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1.
Br Dent J ; 234(2): 92-95, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36707573

RESUMO

Haemophilia is an inherited haematological disorder that can result in prolonged bleeding in patients. Dental procedures such as extractions and periodontal surgery can be associated with post-operative bleeding; therefore, patients with the diagnosis of haemophilia must have proper medical management. In this article, we aim to illustrate the importance of: having the appropriate knowledge to manage a patient with haemophilia suspected by the dental team; the need for proper medical management; and referral of patients with symptoms of a bleeding disorder.


Assuntos
Hemofilia A , Humanos , Hemofilia A/complicações , Hemofilia A/diagnóstico , Saúde Bucal , Extração Dentária/efeitos adversos , Extração Dentária/métodos , Hemorragia Pós-Operatória/etiologia , Encaminhamento e Consulta
2.
J Dent Child (Chic) ; 89(2): 83-87, 2022 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-35986476

RESUMO

Purpose: To evaluate the behavior of moderately sedated pediatric patients treated using rubber dam (RD) or IsoVac isolation.
Methods: A retrospective chart review was completed for patients who underwent restorative procedures under moderate sedation. Behavioral and Frankl scores were evaluated to determine which isolation technique (RD or IsoVac) resulted in better behavior outcomes.
Results: A total of 112 charts were reviewed from October 2019 to May 2021. Fifty- one patients were treated with RD isolation and 61 with IsoVac. Behavioral and Frankl scores were analyzed and showed that RD isolation was associated with better behavior at the time of placement as well as a better overall sedation Frankl score in comparison to IsoVac (P <0.05).
Conclusions: This study showed an association between RD isolation and better behavior during moderate sedation when compared to the IsoVac.


Assuntos
Sedação Consciente , Diques de Borracha , Criança , Assistência Odontológica , Humanos , Estudos Retrospectivos
3.
Pediatr Dent ; 43(6): 457-462, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34937616

RESUMO

Purpose: The purpose of this study was to compare the effectiveness of intranasal dexmedetomidine (DEX), oral midazolam (MID), and oral midazolam combined with oral hydroxyzine (MIDHYD) with nitrous oxide when used for sedation during pediatric dental procedures. Methods: The charts of 146 patients who underwent dental procedures using moderate sedation with DEX, MID, or MIDHYD, all with nitrous oxide, from January 2014 to December 2019, were reviewed retrospectively. Sedations were evaluated for effectiveness based on sedation level and behavior using a modified University of Michigan Sedation Scale and behavior using the American Academy of Pediatric Dentistry sedation behavior scale. Procedures planned and completed were evaluated for each sedation regimen. Results: Overall, the effectiveness was not statistically different between sedation regimens (P=0.71). More stainless steel crowns were planned and completed with DEX, more resins were planned and completed with MIDHYD, and more extractions were planned and completed with MID. The onset of action and working time were found to be statistically significant between sedation regimens; DEX had the longest working time. Conclusions: This retrospective study found that intranasal dexmedetomidine with nitrous oxide showed no statistical difference in effectiveness, compared with oral midazolam or oral midazolam combined with oral hydroxyzine and nitrous oxide, in moderate sedation for pediatric dental procedures. The majority of stimulating time-consuming procedures were completed in the DEX sedation regimen.


Assuntos
Anestesia Dentária , Dexmedetomidina , Preparações Farmacêuticas , Administração Intranasal , Administração Oral , Criança , Sedação Consciente , Humanos , Hipnóticos e Sedativos , Óxido Nitroso , Estudos Retrospectivos
4.
J Dent Child (Chic) ; 88(3): 150-155, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34937624

RESUMO

Purpose: To evaluate the use of lingual frenotomy assessment tools and the anatomical features most commonly used by dentists and otolaryngologists to determine if a frenotomy was indicated.
Methods: A nine-question survey was distributed to American Academy of Pediatric Dentistry members and otolaryngologists in the American Medical Association. The survey consisted of three categories: (1) demographics; (2) use of a standardized assessment tool; and (3) assessing anatomical features for frenotomy. Three different cases of ankyloglossia were given to assess which anatomical features were used to determine if a frenotomy was needed.
Results: Subjects included 404 practitioners. The most common frenotomy assessment tool utilized was the Hazelbaker assessment tool, followed by the LATCH and Bristol tongue assessment tools. The anatomical features used by most responders in determining if a frenotomy was indicated were the appearance of the tongue when lifted, tongue protrusion, frenulum length, and frenulum type.
Conclusions: Many practitioners believe frenotomies for ankyloglossia are indicated when there is a functional impairment and an anatomical component. This study suggests that the general appearance of the tongue when lifted is the most common anatomical feature used for assessing the need for a frenotomy.


Assuntos
Anquiloglossia , Anquiloglossia/cirurgia , Aleitamento Materno , Criança , Feminino , Humanos , Lactente , Freio Lingual/cirurgia , Odontopediatria , Língua/cirurgia
5.
Pediatr Dent ; 43(2): 129-132, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33892838

RESUMO

Purpose: The purpose of this study was to compare the safety of three different sedation regimens for pediatric dental procedures to examine the safety of intranasal dexmedetomidine paired with nitrous oxide (N2O). Methods: This was a retrospective chart review of 149 three-to six-year-old healthy patients who underwent sedation to complete dental treatment. Forty-nine patients received intranasal dexmedetomidine with nitrous oxide (DEXNO), 47 received oral midazolam with nitrous oxide (MIDNO), and 53 received oral midazolam and oral hydroxyzine with nitrous oxide (MIDHYXNO). Demographic data, procedural times, vital signs, and adverse events were recorded. Results: No patients in any of the three groups experienced major adverse events. All groups experienced some degree of hypotension. One of the 49 DEXNO cases experienced bradycardia intraoperatively. No cases required clinical intervention. Conclusion: This pilot study suggested that intranasal dexmedetomidine with nitrous oxide is a safe sedation regimen for pediatric procedures, comparable to combinations of oral midazolam with nitrous oxide and oral midazolam and oral hydroxyzine with nitrous oxide.


Assuntos
Anestesia Dentária , Dexmedetomidina , Criança , Sedação Consciente , Dexmedetomidina/efeitos adversos , Humanos , Hipnóticos e Sedativos/efeitos adversos , Óxido Nitroso/efeitos adversos , Projetos Piloto , Estudos Retrospectivos
6.
J Dent Child (Chic) ; 87(3): 153-158, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-33349299

RESUMO

Purpose: The purpose of this study was to determine which mode of education given to mothers of newborns resulted in the greatest compliance for establishing an age one dental visit and identify reasons why mothers do not bring their child for their first dental visit.
Methods: Several modes of education presented information to mothers: (1) written literature provided by a nurse; (2) a nurse verbally presenting and providing literature; (3) a resident verbally presenting and providing literature; and (4) control-no education. The chi-square test of homogeneity was utilized to determine if there was a difference in compliance to make an age one dental appointment.
Results: The retained sample consisted of 277 children evaluated between 2014 and 2018. There was no statistical difference between the educational methods regarding compliance to make an age one dental visit (P >0.05). There was a significant difference between marital status (P =0.0005), with 95 percent of single mothers likely to schedule the visit.
Conclusion: No particular maternal educational method resulted in greater compliance with scheduling an age one dental visit. Single mothers were more likely to schedule the visit. The primary reason for not visiting was a lack of primary care provider recommendations.


Assuntos
Educação em Saúde , Mães , Fatores Etários , Criança , Escolaridade , Feminino , Humanos , Recém-Nascido , Saúde Bucal , Gravidez
7.
Pediatr Dent ; 41(5): 371-375, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31648668

RESUMO

Purpose: Many dentists utilize health history forms completed by patients' parents/guardians to obtain medical histories. It is unknown if parent-derived health histories are consistent with histories completed by health care providers. The purpose of this study was to compare patient medical electronic health records (EHRs) with parent-/guardian-derived dental health histories in order to identify, quantify, and compare discrepancies of patient medical conditions, medications, and allergies. Methods: Two-hundred randomly selected patient dental charts and corresponding EHRs were reviewed retrospectively from a preexisting patient pool. The number of conditions, medications, and allergies in the dental chart and on the patient's accompanying EHRs were quantified and recorded. Results: Discrepancies between the two records were present for 97.5 percent of patient charts. All charts without discrepancies were for those patients who did not have any past medical history, take any medications, or have any allergies. Chart discrepancies often included conditions involving the head, cardiac, and respiratory systems. Conclusion: It is important for dentists not to rely solely on parent-derived information or medical records. At the initial encounter, dentists should request a history from the patient's physician and review it with the parents for accuracy. Updates should be obtained at each appointment to obtain an accurate medical history. (Pediatr Dent 2019;41(5):371-5).


Assuntos
Registros Eletrônicos de Saúde , Pais , Odontólogos , Humanos , Saúde Bucal , Estudos Retrospectivos
8.
J Dent Child (Chic) ; 85(2): 66-69, 2018 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30345956

RESUMO

Crohn's Disease (CD) is a granulomatous inflammatory disease that can affect any part of the gastrointestinal tract. Oral ulcers can appear months or years before intestinal signs or symptoms are seen, which can lead to a diagnosis of other granulomatous inflammatory diseases, including or facial granulomatosis. A 16-year-old female diagnosed with CD presented with asymptomatic white linear patches and erosions bilaterally in mandibular vestibules. Cobble-stoning lesions were seen on the buccal mucosa bilaterally, and pyostomatitis vegetans was seen palatally. Non-alcoholic oral chlorohexidine rinse was prescribed. The patient was referred to an oral surgeon for a biopsy of the retromolar pad, which confirmed the presence of granulomatous inflammation consistent with CD. The patient was told to follow up with a gastroenterologist for a CD medication adjustment. At a two-week follow-up following an increase in adalimumab, her oral mucosa showed marked improvement compared to her initial presentation.


Assuntos
Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Granulomatose Orofacial/diagnóstico , Granulomatose Orofacial/etiologia , Adalimumab/administração & dosagem , Adolescente , Anti-Inflamatórios/administração & dosagem , Doença de Crohn/tratamento farmacológico , Diagnóstico Precoce , Feminino , Granulomatose Orofacial/tratamento farmacológico , Humanos
9.
Pediatr Dent ; 40(1): 56-58, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29482684

RESUMO

Moyamoya disease (MMD) is a rare cerebrovascular disorder involving progressive constriction of the internal carotid artery and its branches. The disease has a particularly aggressive course in very young patients, and early surgical intervention is often necessary to prevent permanent neurological damage. MMD patients have an increased risk of stroke development, which may be provoked by pain or anxiety. Currently, no reports of pediatric patients with MMD exist in the dental literature. The purpose of this paper was to discuss the dental management of a two-year-old with moyamoya disease who presented with early childhood caries and dental fear, offering recommendations for dental providers with emphasis on stroke prevention, collaboration with the medical team, anesthesia considerations for patients with increased stroke risk, and the challenges to maintain the oral health of a patient undergoing complex medical treatment.


Assuntos
Ansiedade ao Tratamento Odontológico/prevenção & controle , Cárie Dentária/psicologia , Cárie Dentária/terapia , Doença de Moyamoya/psicologia , Anestesia Dentária , Pré-Escolar , Cárie Dentária/complicações , Feminino , Humanos , Doença de Moyamoya/complicações , Equipe de Assistência ao Paciente , Fatores de Risco , Acidente Vascular Cerebral/prevenção & controle
10.
Pediatr Dent ; 34(7): 517-20, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23265174

RESUMO

Down syndrome and juvenile rheumatoid arthritis have been associated with ligament laxity, specifically the atlantoaxial ligament, which maintains the proper positioning of the cervical first and second vertebrae. The joint consists of different pathological processes, and it is paramount that individuals with either condition be screened appropriately before surgery is contemplated. The purpose of this paper was to present a case of an individual with both conditions and describe precautionary measures that were undertaken to safely complete dental treatment under general anesthesia and avoid morbidity.


Assuntos
Anestesia Dentária/métodos , Anestesia Geral/métodos , Artrite Juvenil/complicações , Articulação Atlantoaxial/anormalidades , Lesões Encefálicas/prevenção & controle , Assistência Odontológica para a Pessoa com Deficiência/métodos , Síndrome de Down/complicações , Procedimentos Cirúrgicos Bucais/métodos , Articulação Atlantoaxial/diagnóstico por imagem , Criança , Feminino , Humanos , Cistos Maxilomandibulares/cirurgia , Doenças Maxilares/cirurgia , Processo Odontoide/anormalidades , Processo Odontoide/diagnóstico por imagem , Posicionamento do Paciente , Abscesso Periapical/cirurgia , Radiografia , Extração Dentária
11.
Pediatr Dent ; 34(7): 506-9, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23265172

RESUMO

Radiotherapy treatment options can cause adverse dental sequelae, including xerostomia, dental radiation caries, abnormal tooth development, and osteoradionecrosis (ORN). Hyperbaric oxygen (HBO) therapy can be used prophylactically or therapeutically to treat or reduce the risk of ORN. The purpose of this paper was to describe a case involving a 5-year-old male with rhabdomyosarcoma of the left temporal fossa and a history of radiation therapy who presented with gross radiation caries and xerostomia. Full-mouth extractions of all primary teeth were performed under general anesthesia, with the patient receiving HBO therapy before and after the surgery. The child was monitored postoperatively, and healing occurred with minimal post-operative complications. Based on his results, it can be concluded that hyperbaric oxygen therapy is an effective supplement to consider when treating children who have undergone radiation therapy and require dental care.


Assuntos
Irradiação Craniana/efeitos adversos , Cárie Dentária/etiologia , Rabdomiossarcoma/radioterapia , Neoplasias da Base do Crânio/radioterapia , Xerostomia/etiologia , Anormalidades Induzidas por Radiação , Pré-Escolar , Fossa Craniana Anterior , Cárie Dentária/terapia , Humanos , Oxigenoterapia Hiperbárica , Masculino , Anormalidades Dentárias/etiologia , Extração Dentária , Xerostomia/complicações , Xerostomia/terapia
12.
Pediatr Dent ; 30(2): 147-53, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18481580

RESUMO

PURPOSE: This study's purpose was to examine the current knowledge, attitudes, and experiences related to infant oral health for dental and medical providers in Virginia. METHODS: A survey of infant oral health care was sent to: (a) 300 randomly selected general dentists; (b) 300 randomly selected pediatricians; and (c) all pediatric dentists in Virginia. Survey respondents were tabulated, and percent frequency distributions for responses to each item were computed. RESULTS: The surveys return rate was 48%. A total of 100% of pediatric dentists treated infants and were more likely to recommend that children be seen by age 1 (P < .001). All pediatricians treated infants as well, while only 5% referred for the first dental visit by 1 year of age. Forty-five percent of general dentists surveyed treated infants, and only 12% referred for the first dental visit by 1 year of age. The logistic regression results indicated that there were differences between practitioner type regarding the recommended age of the first dental visit and years in practice. CONCLUSIONS: The majority of pediatricians and general dentists are not advising patients to see the dentist by 1 year of age. There is a need for increased infant oral health care education in the medical and dental communities.


Assuntos
Atitude Frente a Saúde , Assistência Odontológica para Crianças , Odontologia Geral , Cuidado do Lactente , Odontopediatria , Pediatria , Fatores Etários , Pré-Escolar , Atenção à Saúde , Cárie Dentária/prevenção & controle , Feminino , Odontologia Geral/educação , Educação em Saúde Bucal , Humanos , Lactente , Masculino , Higiene Bucal , Pais/educação , Odontopediatria/educação , Pediatria/educação , Encaminhamento e Consulta , Virginia
13.
Pediatr Dent ; 30(6): 516-21, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19186779

RESUMO

PURPOSE: The purpose of this study was to examine local anesthetic selection and dentists' use of articaine in children. METHODS: Using a cross-sectional survey design, a questionnaire regarding the use of local anesthetics in children was mailed to a random sample of dentists and all pediatric dentists from North Carolina and Virginia. The 16-item questionnaire included questions regarding the preferred local anesthetic used in children. The association between dental practitioner type and anesthetic use was tested using the chi-square or Fisher's exact test. RESULTS: There was a 30% response rate. Lidocaine with epinephrine was the local anesthetic preferred overall by all practitioners. Approximately 50% of dentists surveyed reported using articaine in children. There were no significant differences in the preference of articaine between provider types with the exception of older, 7- to 10-year-old patients, where general dentists preferred articaine significantly more than pediatric dentists (28% vs 16%). CONCLUSIONS: While lidocaine with epinephrine was still the preferred local anesthetic for use in children, the use of articaine in children was prevalent among both general and pediatric dentists. The use of articaine became more prevalent as the patient's age increased.


Assuntos
Anestesia Dentária/métodos , Anestésicos Locais/uso terapêutico , Carticaína/uso terapêutico , Assistência Odontológica para Crianças/métodos , Padrões de Prática Odontológica , Adolescente , Criança , Estudos Transversais , Dentística Operatória/métodos , Humanos , Estatísticas não Paramétricas
14.
Anesth Prog ; 54(1): 7-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17352528

RESUMO

We describe a case in which reflection of a palatal flap for removal of a mesiodens is presented as the triggering factor for bradycardia caused by stimulation of the trigeminocardiac reflex. The management of the case, as well as the reflex arc, is discussed.


Assuntos
Anestesia Dentária , Antiarrítmicos/uso terapêutico , Arritmia Sinusal/tratamento farmacológico , Atropina/uso terapêutico , Bradicardia/tratamento farmacológico , Complicações Intraoperatórias/tratamento farmacológico , Extração Dentária , Dente Supranumerário/cirurgia , Arritmia Sinusal/etiologia , Bradicardia/etiologia , Pré-Escolar , Feminino , Humanos , Reflexo Anormal/efeitos dos fármacos , Nervo Trigêmeo/efeitos dos fármacos , Nervo Vago/efeitos dos fármacos
15.
Pediatr Dent ; 29(6): 493-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18254420

RESUMO

PURPOSE: The purposes of this investigation were to: (1) provide a descriptive account of untreated dental caries for Virginia schoolchildren; and (2) examine the relationship between a child's insurance status and the presence of untreated dental caries. METHODS: In 1999, the Virginia Department of Health completed an Oral Health Assessment on first-, third-, and 10th-grade children. The oral assessment used a probability proportional to size sampling scheme to obtain a representative sample of public schoolchildren. Descriptive and multivariable regression analyses were completed to examine the relationship between insurance status and the presence of untreated dental caries. RESULTS: In the primary dentition, schoolchildren with no insurance had the highest prevalence of untreated dental caries (65%) compared to: (1) schoolchildren with medical insurance only (42%); and (2) those with both medical and dental insurance (25%). With the exception of children having only medical insurance, children enrolled in the free and reduced lunch program were more likely to have untreated dental caries. CONCLUSIONS: In the primary dentition, children with no insurance were more likely to have untreated dental caries than those with both medical and dental insurance. Insurance status does not appear to be associated with untreated dental caries in the permanent dentition.


Assuntos
Cárie Dentária/epidemiologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Seguro Odontológico/estatística & dados numéricos , Dente Decíduo/patologia , Adolescente , Criança , Estudos Transversais , Índice CPO , Demografia , Assistência Odontológica/economia , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/terapia , Inquéritos de Saúde Bucal , Dentição Permanente , Feminino , Sistemas Pré-Pagos de Saúde/economia , Sistemas Pré-Pagos de Saúde/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoas sem Cobertura de Seguro de Saúde , Virginia/epidemiologia
16.
Pediatr Dent ; 28(4): 357-62, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16903446

RESUMO

PURPOSE: The purpose of this study was to examine intralingual (IL) and submucosal (SM) delivery offlumazenil as viable alternatives to immediate intravenous (IV) administration for reversing benzodiazepine sedation in an animal model. METHODS: A dog animal model was chosen based upon comparable body weight to children (12-17 kg) and the ease of oral access in this species. Research design was a nonrandomized matched pair study. This type of "before-and-after study" allowed the dogs to receive 3 different routes of flumazenil administration (IV, IL, and SM) following an initial dose of midazolam (0.5 mg/kg IV). Blood samples were obtained (at 0, 2, 4, 8, 15, and 30 minutes) for high performance liquid chromatography (HPLC) analysis of flumazenil and midazolam, and oxygen saturation values were recorded. RESULTS: Both IL and SM delivery of flumazenil were determined to be viable alternatives to immediate IV administration for reversing benzodiazepine-induced oxygen saturation (SaO2) desaturation. For flumazenil to be able to reverse the SaO2 desaturation, the plasma levels must be greater than 5 ng/ml, which was exceeded by IL and SM drug delivery. CONCLUSION: In a benzodiazepine-induced desaturation, the submucosal and intralingual routes are viable alternatives to intravenous administration of flumazenil in an animal model.


Assuntos
Benzodiazepinas/antagonistas & inibidores , Flumazenil/administração & dosagem , Moduladores GABAérgicos/administração & dosagem , Moduladores GABAérgicos/antagonistas & inibidores , Midazolam/antagonistas & inibidores , Oxigênio/sangue , Administração Oral , Animais , Cães , Injeções Intravenosas , Masculino , Modelos Animais
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