Dental Caries-A Hiding Niche for Helicobacter Pylori in Children.

Background: Helicobacter pylori (H. pylori) is one of the human pathogens proven to be present in the oral cavity due to microaerophilic nature of the dental biofilm. The present study aimed to investigate the presence of H. pylori in cavitated carious lesions of children by polymerase chain reaction (PCR). Study design: Forty-eight children aged between 4 to 7-years attending outpatient Pediatric clinic were enrolled in the study. Caries status and caries severity were assessed using the dmft and ICDAS caries index. Dentine samples were collected for DNA isolation for the detection of H. pylori by PCR. Results: H. pylori was detected among 30% of children with severe caries lesions detected by PCR. Overall, the mean ± SD of the dmft score for H. pylori positive children was higher compared to the negative control. Amongst the H. pylori-positive group, the decayed (mean-dt) number of teeth were significantly higher (p<0.05) than the other group. Moreover, association between severity of caries lesions (codes 5 and codes 6) and presence of H. pylori were significant (p<0.05) when compared negative group. Conclusion: The results demonstrate presence of H. pylori in the cavitated, non-gastric niche of children with severe caries, which possibly could serve as a reservoir for microbial dissemination to other sites of the body.

Impact of preventive care orientation on caries status among preschool children.

OBJECTIVE: This study aims to study the impact of preventive care orientation given to caregivers of child daycare centers on their knowledge and on the prevalence of early childhood caries (ECC) among preschool children. MATERIALS AND METHODS: Caregivers of twenty child daycare centers in Emirate of Sharjah were interviewed and 435 children attending these centers were surveyed for decayed missing filled teeth (dmft). The sample data were analyzed using t-tests and one-way ANOVA to assess the statistical significance of the differences in dmft score found between groups. RESULTS: No significant correlation was found between dmft scores and family income of urban or rural centers, mothers' level of education, mothers' employment status in public centers, and frequency of dental visits. There was a significant correlation between dmft scores and mothers' employment status in private centers with the lowest scores among children of working mothers. High caries rates were observed in children attending private daycare centers where sweetened milk, juices, and snacks were served more frequently. There was a significant difference between private and public centers in caregivers' level of knowledge regarding oral health in favor of the latter. Low dmft scores were found to be associated with high level of knowledge of caregivers in public centers. CONCLUSIONS: Children are more likely to develop ECC if their caregivers are lacking knowledge or regular provision of preventive care orientation. This makes caregivers and school teachers better candidates for oral health education programs than parents.

Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder.

BACKGROUND: The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder. MATERIALS AND METHODS: This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5-9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples t-test was used to assess the significance of changes in pulse and O2 saturation levels during each visit. RESULTS: International Caries Detection and Assessment System-code 2 was found to be the most prevalent (n = 58; 52%). A significant difference (P < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions. CONCLUSION: Initial desensitization appointment and "tell-show-do" approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures.

Effect of preoperative oral midazolam sedation on separation anxiety and emergence delirium among children undergoing dental treatment under general anesthesia.

AIM: To investigate the possible effects of preoperative oral Midazolam on parental separation anxiety, emergence delirium, and post-anesthesia care unit time on children undergoing dental rehabilitation under general anesthesia. METHODS: Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/kg, while children of the control group were premedicated with a placebo. Scores for parental separation, mask acceptance, postoperative emergence delirium, and time spent in the post-anesthesia care unit were compared statistically. RESULTS: The test group showed significantly lower parental separation scores and high acceptance rate for anesthetic mask. There was no significant difference between the two groups regarding emergence delirium and time spent in post-anesthesia care unit. CONCLUSIONS: Preoperative oral Midazolam could be a useful adjunct in anxiety management for children suffering dental anxiety. The drug may not reduce the incidence of postoperative emergence delirium. The suggested dose does not seem to affect the post-anesthesia care unit time.

Perceived outcomes and satisfaction of Saudi parents and their children following dental rehabilitation under general anesthesia: A 2-year follow-up.

PURPOSE: To investigate the perceived clinical outcome and parents' satisfaction after dental rehabilitation under general anesthesia over a follow-up period of 2 years. MATERIALS AND METHODS: A prospective study of questionnaire data obtained from 352 pediatric patients before and after treatment of early childhood caries with full dental rehabilitation under general anesthesia. Questionnaires focused on oral symptoms, functional limitations, and emotional and social well-being before and after dental treatment. Cases were followed up for 2 years postoperatively. RESULTS: A dramatic disappearance of symptoms was reported from parents' perspective. There was a high satisfaction rate (99.14%) also among parents of the children included in the study. CONCLUSION: Children with early childhood caries do not necessarily express it verbally as pain. The disease has a lot of other expressions affecting children's behavior and habits, including the ability to sleep, thrive, and socialize. This study contributes to the existing literature that full dental rehabilitation under general anesthesia [dental general anesthesia (DGA)] has an immediate positive impact on the physical and social quality of life of children suffering from early childhood caries as well as on their families. Postoperative preventive care, early diagnosis, and treatment of recurrent caries are key factors to maintain postoperative outcome of DGA.