than the control group. The Cariogram data showed that 55% of the subjects in the control group had 'a high chance of avoiding caries' compared to 10% in the asthma group (p < 0.01). The asthmatic adolescents had higher numbers of sites with gingival bleeding (p < 0.01). To conclude, adolescents with long-term asthma had a higher total DFS and caries risk (according to Cariogram), decreased salivary rate, more gingival bleeding and lower plaque pH than adolescents without asthma.